This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v1.1.0: STU 1.1) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
Generated Narrative
Resource "PASClaimInquiryResponseExample"
Profile: PAS Claim Inquiry Response
identifier: id: 111099
status: active
type: Professional (Claim Type Codes#professional)
use: preauthorization
patient: Patient/SubscriberExample " SMITH"
created: 2019-07-20T11:01:00+05:00
insurer: Organization/InsurerExample "MARYLAND CAPITAL INSURANCE COMPANY"
outcome: complete
item
ItemAuthorizedDate: 2005-05-02 --> 2005-06-02
itemSequence: 1
Adjudications
- Extension Category * Submitted Amount (Adjudication Value Codes#submitted)
- | Sequence | Focal | Coverage |
* | 1 | true | Coverage/InsuranceExample |