ProvenancePayerDataSource
type: CodeSystem
node role: treeRoot
resource.id:
  value: ProvenancePayerDataSource
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: CodeSystem ProvenancePayerDataSource This case-insensitive code system http://hl7.org/fhir/us/davinci-pdex/CodeSystem/ProvenancePayerDataSource defines the following codes: Code Display Definition hl7v2other HL7 v2 HL7 v2 Message hl7v2oru HL7 v2 ORU HL7 v2 Structured Observation Report(ORU) message hl7v2adt HL7 v2 ADT HL7 v2 Admit, Discharge Transfer (ADT) message hl7v2r01 HL7 v2 R01 HL7 v2 Observation (R01) message hl7v2rsp HL7 v2 RSP HL7 V2 Immunization Record Response hl7v2orm HL7 v2 ORM HL7 v2 Orders hl7v2mdm HL7 v2 MDM Medical Document Management hl7v2vxu HL7 v2 VXU HL7 V2 Immunization Transaction hl7v3 HL7 v3 HL7 v3 Message hl7ccda HL7 C-CDA HL7 Consolidated-Clinical Document Architecture hl7cda HL7 CDA HL7 CDA documents that are not C-CDA hl7cdaqrda HL7 CDA QRDA HL7 Quality Reporting Document hl7fhirdstu2 FHIR DSTU2 HL7 FHIR DSTU2 hl7fhirdstu3 FHIR STU3 HL7 FHIR STU3 hl7fhirr4 FHIR R4 HL7 FHIR R4 x12837 837 claim X12 837 Claim x12278 278 X12 Prior Authorization x12275 275 X12 Attachment x12other X12 X12 non-specific transaction script NCPDP SCRIPT National Council for Prescription Drug Programs (NCPDP) SCRIPT message (eRx) ncpdp NCPDP Telecommunication NCPDP Telecommunication transaction (pharmacy claims) capture Direct Capture Direct Capture, such as into a payers case management system customtx Trading Partner Format Trading Partner Proprietary format image Image Fax or scanned document unstructured Unstructured Document PDF, text and other unstructured document other Other Any other document format not specifically defined
domain resource.extension:
  index: 0
  extension.url:
    value: http://hl7.org/fhir/StructureDefinition/structuredefinition-wg
  extension.value code:
    value: fm
domain resource.extension:
  index: 1
  extension.url:
    value: http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm
  extension.value integer:
    value: 2
    element.extension:
      index: 0
      extension.url:
        value: http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom
      extension.value canonical:
        value: http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex
        link: http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex
domain resource.extension:
  index: 2
  extension.url:
    value: http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status
  extension.value code:
    value: trial-use
    element.extension:
      index: 0
      extension.url:
        value: http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom
      extension.value canonical:
        value: http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex
        link: http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex
code system.url:
  value: http://hl7.org/fhir/us/davinci-pdex/CodeSystem/ProvenancePayerDataSource
code system.identifier:
  index: 0
  identifier.system:
    value: urn:ietf:rfc:3986
  identifier.value:
    value: urn:oid:2.16.840.1.113883.4.642.40.8.16.23
code system.version:
  value: 2.2.0
code system.name:
  value: ProvenancePayerDataSource
code system.title:
  value: Provenance Payer Data Source Format
code system.status:
  value: active
code system.experimental:
  value: false
code system.date:
  value: 2026-08-22T03:20:18+10:00
code system.publisher:
  value: HL7 International / Financial Management
code system.contact:
  index: 0
  contact detail.name:
    value: HL7 International / Financial Management
  contact detail.telecom:
    index: 0
    contact point.system:
      value: url
    contact point.value:
      value: http://www.hl7.org/Special/committees/fm
  contact detail.telecom:
    index: 1
    contact point.system:
      value: email
code system.contact:
  index: 1
  contact detail.name:
    value: Mark Scrimshire (mark.scrimshire@onyxhealth.io)
  contact detail.telecom:
    index: 0
    contact point.system:
      value: email
code system.contact:
  index: 2
  contact detail.name:
    value: HL7 International - Financial Management
  contact detail.telecom:
    index: 0
    contact point.system:
      value: url
    contact point.value:
      value: http://www.hl7.org/Special/committees/fm
code system.description:
  value: CodeSystem for source formats that identify what non-FHIR source was used to create FHIR record(s)
code system.jurisdiction:
  index: 0
  codeable concept.coding:
    index: 0
    coding.system:
      value: urn:iso:std:iso:3166
    coding.code:
      value: US
    coding.display:
      value: United States of America
code system.copyright:
  value: Used by permission of HL7 International, all rights reserved Creative Commons License
code system.case sensitive:
  value: false
code system.content:
  value: complete
code system.count:
  value: 26
code system.concept:
  index: 0
  code system.concept.code:
    value: hl7v2other
  code system.concept.display:
    value: HL7 v2
  code system.concept.definition:
    value: HL7 v2 Message
code system.concept:
  index: 1
  code system.concept.code:
    value: hl7v2oru
  code system.concept.display:
    value: HL7 v2 ORU
  code system.concept.definition:
    value: HL7 v2 Structured Observation Report(ORU) message
code system.concept:
  index: 2
  code system.concept.code:
    value: hl7v2adt
  code system.concept.display:
    value: HL7 v2 ADT
  code system.concept.definition:
    value: HL7 v2 Admit, Discharge Transfer (ADT) message
code system.concept:
  index: 3
  code system.concept.code:
    value: hl7v2r01
  code system.concept.display:
    value: HL7 v2 R01
  code system.concept.definition:
    value: HL7 v2 Observation (R01) message
code system.concept:
  index: 4
  code system.concept.code:
    value: hl7v2rsp
  code system.concept.display:
    value: HL7 v2 RSP
  code system.concept.definition:
    value: HL7 V2 Immunization Record Response
code system.concept:
  index: 5
  code system.concept.code:
    value: hl7v2orm
  code system.concept.display:
    value: HL7 v2 ORM
  code system.concept.definition:
    value: HL7 v2 Orders
code system.concept:
  index: 6
  code system.concept.code:
    value: hl7v2mdm
  code system.concept.display:
    value: HL7 v2 MDM
  code system.concept.definition:
    value: Medical Document Management
code system.concept:
  index: 7
  code system.concept.code:
    value: hl7v2vxu
  code system.concept.display:
    value: HL7 v2 VXU
  code system.concept.definition:
    value: HL7 V2 Immunization Transaction
code system.concept:
  index: 8
  code system.concept.code:
    value: hl7v3
  code system.concept.display:
    value: HL7 v3
  code system.concept.definition:
    value: HL7 v3 Message
code system.concept:
  index: 9
  code system.concept.code:
    value: hl7ccda
  code system.concept.display:
    value: HL7 C-CDA
  code system.concept.definition:
    value: HL7 Consolidated-Clinical Document Architecture
code system.concept:
  index: 10
  code system.concept.code:
    value: hl7cda
  code system.concept.display:
    value: HL7 CDA
  code system.concept.definition:
    value: HL7 CDA documents that are not C-CDA

