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Source1

{
  "resourceType": "Claim",
  "id": "ma-ma-schema-1-Claim-11001",
  "meta": {
    "lastUpdated": "2023-12-18T23:07:47Z",
    "source": "urn:telus:emr:ma:ma-schema-1",
    "security": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-Confidentiality",
        "code": "N",
        "display": "normal"
      }
    ]
  },
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "identifier": [
    {
      "use": "official",
      "system": "urn:telus:emr:ma:ma-schema-1:Claim",
      "value": "11001"
    }
  ],
  "status": "active",
  "type": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/claim-type",
        "code": "professional",
        "display": "Professional"
      }
    ]
  },
  "use": "claim",
  "patient": {
    "reference": "Patient/ma-ma-schema-1-Patient-12345",
    "type": "Patient",
    "display": "John Michael Smith"
  },
  "billablePeriod": {
    "start": "2023-12-18T10:00:00Z",
    "end": "2023-12-18T10:45:00Z"
  },
  "created": "2023-12-18T11:00:00Z",
  "enterer": {
    "reference": "Practitioner/ma-ma-schema-1-Practitioner-789",
    "type": "Practitioner",
    "display": "Dr. Sarah Johnson"
  },
  "provider": {
    "reference": "Practitioner/ma-ma-schema-1-Practitioner-789",
    "type": "Practitioner",
    "display": "Dr. Sarah Johnson"
  },
  "priority": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/processpriority",
        "code": "normal"
      }
    ]
  },
  "related": [
    {
      "relationship": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/related-claim-relationship",
            "code": "prior",
            "display": "Prior Claim"
          }
        ]
      }
    }
  ],
  "prescription": {
    "reference": "MedicationRequest/ma-ma-schema-1-MedicationRequest-8002",
    "type": "MedicationRequest"
  },
  "payee": {
    "type": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/payeetype",
          "code": "provider",
          "display": "Provider"
        }
      ]
    },
    "party": {
      "reference": "Practitioner/ma-ma-schema-1-Practitioner-789",
      "type": "Practitioner",
      "display": "Dr. Sarah Johnson"
    }
  },
  "facility": {
    "reference": "Location/ma-ma-schema-1-Location-101",
    "type": "Location",
    "display": "Exam Room 1"
  },
  "careTeam": [
    {
      "sequence": 1,
      "provider": {
        "reference": "Practitioner/ma-ma-schema-1-Practitioner-789",
        "type": "Practitioner",
        "display": "Dr. Sarah Johnson"
      },
      "responsible": true,
      "role": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
            "code": "primary",
            "display": "Primary provider"
          }
        ]
      }
    }
  ],
  "supportingInfo": [
    {
      "sequence": 1,
      "category": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
            "code": "info",
            "display": "Information"
          }
        ]
      },
      "valueReference": {
        "reference": "Condition/ma-ma-schema-1-Condition-problem-list-3001"
      }
    }
  ],
  "diagnosis": [
    {
      "sequence": 1,
      "diagnosisReference": {
        "reference": "Condition/ma-ma-schema-1-Condition-problem-list-3001",
        "type": "Condition",
        "display": "Essential Hypertension"
      },
      "type": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
              "code": "principal",
              "display": "Principal Diagnosis"
            }
          ]
        }
      ]
    }
  ],
  "procedure": [
    {
      "sequence": 1,
      "type": [
        {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/ex-procedure-type",
              "code": "primary"
            }
          ]
        }
      ],
      "date": "2023-12-18T10:15:00Z",
      "procedureReference": {
        "reference": "Procedure/ma-ma-schema-1-Procedure-6001",
        "type": "Procedure",
        "display": "Blood Pressure Measurement"
      }
    }
  ],
  "insurance": [
    {
      "sequence": 1,
      "focal": true,
      "coverage": {
        "display": "Provincial Health Insurance"
      }
    }
  ],
  "item": [
    {
      "sequence": 1,
      "careTeamSequence": [
        1
      ],
      "diagnosisSequence": [
        1
      ],
      "procedureSequence": [
        1
      ],
      "productOrService": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "390906007",
            "display": "Follow-up encounter"
          }
        ],
        "text": "Office Visit - Follow-up"
      },
      "servicedDate": "2023-12-18",
      "locationReference": {
        "reference": "Location/ma-ma-schema-1-Location-101",
        "type": "Location",
        "display": "Exam Room 1"
      },
      "quantity": {
        "value": 1
      },
      "unitPrice": {
        "value": 75,
        "currency": "CAD"
      },
      "net": {
        "value": 75,
        "currency": "CAD"
      },
      "encounter": [
        {
          "reference": "Encounter/ma-ma-schema-1-Encounter-2001",
          "type": "Encounter"
        }
      ]
    }
  ],
  "total": {
    "value": 75,
    "currency": "CAD"
  }
}