pbs-mds
type: ExplanationOfBenefit
node role: treeRoot
resource.id:
  value: pbs-mds
resource.meta:
  meta.profile:
    value: http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-pbs-1
    index: 0
    link: http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-pbs-1
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: ExplanationOfBenefit Resource ExplanationOfBenefit "pbs-mds" Profile: ADHA Record of Claim against PBS or RPBS identifier: id: urn:oid:1.2.36.1.2001.1007.11.8003608833630130.1000000000017396 status: active type: Pharmacy (Claim Type Codes#pharmacy) subType: pbs (australian-benefit-payment-category-1#pbs) use: claim patient: created: 2020-01-16 insurer: Organization/healthau "Australian Government Department of Health" provider: prescription: status: unknown intent: order medication: #mmds subject: authoredOn: 2022-04-08 DispenseRequests - Quantity * 10 outcome: complete Insurances - Focal Coverage * true Items - Sequence Category ProductOrService Serviced[x] * 1 PBS (australian-benefit-payment-category-1#pbs) BENZYLPENICILLIN (PBS Item Codes[v1.0]#02647H) 2020-01-16 Generated Narrative: MedicationRequest #mds status: unknown intent: order medication: #mmds subject: authoredOn: 2022-04-08 DispenseRequests - Quantity * 10 Generated Narrative: Medication #mmds Medication Generic Drug Name: BENZYLPENICILLIN Medication Brand Name: BENPEN code: BENZYLPENICILLIN 3G INJECTION, 1 VIAL (PBS Item Codes[v1.0]#02647H "BENZYLPENICILLIN") manufacturer:
domain resource.contained: MedicationRequest
  index: 0
  resource.id:
    value: mds
  medication request.status:
    value: unknown
  medication request.intent:
    value: order
  medication request.medication reference:
    reference.reference:
      value: #mmds
  medication request.subject:
    reference.identifier:
      identifier.system:
        value: http://ns.electronichealth.net.au/id/hi/ihi/1.0
      identifier.value:
        value: 8003608833630130
  medication request.authored on:
    value: 2022-04-08
  medication request.dispense request:
    medication request.dispense request.quantity:
      quantity.value:
        value: 10
domain resource.contained: Medication
  index: 1
  resource.id:
    value: mmds
  domain resource.extension:
    index: 0
    extension.url:
      value: http://hl7.org.au/fhir/StructureDefinition/medication-generic-name
    extension.value string:
      value: BENZYLPENICILLIN
  domain resource.extension:
    index: 1
    extension.url:
      value: http://hl7.org.au/fhir/StructureDefinition/medication-brand-name
    extension.value string:
      value: BENPEN
  medication.code:
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://pbs.gov.au/code/item
      coding.version:
        value: v1.0
      coding.code:
        value: 02647H
      coding.display:
        value: BENZYLPENICILLIN
    codeable concept.text:
      value: BENZYLPENICILLIN 3G INJECTION, 1 VIAL
  medication.manufacturer:
    reference.identifier:
      identifier.system:
        value: http://pbs.gov.au/code/manufacturer
      identifier.value:
        value: CS
explanation of benefit.identifier:
  index: 0
  identifier.system:
    value: urn:ietf:rfc:3986
  identifier.value:
    value: urn:oid:1.2.36.1.2001.1007.11.8003608833630130.1000000000017396
explanation of benefit.status:
  value: active
explanation of benefit.type:
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/claim-type
    coding.code:
      value: pharmacy
    coding.display:
      value: Pharmacy
explanation of benefit.sub type:
  codeable concept.coding:
    index: 0
    coding.system:
      value: https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1
    coding.code:
      value: pbs
explanation of benefit.use:
  value: claim
explanation of benefit.patient:
  reference.identifier:
    identifier.type:
      codeable concept.coding:
        index: 0
      codeable concept.text:
        value: IHI
    identifier.system:
      value: http://ns.electronichealth.net.au/id/hi/ihi/1.0
    identifier.value:
      value: 8003608833630130
explanation of benefit.created:
  value: 2020-01-16
explanation of benefit.insurer:
  link: http://ns.electronichealth.net.au/fhir/Organization/healthau
  reference.reference:
    value: Organization/healthau
explanation of benefit.provider:
  element.extension:
    index: 0
    extension.url:
      value: http://hl7.org/fhir/StructureDefinition/data-absent-reason
    extension.value code:
      value: unknown
explanation of benefit.prescription:
  reference.reference:
    value: #mds
explanation of benefit.outcome:
  value: complete
explanation of benefit.insurance:
  index: 0
  explanation of benefit.insurance.focal:
    value: true
  explanation of benefit.insurance.coverage:
    element.extension:
      index: 0
      extension.url:
        value: http://hl7.org/fhir/StructureDefinition/data-absent-reason
      extension.value code:
        value: unknown
explanation of benefit.item:
  index: 0
  explanation of benefit.item.sequence:
    value: 1
  explanation of benefit.item.category:
    codeable concept.coding:
      index: 0
      coding.system:
        value: https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1
      coding.code:
        value: pbs
      coding.display:
        value: PBS
  explanation of benefit.item.product or service:
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://pbs.gov.au/code/item
      coding.version:
        value: v1.0
      coding.code:
        value: 02647H
      coding.display:
        value: BENZYLPENICILLIN
  explanation of benefit.item.serviced date:
    value: 2020-01-16

index: 0
coding.system:
  value: http://terminology.hl7.org/CodeSystem/v2-0203
coding.code:
  value: NI
coding.display:
  value: National unique individual identifier

value: IHI

value: NI

value: National unique individual identifier