Claim $submit-institutional

post/Claim/$submit-institutional
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This resource contains the financial details for provider services for a patient visit or treatment. Healthcare organizations can use this resource to request reimbursement while payers can review this resource to process claims and respond with the ClaimResponse resource. 

You can submit, check, or add to claim information using one of the supported operations.

$submit-institutional

This operation allows you to submit an institutional billing claim for any services rendered in a hospital or skilled nursing facility. This may include nursing, medical supplies, or laboratory tests, to name a few examples.

Request parameters and payload

cURL request example

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curl 'https://api.redoxengine.com/fhir/R4/{destinationSlug}/{environmentFlag}/Claim/$submit-institutional' \
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--request POST \
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--header 'Authorization: Bearer $API_TOKEN' \
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--header 'Content-Type: application/fhir+json' \
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--data '{
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"resourceType": "Bundle",
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"id": "InstitutionalClaimBundle",
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"type": "collection",
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"identifier": {
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"system": "urn:ietf:rfc:3986",
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"value": "urn:uuid:59f129cf-2eca-4965-88f2-452558af1934"
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},
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"timestamp": "2021-10-21T19:09:02.452Z",
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"entry": [
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{
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"resource": {
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"resourceType": "Claim",
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"id": "InstitutionalClaim1",
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"status": "active",
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"use": "claim",
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"identifier": [
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{
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"system": "http://myclaim.id",
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"value": "123476789"
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}
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],
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"type": {
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"coding": [
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{
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"code": "institutional",
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"system": "http://terminology.hl7.org/CodeSystem/claim-type"
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}
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]
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},
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"patient": {
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"reference": "Patient/RedoxPABeneficiaryExample"
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},
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"created": "2022-01-18T16:27:49.101Z",
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"total": {
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"value": 89.93,
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"currency": "USD"
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},
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"provider": {
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"reference": "Organization/RedoxPARequestorOrganizationExample"
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},
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"priority": {
47
"coding": [
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{
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"code": "normal",
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"system": "http://terminology.hl7.org/CodeSystem/processpriority"
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}
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]
53
},
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"careTeam": [
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{
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"sequence": 1,
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"provider": {
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"reference": "Practitioner/RedoxPractitionerExamplePat"
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},
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"role": {
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"coding": [
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{
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"code": "attending",
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"system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBClaimCareTeamRole",
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"display": "Attending"
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}
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]
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}
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},
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{
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"sequence": 2,
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"provider": {
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"reference": "Practitioner/RedoxPractitionerExampleJoan"
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},
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"role": {
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"coding": [
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{
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"code": "referring",
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"system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBClaimCareTeamRole",
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"display": "Referring"
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}
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]
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}
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}
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],
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"diagnosis": [
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{
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"sequence": 1,
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"diagnosisCodeableConcept": {
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"coding": [
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{
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"code": "H26.9",
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"system": "http://hl7.org/fhir/sid/icd-10-cm",
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"display": "Unspecified cataract"
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}
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]
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},
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"type": [
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{
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"coding": [
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{
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"code": "principal",
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"system": "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBClaimDiagnosisType",
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"display": "Principal Diagnosis"
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}
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]
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}
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]
109
},
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{
111
"sequence": 2,
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"diagnosisCodeableConcept": {
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"coding": [
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{
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"code": "I16.9",
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"system": "http://hl7.org/fhir/sid/icd-10-cm",
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"display": "Unspecified essential hypertension"
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}
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]
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},
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"type": [
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{
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"coding": [
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{
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"code": "other",
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"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
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"display": "Other Diagnosis"
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}
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]
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}
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]
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},
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{
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"sequence": 3,
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"diagnosisCodeableConcept": {
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"coding": [
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{
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"code": "R94.31",
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"system": "http://hl7.org/fhir/sid/icd-10-cm",
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"display": "Abnormal electrocardiogram"
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}
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]
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},
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"type": [
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{
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"coding": [
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{
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"code": "other",
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"system": "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
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"display": "Other Diagnosis"
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}
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]
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}
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]
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}
156
],
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"insurance": [
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{
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"sequence": 1,
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"focal": true,
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"coverage": {
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"reference": "Coverage/RedoxPACoverageExample"
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}
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}
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],
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"item": [
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{
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"sequence": 1,
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"careTeamSequence": [
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1
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],
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"diagnosisSequence": [
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1,
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2,
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3
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],
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"productOrService": {
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"coding": [
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{
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"code": "85025",
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"system": "http://www.ama-assn.org/go/cpt",
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"display": "Blood count; complete (CBC)"
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}
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],
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"text": "Blood count; complete (CBC)"
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},
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"revenue": {
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"coding": [
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{
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"code": "0305",
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"system": "https://www.nubc.org/CodeSystem/RevenueCodes",
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"display": "Laboratory"
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}
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]
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},
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"quantity": {
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"value": 1
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},
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"locationCodeableConcept": {
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"coding": [
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{
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"code": "21",
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"system": "https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set",
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"display": "HOSPITAL - INPATIENT HOSPITAL"
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}
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]
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},
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"unitPrice": {
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"value": 13.39,
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"currency": "USD"
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},
