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Claim "960150" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

A human-readable rendering of the Claim

<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="960150"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2020-05-25T19:15:57.202Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the Claim</div>
  </text>
  <type value="institutional"/>
  <identifier>
    <system value="http://happyhospital.com/claim"/>
    <value value="9612345"/>
  </identifier>
  <created value="2014-08-16"/>
  <target>
    <reference value="Organization/2"/>
  </target>
  <organization>
    <reference value="Organization/1"/>
  </organization>
  <use value="complete"/>
  <priority>
    <code value="normal"/>
  </priority>
  <payee>
    <type>
      <code value="provider"/>
    </type>
  </payee>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <code value="654456"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/1"/>
  </patient>
  <coverage>
    <sequence value="1"/>
    <focal value="true"/>
    <coverage>
      <reference value="Coverage/9876B1"/>
    </coverage>
    <relationship>
      <code value="self"/>
    </relationship>
  </coverage>
  <item>
    <sequence value="1"/>
    <type>
      <code value="service"/>
    </type>
    <provider>
      <reference value="Practitioner/example"/>
    </provider>
    <service>
      <system value="http://hl7.org/fhir/ex-serviceproduct"/>
      <code value="exam"/>
    </service>
    <serviceDate value="2014-08-16"/>
    <unitPrice>
      <value value="125.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </unitPrice>
    <net>
      <value value="125.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "860150" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

A human-readable rendering of the Claim

<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="860150"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2020-05-25T19:15:56.983Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the Claim</div>
  </text>
  <type value="professional"/>
  <identifier>
    <system value="http://happypdocs.com/claim"/>
    <value value="8612345"/>
  </identifier>
  <created value="2014-08-16"/>
  <target>
    <reference value="Organization/2"/>
  </target>
  <organization>
    <reference value="Organization/1"/>
  </organization>
  <use value="complete"/>
  <priority>
    <code value="normal"/>
  </priority>
  <payee>
    <type>
      <code value="provider"/>
    </type>
  </payee>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <code value="654456"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/1"/>
  </patient>
  <coverage>
    <sequence value="1"/>
    <focal value="true"/>
    <coverage>
      <reference value="Coverage/9876B1"/>
    </coverage>
    <relationship>
      <code value="self"/>
    </relationship>
  </coverage>
  <item>
    <sequence value="1"/>
    <type>
      <code value="service"/>
    </type>
    <provider>
      <reference value="Practitioner/example"/>
    </provider>
    <service>
      <system value="http://hl7.org/fhir/ex-serviceproduct"/>
      <code value="exam"/>
    </service>
    <serviceDate value="2014-08-16"/>
    <unitPrice>
      <value value="75.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </unitPrice>
    <net>
      <value value="75.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "760150" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

A human-readable rendering of the Pharmacy Claim

<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="760150"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2020-05-25T19:15:56.733Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the Pharmacy Claim</div>
  </text>
  <type value="pharmacy"/>
  <identifier>
    <system value="http://happypharma.com/claim"/>
    <value value="7612345"/>
  </identifier>
  <created value="2014-08-16"/>
  <target>
    <reference value="Organization/2"/>
  </target>
  <organization>
    <reference value="Organization/1"/>
  </organization>
  <use value="complete"/>
  <priority>
    <code value="stat"/>
  </priority>
  <payee>
    <type>
      <code value="provider"/>
    </type>
  </payee>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <code value="654456"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/1"/>
  </patient>
  <coverage>
    <sequence value="1"/>
    <focal value="true"/>
    <coverage>
      <reference value="Coverage/9876B1"/>
    </coverage>
    <relationship>
      <code value="self"/>
    </relationship>
  </coverage>
  <item>
    <sequence value="1"/>
    <type>
      <code value="service"/>
    </type>
    <provider>
      <reference value="Practitioner/example"/>
    </provider>
    <service>
      <system value="http://hl7.org/fhir/ex-pharmaservice"/>
      <code value="smokecess"/>
    </service>
    <serviceDate value="2014-08-16"/>
    <unitPrice>
      <value value="60.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </unitPrice>
    <net>
      <value value="60.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "660151" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

A human-readable rendering of the Vision Claim for Glasses

<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="660151"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2020-05-25T19:15:56.698Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the Vision Claim for Glasses</div>
  </text>
  <type value="vision"/>
  <identifier>
    <system value="http://happysight.com/claim"/>
    <value value="6612346"/>
  </identifier>
  <created value="2014-08-16"/>
  <target>
    <reference value="Organization/2"/>
  </target>
  <organization>
    <reference value="Organization/1"/>
  </organization>
  <use value="complete"/>
  <priority>
    <code value="normal"/>
  </priority>
  <prescription>
    <reference value="http://www.optdocs.com/prescription/12345"/>
  </prescription>
  <payee>
    <type>
      <code value="provider"/>
    </type>
  </payee>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <code value="654321"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/1"/>
  </patient>
  <coverage>
    <sequence value="1"/>
    <focal value="true"/>
    <coverage>
      <reference value="Coverage/9876B1"/>
    </coverage>
    <relationship>
      <code value="self"/>
    </relationship>
  </coverage>
  <item>
    <sequence value="1"/>
    <type>
      <code value="group"/>
    </type>
    <provider>
      <reference value="Practitioner/example"/>
    </provider>
    <service>
      <system value="http://hl7.org/fhir/ex-visionservice"/>
      <code value="glasses"/>
    </service>
    <serviceDate value="2014-08-16"/>
    <unitPrice>
      <value value="214.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </unitPrice>
    <net>
      <value value="214.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
    <detail>
      <sequence value="1"/>
      <type>
        <code value="product"/>
      </type>
      <service>
        <system value="http://hl7.org/fhir/ex-visionservice"/>
        <code value="frame"/>
      </service>
      <unitPrice>
        <value value="100.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </unitPrice>
      <net>
        <value value="100.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </net>
    </detail>
    <detail>
      <sequence value="2"/>
      <type>
        <code value="product"/>
      </type>
      <service>
        <system value="http://hl7.org/fhir/ex-visionservice"/>
        <code value="lens"/>
      </service>
      <quantity>
        <value value="2"/>
      </quantity>
      <unitPrice>
        <value value="50.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </unitPrice>
      <net>
        <value value="100.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </net>
    </detail>
    <detail>
      <sequence value="3"/>
      <type>
        <code value="tax"/>
      </type>
      <service>
        <system value="http://hl7.org/fhir/ex-visionservice"/>
        <code value="fst"/>
      </service>
      <unitPrice>
        <value value="200.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </unitPrice>
      <factor value="0.07"/>
      <net>
        <value value="14.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </net>
    </detail>
  </item>
</Claim>

Claim "660150" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

A human-readable rendering of the Vision Claim

<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="660150"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2020-05-25T19:15:56.546Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the Vision Claim</div>
  </text>
  <type value="vision"/>
  <identifier>
    <system value="http://happysight.com/claim"/>
    <value value="6612345"/>
  </identifier>
  <created value="2014-08-16"/>
  <target>
    <reference value="Organization/2"/>
  </target>
  <organization>
    <reference value="Organization/1"/>
  </organization>
  <use value="complete"/>
  <priority>
    <code value="normal"/>
  </priority>
  <payee>
    <type>
      <code value="provider"/>
    </type>
  </payee>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <code value="654321"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/1"/>
  </patient>
  <coverage>
    <sequence value="1"/>
    <focal value="true"/>
    <coverage>
      <reference value="Coverage/9876B1"/>
    </coverage>
    <relationship>
      <code value="self"/>
    </relationship>
  </coverage>
  <item>
    <sequence value="1"/>
    <type>
      <code value="service"/>
    </type>
    <provider>
      <reference value="Practitioner/example"/>
    </provider>
    <service>
      <system value="http://hl7.org/fhir/ex-visionservice"/>
      <code value="exam"/>
    </service>
    <serviceDate value="2014-08-16"/>
    <unitPrice>
      <value value="80.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </unitPrice>
    <net>
      <value value="80.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "100153" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

