Australian Digital Health Agency FHIR Implementation Guide. This is the current published version. It is based on FHIR® version 4.0.1. See the Directory of published versions for a list of available versions.
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{
"resourceType" : "ExplanationOfBenefit",
"id" : "mbs-02",
"meta" : {
"profile" : [
"http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-mbs-1"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ExplanationOfBenefit</b><a name=\"mbs-02\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource ExplanationOfBenefit "mbs-02" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-dh-explanationofbenefit-medicare-mbs-1.html\">ADHA Record of Claim against MBS or DVA</a></p></div><p><b>identifier</b>: id: urn:uuid:79a8b5a5-1631-4eec-b031-815156c9a47b</p><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#professional)</span></p><p><b>subType</b>: mbs <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (australian-benefit-payment-category-1#mbs)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: <a href=\"Patient-mhr-field-sally.html\">Patient/mhr-field-sally</a> " FIELD"</p><p><b>created</b>: 2017-12-04</p><p><b>insurer</b>: <a href=\"Organization-healthau.html\">Organization/healthau: Australian Government Department of Health</a> "Australian Government Department of Health"</p><p><b>provider</b>: <span>: Dr. Jeong-Hoon Kim</span></p><p><b>outcome</b>: complete</p><h3>Insurances</h3><table class=\"grid\"><tr><td>-</td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td>*</td><td>true</td><td><span/></td></tr></table><h3>Items</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>ProductOrService</b></td><td><b>Serviced[x]</b></td></tr><tr><td>*</td><td>1</td><td>Medicare Benefits Schedule <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (australian-benefit-payment-category-1#mbs "MBS")</span></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; margin: 4px; border: 1px solid khaki\"> (unknown#30185)</span></td><td>2017-12-04</td></tr></table></div>"
},
"identifier" : [
{
"system" : "urn:ietf:rfc:3986",
"value" : "urn:uuid:79a8b5a5-1631-4eec-b031-815156c9a47b"
}
],
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claim-type",
"code" : "professional"
}
]
},
"subType" : {
"coding" : [
{
"system" : "https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1",
"code" : "mbs"
}
]
},
"use" : "claim",
"patient" : {
"reference" : "Patient/mhr-field-sally",
"identifier" : {
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "NI",
"display" : "National unique individual identifier"
}
],
"text" : "IHI"
},
"system" : "http://ns.electronichealth.net.au/id/hi/ihi/1.0",
"value" : "8003608833357361"
}
},
"created" : "2017-12-04",
"insurer" : {
"reference" : "Organization/healthau",
"identifier" : {
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "XX"
}
],
"text" : "ABN"
},
"system" : "http://hl7.org.au/id/abn",
"value" : "83605426759"
},
"display" : "Australian Government Department of Health"
},
"provider" : {
"identifier" : {
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "NPI",
"display" : "National provider identifier"
}
],
"text" : "HPI-I"
},
"system" : "http://ns.electronichealth.net.au/id/hi/hpii/1.0",
"value" : "8003614900041243"
},
"display" : "Dr. Jeong-Hoon Kim"
},
"outcome" : "complete",
"insurance" : [
{
"focal" : true,
"coverage" : {
"identifier" : {
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MC"
}
],
"text" : "Medicare Number"
},
"system" : "http://ns.electronichealth.net.au/id/medicare-number",
"value" : "3951032981"
}
}
}
],
"item" : [
{
"sequence" : 1,
"category" : {
"coding" : [
{
"system" : "https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1",
"code" : "mbs",
"display" : "MBS"
}
],
"text" : "Medicare Benefits Schedule"
},
"productOrService" : {
"coding" : [
{
"system" : "urn:oid:1.2.36.1.2001.1005.21",
"code" : "30185",
"display" : "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.)"
}
]
},
"servicedDate" : "2017-12-04"
}
]
}
Publisher: Australian Digital Health Agency ABN 84 425 496 912, Level 25, 175 Liverpool Street, Sydney, NSW 2000
Telephone 1300 901 001 or email help@digitalhealth.gov.au
https://www.digitalhealth.gov.au
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Australian Digital Health Agency FHIR Implementation Guide Version: 1.0.0 ®© FHIR Version: 4.0.1 (IG Publisher v4.0.1-a53ec6ee1b) generated on Fri, Apr 14, 2023 04:02+0000. |
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