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 - XML Representation

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<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://terminology.hl7.org/CodeSystem/PMIXTransmissionFormRxOriginCodeType"/>
            <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://terminology.hl7.org/CodeSystem/PMIXPatientAlertCatCode"/>
            <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://terminology.hl7.org/NamingSystem/usdeanumber"/>
          <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://terminology.hl7.org/NamingSystem/usdeanumber"/>
          <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>