Example: ExplanationOfBenefit-explanationofbenefit-mbs-example-02

Formats: Narrative,XML, JSON, Turtle

Raw xml

<ExplanationOfBenefit xmlns="http://hl7.org/fhir">
  <id value="explanationofbenefit-mbs-example-02"/>
  <meta>
    <profile
             value="http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/explanationofbenefit-medicare"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: explanationofbenefit-mbs-example-02</p><p><b>meta</b>: </p><p><b>identifier</b>: 0000123</p><p><b>type</b>: Pharmacy <span style="background: LightGoldenRodYellow">(Details : {http://hl7.org/fhir/ex-claimtype code 'pharmacy' = 'Pharmacy)</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>: 04/12/2017</p><h3>Items</h3><table class="grid"><tr><td>-</td><td><b>Sequence</b></td><td><b>Service</b></td><td><b>Serviced[x]</b></td></tr><tr><td>*</td><td>1</td><td>Palmar or plantar warts (10 or more), definitive removal of, excluding ablative methods alone, not being a service to which item 30186 or 30187 applies (Anaes.) <span style="background: LightGoldenRodYellow">(Details : {urn:oid:1.2.36.1.2001.1005.21 code '30185' = '30185', given as 'Palmar or plantar warts (10 or more), definitive removal of, excluding ablative methods alone, not being a service to which item 30186 or 30187 applies (Anaes.)'})</span></td><td>16/06/2016</td></tr></table></div>
  </text>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="0000123"/>
  </identifier>
  <type>
    <coding>
      <system value="http://hl7.org/fhir/ex-claimtype"/>
      <code value="pharmacy"/>
    </coding>
  </type>
  <subType>
    <coding>
      <system
              value="https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1"/>
      <code value="mbs"/>
    </coding>
  </subType>
  <patient>
    <identifier>
      <type>
        <coding>
          <system value="http://hl7.org/fhir/v2/0203"/>
          <code value="NI"/>
          <display value="National unique individual identifier"/>
        </coding>
      </type>
      <system value="http://ns.electronichealth.net.au/id/hi/ihi/1.0"/>
      <value value="8003608166690503"/>
    </identifier>
  </patient>
  <created value="2017-12-04"/>
  <item>
    <sequence value="1"/>
    <service>
      <coding>
        <system value="urn:oid:1.2.36.1.2001.1005.21"/>
        <code value="30185"/>
        <display
                 value="Palmar or plantar warts (10 or more), definitive removal of, excluding ablative methods alone, not being a service to which item 30186 or 30187 applies (Anaes.)"/>
      </coding>
    </service>
    <servicedDate value="2016-06-16"/>
  </item>
</ExplanationOfBenefit>