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"servicedPeriod": {
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"start": "2022-01-18T16:20:00.101Z",
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"end": "2022-01-19T16:20:00.101Z"
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}
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},
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{
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"sequence": 2,
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"careTeamSequence": [
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1
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],
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"diagnosisSequence": [
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1,
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2,
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3
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],
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"productOrService": {
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"coding": [
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{
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"code": "93005",
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"system": "http://www.ama-assn.org/go/cpt",
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"display": "Electrocardiogram, routine ECG with at least 12 leads"
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}
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],
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"text": "Electrocardiogram, routine"
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},
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"revenue": {
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"coding": [
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{
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"code": "0730",
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"system": "https://www.nubc.org/CodeSystem/RevenueCodes",
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"display": "EKG/ECG (Electrocardiogram)"
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}
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]
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},
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"quantity": {
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"value": 3
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},
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"locationCodeableConcept": {
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"coding": [
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{
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"code": "21",
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"system": "https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set",
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"display": "HOSPITAL - INPATIENT HOSPITAL"
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}
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]
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},
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"unitPrice": {
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"value": 76.54,
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"currency": "USD"
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},
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"servicedPeriod": {
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"start": "2022-01-18T17:20:00.101Z",
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"end": "2022-01-18T17:40:00.101Z"
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}
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}
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]
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}
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},
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{
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"resource": {
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"resourceType": "Patient",
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"id": "RedoxPABeneficiaryExample",
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"identifier": [
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{
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"system": "urn:redox:MRN",
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"value": "M23462346"
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}
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],
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"name": [
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{
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"given": [
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"Timothy",
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"Paul"
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],
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"family": "Bixby"
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}
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],
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"gender": "male",
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"birthDate": "2008-01-06"
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}
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},
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{
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"resource": {
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"resourceType": "Coverage",
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"id": "RedoxPACoverageExample",
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"class": [
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{
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"type": {
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"coding": [
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{
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"code": "group",
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"system": "http://terminology.hl7.org/CodeSystem/coverage-class"
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}
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]
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},
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"value": "GRP2245"
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}
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],
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"status": "active",
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"beneficiary": {
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"reference": "Patient/RedoxPABeneficiaryExample"
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},
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"payor": [
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{
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"reference": "Organization/RedoxPAInsurerOrganizationExample"
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}
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],
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"subscriber": {
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"reference": "Patient/RedoxPABeneficiaryExample"
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},
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"subscriberId": "T75644"
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}
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},
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{
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"resource": {
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"resourceType": "Organization",
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"id": "RedoxPARequestorOrganizationExample",
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"active": true,
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"name": "Good Health Clinics",
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"address": [
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{
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"line": [
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"123 Main St."
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],
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"city": "Madison",
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"district": "Dane",
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"state": "WI",
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"postalCode": "53703",
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"country": "USA"
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}
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]
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}
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},
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{
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"resource": {
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"resourceType": "Organization",
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"id": "RedoxPAInsurerOrganizationExample",
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"active": true,
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"name": "Aetna",
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"address": [
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{
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"line": [
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"PO Box 14080"
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],
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"city": "Lexington",
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"district": "Fayette",
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"state": "KY",
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"postalCode": "40512-4079",
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"country": "USA"
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}
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]
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}
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},
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{
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"resource": {
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"resourceType": "Practitioner",
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"id": "RedoxPractitionerExamplePat",
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"identifier": [
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{
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"system": "http://hl7.org/fhir/sid/us-npi",
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"value": "4356789876"
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}
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],
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"name": [
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{
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"given": [
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"Pat"
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],
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"family": "Granite"
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}
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],
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"address": [
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{
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"line": [
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"123 Main St."
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],
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"city": "Madison",
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"district": "Dane",
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"state": "WI",
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"postalCode": "53703",
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"country": "USA"
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}
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],
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"telecom": [
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{
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"value": "+16085551234"
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}
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]
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}
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},
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{
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"resource": {
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"resourceType": "Practitioner",
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"id": "RedoxPractitionerExampleJoan",
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"identifier": [
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{
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"system": "http://hl7.org/fhir/sid/us-npi",
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"value": "4336749876"
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}
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],
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"name": [
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{
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"given": [
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"Joan"
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],
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"family": "Fishman"
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}
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],
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"address": [
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{
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"line": [
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"4762 Hickory St."
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],
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"city": "Monroe",
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"district": "Green",
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"state": "WI",
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"postalCode": "53566",
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"country": "USA"
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}
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],
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"telecom": [
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{
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"value": "+16085558899"
435
}
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]
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}
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}
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]
440
}'

