davinci_pas_test_kit 0.15.0 → 0.15.2
This diff represents the content of publicly available package versions that have been released to one of the supported registries. The information contained in this diff is provided for informational purposes only and reflects changes between package versions as they appear in their respective public registries.
- checksums.yaml +4 -4
- data/config/presets/pas_client_example.json +2 -2
- data/config/presets/pas_client_v201_run_against_pas_server.json +2 -2
- data/config/presets/pas_client_v221_run_against_pas_server.json +3 -3
- data/config/presets/pas_ri.json +6 -6
- data/config/presets/pas_server_v201_run_against_pas_client.json.erb +6 -6
- data/config/presets/pas_server_v221_run_against_pas_client.json.erb +10 -10
- data/lib/davinci_pas_test_kit/client/abstract_gather_must_support_test.rb +2 -48
- data/lib/davinci_pas_test_kit/client/client_input_descriptions.rb +29 -0
- data/lib/davinci_pas_test_kit/client/endpoints/claim_endpoint.rb +25 -9
- data/lib/davinci_pas_test_kit/client/user_input_response.rb +25 -6
- data/lib/davinci_pas_test_kit/client/v2.0.1/client_suite.rb +1 -1
- data/lib/davinci_pas_test_kit/client/v2.2.1/client_suite.rb +1 -1
- data/lib/davinci_pas_test_kit/cross_suite/fhirpath_utils.rb +13 -3
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/beneficiary/metadata.yml +4 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/claim_inquiry/metadata.yml +15 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/claim_update/metadata.yml +17 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/claiminquiryresponse/metadata.yml +15 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/claimresponse/metadata.yml +15 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/communication_request/metadata.yml +4 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/coverage/metadata.yml +1 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/device_request/metadata.yml +2 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/encounter/metadata.yml +3 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/insurer/metadata.yml +1 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/medication_request/metadata.yml +2 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/metadata.yml +143 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/nutrition_order/metadata.yml +2 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/pas_inquiry_request_bundle/metadata.yml +2 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/pas_inquiry_response_bundle/metadata.yml +2 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/pas_request_bundle/metadata.yml +2 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/pas_response_bundle/metadata.yml +2 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/practitioner/metadata.yml +1 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/practitioner_role/metadata.yml +1 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/requestor/metadata.yml +1 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/service_request/metadata.yml +3 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/subscriber/metadata.yml +4 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.0.1/task/metadata.yml +1 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/beneficiary/metadata.yml +1 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/claim_inquiry/metadata.yml +23 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/claim_update/metadata.yml +31 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/claiminquiryresponse/metadata.yml +42 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/claimresponse/metadata.yml +42 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/communication_request/metadata.yml +4 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/coverage/metadata.yml +1 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/device_request/metadata.yml +2 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/encounter/metadata.yml +3 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/insurer/metadata.yml +1 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/medication_request/metadata.yml +2 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/metadata.yml +265 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/nutrition_order/metadata.yml +2 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/pas_inquiry_request_bundle/metadata.yml +2 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/pas_inquiry_response_bundle/metadata.yml +2 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/pas_request_bundle/metadata.yml +2 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/pas_response_bundle/metadata.yml +2 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/practitioner/metadata.yml +1 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/practitioner_role/metadata.yml +1 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/requestor/metadata.yml +1 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/service_request/metadata.yml +3 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/subscriber/metadata.yml +1 -0
