US Prescription Drug Monitoring Program (PDMP)
1.0.0-ballot - STU1 Ballot
US Prescription Drug Monitoring Program (PDMP)
1.0.0-ballot - STU1 Ballot
This page is part of the US Prescription Drug Monitoring Program (PDMP) (v1.0.0-ballot: STU1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. . For a full list of available versions, see the Directory of published versions
<Bundle xmlns="http://hl7.org/fhir">
<id value="pdmp-bundle-history-result-2"/>
<meta>
<profile
value="http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-bundle-history-result"/>
</meta>
<type value="collection"/>
<entry>
<fullUrl value="urn:uuid:9ce2a97b-5cab-4986-814f-4734016e6084"/>
<resource>
<MedicationDispense>
<id value="meddispense-res-1"/>
<meta>
<source value="http://example.org/ma-pdmp"/>
<profile
value="http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-medicationdispense"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Record of a dispense to August Samuels for Acetaminophen/Codeine on 2023-06-05</div>
</text>
<extension
url="http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-fill-number">
<valuePositiveInt value="1"/>
</extension>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="FILL"/>
<display value="Filler Identifier"/>
</coding>
</type>
<system value="http://ourpharmacy.com/fillnumber"/>
<value value="2000353"/>
</identifier>
<status value="completed"/>
<medicationCodeableConcept>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="993781"/>
<display
value="acetaminophen 300 MG / codeine phosphate 30 MG Oral Tablet"/>
</coding>
<coding>
<system value="http://hl7.org/fhir/sid/ndc"/>
<code value="00093015001"/>
<userSelected value="true"/>
</coding>
<text value="Acetaminophen 300 mg / Codeine 30 mg oral tablet"/>
</medicationCodeableConcept>
<subject>
<reference value="urn:uuid:53a1e123-5b56-44ae-b7e8-36e0b9800f57"/>
<display value="August Samuels"/>
</subject>
<performer>
<actor>
<reference value="urn:uuid:82ae67e4-f23a-4c17-b80a-9076a37f5d6e"/>
<identifier>
<system
value="http://terminology.hl7.org/CodeSystem/NCPDPProviderIdentificationNumber"/>
<value value="999017"/>
</identifier>
<display value="Our Pharmacy"/>
</actor>
</performer>
<authorizingPrescription>
<reference value="urn:uuid:151b9dd1-ca84-48a4-b132-67b1bbed0194"/>
<identifier>
<system value="http://myprescribingsystem.com/ordernumber"/>
<value value="605153"/>
</identifier>
</authorizingPrescription>
<quantity>
<value value="10"/>
<unit value="each"/>
</quantity>
<daysSupply>
<value value="5"/>
</daysSupply>
<whenPrepared value="2023-06-05"/>
<whenHandedOver>
<extension
url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
<valueCode value="unknown"/>
</extension>
</whenHandedOver>
<dosageInstruction>
<sequence value="1"/>
<text value="1 tab tid prn pain"/>
</dosageInstruction>
</MedicationDispense>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:2706c68c-fb00-4f01-acb9-2547a20c5f63"/>
<resource>
<MedicationDispense>
<id value="meddispense-res-2"/>
<meta>
<source value="http://example.org/ri-pdmp"/>
<profile
value="http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-medicationdispense"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">A record dispense to August Thomas Samuels for alprazolam on 2023-07-08</div>
</text>
<extension
url="http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-fill-number">
<valuePositiveInt value="4"/>
</extension>
<extension
url="http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-lme">
<valueDecimal value="4"/>
</extension>
<extension
url="http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-extension-rx-transmission-method">
<valueCoding>
<system
value="http://hl7.org/fhir/us/pdmp/CodeSystem/temporary-pmix-transmission-form-of-rx-origin"/>
<code value="05"/>
<display value="Electronic Prescription"/>
</valueCoding>
</extension>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="FILL"/>
<display value="Filler Identifier"/>
</coding>
</type>
<system value="http://anotherPharmacy.com/fillnumber"/>
<value value="87355201"/>
</identifier>
<status value="completed"/>
<medicationCodeableConcept>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="433800"/>
<display
value="24 HR alprazolam 1 MG Extended Release Oral Tablet"/>
</coding>
<coding>
<system value="http://hl7.org/fhir/sid/ndc"/>
<code value="00093545106"/>
<userSelected value="true"/>
</coding>
<text value="24 HR alprazolam 1 MG Extended Release Oral Tablet"/>
</medicationCodeableConcept>
<subject>
<reference value="urn:uuid:8b0fcac7-eeb8-4558-a1f6-46f2f4293190"/>
<display value="August Thomas Samuels"/>
</subject>
<performer>
<actor>
<reference value="urn:uuid:d0890c3e-45dc-489c-8498-31ffb6254003"/>
<identifier>
<system
value="http://terminology.hl7.org/CodeSystem/NCPDPProviderIdentificationNumber"/>
<value value="990717"/>
</identifier>
<display value="Another Pharmacy"/>
</actor>
</performer>
<authorizingPrescription>
