Da Vinci Payer Data Exchange
2.1.1 - STU 2.1

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 2.1.1 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

## : PDex Supporting Info Type - TTL Representation

Page standards status: Trial-use | Maturity Level: 2

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    @prefix fhir: <http://hl7.org/fhir/> .
    @prefix owl: <http://www.w3.org/2002/07/owl#> .
    @prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
    @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
    @prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

    # - resource -------------------------------------------------------------------

     a fhir:CodeSystem ;
      fhir:nodeRole fhir:treeRoot ;
      fhir:id [ fhir:v "PDexSupportingInfoTypeCS"] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem PDexSupportingInfoTypeCS</b></p><a name=\"PDexSupportingInfoTypeCS\"> </a><a name=\"hcPDexSupportingInfoTypeCS\"> </a><p>This case-insensitive code system <code>http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCS</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">admissionperiod<a name=\"PDexSupportingInfoTypeCS-admissionperiod\"> </a></td><td>Admission Period</td><td>Dates corresponding with the admission and discharge of the beneficiary to a facility</td></tr><tr><td style=\"white-space:nowrap\">pointoforigin<a name=\"PDexSupportingInfoTypeCS-pointoforigin\"> </a></td><td>Point Of Origin</td><td>UB-04 Source of Admission (FL-15) identifies the place where the patient was identified as needing admission to a facility.</td></tr><tr><td style=\"white-space:nowrap\">admtype<a name=\"PDexSupportingInfoTypeCS-admtype\"> </a></td><td>Admission Type</td><td>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.</td></tr><tr><td style=\"white-space:nowrap\">billingnetworkcontractingstatus<a name=\"PDexSupportingInfoTypeCS-billingnetworkcontractingstatus\"> </a></td><td>Billing Network Contracting Status</td><td>Indicates that the Billing Provider has a contract with the Payer as of the effective date of service or admission.</td></tr><tr><td style=\"white-space:nowrap\">brandgenericindicator<a name=\"PDexSupportingInfoTypeCS-brandgenericindicator\"> </a></td><td>Brand Generic Indicator</td><td>NCPDP code indicating whether the plan adjudicated the claim as a brand or generic drug.</td></tr><tr><td style=\"white-space:nowrap\">clmrecvddate<a name=\"PDexSupportingInfoTypeCS-clmrecvddate\"> </a></td><td>Claim Received Date</td><td>Date the claim was received by the payer.</td></tr><tr><td style=\"white-space:nowrap\">compoundcode<a name=\"PDexSupportingInfoTypeCS-compoundcode\"> </a></td><td>Compound Code</td><td>NCPDP code indicating whether or not the prescription is a compound.</td></tr><tr><td style=\"white-space:nowrap\">dawcode<a name=\"PDexSupportingInfoTypeCS-dawcode\"> </a></td><td>DAW (Dispense As Written) Code</td><td>NCPDP code indicating the prescriber's instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication.</td></tr><tr><td style=\"white-space:nowrap\">dayssupply<a name=\"PDexSupportingInfoTypeCS-dayssupply\"> </a></td><td>Days Supply</td><td>NCPDP value indicating the Number of days supply of medication dispensed by the pharmacy.</td></tr><tr><td style=\"white-space:nowrap\">discharge-status<a name=\"PDexSupportingInfoTypeCS-discharge-status\"> </a></td><td>Discharge Status</td><td>UB-04 Discharge Status (FL-17) indicates the patient’s status as of the discharge date for a facility stay.</td></tr><tr><td style=\"white-space:nowrap\">drg<a name=\"PDexSupportingInfoTypeCS-drg\"> </a></td><td>DRG</td><td>DRG (Diagnosis Related Group), including the code system, the DRG version and the code value</td></tr><tr><td style=\"white-space:nowrap\">performingnetworkcontractingstatus<a name=\"PDexSupportingInfoTypeCS-performingnetworkcontractingstatus\"> </a></td><td>Performing Network Contracting Status</td><td>Indicates that the Performing Provider has a contract with the Payer as of the effective date of service or admission.</td></tr><tr><td style=\"white-space:nowrap\">refillnum<a name=\"PDexSupportingInfoTypeCS-refillnum\"> </a></td><td>Refill Number</td><td>NCPDP value indicating the number fill of the current dispensed supply (0, 1, 2, etc.)