Da Vinci Payer Data Exchange
2.1.0 - STU 2.1 United States of America flag

Publication Build: This will be filled in by the publication tooling

Example MedicationDispense: ExampleMedicationDispenseClaim

Page standards status: Informative

version: 1; Last updated: 2024-04-17 15:26:23+0000

Profile: PDex MedicationDispense

An attribute to express the refill number of a prescription: 1

status: Completed

medication: Lisinopril, 30 TABLET in 1 BLISTER PACK (54458-872-10) (package)

subject: Johnny Appleseed Male, DoB: 1986-01-01 ( Member Number)

Performers

-Actor
*Practitioner Susan Smith

location: Location MyFavorite Pharmacy

type: Refill

quantity: 60

daysSupply: 30

whenHandedOver: 2024-04-15 09:00:23+0000