Generated Narrative: MedicationRequest

Coverage Information

url

coverage

value: Coverage/example

url

covered

value: conditional

url

pa-needed

value: satisfied

url

doc-needed

value: admin

url

doc-purpose

value: withclaim

url

info-needed

value: performer

url

billingCode

value: Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed (Details: http://www.ama-assn.org/go/cpt code 77067 = 'Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed', stated as 'null')

url

reason

value: In-network required unless exigent circumstances (CRD Temporary Codes#gold-card)

code: Authorization out-of-network only (CRD Temporary Codes#auth-out-network-only)

url

detail

url

questionnaire

value: http://example.org/some-payer/Questionnaire/123|1.3.0

url

response

value:

questionnaire: http://example.org/some-payer/Questionnaire/123|1.3.0

status: in-progress

subject: http://example.org/Patient/123: Jane Smith

authored: 2019-02-15

author: : Some payer app name

item

linkId: A1234

text: How many previous treatments have been tried for this issue?

Answers

-	Value[x]
*	2

url

date

value: 2019-02-15

url

coverage-assertion-id

value: 12345ABC

url

satisfied-pa-id

value: XXYYZ

url

contact

value: http://some-payer.org/xyz-sub-org/get-help-here.html

status: draft

intent: original-order

medication: mycophenolate mofetil 250 MG Oral Capsule [Cellcept] (RxNorm#616447)

subject: http://example.org/Patient/123: Jane Smith

encounter: http://example.org/Encounter/ABC

authoredOn: 2019-02-15

requester: http://example.org/PractitionerRole/987: Dr. Jones

note: Unsolicited prior authorization for Jane Smith to receive 6 tablets Cellcept 250 MG Oral Capsule BID granted. Please note prior authorization # 12345 on claim submission. (By XYZ Insurance @Feb 15, 2019, 8:07:18 PM)

dosageInstruction

text: 6 tablets every 12 hours.

timing: Once per 12 hours

doseAndRate

LinkId	Text	Definition	Answer
qr			Questionnaire:http://example.org/some-payer/Questionnaire/123|1.3.0
A1234	How many previous treatments have been tried for this issue?		2
Documentation for this format