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

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## : CDex Task Example 25 - XML Representation

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    <Task xmlns="http://hl7.org/fhir">
      <id value="cdex-task-example25"/>
      <text>
        <status value="extensions"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Task cdex-task-example25</b></p><a name="cdex-task-example25"> </a><a name="hccdex-task-example25"> </a><a name="cdex-task-example25-en-US"> </a><p><b>identifier</b>: Re-Association Tracking Control Number/trackingid1034</p><p><b>status</b>: Completed</p><p><b>intent</b>: order</p><p><b>code</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes attachment-request-questionnaire}">Attachment Request Questionnaire</span></p><p><b>for</b>: <a href="#hccdex-task-example25/patient">Amy Shaw  (no stated gender), DoB: 1987-02-20 ( Patient Account Number: PA-123 (use: usual, ))</a></p><p><b>authoredOn</b>: 2022-06-17 16:16:06+0000</p><p><b>lastModified</b>: 2022-06-18 16:46:06+0000</p><p><b>requester</b>: Identifier: <code>http://example.org/cdex/payer/payer-ids</code>/Payer123</p><p><b>owner</b>: <a href="#hccdex-task-example25/practitionerrole">PractitionerRole</a></p><p><b>reasonCode</b>: <span title="Codes:{http://hl7.org/fhir/claim-use preauthorization}">preauthorization</span></p><p><b>reasonReference</b>: Identifier: <code>http://example.org/cdex/payer/claim-ids</code>/Preauth123</p><h3>Restrictions</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Period</b></td></tr><tr><td style="display: none">*</td><td>?? --&gt; 2022-06-21</td></tr></table><blockquote><p><b>input</b></p><p><b>PALineNumber</b>: 1</p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes questionnaire-context}">Questionnaire Context</span></p><p><b>value</b>: <code>http://example.org/base_adaptive_questionnaire</code></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp signature-flag}">Signature Flag</span></p><p><b>value</b>: true</p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes payer-url}">Payer URL</span></p><p><b>value</b>: <a href="http://example.org/cdex/payer/$submit-attachment">http://example.org/cdex/payer/$submit-attachment</a></p></blockquote><blockquote><p><b>input</b></p><p><b>type</b>: <span title="Codes:{http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp purpose-of-use}">Purpose Of Use</span></p><p><b>value</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ActReason COVAUTH}">coverage authorization</span></p></blockquote><h3>Outputs</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes questionnaire-context}">Questionnaire Context</span></td><td><a href="QuestionnaireResponse-cdex-questionnaireresponse-example2.html">Response to Questionnaire '#cdex-adaptive-questionnaire-example1' about '-&gt;display: string (PrimitiveType/QuestionnaireResponse.subject.display): element = string -&gt; display=string[Amy Shaw]'</a></td></tr></table><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Patient #patient</b></p><a name="cdex-task-example25/patient"> </a><a name="hccdex-task-example25/patient"> </a><a name="cdex-task-example25/patient-en-US"> </a><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Amy Shaw  (no stated gender), DoB: 1987-02-20 ( Patient Account Number: PA-123 (use: usual, ))</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Other Id (see the one above)">Other Id:</td><td colspan="3">Member Number/Member123 (use: usual, )</td></tr></table></blockquote><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: PractitionerRole #practitionerrole</b></p><a name="cdex-task-example25/practitionerrole"> </a><a name="hccdex-task-example25/practitionerrole"> </a><a name="cdex-task-example25/practitionerrole-en-US"> </a><p><b>practitioner</b>: Identifier: <a href="http://terminology.hl7.org/5.3.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/9941339100</p><p><b>organization</b>: Identifier: <a href="http://terminology.hl7.org/5.3.0/NamingSystem-npi.html" title="National Provider Identifier">United States National Provider Identifier</a>/1234567893</p></blockquote></div>
      </text>
      <contained>
        <Patient>
          <id value="patient"/>
          <identifier>
            <use value="usual"/>
            <type>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
                <code value="MB"/>
                <display value="Member Number"/>
              </coding>
              <text value="Member Number"/>
            </type>
            <system value="http://example.org/cdex/payer/member-ids"/>
            <value value="Member123"/>
          </identifier>
          <identifier>
            <use value="usual"/>
            <type>
              <coding>
                <system
                        value="http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType"/>
