Generated Narrative: Claim CR-00001

identifier: https://fhir.dha.go.ke/eclaims/Identifier/claim-number/CLAIM-00001

status: Active

type: Institutional

subType: Inpatient

use: Preauthorization

patient: John Doe Male, DoB: 1980-01-01

billablePeriod: 2025-11-01 --> 2025-11-30

created: 2025-12-16 12:00:00+0300

insurer: Organization Kenya Insurance Company

provider: Organization Nairobi General Hospital

priority: Normal

Relateds

-ClaimRelationship
*Claim: status = active; type = Institutional; use = claim; created = 2025-01-01; priority = NormalAssociated

originalPrescription: MedicationRequest: status = active; intent = order; medication[x] =

Payees

-TypeParty
*ProviderOrganization Nairobi General Hospital

referral: ServiceRequest

facility: Location Main Ward

CareTeams

-SequenceProviderRoleQualification
*1Practitioner Dr. James Kamau Primary ProviderDoctor of Medicine

SupportingInfos

-SequenceCategoryValue[x]
*1Attachmentapplication/pdf @ https://api-edi.provider.sha.go.ke/media/claim/CHURCHILL_X-RAY.pdf

Diagnoses

-SequenceDiagnosis[x]Type
*1Fracture of shaft of femurPrincipal Diagnosis

Insurances

-SequenceFocalCoverage
*1trueCoverage: status = active

item

sequence: 1

careTeamSequence: 1

productOrService: Open reduction and internal fixation: Femur

quantity: 1

UnitPrices

-ValueCurrency
*145600Kenyan shilling

Nets

-ValueCurrency
*145600Kenyan shilling

Totals

-ValueCurrency
*145600Kenyan shilling
 <creation value="2025-11-29T15:17:07+03:00"/> </valueAttachment> </supportingInfo> <diagnosis> <sequence value="1"/> <diagnosisCodeableConcept> <coding> <system value="http://id.who.int/icd/release/11/mms"/> <code value="NC72.5"/> <display value="Fracture of shaft of femur"/> </coding> </diagnosisCodeableConcept> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/ex-diagnosistype"/> <code value="principal"/> <display value="Principal Diagnosis"/> </coding> </type> </diagnosis> <insurance> <sequence value="1"/> <focal value="true"/> <coverage> <reference value="Coverage/COV-0001"/> </coverage> </insurance> <item> <sequence value="1"/> <careTeamSequence value="1"/> <productOrService> <coding> <system value="https://fhir.dha.go.ke/eclaims/CodeSystem/KenyaSocialHealthAuthorityInterventionCS"/> <code value="SHA-19-444"/> <display value="Open reduction and internal fixation: Femur"/> </coding> </productOrService> <quantity> <value value="1"/> </quantity> <unitPrice> <value value="145600"/> <currency value="KES"/> </unitPrice> <net> <value value="145600"/> <currency value="KES"/> </net> </item> <total> <value value="145600"/> <currency value="KES"/> </total> </Claim>