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JSON Format: Claim-b9206284-2148-4c9d-923f-fe5e82d1d0e2

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Validation results for Claim/b9206284-2148-4c9d-923f-fe5e82d1d0e2

LevelTypeLocationMessage
{
  "resourceType" : "Claim",
  "id" : "b9206284-2148-4c9d-923f-fe5e82d1d0e2",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: b9206284-2148-4c9d-923f-fe5e82d1d0e2</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>: Oct 8, 2018, 4:16:44 PM --&gt; Oct 9, 2018, 5:16:44 PM</p><p><b>created</b>: Oct 9, 2018, 5:16:44 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>prescription</b>: <a href=\"MedicationRequest-14634a77-45a9-4c47-aa7d-cbabb4ff1e8b.html\">Generated Summary: id: 14634a77-45a9-4c47-aa7d-cbabb4ff1e8b; status: stopped; intent: order; <span title=\"Codes: {http://www.nlm.nih.gov/research/umls/rxnorm 1736854}\">Cisplatin 50 MG Injection</span>; authoredOn: Oct 8, 2018, 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-2ad27a59-1b6f-4e4b-be0f-055d52a486d4.html\">Generated Summary: id: 2ad27a59-1b6f-4e4b-be0f-055d52a486d4; 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: Oct 8, 2018, 4:16:44 PM --&gt; Oct 9, 2018, 5:16:44 PM</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" : "2018-10-08T16:16:44-07:00",
    "end" : "2018-10-09T17:16:44-07:00"
  },
  "created" : "2018-10-09T17:16:44-07:00",
  "provider" : {
    "reference" : "Organization/18f774ab-db01-37ba-95c4-44c4eab47089",
    "display" : "Quincy Outpatient Clinic"
  },
  "priority" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
        "code" : "normal"
      }
    ]
  },
  "prescription" : {
    "reference" : "MedicationRequest/14634a77-45a9-4c47-aa7d-cbabb4ff1e8b"
  },
  "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/2ad27a59-1b6f-4e4b-be0f-055d52a486d4"
        }
      ]
    }
  ],
  "total" : {
    "value" : 454.89,
    "currency" : "USD"
  }
}