Generated Narrative: Bundle ClaimBundle-preauthorization-example-01

Bundle ClaimBundle-preauthorization-example-01 of type collection

Entry 1 - fullUrl = urn:uuid:4e857d1b-6189-41b5-96c3-20e1a90ce8de

Resource Claim:

Generated Narrative: Claim 4e857d1b-6189-41b5-96c3-20e1a90ce8de

identifier: 7612345

status: Active

type: Inpatient care management (procedure)

use: Preauthorization

patient: Patient

billablePeriod: 2025-03-07 11:01:00+0500 --> 2025-04-07 11:01:00+0500

created: 2025-03-08 11:01:00+0500

insurer: Organization

provider: Organization

priority: Normal

CareTeams

-	Sequence	Provider	Role
*	1	Practitioner	Healthcare professional (occupation)

Diagnoses

-	Sequence	Diagnosis[x]	Type
*	1	Cardiac arrest, unspecified	Final diagnosis (discharge) (contextual qualifier) (qualifier value)

procedure

sequence: 1

procedure: Angiography

procedure

sequence: 2

procedure: Angioplasty of blood vessel

Insurances

-	Sequence	Focal	Coverage
*	1	true	Coverage

item

sequence: 1

careTeamSequence: 1

productOrService: Angiography

UnitPrices

-	Value	Currency
*	10000	INR

Nets

-	Value	Currency
*	10000	INR

item

sequence: 2

careTeamSequence: 1

productOrService: Angioplasty of blood vessel

UnitPrices

-	Value	Currency
*	40000	INR

Nets

-	Value	Currency
*	40000	INR

item

sequence: 3

careTeamSequence: 1

productOrService: Intensive care unit

UnitPrices

-	Value	Currency
*	2000	INR

Nets

-	Value	Currency
*	20000	INR

Totals

-	Value	Currency
*	70000	INR

Entry 2 - fullUrl = urn:uuid:ca5de1b1-0bb6-4cbf-b3b4-2c006f7a72f3

Resource Patient:

Generated Narrative: Patient ca5de1b1-0bb6-4cbf-b3b4-2c006f7a72f3

Adarsh Agrawal Male, DoB: 1981-01-12 ( Adhaar number: 7225-4829-5255)

---

Contact Detail

+919818512600

Entry 3 - fullUrl = urn:uuid:5999df2e-77b5-4398-80ca-f6a4f4904f97

Resource Organization:

Generated Narrative: Organization 5999df2e-77b5-4398-80ca-f6a4f4904f97

identifier: Registry of Hospitals in Network of Insurance (ROHINI) ID/4567878

type: Insurance Company

name: XYZ Insurance Co. Ltd.

contact

telecom: +91 243 2634 1234, contact@xyz.org

Entry 4 - fullUrl = urn:uuid:ae6fc073-c976-415b-8333-0ace1ebd6ac4

Resource Organization:

Generated Narrative: Organization ae6fc073-c976-415b-8333-0ace1ebd6ac4

identifier: Provider number/45675454

type: Healthcare Provider

name: XYZ Hospital Co. Ltd.

contact

telecom: +91 243 2634 1278, contact@xyz.org

Entry 5 - fullUrl = urn:uuid:6166b645-5ff9-4a2e-aa90-b0b8fb0ebb55

Resource Practitioner:

Generated Narrative: Practitioner 6166b645-5ff9-4a2e-aa90-b0b8fb0ebb55

identifier: Medical License number/21-1521-3828-3227

name: Dr. Aayush Agrawal

Entry 6 - fullUrl = urn:uuid:eacc00ce-0948-4e9d-99f2-95ce8fa53fbf

Resource Coverage:

Generated Narrative: Coverage eacc00ce-0948-4e9d-99f2-95ce8fa53fbf

identifier: https://xyzinsurance.in/policynumber//235037120

status: Active

type: health insurance plan policy

subscriber: Patient

subscriberId: ABC123456BI007

beneficiary: Patient

relationship: Self

period: ?? --> 2026-03-17