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 - XML Representation

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

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