- data/lib/davinci_pas_test_kit/cross_suite/generated/v2.2.1/task/metadata.yml +4 -0
- data/lib/davinci_pas_test_kit/cross_suite/pas_bundle_validation.rb +97 -39
- data/lib/davinci_pas_test_kit/cross_suite/pas_constants.rb +6 -0
- data/lib/davinci_pas_test_kit/cross_suite/pas_datatype_constraints.rb +166 -0
- data/lib/davinci_pas_test_kit/cross_suite/response_selection_utils.rb +26 -10
- data/lib/davinci_pas_test_kit/cross_suite/validator_suppressions.rb +206 -146
- data/lib/davinci_pas_test_kit/docs/demo/PAS Client Suite Demonstration.postman_collection.json +4 -4
- data/lib/davinci_pas_test_kit/generator/must_support_test_generator.rb +6 -0
- data/lib/davinci_pas_test_kit/generator/pas_must_support_metadata_extractor.rb +1 -2
- data/lib/davinci_pas_test_kit/generator/server_must_support_group_generator.rb +23 -0
- data/lib/davinci_pas_test_kit/generator/server_suite_generator.rb +6 -0
- data/lib/davinci_pas_test_kit/generator/templates/must_support.rb.erb +3 -2
- data/lib/davinci_pas_test_kit/generator/templates/server_must_support_group.rb.erb +22 -0
- data/lib/davinci_pas_test_kit/generator/templates/server_suite.rb.erb +4 -5
- data/lib/davinci_pas_test_kit/generator/templates/use_case_group.rb.erb +3 -0
- data/lib/davinci_pas_test_kit/generator/use_case_group_generator.rb +14 -8
- data/lib/davinci_pas_test_kit/requirements/generated/davinci_pas_server_suite_v221_requirements_coverage.csv +28 -28
- data/lib/davinci_pas_test_kit/server/generated/v2.0.1/pas_server_approval_use_case_group.rb +1 -0
- data/lib/davinci_pas_test_kit/server/generated/v2.0.1/pas_server_denial_use_case_group.rb +1 -0
- data/lib/davinci_pas_test_kit/server/generated/v2.0.1/pas_server_pended_use_case_group.rb +1 -0
- data/lib/davinci_pas_test_kit/server/generated/v2.0.1/server_suite.rb +4 -5
- data/lib/davinci_pas_test_kit/server/generated/v2.2.1/claiminquiryresponse/server_inquire_response_must_support_claiminquiryresponse_test.rb +2 -0
- data/lib/davinci_pas_test_kit/server/generated/v2.2.1/claimresponse/server_submit_response_must_support_claimresponse_test.rb +2 -0
- data/lib/davinci_pas_test_kit/server/generated/v2.2.1/pas_server_approval_use_case_group.rb +2 -0
- data/lib/davinci_pas_test_kit/server/generated/v2.2.1/pas_server_denial_use_case_group.rb +2 -0
- data/lib/davinci_pas_test_kit/server/generated/v2.2.1/pas_server_must_support_group.rb +12 -0
- data/lib/davinci_pas_test_kit/server/generated/v2.2.1/pas_server_pended_use_case_group.rb +5 -0
- data/lib/davinci_pas_test_kit/server/generated/v2.2.1/server_suite.rb +4 -5
- data/lib/davinci_pas_test_kit/server/server_response_bundle_validation_test.rb +14 -5
- data/lib/davinci_pas_test_kit/server/v2.2.1/claim_inquiry/server_claim_inquiry_response_tests.rb +89 -0
- data/lib/davinci_pas_test_kit/server/v2.2.1/pas_error_group.rb +2 -0
- data/lib/davinci_pas_test_kit/server/v2.2.1/pas_server_claim_inquiry_responses_group.rb +17 -0
- data/lib/davinci_pas_test_kit/server/v2.2.1/pas_server_no_custom_extensions_test.rb +241 -0
- data/lib/davinci_pas_test_kit/server/v2.2.1/pas_server_subscription_capability_statement_test.rb +40 -0
- data/lib/davinci_pas_test_kit/server/v2.2.1/pas_server_subscription_setup.rb +14 -9
- data/lib/davinci_pas_test_kit/server/v2.2.1/server_replaced_pa_inquire_reference_input_test.rb +63 -0
- data/lib/davinci_pas_test_kit/server/v2.2.1/server_replaced_pa_inquire_reference_test.rb +109 -0
- data/lib/davinci_pas_test_kit/version.rb +2 -2
- metadata +9 -2
checksums.yaml
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SHA256:
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metadata.gz:
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data.tar.gz:
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metadata.gz: 3023259fb2f00899ac18554ac2b4a7d37ece5aec114c804f2c175884eeb765d7
