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-pbs-cont-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 xsd: <http://www.w3.org/2001/XMLSchema#> .

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

 a fhir:ExplanationOfBenefit;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "pbs-cont-01"];
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-pbs-1";
       fhir:index 0;
       fhir:link <http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-pbs-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=\"pbs-cont-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 \"pbs-cont-01\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-dh-explanationofbenefit-medicare-pbs-1.html\">ADHA Record of Claim against PBS or RPBS</a></p></div><p><b>identifier</b>: id: urn:uuid:296dcbd7-d763-4ecf-aa78-523bcc11ecda</p><p><b>status</b>: active</p><p><b>type</b>: Pharmacy <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>#pharmacy)</span></p><p><b>subType</b>: pbs <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (australian-benefit-payment-category-1#pbs)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: <span></span></p><p><b>created</b>: 2020-01-16</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>: Mr. Representative Pharmacist at Test Org -DigitalHealth 6 Pharmacy</span></p><p><b>prescription</b>: <a name=\"claim-pbs-01\"> </a></p><blockquote><p></p><p><a name=\"claim-pbs-01\"> </a></p><p><b>status</b>: unknown</p><p><b>intent</b>: order</p><p><b>medication</b>: <a href=\"#cephalexin-01\">#cephalexin-01</a></p><p><b>subject</b>: <span></span></p><p><b>authoredOn</b>: 2020-01-15</p><h3>DispenseRequests</h3><table class=\"grid\"><tr><td>-</td><td><b>NumberOfRepeatsAllowed</b></td><td><b>Quantity</b></td></tr><tr><td>*</td><td>1</td><td>20 capsule</td></tr></table></blockquote><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></tr><tr><td>*</td><td>1</td><td>PBS <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (australian-benefit-payment-category-1#pbs)</span></td><td>cephalexin 500 mg capsule, 20 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org.au/fhir/4.0.0/CodeSystem-pbs-item-external.html\">PBS Item Codes</a>#03119E)</span></td><td>2020-01-16</td></tr></table><hr/><blockquote><p><b>Generated Narrative: MedicationRequest #claim-pbs-01</b><a name=\"claim-pbs-01\"> </a></p><p><b>status</b>: unknown</p><p><b>intent</b>: order</p><p><b>medication</b>: <a href=\"#cephalexin-01\">#cephalexin-01</a></p><p><b>subject</b>: <span></span></p><p><b>authoredOn</b>: 2020-01-15</p><h3>DispenseRequests</h3><table class=\"grid\"><tr><td>-</td><td><b>NumberOfRepeatsAllowed</b></td><td><b>Quantity</b></td></tr><tr><td>*</td><td>1</td><td>20 capsule</td></tr></table></blockquote><hr/><blockquote><p><b>Generated Narrative: Medication #cephalexin-01</b><a name=\"cephalexin-01\"> </a></p><p><b>code</b>: cephalexin 500 mg capsule, 20 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://hl7.org.au/fhir/4.0.0/CodeSystem-pbs-item-external.html\">PBS Item Codes</a>#03119E)</span></p><p><b>manufacturer</b>: <span></span></p></blockquote></div>"
  ];
  fhir:DomainResource.contained [
     a fhir:MedicationRequest;
     fhir:index 0;
     fhir:Resource.id [ fhir:value "claim-pbs-01" ];
     fhir:MedicationRequest.status [ fhir:value "unknown" ];
     fhir:MedicationRequest.intent [ fhir:value "order" ];
     fhir:MedicationRequest.medicationReference [
       fhir:Reference.reference [ fhir:value "#cephalexin-01" ]     ];
     fhir:MedicationRequest.subject [
       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:Coding.display [ fhir:value "National unique individual identifier" ]           ];
           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 "8003608833357361" ]       ]     ];
     fhir:MedicationRequest.authoredOn [ fhir:value "2020-01-15"^^xsd:date ];
     fhir:MedicationRequest.dispenseRequest [
       fhir:MedicationRequest.dispenseRequest.numberOfRepeatsAllowed [ fhir:value "1"^^xsd:nonNegativeInteger ];
       fhir:MedicationRequest.dispenseRequest.quantity [
         fhir:Quantity.value [ fhir:value "20"^^xsd:decimal ];
         fhir:Quantity.unit [ fhir:value "capsule" ]       ]     ]
  ], [
     a fhir:Medication;
     fhir:index 1;
     fhir:Resource.id [ fhir:value "cephalexin-01" ];
     fhir:Medication.code [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://pbs.gov.au/code/item" ];
         fhir:Coding.code [ fhir:value "03119E" ];
         fhir:Coding.display [ fhir:value "cephalexin 500 mg capsule, 20" ]       ]     ];
     fhir:Medication.manufacturer [
       fhir:Reference.identifier [
         fhir:Identifier.system [ fhir:value "http://pbs.gov.au/code/manufacturer" ];
         fhir:Identifier.value [ fhir:value "MM" ]       ]     ]
  ];
  fhir:ExplanationOfBenefit.identifier [
     fhir:index 0;
     fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ];
     fhir:Identifier.value [ fhir:value "urn:uuid:296dcbd7-d763-4ecf-aa78-523bcc11ecda" ]
  ];
  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 "pharmacy" ]     ]
  ];
  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 "pbs" ]     ]
  ];
  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:Coding.display [ fhir:value "National unique individual identifier" ]         ];
         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 "8003608833357361" ]     ]
  ];
  fhir:ExplanationOfBenefit.created [ fhir:value "2020-01-16"^^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 "8003611566708354" ]     ];
     fhir:Reference.display [ fhir:value "Mr. Representative Pharmacist at Test Org -DigitalHealth 6 Pharmacy" ]
  ];
  fhir:ExplanationOfBenefit.prescription [
     fhir:Reference.reference [ fhir:value "#claim-pbs-01" ]
  ];
  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 "3951032981" ]       ]     ]
  ];
  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 "pbs" ];
         fhir:Coding.display [ fhir:value "PBS" ]       ]     ];
     fhir:ExplanationOfBenefit.item.productOrService [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://pbs.gov.au/code/item" ];
         fhir:Coding.code [ fhir:value "03119E" ];
         fhir:Coding.display [ fhir:value "cephalexin 500 mg capsule, 20" ]       ]     ];
     fhir:ExplanationOfBenefit.item.servicedDate [ fhir:value "2020-01-16"^^xsd:date ]
  ].

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

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