Sha256: c8f8acfa5ed3f1147ba6f7cf9a757bc604747b00f3aee75150454bd0f3d33c6a
Contents?: true
Size: 1.81 KB
Versions: 7
Compression:
Stored size: 1.81 KB
Contents
{
"resourceType": "Claim",
"id": "100154",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">This example assumes a national health care scheme where patients, providers and organizations have known business identifiers.</div>"
},
"identifier": [
{
"system": "http://happyvalley.com/claim",
"value": "12347"
}
],
"status": "active",
"type": {
"system": "http://hl7.org/fhir/ex-claimtype",
"code": "oral"
},
"created": "2014-08-16",
"insurerIdentifier": {
"system": "http://www.jurisdiction.com/insurers",
"value": "123456"
},
"organizationIdentifier": {
"system": "http://www.jurisdiction.com/careorganizations",
"value": "HOSP12345"
},
"use": "complete",
"priority": {
"code": "normal"
},
"payee": {
"type": {
"code": "provider"
}
},
"diagnosis": [
{
"sequence": 1,
"diagnosis": {
"code": "123456"
}
}
],
"patientIdentifier": {
"system": "http://www.jurisdiction.com/nationalId",
"value": "123AB345"
},
"coverage": [
{
"sequence": 1,
"focal": true,
"coverageIdentifier": {
"system": "http://www.jurisdiction.com/nationalplan",
"value": "123AB345"
}
}
],
"item": [
{
"sequence": 1,
"careTeam": [
{
"providerIdentifier": {
"system": "http://www.jurisdiction.com/providerId",
"value": "MD98765"
}
}
],
"service": {
"code": "1200"
},
"servicedDate": "2014-08-16",
"unitPrice": {
"value": 135.57,
"system": "urn:iso:std:iso:4217",
"code": "USD"
},
"net": {
"value": 135.57,
"system": "urn:iso:std:iso:4217",
"code": "USD"
}
}
]
}
Version data entries
7 entries across 7 versions & 1 rubygems