340B FHIR Exchange Implementation Guide - Local Development build (v0.1.0-ballot) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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• XML
• JSON
• TTL

: provenance-001 - XML Representation

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<Provenance xmlns="http://hl7.org/fhir">
  <id value="provenance-001"/>
  <meta>
    <profile
             value="https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-provenance"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Provenance provenance-001</b></p><a name="provenance-001"> </a><a name="hcprovenance-001"> </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-340b-provenance.html">340B Provenance Profile</a></p></div><p>Provenance for <a href="ClaimResponse-claimresponse-example-ruleset.html">ClaimResponse: extension = corr-cb-7721,tx-cb-7721,1.2.0,https://exchange.example.org/manufacturers#mfr-77; identifier = https://exchange.example.org/claimresponse-ids#cr-7721; status = active; type = Pharmacy; use = claim; created = 2026-04-24; outcome = complete</a></p><p>Summary</p><table class="grid"><tr><td>Recorded</td><td>2026-04-24 15:05:00+0000</td></tr></table><p><b>Agents</b></p><table class="grid"><tr><td><b>Type</b></td><td><b>who</b></td></tr><tr><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/provenance-participant-type author}">Author</span></td><td><a href="Organization-manufacturer-77.html">Organization Example Manufacturer 77</a></td></tr></table></div>
  </text>
  <extension
             url="https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-exchange-transaction-id">
    <valueString value="tx-1001"/>
  </extension>
  <extension
             url="https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-rule-set-version">
    <valueString value="1.2.0"/>
  </extension>
  <target>🔗 
    <reference value="ClaimResponse/claimresponse-example-ruleset"/>
  </target>
  <recorded value="2026-04-24T15:05:00Z"/>
  <reason>
    <coding>
      <system
              value="https://exchange.example.org/fhir/ig/340b-exchange/CodeSystem/340b-event-type"/>
      <code value="chargeback-adjudicated"/>
      <display value="Chargeback Adjudicated"/>
    </coding>
  </reason>
  <agent>
    <type>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/provenance-participant-type"/>
        <code value="author"/>
      </coding>
    </type>
    <who>🔗 
      <reference value="Organization/manufacturer-77"/>
    </who>
  </agent>
</Provenance>