{
  "resourceType": "ExplanationOfBenefit",
  "id": "explanationofbenefit-pbs-example-01",
  "meta": {
    "profile": [
      "http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/explanationofbenefit-medicare"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: explanationofbenefit-pbs-example-01</p><p><b>meta</b>: </p><p><b>contained</b>: , </p><p><b>identifier</b>: urn:oid:2.25.129844986816735724544008039950138526110</p><p><b>patient</b>: </p><p><b>created</b>: 16/01/2017</p><p><b>prescription</b>: unknown resource contained</p><h3>Items</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>Service</b></td><td><b>Serviced[x]</b></td></tr><tr><td>*</td><td>1</td><td>PBS <span style=\"background: LightGoldenRodYellow\">(Details : {https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1 code 'pbs' = 'pbs', given as 'PBS'})</span></td><td>cephalexin 500 mg capsule, 20 <span style=\"background: LightGoldenRodYellow\">(Details : {urn:oid:1.2.36.1.2001.1005.22 code '03119E' = '03119E', given as 'cephalexin 500 mg capsule, 20'})</span></td><td>16/01/2017</td></tr></table></div>"
  },
  "contained": [
    {
      "resourceType": "Medication",
      "id": "Medication1",
      "code": {
        "coding": [
          {
            "system": "urn:oid:1.2.36.1.2001.1005.22",
            "code": "03119E",
            "display": "cephalexin 500 mg capsule, 20"
          }
        ]
      }
    },
    {
      "resourceType": "MedicationRequest",
      "id": "MedicationRequest1",
      "meta": {
        "profile": [
          "http://ns.electronichealth.net.au/ci/fhir/StructureDefinition/medicationrequest-pbs"
        ]
      },
      "status": "active",
      "intent": "order",
      "medicationReference": {
        "reference": "#Medication1"
      },
      "subject": {
        "identifier": {
          "type": {
            "coding": [
              {
                "system": "http://hl7.org/fhir/v2/0203",
                "code": "NI",
                "display": "National unique individual identifier"
              }
            ]
          },
          "system": "http://ns.electronichealth.net.au/id/hi/ihi/1.0",
          "value": "8003608166690503"
        }
      },
      "authoredOn": "2017-01-15",
      "dispenseRequest": {
        "numberOfRepeatsAllowed": 1,
        "quantity": {
          "value": 500,
          "unit": "tablet"
        }
      }
    }
  ],
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.25.129844986816735724544008039950138526110"
    }
  ],
  "patient": {
    "identifier": {
      "type": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v2/0203",
            "code": "NI",
            "display": "National unique individual identifier"
          }
        ]
      },
      "system": "http://ns.electronichealth.net.au/id/hi/ihi/1.0",
      "value": "8003608166690503"
    }
  },
  "created": "2017-01-16",
  "prescription": {
    "reference": "#MedicationRequest1"
  },
  "item": [
    {
      "sequence": 1,
      "category": {
        "coding": [
          {
            "system": "https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1",
            "code": "pbs",
            "display": "PBS"
          }
        ]
      },
      "service": {
        "coding": [
          {
            "system": "urn:oid:1.2.36.1.2001.1005.22",
            "code": "03119E",
            "display": "cephalexin 500 mg capsule, 20"
          }
        ]
      },
      "servicedDate": "2017-01-16"
    }
  ]
}