{
    "resourceType":"ClaimResponse",
    "id":"1683671",
    "meta":{
        "versionId":"1",
        "lastUpdated":"2015-12-22T09:05:02.696-05:00"
    },
    "contained":[
        {
            "resourceType":"Claim",
            "id":"Claim1",
            "type":"institutional",
            "identifier":[
                {
                    "system":"OID_PRESTADOR\\items_factura",
                    "value":"20910-2"
                },
                {
                    "system":"OID_PRESTADOR\\nros_factura",
                    "value":"B 0000-00000000"
                },
                {
                    "system":"OID_PRESTADOR\\accessions",
                    "value":"H0493823"
                }
            ],
            "created":"2015-10-15",
            "patient":{
                "reference":"Pat20425239"
            }
        }
    ],
    "request":{
        "reference":"#Claim1"
    },
    "created":"2016-02-10",
    "organization":{
        "reference":"organization/C81696FE-2B56-4F77-BCED-440A727D2869"
    },
    "requestOrganization":{
        "reference":"organization/F87E4DC7-BEFA-45D1-B336-09BE61B1AA3E"
    },
    "outcome":"error",
    "disposition":"MENSAJE DE ERROR O DEBITO",
    "item":[
        {
            "sequenceLinkId":1,
            "adjudication":[
                {
                    "code":{
                        "system":"OID_FINANCIADOR/prestaciones",
                        "code":"490475",
                        "display":"HEMOGRAMA"
                    }
                }
            ]
        }
    ],
    "error":[
        {
            "code":{
                "system":"www.mais.org/codesystem/errores",
                "code":"A00",
                "display":"FALTA NUMERO DE AUTORIZACION"
            }
        }
    ],
    "paymentAdjustment":{
        "value":120.33,
        "unit":"ARS"
    },
    "paymentAdjustmentReason":{
        "system":"www.mais.org/codesystem/debitos",
        "code":"A01",
        "display":"NO CORRESPONDE AYUDANTE"
    }
}