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
Page standards status: Informative |
Generated Narrative: Task cdex-task-example27
status: Completed
intent: order
code: Data Request Questionnaire
for: Identifier: Member Number/Member123
authoredOn: 2022-06-17 16:16:06+0000
lastModified: 2022-06-19 12:00:00+0000
requester: Identifier: http://example.org/cdex/payer/payer-ids
/Payer123
owner: Identifier: United States National Provider Identifier/9941339108
reasonReference: Identifier: Payer Claim ID/Claim123
input
type: Questionnaire
input
type: Purpose Of Use
value: coverage under policy or program