Da Vinci Payer Data Exchange
2.1.0 - STU2 United States of America flag

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

ValueSet: PDex SupportingInfo Type (Experimental)

Official URL: http://hl7.org/fhir/us/davinci-pdex/ValueSet/PDexSupportingInfoType Version: 2.1.0
Active as of 2024-03-01 Computable Name: PDexSupportingInfoType

Copyright/Legal: This Valueset is not copyrighted.

Used as the discriminator for the types of supporting information for the PDEX Prior Authorization. Based on the CARIN IG for Blue Button� Implementation Guide.


This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)



Expansion based on codesystem PDex Supporting Info Type v2.1.0 (CodeSystem)

This value set contains 18 concepts.

  admissionperiodhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeAdmission Period

Dates corresponding with the admission and discharge of the beneficiary to a facility

  pointoforiginhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypePoint Of Origin

UB-04 Source of Admission (FL-15) identifies the place where the patient was identified as needing admission to a facility.

  admtypehttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeAdmission Type

UB-04 Priority of the admission (FL-14) indicates, for example, an admission type of elective indicates that the patient's condition permitted time for medical services to be scheduled.

  billingnetworkcontractingstatushttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeBilling Network Contracting Status

Indicates that the Billing Provider has a contract with the Payer as of the effective date of service or admission.

  brandgenericindicatorhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeBrand Generic Indicator

NCPDP code indicating whether the plan adjudicated the claim as a brand or generic drug.

  clmrecvddatehttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeClaim Received Date

Date the claim was received by the payer.

  compoundcodehttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCompound Code

NCPDP code indicating whether or not the prescription is a compound.

  dawcodehttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeDAW (Dispense As Written) Code

NCPDP code indicating the prescriber's instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication.

  dayssupplyhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeDays Supply

NCPDP value indicating the Number of days supply of medication dispensed by the pharmacy.

  discharge-statushttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeDischarge Status

UB-04 Discharge Status (FL-17) indicates the patient’s status as of the discharge date for a facility stay.


DRG (Diagnosis Related Group), including the code system, the DRG version and the code value

  performingnetworkcontractingstatushttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypePerforming Network Contracting Status

Indicates that the Performing Provider has a contract with the Payer as of the effective date of service or admission.

  refillnumhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeRefill Number

NCPDP value indicating the number fill of the current dispensed supply (0, 1, 2, etc.)

  rxorigincodehttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeRx Origin Code

NCPDP code indicating whether the prescription was transmitted as an electronic prescription, by phone, by fax, or as a written paper copy.

  servicefacilityhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeService Facility

The facility where the service occurred. Examples include hospitals, nursing homes, laboratories or homeless shelters.

  typeofbillhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeType of Bill

UB-04 Type of Bill (FL-04) provides specific information for payer purposes.

  medicalrecordnumberhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeMedical Record Number

Patient Medical Record Number associated with the specific claim.

  patientaccountnumberhttp://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypePatient Account Number

Patient Account Number associated with the specific claim.

Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code