Sha256: 22ea15fbbda0968b62bca292e10c5ffe03c8ad3abc27bed6cad3e5b828df8248
Contents?: true
Size: 1.67 KB
Versions: 10
Compression:
Stored size: 1.67 KB
Contents
{
"resourceType": "ClaimResponse",
"id": "R3501",
"identifier": [
{
"system": "http://www.BenefitsInc.com/fhir/remittance",
"value": "R3501"
}
],
"status": "active",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "oral"
}
]
},
"use": "claim",
"patient": {
"reference": "Patient/1"
},
"created": "2014-08-16",
"insurer": {
"identifier": {
"system": "http://www.jurisdiction.org/insurers",
"value": "555123"
}
},
"requestor": {
"reference": "Practitioner/1"
},
"request": {
"reference": "Claim/100156"
},
"outcome": "error",
"disposition": "Claim could not be processed",
"formCode": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/forms-codes",
"code": "2"
}
]
},
"processNote": [
{
"number": 1,
"type": "display",
"text": "Invalid claim",
"language": {
"coding": [
{
"system": "urn:ietf:bcp:47",
"code": "en-CA"
}
]
}
}
],
"communicationRequest": [
{
"reference": "CommunicationRequest/fm-solicit"
}
],
"error": [
{
"itemSequence": 3,
"detailSequence": 2,
"code": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/adjudication-error",
"code": "a002"
}
]
}
}
],
"meta": {
"tag": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
"code": "HTEST",
"display": "test health data"
}
]
}
}
Version data entries
10 entries across 10 versions & 1 rubygems