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

## : BundleExamplePayer1 - XML Representation

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    <Bundle xmlns="http://hl7.org/fhir">
      <id value="1000000-1"/>
      <meta>
        <profile value="http://hl7.org/fhir/StructureDefinition/Bundle"/>
      </meta>
      <type value="transaction-response"/>
      <timestamp value="2019-12-31T20:26:23.217+00:00"/>
      <link>
        <relation value="self"/>
        <url
             value="https://example.com/base/fhir/Patient?ct=W2idG9rZW4iOiIrUklEOn53MThjQUk5RlVPZ0lEQUFBQUFBQU"/>
      </link>
      <entry>
        <fullUrl value="https://example.com/base/Patient/1"/>
        <resource>
          <Patient>
            <id value="1"/>
            <meta>
              <lastUpdated value="2019-07-07T13:26:22.0314215+00:00"/>
              <profile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"/>
            </meta>
            <language value="en-US"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en-US" lang="en-US"><a name="Patient_1"> </a><p class="res-header-id"><b>Generated Narrative: Patient 1</b></p><a name="1"> </a><a name="hc1"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Last updated: 2019-07-07 13:26:22+0000; Language: en-US</p><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/us/core/STU7/StructureDefinition-us-core-patient.html">US Core Patient Profile</a></p></div><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Johnny Appleseed  Male, DoB: 1986-01-01 ( Member Number)</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Record is active">Active:</td><td>true</td><td style="background-color: #f3f5da" title="Known Marital status of Patient">Marital Status:</td><td colspan="3"><span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-NullFlavor UNK}">unknown</span></td></tr><tr><td style="background-color: #f3f5da" title="Other Ids (see the one above)">Other Ids:</td><td colspan="3"><ul><li>Medical record number/1234-234-1243-12345678901m</li><li>Health Plan Identifier/1234-234-1243-12345678901u</li><li>Patient external identifier/1234-234-1243-12345678901a</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Detail</td><td colspan="3"><ul><li>ph: (443)555-1212</li><li>ph: (410)678-2323</li><li>123 Main Street Pittsburgh PA 12519 </li></ul></td></tr></table></div>
            </text>
            <identifier>
              <type>
                <coding>
                  <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
                  <code value="MB"/>
                </coding>
              </type>
              <system
                      value="https://www.xxxhealthplan.com/fhir/memberidentifier"/>
              <value
                     value="https://www.xxxhealthplan.com/fhir/memberidentifier#1234-234-1243-12345678901"/>
            </identifier>
            <identifier>
              <type>
                <coding>
                  <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
                  <code value="MR"/>
                </coding>
              </type>
              <system
                      value="https://www.xxxhealthplan.com/fhir/medicalrecordnumber"/>
              <value value="1234-234-1243-12345678901m"/>
            </identifier>
            <identifier>
              <type>
                <coding>
                  <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
                  <code value="XV"/>
                </coding>
              </type>
              <system
                      value="https://www.xxxhealthplan.com/fhir/uniquememberidentifier"/>
              <value value="1234-234-1243-12345678901u"/>
            </identifier>
            <identifier>
              <type>
                <coding>
                  <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
                  <code value="PT"/>
                </coding>
              </type>
              <system value="https://www.xxxhealthplan.com/fhir/patacctnum"/>
              <value value="1234-234-1243-12345678901a"/>
            </identifier>
            <active value="true"/>
            <name>
              <family value="Appleseed"/>
              <given value="Johnny"/>
            </name>
            <telecom>
              <system value="phone"/>
              <value value="(443)555-1212"/>
              <rank value="1"/>
            </telecom>
            <telecom>
              <system value="phone"/>
              <value value="(410)678-2323"/>
              <rank value="2"/>
            </telecom>
            <gender value="male"/>
            <birthDate value="1986-01-01"/>
            <address>
              <type value="physical"/>
              <line value="123 Main Street"/>
              <city value="Pittsburgh"/>
              <state value="PA"/>
              <postalCode value="12519"/>
            </address>
            <maritalStatus>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/v3-NullFlavor"/>
                <code value="UNK"/>
              </coding>
            </maritalStatus>
          </Patient>
        </resource>
        <response>
          <status value="200"/>
        </response>
      </entry>
      <entry>
        <fullUrl value="https://example.com/base/Encounter/6-1"/>
        <resource>
          <Encounter>
            <id value="6-1"/>
            <meta>
              <lastUpdated value="2019-07-14T19:26:23.217+00:00"/>
