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 in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: pdmp-bundle-history-result-1 - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "pdmp-bundle-history-result-1",
  "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\">A record of a medication that was dispensed to the patient identified in the PDMP request: August Samuels</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" : [
          {
            "identifier" : {
              "type" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                    "code" : "PLAC",
                    "display" : "Placer Identifier"
                  }
                ]
              },
              "system" : "http://myprescribingsystem.com/ordernumber",
              "value" : "605153"
            }
          }
        ],
        "quantity" : {
          "value" : 10,
          "unit" : "each"
        },
        "daysSupply" : {
          "value" : 5
        },
        "whenPrepared" : "2023-06-05",
        "whenHandedOver" : "2023-06-05",
        "dosageInstruction" : [
          {
            "sequence" : 1,
            "text" : "1 tab tid prn pain"
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:53a1e123-5b56-44ae-b7e8-36e0b9800f57",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "patient-res-1-1",
        "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 the patient identified in the PDMP request: August Samuels</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: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\">The pharmacy that dispensed the reported medication: Our Pharmacy</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" : "Minneapolis",
            "state" : "MN",
            "postalCode" : "55008",
            "country" : "USA"
          }
        ]
      }
    }
  ]
}