My Health Record FHIR IG
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My Health Record FHIR IG - Local Development build (v1.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Record of Claim against MBS for 30185 removal of plantar warts for Mr. Mike Broadway - XML Representation

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<ExplanationOfBenefit xmlns="http://hl7.org/fhir">
  <id value="explanationofbenefit-mbs-01"/>
  <meta>
    <profile
             value="http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-mhr-1"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ExplanationOfBenefit explanationofbenefit-mbs-01</b></p><a name="explanationofbenefit-mbs-01"> </a><a name="hcexplanationofbenefit-mbs-01"> </a><a name="explanationofbenefit-mbs-01-en-AU"> </a><p><b>identifier</b>: <a href="http://terminology.hl7.org/5.0.0/NamingSystem-uri.html" title="As defined by RFC 3986 (http://www.ietf.org/rfc/rfc3986.txt)(with many schemes defined in many RFCs). For OIDs and UUIDs, use the URN form (urn:oid:(note: lowercase) and urn:uuid:). See http://www.ietf.org/rfc/rfc3001.txt and http://www.ietf.org/rfc/rfc4122.txt 

This oid is used as an identifier II.root to indicate the the extension is an absolute URI (technically, an IRI). Typically, this is used for OIDs and GUIDs. Note that when this OID is used with OIDs and GUIDs, the II.extension should start with urn:oid or urn:uuid: 

Note that this OID is created to aid with interconversion between CDA and FHIR - FHIR uses urn:ietf:rfc:3986 as equivalent to this OID. URIs as identifiers appear more commonly in FHIR.

This OID may also be used in CD.codeSystem.">URI</a>/urn:uuid:a7b64195-3553-4708-957e-04d571c7db92</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/claim-type institutional}">Institutional</span></p><p><b>subType</b>: <span title="Codes:{https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1 mbs}">MBS</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: Identifier: IHI/8003608000228437</p><p><b>created</b>: 2019-02-07</p><p><b>insurer</b>: <a href="Organization-healthau.html">Australian Government Department of Health</a></p><p><b>provider</b>: Identifier: HPI-I/8003614900041243</p><p><b>outcome</b>: Processing Complete</p><h3>Insurances</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style="display: none">*</td><td>true</td><td>Identifier: Medicare Number/29533070311</td></tr></table><h3>Items</h3><table class="grid"><tr><td style="display: none">-</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 style="display: none">*</td><td>1</td><td><span title="Codes:{https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1 mbs}">Medicare Benefits Schedule</span></td><td><span title="Codes:{urn:oid:1.2.36.1.2001.1005.21 15275}">Radiation oncology treatment</span></td><td>2019-02-07</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-RoleCode HOSP}, {http://snomed.info/sct 22232009}">Hospital</span></td></tr></table></div>
  </text>
  <!-- identifier from Bundle uploaded from MBS Medicare repository if in Bundle | If single post is 'document identifier' stored in ExplanationOfBenefit.identifier -->
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:uuid:a7b64195-3553-4708-957e-04d571c7db92"/>
  </identifier>
  <status value="active"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
      <code value="institutional"/>
      <display value="Institutional"/>
    </coding>
  </type>
  <subType>
    <coding>
      <system
              value="https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1"/>
      <code value="mbs"/>
      <display value="MBS"/>
    </coding>
  </subType>
  <use value="claim"/>
  <patient>
    <identifier>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <code value="NI"/>
        </coding>
        <text value="IHI"/>
      </type>
      <system value="http://ns.electronichealth.net.au/id/hi/ihi/1.0"/>
      <value value="8003608000228437"/>
    </identifier>
  </patient>
  <created value="2019-02-07"/>
  <insurer>🔗 
    <reference value="Organization/healthau"/>
    <identifier>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <code value="XX"/>
        </coding>
        <text value="ABN"/>
      </type>
      <system value="http://hl7.org.au/id/abn"/>
      <value value="83605426759"/>
    </identifier>
    <display value="Australian Government Department of Health"/>
  </insurer>
  <provider>
    <identifier>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <code value="NPI"/>
          <display value="National provider identifier"/>
        </coding>
        <text value="HPI-I"/>
      </type>
      <system value="http://ns.electronichealth.net.au/id/hi/hpii/1.0"/>
      <value value="8003614900041243"/>
    </identifier>
  </provider>
  <!-- <referral>
		<reference value="#claim-mbs-01"/>
	</referral> -->
  <outcome value="complete"/>
  <insurance>
    <focal value="true"/>
    <coverage>
      <identifier>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
            <code value="MC"/>
          </coding>
          <text value="Medicare Number"/>
        </type>
        <system value="http://ns.electronichealth.net.au/id/medicare-number"/>
        <value value="29533070311"/>
      </identifier>
    </coverage>
  </insurance>
  <item>
    <sequence value="1"/>
    <category>
      <coding>
        <system
                value="https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1"/>
        <code value="mbs"/>
        <display value="MBS"/>
      </coding>
      <text value="Medicare Benefits Schedule"/>
    </category>
    <productOrService>
      <coding>
        <system value="urn:oid:1.2.36.1.2001.1005.21"/>
        <code value="15275"/>
        <display value="Radiation oncology treatment"/>
      </coding>
    </productOrService>
    <servicedDate value="2019-02-07"/>
    <locationCodeableConcept>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
        <code value="HOSP"/>
        <display value="Hospital"/>
      </coding>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="22232009"/>
        <display value="Hospital"/>
      </coding>
    </locationCodeableConcept>
  </item>
</ExplanationOfBenefit>