Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions
Page standards status: Informative |
Generated Narrative: Claim PCT-GFE-Institutional-MRI
identifier: Placer Identifier/GFEProviderAssignedID0001MRI
status: Active
type: Institutional
use: Predetermination
patient: Eve Betterhalf Female, DoB: 1955-07-23 ( http://example.com/identifiers/patient#1001)
created: 2022-02-02
insurer: Organization Umbrella Insurance Company
provider: Organization GFE Service Help INC.
priority: Normal
Type |
Provider |
referral: Referral Number
Sequence | Category | Code |
1 | Type of Bill | example-bill-type |
Sequence | Diagnosis[x] | Type | PackageCode |
1 | Unspecified focal traumatic brain injury | Principal Diagnosis | Head trauma - concussion |
item
sequence: 1
revenue: Magnetic Resonance Technology (MRT) - Brain/brain stem
productOrService: Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material
serviced: 2022-02-02
quantity: 1
Nets
Value Currency 266 United States dollar
Value | Currency |
266 | United States dollar |