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
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
Type | Party |
Provider (Payee Type Codes#provider) | Practitioner/example " CAREFUL" |
Sequence | Provider |
1 | Practitioner/example " CAREFUL" |
Sequence | Diagnosis[x] |
1 | H44.23 (icd-10-cm#H44.23) |
Sequence | Focal | Coverage |
1 | true | Coverage/example |
item
sequence: 1
careTeamSequence: 1
productOrService: glasses (ex-visionservice#glasses)
serviced: 2014-08-16
UnitPrices
Value Currency 214.00 USD detail
sequence: 1
productOrService: frame (ex-visionservice#frame)
UnitPrices
Value Currency 100.00 USD Nets
Value Currency 100.00 USD detail
sequence: 2
productOrService: lens (ex-visionservice#lens)
quantity: 2
UnitPrices
Value Currency 50.00 USD Nets
Value Currency 100.00 USD detail
sequence: 3
productOrService: fst (ex-visionservice#fst)
UnitPrices
Value Currency 200.00 USD factor: 0.07
Nets
Value Currency 14.00 USD