Tanzania FHIR Facade Implementation Guide
0.1.0 - ci-build Tanzania

Tanzania FHIR Facade Implementation Guide, published by Ministry of Health – Tanzania. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Speedykom/tz-fhir-ig/ and changes regularly. See the Directory of published versions

: zhsf-claim-submission - XML Representation

Raw xml | Download


<Claim xmlns="http://hl7.org/fhir">
  <id value="zhsf-claim-submission"/>
  <meta>
    <profile value="http://moh.tz/fhir/StructureDefinition/tz-claim"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Claim zhsf-claim-submission</b></p><a name="zhsf-claim-submission"> </a><a name="hczhsf-claim-submission"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-tz-claim.html">Tanzania Claim Profile</a></p></div><p><b>identifier</b>: <code>http://moh.tz/fhir/claim-submission-no</code>/S900978360112</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/claim-type professional}">Professional</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: Identifier: <code>http://moh.tz/fhir/card-no</code>/10100000000</p><p><b>created</b>: 0001-01-01 00:00:00+0000</p><p><b>insurer</b>: Identifier: <code>http://moh.tz/fhir/organization</code>/ZHSF</p><p><b>facility</b>: Identifier: <code>http://moh.tz/fhir/facility</code>/06697</p><h3>SupportingInfos</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td>1</td><td><span title="Codes:">Remarks</span></td><td>Claim Received Successfully</td></tr></table><h3>Insurances</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style="display: none">*</td><td>1</td><td>true</td><td>Identifier: <code>http://moh.tz/fhir/scheme-id</code>/1001</td></tr></table><h3>Totals</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>40000.00</td><td>Tanzanian shilling</td></tr></table></div>
  </text>
  <identifier>
    <system value="http://moh.tz/fhir/claim-submission-no"/>
    <value value="S900978360112"/>
  </identifier>
  <status value="active"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
      <code value="professional"/>
    </coding>
  </type>
  <use value="claim"/>
  <patient>
    <identifier>
      <system value="http://moh.tz/fhir/card-no"/>
      <value value="10100000000"/>
    </identifier>
  </patient>
  <created value="0001-01-01T00:00:00Z"/>
  <insurer>
    <identifier>
      <system value="http://moh.tz/fhir/organization"/>
      <value value="ZHSF"/>
    </identifier>
  </insurer>
  <facility>
    <identifier>
      <system value="http://moh.tz/fhir/facility"/>
      <value value="06697"/>
    </identifier>
  </facility>
  <supportingInfo>
    <sequence value="1"/>
    <category>
      <text value="Remarks"/>
    </category>
    <valueString value="Claim Received Successfully"/>
  </supportingInfo>
  <insurance>
    <sequence value="1"/>
    <focal value="true"/>
    <coverage>
      <identifier>
        <system value="http://moh.tz/fhir/scheme-id"/>
        <value value="1001"/>
      </identifier>
    </coverage>
  </insurance>
  <total>
    <value value="40000.00"/>
    <currency value="TZS"/>
  </total>
</Claim>