Uzbekistan Digital Health Platform - Local Development build (v0.7.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

• Narrative Content
• JSON

: Example Claim Response

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{
  "resourceType" : "ClaimResponse",
  "id" : "example-claim-response",
  "meta" : {
    "profile" : [
      🔗 "https://dhp.uz/fhir/core/StructureDefinition/uz-core-claim-response"
    ]
  },
  "language" : "en",
  "text" : {
    "status" : "extensions",
    "div" : "<div xml:lang=\"en\" lang=\"en\"><hr/><p><b>English</b></p><hr/><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse example-claim-response</b></p><a name=\"example-claim-response\"> </a><a name=\"hcexample-claim-response\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-uz-core-claim-response.html\">UZ Core Claim Response</a></p></div><p><b>ClaimResponse Cancellation Reason</b>: <span title=\"Codes:{https://terminology.dhp.uz/fhir/core/CodeSystem/cancellation-reason-cs Reimb0001-00001}\">Expired</span></p><p><b>status</b>: Cancelled</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type institutional}\">Institutional</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href=\"Patient-example-salim.html\">Усманов Салим Салиевич Male, DoB: 1994-01-27 ( National unique individual identifier)</a></p><p><b>created</b>: 2026-03-10</p><p><b>insurer</b>: <a href=\"Organization-example-organization.html\">Organization Respublika onkologiya markazi</a></p><p><b>request</b>: <a href=\"Claim-example-claim.html\">Claim: status = active; type = Institutional; use = preauthorization; created = 2026-10-03</a></p><p><b>outcome</b>: Processing Complete</p><p><b>decision</b>: <span title=\"Codes:{http://hl7.org/fhir/claim-decision approved}\">Approved</span></p><p><b>preAuthRef</b>: PA-2026-001</p><p><b>preAuthPeriod</b>: 2026-03-11 --&gt; 2026-05-11</p><blockquote><p><b>total</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}\">Benefit Amount</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>10000</td><td>Uzbekistan som</td></tr></table></blockquote></div>"
  },
  "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"
      }
    }
  ]
}