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superbill-test-data.ts5.58 kB
// SPDX-FileCopyrightText: Copyright Orangebot, Inc. and Medplum contributors // SPDX-License-Identifier: Apache-2.0 import type { Bundle } from '@medplum/fhirtypes'; export const testData: Bundle = { resourceType: 'Bundle', type: 'transaction', entry: [ { fullUrl: 'urn:uuid:6f7d3266-1f6a-4d6b-be08-5e5fc19c01e9', request: { method: 'POST', url: 'Patient' }, resource: { resourceType: 'Patient', name: [ { given: ['Homer'], family: 'Simpson', }, ], gender: 'male', birthDate: '2003-02-24T14:33:34.326Z', telecom: [ { system: 'email', value: 'homersimpson@aol.com', }, { system: 'phone', use: 'mobile', value: '3405559023', }, ], address: [ { use: 'home', line: ['742 Evergreen Terrace'], city: 'Springfield', }, ], }, }, { fullUrl: 'urn:uuid:c5053eed-5f22-4818-8f81-c1edb864703b', request: { method: 'POST', url: 'Organization' }, resource: { resourceType: 'Organization', name: 'Independence Blue Cross Blue Shield', }, }, { fullUrl: '29b59d2d-a47c-4b8f-a0d7-7d87bd7195d7', request: { method: 'POST', url: 'Coverage' }, resource: { resourceType: 'Coverage', status: 'active', beneficiary: { reference: 'urn:uuid:6f7d3266-1f6a-4d6b-be08-5e5fc19c01e9', display: 'Homer Simpson' }, payor: [ { reference: 'urn:uuid:c5053eed-5f22-4818-8f81-c1edb864703b', display: 'Independence Blue Cross Blue Shield', }, ], }, }, { fullUrl: 'urn:uuid:59811b9f-3b5f-4cce-83cb-51ee1e4e7be2', request: { method: 'POST', url: 'Practitioner' }, resource: { resourceType: 'Practitioner', name: [ { given: ['Kevin'], family: 'Smith', }, ], qualification: [ { code: { coding: [ { display: 'General Practitioner', }, ], }, }, ], }, }, { fullUrl: 'urn:uuid:bee47170-488a-4190-a75a-4f79bc3f9328', request: { method: 'POST', url: 'Encounter' }, resource: { resourceType: 'Encounter', identifier: [ { system: 'http://example.org/encounters', value: 'example-encounter', }, ], status: 'finished', period: { end: '2024-06-10T14:33:34.326Z', }, class: { system: 'http://ama-assn.org/go/cpt', code: '99204', display: 'New patient office visit', }, serviceType: { coding: [ { system: 'http://ama-assn.org/go/cpt', code: '71045', display: 'Radiological examination, chest; single view ', }, ], }, subject: { reference: 'urn:uuid:6f7d3266-1f6a-4d6b-be08-5e5fc19c01e9', display: 'Homer Simpson' }, participant: [ { type: [ { coding: [ { code: 'ATND', display: 'Attender', }, ], }, ], individual: { reference: 'urn:uuid:59811b9f-3b5f-4cce-83cb-51ee1e4e7be2', display: 'Kevin Smith' }, }, ], }, }, ], }; const dd = { content: [ { text: 'Patient Information', style: 'header', }, { table: { body: [ ['Name:', 'Homer Simpson'], ['Age:', 21], ['Gender:', undefined], ['Date of Birth:', '2/24/2003'], ['Phone Number:', '3405559023'], ['Email Address:', 'homersimpson@aol.com'], ['Home Address:', '742 Evergreen Terrace, Springfield'], ], }, layout: 'noBorders', margin: [0, 10], }, { text: 'Insurance Information', sytle: 'header', }, { table: { body: [ ['Insurer:', 'Independence Blue Cross Blue Shield'], ['Policy Number:', '4290824'], ], }, }, [ { text: 'Provider Information', style: 'header', }, { table: { body: [ ['Physician Name:', 'Kevin Smith'], ['Title:', 'General Practitioner'], ['Date:', '2024-06-14T14:51:23.458Z'], ], }, }, ], [ { table: { body: [ [ { text: '', noWrap: true, }, 'New patient office visit', { text: '100', noWrap: true, }, ], [ { text: '', noWrap: true, }, 'Radiological examination, chest; single view', { text: '80', noWrap: true, }, ], ], }, }, ], ], styles: { tableHeader: { bold: true, fontSize: 13, color: 'black', alignment: 'center', }, header: { bold: true, fontSize: 13, }, }, }; console.log(dd);

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