---
type: "example"
title: "Claim Example: claim-example-oral-contained-identifier"
resource: "Claim"
example: "claim-example-oral-contained-identifier"
---
# Claim Example: claim-example-oral-contained-identifier

## Narrative

This example assumes a national health care scheme where patients, providers and organizations have known business identifiers.

## Example XML



```xml
<?xml version="1.0" encoding="UTF-8"?>

<Claim xmlns="http://hl7.org/fhir">
	<id value="100155"/>

	<text>
		<status value="generated"/>
		<div xmlns="http://www.w3.org/1999/xhtml">This example assumes a national health care scheme where patients, providers and organizations have known business identifiers.</div>
	</text>

	<contained>
		<Patient>
			<id value="patient-1"/>
			<name>
				<use value="official"/>
				<family value="Donald"/>
				<given value="Duck"/>
			</name>
			<gender value="male"/>
			<birthDate value="1986-05-17"/>
			<address>
				<use value="home"/>
				<line value="1234 Main Street"/>
				<city value="Vancouver"/>
				<postalCode value="V2H1Y3"/>
				<country value="CAD"/>
			</address>
		</Patient>
	</contained>

	<identifier>
		<system value="http://happyvalley.com/claim"/>
		<value value="12347"/>
	</identifier>

	<status value = "active"/>

	<type>
		<coding>
			<system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
			<code value="oral"/>
		</coding>
	</type>

	<use value="claim"/>

	<subject>
		<reference value="#patient-1"/>
	</subject>

	<created value="2014-08-16"/>

	<insurer>
		<identifier>
			<system value="http://www.jurisdiction.com/insurers"/>
			<value value="123456"/>
		</identifier>
	</insurer>

	<provider>
		<identifier>
			<system value="http://www.jurisdiction.com/careorganizations"/>
			<value value="HOSP12345"/>
		</identifier>
	</provider>

	<priority>
		<coding>
			<code value="normal"/>
		</coding>
	</priority>

	<payee>
		<type>
			<coding>
				<code value="provider"/>
			</coding>
		</type>
	</payee>

	<careTeam>
		<sequence value="1"/>
		<provider>
			<identifier>
				<system value="http://www.jurisdiction.com/providerId"/>
				<value value="MD98765"/>
			</identifier>
		</provider>
	</careTeam>

	<diagnosis>
		<sequence value="1"/>
		<diagnosisCodeableConcept>
			<coding>
				<code value="123456"/>
			</coding>
		</diagnosisCodeableConcept>
	</diagnosis>

	<insurance>
		<sequence value="1"/>
		<focal value="true"/>
		<coverage>
			<reference value="http://www.jurisdiction.com/nationalplan/123AB345" />
		</coverage>
	</insurance>

	<item>
		<sequence value="1"/>
		<careTeamSequence value="1"/>
		<productOrService>
			<coding>
				<code value="1200"/>
			</coding>
		</productOrService>
		<servicedDate value="2014-08-16"/>
		<unitPrice>
			<value value="135.57"/>
			<currency value="USD"/>
		</unitPrice>
		<net>
			<value value="135.57"/>
			<currency value="USD"/>
		</net>
	</item>
</Claim>
```