JSON Format: Claim-851973f5-2695-4f3c-846e-86a845111166
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Validation results for Claim/851973f5-2695-4f3c-846e-86a845111166
Level | Type | Location | Message |
{ "resourceType" : "Claim", "id" : "851973f5-2695-4f3c-846e-86a845111166", "text" : { "status" : "generated", "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: 851973f5-2695-4f3c-846e-86a845111166</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>: Dec 31, 2017, 3:16:44 PM --> Jan 1, 2018, 6:16:44 PM</p><p><b>created</b>: Jan 1, 2018, 6:16:44 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>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-615e830f-7da2-4d8c-b500-0fc5c6349235.html\">Generated Summary: id: 615e830f-7da2-4d8c-b500-0fc5c6349235; status: completed; <span title=\"Codes: {http://snomed.info/sct 703423002}\">Combined chemotherapy and radiation therapy (procedure)</span>; performed: Dec 31, 2017, 3:16:44 PM --> Dec 31, 2017, 6:16:44 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 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-e4d82889-8740-471c-b887-908add363ebe.html\">Generated Summary: id: e4d82889-8740-471c-b887-908add363ebe; status: finished; <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode IMP}\">inpatient encounter</span>; <span title=\"Codes: {http://snomed.info/sct 185347001}\">Encounter for problem</span>; period: Dec 31, 2017, 3:16:44 PM --> Jan 1, 2018, 6:16:44 PM</a></p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>procedureSequence</b>: 1</p><p><b>productOrService</b>: Combined chemotherapy and radiation therapy (procedure) <span style=\"background: LightGoldenRodYellow\">(Details : {SNOMED CT code '703423002' = 'Combined chemotherapy and radiation therapy (procedure)', given as 'Combined chemotherapy and radiation therapy (procedure)'})</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" : "2017-12-31T15:16:44-08:00", "end" : "2018-01-01T18:16:44-08:00" }, "created" : "2018-01-01T18:16:44-08:00", "provider" : { "reference" : "Organization/18f774ab-db01-37ba-95c4-44c4eab47089", "display" : "Quincy Outpatient Clinic" }, "priority" : { "coding" : [ { "system" : "http://terminology.hl7.org/CodeSystem/processpriority", "code" : "normal" } ] }, "facility" : { "reference" : "Location/7653e0ab-0566-4083-95d8-c695e4735e53", "display" : "Quincy Outpatient Clinic" }, "procedure" : [ { "sequence" : 1, "procedureReference" : { "reference" : "Procedure/615e830f-7da2-4d8c-b500-0fc5c6349235" } } ], "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/e4d82889-8740-471c-b887-908add363ebe" } ] }, { "sequence" : 2, "procedureSequence" : [ 1 ], "productOrService" : { "coding" : [ { "system" : "http://snomed.info/sct", "code" : "703423002", "display" : "Combined chemotherapy and radiation therapy (procedure)" } ], "text" : "Combined chemotherapy and radiation therapy (procedure)" }, "net" : { "value" : 16784.6, "currency" : "USD" } } ], "total" : { "value" : 129.16, "currency" : "USD" } }