This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v1.0.0: STU 1) based on FHIR R4. The current version which supercedes this version is 1.1.0. For a full list of available versions, see the Directory of published versions
Generated Narrative
identifier: id: 111099
status: active
type: Professional
use: preauthorization
patient: Generated Summary: id: 12345678901; JOE SMITH ; gender: male
created: May 2, 2005 6:02:00 AM
insurer: Generated Summary: id: 789312; active; PR; name: MARYLAND CAPITAL INSURANCE COMPANY
requestor: Generated Summary: id: 8189991234; active; X3; name: DR. JOE SMITH CORPORATION
outcome: complete
item
ReviewAction
Urls
- * value: AUTH0001
Urls
- * value: Certified in total
AuthorizedDate: 2005-05-02 --> 2005-06-02
itemSequence: 1
Adjudications
- Category * Submitted Amount