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Source1

{
  "resourceType": "Claim",
  "id": "3197",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2020-08-18T09:49:00+00:00",
    "profile": [
      "https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Abrechnung_Vorlaeufig|1.2.0"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "status": "active",
  "type": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/claim-type",
        "code": "professional"
      }
    ]
  },
  "subType": {
    "coding": [
      {
        "system": "https://fhir.kbv.de/CodeSystem/KBV_CS_AW_Abrechnung_Art",
        "code": "Abrechnung_Vorlaeufig"
      }
    ]
  },
  "use": "predetermination",
  "patient": {
    "reference": "Patient/3181"
  },
  "created": "2020-08-18",
  "provider": {
    "reference": "PractionerRole/1000"
  },
  "priority": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/processpriority",
        "code": "normal"
      }
    ]
  },
  "insurance": [
    {
      "sequence": 1,
      "focal": true,
      "coverage": {
        "display": "N.N."
      }
    }
  ],
  "item": [
    {
      "extension": [
        {
          "url": "https://fhir.kbv.de/StructureDefinition/KBV_EX_AW_Abrechnung_spezielle_Abrechnungsbegruendung",
          "extension": [
            {
              "url": "art_der_Untersuchung",
              "valueString": "Blutdruckmessung"
            },
            {
              "url": "name_des_Arztes",
              "valueString": "Dr. Müller"
            },
            {
              "url": "poststationaer_erbrachte_Leistung",
              "valueBoolean": false
            },
            {
              "url": "freie_Begruendung",
              "valueString": "Die Patientin leidet an extremer externer Pigmentation."
            },
            {
              "url": "prozent_der_Leistung",
              "valueQuantity": {
                "value": 20,
                "unit": "Prozent",
                "system": "http://unitsofmeasure.org",
                "code": "%"
              }
            },
            {
              "url": "gop_fuer_bezugsperson",
              "valueBoolean": false
            },
            {
              "url": "wiederholungsuntersuchung",
              "valueBoolean": true
            },
            {
              "url": "jahr_der_letzten_Krebsfrueherkennung",
              "valueDate": "2017"
            },
            {
              "url": "betreffendes_Organ",
              "valueString": "Leber"
            },
            {
              "url": "gop_Zusatz",
              "valueString": "ein GOP-Zusatz"
            },
            {
              "url": "patientennummer_EDV_des_FEK-Bogens",
              "valueString": "66548/665"
            },
            {
              "url": "asv-Teamnr",
              "valueIdentifier": {
                "system": "http://fhir.de/NamingSystem/asv/teamnummer",
                "value": "554433221"
              }
            },
            {
              "url": "kontrast_Arzneimittel",
              "valueQuantity": {
                "value": 30,
                "unit": "ml",
                "system": "http://unitsofmeasure.org",
                "code": "ml"
              }
            },
            {
              "url": "tsvg_Vermittlungsart",
              "valueCodeableConcept": {
                "coding": [
                  {
                    "system": "https://fhir.kbv.de/CodeSystem/KBV_CS_AW_TSVG_Vermittlungsart",
                    "code": "5"
                  }
                ]
              }
            },
            {
              "url": "tsvg_Kontaktaufnahme",
              "valueDate": "2020-08-15"
            },
            {
              "url": "tsvg_Vermittler_FA",
              "valueReference": {
                "identifier": {
                  "system": "https://fhir.kbv.de/NamingSystem/KBV_NS_Base_BSNR",
                  "value": "882244665"
                }
              }
            }
          ]
        },
        {
          "url": "https://fhir.kbv.de/StructureDefinition/KBV_EX_AW_Abrechnung_Item_Kontext",
          "extension": [
            {
              "url": "link_zu_genetische_Untersuchung",
              "valueReference": {
                "reference": "Procedure/3202"
              }
            },
            {
              "url": "link_zu_ambulante_Operation",
              "valueReference": {
                "reference": "Procedure/3199"
              }
            }
          ]
        },
        {
          "url": "https://fhir.kbv.de/StructureDefinition/KBV_EX_AW_istAbrechnungsrelevant",
          "valueBoolean": true
        }
      ],
      "sequence": 1,
      "category": {
        "coding": [
          {
            "system": "https://fhir.kbv.de/CodeSystem/KBV_CS_AW_Abrechnung_Item_Kategorie",
            "code": "GOP"
          }
        ]
      },
      "productOrService": {
        "coding": [
          {
            "system": "https://fhir.kbv.de/NamingSystem/KBV_NS_AW_HZV_Selektiv",
            "code": "11111111"
          }
        ]
      },
      "quantity": {
        "value": 1,
        "unit": "1",
        "system": "http://unitsofmeasure.org",
        "code": "1"
      },
      "unitPrice": {
        "value": 7.89,
        "currency": "EUR"
      },
      "factor": 1.22,
      "net": {
        "value": 11.45,
        "currency": "EUR"
      },
      "encounter": [
        {
          "reference": "Encounter/3188"
        }
      ],
      "detail": [
        {
          "sequence": 1,
          "productOrService": {
            "coding": [
              {
                "system": "https://fhir.kbv.de/NamingSystem/KBV_NS_Base_EBM",
                "code": "11111111"
              }
            ]
          },
          "unitPrice": {
            "value": 7.89,
            "currency": "EUR"
          },
          "udi": [
            {
              "reference": "Device/3178"
            }
          ]
        }
      ]
    }
  ]
}