Da Vinci Prior Authorization Support (PAS) FHIR IG
2.2.0-ballot - STU 2.2 - Ballot

Da Vinci Prior Authorization Support (PAS) FHIR IG, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.2.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pas/ and changes regularly. See the Directory of published versions

## : Submit Claim Requestor Example - XML Representation

Page standards status: Informative

Raw xml | Download

    <Organization xmlns="http://hl7.org/fhir">
      <id value="UMOExample"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-requestor"/>
      </meta>
      <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Organization UMOExample</b></p><a name="UMOExample"> </a><a name="hcUMOExample"> </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"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-profile-requestor.html">PAS Requestor Organization</a></p></div><p><b>identifier</b>: <a href="http://terminology.hl7.org/6.2.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/8189991234</p><p><b>active</b>: true</p><p><b>type</b>: <span title="Codes:{https://codesystem.x12.org/005010/98 X3}">X3</span></p><p><b>name</b>: DR. JOE SMITH CORPORATION</p><p><b>address</b>: 111 1ST STREET SAN DIEGO CA 92101 US </p></div>
      </text>
      <identifier>
        <system value="http://hl7.org/fhir/sid/us-npi"/>
        <value value="8189991234"/>
      </identifier>
      <active value="true"/>
      <type>
        <coding>
          <system value="https://codesystem.x12.org/005010/98"/>
          <code value="X3"/>
        </coding>
      </type>
      <name value="DR. JOE SMITH CORPORATION"/>
      <address>
        <line value="111 1ST STREET"/>
        <city value="SAN DIEGO"/>
        <state value="CA"/>
        <postalCode value="92101"/>
        <country value="US"/>
      </address>
    </Organization>