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data.tar.gz: 3bd995e4a8e71e390772b35d33f37dab1b345f20ffd2bfcbbeb7a470cc6163c6
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metadata.gz:
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metadata.gz: 05f64e5a39a2898215643d70384eec54d9d62720537d9816616d3bef344d7abb5738faeab1a34968c6955e00672fe27395d4712a1903652f5e4ad10fa8cc11e0
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data.tar.gz: e61bd2cb364ec659dc7559382eada253854e9a1efea9dcbf7e834fc021c5ac425287714823da0af7d393460befe45bab72f2c7727d22082cd49325d6add23698
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"value": "{\r\n \"id\": \"095641c0-8ad9-41ce-abae-f53b446fefff\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-pas-response-bundle\"\r\n ]\r\n },\r\n \"type\": \"collection\",\r\n \"timestamp\": \"2024-01-30T13:29:32Z\",\r\n \"entry\": [\r\n {\r\n \"fullUrl\": \"urn:uuid:45e176b5-c381-42df-9264-ffd74a38ef92\",\r\n \"resource\": {\r\n \"id\": \"45e176b5-c381-42df-9264-ffd74a38ef92\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-claimresponse\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http:\/\/notreal.com\/PATIENT_EVENT_TRACE_NUMBER\",\r\n \"value\": \"111366\",\r\n \"assigner\": {\r\n \"identifier\": {\r\n \"system\": \"http:\/\/notreal.com\/USER_ASSIGNED\",\r\n \"value\": \"5556667771\"\r\n }\r\n }\r\n }\r\n ],\r\n \"status\": \"active\",\r\n \"type\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http:\/\/terminology.hl7.org\/CodeSystem\/claim-type\",\r\n \"code\": \"professional\"\r\n }\r\n ]\r\n },\r\n \"use\": \"preauthorization\",\r\n \"patient\": {\r\n \"reference\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\"\r\n },\r\n \"created\": \"2024-01-30T13:29:32Z\",\r\n \"insurer\": {\r\n \"reference\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\"\r\n },\r\n \"requestor\": {\r\n \"reference\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\"\r\n },\r\n \"outcome\": \"complete\",\r\n \"item\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-itemPreAuthIssueDate\",\r\n \"valueDate\": \"2024-01-30\"\r\n },\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-itemPreAuthPeriod\",\r\n \"valuePeriod\": {\r\n \"start\": \"2024-01-30\",\r\n \"end\": \"2024-02-29\"\r\n }\r\n }\r\n ],\r\n \"itemSequence\": 1,\r\n \"adjudication\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-reviewActionCode\",\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"https:\/\/codesystem.x12.org\/005010\/306\",\r\n \"code\": \"DENIEDCODE\",\r\n \"display\": \"Not Certified\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-reviewAction\"\r\n }\r\n ],\r\n \"category\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http:\/\/terminology.hl7.org\/CodeSystem\/adjudication\",\r\n \"code\": \"submitted\"\r\n }\r\n ]\r\n }\r\n }\r\n ]\r\n },\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-itemPreAuthIssueDate\",\r\n \"valueDate\": \"2024-01-30\"\r\n },\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-itemPreAuthPeriod\",\r\n \"valuePeriod\": {\r\n \"start\": \"2024-01-30\",\r\n \"end\": \"2024-02-29\"\r\n }\r\n }\r\n ],\r\n \"itemSequence\": 2,\r\n \"adjudication\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-reviewActionCode\",\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"https:\/\/codesystem.x12.org\/005010\/306\",\r\n \"code\": \"A1\",\r\n \"display\": \"Certified in total\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-reviewAction\"\r\n }\r\n ],\r\n \"category\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http:\/\/terminology.hl7.org\/CodeSystem\/adjudication\",\r\n \"code\": \"submitted\"\r\n }\r\n ]\r\n }\r\n }\r\n ]\r\n }\r\n ],\r\n \"resourceType\": \"ClaimResponse\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\",\r\n \"resource\": {\r\n \"id\": \"0b321e9e-571b-4f83-8cea-fa23424383bb\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-subscriber\"\r\n ]\r\n },\r\n \"extension\": [\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-militaryStatus\",\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"https:\/\/codesystem.x12.org\/005010\/584\",\r\n \"code\": \"RU\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"identifier\": [\r\n {\r\n \"system\": \"http:\/\/notreal.com\/MIN\",\r\n \"value\": \"12345678901\"\r\n }\r\n ],\r\n \"name\": [\r\n {\r\n \"family\": \"SMITH\",\r\n \"given\": [\r\n \"JOE\"\r\n ]\r\n }\r\n ],\r\n \"gender\": \"male\",\r\n \"resourceType\": \"Patient\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\",\r\n \"resource\": {\r\n \"id\": \"ff7adc9d-8854-4947-874a-8b61bca953c1\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-insurer\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http:\/\/hl7.org\/fhir\/sid\/us-npi\",\r\n \"value\": \"789312\"\r\n }\r\n ],\r\n \"active\": true,\r\n \"type\": [\r\n {\r\n \"coding\": [\r\n {\r\n \"system\": \"https:\/\/codesystem.x12.org\/005010\/98\",\r\n \"code\": \"PR\"\r\n }\r\n ]\r\n }\r\n ],\r\n \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\",\r\n \"resourceType\": \"Organization\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\",\r\n \"resource\": {\r\n \"id\": \"b0881003-0d22-499d-840b-91dc7f6f4479\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-requestor\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http:\/\/hl7.org\/fhir\/sid\/us-npi\",\r\n \"value\": \"8189991234\"\r\n }\r\n ],\r\n \"active\": true,\r\n \"type\": [\r\n {\r\n \"coding\": [\r\n {\r\n \"system\": \"https:\/\/codesystem.x12.org\/005010\/98\",\r\n \"code\": \"X3\"\r\n }\r\n ]\r\n }\r\n ],\r\n \"name\": \"DR. JOE SMITH CORPORATION\",\r\n \"address\": [\r\n {\r\n \"line\": [\r\n \"111 1ST STREET\"\r\n ],\r\n \"city\": \"SAN DIEGO\",\r\n \"state\": \"CA\",\r\n \"postalCode\": \"92101\",\r\n \"country\": \"US\"\r\n }\r\n ],\r\n \"resourceType\": \"Organization\"\r\n }\r\n }\r\n ],\r\n \"resourceType\": \"Bundle\"\r\n}",
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"value": "{\r\n \"id\": \"095641c0-8ad9-41ce-abae-f53b446fefff\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-pas-response-bundle\"\r\n ]\r\n },\r\n \"type\": \"collection\",\r\n \"timestamp\": \"2024-01-30T13:29:32Z\",\r\n \"entry\": [\r\n {\r\n \"fullUrl\": \"urn:uuid:45e176b5-c381-42df-9264-ffd74a38ef92\",\r\n \"resource\": {\r\n \"id\": \"45e176b5-c381-42df-9264-ffd74a38ef92\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-claimresponse\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http:\/\/notreal.com\/PATIENT_EVENT_TRACE_NUMBER\",\r\n \"value\": \"111366\",\r\n \"assigner\": {\r\n \"identifier\": {\r\n \"system\": \"http:\/\/notreal.com\/USER_ASSIGNED\",\r\n \"value\": \"5556667771\"\r\n }\r\n }\r\n }\r\n ],\r\n \"status\": \"active\",\r\n \"type\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http:\/\/terminology.hl7.org\/CodeSystem\/claim-type\",\r\n \"code\": \"professional\"\r\n }\r\n ]\r\n },\r\n \"use\": \"preauthorization\",\r\n \"patient\": {\r\n \"reference\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\"\r\n },\r\n \"created\": \"2024-01-30T13:29:32Z\",\r\n \"insurer\": {\r\n \"reference\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\"\r\n },\r\n \"requestor\": {\r\n \"reference\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\"\r\n },\r\n \"outcome\": \"complete\",\r\n \"item\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-itemPreAuthIssueDate\",\r\n \"valueDate\": \"2024-01-30\"\r\n },\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-itemPreAuthPeriod\",\r\n \"valuePeriod\": {\r\n \"start\": \"2024-01-30\",\r\n \"end\": \"2024-02-29\"\r\n }\r\n }\r\n ],\r\n \"itemSequence\": 1,\r\n \"adjudication\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-reviewActionCode\",\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"https:\/\/codesystem.x12.org\/005010\/306\",\r\n \"code\": \"DENIEDCODE\",\r\n \"display\": \"Not Certified\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-reviewAction\"\r\n }\r\n ],\r\n \"category\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http:\/\/terminology.hl7.org\/CodeSystem\/adjudication\",\r\n \"code\": \"submitted\"\r\n }\r\n ]\r\n }\r\n }\r\n ]\r\n },\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-itemPreAuthIssueDate\",\r\n \"valueDate\": \"2024-01-30\"\r\n },\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-itemPreAuthPeriod\",\r\n \"valuePeriod\": {\r\n \"start\": \"2024-01-30\",\r\n \"end\": \"2024-02-29\"\r\n }\r\n }\r\n ],\r\n \"itemSequence\": 2,\r\n \"adjudication\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-reviewActionCode\",\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"https:\/\/codesystem.x12.org\/005010\/306\",\r\n \"code\": \"A1\",\r\n \"display\": \"Certified in total\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-reviewAction\"\r\n }\r\n ],\r\n \"category\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http:\/\/terminology.hl7.org\/CodeSystem\/adjudication\",\r\n \"code\": \"submitted\"\r\n }\r\n ]\r\n }\r\n }\r\n ]\r\n }\r\n ],\r\n \"resourceType\": \"ClaimResponse\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\",\r\n \"resource\": {\r\n \"id\": \"0b321e9e-571b-4f83-8cea-fa23424383bb\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-subscriber\"\r\n ]\r\n },\r\n \"extension\": [\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-militaryStatus\",\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"https:\/\/codesystem.x12.org\/005010\/584\",\r\n \"code\": \"RU\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"identifier\": [\r\n {\r\n \"system\": \"http:\/\/notreal.com\/MIN\",\r\n \"value\": \"12345678901\"\r\n }\r\n ],\r\n \"name\": [\r\n {\r\n \"family\": \"SMITH\",\r\n \"given\": [\r\n \"JOE\"\r\n ]\r\n }\r\n ],\r\n \"gender\": \"male\",\r\n \"resourceType\": \"Patient\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\",\r\n \"resource\": {\r\n \"id\": \"ff7adc9d-8854-4947-874a-8b61bca953c1\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-insurer\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http:\/\/hl7.org\/fhir\/sid\/us-npi\",\r\n \"value\": \"8383066098\"\r\n }\r\n ],\r\n \"active\": true,\r\n \"type\": [\r\n {\r\n \"coding\": [\r\n {\r\n \"system\": \"https:\/\/codesystem.x12.org\/005010\/98\",\r\n \"code\": \"PR\"\r\n }\r\n ]\r\n }\r\n ],\r\n \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\",\r\n \"resourceType\": \"Organization\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\",\r\n \"resource\": {\r\n \"id\": \"b0881003-0d22-499d-840b-91dc7f6f4479\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-requestor\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http:\/\/hl7.org\/fhir\/sid\/us-npi\",\r\n \"value\": \"8189991234\"\r\n }\r\n ],\r\n \"active\": true,\r\n \"type\": [\r\n {\r\n \"coding\": [\r\n {\r\n \"system\": \"https:\/\/codesystem.x12.org\/005010\/98\",\r\n \"code\": \"X3\"\r\n }\r\n ]\r\n }\r\n ],\r\n \"name\": \"DR. JOE SMITH CORPORATION\",\r\n \"address\": [\r\n {\r\n \"line\": [\r\n \"111 1ST STREET\"\r\n ],\r\n \"city\": \"SAN DIEGO\",\r\n \"state\": \"CA\",\r\n \"postalCode\": \"92101\",\r\n \"country\": \"US\"\r\n }\r\n ],\r\n \"resourceType\": \"Organization\"\r\n }\r\n }\r\n ],\r\n \"resourceType\": \"Bundle\"\r\n}",
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"_title": "Claim denied response JSON",
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"_description": "\n The response provided will be validated against the PAS Response Bundle profile. If determined to be\n invalid, a validation message will be returned, and the test group will be skipped.\n ",
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"_type": "textarea",
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@@ -20,7 +20,7 @@
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{
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"name": "pended_json_response",
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"value": "{\r\n \"id\": \"28c1b339-16d1-4bd3-b397-cce304a31d50\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-pas-response-bundle\"\r\n ]\r\n },\r\n \"type\": \"collection\",\r\n \"timestamp\": \"2024-01-30T13:44:30Z\",\r\n \"entry\": [\r\n {\r\n \"fullUrl\": \"urn:uuid:482fd012-7825-423d-83de-69d09920198b\",\r\n \"resource\": {\r\n \"id\": \"482fd012-7825-423d-83de-69d09920198b\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-claimresponse\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http:\/\/notreal.com\/PATIENT_EVENT_TRACE_NUMBER\",\r\n \"value\": \"1263291\",\r\n \"assigner\": {\r\n \"identifier\": {\r\n \"system\": \"http:\/\/notreal.com\/USER_ASSIGNED\",\r\n \"value\": \"99102388213\"\r\n }\r\n }\r\n }\r\n ],\r\n \"status\": \"active\",\r\n \"type\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http:\/\/terminology.hl7.org\/CodeSystem\/claim-type\",\r\n \"code\": \"professional\"\r\n }\r\n ]\r\n },\r\n \"use\": \"preauthorization\",\r\n \"patient\": {\r\n \"reference\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\"\r\n },\r\n \"created\": \"2024-01-30T13:44:30Z\",\r\n \"insurer\": {\r\n \"reference\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\"\r\n },\r\n \"requestor\": {\r\n \"reference\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\"\r\n },\r\n \"outcome\": \"queued\",\r\n \"item\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-itemPreAuthIssueDate\",\r\n \"valueDate\": \"2024-01-30\"\r\n },\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-itemPreAuthPeriod\",\r\n \"valuePeriod\": {\r\n \"start\": \"2024-01-30\",\r\n \"end\": \"2024-02-29\"\r\n }\r\n }\r\n ],\r\n \"itemSequence\": 1,\r\n \"adjudication\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-reviewActionCode\",\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"https:\/\/codesystem.x12.org\/005010\/306\",\r\n \"code\": \"PENDEDCODE\",\r\n \"display\": \"Pended\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-reviewAction\"\r\n }\r\n ],\r\n \"category\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http:\/\/terminology.hl7.org\/CodeSystem\/adjudication\",\r\n \"code\": \"submitted\"\r\n }\r\n ]\r\n }\r\n }\r\n ]\r\n }\r\n ],\r\n \"resourceType\": \"ClaimResponse\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\",\r\n \"resource\": {\r\n \"id\": \"0b321e9e-571b-4f83-8cea-fa23424383bb\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-subscriber\"\r\n ]\r\n },\r\n \"extension\": [\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-militaryStatus\",\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"https:\/\/codesystem.x12.org\/005010\/584\",\r\n \"code\": \"RU\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"identifier\": [\r\n {\r\n \"system\": \"http:\/\/notreal.com\/MIN\",\r\n \"value\": \"12345678901\"\r\n }\r\n ],\r\n \"name\": [\r\n {\r\n \"family\": \"SMITH\",\r\n \"given\": [\r\n \"JOE\"\r\n ]\r\n }\r\n ],\r\n \"gender\": \"male\",\r\n \"resourceType\": \"Patient\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\",\r\n \"resource\": {\r\n \"id\": \"ff7adc9d-8854-4947-874a-8b61bca953c1\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-insurer\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http:\/\/hl7.org\/fhir\/sid\/us-npi\",\r\n \"value\": \"
|
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+
"value": "{\r\n \"id\": \"28c1b339-16d1-4bd3-b397-cce304a31d50\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-pas-response-bundle\"\r\n ]\r\n },\r\n \"type\": \"collection\",\r\n \"timestamp\": \"2024-01-30T13:44:30Z\",\r\n \"entry\": [\r\n {\r\n \"fullUrl\": \"urn:uuid:482fd012-7825-423d-83de-69d09920198b\",\r\n \"resource\": {\r\n \"id\": \"482fd012-7825-423d-83de-69d09920198b\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-claimresponse\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http:\/\/notreal.com\/PATIENT_EVENT_TRACE_NUMBER\",\r\n \"value\": \"1263291\",\r\n \"assigner\": {\r\n \"identifier\": {\r\n \"system\": \"http:\/\/notreal.com\/USER_ASSIGNED\",\r\n \"value\": \"99102388213\"\r\n }\r\n }\r\n }\r\n ],\r\n \"status\": \"active\",\r\n \"type\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http:\/\/terminology.hl7.org\/CodeSystem\/claim-type\",\r\n \"code\": \"professional\"\r\n }\r\n ]\r\n },\r\n \"use\": \"preauthorization\",\r\n \"patient\": {\r\n \"reference\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\"\r\n },\r\n \"created\": \"2024-01-30T13:44:30Z\",\r\n \"insurer\": {\r\n \"reference\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\"\r\n },\r\n \"requestor\": {\r\n \"reference\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\"\r\n },\r\n \"outcome\": \"queued\",\r\n \"item\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-itemPreAuthIssueDate\",\r\n \"valueDate\": \"2024-01-30\"\r\n },\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-itemPreAuthPeriod\",\r\n \"valuePeriod\": {\r\n \"start\": \"2024-01-30\",\r\n \"end\": \"2024-02-29\"\r\n }\r\n }\r\n ],\r\n \"itemSequence\": 1,\r\n \"adjudication\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-reviewActionCode\",\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"https:\/\/codesystem.x12.org\/005010\/306\",\r\n \"code\": \"PENDEDCODE\",\r\n \"display\": \"Pended\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-reviewAction\"\r\n }\r\n ],\r\n \"category\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http:\/\/terminology.hl7.org\/CodeSystem\/adjudication\",\r\n \"code\": \"submitted\"\r\n }\r\n ]\r\n }\r\n }\r\n ]\r\n }\r\n ],\r\n \"resourceType\": \"ClaimResponse\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\",\r\n \"resource\": {\r\n \"id\": \"0b321e9e-571b-4f83-8cea-fa23424383bb\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-subscriber\"\r\n ]\r\n },\r\n \"extension\": [\r\n {\r\n \"url\": \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/extension-militaryStatus\",\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"https:\/\/codesystem.x12.org\/005010\/584\",\r\n \"code\": \"RU\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"identifier\": [\r\n {\r\n \"system\": \"http:\/\/notreal.com\/MIN\",\r\n \"value\": \"12345678901\"\r\n }\r\n ],\r\n \"name\": [\r\n {\r\n \"family\": \"SMITH\",\r\n \"given\": [\r\n \"JOE\"\r\n ]\r\n }\r\n ],\r\n \"gender\": \"male\",\r\n \"resourceType\": \"Patient\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\",\r\n \"resource\": {\r\n \"id\": \"ff7adc9d-8854-4947-874a-8b61bca953c1\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-insurer\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http:\/\/hl7.org\/fhir\/sid\/us-npi\",\r\n \"value\": \"8383066098\"\r\n }\r\n ],\r\n \"active\": true,\r\n \"type\": [\r\n {\r\n \"coding\": [\r\n {\r\n \"system\": \"https:\/\/codesystem.x12.org\/005010\/98\",\r\n \"code\": \"PR\"\r\n }\r\n ]\r\n }\r\n ],\r\n \"name\": \"MARYLAND CAPITAL INSURANCE COMPANY\",\r\n \"resourceType\": \"Organization\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\",\r\n \"resource\": {\r\n \"id\": \"b0881003-0d22-499d-840b-91dc7f6f4479\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http:\/\/hl7.org\/fhir\/us\/davinci-pas\/StructureDefinition\/profile-requestor\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http:\/\/hl7.org\/fhir\/sid\/us-npi\",\r\n \"value\": \"8189991234\"\r\n }\r\n ],\r\n \"active\": true,\r\n \"type\": [\r\n {\r\n \"coding\": [\r\n {\r\n \"system\": \"https:\/\/codesystem.x12.org\/005010\/98\",\r\n \"code\": \"X3\"\r\n }\r\n ]\r\n }\r\n ],\r\n \"name\": \"DR. JOE SMITH CORPORATION\",\r\n \"address\": [\r\n {\r\n \"line\": [\r\n \"111 1ST STREET\"\r\n ],\r\n \"city\": \"SAN DIEGO\",\r\n \"state\": \"CA\",\r\n \"postalCode\": \"92101\",\r\n \"country\": \"US\"\r\n }\r\n ],\r\n \"resourceType\": \"Organization\"\r\n }\r\n }\r\n ],\r\n \"resourceType\": \"Bundle\"\r\n}",
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"_title": "Claim pended response JSON",
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"_description": "\n The response provided will be validated against the PAS Response Bundle profile. If determined to be\n invalid, a validation message will be returned, and the test group will be skipped.\n ",
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"_type": "textarea",
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@@ -25,7 +25,7 @@
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"optional": true,
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"title": "Claim denied response JSON",
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"type": "textarea",
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"value": "{\r\n \"id\": \"095641c0-8ad9-41ce-abae-f53b446fefff\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-response-bundle\"\r\n ]\r\n },\r\n \"type\": \"collection\",\r\n \"timestamp\": \"2024-01-30T13:29:32Z\",\r\n \"entry\": [\r\n {\r\n \"fullUrl\": \"urn:uuid:45e176b5-c381-42df-9264-ffd74a38ef92\",\r\n \"resource\": {\r\n \"id\": \"45e176b5-c381-42df-9264-ffd74a38ef92\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http://notreal.com/PATIENT_EVENT_TRACE_NUMBER\",\r\n \"value\": \"111366\",\r\n \"assigner\": {\r\n \"identifier\": {\r\n \"system\": \"http://notreal.com/USER_ASSIGNED\",\r\n \"value\": \"5556667771\"\r\n }\r\n }\r\n }\r\n ],\r\n \"status\": \"active\",\r\n \"type\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\r\n \"code\": \"professional\"\r\n }\r\n ]\r\n },\r\n \"use\": \"preauthorization\",\r\n \"patient\": {\r\n \"reference\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\"\r\n },\r\n \"created\": \"2024-01-30T13:29:32Z\",\r\n \"insurer\": {\r\n \"reference\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\"\r\n },\r\n \"requestor\": {\r\n \"reference\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\"\r\n },\r\n \"outcome\": \"complete\",\r\n \"item\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate\",\r\n \"valueDate\": \"2024-01-30\"\r\n },\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod\",\r\n \"valuePeriod\": {\r\n \"start\": \"2024-01-30\",\r\n \"end\": \"2024-02-29\"\r\n }\r\n }\r\n ],\r\n \"itemSequence\": 1,\r\n \"adjudication\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": 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28
