0.2.3 - ci-build

HealthDataReceipt - Local Development build (v0.2.3). See the Directory of published versions

: Receipt-Purchase - JSON Representation

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{
  "resourceType" : "Claim",
  "id" : "Receipt-Purchase",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-10-04T19:42:52.061-04:00"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Claim</b><a name=\"Receipt-Purchase\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Claim \"Receipt-Purchase\" Version \"1\" Updated \"2018-10-04 07:42:52-0400\" </p></div><p><b>status</b>: active</p><p><b>type</b>: Over The Counter <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#over-the-counter)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: <a href=\"Patient/john-smith\">Patient/john-smith: John Smith</a></p><p><b>created</b>: 2018-10-04</p><p><b>provider</b>: <a href=\"Patient/acme-pharmacy\">Patient/acme-pharmacy: ACME Pharmacy</a></p><p><b>priority</b>: Normal <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#normal)</span></p><h3>SupportingInfos</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>1</td><td>Medical Care <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-ex-benefitcategory.html\">Benefit Category Codes</a>#1)</span></td><td><a href=\"Medication/zyrtec\">Medication/zyrtec: Zyrtec</a></td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td>*</td><td>1</td><td>false</td><td><a href=\"Coverage/self-pay\">Coverage/self-pay: Self-pay</a></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: Expense <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-ex-USCLS.html\">USCLS Codes</a>#99555)</span></p><p><b>serviced</b>: 2018-10-04</p><p><b>quantity</b>: 1</p><h3>UnitPrices</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td>*</td><td>12.95</td><td>USD</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td>*</td><td>13.65</td><td>USD</td></tr></table></blockquote><h3>Totals</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td>*</td><td>13.65</td><td>USD</td></tr></table></div>"
  },
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
        "code" : "over-the-counter",
        "display" : "Over The Counter"
      }
    ]
  },
  "use" : "claim",
  "patient" : {
    "reference" : "Patient/john-smith",
    "display" : "John Smith"
  },
  "created" : "2018-10-04",
  "provider" : {
    "reference" : "Patient/acme-pharmacy",
    "display" : "ACME Pharmacy"
  },
  "priority" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
        "code" : "normal",
        "display" : "Normal"
      }
    ]
  },
  "supportingInfo" : [
    {
      "sequence" : 1,
      "category" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/ex-benefitcategory",
            "code" : "1",
            "display" : "Medical Care"
          }
        ]
      },
      "valueReference" : {
        "reference" : "Medication/zyrtec",
        "display" : "Zyrtec"
      }
    }
  ],
  "insurance" : [
    {
      "sequence" : 1,
      "focal" : false,
      "coverage" : {
        "reference" : "Coverage/self-pay",
        "display" : "Self-pay"
      }
    }
  ],
  "item" : [
    {
      "sequence" : 1,
      "productOrService" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/ex-USCLS",
            "code" : "99555",
            "display" : "Expense"
          }
        ]
      },
      "servicedDate" : "2018-10-04",
      "quantity" : {
        "value" : 1
      },
      "unitPrice" : {
        "value" : 12.95,
        "currency" : "USD"
      },
      "net" : {
        "value" : 13.65,
        "currency" : "USD"
      }
    }
  ],
  "total" : {
    "value" : 13.65,
    "currency" : "USD"
  }
}