A human-readable rendering of the Oral Health Claim

<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="100153"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2020-05-25T19:15:56.327Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the Oral Health Claim</div>
  </text>
  <type value="oral"/>
  <identifier>
    <system value="http://happyvalley.com/claim"/>
    <value value="12355"/>
  </identifier>
  <created value="2015-03-16"/>
  <target>
    <reference value="Organization/2"/>
  </target>
  <organization>
    <reference value="Organization/1"/>
  </organization>
  <use value="proposed"/>
  <priority>
    <code value="normal"/>
  </priority>
  <payee>
    <type>
      <code value="provider"/>
    </type>
  </payee>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <system value="http://hl7.org/fhir/sid/icd-10"/>
      <code value="123457"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/1"/>
  </patient>
  <coverage>
    <sequence value="1"/>
    <focal value="true"/>
    <coverage>
      <reference value="Coverage/9876B1"/>
    </coverage>
    <relationship>
      <code value="self"/>
    </relationship>
  </coverage>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="FRAMEING"/>
    </type>
    <provider>
      <reference value="Practitioner/example"/>
    </provider>
    <diagnosisLinkId value="1"/>
    <service>
      <system value="http://hl7.org/fhir/oralservicecodes"/>
      <code value="ORTHPLAN"/>
    </service>
    <serviceDate value="2015-05-16"/>
    <unitPrice>
      <value value="9000.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </unitPrice>
    <net>
      <value value="9000.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
    <detail>
      <sequence value="1"/>
      <type>
        <system value="http://hl7.org/fhir/v3/ActCode"/>
        <code value="CSINV"/>
      </type>
      <service>
        <system value="http://hl7.org/fhir/oralservicecodes"/>
        <code value="ORTHOEXAM"/>
      </service>
      <unitPrice>
        <value value="1000.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </unitPrice>
      <net>
        <value value="1000.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </net>
    </detail>
    <detail>
      <sequence value="2"/>
      <type>
        <system value="http://hl7.org/fhir/v3/ActCode"/>
        <code value="CSINV"/>
      </type>
      <service>
        <system value="http://hl7.org/fhir/oralservicecodes"/>
        <code value="ORTHODIAG"/>
      </service>
      <unitPrice>
        <value value="1500.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </unitPrice>
      <net>
        <value value="1500.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </net>
    </detail>
    <detail>
      <sequence value="3"/>
      <type>
        <system value="http://hl7.org/fhir/v3/ActCode"/>
        <code value="CSINV"/>
      </type>
      <service>
        <system value="http://hl7.org/fhir/oralservicecodes"/>
        <code value="ORTHOINITIAL"/>
      </service>
      <unitPrice>
        <value value="500.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </unitPrice>
      <net>
        <value value="500.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </net>
    </detail>
    <detail>
      <sequence value="4"/>
      <type>
        <system value="http://hl7.org/fhir/v3/ActCode"/>
        <code value="CSINV"/>
      </type>
      <service>
        <system value="http://hl7.org/fhir/oralservicecodes"/>
        <code value="ORTHOMONTHS"/>
      </service>
      <quantity>
        <value value="24"/>
      </quantity>
    </detail>
    <detail>
      <sequence value="5"/>
      <type>
        <system value="http://hl7.org/fhir/v3/ActCode"/>
        <code value="CSINV"/>
      </type>
      <service>
        <system value="http://hl7.org/fhir/oralservicecodes"/>
        <code value="ORTHOPERIODIC"/>
      </service>
      <quantity>
        <value value="24"/>
      </quantity>
      <unitPrice>
        <value value="250.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </unitPrice>
      <net>
        <value value="250.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </net>
    </detail>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <code value="service"/>
    </type>
    <provider>
      <reference value="Practitioner/example"/>
    </provider>
    <service>
      <system value="http://hl7.org/fhir/oralservicecodes"/>
      <code value="21211"/>
    </service>
    <serviceDate value="2014-08-16"/>
    <unitPrice>
      <value value="105.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </unitPrice>
    <net>
      <value value="105.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
    <bodySite>
      <system value="http://fdi.org/fhir/oraltoothcodes"/>
      <code value="21"/>
    </bodySite>
    <subSite>
      <system value="http://fdi.org/fhir/oralsurfacecodes"/>
      <code value="L"/>
    </subSite>
  </item>
  <item>
    <sequence value="3"/>
    <type>
      <code value="group"/>
    </type>
    <provider>
      <reference value="Practitioner/example"/>
    </provider>
    <service>
      <system value="http://hl7.org/fhir/oralservicecodes"/>
      <code value="27211"/>
    </service>
    <serviceDate value="2014-08-16"/>
    <unitPrice>
      <value value="1100.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </unitPrice>
    <net>
      <value value="1100.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
    <bodySite>
      <system value="http://fdi.org/fhir/oraltoothcodes"/>
      <code value="36"/>
    </bodySite>
    <detail>
      <sequence value="1"/>
      <type>
        <code value="service"/>
      </type>
      <service>
        <system value="http://hl7.org/fhir/oralservicecodes"/>
        <code value="27211"/>
      </service>
      <unitPrice>
        <value value="750.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </unitPrice>
      <net>
        <value value="750.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </net>
    </detail>
    <detail>
      <sequence value="2"/>
      <type>
        <code value="service"/>
      </type>
      <service>
        <system value="http://hl7.org/fhir/oralservicecodes"/>
        <code value="lab"/>
      </service>
      <unitPrice>
        <value value="350.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </unitPrice>
      <net>
        <value value="350.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </net>
    </detail>
  </item>
</Claim>

Claim "100152" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

A human-readable rendering of the Oral Health Claim

<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="100152"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2020-05-25T19:15:55.999Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the Oral Health Claim</div>
  </text>
  <contained>
    <Organization>
      <id value="organization-1"/>
      <identifier>
        <system value="http://www.jurisdiction.com/oralhealthoffices"/>
        <value value="3456"/>
      </identifier>
    </Organization>
  </contained>
  <contained>
    <Organization>
      <id value="organization-2"/>
      <identifier>
        <system value="http://www.bindb.com/bin"/>
        <value value="123456"/>
      </identifier>
    </Organization>
  </contained>
  <contained>
    <Practitioner>
      <id value="practitioner-1"/>
      <identifier>
        <system value="http://www.jurisdiction.com/oralhealthproviders"/>
        <value value="123456789"/>
      </identifier>
    </Practitioner>
  </contained>
  <contained>
    <Patient>
      <id value="patient-1"/>
      <name>
        <use value="official"/>
        <family value="Donald"/>
        <given value="Duck"/>
      </name>
      <gender value="male"/>
      <birthDate value="1986-05-17"/>
      <address>
        <use value="home"/>
        <line value="1234 Main Street"/>
        <city value="Vancouver"/>
        <postalCode value="V2H1Y3"/>
        <country value="CAD"/>
      </address>
    </Patient>
  </contained>
  <contained>
    <Coverage>
      <id value="coverage-1"/>
      <issuer>
        <reference value="#organization-2"/>
      </issuer>
      <type>
        <system value="http://hl7.org/fhir/v3/ActCode"/>
        <code value="EHCPOL"/>
      </type>
      <identifier>
        <system value="http://benefitsinc.com/certificate"/>
        <value value="12345"/>
      </identifier>
      <plan value="CBI35"/>
      <subPlan value="123"/>
      <dependent value="1"/>
      <sequence value="1"/>
      <subscriber>
        <reference value="#patient-1"/>
      </subscriber>
    </Coverage>
  </contained>
  <type value="oral"/>
  <identifier>
    <system value="http://happyvalley.com/claim"/>
    <value value="12347"/>
  </identifier>
  <created value="2014-08-16"/>
  <target>
    <reference value="#organization-2"/>
  </target>
  <organization>
    <reference value="#organization-1"/>
  </organization>
  <use value="complete"/>
  <priority>
    <code value="normal"/>
  </priority>
  <payee>
    <type>
      <code value="provider"/>
    </type>
  </payee>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <code value="123456"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="#patient-1"/>
  </patient>
  <coverage>
    <sequence value="1"/>
    <focal value="true"/>
    <coverage>
      <reference value="#coverage-1"/>
    </coverage>
    <relationship>
      <code value="self"/>
    </relationship>
  </coverage>
  <item>
    <sequence value="1"/>
    <type>
      <code value="service"/>
    </type>
    <provider>
      <reference value="#practitioner-1"/>
    </provider>
    <service>
      <code value="1200"/>
    </service>
    <serviceDate value="2014-08-16"/>
    <unitPrice>
      <value value="135.57"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </unitPrice>
    <net>
      <value value="135.57"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "100151" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

