This page is part of the Da Vinci Clinical Documentation Exchange (v2.1.0-snapshot: QA Preview) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions
{
"resourceType" : "Parameters",
"parameter" : [
{
"name" : "TrackingId",
"valueIdentifier" : {
"system" : "http://example.org/payer",
"value" : "trackingid1012"
}
},
{
"name" : "AttachTo",
"valueCode" : "preauthorization"
},
{
"name" : "PayerId",
"valueIdentifier" : {
"system" : "http://example.org/cdex/payer/payer-ids",
"value" : "payer123"
}
},
{
"name" : "OrganizationId",
"valueIdentifier" : {
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "1234567893"
}
},
{
"name" : "ProviderId",
"valueIdentifier" : {
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "9941339100"
}
},
{
"name" : "MemberId",
"valueIdentifier" : {
"system" : "http://example.org/cdex/payer/member-ids",
"value" : "Member123"
}
},
{
"name" : "Attachment",
"part" : [
{
"name" : "LineItem",
"valueString" : "1"
},
{
"name" : "Content",
"resource" : {
"resourceType" : "QuestionnaireResponse",
"id" : "cdex-questionnaireresponse-example1",
"questionnaire" : "http://example.org/cdex-questionnaire-example1",
"status" : "completed",
"subject" : {
"identifier" : {
"use" : "usual",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MB",
"display" : "Member Number"
}
],
"text" : "Member Number"
},
"system" : "http://example.org/cdex/payer/member-ids",
"value" : "Member123"
},
"display" : "Amy Shaw"
},
"authored" : "2022-06-17",
"author" : {
"identifier" : {
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "9941339100"
}
},
"item" : [
{
"linkId" : "1",
"text" : "Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)",
"answer" : [
{
"valueString" : "Examplitis"
}
]
},
{
"linkId" : "2",
"text" : "Order Reason",
"answer" : [
{
"valueCoding" : {
"system" : "http://example.org",
"code" : "4",
"display" : "Replacement"
}
}
]
}
]
}
}
]
}
]
}