Claim/79237e11-dba2-4e25-9ced-ede0694d835b
Validation Results
Level | Type | Location | Message |
Narrative View
Generated Narrative with Details
id: 79237e11-dba2-4e25-9ced-ede0694d835b
status: active
type: Institutional (Details : {http://terminology.hl7.org/CodeSystem/claim-type code 'institutional' = 'Institutional)
use: claim
billablePeriod: Oct 2, 2012, 4:16:44 PM --> Oct 2, 2012, 4:46:44 PM
created: Oct 2, 2012, 4:46:44 PM
priority: Normal (Details : {http://terminology.hl7.org/CodeSystem/processpriority code 'normal' = 'Normal)
SupportingInfos
- | Sequence | Category | Value[x] |
* | 1 | Information (Details : {http://terminology.hl7.org/CodeSystem/claiminformationcategory code 'info' = 'Information) | Generated Summary: id: cee083d0-960e-4112-878e-cd4199fa0e47; status: completed; Influenza, seasonal, injectable, preservative free; occurrence: Oct 2, 2012, 4:16:44 PM; primarySource |
procedure
sequence: 1
procedure
sequence: 2
Insurances
- | Sequence | Focal | Coverage |
* | 1 | true | Medicare |
item
sequence: 1
productOrService: Encounter for check up (procedure) (Details : {SNOMED CT code '185349003' = 'Encounter for check up (procedure)', given as 'Encounter for check up (procedure)'})
item
sequence: 2
procedureSequence: 1
productOrService: Catheter ablation of tissue of heart (Details : {SNOMED CT code '18286008' = 'Catheter ablation of tissue of heart', given as 'Catheter ablation of tissue of heart'})
net:
item
sequence: 3
informationSequence: 1
productOrService: Influenza, seasonal, injectable, preservative free (Details : {http://hl7.org/fhir/sid/cvx code '140' = 'Influenza, seasonal, injectable, preservative free', given as 'Influenza, seasonal, injectable, preservative free'})
net:
item
sequence: 4
procedureSequence: 2
productOrService: Medication Reconciliation (procedure) (Details : {SNOMED CT code '430193006' = 'Medication Reconciliation (procedure)', given as 'Medication Reconciliation (procedure)'})
net:
total: