This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.1.0: STU 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
Page standards status: Informative |
Generated Narrative: ClaimResponse PractitionerRequestorPendingResponseExample
identifier: http://example.org/PATIENT_EVENT_TRACE_NUMBER
/111099
status: Active
type: Professional
use: Preauthorization
patient: JOE SMITH Male, DoB Unknown ( Member Number)
created: 2005-05-02 11:02:00+0500
insurer: Organization MARYLAND CAPITAL INSURANCE COMPANY
requestor: PractitionerRole
outcome: Processing Complete
item
AdministrationReferenceNumber: PEND0001
itemSequence: 1
Adjudications
Extension Category Submitted Amount