SOA Dental Claim using identifiers
{
"resourceType": "Claim",
"id": "100154",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">This example assumes a national health care scheme where patients, providers and organizations have known business identifiers.</div>"
},
"identifier": [
{
"system": "http://happyvalley.com/claim",
"value": "12347"
}
],
"status": "active",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "oral"
}
]
},
"use": "claim",
"patient": {
"identifier": {
"system": "http://www.jurisdiction.com/nationalId",
"value": "123AB345"
}
},
"created": "2014-08-16",
"insurer": {
"identifier": {
"system": "http://www.jurisdiction.com/insurers",
"value": "123456"
}
},
"provider": {
"identifier": {
"system": "http://www.jurisdiction.com/careorganizations",
"value": "HOSP12345"
}
},
"priority": {
"coding": [
{
"code": "normal"
}
]
},
"payee": {
"type": {
"coding": [
{
"code": "provider"
}
]
}
},
"careTeam": [
{
"sequence": 1,
"provider": {
"identifier": {
"system": "http://www.jurisdiction.com/providerId",
"value": "MD98765"
}
}
}
],
"diagnosis": [
{
"sequence": 1,
"diagnosisCodeableConcept": {
"coding": [
{
"code": "123456"
}
]
}
}
],
"insurance": [
{
"sequence": 1,
"focal": true,
"coverage": {
"identifier": {
"system": "http://www.jurisdiction.com/nationalplan",
"value": "123AB345"
}
}
}
],
"item": [
{
"sequence": 1,
"careTeamSequence": [
1
],
"productOrService": {
"coding": [
{
"code": "1200"
}
]
},
"servicedDate": "2014-08-16",
"unitPrice": {
"value": 135.57,
"currency": "USD"
},
"net": {
"value": 135.57,
"currency": "USD"
}
}
]
}
Usage note: every effort has been made to ensure that the
examples are correct and useful, but they are not a normative part
of the specification.