US Prescription Drug Monitoring Program (PDMP)
1.0.0 - STU1 United States of America flag

This page is part of the US Prescription Drug Monitoring Program (PDMP) (v1.0.0: STU1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: pdmp-bundle-history-result-2 - JSON Representation

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