A human-readable rendering of the Oral Health Claim

<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="100151"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2020-05-25T19:15:55.749Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the Oral Health Claim</div>
  </text>
  <type value="oral"/>
  <identifier>
    <system value="http://happyvalley.com/claim"/>
    <value value="12346"/>
  </identifier>
  <created value="2014-08-16"/>
  <target>
    <reference value="Organization/2"/>
  </target>
  <organization>
    <reference value="Organization/1"/>
  </organization>
  <use value="complete"/>
  <priority>
    <code value="normal"/>
  </priority>
  <payee>
    <type>
      <code value="provider"/>
    </type>
  </payee>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <code value="123456"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/1"/>
  </patient>
  <coverage>
    <sequence value="1"/>
    <focal value="true"/>
    <coverage>
      <reference value="Coverage/9876B1"/>
    </coverage>
    <relationship>
      <code value="self"/>
    </relationship>
  </coverage>
  <item>
    <sequence value="1"/>
    <type>
      <code value="service"/>
    </type>
    <provider>
      <reference value="Practitioner/example"/>
    </provider>
    <service>
      <system value="http://hl7.org/fhir/oralservicecodes"/>
      <code value="1200"/>
    </service>
    <serviceDate value="2014-08-16"/>
    <unitPrice>
      <value value="135.57"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </unitPrice>
    <net>
      <value value="135.57"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <code value="service"/>
    </type>
    <provider>
      <reference value="Practitioner/example"/>
    </provider>
    <service>
      <system value="http://hl7.org/fhir/oralservicecodes"/>
      <code value="21211"/>
    </service>
    <serviceDate value="2014-08-16"/>
    <unitPrice>
      <value value="105.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </unitPrice>
    <net>
      <value value="105.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
    <bodySite>
      <system value="http://fdi.org/fhir/oraltoothcodes"/>
      <code value="21"/>
    </bodySite>
    <subSite>
      <system value="http://fdi.org/fhir/oralsurfacecodes"/>
      <code value="L"/>
    </subSite>
  </item>
  <item>
    <sequence value="3"/>
    <type>
      <code value="group"/>
    </type>
    <provider>
      <reference value="Practitioner/example"/>
    </provider>
    <service>
      <system value="http://hl7.org/fhir/oralservicecodes"/>
      <code value="27211"/>
    </service>
    <serviceDate value="2014-08-16"/>
    <unitPrice>
      <value value="1100.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </unitPrice>
    <net>
      <value value="1100.00"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
    <bodySite>
      <system value="http://fdi.org/fhir/oraltoothcodes"/>
      <code value="36"/>
    </bodySite>
    <detail>
      <sequence value="1"/>
      <type>
        <code value="service"/>
      </type>
      <service>
        <system value="http://hl7.org/fhir/oralservicecodes"/>
        <code value="27211"/>
      </service>
      <unitPrice>
        <value value="750.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </unitPrice>
      <net>
        <value value="750.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </net>
    </detail>
    <detail>
      <sequence value="2"/>
      <type>
        <code value="service"/>
      </type>
      <service>
        <system value="http://hl7.org/fhir/oralservicecodes"/>
        <code value="lab"/>
      </service>
      <unitPrice>
        <value value="350.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </unitPrice>
      <net>
        <value value="350.00"/>
        <system value="urn:iso:std:iso:4217"/>
        <code value="USD"/>
      </net>
    </detail>
  </item>
</Claim>

Claim "100150" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

A human-readable rendering of the Oral Health Claim

<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="100150"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2020-05-25T19:15:55.597Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the Oral Health Claim</div>
  </text>
  <type value="oral"/>
  <identifier>
    <system value="http://happyvalley.com/claim"/>
    <value value="12345"/>
  </identifier>
  <created value="2014-08-16"/>
  <target>
    <reference value="Organization/2"/>
  </target>
  <organization>
    <reference value="Organization/1"/>
  </organization>
  <use value="complete"/>
  <priority>
    <code value="normal"/>
  </priority>
  <payee>
    <type>
      <code value="provider"/>
    </type>
  </payee>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <code value="123456"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/1"/>
  </patient>
  <coverage>
    <sequence value="1"/>
    <focal value="true"/>
    <coverage>
      <reference value="Coverage/9876B1"/>
    </coverage>
    <relationship>
      <code value="self"/>
    </relationship>
  </coverage>
  <item>
    <sequence value="1"/>
    <type>
      <code value="service"/>
    </type>
    <provider>
      <reference value="Practitioner/example"/>
    </provider>
    <service>
      <code value="1200"/>
    </service>
    <serviceDate value="2014-08-16"/>
    <unitPrice>
      <value value="135.57"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </unitPrice>
    <net>
      <value value="135.57"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "1f22a3ee-ca4f-4b59-9052-b0a42585e26d" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 1f22a3ee-ca4f-4b59-9052-b0a42585e26d

type: institutional

organization: Organization/465de31f-3098-365c-af70-48a071e1f5aa

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="1f22a3ee-ca4f-4b59-9052-b0a42585e26d"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:55.515Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 1f22a3ee-ca4f-4b59-9052-b0a42585e26d</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/465de31f-3098-365c-af70-48a071e1f5aa">Organization/465de31f-3098-365c-af70-48a071e1f5aa</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/465de31f-3098-365c-af70-48a071e1f5aa"/>
  </organization>
  <use value="complete"/>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <system value="http://snomed.info/sct"/>
      <code value="301011002"/>
      <display value="Escherichia coli urinary tract infection"/>
    </diagnosis>
  </diagnosis>
  <diagnosis>
    <sequence value="2"/>
    <diagnosis>
      <system value="http://snomed.info/sct"/>
      <code value="197927001"/>
      <display value="Recurrent urinary tract infection"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="185345009"/>
      <display value="Encounter for symptom"/>
    </service>
  </item>
</Claim>

Claim "0cd91369-0157-49f3-b2f4-daa0bd687aa4" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 0cd91369-0157-49f3-b2f4-daa0bd687aa4

type: institutional

organization: Organization/465de31f-3098-365c-af70-48a071e1f5aa

use: complete

prescription: MedicationOrder/5efb08a1-3473-4575-9d49-599c8716b8d9

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="0cd91369-0157-49f3-b2f4-daa0bd687aa4"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:55.187Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 0cd91369-0157-49f3-b2f4-daa0bd687aa4</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/465de31f-3098-365c-af70-48a071e1f5aa">Organization/465de31f-3098-365c-af70-48a071e1f5aa</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>prescription</b>:
        <a href="MedicationOrder/5efb08a1-3473-4575-9d49-599c8716b8d9">MedicationOrder/5efb08a1-3473-4575-9d49-599c8716b8d9</a>
      </p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/465de31f-3098-365c-af70-48a071e1f5aa"/>
  </organization>
  <use value="complete"/>
  <prescription>
    <reference value="MedicationOrder/5efb08a1-3473-4575-9d49-599c8716b8d9"/>
  </prescription>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
</Claim>

Claim "a90719e5-2e97-4062-925e-363a4ae6c534" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: a90719e5-2e97-4062-925e-363a4ae6c534

type: institutional

organization: Organization/465de31f-3098-365c-af70-48a071e1f5aa

use: complete

prescription: MedicationOrder/9f4bc844-c47a-4e01-8580-94dd75cab612

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="a90719e5-2e97-4062-925e-363a4ae6c534"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:54.781Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: a90719e5-2e97-4062-925e-363a4ae6c534</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/465de31f-3098-365c-af70-48a071e1f5aa">Organization/465de31f-3098-365c-af70-48a071e1f5aa</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>prescription</b>:
        <a href="MedicationOrder/9f4bc844-c47a-4e01-8580-94dd75cab612">MedicationOrder/9f4bc844-c47a-4e01-8580-94dd75cab612</a>
      </p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/465de31f-3098-365c-af70-48a071e1f5aa"/>
  </organization>
  <use value="complete"/>
  <prescription>
    <reference value="MedicationOrder/9f4bc844-c47a-4e01-8580-94dd75cab612"/>
  </prescription>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
</Claim>

Claim "b8bba955-8d95-42e4-9be6-eda7d7f767e4" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: b8bba955-8d95-42e4-9be6-eda7d7f767e4

type: institutional

organization: Organization/ad18df08-2958-3f21-a5af-f62a276ff31f

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="b8bba955-8d95-42e4-9be6-eda7d7f767e4"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:53.484Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: b8bba955-8d95-42e4-9be6-eda7d7f767e4</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f">Organization/ad18df08-2958-3f21-a5af-f62a276ff31f</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="162673000"/>
      <display value="General examination of patient (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="140"/>
      <display value="Influenza, seasonal, injectable, preservative free"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="3"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="430193006"/>
      <display value="Medication Reconciliation (procedure)"/>
    </service>
    <net>
      <value value="580.23"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "fe3f10d4-eea4-46e3-a89f-8709e59b637b" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: fe3f10d4-eea4-46e3-a89f-8709e59b637b

type: institutional

organization: Organization/ad18df08-2958-3f21-a5af-f62a276ff31f

use: complete

prescription: MedicationOrder/924d74f8-b315-48e0-a77c-3d1b7c12b49e

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="fe3f10d4-eea4-46e3-a89f-8709e59b637b"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:53.062Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: fe3f10d4-eea4-46e3-a89f-8709e59b637b</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f">Organization/ad18df08-2958-3f21-a5af-f62a276ff31f</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>prescription</b>:
        <a href="MedicationOrder/924d74f8-b315-48e0-a77c-3d1b7c12b49e">MedicationOrder/924d74f8-b315-48e0-a77c-3d1b7c12b49e</a>
      </p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f"/>
  </organization>
  <use value="complete"/>
  <prescription>
    <reference value="MedicationOrder/924d74f8-b315-48e0-a77c-3d1b7c12b49e"/>
  </prescription>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
</Claim>

Claim "9fb7c3e3-eb14-4cef-920f-a30ce0d61779" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 9fb7c3e3-eb14-4cef-920f-a30ce0d61779

type: institutional

organization: Organization/ad18df08-2958-3f21-a5af-f62a276ff31f

use: complete

prescription: MedicationOrder/dfaf1a9f-9ba7-4291-88e3-0917c7382a27

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="9fb7c3e3-eb14-4cef-920f-a30ce0d61779"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:52.719Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 9fb7c3e3-eb14-4cef-920f-a30ce0d61779</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f">Organization/ad18df08-2958-3f21-a5af-f62a276ff31f</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>prescription</b>:
        <a href="MedicationOrder/dfaf1a9f-9ba7-4291-88e3-0917c7382a27">MedicationOrder/dfaf1a9f-9ba7-4291-88e3-0917c7382a27</a>
      </p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f"/>
  </organization>
  <use value="complete"/>
  <prescription>
    <reference value="MedicationOrder/dfaf1a9f-9ba7-4291-88e3-0917c7382a27"/>
  </prescription>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
</Claim>

Claim "0620d64c-2346-4aca-a997-ce6ae88d5b0c" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 0620d64c-2346-4aca-a997-ce6ae88d5b0c

type: institutional

organization: Organization/465de31f-3098-365c-af70-48a071e1f5aa

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="0620d64c-2346-4aca-a997-ce6ae88d5b0c"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:51.078Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 0620d64c-2346-4aca-a997-ce6ae88d5b0c</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/465de31f-3098-365c-af70-48a071e1f5aa">Organization/465de31f-3098-365c-af70-48a071e1f5aa</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/465de31f-3098-365c-af70-48a071e1f5aa"/>
  </organization>
  <use value="complete"/>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <system value="http://snomed.info/sct"/>
      <code value="83664006"/>
      <display value="Idiopathic atrophic hypothyroidism"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="185347001"/>
      <display value="Encounter for Problem"/>
    </service>
  </item>
</Claim>

Claim "938a1617-8fe5-494d-8fcb-ac1c2cbc9140" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 938a1617-8fe5-494d-8fcb-ac1c2cbc9140

type: institutional

organization: Organization/465de31f-3098-365c-af70-48a071e1f5aa

use: complete

prescription: MedicationOrder/2ede45b6-b1e0-4910-9364-5409bcf010ca

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="938a1617-8fe5-494d-8fcb-ac1c2cbc9140"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:51.031Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 938a1617-8fe5-494d-8fcb-ac1c2cbc9140</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/465de31f-3098-365c-af70-48a071e1f5aa">Organization/465de31f-3098-365c-af70-48a071e1f5aa</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>prescription</b>:
        <a href="MedicationOrder/2ede45b6-b1e0-4910-9364-5409bcf010ca">MedicationOrder/2ede45b6-b1e0-4910-9364-5409bcf010ca</a>
      </p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/465de31f-3098-365c-af70-48a071e1f5aa"/>
  </organization>
  <use value="complete"/>
  <prescription>
    <reference value="MedicationOrder/2ede45b6-b1e0-4910-9364-5409bcf010ca"/>
  </prescription>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
</Claim>

Claim "7f455070-328e-4080-9989-f07dec622950" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 7f455070-328e-4080-9989-f07dec622950

type: institutional

organization: Organization/465de31f-3098-365c-af70-48a071e1f5aa

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="7f455070-328e-4080-9989-f07dec622950"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:50.328Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 7f455070-328e-4080-9989-f07dec622950</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/465de31f-3098-365c-af70-48a071e1f5aa">Organization/465de31f-3098-365c-af70-48a071e1f5aa</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/465de31f-3098-365c-af70-48a071e1f5aa"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="185347001"/>
      <display value="Encounter for Problem"/>
    </service>
  </item>
</Claim>

Claim "ad6df734-1584-42aa-b700-587a138ebd4b" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: ad6df734-1584-42aa-b700-587a138ebd4b

type: institutional

organization: Organization/465de31f-3098-365c-af70-48a071e1f5aa

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="ad6df734-1584-42aa-b700-587a138ebd4b"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:49.640Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: ad6df734-1584-42aa-b700-587a138ebd4b</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/465de31f-3098-365c-af70-48a071e1f5aa">Organization/465de31f-3098-365c-af70-48a071e1f5aa</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/465de31f-3098-365c-af70-48a071e1f5aa"/>
  </organization>
  <use value="complete"/>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <system value="http://snomed.info/sct"/>
      <code value="38822007"/>
      <display value="Cystitis"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="185345009"/>
      <display value="Encounter for symptom"/>
    </service>
  </item>
</Claim>

Claim "95b5164d-375a-47a3-a1b8-54b1e0255a1d" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 95b5164d-375a-47a3-a1b8-54b1e0255a1d

type: institutional

organization: Organization/465de31f-3098-365c-af70-48a071e1f5aa

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="95b5164d-375a-47a3-a1b8-54b1e0255a1d"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:49.047Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 95b5164d-375a-47a3-a1b8-54b1e0255a1d</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/465de31f-3098-365c-af70-48a071e1f5aa">Organization/465de31f-3098-365c-af70-48a071e1f5aa</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/465de31f-3098-365c-af70-48a071e1f5aa"/>
  </organization>
  <use value="complete"/>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <system value="http://snomed.info/sct"/>
      <code value="70704007"/>
      <display value="Sprain of wrist"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="50849002"/>
      <display value="Emergency room admission (procedure)"/>
    </service>
  </item>
</Claim>

