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-history-input-parameters-4-delegate - JSON Representation

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{
  "resourceType" : "Parameters",
  "id" : "pdmp-history-input-parameters-4-delegate",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-parameters-request"
    ]
  },
  "parameter" : [
    {
      "name" : "patient",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "patient-req-4",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/pdmp/StructureDefinition/pdmp-patient"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Patient: Jules Julien</div>"
        },
        "identifier" : [
          {
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "MR",
                  "display" : "Medical record number"
                }
              ]
            },
            "system" : "http://highview-va.example.org/mrn",
            "value" : "10035666601"
          }
        ],
        "active" : true,
        "name" : [
          {
            "family" : "Julien",
            "given" : [
              "Jules"
            ]
          }
        ],
        "gender" : "female",
        "birthDate" : "1980-05-20",
        "address" : [
          {
            "line" : [
              "10023 Santa Clara Blvd"
            ],
            "state" : "MA",
            "postalCode" : "01742"
          }
        ]
      }
    },
    {
      "name" : "authorized-practitioner",
      "resource" : {
        "resourceType" : "Practitioner",
        "id" : "practitioner-req-4",
        "meta" : {
          "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\">Mari Kimble MD</div>"
        },
        "identifier" : [
          {
            "system" : "http://hl7.org/fhir/sid/us-npi",
            "value" : "1665015602"
          }
        ],
        "name" : [
          {
            "family" : "Kimble"
          }
        ]
      }
    },
    {
      "name" : "authorized-practitioner-role",
      "resource" : {
        "resourceType" : "PractitionerRole",
        "id" : "practitionerrole-req-4",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole|6.1.0"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Mari Kimble, Internal Medicine, Highview VA Clinic</div>"
        },
        "practitioner" : {
          "reference" : "Practitioner/practitioner-req-4",
          "display" : "Mari Kimble"
        },
        "organization" : {
          "reference" : "Organization/organization-req-4",
          "display" : "Highview VA Clinic"
        },
        "specialty" : [
          {
            "coding" : [
              {
                "system" : "http://nucc.org/provider-taxonomy",
                "code" : "207R00000X",
                "display" : "Internal Medicine Physician"
              }
            ]
          }
        ],
        "telecom" : [
          {
            "system" : "phone",
            "value" : "508-856-1234"
          }
        ]
      }
    },
    {
      "name" : "authorized-practitioner-organization",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "organization-req-4",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization|6.1.0"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Highview VA Clinic</div>"
        },
        "active" : true,
        "name" : "Highview VA Clinic",
        "telecom" : [
          {
            "system" : "phone",
            "value" : "508-856-5555"
          }
        ],
        "address" : [
          {
            "line" : [
              "2002 Highview Ln"
            ],
            "city" : "Worcester",
            "state" : "MA",
            "postalCode" : "01604"
          }
        ]
      }
    },
    {
      "name" : "delegate-practitioner",
      "resource" : {
        "resourceType" : "Practitioner",
        "id" : "practitioner-req-4-del",
        "meta" : {
          "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\">Boris Bartok</div>"
        },
        "identifier" : [
          {
            "system" : "http://hl7.org/fhir/sid/us-npi",
            "value" : "1554505606"
          }
        ],
        "name" : [
          {
            "family" : "Bartok"
          }
        ]
      }
    },
    {
      "name" : "delegate-practitioner-role",
      "resource" : {
        "resourceType" : "PractitionerRole",
        "id" : "practitionerrole-req-4-del",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole|6.1.0"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Boris Bartok RN, Highview VA Clinic</div>"
        },
        "practitioner" : {
          "reference" : "Practitioner/practitioner-req-4-del",
          "display" : "Mari Kimble"
        },
        "organization" : {
          "reference" : "Organization/organization-req-4-del",
          "display" : "Highview VA Clinic"
        },
        "specialty" : [
          {
            "coding" : [
              {
                "system" : "http://nucc.org/provider-taxonomy",
                "code" : "163W00000X",
                "display" : "Registered Nurse"
              }
            ]
          }
        ],
        "telecom" : [
          {
            "system" : "phone",
            "value" : "508-856-9999"
          }
        ]
      }
    },
    {
      "name" : "delegate-organization",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "organization-req-4-del",
        "meta" : {
          "profile" : [
            🔗 "http://hl7.org/fhir/us/core/StructureDefinition/us-core-organization|6.1.0"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">Highview VA Clinic</div>"
        },
        "active" : true,
        "name" : "Highview VA Clinic",
        "telecom" : [
          {
            "system" : "phone",
            "value" : "508-856-5555"
          }
        ],
        "address" : [
          {
            "line" : [
              "2002 Highview Ln"
            ],
            "city" : "Worcester",
            "state" : "MA",
            "postalCode" : "01604"
          }
        ]
      }
    },
    {
      "name" : "pre-stage-only",
      "valueBoolean" : false
    }
  ]
}