QI-Core Implementation Guide
6.0.0 - STU6 United States of America flag

QI-Core Implementation Guide, published by HL7 International / Clinical Quality Information. This guide is not an authorized publication; it is the continuous build for version 6.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

Example Claim: Claim example

Generated Narrative: Claim

Resource Claim "example"

Profile: QICore Claim

identifier: http://happysight.com/claim/6612346

status: active

type: Vision (Claim Type Codes#vision)

use: claim

patient: Patient/example " CHALMERS"

created: 2014-08-16

insurer: Organization/example "Health Level Seven International"

provider: Practitioner/example " CAREFUL"

priority: Normal (Process Priority Codes#normal)

prescription: MedicationRequest/example

Payees

-TypeParty
*Provider (Payee Type Codes#provider)Practitioner/example " CAREFUL"

CareTeams

-SequenceProvider
*1Practitioner/example " CAREFUL"

Diagnoses

-SequenceDiagnosis[x]
*1H44.23 (icd-10-cm#H44.23)

Insurances

-SequenceFocalCoverage
*1trueCoverage/example

item

sequence: 1

careTeamSequence: 1

productOrService: glasses (ex-visionservice#glasses)

serviced: 2014-08-16

UnitPrices

-ValueCurrency
*214.00USD

detail

sequence: 1

productOrService: frame (ex-visionservice#frame)

UnitPrices

-ValueCurrency
*100.00USD

Nets

-ValueCurrency
*100.00USD

detail

sequence: 2

productOrService: lens (ex-visionservice#lens)

quantity: 2

UnitPrices

-ValueCurrency
*50.00USD

Nets

-ValueCurrency
*100.00USD

detail

sequence: 3

productOrService: fst (ex-visionservice#fst)

UnitPrices

-ValueCurrency
*200.00USD

factor: 0.07

Nets

-ValueCurrency
*14.00USD