0.1.0 - ci-build

kenyaClaimsIG - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Example Claim - XML Representation

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<Claim xmlns="http://hl7.org/fhir">
  <id value="ClaimProfileExample"/>
  <meta>
    <profile
             value="https://shr.tiberbuapps.com/fhir/StructureDefinition/ClaimProfile"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Claim ClaimProfileExample</b></p><a name="ClaimProfileExample"> </a><a name="hcClaimProfileExample"> </a><a name="ClaimProfileExample-en-US"> </a><p><b>identifier</b>: <code>http://example.org/fhir/claims</code>/123456</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/claim-type institutional}">Institutional</span></p><p><b>subType</b>: <span title="Codes:{http://example.org/fhir/claim-subtypes emergency}">emergency</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: <a href="Patient-SHAPatientExample.html">Eliud Kipchoge Kiptun Male, DoB: 1984-11-05 ( Unique Patient Identifier: 123456 (use: official, ))</a></p><p><b>billablePeriod</b>: 2023-01-01 --&gt; 2023-01-31</p><p><b>created</b>: 2023-02-01</p><p><b>insurer</b>: <a href="Organization-SHAOrganizationExample.html">Organization Kenyatta National Hospital</a></p><p><b>provider</b>: <a href="Practitioner-PractitionerExample.html">Practitioner John Doe </a></p><p><b>priority</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}">Normal</span></p><h3>Relateds</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Claim</b></td><td><b>Relationship</b></td></tr><tr><td style="display: none">*</td><td><a href="Claim-ClaimExample.html">Claim: status = active; type = Professional; use = claim; created = 2020-06-15; priority = Normal</a></td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/ex-claimrelationship associated}">associated</span></td></tr></table><p><b>prescription</b>: <a href="MedicationRequest-MedicationRequestExample.html">MedicationRequest: status = active; intent = order; medication[x] = -&gt;Medication Codeine phosphate</a></p><p><b>originalPrescription</b>: <a href="MedicationRequest-MedicationRequestExample.html">MedicationRequest: status = active; intent = order; medication[x] = -&gt;Medication Codeine phosphate</a></p><h3>Payees</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/payeetype provider}">Provider</span></td></tr></table><p><b>referral</b>: <a href="ServiceRequest-ServiceRequestExample.html">ServiceRequest: status = active; intent = order</a></p><p><b>facility</b>: <a href="Location-LocationExample.html">Location Kenya Medical Research Institute</a></p><h3>CareTeams</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>Provider</b></td><td><b>Role</b></td></tr><tr><td style="display: none">*</td><td>1</td><td><a href="Practitioner-PractitionerExample.html">Practitioner John Doe </a></td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/claimcareteamrole primary}">Primary provider</span></td></tr></table><h3>SupportingInfos</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>Code</b></td><td><b>Timing[x]</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td>1</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/claiminformationcategory info}">Information</span></td><td><span title="Codes:{http://example.org/fhir/supporting-info additional-info}">additional-info</span></td><td>2023-01-15</td><td>Supporting information value</td></tr></table><h3>Diagnoses</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td><td><b>Type</b></td></tr><tr><td style="display: none">*</td><td>1</td><td><span title="Codes:{http://hl7.org/fhir/sid/icd-10 I}">DIAG-1a</span></td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/diagnosis-type principal}">principal</span></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><td><b>ClaimResponse</b></td></tr><tr><td style="display: none">*</td><td>1</td><td>true</td><td><a href="CoverageExample">CoverageExample</a></td><td><a href="ClaimResponse-ClaimResponseExample.html">ClaimResponse: status = active; type = Professional; use = claim; created = 2020-06-15; outcome = complete</a></td></tr></table><h3>Accidents</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Date</b></td><td><b>Type</b></td><td><b>Location[x]</b></td></tr><tr><td style="display: none">*</td><td>2023-01-20</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ActIncidentCode MVA}">MVA</span></td><td>1234 Elm Street, Somewhere, ST 12345</td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: <span title="Codes:{http://example.org/fhir/item-codes exam}">exam</span></p><p><b>serviced</b>: 2023-01-21</p><p><b>quantity</b>: 1</p><h3>UnitPrices</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td></tr><tr><td style="display: none">*</td><td>100</td></tr></table><h3>Nets</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td></tr><tr><td style="display: none">*</td><td>100</td></tr></table><p><b>udi</b>: <a href="Device-DeviceExample.html">Device: status = active</a></p><p><b>bodySite</b>: <span title="Codes:{http://example.org/fhir/bodysites forehead}">forehead</span></p><p><b>subSite</b>: <span title="Codes:{http://example.org/fhir/subsites left}">left</span></p><blockquote><p><b>detail</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: <span title="Codes:{http://example.org/fhir/item-detail-codes service}">service</span></p><p><b>quantity</b>: 1</p><h3>UnitPrices</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td></tr><tr><td style="display: none">*</td><td>50</td></tr></table><h3>Nets</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td></tr><tr><td style="display: none">*</td><td>50</td></tr></table><p><b>udi</b>: <a href="Device-DeviceExample.html">Device: status = active</a></p><blockquote><p><b>subDetail</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: <span title="Codes:{http://example.org/fhir/billings Billing}">Billing</span></p><p><b>quantity</b>: 1</p><h3>UnitPrices</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td></tr><tr><td style="display: none">*</td><td>25</td></tr></table><h3>Nets</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td></tr><tr><td style="display: none">*</td><td>25</td></tr></table><p><b>udi</b>: <a href="Device-DeviceExample.html">Device: status = active</a></p></blockquote></blockquote></blockquote><h3>Totals</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td></tr><tr><td style="display: none">*</td><td>175</td></tr></table></div>