Claim "57ab13af-7665-47e8-8ecd-cb1bea92e914" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 57ab13af-7665-47e8-8ecd-cb1bea92e914

type: institutional

organization: Organization/465de31f-3098-365c-af70-48a071e1f5aa

use: complete

prescription: MedicationOrder/b8291790-a4b0-4228-9951-401b279fa0b3

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="57ab13af-7665-47e8-8ecd-cb1bea92e914"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:48.937Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 57ab13af-7665-47e8-8ecd-cb1bea92e914</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/465de31f-3098-365c-af70-48a071e1f5aa">Organization/465de31f-3098-365c-af70-48a071e1f5aa</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>prescription</b>:
        <a href="MedicationOrder/b8291790-a4b0-4228-9951-401b279fa0b3">MedicationOrder/b8291790-a4b0-4228-9951-401b279fa0b3</a>
      </p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/465de31f-3098-365c-af70-48a071e1f5aa"/>
  </organization>
  <use value="complete"/>
  <prescription>
    <reference value="MedicationOrder/b8291790-a4b0-4228-9951-401b279fa0b3"/>
  </prescription>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
</Claim>

Claim "ad46fe83-f4bf-4b6c-a6ef-06bbd32d3d0c" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: ad46fe83-f4bf-4b6c-a6ef-06bbd32d3d0c

type: institutional

organization: Organization/ad18df08-2958-3f21-a5af-f62a276ff31f

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="ad46fe83-f4bf-4b6c-a6ef-06bbd32d3d0c"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:47.969Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: ad46fe83-f4bf-4b6c-a6ef-06bbd32d3d0c</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f">Organization/ad18df08-2958-3f21-a5af-f62a276ff31f</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="162673000"/>
      <display value="General examination of patient (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="140"/>
      <display value="Influenza, seasonal, injectable, preservative free"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "11f03a09-f859-461a-b9fb-1756d26131b8" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 11f03a09-f859-461a-b9fb-1756d26131b8

type: institutional

organization: Organization/ad18df08-2958-3f21-a5af-f62a276ff31f

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="11f03a09-f859-461a-b9fb-1756d26131b8"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:45.375Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 11f03a09-f859-461a-b9fb-1756d26131b8</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f">Organization/ad18df08-2958-3f21-a5af-f62a276ff31f</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="162673000"/>
      <display value="General examination of patient (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="140"/>
      <display value="Influenza, seasonal, injectable, preservative free"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "bbba7dd0-e3c9-4077-8378-35a110073887" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: bbba7dd0-e3c9-4077-8378-35a110073887

type: institutional

organization: Organization/ad18df08-2958-3f21-a5af-f62a276ff31f

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="bbba7dd0-e3c9-4077-8378-35a110073887"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:43.672Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: bbba7dd0-e3c9-4077-8378-35a110073887</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f">Organization/ad18df08-2958-3f21-a5af-f62a276ff31f</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="162673000"/>
      <display value="General examination of patient (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="121"/>
      <display value="zoster"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="3"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="140"/>
      <display value="Influenza, seasonal, injectable, preservative free"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="4"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="113"/>
      <display value="Td (adult) preservative free"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="5"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="430193006"/>
      <display value="Medication Reconciliation (procedure)"/>
    </service>
    <net>
      <value value="398.23"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "6da690a2-9744-44a5-a698-1a1cbedb6815" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 6da690a2-9744-44a5-a698-1a1cbedb6815

type: institutional

organization: Organization/465de31f-3098-365c-af70-48a071e1f5aa

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="6da690a2-9744-44a5-a698-1a1cbedb6815"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:38.234Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 6da690a2-9744-44a5-a698-1a1cbedb6815</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/465de31f-3098-365c-af70-48a071e1f5aa">Organization/465de31f-3098-365c-af70-48a071e1f5aa</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/465de31f-3098-365c-af70-48a071e1f5aa"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="185349003"/>
      <display value="Encounter for &apos;check-up&apos;"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="73761001"/>
      <display value="Colonoscopy"/>
    </service>
    <net>
      <value value="14356.06"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="3"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="430193006"/>
      <display value="Medication Reconciliation (procedure)"/>
    </service>
    <net>
      <value value="582.36"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "0eb92e81-babd-4767-b994-1b36671fe936" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 0eb92e81-babd-4767-b994-1b36671fe936

type: institutional

organization: Organization/ad18df08-2958-3f21-a5af-f62a276ff31f

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="0eb92e81-babd-4767-b994-1b36671fe936"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:36.375Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 0eb92e81-babd-4767-b994-1b36671fe936</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f">Organization/ad18df08-2958-3f21-a5af-f62a276ff31f</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="162673000"/>
      <display value="General examination of patient (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="121"/>
      <display value="zoster"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="3"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="140"/>
      <display value="Influenza, seasonal, injectable, preservative free"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "f6838f91-f23e-46d9-9cf2-4eeaf9e80cd7" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: f6838f91-f23e-46d9-9cf2-4eeaf9e80cd7

type: institutional

organization: Organization/ad18df08-2958-3f21-a5af-f62a276ff31f

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="f6838f91-f23e-46d9-9cf2-4eeaf9e80cd7"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:33.767Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: f6838f91-f23e-46d9-9cf2-4eeaf9e80cd7</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f">Organization/ad18df08-2958-3f21-a5af-f62a276ff31f</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="162673000"/>
      <display value="General examination of patient (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="140"/>
      <display value="Influenza, seasonal, injectable, preservative free"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "086675dd-c2d8-43ca-b5be-930294486134" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 086675dd-c2d8-43ca-b5be-930294486134

type: institutional

organization: Organization/465de31f-3098-365c-af70-48a071e1f5aa

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="086675dd-c2d8-43ca-b5be-930294486134"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:32.312Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 086675dd-c2d8-43ca-b5be-930294486134</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/465de31f-3098-365c-af70-48a071e1f5aa">Organization/465de31f-3098-365c-af70-48a071e1f5aa</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/465de31f-3098-365c-af70-48a071e1f5aa"/>
  </organization>
  <use value="complete"/>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <system value="http://snomed.info/sct"/>
      <code value="195662009"/>
      <display value="Acute viral pharyngitis (disorder)"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="185345009"/>
      <display value="Encounter for symptom"/>
    </service>
  </item>
</Claim>

Claim "a04ea668-c9ab-4cda-88ab-1cf008140d19" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: a04ea668-c9ab-4cda-88ab-1cf008140d19

type: institutional

organization: Organization/ad18df08-2958-3f21-a5af-f62a276ff31f

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="a04ea668-c9ab-4cda-88ab-1cf008140d19"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:31.656Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: a04ea668-c9ab-4cda-88ab-1cf008140d19</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f">Organization/ad18df08-2958-3f21-a5af-f62a276ff31f</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="162673000"/>
      <display value="General examination of patient (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="140"/>
      <display value="Influenza, seasonal, injectable, preservative free"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "220171f0-a8d9-4a30-aa97-11f366f943ce" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 220171f0-a8d9-4a30-aa97-11f366f943ce

type: institutional

organization: Organization/465de31f-3098-365c-af70-48a071e1f5aa

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="220171f0-a8d9-4a30-aa97-11f366f943ce"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:30.234Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 220171f0-a8d9-4a30-aa97-11f366f943ce</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/465de31f-3098-365c-af70-48a071e1f5aa">Organization/465de31f-3098-365c-af70-48a071e1f5aa</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/465de31f-3098-365c-af70-48a071e1f5aa"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="185349003"/>
      <display value="Encounter for check up (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="140"/>
      <display value="Influenza, seasonal, injectable, preservative free"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="3"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="430193006"/>
      <display value="Medication Reconciliation (procedure)"/>
    </service>
    <net>
      <value value="993.3"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "fbfef61c-719f-45ea-8aba-b722f812731e" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: fbfef61c-719f-45ea-8aba-b722f812731e

