US Core R4 Validator Implementation Guide CI Build

JSON Format: Claim-a7220bdb-76ad-4c00-9760-f1a2038f8bd2

Download Raw json

Validation results for Claim/a7220bdb-76ad-4c00-9760-f1a2038f8bd2

LevelTypeLocationMessage
{
  "resourceType" : "Claim",
  "id" : "a7220bdb-76ad-4c00-9760-f1a2038f8bd2",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: a7220bdb-76ad-4c00-9760-f1a2038f8bd2</p><p><b>status</b>: active</p><p><b>type</b>: Pharmacy <span style=\"background: LightGoldenRodYellow\">(Details : {http://terminology.hl7.org/CodeSystem/claim-type code 'pharmacy' = 'Pharmacy)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: <a href=\"Patient-3ab28624-a549-4cb9-a32e-99e3c2c41129.html\">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 --&gt; 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>prescription</b>: <a href=\"MedicationRequest-0aeaedc2-2371-4129-981e-ce51c0d730ee.html\">Generated Summary: id: 0aeaedc2-2371-4129-981e-ce51c0d730ee; status: active; intent: order; <span title=\"Codes: {http://www.nlm.nih.gov/research/umls/rxnorm 752899}\">0.25 ML Leuprolide Acetate 30 MG/ML Prefilled Syringe</span>; authoredOn: Jun 3, 2008, 4:16:44 PM</a></p><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><h3>Items</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>ProductOrService</b></td><td><b>Encounter</b></td></tr><tr><td>*</td><td>1</td><td>Encounter for problem <span style=\"background: LightGoldenRodYellow\">(Details : {SNOMED CT code '185347001' = 'Encounter for problem', given as 'Encounter for problem'})</span></td><td><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 --&gt; Jun 3, 2008, 8:31:44 PM; <span title=\"Codes: {http://snomed.info/sct 126906006}\">Neoplasm of prostate</span></a></td></tr></table><p><b>total</b>: </p></div>"
  },
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
        "code" : "pharmacy"
      }
    ]
  },
  "use" : "claim",
  "patient" : {
    "reference" : "Patient/3ab28624-a549-4cb9-a32e-99e3c2c41129"
  },
  "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"
      }
    ]
  },
  "prescription" : {
    "reference" : "MedicationRequest/0aeaedc2-2371-4129-981e-ce51c0d730ee"
  },
  "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"
        }
      ]
    }
  ],
  "total" : {
    "value" : 263.49,
    "currency" : "USD"
  }
}