This is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions
SOA Dental Claim using identifiers and Contained
{
"resourceType" : "Claim",
"id" : "100155",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">This example assumes a national health care scheme where patients, providers and organizations have known business identifiers.</div>"
},
"contained" : [{
"resourceType" : "Patient",
"id" : "patient-1",
"name" : [{
"use" : "official",
"family" : "Donald",
"given" : ["Duck"]
}],
"gender" : "male",
"birthDate" : "1986-05-17",
"address" : [{
"use" : "home",
"line" : ["1234 Main Street"],
"city" : "Vancouver",
"postalCode" : "V2H1Y3",
"country" : "CAD"
}]
}],
"identifier" : [{
"system" : "http://happyvalley.com/claim",
"value" : "12347"
}],
"status" : "active",
"type" : {
"coding" : [{
"system" : "http://terminology.hl7.org/CodeSystem/claim-type",
"code" : "oral"
}]
},
"use" : "claim",
"patient" : {
"reference" : "#patient-1"
},
"created" : "2014-08-16",
"insurer" : {
"identifier" : {
"system" : "http://www.jurisdiction.com/insurers",
"value" : "123456"
}
},
"provider" : {
"identifier" : {
"system" : "http://www.jurisdiction.com/careorganizations",
"value" : "HOSP12345"
}
},
"priority" : {
"coding" : [{
"code" : "normal"
}]
},
"payee" : {
"type" : {
"coding" : [{
"code" : "provider"
}]
}
},
"careTeam" : [{
"sequence" : 1,
"provider" : {
"identifier" : {
"system" : "http://www.jurisdiction.com/providerId",
"value" : "MD98765"
}
}
}],
"diagnosis" : [{
"sequence" : 1,
"diagnosisCodeableConcept" : {
"coding" : [{
"code" : "123456"
}]
}
}],
"insurance" : [{
"sequence" : 1,
"focal" : true,
"coverage" : {
"reference" : "http://www.jurisdiction.com/nationalplan/123AB345"
}
}],
"item" : [{
"sequence" : 1,
"careTeamSequence" : [1],
"productOrService" : {
"coding" : [{
"code" : "1200"
}]
},
"servicedDate" : "2014-08-16",
"unitPrice" : {
"value" : 135.57,
"currency" : "USD"
},
"net" : {
"value" : 135.57,
"currency" : "USD"
}
}]
}
Usage note: every effort has been made to ensure that the
examples are correct and useful, but they are not a normative part
of the specification.