Patient Cost Transparency Implementation Guide
2.0.0-ballot - STU 2 Ballot
Patient Cost Transparency Implementation Guide
2.0.0-ballot - STU 2 Ballot
Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions
| Page standards status: Informative |
Generated Narrative: Claim PCT-GFE-Professional-MRI
ProviderEventMethodology: EEMM1022
GFEServiceLinkingInfo
- linkingIdentifier: 223452-2342-2435-008001
- plannedPeriodOfService: 2021-10-31
identifier: Placer Identifier/GFEProviderAssignedID0002
status: Active
type: Professional
use: Predetermination
patient: Eve Betterhalf Female, DoB: 1955-07-23 ( http://example.com/identifiers/patient#1001)
created: 2021-10-05
insurer: Organization Umbrella Insurance Company
provider: Practitioner Nora Ologist
priority: Normal
| Type |
| Provider |
referral: Referral Number
| Sequence | Diagnosis[x] | Type | PackageCode |
| 1 | Unspecified focal traumatic brain injury | Principal Diagnosis | Head trauma - concussion |
| Sequence | Focal | Coverage |
| 1 | true | Coverage: extension = insurance,false; status = active; subscriberId = PFP123450000; relationship = Self; period = 2021-01-01 --> 2022-01-01 |
item
Service Description: Imaging
GFEBillingProviderLineItemCtrlNum: GFEBillingProviderLineItemCtrlNum-0001
sequence: 1
productOrService: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material
modifier: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material
serviced: 2021-10-31
location: Inpatient Hospital
quantity: 1
UnitPrices
Value Currency 200 United States dollar Nets
Value Currency 200 United States dollar
| Value | Currency |
| 200 | United States dollar |
IG © 2023+ HL7 International / Financial Management. Package hl7.fhir.us.davinci-pct#2.0.0-ballot based on FHIR 4.0.1. Generated 2024-11-20
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| Version History |
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