changes.mady.by.user Faris Ahmetasevic
Saved on Jul 06, 2020
...
{ "resourceType": "Claim", "billablePeriod": { "end": "2019-05-13", "start": "2019-05-13" }, "created": "2019-05-14", "diagnosis": [ { "diagnosisReference": { "reference": "Condition/A03" }, "sequence": 1, "type": [ { "coding": [ { "code": "icd_0" } ] } ] }, { "diagnosisReference": { "reference": "Condition/A01" }, "sequence": 2, "type": [ { "coding": [ { "code": "icd_1" } ] } ] }, { "diagnosisReference": { "reference": "Condition/A02" }, "sequence": 3, "type": [ { "coding": [ { "code": "icd_2" } ] } ] } ], "enterer": { "reference": "Practitioner/BC32112F-9DF2-4F46-AD5D-97727E07CBD7" }, "facility": { "reference": "HealthcareService/50E9ABD9-A826-4071-BFED-F731F5FAFB55" }, "id": "6F6062DB-F912-4FC9-B659-BA9D0032EF99", "identifier": [ { "type": { "coding": [ { "code": "UUID", "system": "https://hl7.org/fhir/valueset-identifier-type.html" } ] }, "use": "usual", "value": "6F6062DB-F912-4FC9-B659-BA9D0032EF99" }, { "type": { "coding": [ { "code": "MR", "system": "https://hl7.org/fhir/valueset-identifier-type.html" } ] }, "use": "usual", "value": "chs123" } ], "item": [ { "category": { "text": "item" }, "extension": [ { "url": "Medication", "valueReference": { "reference": "Medication/6b4175c6a3b57fc3-73f8beb2-43ff4919-9ec58856-c9f1fa4a32b63f79c9598610" } } ], "productOrService": { "text": "0002" }, "quantity": { "value": 1.0 }, "sequence": 1, "unitPrice": { "currency": "$", "value": 1000.0 } }, { "category": { "text": "item" }, "extension": [ { "url": "Medication", "valueReference": { "reference": "Medication/fd94dd67332fe61c-7450ba2f-40c245b9-988ab253-9e930d0895a5811a5c3c630c" } } ], "productOrService": { "text": "0002" }, "quantity": { "value": 1.0 }, "sequence": 2, "unitPrice": { "currency": "$", "value": 1000.0 } }, { "category": { "text": "item" }, "extension": [ { "url": "Medication", "valueReference": { "reference": "Medication/e2a343f10a7584c2-7f66cf5a-46624e56-b94ba2db-d26c6a651ca78d2f841bd558" } } ], "productOrService": { "text": "0002" }, "quantity": { "value": 1.0 }, "sequence": 3, "unitPrice": { "currency": "$", "value": 1000.0 } }, { "category": { "text": "service" }, "extension": [ { "url": "ActivityDefinition", "valueReference": { "reference": "ActivityDefinition/ce56189ad7e14f69-0a8c5c4b-4c504c4c-a8d4a700-6c9456504b13b7efdc998e97" } } ], "productOrService": { "text": "M4" }, "quantity": { "value": 1.0 }, "sequence": 4, "unitPrice": { "currency": "$", "value": 21000.0 } }, { "category": { "text": "service" }, "extension": [ { "url": "ActivityDefinition", "valueReference": { "reference": "ActivityDefinition/9dc0a4d11700b0ea-ba32ad73-437e493d-84ab9622-fae2ae4e409e15c65e633cb7" } } ], "productOrService": { "text": "M3" }, "quantity": { "value": 1.0 }, "sequence": 5, "unitPrice": { "currency": "$", "value": 21000.0 } }, { "category": { "text": "service" }, "extension": [ { "url": "ActivityDefinition", "valueReference": { "reference": "ActivityDefinition/da2bf3a0f02ae94f-f3b1f423-45dc4feb-95faaffb-7221e38b9a52f580ead1b798" } } ], "productOrService": { "text": "M6" }, "quantity": { "value": 1.0 }, "sequence": 6, "unitPrice": { "currency": "$", "value": 21000.0 } }, { "category": { "text": "service" }, "extension": [ { "url": "ActivityDefinition", "valueReference": { "reference": "ActivityDefinition/49582feaa1d2862c-ac718d97-41164122-b6738b95-1742215984cceaebab064388" } } ], "productOrService": { "text": "M2" }, "quantity": { "value": 1.0 }, "sequence": 7, "unitPrice": { "currency": "$", "value": 21000.0 } } ], "patient": { "reference": "Patient/F2EC72C9-7489-45AA-95C5-30D79216E74F" }, "supportingInfo": [ { "category": { "text": "guarantee_id" }, "sequence": 1, "valueString": "sdasdasd" }, { "category": { "text": "explanation" }, "sequence": 2, "valueString": "asdasdasd" } ], "total": { "currency": "$", "value": 87000.0 }, "type": { "text": "E" } }