Sha256: dc9721912349ea72ed4470af5e7a541588397fa075b2742816f5a76a604735d7
Contents?: true
Size: 1.79 KB
Versions: 7
Compression:
Stored size: 1.79 KB
Contents
<?xml version="1.0" encoding="UTF-8"?><Claim xmlns="http://hl7.org/fhir">
<id value="660150"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the Vision Claim</div>
</text>
<identifier>
<system value="http://happysight.com/claim"/>
<value value="6612345"/>
</identifier>
<status value="active"/>
<type>
<system value="http://hl7.org/fhir/ex-claimtype"/>
<code value="vision"/>
</type>
<created value="2014-08-16"/>
<insurerReference>
<reference value="Organization/2"/>
</insurerReference>
<organizationReference>
<reference value="Organization/1"/>
</organizationReference>
<use value="complete"/>
<priority>
<code value="normal"/>
</priority>
<payee>
<type>
<code value="provider"/>
</type>
</payee>
<diagnosis>
<sequence value="1"/>
<diagnosis>
<code value="654321"/>
</diagnosis>
</diagnosis>
<patientReference>
<reference value="Patient/1"/>
</patientReference>
<coverage>
<sequence value="1"/>
<focal value="true"/>
<coverageReference>
<reference value="Coverage/9876B1"/>
</coverageReference>
</coverage>
<item>
<sequence value="1"/>
<!-- type>
<code value="service"/>
</type -->
<careTeam>
<providerReference>
<reference value="Practitioner/example"/>
</providerReference>
</careTeam>
<service>
<system value="http://hl7.org/fhir/ex-visionservice"/>
<code value="exam"/>
</service>
<servicedDate value="2014-08-16"/>
<unitPrice>
<value value="80.00"/>
<system value="urn:iso:std:iso:4217"/>
<code value="USD"/>
</unitPrice>
<net>
<value value="80.00"/>
<system value="urn:iso:std:iso:4217"/>
<code value="USD"/>
</net>
</item>
</Claim>
Version data entries
7 entries across 7 versions & 1 rubygems