type: institutional

organization: Organization/465de31f-3098-365c-af70-48a071e1f5aa

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="fbfef61c-719f-45ea-8aba-b722f812731e"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:26.093Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: fbfef61c-719f-45ea-8aba-b722f812731e</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/465de31f-3098-365c-af70-48a071e1f5aa">Organization/465de31f-3098-365c-af70-48a071e1f5aa</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/465de31f-3098-365c-af70-48a071e1f5aa"/>
  </organization>
  <use value="complete"/>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <system value="http://snomed.info/sct"/>
      <code value="10509002"/>
      <display value="Acute bronchitis (disorder)"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="185345009"/>
      <display value="Encounter for symptom"/>
    </service>
  </item>
  <item>
    <sequence value="3"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="269911007"/>
      <display value="Sputum examination (procedure)"/>
    </service>
    <net>
      <value value="9045.19"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "33f22b0e-28d0-41ca-a84d-ed5ec81e595b" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 33f22b0e-28d0-41ca-a84d-ed5ec81e595b

type: institutional

organization: Organization/465de31f-3098-365c-af70-48a071e1f5aa

use: complete

prescription: MedicationOrder/4ecc7d01-37bd-42ea-af1f-c88c51df4fc0

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="33f22b0e-28d0-41ca-a84d-ed5ec81e595b"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:25.797Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 33f22b0e-28d0-41ca-a84d-ed5ec81e595b</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/465de31f-3098-365c-af70-48a071e1f5aa">Organization/465de31f-3098-365c-af70-48a071e1f5aa</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>prescription</b>:
        <a href="MedicationOrder/4ecc7d01-37bd-42ea-af1f-c88c51df4fc0">MedicationOrder/4ecc7d01-37bd-42ea-af1f-c88c51df4fc0</a>
      </p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/465de31f-3098-365c-af70-48a071e1f5aa"/>
  </organization>
  <use value="complete"/>
  <prescription>
    <reference value="MedicationOrder/4ecc7d01-37bd-42ea-af1f-c88c51df4fc0"/>
  </prescription>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
</Claim>

Claim "6d7bf0ee-cc63-4b80-85de-f582e503ad70" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 6d7bf0ee-cc63-4b80-85de-f582e503ad70

type: institutional

organization: Organization/465de31f-3098-365c-af70-48a071e1f5aa

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="6d7bf0ee-cc63-4b80-85de-f582e503ad70"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:25.375Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 6d7bf0ee-cc63-4b80-85de-f582e503ad70</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/465de31f-3098-365c-af70-48a071e1f5aa">Organization/465de31f-3098-365c-af70-48a071e1f5aa</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/465de31f-3098-365c-af70-48a071e1f5aa"/>
  </organization>
  <use value="complete"/>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <system value="http://snomed.info/sct"/>
      <code value="239873007"/>
      <display value="Osteoarthritis of knee"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="185347001"/>
      <display value="Encounter for problem"/>
    </service>
  </item>
</Claim>

Claim "3d375503-d547-4575-a224-f4da56110e1f" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 3d375503-d547-4575-a224-f4da56110e1f

type: institutional

organization: Organization/465de31f-3098-365c-af70-48a071e1f5aa

use: complete

prescription: MedicationOrder/137ded44-1a87-4f6d-9913-8465c654b2fa

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="3d375503-d547-4575-a224-f4da56110e1f"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:25.093Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 3d375503-d547-4575-a224-f4da56110e1f</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/465de31f-3098-365c-af70-48a071e1f5aa">Organization/465de31f-3098-365c-af70-48a071e1f5aa</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>prescription</b>:
        <a href="MedicationOrder/137ded44-1a87-4f6d-9913-8465c654b2fa">MedicationOrder/137ded44-1a87-4f6d-9913-8465c654b2fa</a>
      </p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/465de31f-3098-365c-af70-48a071e1f5aa"/>
  </organization>
  <use value="complete"/>
  <prescription>
    <reference value="MedicationOrder/137ded44-1a87-4f6d-9913-8465c654b2fa"/>
  </prescription>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
</Claim>

Claim "58fad7f8-5e40-4ba9-b694-1d05720e54cf" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 58fad7f8-5e40-4ba9-b694-1d05720e54cf

type: institutional

organization: Organization/ad18df08-2958-3f21-a5af-f62a276ff31f

use: complete

patient: Patient/5ba72c85-ea76-4275-8093-435e015f7db6


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="58fad7f8-5e40-4ba9-b694-1d05720e54cf"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:24.156Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 58fad7f8-5e40-4ba9-b694-1d05720e54cf</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f">Organization/ad18df08-2958-3f21-a5af-f62a276ff31f</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/5ba72c85-ea76-4275-8093-435e015f7db6">Patient/5ba72c85-ea76-4275-8093-435e015f7db6</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/ad18df08-2958-3f21-a5af-f62a276ff31f"/>
  </organization>
  <use value="complete"/>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <system value="http://snomed.info/sct"/>
      <code value="162864005"/>
      <display value="Body mass index 30+ - obesity (finding)"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/5ba72c85-ea76-4275-8093-435e015f7db6"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="162673000"/>
      <display value="General examination of patient (procedure)"/>
    </service>
  </item>
</Claim>

Claim "6a047e43-c2e4-44e0-a037-4b8d679f5a5b" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 6a047e43-c2e4-44e0-a037-4b8d679f5a5b

type: institutional

organization: Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94

use: complete

patient: Patient/29f76534-8f69-4402-b515-fd4611ea124f


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="6a047e43-c2e4-44e0-a037-4b8d679f5a5b"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:15.109Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 6a047e43-c2e4-44e0-a037-4b8d679f5a5b</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94">Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/29f76534-8f69-4402-b515-fd4611ea124f">Patient/29f76534-8f69-4402-b515-fd4611ea124f</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/29f76534-8f69-4402-b515-fd4611ea124f"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="410620009"/>
      <display value="Well child visit (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="140"/>
      <display value="Influenza, seasonal, injectable, preservative free"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "b8c304ec-e0e6-428c-bc1a-43742cb2585c" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: b8c304ec-e0e6-428c-bc1a-43742cb2585c

type: institutional

organization: Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94

use: complete

patient: Patient/29f76534-8f69-4402-b515-fd4611ea124f


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="b8c304ec-e0e6-428c-bc1a-43742cb2585c"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:13.328Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: b8c304ec-e0e6-428c-bc1a-43742cb2585c</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94">Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/29f76534-8f69-4402-b515-fd4611ea124f">Patient/29f76534-8f69-4402-b515-fd4611ea124f</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/29f76534-8f69-4402-b515-fd4611ea124f"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="410620009"/>
      <display value="Well child visit (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="20"/>
      <display value="DTaP"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="3"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="430193006"/>
      <display value="Medication Reconciliation (procedure)"/>
    </service>
    <net>
      <value value="803.62"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "aef119ac-49ba-4725-8683-e0d20b2cc744" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: aef119ac-49ba-4725-8683-e0d20b2cc744

type: institutional

organization: Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94

use: complete

patient: Patient/29f76534-8f69-4402-b515-fd4611ea124f


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="aef119ac-49ba-4725-8683-e0d20b2cc744"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:11.172Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: aef119ac-49ba-4725-8683-e0d20b2cc744</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94">Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/29f76534-8f69-4402-b515-fd4611ea124f">Patient/29f76534-8f69-4402-b515-fd4611ea124f</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/29f76534-8f69-4402-b515-fd4611ea124f"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="410620009"/>
      <display value="Well child visit (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="49"/>
      <display value="Hib (PRP-OMP)"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="3"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="21"/>
      <display value="varicella"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="4"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="03"/>
      <display value="MMR"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="5"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="133"/>
      <display value="Pneumococcal conjugate PCV 13"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="6"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="83"/>
      <display value="Hep A, ped/adol, 2 dose"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "d5c8ba8d-d5d8-4111-9050-446369b63b16" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: d5c8ba8d-d5d8-4111-9050-446369b63b16

type: institutional

organization: Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94

use: complete

patient: Patient/29f76534-8f69-4402-b515-fd4611ea124f


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="d5c8ba8d-d5d8-4111-9050-446369b63b16"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:08.672Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: d5c8ba8d-d5d8-4111-9050-446369b63b16</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94">Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/29f76534-8f69-4402-b515-fd4611ea124f">Patient/29f76534-8f69-4402-b515-fd4611ea124f</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/29f76534-8f69-4402-b515-fd4611ea124f"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="410620009"/>
      <display value="Well child visit (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="430193006"/>
      <display value="Medication Reconciliation (procedure)"/>
    </service>
    <net>
      <value value="753.74"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "883dfbea-b2c6-4a5b-9e31-c8d0add49a34" Version "1"

