This page is part of the Australian Digital Health Agency FHIR Implementation Guide 1.1.0. It is based on FHIR® version 4.0.1. See the Directory of published versions for a list of available previous versions.

Example: ExplanationOfBenefit-mbs-01

Formats: Narrative, XML, JSON, Turtle

Raw ttl

@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:ExplanationOfBenefit;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "mbs-01"];
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-mbs-1";
       fhir:index 0;
       fhir:link <http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-mbs-1>     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ExplanationOfBenefit</b><a name=\"mbs-01\"> </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-01\" </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:a7b64195-3553-4708-957e-04d571c7db92</p><p><b>status</b>: active</p><p><b>type</b>: Institutional <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>#institutional)</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>: <span></span></p><p><b>created</b>: 2019-02-07</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></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></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><td><b>Location[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>Radiation oncology treatment <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (unknown#15275)</span></td><td>2019-02-07</td><td>Hospital <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-RoleCode.html\">RoleCode</a>#HOSP; <a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#22232009)</span></td></tr></table></div>"
  ];
  fhir:ExplanationOfBenefit.identifier [
     fhir:index 0;
     fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ];
     fhir:Identifier.value [ fhir:value "urn:uuid:a7b64195-3553-4708-957e-04d571c7db92" ]
  ];
  fhir:ExplanationOfBenefit.status [ fhir:value "active"];
  fhir:ExplanationOfBenefit.type [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ];
       fhir:Coding.code [ fhir:value "institutional" ]     ]
  ];
  fhir:ExplanationOfBenefit.subType [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1" ];
       fhir:Coding.code [ fhir:value "mbs" ]     ]
  ];
  fhir:ExplanationOfBenefit.use [ fhir:value "claim"];
  fhir:ExplanationOfBenefit.patient [
     fhir:Reference.identifier [
       fhir:Identifier.type [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0203" ];
           fhir:Coding.code [ fhir:value "NI" ]         ];
         fhir:CodeableConcept.text [ fhir:value "IHI" ]       ];
       fhir:Identifier.system [ fhir:value "http://ns.electronichealth.net.au/id/hi/ihi/1.0" ];
       fhir:Identifier.value [ fhir:value "8003608000228437" ]     ]
  ];
  fhir:ExplanationOfBenefit.created [ fhir:value "2019-02-07"^^xsd:date];
  fhir:ExplanationOfBenefit.insurer [
     fhir:Reference.reference [ fhir:value "Organization/healthau" ];
     fhir:Reference.identifier [
       fhir:Identifier.type [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0203" ];
           fhir:Coding.code [ fhir:value "XX" ]         ];
         fhir:CodeableConcept.text [ fhir:value "ABN" ]       ];
       fhir:Identifier.system [ fhir:value "http://hl7.org.au/id/abn" ];
       fhir:Identifier.value [ fhir:value "83605426759" ]     ];
     fhir:Reference.display [ fhir:value "Australian Government Department of Health" ]
  ];
  fhir:ExplanationOfBenefit.provider [
     fhir:Reference.identifier [
       fhir:Identifier.type [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0203" ];
           fhir:Coding.code [ fhir:value "NPI" ];
           fhir:Coding.display [ fhir:value "National provider identifier" ]         ];
         fhir:CodeableConcept.text [ fhir:value "HPI-I" ]       ];
       fhir:Identifier.system [ fhir:value "http://ns.electronichealth.net.au/id/hi/hpii/1.0" ];
       fhir:Identifier.value [ fhir:value "8003614900041243" ]     ]
  ];
  fhir:ExplanationOfBenefit.outcome [ fhir:value "complete"];
  fhir:ExplanationOfBenefit.insurance [
     fhir:index 0;
     fhir:ExplanationOfBenefit.insurance.focal [ fhir:value "true"^^xsd:boolean ];
     fhir:ExplanationOfBenefit.insurance.coverage [
       fhir:Reference.identifier [
         fhir:Identifier.type [
           fhir:CodeableConcept.coding [
             fhir:index 0;
             fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0203" ];
             fhir:Coding.code [ fhir:value "MC" ]           ];
           fhir:CodeableConcept.text [ fhir:value "Medicare Number" ]         ];
         fhir:Identifier.system [ fhir:value "http://ns.electronichealth.net.au/id/medicare-number" ];
         fhir:Identifier.value [ fhir:value "29533070311" ]       ]     ]
  ];
  fhir:ExplanationOfBenefit.item [
     fhir:index 0;
     fhir:ExplanationOfBenefit.item.sequence [ fhir:value "1"^^xsd:positiveInteger ];
     fhir:ExplanationOfBenefit.item.category [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1" ];
         fhir:Coding.code [ fhir:value "mbs" ];
         fhir:Coding.display [ fhir:value "MBS" ]       ];
       fhir:CodeableConcept.text [ fhir:value "Medicare Benefits Schedule" ]     ];
     fhir:ExplanationOfBenefit.item.productOrService [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "urn:oid:1.2.36.1.2001.1005.21" ];
         fhir:Coding.code [ fhir:value "15275" ];
         fhir:Coding.display [ fhir:value "Radiation oncology treatment" ]       ]     ];
     fhir:ExplanationOfBenefit.item.servicedDate [ fhir:value "2019-02-07"^^xsd:date ];
     fhir:ExplanationOfBenefit.item.locationCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-RoleCode" ];
         fhir:Coding.code [ fhir:value "HOSP" ];
         fhir:Coding.display [ fhir:value "Hospital" ]       ], [
         fhir:index 1;
         a sct:22232009;
         fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
         fhir:Coding.code [ fhir:value "22232009" ];
         fhir:Coding.display [ fhir:value "Hospital" ]       ]     ]
  ].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.