PAS-ClaimResponse
type: ClaimResponse
node role: treeRoot
id:
  v: PAS-ClaimResponse
text:
  status:
    v: generated
  div: Eylea Injection Prior Authorization Response This response indicates approval for Eylea injection treatment.
status:
  v: active
type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/claim-type
    code:
      v: professional
    display:
      v: Professional Claim
use:
  v: preauthorization
patient:
  link: http://example.org/fhir/MHK-Interop-IG/Patient/example
  reference:
    v: Patient/example
created:
  v: 2025-06-05
insurer:
  link: http://example.org/fhir/MHK-Interop-IG/Organization/payer
  reference:
    v: Organization/payer
outcome:
  v: complete
disposition:
  v: Approved for Eylea injection
item:
  item sequence:
    v: 1
  adjudication:
    amount:
      value:
        v: 500
      currency:
        v: USD
payment:
  type:
    coding:
      system:
        v: http://hl7.org/fhir/payment-type
      code:
        v: payment
      display:
        v: Payment
  amount:
    value:
      v: 500
    currency:
      v: USD

v: eligible

v: Eligible Amount