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This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 883dfbea-b2c6-4a5b-9e31-c8d0add49a34

type: institutional

organization: Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94

use: complete

patient: Patient/29f76534-8f69-4402-b515-fd4611ea124f


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="883dfbea-b2c6-4a5b-9e31-c8d0add49a34"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:07.281Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 883dfbea-b2c6-4a5b-9e31-c8d0add49a34</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94">Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/29f76534-8f69-4402-b515-fd4611ea124f">Patient/29f76534-8f69-4402-b515-fd4611ea124f</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/29f76534-8f69-4402-b515-fd4611ea124f"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="410620009"/>
      <display value="Well child visit (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="10"/>
      <display value="IPV"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="3"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="140"/>
      <display value="Influenza, seasonal, injectable, preservative free"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="4"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="20"/>
      <display value="DTaP"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="5"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="133"/>
      <display value="Pneumococcal conjugate PCV 13"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="6"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="08"/>
      <display value="Hep B, adolescent or pediatric"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="7"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="430193006"/>
      <display value="Medication Reconciliation (procedure)"/>
    </service>
    <net>
      <value value="659.16"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "9e9f1e10-a04c-4f0f-b800-29adf68e5e57" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 9e9f1e10-a04c-4f0f-b800-29adf68e5e57

type: institutional

organization: Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94

use: complete

patient: Patient/29f76534-8f69-4402-b515-fd4611ea124f


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="9e9f1e10-a04c-4f0f-b800-29adf68e5e57"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:04.859Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 9e9f1e10-a04c-4f0f-b800-29adf68e5e57</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94">Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/29f76534-8f69-4402-b515-fd4611ea124f">Patient/29f76534-8f69-4402-b515-fd4611ea124f</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/29f76534-8f69-4402-b515-fd4611ea124f"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="410620009"/>
      <display value="Well child visit (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="49"/>
      <display value="Hib (PRP-OMP)"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="3"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="119"/>
      <display value="rotavirus, monovalent"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="4"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="10"/>
      <display value="IPV"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="5"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="20"/>
      <display value="DTaP"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="6"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="133"/>
      <display value="Pneumococcal conjugate PCV 13"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "3b38b659-d4e3-42c2-be8a-7b90ec7bf2f5" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 3b38b659-d4e3-42c2-be8a-7b90ec7bf2f5

type: institutional

organization: Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94

use: complete

patient: Patient/29f76534-8f69-4402-b515-fd4611ea124f


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="3b38b659-d4e3-42c2-be8a-7b90ec7bf2f5"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:02.812Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 3b38b659-d4e3-42c2-be8a-7b90ec7bf2f5</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94">Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/29f76534-8f69-4402-b515-fd4611ea124f">Patient/29f76534-8f69-4402-b515-fd4611ea124f</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/29f76534-8f69-4402-b515-fd4611ea124f"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="410620009"/>
      <display value="Well child visit (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="49"/>
      <display value="Hib (PRP-OMP)"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="3"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="119"/>
      <display value="rotavirus, monovalent"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="4"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="10"/>
      <display value="IPV"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="5"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="20"/>
      <display value="DTaP"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="6"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="133"/>
      <display value="Pneumococcal conjugate PCV 13"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "cd78de01-0a7f-4bf3-aff3-574e1c7b91b8" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: cd78de01-0a7f-4bf3-aff3-574e1c7b91b8

type: institutional

organization: Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94

use: complete

patient: Patient/29f76534-8f69-4402-b515-fd4611ea124f


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="cd78de01-0a7f-4bf3-aff3-574e1c7b91b8"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:32:00.968Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: cd78de01-0a7f-4bf3-aff3-574e1c7b91b8</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94">Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/29f76534-8f69-4402-b515-fd4611ea124f">Patient/29f76534-8f69-4402-b515-fd4611ea124f</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/29f76534-8f69-4402-b515-fd4611ea124f"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="410620009"/>
      <display value="Well child visit (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="08"/>
      <display value="Hep B, adolescent or pediatric"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="3"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="430193006"/>
      <display value="Medication Reconciliation (procedure)"/>
    </service>
    <net>
      <value value="583.97"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "e69dc24c-e6be-4144-a9e3-9b5d34a9d583" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: e69dc24c-e6be-4144-a9e3-9b5d34a9d583

type: institutional

organization: Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94

use: complete

patient: Patient/29f76534-8f69-4402-b515-fd4611ea124f


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="e69dc24c-e6be-4144-a9e3-9b5d34a9d583"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:31:58.969Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: e69dc24c-e6be-4144-a9e3-9b5d34a9d583</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94">Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/29f76534-8f69-4402-b515-fd4611ea124f">Patient/29f76534-8f69-4402-b515-fd4611ea124f</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/21a098a1-7ffd-3ac3-a297-c11a67e45f94"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/29f76534-8f69-4402-b515-fd4611ea124f"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="410620009"/>
      <display value="Well child visit (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="08"/>
      <display value="Hep B, adolescent or pediatric"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "ba57d79a-daeb-44da-8477-b3f61ba2b7b0" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: ba57d79a-daeb-44da-8477-b3f61ba2b7b0

type: institutional

organization: Organization/29e2af56-1d4e-3d79-b2cc-900f14ce52bc

use: complete

patient: Patient/36663edc-5afc-4c8c-88be-f683cc032d14


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="ba57d79a-daeb-44da-8477-b3f61ba2b7b0"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:31:49.250Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: ba57d79a-daeb-44da-8477-b3f61ba2b7b0</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/29e2af56-1d4e-3d79-b2cc-900f14ce52bc">Organization/29e2af56-1d4e-3d79-b2cc-900f14ce52bc</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/36663edc-5afc-4c8c-88be-f683cc032d14">Patient/36663edc-5afc-4c8c-88be-f683cc032d14</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/29e2af56-1d4e-3d79-b2cc-900f14ce52bc"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/36663edc-5afc-4c8c-88be-f683cc032d14"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="410620009"/>
      <display value="Well child visit (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="140"/>
      <display value="Influenza, seasonal, injectable, preservative free"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "7c43ee3e-5fbe-4525-90e5-928d427577d5" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 7c43ee3e-5fbe-4525-90e5-928d427577d5

type: institutional

organization: Organization/29e2af56-1d4e-3d79-b2cc-900f14ce52bc

use: complete

patient: Patient/36663edc-5afc-4c8c-88be-f683cc032d14


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="7c43ee3e-5fbe-4525-90e5-928d427577d5"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:31:47.078Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 7c43ee3e-5fbe-4525-90e5-928d427577d5</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/29e2af56-1d4e-3d79-b2cc-900f14ce52bc">Organization/29e2af56-1d4e-3d79-b2cc-900f14ce52bc</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/36663edc-5afc-4c8c-88be-f683cc032d14">Patient/36663edc-5afc-4c8c-88be-f683cc032d14</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/29e2af56-1d4e-3d79-b2cc-900f14ce52bc"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/36663edc-5afc-4c8c-88be-f683cc032d14"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="410620009"/>
      <display value="Well child visit (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="140"/>
      <display value="Influenza, seasonal, injectable, preservative free"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "5c608c4a-fd8b-4b48-8798-689fe6ff9715" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 5c608c4a-fd8b-4b48-8798-689fe6ff9715

