QI-Core Implementation Guide
6.0.0 - STU6
QI-Core Implementation Guide
6.0.0 - STU6
This page is part of the Quality Improvement Core Framework (v6.0.0: STU6 (v6.0.0)) 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
Resource Claim "example"
Profile: QICore Claim
identifier: http://happysight.com/claim/6612346
status: active
type: Vision (Claim Type Codes#vision)
use: claim
patient: Patient/example " CHALMERS"
created: 2014-08-16
insurer: Organization/example "Health Level Seven International"
provider: Practitioner/example " CAREFUL"
priority: Normal (Process Priority Codes#normal)
prescription: MedicationRequest/example
| Type | Party |
| Provider (Payee Type Codes#provider) | Practitioner/example " CAREFUL" |
| Sequence | Provider |
| 1 | Practitioner/example " CAREFUL" |
| Sequence | Diagnosis[x] |
| 1 | H44.23 (icd-10-cm#H44.23) |
| Sequence | Focal | Coverage |
| 1 | true | Coverage/example |
item
sequence: 1
careTeamSequence: 1
productOrService: glasses (ex-visionservice#glasses)
serviced: 2014-08-16
UnitPrices
Value Currency 214.00 USD detail
sequence: 1
productOrService: frame (ex-visionservice#frame)
UnitPrices
Value Currency 100.00 USD Nets
Value Currency 100.00 USD detail
sequence: 2
productOrService: lens (ex-visionservice#lens)
quantity: 2
UnitPrices
Value Currency 50.00 USD Nets
Value Currency 100.00 USD detail
sequence: 3
productOrService: fst (ex-visionservice#fst)
UnitPrices
Value Currency 200.00 USD factor: 0.07
Nets
Value Currency 14.00 USD
IG © 2019+ HL7 International / Clinical Quality Information. Package hl7.fhir.us.qicore#6.0.0 based on FHIR 4.0.1. Generated 2024-03-01
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QA Report
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