FHIR IG analytics| Package | kbv.ita.aws |
| Resource Type | Claim |
| Id | BSP_KBV_PR_AW_Abrechnung_privat.json |
| FHIR Version | R4 |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
FHIR
FHIRsmith{
"resourceType": "Claim",
"id": "3195",
"meta": {
"versionId": "1",
"lastUpdated": "2020-08-24T16:50:00+00:00",
"profile": [
"https://fhir.kbv.de/StructureDefinition/KBV_PR_AW_Abrechnung_privat|1.2.0"
]
},
"text": {
"status": "extensions",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"url": "https://fhir.kbv.de/StructureDefinition/KBV_EX_AW_Abrechnung_Mahnung",
"extension": [
{
"url": "mahndatum",
"valueDateTime": "2018-05-15"
},
{
"url": "mahnstufe",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.kbv.de/CodeSystem/KBV_CS_AW_Abrechnung_Mahnung",
"code": "1"
}
]
}
},
{
"url": "mahngebuehr",
"valueMoney": {
"value": 0,
"currency": "EUR"
}
},
{
"url": "zahldatum",
"valueDateTime": "2018-05-25"
},
{
"url": "zahlbetrag",
"valueMoney": {
"value": 0.45,
"currency": "EUR"
}
}
]
},
{
"url": "https://fhir.kbv.de/StructureDefinition/KBV_EX_AW_Abrechnung_Mahnung",
"extension": [
{
"url": "mahndatum",
"valueDateTime": "2018-07-29"
},
{
"url": "mahnstufe",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.kbv.de/CodeSystem/KBV_CS_AW_Abrechnung_Mahnung",
"code": "2"
}
]
}
},
{
"url": "mahngebuehr",
"valueMoney": {
"value": 2,
"currency": "EUR"
}
},
{
"url": "zahldatum",
"valueDateTime": "2018-08-05"
},
{
"url": "zahlbetrag",
"valueMoney": {
"value": 4.45,
"currency": "EUR"
}
}
]
},
{
"url": "https://fhir.kbv.de/StructureDefinition/KBV_EX_AW_Privatabrechnung_Rechnungsempfaenger",
"valueReference": {
"reference": "RelatedPerson/3183"
}
}
],
"identifier": [
{
"type": {
"coding": [
{
"system": "https://fhir.kbv.de/CodeSystem/KBV_CS_AW_Abrechnung_Identifiertyp",
"code": "Rechnungsnummer"
}
]
},
"value": "99886654"
}
],
"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": "Privat"
}
]
},
"use": "claim",
"patient": {
"reference": "Patient/3181"
},
"created": "2018-03-31",
"insurer": {
"extension": [
{
"url": "https://fhir.kbv.de/StructureDefinition/KBV_EX_AW_Abrechnung_Kundennummer_Abrechungsdienst",
"valueString": "1234455"
}
],
"identifier": {
"system": "http://fhir.de/NamingSystem/arge-ik/iknr",
"value": "123"
}
},
"provider": {
"reference": "Organization/3155"
},
"priority": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
}
]
},
"related": [
{
"claim": {
"reference": "Claim/3197"
}
}
],
"payee": {
"extension": [
{
"url": "https://fhir.kbv.de/StructureDefinition/KBV_EX_AW_Privatabrechnung_Kontoverbindung",
"extension": [
{
"url": "iban",
"valueString": "DE12500105170648489890"
},
{
"url": "bic",
"valueString": "ABCDEFGH"
}
]
}
],
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/payeetype",
"code": "provider"
}
]
}
},
"referral": {
"reference": "ReferralRequest/3218"
},
"insurance": [
{
"sequence": 1,
"focal": true,
"coverage": {
"display": "Selbstzahler"
}
}
],
"item": [
{
"sequence": 1,
"productOrService": {
"coding": [
{
"system": "https://fhir.kbv.de/CodeSystem/KBV_CS_AW_Abrechnung_Item_Kategorie",
"code": "Entschaedigung"
}
]
},
"modifier": [
{
"coding": [
{
"system": "https://fhir.kbv.de/CodeSystem/KBV_CS_AW_Entschaedigungsart",
"code": "Reisekosten"
}
]
}
],
"quantity": {
"value": 18,
"unit": "1",
"system": "http://unitsofmeasure.org",
"code": "1"
},
"unitPrice": {
"value": 0.3,
"currency": "EUR"
},
"encounter": [
{
"reference": "Encounter/3188"
}
]
},
{
"sequence": 2,
"productOrService": {
"coding": [
{
"system": "https://fhir.kbv.de/CodeSystem/KBV_CS_AW_Abrechnung_Item_Kategorie",
"code": "Auslagen"
}
]
},
"modifier": [
{
"coding": [
{
"system": "https://fhir.kbv.de/CodeSystem/KBV_CS_AW_Abrechnung_Auslagenart",
"code": "Porto_Versandkosten"
}
]
}
],
"quantity": {
"value": 1,
"unit": "1",
"system": "http://unitsofmeasure.org",
"code": "1"
},
"unitPrice": {
"value": 0.7,
"currency": "EUR"
},
"encounter": [
{
"reference": "Encounter/3188"
}
]
},
{
"sequence": 3,
"productOrService": {
"coding": [
{
"system": "https://fhir.kbv.de/CodeSystem/KBV_CS_AW_Abrechnung_Item_Kategorie",
"code": "Besondere_Kosten"
}
],
"text": "Desinfektionsmittel"
},
"quantity": {
"value": 1,
"unit": "1",
"system": "http://unitsofmeasure.org",
"code": "1"
},
"unitPrice": {
"value": 1.55,
"currency": "EUR"
},
"encounter": [
{
"reference": "Encounter/3188"
}
]
}
]
}