type: institutional

organization: Organization/29e2af56-1d4e-3d79-b2cc-900f14ce52bc

use: complete

patient: Patient/36663edc-5afc-4c8c-88be-f683cc032d14


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="5c608c4a-fd8b-4b48-8798-689fe6ff9715"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:31:45.109Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 5c608c4a-fd8b-4b48-8798-689fe6ff9715</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/29e2af56-1d4e-3d79-b2cc-900f14ce52bc">Organization/29e2af56-1d4e-3d79-b2cc-900f14ce52bc</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/36663edc-5afc-4c8c-88be-f683cc032d14">Patient/36663edc-5afc-4c8c-88be-f683cc032d14</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/29e2af56-1d4e-3d79-b2cc-900f14ce52bc"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/36663edc-5afc-4c8c-88be-f683cc032d14"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="410620009"/>
      <display value="Well child visit (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="140"/>
      <display value="Influenza, seasonal, injectable, preservative free"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "313975ed-e988-40f5-ad1c-60a012d75579" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: 313975ed-e988-40f5-ad1c-60a012d75579

type: institutional

organization: Organization/29e2af56-1d4e-3d79-b2cc-900f14ce52bc

use: complete

patient: Patient/36663edc-5afc-4c8c-88be-f683cc032d14


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="313975ed-e988-40f5-ad1c-60a012d75579"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:31:40.843Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: 313975ed-e988-40f5-ad1c-60a012d75579</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/29e2af56-1d4e-3d79-b2cc-900f14ce52bc">Organization/29e2af56-1d4e-3d79-b2cc-900f14ce52bc</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/36663edc-5afc-4c8c-88be-f683cc032d14">Patient/36663edc-5afc-4c8c-88be-f683cc032d14</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/29e2af56-1d4e-3d79-b2cc-900f14ce52bc"/>
  </organization>
  <use value="complete"/>
  <patient>
    <reference value="Patient/36663edc-5afc-4c8c-88be-f683cc032d14"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="410620009"/>
      <display value="Well child visit (procedure)"/>
    </service>
  </item>
  <item>
    <sequence value="2"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="21"/>
      <display value="varicella"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="3"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="10"/>
      <display value="IPV"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="4"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="140"/>
      <display value="Influenza, seasonal, injectable, preservative free"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="5"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="20"/>
      <display value="DTaP"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
  <item>
    <sequence value="6"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://hl7.org/fhir/sid/cvx"/>
      <code value="03"/>
      <display value="MMR"/>
    </service>
    <net>
      <value value="140.52"/>
      <system value="urn:iso:std:iso:4217"/>
      <code value="USD"/>
    </net>
  </item>
</Claim>

Claim "a79f2739-56eb-47a0-9391-d9c8b1b33029" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: a79f2739-56eb-47a0-9391-d9c8b1b33029

type: institutional

organization: Organization/27379046-608b-32f0-9df7-8c833cf5d11d

use: complete

patient: Patient/36663edc-5afc-4c8c-88be-f683cc032d14


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="a79f2739-56eb-47a0-9391-d9c8b1b33029"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:31:38.422Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: a79f2739-56eb-47a0-9391-d9c8b1b33029</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/27379046-608b-32f0-9df7-8c833cf5d11d">Organization/27379046-608b-32f0-9df7-8c833cf5d11d</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>patient</b>:
        <a href="Patient/36663edc-5afc-4c8c-88be-f683cc032d14">Patient/36663edc-5afc-4c8c-88be-f683cc032d14</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/27379046-608b-32f0-9df7-8c833cf5d11d"/>
  </organization>
  <use value="complete"/>
  <diagnosis>
    <sequence value="1"/>
    <diagnosis>
      <system value="http://snomed.info/sct"/>
      <code value="65363002"/>
      <display value="Otitis media"/>
    </diagnosis>
  </diagnosis>
  <patient>
    <reference value="Patient/36663edc-5afc-4c8c-88be-f683cc032d14"/>
  </patient>
  <item>
    <sequence value="1"/>
    <type>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="CSINV"/>
      <display value="clinical service invoice"/>
    </type>
    <service>
      <system value="http://snomed.info/sct"/>
      <code value="185345009"/>
      <display value="Encounter for symptom"/>
    </service>
  </item>
</Claim>

Claim "cd339c0a-e266-485d-a4cc-9bfaf9bb2da2" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: cd339c0a-e266-485d-a4cc-9bfaf9bb2da2

type: institutional

organization: Organization/27379046-608b-32f0-9df7-8c833cf5d11d

use: complete

prescription: MedicationOrder/1111ed47-ac52-475f-a895-2416409f7bfd

patient: Patient/36663edc-5afc-4c8c-88be-f683cc032d14


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="cd339c0a-e266-485d-a4cc-9bfaf9bb2da2"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:31:38.359Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: cd339c0a-e266-485d-a4cc-9bfaf9bb2da2</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/27379046-608b-32f0-9df7-8c833cf5d11d">Organization/27379046-608b-32f0-9df7-8c833cf5d11d</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>prescription</b>:
        <a href="MedicationOrder/1111ed47-ac52-475f-a895-2416409f7bfd">MedicationOrder/1111ed47-ac52-475f-a895-2416409f7bfd</a>
      </p>
      <p>
        <b>patient</b>:
        <a href="Patient/36663edc-5afc-4c8c-88be-f683cc032d14">Patient/36663edc-5afc-4c8c-88be-f683cc032d14</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/27379046-608b-32f0-9df7-8c833cf5d11d"/>
  </organization>
  <use value="complete"/>
  <prescription>
    <reference value="MedicationOrder/1111ed47-ac52-475f-a895-2416409f7bfd"/>
  </prescription>
  <patient>
    <reference value="Patient/36663edc-5afc-4c8c-88be-f683cc032d14"/>
  </patient>
</Claim>

Claim "da7f91d9-0ac9-4196-bf87-0336fe562f8f" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: da7f91d9-0ac9-4196-bf87-0336fe562f8f

type: institutional

organization: Organization/27379046-608b-32f0-9df7-8c833cf5d11d

use: complete

prescription: MedicationOrder/f08df8f5-7351-446d-b40d-b2f8cec277f4

patient: Patient/36663edc-5afc-4c8c-88be-f683cc032d14


<?xml version="1.0" encoding="UTF-8"?>
<Claim xmlns="http://hl7.org/fhir">
  <id value="da7f91d9-0ac9-4196-bf87-0336fe562f8f"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2019-11-27T15:31:37.734Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Generated Narrative with Details</b>
      </p>
      <p>
        <b>id</b>: da7f91d9-0ac9-4196-bf87-0336fe562f8f</p>
      <p>
        <b>type</b>: institutional</p>
      <p>
        <b>organization</b>:
        <a href="Organization/27379046-608b-32f0-9df7-8c833cf5d11d">Organization/27379046-608b-32f0-9df7-8c833cf5d11d</a>
      </p>
      <p>
        <b>use</b>: complete</p>
      <p>
        <b>prescription</b>:
        <a href="MedicationOrder/f08df8f5-7351-446d-b40d-b2f8cec277f4">MedicationOrder/f08df8f5-7351-446d-b40d-b2f8cec277f4</a>
      </p>
      <p>
        <b>patient</b>:
        <a href="Patient/36663edc-5afc-4c8c-88be-f683cc032d14">Patient/36663edc-5afc-4c8c-88be-f683cc032d14</a>
      </p>
    </div>
  </text>
  <type value="institutional"/>
  <organization>
    <reference value="Organization/27379046-608b-32f0-9df7-8c833cf5d11d"/>
  </organization>
  <use value="complete"/>
  <prescription>
    <reference value="MedicationOrder/f08df8f5-7351-446d-b40d-b2f8cec277f4"/>
  </prescription>
  <patient>
    <reference value="Patient/36663edc-5afc-4c8c-88be-f683cc032d14"/>
  </patient>
</Claim>