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

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: example-zhsf-claimsubmission-parameters - XML Representation

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<Parameters xmlns="http://hl7.org/fhir">
  <id value="example-zhsf-claimsubmission-parameters"/>
  <parameter>
    <name value="source"/>
    <resource>
      <Basic>
        <id value="example-zhsf-claimsubmission"/>
        <meta>
          <profile
                   value="http://moh.tz/fhir/StructureDefinition/zhsf-claim-submission-payload"/>
        </meta>
        <extension
                   url="http://moh.tz/fhir/StructureDefinition/zhsf-claim-submission-payload#SubmissionID">
          <valueString value="ba8f5352-55a9-4518-b804-4b84b3cf96f3"/>
        </extension>
        <extension
                   url="http://moh.tz/fhir/StructureDefinition/zhsf-claim-submission-payload#SubmissionNo">
          <valueString value="S900978360112"/>
        </extension>
        <extension
                   url="http://moh.tz/fhir/StructureDefinition/zhsf-claim-submission-payload#FacilityCode">
          <valueString value="06697"/>
        </extension>
        <extension
                   url="http://moh.tz/fhir/StructureDefinition/zhsf-claim-submission-payload#ClaimYear">
          <valueInteger value="2021"/>
        </extension>
        <extension
                   url="http://moh.tz/fhir/StructureDefinition/zhsf-claim-submission-payload#ClaimMonth">
          <valueInteger value="10"/>
        </extension>
        <extension
                   url="http://moh.tz/fhir/StructureDefinition/zhsf-claim-submission-payload#CardNo">
          <valueString value="10100000000"/>
        </extension>
        <extension
                   url="http://moh.tz/fhir/StructureDefinition/zhsf-claim-submission-payload#AuthorizationNo">
          <valueString value="951811257499"/>
        </extension>
        <extension
                   url="http://moh.tz/fhir/StructureDefinition/zhsf-claim-submission-payload#AmountClaimed">
          <valueString value="40000.00"/>
        </extension>
        <extension
                   url="http://moh.tz/fhir/StructureDefinition/zhsf-claim-submission-payload#Remarks">
          <valueString value="Claim Received Successfully"/>
        </extension>
        <code>
          <coding>
            <system value="http://moh.tz/fhir/example-type"/>
            <code value="ZHSFClaimSubmissionPayload"/>
            <display value="Example ZHSF Claim Submission Logical Model"/>
          </coding>
        </code>
      </Basic>
    </resource>
  </parameter>
</Parameters>