{ "resourceType": "Claim", "id": "960150", "text": { "status": "generated", "div": "
A human-readable rendering of the Claim
" }, "identifier": [ { "system": "http://happyhospital.com/claim", "value": "9612345" } ], "status": "active", "type": { "coding": [ { "system": "http://hl7.org/fhir/ex-claimtype", "code": "institutional" } ] }, "use": "complete", "patient": { "reference": "Patient/1" }, "created": "2014-08-16", "enterer": { "identifier": { "system": "http://jurisdiction.org/facilities/HOSP1234/users", "value": "UC1234" } }, "insurer": { "reference": "Organization/2" }, "organization": { "reference": "Organization/1" }, "priority": { "coding": [ { "code": "normal" } ] }, "payee": { "type": { "coding": [ { "code": "provider" } ] } }, "facility": { "identifier": { "system": "http://jurisdiction.org/facilities", "value": "HOSP1234" } }, "careTeam": [ { "sequence": 1, "provider": { "reference": "Practitioner/example" } } ], "diagnosis": [ { "sequence": 1, "diagnosisCodeableConcept": { "coding": [ { "code": "654456" } ] } } ], "insurance": [ { "sequence": 1, "focal": true, "coverage": { "reference": "Coverage/9876B1" } } ], "item": [ { "sequence": 1, "careTeamLinkId": [ 1 ], "service": { "coding": [ { "system": "http://hl7.org/fhir/ex-serviceproduct", "code": "exam" } ] }, "servicedDate": "2014-08-16", "unitPrice": { "value": 125.00, "system": "urn:iso:std:iso:4217", "code": "USD" }, "net": { "value": 125.00, "system": "urn:iso:std:iso:4217", "code": "USD" } } ], "total": { "value": 125.00, "system": "urn:iso:std:iso:4217", "code": "USD" } }