                <code value="pat"/>
                <display value="Patient Account Number"/>
              </coding>
              <text value="Patient Account Number"/>
            </type>
            <system value="http://example.org/cdex/provider/patient-ids"/>
            <value value="PA-123"/>
          </identifier>
          <name>
            <family value="Shaw"/>
            <given value="Amy"/>
          </name>
          <birthDate value="1987-02-20"/>
        </Patient>
      </contained>
      <contained>
        <PractitionerRole>
          <id value="practitionerrole"/>
          <practitioner>
            <identifier>
              <system value="http://hl7.org/fhir/sid/us-npi"/>
              <value value="9941339100"/>
            </identifier>
          </practitioner>
          <organization>
            <identifier>
              <system value="http://hl7.org/fhir/sid/us-npi"/>
              <value value="1234567893"/>
            </identifier>
          </organization>
        </PractitionerRole>
      </contained>
      <identifier>
        <type>
          <coding>
            <system
                    value="http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"/>
            <code value="tracking-id"/>
            <display value="Tracking Id"/>
          </coding>
          <text value="Re-Association Tracking Control Number"/>
        </type>
        <system value="http://example.org/payer"/>
        <value value="trackingid1034"/>
      </identifier>
      <status value="completed"/>
      <intent value="order"/>
      <code>
        <coding>
          <system
                  value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
          <code value="attachment-request-questionnaire"/>
        </coding>
        <text value="Attachment Request Questionnaire"/>
      </code>
      <for>
        <reference value="#patient"/>
      </for>
      <authoredOn value="2022-06-17T16:16:06Z"/>
      <lastModified value="2022-06-18T16:46:06Z"/>
      <requester>
        <identifier>
          <system value="http://example.org/cdex/payer/payer-ids"/>
          <value value="Payer123"/>
        </identifier>
      </requester>
      <owner>
        <reference value="#practitionerrole"/>
      </owner>
      <reasonCode>
        <coding>
          <system value="http://hl7.org/fhir/claim-use"/>
          <code value="preauthorization"/>
          <display value="Preauthorization"/>
        </coding>
        <text value="preauthorization"/>
      </reasonCode>
      <reasonReference>
        <identifier>
          <system value="http://example.org/cdex/payer/claim-ids"/>
          <value value="Preauth123"/>
        </identifier>
      </reasonReference>
      <restriction>
        <period>
          <end value="2022-06-21"/>
        </period>
      </restriction>
      <input>
        <extension
                   url="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-paLineNumber">
          <valueInteger value="1"/>
        </extension>
        <type>
          <coding>
            <system
                    value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
            <code value="questionnaire-context"/>
          </coding>
        </type>
        <valueCanonical value="http://example.org/base_adaptive_questionnaire"/>
      </input>
      <input>
        <type>
          <coding>
            <system
                    value="http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"/>
            <code value="signature-flag"/>
          </coding>
        </type>
        <valueBoolean value="true"/>
      </input>
      <input>
        <type>
          <coding>
            <system
                    value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
            <code value="payer-url"/>
          </coding>
        </type>
        <valueUrl value="http://example.org/cdex/payer/$submit-attachment"/>
      </input>
      <input>
        <type>
          <coding>
            <system
                    value="http://hl7.org/fhir/us/davinci-cdex/CodeSystem/cdex-temp"/>
            <code value="purpose-of-use"/>
          </coding>
        </type>
        <valueCodeableConcept>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
            <code value="COVAUTH"/>
            <display value="coverage authorization"/>
          </coding>
        </valueCodeableConcept>
      </input>
      <output>
        <type>
          <coding>
            <system
                    value="http://hl7.org/fhir/us/davinci-pas/CodeSystem/PASTempCodes"/>
            <code value="questionnaire-context"/>
          </coding>
        </type>
        <valueReference>🔗
          <reference
                     value="QuestionnaireResponse/cdex-questionnaireresponse-example2"/>
        </valueReference>
      </output>
    </Task>