Request Body Schema

  • resourceType
    required, string

    Identifies the type of the resource

    Value: Bundle
  • type
    required, string

    Indicates the purpose of this bundle - how it is intended to be used.

    Value: collection
  • entry
    required, Array of Claim, Patient, Coverage, Practitioner, RelatedPerson or Other

    An array of FHIR resources. At a minimum, a Claim should include the following entries:

    • Claim - the most important part of the request - contains references to all other resources, and the actual service line items in item
    • Patient - the patient the claim is for
    • Organization - at least one resource representing the party responsible for making the claim. Additional organization resources may carry information such as pharmacy, primary payer, or addtional payers.
    • Practitioner - Practitioners that were part of the claim - linked to the claim via careTeam.
    • Coverage - the patient's insurance(s)

    Additional resources such as RelatedPerson should be included in scenarios where the Patient is a dependent of the coverage holder.

    • resource
      required, object

      The Resource for the entry. The purpose/meaning of the resource is determined by the Bundle.type.

      • resourceType
        required, string

        Identifies the type of the resource

        Value: Claim
      • id
        required, string

        A unique identifier for the claim that will be echoed on status checks and response payloads.

      • status
        required, string

        The status of the resource instance.

        Value: active
      • type
        required, object

        Type of claim. Example Codes The recommended system is http://terminology.hl7.org/CodeSystem/claim-type. Typical values include

        • pharmacy - Pharmacy claims for goods and services
        • professional - Typically outpatient claims such as Psychological, Chiropractor, rehabilitative, consulting
        • institutional - Hospital, clinic and other inpatient claims
        • coding
          Array of object

          A reference to a code defined by a terminology system.

          • system
            string

            The identification of the code system that defines the meaning of the symbol in the code.

          • code
            string

            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        • text
          string

          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

      • use
        required, string

        A code to indicate whether the nature of the request is: to request adjudication of products and services previously rendered; or requesting authorization and adjudication for provision in the future; or requesting the non-binding adjudication of the listed products and services which could be provided in the future.

        Value: claim
      • patient
        required, object

        The party to whom the professional services and/or products have been supplied or are being considered and for whom actual or forecast reimbursement is sought.

        Must be a resource of type Patient.

        • reference
          string

          A reference to a Patient resource

      • created
        required, string

        The date this resource was created.

      • provider
        required, object

        The provider which is responsible for the claim, predetermination or preauthorization.

        Must reference one of the following types of resources:

        • Practitioner
        • Organization
        • reference
          string

          A reference to either an Organization or Provider.

      • priority
        required, object

        The provider-required urgency of processing the request. Typical values include: stat, routine, and deferred. If sending one of these statuses, use the system http://terminology.hl7.org/CodeSystem/processpriority

        • coding
          Array of object

          A reference to a code defined by a terminology system.

          • system
            string

            The identification of the code system that defines the meaning of the symbol in the code.

          • code
            string

            A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

        • text
          string

          A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

      • insurance
        required, Array of object

        Financial instruments for reimbursement for the health care products and services specified on the claim.