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JOE SMITH CORPORATION\",\r\n \"address\": [\r\n {\r\n \"line\": [\r\n \"111 1ST STREET\"\r\n ],\r\n \"city\": \"SAN DIEGO\",\r\n \"state\": \"CA\",\r\n \"postalCode\": \"92101\",\r\n \"country\": \"US\"\r\n }\r\n ],\r\n \"resourceType\": \"Organization\"\r\n }\r\n }\r\n ],\r\n \"resourceType\": \"Bundle\"\r\n}"
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},
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{
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"name": "pended_json_response",
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@@ -33,7 +33,7 @@
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"optional": true,
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"title": "Claim pended response JSON",
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"type": "textarea",
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-
"value": "{\r\n \"id\": \"28c1b339-16d1-4bd3-b397-cce304a31d50\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-pas-response-bundle\"\r\n ]\r\n },\r\n \"type\": \"collection\",\r\n \"timestamp\": \"2024-01-30T13:44:30Z\",\r\n \"entry\": [\r\n {\r\n \"fullUrl\": \"urn:uuid:482fd012-7825-423d-83de-69d09920198b\",\r\n \"resource\": {\r\n \"id\": \"482fd012-7825-423d-83de-69d09920198b\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http://notreal.com/PATIENT_EVENT_TRACE_NUMBER\",\r\n \"value\": \"1263291\",\r\n \"assigner\": {\r\n \"identifier\": {\r\n \"system\": \"http://notreal.com/USER_ASSIGNED\",\r\n \"value\": \"99102388213\"\r\n }\r\n }\r\n }\r\n ],\r\n \"status\": \"active\",\r\n \"type\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\r\n \"code\": \"professional\"\r\n }\r\n ]\r\n },\r\n \"use\": \"preauthorization\",\r\n \"patient\": {\r\n \"reference\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\"\r\n },\r\n \"created\": \"2024-01-30T13:44:30Z\",\r\n \"insurer\": {\r\n \"reference\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\"\r\n },\r\n \"requestor\": {\r\n \"reference\": \"urn:uuid:b0881003-0d22-499d-840b-91dc7f6f4479\"\r\n },\r\n \"outcome\": \"queued\",\r\n \"item\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate\",\r\n \"valueDate\": \"2024-01-30\"\r\n },\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod\",\r\n \"valuePeriod\": {\r\n \"start\": \"2024-01-30\",\r\n \"end\": \"2024-02-29\"\r\n }\r\n }\r\n ],\r\n \"itemSequence\": 1,\r\n \"adjudication\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"extension\": [\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode\",\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"https://codesystem.x12.org/005010/306\",\r\n \"code\": \"A4\",\r\n \"display\": \"Pended\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction\"\r\n }\r\n ],\r\n \"category\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"http://terminology.hl7.org/CodeSystem/adjudication\",\r\n \"code\": \"submitted\"\r\n }\r\n ]\r\n }\r\n }\r\n ]\r\n }\r\n ],\r\n \"resourceType\": \"ClaimResponse\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:0b321e9e-571b-4f83-8cea-fa23424383bb\",\r\n \"resource\": {\r\n \"id\": \"0b321e9e-571b-4f83-8cea-fa23424383bb\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-subscriber\"\r\n ]\r\n },\r\n \"extension\": [\r\n {\r\n \"url\": \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-militaryStatus\",\r\n \"valueCodeableConcept\": {\r\n \"coding\": [\r\n {\r\n \"system\": \"https://codesystem.x12.org/005010/584\",\r\n \"code\": \"RU\"\r\n }\r\n ]\r\n }\r\n }\r\n ],\r\n \"identifier\": [\r\n {\r\n \"system\": \"http://notreal.com/MIN\",\r\n \"value\": \"12345678901\"\r\n }\r\n ],\r\n \"name\": [\r\n {\r\n \"family\": \"SMITH\",\r\n \"given\": [\r\n \"JOE\"\r\n ]\r\n }\r\n ],\r\n \"gender\": \"male\",\r\n \"resourceType\": \"Patient\"\r\n }\r\n },\r\n {\r\n \"fullUrl\": \"urn:uuid:ff7adc9d-8854-4947-874a-8b61bca953c1\",\r\n \"resource\": {\r\n \"id\": \"ff7adc9d-8854-4947-874a-8b61bca953c1\",\r\n \"meta\": {\r\n \"profile\": [\r\n \"http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-insurer\"\r\n ]\r\n },\r\n \"identifier\": [\r\n {\r\n \"system\": \"http://hl7.org/fhir/sid/us-npi\",\r\n \"value\": \"
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36
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37
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}
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38
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39
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