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
{
"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"
}
]
}
}
]
}