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 - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="pdmp-bundle-history-result-1"/>
  <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">A record of a medication that was dispensed to the patient identified in the PDMP request: August Samuels</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>
          <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>
        </authorizingPrescription>
        <quantity>
          <value value="10"/>
          <unit value="each"/>
        </quantity>
        <daysSupply>
          <value value="5"/>
        </daysSupply>
        <whenPrepared value="2023-06-05"/>
        <whenHandedOver value="2023-06-05"/>
        <dosageInstruction>
          <sequence value="1"/>
          <text value="1 tab tid prn pain"/>
        </dosageInstruction>
      </MedicationDispense>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:53a1e123-5b56-44ae-b7e8-36e0b9800f57"/>
    <resource>
      <Patient>
        <id value="patient-res-1-1"/>
        <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 the patient identified in the PDMP request: August Samuels</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: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">The pharmacy that dispensed the reported medication: Our Pharmacy</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="Minneapolis"/>
          <state value="MN"/>
          <postalCode value="55008"/>
          <country value="USA"/>
        </address>
      </Organization>
    </resource>
  </entry>
</Bundle>