{

"resourceType": "Claim",
"id": "960150",
"identifier": [
  {
    "system": "http://happyhospital.com/claim",
    "value": "9612345"
  }
],
"status": "active",
"type": {
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/claim-type",
      "code": "institutional"
    }
  ]
},
"subType": {
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/ex-claimsubtype",
      "code": "emergency"
    }
  ]
},
"use": "claim",
"patient": {
  "reference": "Patient/1"
},
"created": "2014-08-16",
"enterer": {
  "identifier": {
    "system": "http://jurisdiction.org/facilities/HOSP1234/users",
    "value": "UC1234"
  }
},
"insurer": {
  "reference": "Organization/2"
},
"provider": {
  "reference": "Organization/1"
},
"priority": {
  "coding": [
    {
      "code": "normal"
    }
  ]
},
"payee": {
  "type": {
    "coding": [
      {
        "code": "provider"
      }
    ]
  }
},
"facility": {
  "identifier": {
    "system": "http://jurisdiction.org/facilities",
    "value": "HOSP1234"
  }
},
"careTeam": [
  {
    "sequence": 1,
    "provider": {
      "reference": "Practitioner/example"
    }
  }
],
"diagnosis": [
  {
    "sequence": 1,
    "diagnosisCodeableConcept": {
      "coding": [
        {
          "code": "654456"
        }
      ]
    }
  }
],
"procedure": [
  {
    "sequence": 1,
    "type": [
      {
        "coding": [
          {
            "code": "primary"
          }
        ]
      }
    ],
    "date": "2014-08-16",
    "procedureCodeableConcept": {
      "coding": [
        {
          "code": "SDI9901"
        }
      ],
      "text": "Subcutaneous diagnostic implant"
    },
    "udi": [
      {
        "reference": "Device/example"
      }
    ]
  }
],
"insurance": [
  {
    "sequence": 1,
    "focal": true,
    "coverage": {
      "reference": "Coverage/9876B1"
    }
  }
],
"item": [
  {
    "sequence": 1,
    "careTeamSequence": [
      1
    ],
    "productOrService": {
      "coding": [
        {
          "system": "http://hl7.org/fhir/ex-serviceproduct",
          "code": "exam"
        }
      ]
    },
    "servicedDate": "2014-08-16",
    "unitPrice": {
      "value": 125.0,
      "currency": "USD"
    },
    "net": {
      "value": 125.0,
      "currency": "USD"
    },
    "encounter": [
      {
        "reference": "Encounter/example"
      }
    ]
  }
],
"total": {
  "value": 125.0,
  "currency": "USD"
},
"meta": {
  "tag": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
      "code": "HTEST",
      "display": "test health data"
    }
  ]
}

}