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

## : Provenance Payer Data Source Format - XML Representation

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

Raw xml | Download

    <CodeSystem xmlns="http://hl7.org/fhir">
      <id value="ProvenancePayerDataSource"/>
      <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: CodeSystem ProvenancePayerDataSource</b></p><a name="ProvenancePayerDataSource"> </a><a name="hcProvenancePayerDataSource"> </a><p>This case-insensitive code system <code>http://hl7.org/fhir/us/davinci-pdex/CodeSystem/ProvenancePayerDataSource</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">hl7v2other<a name="ProvenancePayerDataSource-hl7v2other"> </a></td><td>HL7 v2</td><td>HL7 v2 Message</td></tr><tr><td style="white-space:nowrap">hl7v2oru<a name="ProvenancePayerDataSource-hl7v2oru"> </a></td><td>HL7 v2 ORU</td><td>HL7 v2 Structured Observation Report(ORU) message</td></tr><tr><td style="white-space:nowrap">hl7v2adt<a name="ProvenancePayerDataSource-hl7v2adt"> </a></td><td>HL7 v2 ADT</td><td>HL7 v2 Admit, Discharge Transfer (ADT) message</td></tr><tr><td style="white-space:nowrap">hl7v2r01<a name="ProvenancePayerDataSource-hl7v2r01"> </a></td><td>HL7 v2 R01</td><td>HL7 v2 Observation (R01) message</td></tr><tr><td style="white-space:nowrap">hl7v2rsp<a name="ProvenancePayerDataSource-hl7v2rsp"> </a></td><td>HL7 v2 RSP</td><td>HL7 V2 Immunization Record Response</td></tr><tr><td style="white-space:nowrap">hl7v2orm<a name="ProvenancePayerDataSource-hl7v2orm"> </a></td><td>HL7 v2 ORM</td><td>HL7 v2 Orders</td></tr><tr><td style="white-space:nowrap">hl7v2mdm<a name="ProvenancePayerDataSource-hl7v2mdm"> </a></td><td>HL7 v2 MDM</td><td>Medical Document Management</td></tr><tr><td style="white-space:nowrap">hl7v2vxu<a name="ProvenancePayerDataSource-hl7v2vxu"> </a></td><td>HL7 v2 VXU</td><td>HL7 V2 Immunization Transaction</td></tr><tr><td style="white-space:nowrap">hl7v3<a name="ProvenancePayerDataSource-hl7v3"> </a></td><td>HL7 v3</td><td>HL7 v3 Message</td></tr><tr><td style="white-space:nowrap">hl7ccda<a name="ProvenancePayerDataSource-hl7ccda"> </a></td><td>HL7 C-CDA</td><td>HL7 Consolidated-Clinical Document Architecture</td></tr><tr><td style="white-space:nowrap">hl7cda<a name="ProvenancePayerDataSource-hl7cda"> </a></td><td>HL7 CDA</td><td>HL7 CDA documents that are not C-CDA</td></tr><tr><td style="white-space:nowrap">hl7cdaqrda<a name="ProvenancePayerDataSource-hl7cdaqrda"> </a></td><td>HL7 CDA QRDA</td><td>HL7 Quality Reporting Document</td></tr><tr><td style="white-space:nowrap">hl7fhirdstu2<a name="ProvenancePayerDataSource-hl7fhirdstu2"> </a></td><td>FHIR DSTU2</td><td>HL7 FHIR DSTU2</td></tr><tr><td style="white-space:nowrap">hl7fhirdstu3<a name="ProvenancePayerDataSource-hl7fhirdstu3"> </a></td><td>FHIR STU3</td><td>HL7 FHIR STU3</td></tr><tr><td style="white-space:nowrap">hl7fhirr4<a name="ProvenancePayerDataSource-hl7fhirr4"> </a></td><td>FHIR R4</td><td>HL7 FHIR R4</td></tr><tr><td style="white-space:nowrap">x12837<a name="ProvenancePayerDataSource-x12837"> </a></td><td>837 claim</td><td>X12 837 Claim</td></tr><tr><td style="white-space:nowrap">x12278<a name="ProvenancePayerDataSource-x12278"> </a></td><td>278</td><td>X12 Prior Authorization</td></tr><tr><td style="white-space:nowrap">x12275<a name="ProvenancePayerDataSource-x12275"> </a></td><td>275</td><td>X12 Attachment</td></tr><tr><td style="white-space:nowrap">x12other<a name="ProvenancePayerDataSource-x12other"> </a></td><td>X12</td><td>X12 non-specific transaction</td></tr><tr><td style="white-space:nowrap">script<a name="ProvenancePayerDataSource-script"> </a></td><td>NCPDP SCRIPT</td><td>National Council for Prescription Drug Programs (NCPDP) SCRIPT message (eRx)</td></tr><tr><td style="white-space:nowrap">ncpdp<a name="ProvenancePayerDataSource-ncpdp"> </a></td><td>NCPDP Telecommunication</td><td>NCPDP Telecommunication transaction (pharmacy claims)</td></tr><tr><td style="white-space:nowrap">capture<a name="ProvenancePayerDataSource-capture"> </a></td><td>Direct Capture</td><td>Direct Capture, such as into a payers case management system</td></tr><tr><td style="white-space:nowrap">customtx<a name="ProvenancePayerDataSource-customtx"> </a></td><td>Trading Partner Format</td><td>Trading Partner Proprietary format</td></tr><tr><td style="white-space:nowrap">image<a name="ProvenancePayerDataSource-image"> </a></td><td>Image</td><td>Fax or scanned document</td></tr><tr><td style="white-space:nowrap">unstructured<a name="ProvenancePayerDataSource-unstructured"> </a></td><td>Unstructured Document</td><td>PDF, text and other unstructured document</td></tr><tr><td style="white-space:nowrap">other<a name="ProvenancePayerDataSource-other"> </a></td><td>Other</td><td>Any other document format not specifically defined</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/ProvenancePayerDataSource"/>
      <version value="2.1.1"/>
      <name value="ProvenancePayerDataSource"/>
      <title value="Provenance Payer Data Source Format"/>
