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Source1

{
  "resourceType": "Claim",
  "id": "CR-00001",
  "meta": {
    "profile": [
      "https://example.com/fhir/StructureDefinition/eclaims-claim",
      "http://fhir.sha.go.ke/fhir/StructureDefinition/eclaims-claim"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "identifier": [
    {
      "system": "http://fhir.sha.go.ke/fhir/Identifier/claim-number",
      "value": "CLAIM-00001"
    }
  ],
  "status": "active",
  "type": {
    "coding": [
      {
        "system": "http://fhir.sha.go.ke/fhir/CodeSystem/claim-type",
        "code": "institutional",
        "display": "Institutional Claim"
      }
    ]
  },
  "subType": {
    "coding": [
      {
        "system": "http://fhir.sha.go.ke/fhir/CodeSystem/claim-subtype",
        "code": "inpatient",
        "display": "Inpatient"
      }
    ]
  },
  "use": "preauthorization",
  "patient": {
    "reference": "Patient/PT-0001"
  },
  "billablePeriod": {
    "start": "2025-11-01",
    "end": "2025-11-30"
  },
  "created": "2025-12-16T12:00:00+03:00",
  "insurer": {
    "reference": "Organization/INS-001"
  },
  "provider": {
    "reference": "Organization/ORG-001"
  },
  "priority": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/processpriority",
        "code": "routine",
        "display": "Routine"
      }
    ]
  },
  "related": [
    {
      "claim": {
        "reference": "Claim/CLAIM-0000X"
      },
      "relationship": {
        "coding": [
          {
            "system": "http://fhir.sha.go.ke/fhir/CodeSystem/claim-relation-type",
            "code": "claim",
            "display": "Claim"
          }
        ]
      }
    }
  ],
  "originalPrescription": {
    "reference": "MedicationRequest/MED-0001"
  },
  "payee": {
    "type": {
      "coding": [
        {
          "system": "http://fhir.sha.go.ke/fhir/CodeSystem/payee-type",
          "code": "provider",
          "display": "Provider"
        }
      ]
    },
    "party": {
      "reference": "Organization/ORG-001"
    }
  },
  "referral": {
    "reference": "ServiceRequest/SRV-0001"
  },
  "facility": {
    "reference": "Location/LOC-001"
  },
  "careTeam": [
    {
      "sequence": 1,
      "provider": {
        "reference": "Practitioner/PRA-001"
      },
      "role": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
            "code": "primary",
            "display": "Primary Provider"
          }
        ]
      },
      "qualification": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0360/2.7",
            "code": "MD",
            "display": "Medical Doctor"
          }
        ]
      }
    }
  ],
  "supportingInfo": [
    {
      "sequence": 1,
      "category": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
            "code": "attachment",
            "display": "Attachment"
          }
        ]
      },
      "valueAttachment": {
        "contentType": "application-pdf",
        "url": "https://api-edi.provider.sha.go.ke/media/claim/CHURCHILL_X-RAY.pdf",
        "title": "CHURCHILL X-RAY",
        "creation": "2025-11-29T15:17:07+03:00"
      }
    }
  ],
  "diagnosis": [
    {
      "sequence": 1,
      "diagnosisCodeableConcept": {
        "coding": [
          {
            "system": "https://fhir.sha.go.ke/fhir/terminology/CodeSystem/icd-11",
            "code": "NC72.5",
            "display": "Fracture of shaft of femur"
          }
        ]
      },
      "type": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
              "code": "principal",
              "display": "Principal Diagnosis"
            }
          ]
        }
      ]
    }
  ],
  "insurance": [
    {
      "sequence": 1,
      "focal": true,
      "coverage": {
        "reference": "Coverage/COV-0001"
      }
    }
  ],
  "item": [
    {
      "sequence": 1,
      "careTeamSequence": [
        1
      ],
      "productOrService": {
        "coding": [
          {
            "system": "https://fhir.sha.go.ke/fhir/CodeSystem/intervention-codes",
            "code": "SHA-19-444",
            "display": "Open reduction and internal fixation: Femur"
          }
        ]
      },
      "quantity": {
        "value": 1
      },
      "unitPrice": {
        "value": 145600,
        "currency": "KES"
      },
      "net": {
        "value": 145600,
        "currency": "KES"
      }
    }
  ],
  "total": {
    "value": 145600,
    "currency": "KES"
  }
}