Claim Examples

• 100150 — claim-example — Simple dental Claim
• 100151 — claim-example-oral-average — Average dental Claim with Information (Missing Teeth and Student)
• 100152 — claim-example-oral-contained — SOA Dental Claim (Contained)
• 100153 — claim-example-oral-orthoplan — PreAuthorization with Orthodontic Treatment Plan
• 100154 — claim-example-oral-identifier — SOA Dental Claim using identifiers
• 100155 — claim-example-oral-contained-identifier — SOA Dental Claim using identifiers and Contained
• 100156 — claim-example-oral-bridge — PreAuthorization with Bridge and Crown
• 660150 — claim-example-vision — Simple Vision Claim
• 660151 — claim-example-vision-glasses — Glasses Claim
• 660152 — claim-example-vision-glasses-3tier — Glasses Claim, 3 Tier, Secondary Coverage
• 760150 — claim-example-pharmacy — Simple Pharmacy Service Claim
• 760151 — claim-example-pharmacy-medication — Simple Pharmacy Medication Claim
• 760152 — claim-example-pharmacy-compound — Simple Pharmacy Compound Claim
• 860150 — claim-example-professional — Simple Professional Service Claim
• 960150 — claim-example-institutional — Simple Institutional Service Claim
• 960151 — claim-example-institutional-rich — Rich Institutional Service Claim
• claim-example — claim-example
• claim-example-cms1500-medical — claim-example-cms1500-medical
• claim-example-institutional — claim-example-institutional
• claim-example-institutional-rich — claim-example-institutional-rich
• claim-example-oral-average — claim-example-oral-average
• claim-example-oral-bridge — claim-example-oral-bridge
• claim-example-oral-contained — claim-example-oral-contained
• claim-example-oral-contained-identifier — claim-example-oral-contained-identifier
• claim-example-oral-identifier — claim-example-oral-identifier
• claim-example-oral-orthoplan — claim-example-oral-orthoplan
• claim-example-pharmacy — claim-example-pharmacy
• claim-example-pharmacy-compound — claim-example-pharmacy-compound
• claim-example-pharmacy-medication — claim-example-pharmacy-medication
• claim-example-professional — claim-example-professional
• claim-example-vision — claim-example-vision
• claim-example-vision-glasses — claim-example-vision-glasses
• claim-example-vision-glasses-3tier — claim-example-vision-glasses-3tier
• claim-examples-header — claim-examples-header
• MED-00050 — claim-example-cms1500-medical — Simple US Medical Surgery Claim