https://example.com/fhir/Claim/f6dc7f9e-1558-4b92-adbd-447771c7b2f9
type: Claim
node role: treeRoot
meta:
  profile:
    v: https://example.com/fhir/StructureDefinition/eclaims-claim
    l: eclaims-claim
text:
  status:
    v: extensions
  div:
    v: Generated Narrative: Claim f6dc7f9e-1558-4b92-adbd-447771c7b2f9 Profile: Claim Profile identifier: https://uat-mis.apeiro-digital.com/fhir/claim/f6dc7f9e-1558-4b92-adbd-447771c7b2f9 status: Active type: Institutional subType: op use: Preauthorization patient: https://uat-mis.apeiro-digital.com/fhir/Patient/BZ38380568-6 billablePeriod: 2025-01-04 --> 2025-01-05 created: 2025-01-03 provider: Organization/FID-22-101101-0 priority: Normal Diagnoses - Sequence Diagnosis[x] * 1 XT77 Insurances - Sequence Focal Coverage * 1 true https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage item com/fhir/sha-coverage/StructureDefinition/Coverage: https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage sequence: 1 category: Procedure productOrService: SHA-12-001 serviced: 2025-01-04 quantity: 1 UnitPrices - Value Currency * 50 Kenyan shilling factor: 1 Nets - Value Currency * 50 Kenyan shilling Totals - Value Currency * 50 Kenyan shilling
identifier:
  system:
    v: https://uat-mis.apeiro-digital.com/fhir/claim
    l: claim
status:
  v: active
type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/claim-type
      l: claim-type
    code:
      v: institutional
sub type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/ex-claimsubtype
      l: ex-claimsubtype
    code:
      v: op
use:
  v: preauthorization
patient:
  l: BZ38380568-6
  reference:
    v: https://uat-mis.apeiro-digital.com/fhir/Patient/BZ38380568-6
  type:
    v: Patient
    l: Patient
  identifier:
    use:
      v: official
    system:
      v: https://uat-mis.apeiro-digital.com/fhir/identifier/shanumber
      l: shanumber
    value:
      v: BZ38380568-6
billable period:
  start:
    v: 2025-01-04
  end:
    v: 2025-01-05
created:
  v: 2025-01-03
provider:
  l: FID-22-101101-0
  reference:
    v: Organization/FID-22-101101-0
  type:
    v: Organization
    l: Organization
  identifier:
    use:
      v: official
    system:
      v: https://fr.kenya-hie.health/api/v4/Organization
      l: Organization
    value:
      v: FID-22-101101-0
priority:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/processpriority
      l: processpriority
    code:
      v: normal
diagnosis:
  sequence:
    v: 1
  diagnosis: CodeableConcept
    coding:
      system:
        v: https://uat-mis.apeiro-digital.com/fhir/terminology/CodeSystem/icd-11
        l: icd-11
      code:
        v: XT77
      display:
        v: XT77
insurance:
  sequence:
    v: 1
  focal:
    v: true
  coverage:
    l: CR6164711105276-6-sha-coverage
    reference:
      v: https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage
item:
  extension:
    url:
      v: https://uat-mis.apeiro-digital.com/fhir/sha-coverage/StructureDefinition/Coverage
      l: Coverage
    value: Reference
      l: CR6164711105276-6-sha-coverage
      reference:
        v: https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage
  sequence:
    v: 1
  category:
    coding:
      system:
        v: https://uat-mis.apeiro-digital.com/fhir/CodeSystem/category-codes
        l: category-codes
      code:
        v: procedure
      display:
        v: Procedure
  product or service:
    coding:
      system:
        v: https://uat-mis.apeiro-digital.com/fhir/CodeSystem/intervention-codes
        l: intervention-codes
      code:
        v: SHA-12-001
      display:
        v: SHA-12-001
  serviced: Date
    v: 2025-01-04
  quantity:
    value:
      v: 1
  unit price:
    value:
      v: 50
    currency:
      v: KES
  factor:
    v: 1
  net:
    value:
      v: 50
    currency:
      v: KES
total:
  value:
    v: 50
  currency:
    v: KES

v: fr-code