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Validation results for Claim/2dee64df-d1dd-4ddb-aaf3-aa43c0250905
| Level | Type | Location | Message |
{
"resourceType" : "Claim",
"id" : "2dee64df-d1dd-4ddb-aaf3-aa43c0250905",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 2dee64df-d1dd-4ddb-aaf3-aa43c0250905</p><p><b>status</b>: active</p><p><b>type</b>: Institutional <span style=\"background: LightGoldenRodYellow\">(Details : {http://terminology.hl7.org/CodeSystem/claim-type code 'institutional' = 'Institutional)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: <a href=\"Patient-3ab28624-a549-4cb9-a32e-99e3c2c41129.html\">Jose871 Cruickshank494. Generated Summary: id: 3ab28624-a549-4cb9-a32e-99e3c2c41129; 52fb90a7-9e4f-4140-8c3c-c8afbbb3fbf9, Medical Record Number = 52fb90a7-9e4f-4140-8c3c-c8afbbb3fbf9, Social Security Number = 999-96-5270, Driver's License = S99943652, Passport Number = X37948891X; Jose871 Cruickshank494 (OFFICIAL); ph: 555-170-1696(HOME); gender: male; birthDate: Feb 20, 1940; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}\">M</span>; </a></p><p><b>billablePeriod</b>: Sep 7, 2010, 4:16:44 PM --> Sep 7, 2010, 4:46:44 PM</p><p><b>created</b>: Sep 7, 2010, 4:46:44 PM</p><p><b>provider</b>: <a href=\"Organization-18f774ab-db01-37ba-95c4-44c4eab47089.html\">Quincy Outpatient Clinic. Generated Summary: id: 18f774ab-db01-37ba-95c4-44c4eab47089; 18f774ab-db01-37ba-95c4-44c4eab47089; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: Quincy Outpatient Clinic; ph: 800-865-3384</a></p><p><b>priority</b>: Normal <span style=\"background: LightGoldenRodYellow\">(Details : {http://terminology.hl7.org/CodeSystem/processpriority code 'normal' = 'Normal)</span></p><p><b>facility</b>: <a href=\"Location-7653e0ab-0566-4083-95d8-c695e4735e53.html\">Quincy Outpatient Clinic. Generated Summary: id: 7653e0ab-0566-4083-95d8-c695e4735e53; status: active; name: Quincy Outpatient Clinic; ph: 800-865-3384</a></p><h3>SupportingInfos</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>1</td><td>Information <span style=\"background: LightGoldenRodYellow\">(Details : {http://terminology.hl7.org/CodeSystem/claiminformationcategory code 'info' = 'Information)</span></td><td><a href=\"Immunization-0a89058b-47e2-4b7f-aa0a-8de970a3bac3.html\">Generated Summary: id: 0a89058b-47e2-4b7f-aa0a-8de970a3bac3; status: completed; <span title=\"Codes: {http://hl7.org/fhir/sid/cvx 140}\">Influenza, seasonal, injectable, preservative free</span>; occurrence: Sep 7, 2010, 4:16:44 PM; primarySource</a></td></tr></table><h3>Diagnoses</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td>*</td><td>1</td><td><a href=\"Condition-14561089-c20d-495a-a0b8-5e03fc7b96ec.html\">Generated Summary: id: 14561089-c20d-495a-a0b8-5e03fc7b96ec; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/condition-clinical active}\">Active</span>; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/condition-ver-status confirmed}\">Confirmed</span>; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/condition-category encounter-diagnosis}\">Encounter Diagnosis</span>; <span title=\"Codes: {http://snomed.info/sct 49436004}\">Atrial Fibrillation</span>; onset: Sep 7, 2010, 4:16:44 PM; recordedDate: Sep 7, 2010, 4:16:44 PM</a></td></tr></table><h3>Procedures</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Procedure[x]</b></td></tr><tr><td>*</td><td>1</td><td><a href=\"Procedure-5d47b60b-1d73-45be-8d98-b44c1b63d537.html\">Generated Summary: id: 5d47b60b-1d73-45be-8d98-b44c1b63d537; status: completed; <span title=\"Codes: {http://snomed.info/sct 180325003}\">Electrical cardioversion</span>; performed: Sep 7, 2010, 4:16:44 PM --> Sep 7, 2010, 4:31:44 PM</a></td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td>*</td><td>1</td><td>true</td><td>Medicare</td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: Encounter for check up (procedure) <span style=\"background: LightGoldenRodYellow\">(Details : {SNOMED CT code '185349003' = 'Encounter for check up (procedure)', given