Da Vinci Clinical Data Exchange (CDex)
2.1.0 - STU 2.1

Publication Build: This will be filled in by the publication tooling

## Example Task: CDex Task Example 25

Page standards status: Informative

Generated Narrative: Task cdex-task-example25

identifier: Re-Association Tracking Control Number/trackingid1034

status: Completed

intent: order

code: Attachment Request Questionnaire

for: Amy Shaw (no stated gender), DoB: 1987-02-20 ( Patient Account Number: PA-123 (use: usual, ))

authoredOn: 2022-06-17 16:16:06+0000

lastModified: 2022-06-18 16:46:06+0000

requester: Identifier: `http://example.org/cdex/payer/payer-ids`/Payer123

owner: PractitionerRole

reasonCode: preauthorization

reasonReference: Identifier: `http://example.org/cdex/payer/claim-ids`/Preauth123

### Restrictions

- | Period
* | ?? --> 2022-06-21

> input

> PALineNumber: 1

> type: Questionnaire Context

> value: `http://example.org/base_adaptive_questionnaire`

> input

> type: Signature Flag

> value: true

> input

> type: Payer URL

> value: http://example.org/cdex/payer/$submit-attachment

> input

> type: Purpose Of Use

> value: coverage authorization

### Outputs

- | Type | Value[x]
* | Questionnaire Context | Response to Questionnaire '#cdex-adaptive-questionnaire-example1' about '->display: string (PrimitiveType/QuestionnaireResponse.subject.display): element = string -> display=string[Amy Shaw]'

> Generated Narrative: Patient #patient

> Amy Shaw (no stated gender), DoB: 1987-02-20 ( Patient Account Number: PA-123 (use: usual, ))

> Other Id: | Member Number/Member123 (use: usual, )

> Generated Narrative: PractitionerRole #practitionerrole

> practitioner: Identifier: United States National Provider Identifier/9941339100

> organization: Identifier: United States National Provider Identifier/1234567893