JSON Format: Claim-cf76f9d5-9f95-44a1-bf11-535df08ee5e2
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Validation results for Claim/cf76f9d5-9f95-44a1-bf11-535df08ee5e2
| Level | Type | Location | Message |
{
"resourceType" : "Claim",
"id" : "cf76f9d5-9f95-44a1-bf11-535df08ee5e2",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: cf76f9d5-9f95-44a1-bf11-535df08ee5e2</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>: Jul 17, 2016, 4:16:44 PM --> Jul 17, 2016, 5:28:44 PM</p><p><b>created</b>: Jul 17, 2016, 5:28:44 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><h3>Diagnoses</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td>*</td><td>1</td><td><a href=\"Condition-d948a4e9-8e90-4742-9b2f-6eb095a66808.html\">Generated Summary: id: d948a4e9-8e90-4742-9b2f-6eb095a66808; <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 162573006}\">Suspected lung cancer (situation)</span>; onset: Jul 17, 2016, 4:16:44 PM; recordedDate: Jul 17, 2016, 4:16:44 PM</a></td></tr></table><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-7ac86c5c-47e4-43e2-b998-6f1201d3d359.html\">Generated Summary: id: 7ac86c5c-47e4-43e2-b998-6f1201d3d359; status: completed; <span title=\"Codes: {http://snomed.info/sct 399208008}\">Plain chest X-ray (procedure)</span>; performed: Jul 17, 2016, 4:16:44 PM --> Jul 17, 2016, 4:28:44 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>: Emergency Room Admission <span style=\"background: LightGoldenRodYellow\">(Details : {SNOMED CT code '50849002' = 'Admission to accident and emergency department', given as 'Emergency Room Admission'})</span></p><p><b>encounter</b>: <a href=\"Encounter-d106c331-92d9-4f8f-9b3a-2ef1d4b9836f.html\">Generated Summary: id: d106c331-92d9-4f8f-9b3a-2ef1d4b9836f; status: finished; <span title=\"{http://terminology.hl7.org/CodeSystem/v3-ActCode EMER}\">emergency</span>; <span title=\"Codes: {http://snomed.info/sct 50849002}\">Emergency Room Admission</span>; period: Jul 17, 2016, 4:16:44 PM --> Jul 17, 2016, 5:28:44 PM; <span title=\"Codes: {http://snomed.info/sct 162573006}\">Suspected lung cancer (situation)</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>: Suspected lung cancer (situation) <span style=\"background: LightGoldenRodYellow\">(Details : {SNOMED CT code '162573006' = 'Suspected lung cancer', given as 'Suspected lung cancer (situation)'})</span></p></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 3</p><p><b>procedureSequence</b>: 1</p><p><b>productOrService</b>: Plain chest X-ray (procedure) <span style=\"background: LightGoldenRodYellow\">(Details : {SNOMED CT code '399208008' = 'Plain chest X-ray (procedure)', given as 'Plain chest X-ray (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" : "2016-07-17T16:16:44-07:00",
"end" : "2016-07-17T17:28:44-07:00"
},
"created" : "2016-07-17T17:28:44-07:00",
"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/d948a4e9-8e90-4742-9b2f-6eb095a66808"
}
}
],
"procedure" : [
{
"sequence" : 1,
"procedureReference" : {
"reference" : "Procedure/7ac86c5c-47e4-43e2-b998-6f1201d3d359"
}
}
],
"insurance" : [
{
"sequence" : 1,
"focal" : true,
"coverage" : {
"display" : "Medicare"
}
}
],
"item" : [
{
"sequence" : 1,
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "50849002",
"display" : "Emergency Room Admission"
}
],
"text" : "Emergency Room Admission"
},
"encounter" : [
{
"reference" : "Encounter/d106c331-92d9-4f8f-9b3a-2ef1d4b9836f"
}
]
},
{
"sequence" : 2,
"diagnosisSequence" : [
1
],
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "162573006",
"display" : "Suspected lung cancer (situation)"
}
],
"text" : "Suspected lung cancer (situation)"
}
},
{
"sequence" : 3,
"procedureSequence" : [
1
],
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "399208008",
"display" : "Plain chest X-ray (procedure)"
}
],
"text" : "Plain chest X-ray (procedure)"
},
"net" : {
"value" : 14463.05,
"currency" : "USD"
}
}
],
"total" : {
"value" : 129.16,
"currency" : "USD"
}
}
