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Packageuz.dhp.core
Resource TypeClaimResponse
IdClaimResponse-example-claim-response.json
FHIR VersionR5

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Narrative

Note: links and images are rebased to the (stated) source


English


Generated Narrative: ClaimResponse example-claim-response

ClaimResponse Cancellation Reason: Expired

status: Cancelled

type: Institutional

use: Preauthorization

patient: Усманов Салим Салиевич Male, DoB: 1994-01-27 ( National unique individual identifier)

created: 2026-03-10

insurer: Organization Respublika onkologiya markazi

request: Claim: status = active; type = Institutional; use = preauthorization; created = 2026-10-03

outcome: Processing Complete

decision: Approved

preAuthRef: PA-2026-001

preAuthPeriod: 2026-03-11 --> 2026-05-11

total

category: Benefit Amount

Amounts

-ValueCurrency
*10000Uzbekistan som

Russian


Сгенерированный нарратив: ClaimResponse example-claim-response

Профиль: UZ Core Claim Response

ClaimResponse Cancellation Reason: Expired

status: Cancelled

type: Institutional

use: Preauthorization

patient: Усманов Салим Салиевич Male, БД: 1994-01-27 ( National unique individual identifier)

created: 2026-03-10

insurer: Organization Республиканский онкологический центр

request: Claim: status = active; type = Institutional; use = preauthorization; created = 2026-10-03

outcome: Processing Complete

decision: Approved

preAuthRef: PA-2026-001

preAuthPeriod: 2026-03-11 --> 2026-05-11

total

category: Benefit Amount

Amounts

-ValueCurrency
*10000Uzbekistan som

Uzbek


Generated Narrative: ClaimResponse example-claim-response

ClaimResponse Cancellation Reason: Expired

status: Cancelled

type: Institutional

use: Preauthorization

patient: Усманов Салим Салиевич Male, DoB: 1994-01-27 ( National unique individual identifier)

created: 2026-03-10

insurer: Organization Respublika onkologiya markazi

request: Claim: status = active; type = Institutional; use = preauthorization; created = 2026-10-03

outcome: Processing Complete

decision: Approved

preAuthRef: PA-2026-001

preAuthPeriod: 2026-03-11 --> 2026-05-11

total

category: Benefit Amount

Amounts

-ValueCurrency
*10000Uzbekistan som

Source1

{
  "resourceType": "ClaimResponse",
  "id": "example-claim-response",
  "meta": {
    "profile": [
      "https://dhp.uz/fhir/core/StructureDefinition/uz-core-claim-response"
    ]
  },
  "text": {
    "status": "extensions",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "https://dhp.uz/fhir/core/StructureDefinition/claim-response-cancellation-reason",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://terminology.dhp.uz/fhir/core/CodeSystem/cancellation-reason-cs",
            "code": "Reimb0001-00001",
            "display": "Expired"
          }
        ]
      }
    }
  ],
  "status": "cancelled",
  "type": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/claim-type",
        "code": "institutional"
      }
    ]
  },
  "use": "preauthorization",
  "patient": {
    "reference": "Patient/example-salim"
  },
  "created": "2026-03-10",
  "insurer": {
    "reference": "Organization/example-organization"
  },
  "request": {
    "reference": "Claim/example-claim"
  },
  "outcome": "complete",
  "decision": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/claim-decision",
        "code": "approved",
        "display": "Approved"
      }
    ]
  },
  "preAuthRef": "PA-2026-001",
  "preAuthPeriod": {
    "start": "2026-03-11",
    "end": "2026-05-11"
  },
  "total": [
    {
      "category": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
            "code": "benefit",
            "display": "Benefit Amount"
          }
        ]
      },
      "amount": {
        "value": 10000,
        "currency": "UZS"
      }
    }
  ]
}