QI-Core Implementation Guide
4.1.0 - release

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## Example Claim: Claim example

Generated Narrative

Resource "example"

Profile: QICoreClaim

identifier: id: 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

- | Type | Party
* | Provider (ClaimPayeeTypeCodes#provider) | Practitioner/example " CAREFUL"

### CareTeams

- | Sequence | Provider
* | 1 | Practitioner/example " CAREFUL"

### Diagnoses

- | Sequence | Diagnosis[x]
* | 1 | 654321 (CodeSystem#654321)

### Insurances

- | Sequence | Focal | Coverage
* | 1 | true | Coverage/example

> item

> sequence: 1

> careTeamSequence: 1

> productOrService: glasses (ex-visionservice#glasses)

> serviced: 2014-08-16

> > detail

> > sequence: 1

> > productOrService: frame (ex-visionservice#frame)

> > detail

> > sequence: 2

> > productOrService: lens (ex-visionservice#lens)

> > quantity: 2

> > detail

> > sequence: 3

> > productOrService: fst (ex-visionservice#fst)

> > factor: 0.07