QI-Core Implementation Guide
8.0.0-ballot - STU 8 - ballot

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 8.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/fhir-qi-core/ and changes regularly. See the Directory of published versions

## Example ClaimResponse: ClaimResponse example

Page standards status: Informative

Language: en

Profile: QICore ClaimResponse

status: Active

type: Vision

use: Preauthorization

patient: Jim Chalmers Male, DoB: 1974-12-25 ( Medical record number (use: usual, period: 2001-05-06 --> (ongoing)))

created: 2018-02-24

insurer: Organization Health Level Seven International

requestor: Practitioner Adam Careful

request: Claim: identifier = http://example.org/claim#6612346; status = active; type = Vision; use = claim; created = 2014-08-16; priority = Normal

outcome: Queued

> item

> itemSequence: 1

> > adjudication

> > category: Submitted Amount

> > ### Amounts

> > - | Value | Currency
> > * | 235.40 | United States dollar