        • sequence
          required, number

          A number to uniquely identify insurance entries and provide a sequence of coverages to convey coordination of benefit order.

        • focal
          required, boolean

          A flag to indicate that this Coverage is to be used for adjudication of this claim when set to true.

        • coverage
          required, object

          Reference to Coverage resource for patient.

          Must be a resource of type Coverage.

          • reference
            string

            A reference to another resource. This is typically either a relative reference which includes the resource type and ID, or an internal reference which starts with # and refers to a contained resource.

        • businessArrangement
          string

          A business agreement number established between the provider and the insurer for special business processing purposes.

        • preAuthRef
          Array of string

          Reference numbers previously provided by the insurer to the provider to be quoted on subsequent claims containing services or products related to the prior authorization.

      • insurer
        object

        The Insurer who is target of the request.

        Must be a resource of type Organization.

        • reference
          string

          A reference to an Organization resource

      • related
        Array of object

        Other claims which are related to this claim such as prior submissions or claims for related services or for the same event.

        • claim
          object

          Reference to a related claim.

          Must be a resource of type Claim.

          • reference
            string

            Contains the resource ID of the original claim that this resource is updating

        • relationship
          object

          When modifying a prior claim, set this to code='prior' and system='http://terminology.hl7.org/CodeSystem/ex-relatedclaimrelationship'

          • coding
            Array of object

            A reference to a code defined by a terminology system.

            • system
              string

              The identification of the code system that defines the meaning of the symbol in the code.

            • code
              string

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

      • careTeam
        Array of object

        An array of care team members. Each piece of information is is linked to a claim line item via sequence, and the type/role is denoted with by role.

        • sequence
          required, number

          A number to uniquely identify care team entries.

        • provider
          required, object

          Reference to Practitioner who particpated in the claim.

          Must be a resource of type Practitioner.

          • reference
            string

            A reference to another resource. This is typically either a relative reference which includes the resource type and ID, or an internal reference which starts with # and refers to a contained resource.

        • responsible
          boolean

          The party who is billing and/or responsible for the claimed products or services.

        • role
          object

          The lead, assisting or supervising practitioner and their discipline if a multidisciplinary team.

          • coding
            Array of object

            A reference to a code defined by a terminology system.

            • system
              string

              The identification of the code system that defines the meaning of the symbol in the code.

            • code
              string

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

      • supportingInfo
        Array of object

        An array of supporting information for the claim. Generally this is implementation-specific, key-value pairs identified by code and value[x]. Each piece of information is is linked to a claim line item via sequence and its type is identified by category

        • sequence
          required, number

          A number to uniquely identify supporting information entries.

        • category
          required, object

          The general class of the information supplied: information; exception; accident, employment; onset, etc.

          • coding
            Array of object

            A reference to a code defined by a terminology system.

            • system
              string

              The identification of the code system that defines the meaning of the symbol in the code.

            • code
              string

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        • code
          object

          The specific type of information being sent.

          • coding
            Array of object

            A reference to a code defined by a terminology system.

            • system
              string

              The identification of the code system that defines the meaning of the symbol in the code.

            • code
              string

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        • timingPeriod
          object

          The date when or period to which this information refers.

          • start
            string

            The start of the period. The boundary is inclusive.

          • end
            string

            The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

        • valueBoolean
          boolean

          Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.

          Only one of valueBoolean, valueString, valueQuantity, valueReference may be present.

        • valueString
          string

          Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.

          Only one of valueBoolean, valueString, valueQuantity, valueReference may be present.

        • valueQuantity
          object

          Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.

          Only one of valueBoolean, valueString, valueQuantity, valueReference may be present.

          • value
            number

            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

          • system
            string

            The identification of the system that provides the coded form of the unit.

          • code
            string

            A computer processable form of the unit in some unit representation system.

        • valueReference
          object

          Additional data or information such as resources, documents, images etc. including references to the data or the actual inclusion of the data.

          Only one of valueBoolean, valueString, valueQuantity, valueReference may be present.

          Must be a resource of type Resource.

          • reference
            string

            A reference to another resource. This is typically either a relative reference which includes the resource type and ID, or an internal reference which starts with # and refers to a contained resource.