<reference value="urn:uuid:47a9b899-1bee-4490-bd41-b3ca12eb441a"/>
<identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="PLAC"/>
<display value="Placer Identifier"/>
</coding>
</type>
<system value="http://myprescribingsystem.com/ordernumber"/>
<value value="580331"/>
</identifier>
</authorizingPrescription>
<quantity>
<value value="60"/>
<unit value="each"/>
</quantity>
<daysSupply>
<value value="30"/>
</daysSupply>
<whenPrepared value="2023-07-08"/>
<whenHandedOver value="2023-07-08"/>
<dosageInstruction>
<sequence value="1"/>
<text value="2 tablets every morning"/>
</dosageInstruction>
</MedicationDispense>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:53a1e123-5b56-44ae-b7e8-36e0b9800f57"/>
<resource>
<Patient>
<id value="patient-res-1"/>
<meta>
<source value="http://example.org/ma-pdmp"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|6.1.0"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The PDMP Responder's patient record for August Samuels, dob 1989-03-12, SSN 120-35-2435</div>
</text>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="SS"/>
</coding>
</type>
<system value="http://hl7.org/fhir/sid/us-ssn"/>
<value value="120-35-2435"/>
</identifier>
<name>
<family value="Samuels"/>
<given value="August"/>
</name>
<gender value="male"/>
<birthDate value="1989-03-12"/>
<address>
<state value="MA"/>
<postalCode value="01059"/>
</address>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:8b0fcac7-eeb8-4558-a1f6-46f2f4293190"/>
<resource>
<Patient>
<id value="patient-res-2"/>
<meta>
<source value="http://example.org/ri-pdmp"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|6.1.0"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The PDMP Responder's patient record for August Thomas Samuels, dob 1989-03-12, MRN 28-145-2249</div>
</text>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MR"/>
</coding>
</type>
<system value="http://Highview.org/EHR/patient/mrn"/>
<value value="28-145-2249"/>
</identifier>
<name>
<family value="Samuels"/>
<given value="August"/>
<given value="Thomas"/>
</name>
<gender value="male"/>
<birthDate value="1989-03-12"/>
<address>
<state value="MA"/>
<postalCode value="01059"/>
</address>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:82ae67e4-f23a-4c17-b80a-9076a37f5d6e"/>
<resource>
<Organization>
<id value="pharmacy-res-1-1"/>
<meta>
<source value="http://example.org/ma-pdmp"/>
<profile
value="http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-organization-pharmacy"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Pharmacy: Our Pharmacy, NCPDP ID 999017</div>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="1669512349"/>
</identifier>
<identifier>
<system
value="http://terminology.hl7.org/CodeSystem/NCPDPProviderIdentificationNumber"/>
<value value="999017"/>
</identifier>
<active value="true"/>
<name value="Our Pharmacy"/>
<telecom>
<system value="phone"/>
<value value="952-555-5555"/>
</telecom>
<telecom>
<system value="email"/>
<value value="contact-our-pharmacy@email.org"/>
</telecom>
<address>
<line value="220 Oak St"/>
<city value="Sheldonville"/>
<state value="MA"/>
<postalCode value="02093"/>
<country value="USA"/>
</address>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:d0890c3e-45dc-489c-8498-31ffb6254003"/>
<resource>
<Organization>
<id value="pharmacy-res-2"/>
<meta>
<source value="http://example.org/ri-pdmp"/>
<profile
value="http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-organization-pharmacy"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">Pharmacy: Another Pharmacy, NCPDP ID 999717</div>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="1682435585"/>
</identifier>
<identifier>
<system
value="http://terminology.hl7.org/CodeSystem/NCPDPProviderIdentificationNumber"/>
<value value="999717"/>
</identifier>
<active value="true"/>
<name value="Another Pharmacy"/>
<telecom>
<system value="phone"/>
<value value="952-555-1134"/>
</telecom>
<telecom>
<system value="email"/>
<value value="contact-another-pharmacy@email.org"/>
</telecom>
<address>
<line value="1809 Broad St"/>
<city value="Cumberland"/>
<state value="RI"/>
<postalCode value="02864"/>
<country value="USA"/>
</address>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:1ae374d2-7bb9-4298-8c54-2179410c549e"/>
<resource>
<DetectedIssue>
<id value="alert-1"/>
<meta>
<source value="http://example.org/ma-pdmp"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">An alert generated by the PDMP: 03 Doctor/pharmacy shopping alert</div>
</text>
<status value="final"/>
<code>
<coding>
<system
value="http://hl7.org/fhir/us/pdmp/CodeSystem/temporary-pmix-patient-alert-category-code"/>
<code value="03"/>
</coding>
<text value="Doctor/pharmacy shopping alert"/>
</code>
<patient>
<reference value="urn:uuid:8b0fcac7-eeb8-4558-a1f6-46f2f4293190"/>
<display value="August Thomas Samuels"/>
</patient>
</DetectedIssue>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:47a9b899-1bee-4490-bd41-b3ca12eb441a"/>