              <profile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Encounter_6-1"> </a><p class="res-header-id"><b>Generated Narrative: Encounter 6-1</b></p><a name="6-1"> </a><a name="hc6-1"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Last updated: 2019-07-14 19:26:23+0000</p><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/us/core/STU7/StructureDefinition-us-core-encounter.html">US Core Encounter Profile</a></p></div><p><b>status</b>: Finished</p><p><b>class</b>: <a href="http://terminology.hl7.org/6.3.0/CodeSystem-v3-ActCode.html#v3-ActCode-AMB">ActCode: AMB</a> (Ambulatory)</p><p><b>type</b>: <span title="Codes:{http://snomed.info/sct 11429006}">Consultation</span></p><p><b>subject</b>: <a href="Patient-1.html">Johnny Appleseed  Male, DoB: 1986-01-01 ( Member Number)</a></p></div>
            </text>
            <status value="finished"/>
            <class>
              <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
              <code value="AMB"/>
              <display value="Ambulatory"/>
            </class>
            <type>
              <coding>
                <system value="http://snomed.info/sct"/>
                <version value="http://snomed.info/sct/731000124108"/>
                <code value="11429006"/>
                <display value="Consultation"/>
              </coding>
            </type>
            <subject>🔗
              <reference value="Patient/1"/>
            </subject>
          </Encounter>
        </resource>
        <response>
          <status value="200"/>
        </response>
      </entry>
      <entry>
        <fullUrl value="https://example.com/base/Encounter/7-1"/>
        <resource>
          <Encounter>
            <id value="7-1"/>
            <meta>
              <lastUpdated value="2019-10-15T20:26:23.217+00:00"/>
              <profile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-encounter"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Encounter_7-1"> </a><p class="res-header-id"><b>Generated Narrative: Encounter 7-1</b></p><a name="7-1"> </a><a name="hc7-1"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Last updated: 2019-10-15 20:26:23+0000</p><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/us/core/STU7/StructureDefinition-us-core-encounter.html">US Core Encounter Profile</a></p></div><p><b>status</b>: Finished</p><p><b>class</b>: <a href="http://terminology.hl7.org/6.3.0/CodeSystem-v3-ActCode.html#v3-ActCode-AMB">ActCode: AMB</a> (Ambulatory)</p><p><b>type</b>: <span title="Codes:{http://snomed.info/sct 11429006}">Consultation</span></p><p><b>subject</b>: <a href="Patient-1.html">Johnny Appleseed  Male, DoB: 1986-01-01 ( Member Number)</a></p></div>
            </text>
            <status value="finished"/>
            <class>
              <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
              <code value="AMB"/>
              <display value="Ambulatory"/>
            </class>
            <type>
              <coding>
                <system value="http://snomed.info/sct"/>
                <version value="http://snomed.info/sct/731000124108"/>
                <code value="11429006"/>
                <display value="Consultation"/>
              </coding>
            </type>
            <subject>🔗
              <reference value="Patient/1"/>
            </subject>
          </Encounter>
        </resource>
        <response>
          <status value="200"/>
        </response>
      </entry>
      <entry>
        <fullUrl value="https://example.com/base/Provenance/1000002-1"/>
        <resource>
          <Provenance>
            <id value="1000002-1"/>
            <meta>
              <versionId value="1"/>
              <lastUpdated value="2019-07-14T19:26:23.217+00:00"/>
              <profile
                       value="http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/pdex-provenance"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Provenance_1000002-1"> </a><p class="res-header-id"><b>Generated Narrative: Provenance 1000002-1</b></p><a name="1000002-1"> </a><a name="hc1000002-1"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">version: 1; Last updated: 2019-07-14 19:26:23+0000</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-pdex-provenance.html">PDex Provenance</a></p></div><p>Provenance for <a href="Bundle-1000000-1.html#https-//example.com/base/Encounter/6-1">Encounter: status = finished; class = Ambulatory (ActCode#AMB); type = Consultation</a></p><p>Summary</p><table class="grid"><tr><td>Recorded</td><td>2020-07-10 16:26:23+0000</td></tr></table><p><b>Agents</b></p><table class="grid"><tr><td><b>Type</b></td><td><b>who</b></td></tr><tr><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/provenance-participant-type author}">Author</span></td><td><a href="Organization-ProviderOrg1.html">Organization Provider 1</a></td></tr></table></div>
            </text>
            <target>
              <reference value="https://example.com/base/Encounter/6-1"/>
            </target>
            <recorded value="2020-07-10T16:26:23.217+00:00"/>
            <agent>
              <type>
                <coding>
                  <system
                          value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/>
                  <code value="author"/>
                  <display value="Author"/>
                </coding>
              </type>
              <who>🔗
                <reference value="Organization/ProviderOrg1"/>
              </who>
            </agent>
            <entity>
              <extension
                         url="http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/ProvenanceSourceFrom">