</td></tr><tr><td style=\"white-space:nowrap\">rxorigincode<a name=\"PDexSupportingInfoTypeCS-rxorigincode\"> </a></td><td>Rx Origin Code</td><td>NCPDP code indicating whether the prescription was transmitted as an electronic prescription, by phone, by fax, or as a written paper copy.</td></tr><tr><td style=\"white-space:nowrap\">servicefacility<a name=\"PDexSupportingInfoTypeCS-servicefacility\"> </a></td><td>Service Facility</td><td>The facility where the service occurred.  Examples include hospitals, nursing homes, laboratories or homeless shelters.</td></tr><tr><td style=\"white-space:nowrap\">typeofbill<a name=\"PDexSupportingInfoTypeCS-typeofbill\"> </a></td><td>Type of Bill</td><td>UB-04 Type of Bill (FL-04) provides specific information for payer purposes.</td></tr><tr><td style=\"white-space:nowrap\">medicalrecordnumber<a name=\"PDexSupportingInfoTypeCS-medicalrecordnumber\"> </a></td><td>Medical Record Number</td><td>Patient Medical Record Number associated with the specific claim.</td></tr><tr><td style=\"white-space:nowrap\">patientaccountnumber<a name=\"PDexSupportingInfoTypeCS-patientaccountnumber\"> </a></td><td>Patient Account Number</td><td>Patient Account Number associated with the specific claim.</td></tr></table></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:extension ( [
    fhir:url [
    fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-wg>     ] ;
    fhir:value [
    a fhir:Code ;
    fhir:v "fm"     ]
      ] [
    fhir:url [
    fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm>     ] ;
    fhir:value [
    a fhir:Integer ;
    fhir:v 2 ;
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom>         ] ;
    fhir:value [
    a fhir:Canonical ;
    fhir:v "http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex>         ]       ] )     ]
      ] [
    fhir:url [
    fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status>     ] ;
    fhir:value [
    a fhir:Code ;
    fhir:v "trial-use" ;
          ( fhir:extension [
    fhir:url [
    fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom>         ] ;
    fhir:value [
    a fhir:Canonical ;
    fhir:v "http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/us/davinci-pdex/ImplementationGuide/hl7.fhir.us.davinci-pdex>         ]       ] )     ]
      ] ) ; #
      fhir:url [
    fhir:v "http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCS"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/us/davinci-pdex/CodeSystem/PDexSupportingInfoTypeCS>
      ] ; #
      fhir:version [ fhir:v "2.1.1"] ; #
      fhir:name [ fhir:v "PDexSupportingInfoTypeCS"] ; #
      fhir:title [ fhir:v "PDex Supporting Info Type"] ; #
      fhir:status [ fhir:v "active"] ; #
      fhir:experimental [ fhir:v false] ; #
      fhir:date [ fhir:v "2025-12-18T03:22:36+00:00"^^xsd:dateTime] ; #
      fhir:publisher [ fhir:v "HL7 International / Financial Management"] ; #
      fhir:contact ( [
    fhir:name [ fhir:v "HL7 International / Financial Management" ] ;
        ( fhir:telecom [
    fhir:system [ fhir:v "url" ] ;
    fhir:value [ fhir:v "http://www.hl7.org/Special/committees/fm" ]     ] [
    fhir:system [ fhir:v "email" ] ;
    fhir:value [ fhir:v "fm@lists.HL7.org" ]     ] )
      ] [
    fhir:name [ fhir:v "Mark Scrimshire (mark.scrimshire@onyxhealth.io)" ] ;
        ( fhir:telecom [
    fhir:system [ fhir:v "email" ] ;
    fhir:value [ fhir:v "mailto:mark.scrimshire@onyxhealth.io" ]     ] )
      ] [
    fhir:name [ fhir:v "HL7 International - Financial Management" ] ;
        ( fhir:telecom [
    fhir:system [ fhir:v "url" ] ;
    fhir:value [ fhir:v "http://www.hl7.org/Special/committees/fm" ]     ] )
      ] ) ; #
      fhir:description [ fhir:v "Claim Information Category - Used as the discriminator for supportingInfo"] ; #
      fhir:jurisdiction ( [
        ( fhir:coding [
    fhir:system [
    fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ;
    fhir:l <urn:iso:std:iso:3166>       ] ;
    fhir:code [ fhir:v "US" ] ;
    fhir:display [ fhir:v "United States of America" ]     ] )
      ] ) ; #
      fhir:copyright [ fhir:v "This CodeSystem is not copyrighted."] ; #
      fhir:caseSensitive [ fhir:v false] ; #
      fhir:content [ fhir:v "complete"] ; #