      <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="CodeSystem for source formats that identify what non-FHIR source was used to create FHIR record(s)"/>
      <jurisdiction>
        <coding>
          <system value="urn:iso:std:iso:3166"/>
          <code value="US"/>
          <display value="United States of America"/>
        </coding>
      </jurisdiction>
      <copyright
                 value="Used by permission of HL7 International, all rights reserved Creative Commons License"/>
      <caseSensitive value="false"/>
      <content value="complete"/>
      <count value="26"/>
      <concept>
        <code value="hl7v2other"/>
        <display value="HL7 v2"/>
        <definition value="HL7 v2 Message"/>
      </concept>
      <concept>
        <code value="hl7v2oru"/>
        <display value="HL7 v2 ORU"/>
        <definition value="HL7 v2 Structured Observation Report(ORU) message"/>
      </concept>
      <concept>
        <code value="hl7v2adt"/>
        <display value="HL7 v2 ADT"/>
        <definition value="HL7 v2 Admit, Discharge Transfer (ADT) message"/>
      </concept>
      <concept>
        <code value="hl7v2r01"/>
        <display value="HL7 v2 R01"/>
        <definition value="HL7 v2 Observation (R01) message"/>
      </concept>
      <concept>
        <code value="hl7v2rsp"/>
        <display value="HL7 v2 RSP"/>
        <definition value="HL7 V2 Immunization Record Response"/>
      </concept>
      <concept>
        <code value="hl7v2orm"/>
        <display value="HL7 v2 ORM"/>
        <definition value="HL7 v2 Orders"/>
      </concept>
      <concept>
        <code value="hl7v2mdm"/>
        <display value="HL7 v2 MDM"/>
        <definition value="Medical Document Management"/>
      </concept>
      <concept>
        <code value="hl7v2vxu"/>
        <display value="HL7 v2 VXU"/>
        <definition value="HL7 V2 Immunization Transaction"/>
      </concept>
      <concept>
        <code value="hl7v3"/>
        <display value="HL7 v3"/>
        <definition value="HL7 v3 Message"/>
      </concept>
      <concept>
        <code value="hl7ccda"/>
        <display value="HL7 C-CDA"/>
        <definition value="HL7 Consolidated-Clinical Document Architecture"/>
      </concept>
      <concept>
        <code value="hl7cda"/>
        <display value="HL7 CDA"/>
        <definition value="HL7 CDA documents that are not C-CDA"/>
      </concept>
      <concept>
        <code value="hl7cdaqrda"/>
        <display value="HL7 CDA QRDA"/>
        <definition value="HL7 Quality Reporting Document"/>
      </concept>
      <concept>
        <code value="hl7fhirdstu2"/>
        <display value="FHIR DSTU2"/>
        <definition value="HL7 FHIR DSTU2"/>
      </concept>
      <concept>
        <code value="hl7fhirdstu3"/>
        <display value="FHIR STU3"/>
        <definition value="HL7 FHIR STU3"/>
      </concept>
      <concept>
        <code value="hl7fhirr4"/>
        <display value="FHIR R4"/>
        <definition value="HL7 FHIR R4"/>
      </concept>
      <concept>
        <code value="x12837"/>
        <display value="837 claim"/>
        <definition value="X12 837 Claim"/>
      </concept>
      <concept>
        <code value="x12278"/>
        <display value="278"/>
        <definition value="X12 Prior Authorization"/>
      </concept>
      <concept>
        <code value="x12275"/>
        <display value="275"/>
        <definition value="X12 Attachment"/>
      </concept>
      <concept>
        <code value="x12other"/>
        <display value="X12"/>
        <definition value="X12 non-specific transaction"/>
      </concept>
      <concept>
        <code value="script"/>
        <display value="NCPDP SCRIPT"/>
        <definition
                    value="National Council for Prescription Drug Programs (NCPDP) SCRIPT message (eRx)"/>
      </concept>
      <concept>
        <code value="ncpdp"/>
        <display value="NCPDP Telecommunication"/>
        <definition
                    value="NCPDP Telecommunication transaction (pharmacy claims)"/>
      </concept>
      <concept>
        <code value="capture"/>
        <display value="Direct Capture"/>
        <definition
                    value="Direct Capture, such as into a payers case management system"/>
      </concept>
      <concept>
        <code value="customtx"/>
        <display value="Trading Partner Format"/>
        <definition value="Trading Partner Proprietary format"/>
      </concept>
      <concept>
        <code value="image"/>
        <display value="Image"/>
        <definition value="Fax or scanned document"/>
      </concept>
      <concept>
        <code value="unstructured"/>
        <display value="Unstructured Document"/>
        <definition value="PDF, text and other unstructured document"/>
      </concept>
      <concept>
        <code value="other"/>
        <display value="Other"/>
        <definition value="Any other document format not specifically defined"/>
      </concept>
    </CodeSystem>