                <valueCodeableConcept>
                  <coding>
                    <system
                            value="http://hl7.org/fhir/us/davinci-pdex/CodeSystem/ProvenancePayerDataSource"/>
                    <code value="hl7ccda"/>
                    <display value="HL7 C-CDA"/>
                  </coding>
                </valueCodeableConcept>
              </extension>
              <role value="source"/>
              <what>
                <display value="No reference available"/>
              </what>
            </entity>
          </Provenance>
        </resource>
        <response>
          <status value="200"/>
        </response>
      </entry>
      <entry>
        <fullUrl value="https://example.com/base/Provenance/1000003-1"/>
        <resource>
          <Provenance>
            <id value="1000003-1"/>
            <meta>
              <versionId value="1"/>
              <lastUpdated value="2019-10-15T20:26:23.217+00:00"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Provenance_1000003-1"> </a><p class="res-header-id"><b>Generated Narrative: Provenance 1000003-1</b></p><a name="1000003-1"> </a><a name="hc1000003-1"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">version: 1; Last updated: 2019-10-15 20:26:23+0000</p></div><p>Provenance for <a href="Bundle-1000000-1.html#Encounter_7-1">Encounter: status = finished; class = Ambulatory (ActCode#AMB); type = Consultation</a></p><p>Summary</p><table class="grid"><tr><td>Recorded</td><td>2020-07-10 16:26:23+0000</td></tr></table><p><b>Agents</b></p><table class="grid"><tr><td><b>Type</b></td><td><b>who</b></td></tr><tr><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/provenance-participant-type author}">Author</span></td><td><a href="Organization-ProviderOrg1.html">Organization Provider 1</a></td></tr></table></div>
            </text>
            <target>
              <reference value="Encounter/7-1"/>
            </target>
            <recorded value="2020-07-10T16:26:23.217+00:00"/>
            <agent>
              <type>
                <coding>
                  <system
                          value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/>
                  <code value="author"/>
                  <display value="Author"/>
                </coding>
              </type>
              <who>🔗
                <reference value="Organization/ProviderOrg1"/>
              </who>
            </agent>
            <entity>
              <extension
                         url="http://hl7.org/fhir/us/davinci-pdex/StructureDefinition/ProvenanceSourceFrom">
                <valueCodeableConcept>
                  <coding>
                    <system
                            value="http://hl7.org/fhir/us/davinci-pdex/CodeSystem/ProvenancePayerDataSource"/>
                    <code value="hl7ccda"/>
                    <display value="HL7 C-CDA"/>
                  </coding>
                </valueCodeableConcept>
              </extension>
              <role value="source"/>
              <what>
                <display value="No reference available"/>
              </what>
            </entity>
          </Provenance>
        </resource>
        <response>
          <status value="200"/>
        </response>
      </entry>
      <entry>
        <fullUrl value="https://example.com/base/Provenance/1000004-1"/>
        <resource>
          <Provenance>
            <id value="1000004-1"/>
            <meta>
              <versionId value="1"/>
              <lastUpdated value="2019-12-31T20:26:23.217+00:00"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Provenance_1000004-1"> </a><p class="res-header-id"><b>Generated Narrative: Provenance 1000004-1</b></p><a name="1000004-1"> </a><a name="hc1000004-1"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">version: 1; Last updated: 2019-12-31 20:26:23+0000</p></div><p>Provenance for <a href="Bundle-1000000-1.html">Bundle: type = transaction-response; timestamp = 2019-12-31 20:26:23+0000</a></p><p>Summary</p><table class="grid"><tr><td>Recorded</td><td>2019-12-31 20:26:23+0000</td></tr></table><p><b>Agents</b></p><table class="grid"><tr><td><b>Type</b></td><td><b>Role</b></td><td><b>who</b></td></tr><tr><td><span title="Codes:{http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type transmitter}">Transmitter</span></td><td/><td><a href="Organization-Payer1.html">Organization Payer 1</a></td></tr></table></div>
            </text>
            <target>🔗
              <reference value="Bundle/1000000-1"/>
            </target>
            <recorded value="2019-12-31T20:26:23.217+00:00"/>
            <agent>
              <type>
                <coding>
                  <system
                          value="http://hl7.org/fhir/us/core/CodeSystem/us-core-provenance-participant-type"/>
                  <code value="transmitter"/>
                  <display value="Transmitter"/>
                </coding>
              </type>
              <role>
                <coding>
                  <system
                          value="http://terminology.hl7.org/CodeSystem/contractsignertypecodes"/>
                  <code value="TRANS"/>
                </coding>
              </role>
              <who>🔗
                <reference value="Organization/Payer1"/>
              </who>
            </agent>
          </Provenance>
        </resource>
        <response>
          <status value="200"/>
        </response>
      </entry>
    </Bundle>