index: 11
code system.concept.code:
  value: hl7cdaqrda
code system.concept.display:
  value: HL7 CDA QRDA
code system.concept.definition:
  value: HL7 Quality Reporting Document

index: 12
code system.concept.code:
  value: hl7fhirdstu2
code system.concept.display:
  value: FHIR DSTU2
code system.concept.definition:
  value: HL7 FHIR DSTU2

index: 13
code system.concept.code:
  value: hl7fhirdstu3
code system.concept.display:
  value: FHIR STU3
code system.concept.definition:
  value: HL7 FHIR STU3

index: 14
code system.concept.code:
  value: hl7fhirr4
code system.concept.display:
  value: FHIR R4
code system.concept.definition:
  value: HL7 FHIR R4

index: 15
code system.concept.code:
  value: x12837
code system.concept.display:
  value: 837 claim
code system.concept.definition:
  value: X12 837 Claim

index: 16
code system.concept.code:
  value: x12278
code system.concept.display:
  value: 278
code system.concept.definition:
  value: X12 Prior Authorization

index: 17
code system.concept.code:
  value: x12275
code system.concept.display:
  value: 275
code system.concept.definition:
  value: X12 Attachment

index: 18
code system.concept.code:
  value: x12other
code system.concept.display:
  value: X12
code system.concept.definition:
  value: X12 non-specific transaction

index: 19
code system.concept.code:
  value: script
code system.concept.display:
  value: NCPDP SCRIPT
code system.concept.definition:
  value: National Council for Prescription Drug Programs (NCPDP) SCRIPT message (eRx)

index: 20
code system.concept.code:
  value: ncpdp
code system.concept.display:
  value: NCPDP Telecommunication
code system.concept.definition:
  value: NCPDP Telecommunication transaction (pharmacy claims)

index: 21
code system.concept.code:
  value: capture
code system.concept.display:
  value: Direct Capture
code system.concept.definition:
  value: Direct Capture, such as into a payers case management system

index: 22
code system.concept.code:
  value: customtx
code system.concept.display:
  value: Trading Partner Format
code system.concept.definition:
  value: Trading Partner Proprietary format

index: 23
code system.concept.code:
  value: image
code system.concept.display:
  value: Image
code system.concept.definition:
  value: Fax or scanned document

index: 24
code system.concept.code:
  value: unstructured
code system.concept.display:
  value: Unstructured Document
code system.concept.definition:
  value: PDF, text and other unstructured document

index: 25
code system.concept.code:
  value: other
code system.concept.display:
  value: Other
code system.concept.definition:
  value: Any other document format not specifically defined