      • diagnosis
        Array of object

        An array of diagnoses for Patient. Each diagnosis is is linked to a claim line item via sequence

        • sequence
          required, number

          A number to uniquely identify diagnosis entries.

        • diagnosisCodeableConcept
          required, object

          The nature of illness or problem in a coded form or as a reference to an external defined Condition.

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        • type
          Array of object

          When the condition was observed or the relative ranking.

          • coding
            Array of object

            A reference to a code defined by a terminology system.

            • system
              string

              The identification of the code system that defines the meaning of the symbol in the code.

            • code
              string

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        • onAdmission
          object

          Indication of whether the diagnosis was present on admission to a facility.

          • coding
            Array of object

            A reference to a code defined by a terminology system.

            • system
              string

              The identification of the code system that defines the meaning of the symbol in the code.

            • code
              string

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        • packageCode
          object

          A package billing code or bundle code used to group products and services to a particular health condition (such as heart attack) which is based on a predetermined grouping code system.

          • coding
            Array of object

            A reference to a code defined by a terminology system.

            • system
              string

              The identification of the code system that defines the meaning of the symbol in the code.

            • code
              string

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

      • procedure
        Array of object

        An array of procedures for Patient. Each procedure is is linked to a claim line item via sequence

        • sequence
          required, number

          A number to uniquely identify procedure entries.

        • procedureCodeableConcept
          required, object

          The code or reference to a Procedure resource which identifies the clinical intervention performed.

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        • type
          Array of object

          When the condition was observed or the relative ranking.

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        • date
          string

          Date and optionally time the procedure was performed.

      • accident
        object

        Details of an accident which resulted in injuries which required the products and services listed in the claim.

        • date
          required, string

          Date of an accident event related to the products and services contained in the claim.

        • type
          object

          The type or context of the accident event for the purposes of selection of potential insurance coverages and determination of coordination between insurers.

          • coding
            Array of object

            A reference to a code defined by a terminology system.

            • system
              string

              The identification of the code system that defines the meaning of the symbol in the code.

            • code
              string

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        • locationAddress
          object

          The physical location of the accident event.

          • use
            string

            The purpose of this address.

            Possible Values: home, work, temp, old, billing
          • line
            Array of string

            This component contains the house number, apartment number, street name, street direction, P.O. Box number, delivery hints, and similar address information.

          • city
            string

            The name of the city, town, suburb, village or other community or delivery center.

          • district
            string

            The name of the administrative area (county).

          • state
            string

            Sub-unit of a country with limited sovereignty in a federally organized country. A code may be used if codes are in common use (e.g. US 2 letter state codes).

          • postalCode
            string

            A postal code designating a region defined by the postal service.

          • country
            string

            Country - a nation as commonly understood or generally accepted.

      • item
        Array of object

        A claim line. Either a simple product or service or a 'group' of details which can each be a simple items or groups of sub-details.

        • sequence
          required, number

          A number to uniquely identify item entries.

        • productOrService
          required, object

          For prior auth, the requestedService extension carries more information than this field, and this field should just duplicate the product or service code found in that resource.

          • coding
            Array of object

            A reference to a code defined by a terminology system.

            • system
              string

              The identification of the code system that defines the meaning of the symbol in the code.

            • code
              string

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        • id
          string

          A unique id for the line item. This can be used on subsequent status checks to get-line-level status information.

        • careTeamSequence
          Array of number

          An array of sequence numbers from Claim.careTeam that apply to this line item.

        • diagnosisSequence
          Array of number

          An array of sequence numbers from Claim.diagnosis that apply to this line item.

        • procedureSequence
          Array of number

          An array of sequence numbers from Claim.procedure that apply to this line item.

        • informationSequence
          Array of number

          An array of sequence numbers from Claim.supportingInfo that apply to this line item.

        • revenue
          object

          The type of revenue or cost center providing the product and/or service.

          • coding
            Array of object

            A reference to a code defined by a terminology system.

            • system
              string

              The identification of the code system that defines the meaning of the symbol in the code.

            • code
              string

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        • modifier
          Array of object

          Item typification or modifiers codes to convey additional context for the product or service.

          • coding
            Array of object

            A reference to a code defined by a terminology system.

            • system
              string

              The identification of the code system that defines the meaning of the symbol in the code.

