---
type: "examples"
title: "Claim Examples"
resource: "Claim"
---
# Claim Examples

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