JSON Format: Claim-33dafab0-de6d-489f-b4a4-f0f1c1941d3a
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Validation results for Claim/33dafab0-de6d-489f-b4a4-f0f1c1941d3a
| Level | Type | Location | Message |
{
"resourceType" : "Claim",
"id" : "33dafab0-de6d-489f-b4a4-f0f1c1941d3a",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 33dafab0-de6d-489f-b4a4-f0f1c1941d3a</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>: Jun 3, 2008, 4:16:44 PM --> Jun 3, 2008, 8:31:44 PM</p><p><b>created</b>: Jun 3, 2008, 8:31:44 PM</p><p><b>provider</b>: <a href=\"Organization-27379046-608b-32f0-9df7-8c833cf5d11d.html\">BRIGHAM AND WOMEN'S HOSPITAL. Generated Summary: id: 27379046-608b-32f0-9df7-8c833cf5d11d; 27379046-608b-32f0-9df7-8c833cf5d11d; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span>; name: BRIGHAM AND WOMEN'S HOSPITAL; ph: 6177325500</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-a615098b-6b1a-4437-a7c7-fa2eaa6969f6.html\">BRIGHAM AND WOMEN'S HOSPITAL. Generated Summary: id: a615098b-6b1a-4437-a7c7-fa2eaa6969f6; status: active; name: BRIGHAM AND WOMEN'S HOSPITAL; ph: 6177325500</a></p><blockquote><p><b>diagnosis</b></p><p><b>sequence</b>: 1</p><p><b>diagnosis</b>: <a href=\"Condition-4409c5ff-4625-4a96-a118-9e002a1b4165.html\">Generated Summary: id: 4409c5ff-4625-4a96-a118-9e002a1b4165; <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 126906006}\">Neoplasm of prostate</span>; onset: Jun 3, 2008, 4:16:44 PM; recordedDate: Jun 3, 2008, 4:16:44 PM</a></p></blockquote><blockquote><p><b>diagnosis</b></p><p><b>sequence</b>: 2</p><p><b>diagnosis</b>: <a href=\"Condition-c5f49c33-574f-476c-ab02-6c97942c82e8.html\">Generated Summary: id: c5f49c33-574f-476c-ab02-6c97942c82e8; <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 92691004}\">Carcinoma in situ of prostate (disorder)</span>; onset: Jun 3, 2008, 4:16:44 PM; recordedDate: Jun 3, 2008, 4:16:44 PM</a></p></blockquote><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 problem <span style=\"background: LightGoldenRodYellow\">(Details : {SNOMED CT code '185347001' = 'Encounter for problem', given as 'Encounter for problem'})</span></p><p><b>encounter</b>: <a href=\"Encounter-28d35dc3-d8c3-4b41-85c3-8b552b3501da.html\">Generated Summary: id: 28d35dc3-d8c3-4b41-85c3-8b552b3501da; status: finished; <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode AMB}\">ambulatory</span>; <span title=\"Codes: {http://snomed.info/sct 185347001}\">Encounter for problem</span>; period: Jun 3, 2008, 4:16:44 PM --> Jun 3, 2008, 8:31:44 PM; <span title=\"Codes: {http://snomed.info/sct 126906006}\">Neoplasm of prostate</span></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>: Neoplasm of prostate <span style=\"background: LightGoldenRodYellow\">(Details : {SNOMED CT code '126906006' = 'Tumor of prostate', given as 'Neoplasm of prostate'})</span></p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 3</p><p><b>diagnosisSequence</b>: 2</p><p><b>productOrService</b>: Carcinoma in situ of prostate (disorder) <span style=\"background: LightGoldenRodYellow\">(Details : {SNOMED CT code '92691004' = 'Carcinoma in situ of prostate', given as 'Carcinoma in situ of prostate (disorder)'})</span></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" : "2008-06-03T16:16:44-07:00",
"end" : "2008-06-03T20:31:44-07:00"
},
"created" : "2008-06-03T20:31:44-07:00",
"provider" : {
"reference" : "Organization/27379046-608b-32f0-9df7-8c833cf5d11d",
"display" : "BRIGHAM AND WOMEN'S HOSPITAL"
},
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/processpriority",
"code" : "normal"
}
]
},
"facility" : {
"reference" : "Location/a615098b-6b1a-4437-a7c7-fa2eaa6969f6",
"display" : "BRIGHAM AND WOMEN'S HOSPITAL"
},
"diagnosis" : [
{
"sequence" : 1,
"diagnosisReference" : {
"reference" : "Condition/4409c5ff-4625-4a96-a118-9e002a1b4165"
}
},
{
"sequence" : 2,
"diagnosisReference" : {
"reference" : "Condition/c5f49c33-574f-476c-ab02-6c97942c82e8"
}
}
],
"insurance" : [
{
"sequence" : 1,
"focal" : true,
"coverage" : {
"display" : "Medicare"
}
}
],
"item" : [
{
"sequence" : 1,
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "185347001",
"display" : "Encounter for problem"
}
],
"text" : "Encounter for problem"
},
"encounter" : [
{
"reference" : "Encounter/28d35dc3-d8c3-4b41-85c3-8b552b3501da"
}
]
},
{
"sequence" : 2,
"diagnosisSequence" : [
1
],
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "126906006",
"display" : "Neoplasm of prostate"
}
],
"text" : "Neoplasm of prostate"
}
},
{
"sequence" : 3,
"diagnosisSequence" : [
2
],
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "92691004",
"display" : "Carcinoma in situ of prostate (disorder)"
}
],
"text" : "Carcinoma in situ of prostate (disorder)"
}
}
],
"total" : {
"value" : 129.16,
"currency" : "USD"
}
}
