Example: ExplanationOfBenefit-explanationofbenefit-mbs-example-01

Formats: Narrative,XML, JSON, Turtle

Raw json

{
  "resourceType" : "ExplanationOfBenefit",
  "id" : "explanationofbenefit-mbs-example-01",
  "meta" : {
    "profile" : [
      "http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/explanationofbenefit-medicare"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: explanationofbenefit-mbs-example-01</p><p><b>meta</b>: </p><p><b>contained</b>: , , </p><p><b>identifier</b>: urn:oid:2.25.129844986816735724544008039950138526110</p><p><b>type</b>: Professional <span style="background: LightGoldenRodYellow">(Details : {http://hl7.org/fhir/ex-claimtype code 'professional' = 'Professional)</span></p><p><b>subType</b>: mbs <span style="background: LightGoldenRodYellow">(Details : {https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1 code 'mbs' = 'mbs)</span></p><p><b>patient</b>: </p><p><b>created</b>: 21/06/2016</p><p><b>provider</b>: unknown resource contained</p><p><b>referral</b>: unknown resource contained</p><h3>Items</h3><table class="grid"><tr><td>-</td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>Service</b></td><td><b>Serviced[x]</b></td><td><b>Location[x]</b></td></tr><tr><td>*</td><td>1</td><td>MBS <span style="background: LightGoldenRodYellow">(Details : {https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1 code 'mbs' = 'mbs', given as 'MBS'})</span></td><td>Radiation oncology treatment <span style="background: LightGoldenRodYellow">(Details : {urn:oid:1.2.36.1.2001.1005.21 code '15275' = '15275', given as 'Radiation oncology treatment'})</span></td><td>16/06/2016</td><td>Inpatient Hospital <span style="background: LightGoldenRodYellow">(Details : {http://hl7.org/fhir/ex-serviceplace code '21' = 'Inpatient Hospital', given as 'Inpatient Hospital'})</span></td></tr></table></div>"
  },
  "contained" : [
    {
      "resourceType" : "ReferralRequest",
      "id" : "ReferralRequest1",
      "meta" : {
        "profile" : [
          "http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/referralrequest-mbsdva"
        ]
      },
      "status" : "completed",
      "intent" : "order",
      "subject" : {
        "identifier" : {
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/v2/0203",
                "code" : "NI",
                "display" : "National unique individual identifier"
              }
            ]
          },
          "system" : "http://ns.electronichealth.net.au/id/hi/ihi/1.0",
          "value" : "8003608166690503"
        }
      },
      "requester" : {
        "agent" : {
          "reference" : "#Practitioner2"
        }
      }
    },
    {
      "resourceType" : "Practitioner",
      "id" : "Practitioner1",
      "meta" : {
        "profile" : [
          "http://hl7.org.au/fhir/StructureDefinition/au-practitioner"
        ]
      },
      "identifier" : [
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org/fhir/v2/0203",
                "code" : "NPI",
                "display" : "National provider identifier"
              }
            ],
            "text" : "HPI-I"
          },
          "system" : "http://ns.electronichealth.net.au/id/hi/hpii/1.0",
          "value" : "8003610833334085"
        }
      ]
    },
    {
      "resourceType" : "Practitioner",
      "id" : "Practitioner2",
      "meta" : {
        "profile" : [
          "http://hl7.org.au/fhir/StructureDefinition/au-practitioner"
        ]
      },
      "identifier" : [
        {
          "type" : {
            "coding" : [
              {
                "system" : "http://hl7.org.au/fhir/v2/0203",
                "code" : "PRES",
                "display" : "Prescriber Number"
              }
            ],
            "text" : "Prescriber Number"
          },
          "system" : "http://ns.electronichealth.net.au/id/prescriber-number",
          "value" : "453221"
        }
      ],
      "name" : [
        {
          "family" : "Good",
          "given" : [
            "Fab"
          ],
          "prefix" : [
            "Dr"
          ]
        }
      ]
    }
  ],
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.25.129844986816735724544008039950138526110"
    }
  ],
  "type" : {
    "coding" : [
      {
        "system" : "http://hl7.org/fhir/ex-claimtype",
        "code" : "professional"
      }
    ]
  },
  "subType" : [
    {
      "coding" : [
        {
          "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1",
          "code" : "mbs"
        }
      ]
    }
  ],
  "patient" : {
    "identifier" : {
      "type" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/v2/0203",
            "code" : "NI",
            "display" : "National unique individual identifier"
          }
        ]
      },
      "system" : "http://ns.electronichealth.net.au/id/hi/ihi/1.0",
      "value" : "8003608166690503"
    }
  },
  "created" : "2016-06-21",
  "provider" : {
    "reference" : "#Practitioner1"
  },
  "referral" : {
    "reference" : "#ReferralRequest1"
  },
  "item" : [
    {
      "sequence" : 1,
      "category" : {
        "coding" : [
          {
            "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1",
            "code" : "mbs",
            "display" : "MBS"
          }
        ]
      },
      "service" : {
        "coding" : [
          {
            "system" : "urn:oid:1.2.36.1.2001.1005.21",
            "code" : "15275",
            "display" : "Radiation oncology treatment"
          }
        ]
      },
      "servicedDate" : "2016-06-16",
      "locationCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/ex-serviceplace",
            "code" : "21",
            "display" : "Inpatient Hospital"
          }
        ]
      }
    }
  ]
}