  </text>
  <identifier>
    <system value="http://example.org/fhir/claims"/>
    <value value="123456"/>
  </identifier>
  <status value="active"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
      <code value="institutional"/>
    </coding>
  </type>
  <subType>
    <coding>
      <system value="http://example.org/fhir/claim-subtypes"/>
      <code value="emergency"/>
    </coding>
  </subType>
  <use value="claim"/>
  <patient>🔗 
    <reference value="Patient/SHAPatientExample"/>
  </patient>
  <billablePeriod>
    <start value="2023-01-01"/>
    <end value="2023-01-31"/>
  </billablePeriod>
  <created value="2023-02-01"/>
  <insurer>🔗 
    <reference value="Organization/SHAOrganizationExample"/>
  </insurer>
  <provider>🔗 
    <reference value="Practitioner/PractitionerExample"/>
  </provider>
  <priority>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/processpriority"/>
      <code value="normal"/>
    </coding>
  </priority>
  <related>
    <claim>🔗 
      <reference value="Claim/ClaimExample"/>
    </claim>
    <relationship>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/ex-claimrelationship"/>
        <code value="associated"/>
      </coding>
    </relationship>
  </related>
  <prescription>🔗 
    <reference value="MedicationRequest/MedicationRequestExample"/>
  </prescription>
  <originalPrescription>🔗 
    <reference value="MedicationRequest/MedicationRequestExample"/>
  </originalPrescription>
  <payee>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/payeetype"/>
        <code value="provider"/>
      </coding>
    </type>
  </payee>
  <referral>🔗 
    <reference value="ServiceRequest/ServiceRequestExample"/>
  </referral>
  <facility>🔗 
    <reference value="Location/LocationExample"/>
  </facility>
  <careTeam>
    <sequence value="1"/>
    <provider>🔗 
      <reference value="Practitioner/PractitionerExample"/>
    </provider>
    <role>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/claimcareteamrole"/>
        <code value="primary"/>
      </coding>
    </role>
  </careTeam>
  <supportingInfo>
    <sequence value="1"/>
    <category>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/claiminformationcategory"/>
        <code value="info"/>
      </coding>
    </category>
    <code>
      <coding>
        <system value="http://example.org/fhir/supporting-info"/>
        <code value="additional-info"/>
      </coding>
    </code>
    <timingDate value="2023-01-15"/>
    <valueString value="Supporting information value"/>
  </supportingInfo>
  <diagnosis>
    <sequence value="1"/>
    <diagnosisCodeableConcept>
      <coding>
        <system value="http://hl7.org/fhir/sid/icd-10"/>
        <code value="I"/>
        <display value="Certain infectious and parasitic diseases"/>
      </coding>
      <text value="DIAG-1a"/>
    </diagnosisCodeableConcept>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/diagnosis-type"/>
        <code value="principal"/>
      </coding>
    </type>
  </diagnosis>
  <insurance>
    <sequence value="1"/>
    <focal value="true"/>
    <coverage>
      <reference value="CoverageExample"/>
    </coverage>
    <claimResponse>🔗 
      <reference value="ClaimResponse/ClaimResponseExample"/>
    </claimResponse>
  </insurance>
  <accident>
    <date value="2023-01-20"/>
    <type>
      <coding>
        <system
                value="http://terminology.hl7.org/CodeSystem/v3-ActIncidentCode"/>
        <code value="MVA"/>
      </coding>
    </type>
    <locationAddress>
      <text value="1234 Elm Street, Somewhere, ST 12345"/>
    </locationAddress>
  </accident>
  <item>
    <sequence value="1"/>
    <productOrService>
      <coding>
        <system value="http://example.org/fhir/item-codes"/>
        <code value="exam"/>
      </coding>
    </productOrService>
    <servicedDate value="2023-01-21"/>
    <quantity>
      <value value="1"/>
    </quantity>
    <unitPrice>
      <value value="100"/>
    </unitPrice>
    <net>
      <value value="100"/>
    </net>
    <udi>🔗 
      <reference value="Device/DeviceExample"/>
    </udi>
    <bodySite>
      <coding>
        <system value="http://example.org/fhir/bodysites"/>
        <code value="forehead"/>
      </coding>
    </bodySite>
    <subSite>
      <coding>
        <system value="http://example.org/fhir/subsites"/>
        <code value="left"/>
      </coding>
    </subSite>
    <detail>
      <sequence value="1"/>
      <productOrService>
        <coding>
          <system value="http://example.org/fhir/item-detail-codes"/>
          <code value="service"/>
        </coding>
      </productOrService>
      <quantity>
        <value value="1"/>
      </quantity>
      <unitPrice>
        <value value="50"/>
      </unitPrice>
      <net>
        <value value="50"/>
      </net>
      <udi>🔗 
        <reference value="Device/DeviceExample"/>
      </udi>
      <subDetail>
        <sequence value="1"/>
        <productOrService>
          <coding>
            <system value="http://example.org/fhir/billings"/>
            <code value="Billing"/>
          </coding>
        </productOrService>
        <quantity>
          <value value="1"/>
        </quantity>
        <unitPrice>
          <value value="25"/>
        </unitPrice>
        <net>
          <value value="25"/>
        </net>
        <udi>🔗 
          <reference value="Device/DeviceExample"/>
        </udi>
      </subDetail>
    </detail>
  </item>
  <total>
    <value value="175"/>
  </total>
</Claim>