<?xml version="1.0" encoding="utf-8"?>
<Claim.Submission xmlns:tns="http://www.haad.ae/DataDictionary/CommonTypes" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:noNamespaceSchemaLocation="http://www.haad.ae/DataDictionary/CommonTypes/ClaimSubmission.xsd">

	<!-- Header: Submission identification information -->
	<Header>
		<SenderID>MF2057</SenderID>
		<ReceiverID>A001</ReceiverID>
		<TransactionDate>05/07/2009 15:00</TransactionDate>
		<RecordCount>3</RecordCount>
		<DispositionFlag>PRODUCTION</DispositionFlag>
	</Header>
	
	<!-- Example of a Claim with Diabetes observations -->
	<Claim>
		<!-- Claim identification information -->
		<ID>123</ID>
		<IDPayer>456</IDPayer>
		<MemberID>m01254</MemberID>
		<PayerID>A001</PayerID>
		<ProviderID>MF2057</ProviderID>
		<EmiratesIDNumber>111-1111-1111111-1</EmiratesIDNumber>
		<Gross>400</Gross>
		<PatientShare>155</PatientShare>
		<Net>245</Net>
		
		<!-- Encounter information -->
		<Encounter>
			<FacilityID>MF2057</FacilityID>
			<Type>1</Type>
			<PatientID>1245</PatientID>
			<Start>01/01/2009 12:00</Start>
			<End>01/01/2009 15:00</End>
			<StartType>3</StartType>
			<EndType>2</EndType>
		</Encounter>
		
		<!-- Diagnosis information: principal diagnosis - DIABETES MELLITUS WITHOUT MENTION OF COMPLICATION -->
		<Diagnosis>
			<Type>Principal</Type>
			<Code>250.0</Code>
		</Diagnosis>
		
		<!-- Activity information: activity - HbA1c (Glycosylated haemoglobin level) -->
		<Activity>
			<Start>01/01/2009 13:00</Start>
			<Type>3</Type>
			<Code>83036</Code>
			<Quantity>1</Quantity>
			<Net>0</Net>
			<Clinician>GD6476</Clinician>
			<!-- Observation information: observation - HbA1c measurement device panel -->
			<Observation>
				<Type>LOINC</Type>
				<Code>43150-2</Code>
				<Value>5</Value>
				<ValueType>%</ValueType>
			</Observation>
		</Activity>

		<!-- Activity information: activity - Fasting plasma glucose (pre-glucose challenge) -->
		<Activity>
			<Start>01/01/2009 13:00</Start>
			<Type>3</Type>
			<Code>82947</Code>
			<Quantity>1</Quantity>
			<Net>0</Net>
			<Clinician>GD6476</Clinician>
			<!-- Observation information: observation - pre-12h CFst -->
			<Observation>
				<Type>LOINC</Type>
				<Code>14769-4</Code>
				<Value>5</Value>
				<ValueType>mmol/l</ValueType>
			</Observation>
		</Activity>

    <!-- Activity information with DRG Code -->
    <Activity>
      <!-- Start: earliest date of all activities -->
      <Start>01/01/2009 13:00</Start>
      <!-- Type: Type used for DRG -->
      <Type>9</Type>
      <!-- Code: DRG code -->
      <Code>034152</Code>
      <!-- Quantity: Always 1 -->
      <Quantity>1</Quantity>
      <!-- Net: Always 0 -->
      <Net>0</Net>
      <!-- Clinician: clinician of the earliest activity used previously in the start field -->
      <Clinician>GD6476</Clinician> 
    </Activity>
	</Claim>
	

</Claim.Submission>