            • code
              string

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        • programCode
          Array of object

          Identifies the program under which this may be recovered.

          • coding
            Array of object

            A reference to a code defined by a terminology system.

            • system
              string

              The identification of the code system that defines the meaning of the symbol in the code.

            • code
              string

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        • quantity
          object

          The number of repetitions of a service or product.

          • value
            number

            The value of the measured amount. The value includes an implicit precision in the presentation of the value.

          • _value
            object

            This element contains extensions for value. Depending on the extensions present it could be used in place of value or contain additional information about value. See the extension element for more details on the possible extensions being sent.

            • extension
              Array of Precision or Other

              A Precision extension allows the communication of values more precise than a JSON number, for example, 3.10 as opposed to just 3.1.

                Explicit precision of the number. If the actual value is 3.10, the value field will contain the number 3.1 while the precision extension will contain 2.

                See http://hl7.org/fhir/StructureDefinition/quantity-precision for more information

              • url
                required, string

                Source of the definition for the extension code - a logical name or a URL.

                Value: http://hl7.org/fhir/StructureDefinition/quantity-precision
              • valueInteger
                required, number

                Number of significant decimal places after the decimal.

          • unit
            string

            A human-readable form of the unit.

        • unitPrice
          object

          If the item is not a group then this is the fee for the product or service, otherwise this is the total of the fees for the details of the group.

          • value
            number

            Numerical value (with implicit precision).

          • currency
            string

            ISO 4217 Currency Code (e.g. USD for US Dollar)

        • bodySite
          object

          Physical service site on the patient (limb, tooth, etc.).

          • coding
            Array of object

            A reference to a code defined by a terminology system.

            • system
              string

              The identification of the code system that defines the meaning of the symbol in the code.

            • code
              string

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

        • encounter
          Array of object

          The Encounters during which this Claim was created or to which the creation of this record is tightly associated.

          Must be a resource of type Encounter.

          • reference
            string

            A reference to another resource. This is typically either a relative reference which includes the resource type and ID, or an internal reference which starts with # and refers to a contained resource.

        • servicedPeriod
          object

          The date or dates when the service or product was supplied, performed or completed.

          • start
            string

            The start of the period. The boundary is inclusive.

          • end
            string

            The end of the period. If the end of the period is missing, it means no end was known or planned at the time the instance was created. The start may be in the past, and the end date in the future, which means that period is expected/planned to end at that time.

        • locationCodeableConcept
          object

          Where the product or service was provided.

          • coding
            Array of object

            A reference to a code defined by a terminology system.

            • system
              string

              The identification of the code system that defines the meaning of the symbol in the code.

            • code
              string

              A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

          • text
            string

            A human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user.

      • total
        object

        The total value of the all the items in the claim.

        • value
          number

          Numerical value (with implicit precision).

        • currency
          string

          ISO 4217 Currency Code (e.g. USD for US Dollar)

Response fields and example

Example payload generated from schema

1
{
2
"resourceType": "OperationOutcome",
3
"issue": [
4
{
5
"id": "string",
6
"severity": "fatal",
7
"code": "string",
8
"details": {
9
"coding": [
10
{
11
"system": "string",
12
"code": "string"
13
}
14
],
15
"text": "string"
16
},
17
"diagnostics": "string"
18
}
19
]
20
}
  • resourceType
    required, string

    Identifies the type of the resource

    Value: OperationOutcome
  • issue
    required, Array of object

    A structured respresentation of the error that occurred

    • severity
      required, string

      Generally error or fatal

      Possible Values: fatal, error, warning, information
    • code
      required, string

      A FHIR category code that describes the general type of issue. See http://hl7.org/fhir/ValueSet/issue-type for details

    • id
      string

      If the error occurs in the RedoxEngine, this corresponds to an Error record in the organization.

    • details
      object

      Additional details about the error. This may be a text description of the error or a system code that identifies the error.

      • coding
        Array of object

        A more granular FHIR code for the specific error. Typically from http://hl7.org/fhir/ValueSet/operation-outcome

        • system
          string

          The identification of the code system that defines the meaning of the symbol in the code.

        • code
          string

          A symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination).

      • text
        string

        A human-readable interpretation of the issue code

    • diagnostics
      string

      Additional diagnostic information about the issue.