as 'Encounter for check up (procedure)'})</span></p><p><b>encounter</b>: <a href=\"Encounter-b8c2cf6a-a35c-408b-84ac-dfa2443fe907.html\">Generated Summary: id: b8c2cf6a-a35c-408b-84ac-dfa2443fe907; status: finished; <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}\">ambulatory</span>; <span title=\"Codes: {http://snomed.info/sct 185349003}\">Encounter for check up (procedure)</span>; period: Sep 7, 2010, 4:16:44 PM --> Sep 7, 2010, 4:46:44 PM</a></p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>diagnosisSequence</b>: 1</p><p><b>productOrService</b>: Atrial Fibrillation <span style=\"background: LightGoldenRodYellow\">(Details : {SNOMED CT code '49436004' = 'AF - Atrial fibrillation', given as 'Atrial Fibrillation'})</span></p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 3</p><p><b>procedureSequence</b>: 1</p><p><b>productOrService</b>: Electrical cardioversion <span style=\"background: LightGoldenRodYellow\">(Details : {SNOMED CT code '180325003' = 'Electrical cardioversion', given as 'Electrical cardioversion'})</span></p><p><b>net</b>: </p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 4</p><p><b>informationSequence</b>: 1</p><p><b>productOrService</b>: Influenza, seasonal, injectable, preservative free <span style=\"background: LightGoldenRodYellow\">(Details : {http://hl7.org/fhir/sid/cvx code '140' = 'Influenza, seasonal, injectable, preservative free', given as 'Influenza, seasonal, injectable, preservative free'})</span></p><p><b>net</b>: </p></blockquote><p><b>total</b>: </p></div>"
},
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claim-type",
"code" : "institutional"
}
]
},
"use" : "claim",
"patient" : {
"reference" : "Patient/3ab28624-a549-4cb9-a32e-99e3c2c41129",
"display" : "Jose871 Cruickshank494"
},
"billablePeriod" : {
"start" : "2010-09-07T16:16:44-07:00",
"end" : "2010-09-07T16:46:44-07:00"
},
"created" : "2010-09-07T16:46:44-07:00",
"provider" : {
"reference" : "Organization/18f774ab-db01-37ba-95c4-44c4eab47089",
"display" : "Quincy Outpatient Clinic"
},
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/processpriority",
"code" : "normal"
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},
"facility" : {
"reference" : "Location/7653e0ab-0566-4083-95d8-c695e4735e53",
"display" : "Quincy Outpatient Clinic"
},
"supportingInfo" : [
{
"sequence" : 1,
"category" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
"code" : "info"
}
]
},
"valueReference" : {
"reference" : "Immunization/0a89058b-47e2-4b7f-aa0a-8de970a3bac3"
}
}
],
"diagnosis" : [
{
"sequence" : 1,
"diagnosisReference" : {
"reference" : "Condition/14561089-c20d-495a-a0b8-5e03fc7b96ec"
}
}
],
"procedure" : [
{
"sequence" : 1,
"procedureReference" : {
"reference" : "Procedure/5d47b60b-1d73-45be-8d98-b44c1b63d537"
}
}
],
"insurance" : [
{
"sequence" : 1,
"focal" : true,
"coverage" : {
"display" : "Medicare"
}
}
],
"item" : [
{
"sequence" : 1,
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "185349003",
"display" : "Encounter for check up (procedure)"
}
],
"text" : "Encounter for check up (procedure)"
},
"encounter" : [
{
"reference" : "Encounter/b8c2cf6a-a35c-408b-84ac-dfa2443fe907"
}
]
},
{
"sequence" : 2,
"diagnosisSequence" : [
1
],
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "49436004",
"display" : "Atrial Fibrillation"
}
],
"text" : "Atrial Fibrillation"
}
},
{
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"procedureSequence" : [
1
],
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "180325003",
"display" : "Electrical cardioversion"
}
],
"text" : "Electrical cardioversion"
},
"net" : {
"value" : 35020.91,
"currency" : "USD"
}
},
{
"sequence" : 4,
"informationSequence" : [
1
],
"productOrService" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/sid/cvx",
"code" : "140",
"display" : "Influenza, seasonal, injectable, preservative free"
}
],
"text" : "Influenza, seasonal, injectable, preservative free"
},
"net" : {
"value" : 140.52,
"currency" : "USD"
}
}
],
"total" : {
"value" : 129.16,
"currency" : "USD"
}
}
