Da Vinci Clinical Data Exchange (CDex)
2.1.0-preview - CI Build United States of America flag

Da Vinci Clinical Data Exchange (CDex), published by HL7 International / Payer/Provider Information Exchange Work Group. This guide is not an authorized publication; it is the continuous build for version 2.1.0-preview built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-ecdx/ and changes regularly. See the Directory of published versions

: CDex Inline Task Example 22 - JSON Representation

Page standards status: Informative

Raw json | Download


{
  "resourceType" : "Task",
  "meta" : {
    "extension" : [
      {
        "url" : "http://hl7.org/fhir/StructureDefinition/instance-name",
        "valueString" : "CDex Inline Task Example 22"
      },
      {
        "url" : "http://hl7.org/fhir/StructureDefinition/instance-description",
        "valueMarkdown" : "Task example used to create inline [requesting attachments using questionnaire transaction](requesting-attachments-questionnaire.html#complete-solicited-attachment-transaction)"
      }
    ],
    "profile" : [
      🔗 "http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-task-attachment-request"
    ]
  },
  "contained" : [
    {
      "resourceType" : "Patient",
      "id" : "patient",
      "meta" : {
        "profile" : [
          🔗 "http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-patient-demographics"
        ]
      },
      "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"
        },
        {
          "use" : "usual",
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType",
                "code" : "pat",
                "display" : "Patient Account Number"
              }
            ],
            "text" : "Patient Account Number"
          },
          "system" : "http://example.org/cdex/provider/patient-ids",
          "value" : "PA-123"
        }
      ],
      "name" : [
        {
          "family" : "Shaw",
          "given" : [
            "Amy"
          ]
        }
      ],
      "birthDate" : "1987-02-20"
    },
    {
      "resourceType" : "PractitionerRole",
      "id" : "practitionerrole",
      "meta" : {
        "profile" : [
          🔗 "http://hl7.org/fhir/us/davinci-cdex/StructureDefinition/cdex-practitionerrole"
        ]
      },
      "practitioner" : {
        "identifier" : {
          "system" : "http://hl7.org/fhir/sid/us-npi",
          "value" : "9941339100"
        }
      },
      "organization" : {
        "identifier" : {
          "system" : "http://hl7.org/fhir/sid/us-npi",
          "value" : "1234567893"
        }
      }
    }
  ],
  "identifier" : [
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
            "code" : "tracking-id",
            "display" : "Tracking Id"
          }
        ],
        "text" : "Re-Association Tracking Control Number"
      },
      "system" : "http://example.org/payer",
      "value" : "trackingid1012"
    }
  ],
  "status" : "requested",
  "intent" : "order",
  "code" : {
    "coding" : [
      {
        "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
        "code" : "attachment-request-questionnaire"
      }
    ],
    "text" : "Attachment Request Questionnaire"
  },
  "for" : {
    "reference" : "#patient"
  },
  "authoredOn" : "2022-06-17T16:16:06Z",
  "lastModified" : "2022-06-17T16:16:06Z",
  "requester" : {
    "identifier" : {
      "system" : "http://example.org/cdex/payer/payer-ids",
      "value" : "Payer123"
    }
  },
  "owner" : {
    "reference" : "#practitionerrole"
  },
  "reasonCode" : {
    "coding" : [
      {
        "system" : "http://hl7.org/fhir/claim-use",
        "code" : "preauthorization",
        "display" : "Preauthorization"
      }
    ],
    "text" : "preauthorization"
  },
  "reasonReference" : {
    "identifier" : {
      "system" : "http://example.org/cdex/payer/claim-ids",
      "value" : "Preauth123"
    }
  },
  "restriction" : {
    "period" : {
      "end" : "2022-06-21"
    }
  },
  "input" : [
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-paLineNumber",
          "valueInteger" : 1
        }
      ],
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
            "code" : "questionnaires-needed"
          }
        ]
      },
      "valueCanonical" : "http://example.org/cdex-questionnaire-inline-example1|2.1.0-preview"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes",
            "code" : "payer-url"
          }
        ]
      },
      "valueUrl" : "http://example.org/cdex/payer/$submit-attachment"
    },
    {
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp",
            "code" : "purpose-of-use"
          }
        ]
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
            "code" : "COVAUTH",
            "display" : "coverage authorization"
          }
        ]
      }
    }
  ]
}