      fhir:count [ fhir:v "18"^^xsd:nonNegativeInteger] ; #
      fhir:concept ( [
    fhir:code [ fhir:v "admissionperiod" ] ;
    fhir:display [ fhir:v "Admission Period" ] ;
    fhir:definition [ fhir:v "Dates corresponding with the admission and discharge of the beneficiary to a facility" ]
      ] [
    fhir:code [ fhir:v "pointoforigin" ] ;
    fhir:display [ fhir:v "Point Of Origin" ] ;
    fhir:definition [ fhir:v "UB-04 Source of Admission (FL-15) identifies the place where the patient was identified as needing admission to a facility." ]
      ] [
    fhir:code [ fhir:v "admtype" ] ;
    fhir:display [ fhir:v "Admission Type" ] ;
    fhir:definition [ fhir:v "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." ]
      ] [
    fhir:code [ fhir:v "billingnetworkcontractingstatus" ] ;
    fhir:display [ fhir:v "Billing Network Contracting Status" ] ;
    fhir:definition [ fhir:v "Indicates that the Billing Provider has a contract with the Payer as of the effective date of service or admission." ]
      ] [
    fhir:code [ fhir:v "brandgenericindicator" ] ;
    fhir:display [ fhir:v "Brand Generic Indicator" ] ;
    fhir:definition [ fhir:v "NCPDP code indicating whether the plan adjudicated the claim as a brand or generic drug." ]
      ] [
    fhir:code [ fhir:v "clmrecvddate" ] ;
    fhir:display [ fhir:v "Claim Received Date" ] ;
    fhir:definition [ fhir:v "Date the claim was received by the payer." ]
      ] [
    fhir:code [ fhir:v "compoundcode" ] ;
    fhir:display [ fhir:v "Compound Code" ] ;
    fhir:definition [ fhir:v "NCPDP code indicating whether or not the prescription is a compound." ]
      ] [
    fhir:code [ fhir:v "dawcode" ] ;
    fhir:display [ fhir:v "DAW (Dispense As Written) Code" ] ;
    fhir:definition [ fhir:v "NCPDP code indicating the prescriber's instruction regarding substitution of generic equivalents or order to dispense the specific prescribed medication." ]
      ] [
    fhir:code [ fhir:v "dayssupply" ] ;
    fhir:display [ fhir:v "Days Supply" ] ;
    fhir:definition [ fhir:v "NCPDP value indicating the Number of days supply of medication dispensed by the pharmacy." ]
      ] [
    fhir:code [ fhir:v "discharge-status" ] ;
    fhir:display [ fhir:v "Discharge Status" ] ;
    fhir:definition [ fhir:v "UB-04 Discharge Status (FL-17) indicates the patient’s status as of the discharge date for a facility stay." ]
      ] [
    fhir:code [ fhir:v "drg" ] ;
    fhir:display [ fhir:v "DRG" ] ;
    fhir:definition [ fhir:v "DRG (Diagnosis Related Group), including the code system, the DRG version and the code value" ]
      ] [
    fhir:code [ fhir:v "performingnetworkcontractingstatus" ] ;
    fhir:display [ fhir:v "Performing Network Contracting Status" ] ;
    fhir:definition [ fhir:v "Indicates that the Performing Provider has a contract with the Payer as of the effective date of service or admission." ]
      ] [
    fhir:code [ fhir:v "refillnum" ] ;
    fhir:display [ fhir:v "Refill Number" ] ;
    fhir:definition [ fhir:v "NCPDP value indicating the number fill of the current dispensed supply (0, 1, 2, etc.)" ]
      ] [
    fhir:code [ fhir:v "rxorigincode" ] ;
    fhir:display [ fhir:v "Rx Origin Code" ] ;
    fhir:definition [ fhir:v "NCPDP code indicating whether the prescription was transmitted as an electronic prescription, by phone, by fax, or as a written paper copy." ]
      ] [
    fhir:code [ fhir:v "servicefacility" ] ;
    fhir:display [ fhir:v "Service Facility" ] ;
    fhir:definition [ fhir:v "The facility where the service occurred.  Examples include hospitals, nursing homes, laboratories or homeless shelters." ]
      ] [
    fhir:code [ fhir:v "typeofbill" ] ;
    fhir:display [ fhir:v "Type of Bill" ] ;
    fhir:definition [ fhir:v "UB-04 Type of Bill (FL-04) provides specific information for payer purposes." ]
      ] [
    fhir:code [ fhir:v "medicalrecordnumber" ] ;
    fhir:display [ fhir:v "Medical Record Number" ] ;
    fhir:definition [ fhir:v "Patient Medical Record Number associated with the specific claim." ]
      ] [
    fhir:code [ fhir:v "patientaccountnumber" ] ;
    fhir:display [ fhir:v "Patient Account Number" ] ;
    fhir:definition [ fhir:v "Patient Account Number associated with the specific claim." ]
      ] ) . #