<resource>
<MedicationRequest>
<id value="authorizing-prescription-2"/>
<meta>
<source value="http://example.org/ri-pdmp"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest|6.1.0"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The authorizing prescription for prescription dispense 87355201</div>
</text>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="PLAC"/>
<display value="Placer Identifier"/>
</coding>
</type>
<system value="http://myprescribingsystem.com/ordernumber"/>
<value value="580331"/>
</identifier>
<status value="active"/>
<intent value="order"/>
<medicationCodeableConcept>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="433800"/>
<display
value="24 HR alprazolam 1 MG Extended Release Oral Tablet"/>
<userSelected value="true"/>
</coding>
</medicationCodeableConcept>
<subject>
<reference value="urn:uuid:8b0fcac7-eeb8-4558-a1f6-46f2f4293190"/>
<display value="August Thomas Samuels"/>
</subject>
<requester>
<reference value="urn:uuid:77ee025a-59fc-4d1e-a189-2133a9a56c26"/>
<display value="Marie Fiorella, MD"/>
</requester>
<dosageInstruction>
<text value="2 tablets every morning"/>
</dosageInstruction>
<dispenseRequest>
<numberOfRepeatsAllowed value="5"/>
<quantity>
<value value="60"/>
<unit value="each"/>
</quantity>
<expectedSupplyDuration>
<value value="30"/>
<unit value="days"/>
<system value="http://unitsofmeasure.org"/>
<code value="d"/>
</expectedSupplyDuration>
</dispenseRequest>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:77ee025a-59fc-4d1e-a189-2133a9a56c26"/>
<resource>
<Practitioner>
<id value="practitioner-2"/>
<meta>
<source value="http://example.org/ri-pdmp"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|6.1.0"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The PDMP record for Marie Fiorella, MD</div>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="9941339100"/>
</identifier>
<identifier>
<system value="http://example.com/ri-dea"/>
<value value="CF1234563"/>
</identifier>
<name>
<family value="Fiorella"/>
<given value="Marie"/>
<suffix value="MD"/>
</name>
<telecom>
<system value="phone"/>
<value value="401-333-3333"/>
</telecom>
<address>
<use value="work"/>
<line value="201 S Main St #150"/>
<city value="Cumberland"/>
<state value="RI"/>
<postalCode value="02864"/>
<country value="USA"/>
</address>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:151b9dd1-ca84-48a4-b132-67b1bbed0194"/>
<resource>
<MedicationRequest>
<id value="authorizing-prescription-1"/>
<meta>
<source value="http://example.org/ma-pdmp"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-medicationrequest|6.1.0"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The authorizing prescription for prescription dispense 2000353</div>
</text>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="PLAC"/>
<display value="Placer Identifier"/>
</coding>
</type>
<system value="http://myprescribingsystem.com/ordernumber"/>
<value value="605153"/>
</identifier>
<status value="active"/>
<intent value="order"/>
<medicationCodeableConcept>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="993781"/>
<display
value="acetaminophen 300 MG / codeine phosphate 30 MG Oral Tablet"/>
<userSelected value="true"/>
</coding>
</medicationCodeableConcept>
<subject>
<reference value="urn:uuid:53a1e123-5b56-44ae-b7e8-36e0b9800f57"/>
<display value="August Samuels"/>
</subject>
<requester>
<reference value="urn:uuid:23c69153-03c7-470d-9cc8-08265491d095"/>
<display value="Marie Fiorella, MD"/>
</requester>
<dosageInstruction>
<text value="1 tab tid prn pain"/>
</dosageInstruction>
<dispenseRequest>
<numberOfRepeatsAllowed value="1"/>
<quantity>
<value value="10"/>
<unit value="each"/>
</quantity>
<expectedSupplyDuration>
<value value="5"/>
<unit value="days"/>
<system value="http://unitsofmeasure.org"/>
<code value="d"/>
</expectedSupplyDuration>
</dispenseRequest>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:23c69153-03c7-470d-9cc8-08265491d095"/>
<resource>
<Practitioner>
<id value="practitioner-1"/>
<meta>
<source value="http://example.org/ma-pdmp"/>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|6.1.0"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">The PDMP record for Marie Fiorella, MD</div>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="9941339100"/>
</identifier>
<identifier>
<system value="http://example.com/ma-dea"/>
<value value="CF6543210"/>
</identifier>
<name>
<family value="Fiorella"/>
<given value="Marie"/>
<suffix value="MD"/>
</name>
<telecom>
<system value="phone"/>
<value value="401-333-3333"/>
</telecom>
<address>
<use value="work"/>
<line value="201 S Main St #150"/>
<city value="Cumberland"/>
<state value="RI"/>
<postalCode value="02864"/>
<country value="USA"/>
</address>
</Practitioner>
</resource>
</entry>
</Bundle>
IG © 2023+ HL7 International / Pharmacy. Package hl7.fhir.us.pdmp#1.0.0-ballot based on FHIR 4.0.1. Generated 2024-04-04
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