Sha256: 2d2d2833c99df84dc76f506ae70418cd18888bd16e48f890073df1ad447fc147
Contents?: true
Size: 1.83 KB
Versions: 10
Compression:
Stored size: 1.83 KB
Contents
<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
<id value="100150"/>
<meta>
<security>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
<code value="HTEST"/>
<display value="test health data"/>
</security>
</meta>
<identifier>
<system value="http://happyvalley.com/claim"/>
<value value="12345"/>
</identifier>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
<code value="oral"/>
</coding>
</type>
<use value="claim"/>
<patient>
<reference value="Patient/1"/>
</patient>
<created value="2014-08-16"/>
<insurer>
<reference value="Organization/2"/>
</insurer>
<provider>
<reference value="Organization/1"/>
</provider>
<priority>
<coding>
<code value="normal"/>
</coding>
</priority>
<payee>
<type>
<coding>
<code value="provider"/>
</coding>
</type>
</payee>
<careTeam>
<sequence value="1"/>
<provider>
<reference value="Practitioner/example"/>
</provider>
</careTeam>
<diagnosis>
<sequence value="1"/>
<diagnosisCodeableConcept>
<coding>
<code value="123456"/>
</coding>
</diagnosisCodeableConcept>
</diagnosis>
<insurance>
<sequence value="1"/>
<focal value="true"/>
<identifier>
<system value="http://happyvalley.com/claim"/>
<value value="12345"/>
</identifier>
<coverage>
<reference value="Coverage/9876B1"/>
</coverage>
</insurance>
<item>
<sequence value="1"/>
<careTeamSequence value="1"/>
<productOrService>
<coding>
<code value="1200"/>
</coding>
</productOrService>
<servicedDate value="2014-08-16"/>
<unitPrice>
<value value="135.57"/>
<currency value="USD"/>
</unitPrice>
<net>
<value value="135.57"/>
<currency value="USD"/>
</net>
</item>
</Claim>
Version data entries
10 entries across 10 versions & 1 rubygems