FHIR Implementation Guide for HCX
0.7.1 - CI Build
FHIR Implementation Guide for HCX
0.7.1 - CI Build
FHIR Implementation Guide for HCX - Local Development build (v0.7.1). See the Directory of published versions
Generated Narrative: ClaimResponse
Resource ClaimResponse "example-01" Version "1" Updated "2020-07-03 22:50:39+0000"
Information Source: #JrkobxCRdZUI6QNh!
identifier: id: dc82673b-8c71-48c2-2k9s-16dcb3b829m2
status: active
type: Institutional (Claim Type Codes#institutional)
use: preauthorization
patient:
created: 2020-07-03 18:50:39-0400
insurer:
requestor:
request:
outcome: complete
item
itemSequence: 1
adjudication
category: Eligible Amount (Adjudication Value Codes#eligible)
Amounts
- Value Currency * 500000 INR adjudication
category: CoPay (Adjudication Value Codes#copay)
Amounts
- Value Currency * 50000 INR adjudication
category: Eligible % (Adjudication Value Codes#eligpercent)
value: 80.00
adjudication
category: Benefit Amount (Adjudication Value Codes#benefit)
reason: Plan Limit Reached (Adjudication Reason Codes#ar002)
Amounts
- Value Currency * 360000 INR
total
category: Submitted Amount (Adjudication Value Codes#submitted)
Amounts
- Value Currency * 500000 INR
total
category: Benefit Amount (Adjudication Value Codes#benefit)
Amounts
- Value Currency * 360000 INR
payment
type: Complete (Example Payment Type Codes#complete)
date: 2014-08-31
Amounts
- Value Currency * 410000 INR identifier: id: 201408-2-1569478