Sha256: ac4483b6d451057f0d16597ba27ff68783ae80bb6ff0dbcf4dd65ecc6e2a2a43
Contents?: true
Size: 1.85 KB
Versions: 15
Compression:
Stored size: 1.85 KB
Contents
<?xml version="1.0" encoding="UTF-8"?><Claim xmlns="http://hl7.org/fhir">
<id value="100150"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the Oral Health Claim</div>
</text>
<identifier>
<system value="http://happyvalley.com/claim"/>
<value value="12345"/>
</identifier>
<status value="active"/>
<type>
<coding>
<system value="http://hl7.org/fhir/ex-claimtype"/>
<code value="oral"/>
</coding>
</type>
<use value="complete"/>
<patient>
<reference value="Patient/1"/>
</patient>
<created value="2014-08-16"/>
<insurer>
<reference value="Organization/2"/>
</insurer>
<organization>
<reference value="Organization/1"/>
</organization>
<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"/>
<coverage>
<reference value="Coverage/9876B1"/>
</coverage>
</insurance>
<item>
<sequence value="1"/>
<careTeamLinkId value="1"/>
<service>
<coding>
<code value="1200"/>
</coding>
</service>
<servicedDate value="2014-08-16"/>
<unitPrice>
<value value="135.57"/>
<system value="urn:iso:std:iso:4217"/>
<code value="USD"/>
</unitPrice>
<net>
<value value="135.57"/>
<system value="urn:iso:std:iso:4217"/>
<code value="USD"/>
</net>
</item>
</Claim>
Version data entries
15 entries across 15 versions & 3 rubygems