Healthcare Financial Services IG Edition 1
0.3.0 - ci-build Saudi Arabia flag

Healthcare Financial Services IG Edition 1 - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Example Claim: Authorization Professional Request #1

Generated Narrative: Claim 173086

Encounter: Encounter: extension = Very Urgent,2023-12-04 07:15:05+0000,Initial client service event; identifier = http://saudiprofessional.com.sa/identifiers/encounter#AB0001; status = in-progress; class = emergency (ActCode#EMER); serviceType = Acute Care; priority = emergency; period = 2023-12-04 --> (ongoing)

identifier: http://saudiprofessionalclinic.com.sa/identifiers/authorization/req_17308886

status: Active

type: Professional

subType: Emergency

use: Preauthorization

patient: Ahmad Khaled Abbas(official) Male, DoB: 1984-12-25 ( Passport Number: G12345678)

created: 2023-12-04 10:38:00+0300

insurer: Organization Saudi National Insurance

provider: Organization Saudi Professional Clinic

priority: Normal

Payees

-Type
*Provider

CareTeams

-SequenceProviderRoleQualification
*1Practitioner Dr. Amar Moustafa(official)Primary providerCardiology

supportingInfo

sequence: 1

category: Systolic

timing: 2023-12-04 10:38:00+0300 --> 2023-12-04 11:38:00+0300

value: 160 mm[Hg] (Details: UCUM codemm[Hg] = 'mm[Hg]')

supportingInfo

sequence: 2

category: Diastolic

timing: 2023-12-04 10:38:00+0300 --> 2023-12-04 11:38:00+0300

value: 100 mm[Hg] (Details: UCUM codemm[Hg] = 'mm[Hg]')

supportingInfo

sequence: 3

category: Height

timing: 2023-12-04 10:38:00+0300 --> 2023-12-04 11:38:00+0300

value: 133 cm (Details: UCUM codecm = 'cm')

supportingInfo

sequence: 4

category: Weight

timing: 2023-12-04 10:38:00+0300 --> 2023-12-04 11:38:00+0300

value: 120 kg (Details: UCUM codekg = 'kg')

supportingInfo

sequence: 5

category: Pulse

timing: 2023-12-04 10:38:00+0300 --> 2023-12-04 11:38:00+0300

value: 140 /min (Details: UCUM code/min = '/min')

supportingInfo

sequence: 6

category: Temperature

timing: 2023-12-04 10:38:00+0300 --> 2023-12-04 11:38:00+0300

value: 37 Cel (Details: UCUM codeCel = 'Cel')

supportingInfo

sequence: 7

category: chief complaint

code: Chest tightness

supportingInfo

sequence: 8

category: Oxygen Saturation

timing: 2023-12-04 10:38:00+0300 --> 2023-12-04 11:38:00+0300

value: 100 % (Details: UCUM code% = '%')

supportingInfo

sequence: 9

category: Respiratory Rate

timing: 2023-12-04 10:38:00+0300 --> 2023-12-04 11:38:00+0300

value: 70 /min (Details: UCUM code/min = '/min')

supportingInfo

sequence: 10

category: patient history

value: No systemic disease

supportingInfo

sequence: 11

category: Investigation Result

code: Investigation(s) not performed

supportingInfo

sequence: 12

category: Treatment Plan

value: administration of thrombolytic agent

supportingInfo

sequence: 13

category: Physical Examination

value: Stable

supportingInfo

sequence: 14

category: history Of Present Illness

value: No history

Diagnoses

-SequenceDiagnosis[x]Type
*1Acute myocardial infarction, unspecifiedPrincipal Diagnosis

Insurances

-SequenceFocalCoverage
*1trueCoverage: identifier = http://sni.com.sa/identifiers/memberid#0000000001; status = active; type = extended healthcare; dependent = 01; relationship = Self; network = Golden C

item

Package Code: false

Patient Share: SAR0.00 (SAR)

Maternity: false

sequence: 1

careTeamSequence: 1

diagnosisSequence: 1

productOrService: Intra-arterial administration of pharmacological agent, thrombolytic agent

serviced: 2023-12-04

quantity: 1

UnitPrices

-ValueCurrency
*120Saudi riyal

Nets

-ValueCurrency
*120Saudi riyal

Totals

-ValueCurrency
*120Saudi riyal