German Dental FHIR Profiles (R4)
0.36.1 - trial-use DE

German Dental FHIR Profiles (R4) - Local Development build (v0.36.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Beispiel GKV-Abrechnungsanspruch Q1/2026 mit BEMA-Position - JSON Representation

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{
  "resourceType" : "Claim",
  "id" : "ExampleDentalClaimGkvQ1",
  "meta" : {
    "profile" : [
      🔗 "https://fhir.cognovis.de/dental/StructureDefinition/dental-claim-de"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Claim ExampleDentalClaimGkvQ1</b></p><a name=\"ExampleDentalClaimGkvQ1\"> </a><a name=\"hcExampleDentalClaimGkvQ1\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-dental-claim-de.html\">Zahnärztlicher Abrechnungsanspruch (DE)</a></p></div><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type professional}\">Professional</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: <a href=\"Patient-pat-gkv-01.html\">Klaus Bergmann (official) (no stated gender), DoB: 1962-04-17 ( Krankenversichertennummer)</a></p><p><b>billablePeriod</b>: 2026-01-01 --&gt; 2026-03-31</p><p><b>created</b>: 2026-01-31</p><p><b>insurer</b>: AOK Bayern</p><p><b>provider</b>: <a href=\"PractitionerRole-role-schoell-gibitzenhof.html\">PractitionerRole Doctor</a></p><p><b>priority</b>: <span title=\"Codes:\">normal</span></p><h3>SupportingInfos</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claiminformationcategory info}\">Information</span></td><td><a href=\"ChargeItem-ExampleBemaChargeItem.html\">ChargeItem Kompositfüllung dreiflächig</a></td></tr></table><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><a href=\"Condition-ExampleDentalCondition.html\">Condition Karies des Dentins</a></td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"Coverage-cov-gkv-01-aok.html\">Coverage: status = active; type = Gesetzliche Krankenversicherung; period = 2020-01-01 --&gt; (ongoing)</a></td></tr></table><h3>Items</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>ProductOrService</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://fhir.de/CodeSystem/kzbv/bema 13c}\">Kompositfüllung dreiflächig</span></td></tr></table></div>"
  },
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
        "code" : "professional"
      }
    ]
  },
  "use" : "claim",
  "patient" : {
    🔗 "reference" : "Patient/pat-gkv-01"
  },
  "billablePeriod" : {
    "start" : "2026-01-01",
    "end" : "2026-03-31"
  },
  "created" : "2026-01-31",
  "insurer" : {
    "display" : "AOK Bayern"
  },
  "provider" : {
    🔗 "reference" : "PractitionerRole/role-schoell-gibitzenhof"
  },
  "priority" : {
    "coding" : [
      {
        "code" : "normal"
      }
    ]
  },
  "supportingInfo" : [
    {
      "sequence" : 1,
      "category" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
            "code" : "info"
          }
        ]
      },
      "valueReference" : {
        🔗 "reference" : "ChargeItem/ExampleBemaChargeItem"
      }
    }
  ],
  "diagnosis" : [
    {
      "sequence" : 1,
      "diagnosisReference" : {
        🔗 "reference" : "Condition/ExampleDentalCondition"
      }
    }
  ],
  "insurance" : [
    {
      "sequence" : 1,
      "focal" : true,
      "coverage" : {
        🔗 "reference" : "Coverage/cov-gkv-01-aok"
      }
    }
  ],
  "item" : [
    {
      "sequence" : 1,
      "productOrService" : {
        "coding" : [
          {
            "system" : "http://fhir.de/CodeSystem/kzbv/bema",
            "code" : "13c",
            "display" : "Kompositfüllung dreiflächig"
          }
        ]
      }
    }
  ]
}