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

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## : CDex Inline Task Example 22 - XML Representation

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    <Task xmlns="http://hl7.org/fhir">
      <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="trackingid1012"/>
      </identifier>
      <status value="requested"/>
      <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="2022-06-17T16:16:06Z"/>
      <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/cdex-questionnaire-example1"/>
      </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>
    </Task>