My Health Record FHIR IG
1.2.0 - active

My Health Record FHIR IG - Local Development build (v1.2.0) 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 - JSON Representation

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    {
      "resourceType" : "ExplanationOfBenefit",
      "id" : "explanationofbenefit-mbs-01",
      "meta" : {
        "profile" : [
          🔗 "http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-mbs-1"
        ]
      },
      "text" : {
        "status" : "generated",
        "div" : "<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 \r\n\r\nThis 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: \r\n\r\nNote 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.\r\n\r\nThis 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>"
      },
      "identifier" : [
        // identifier from Bundle uploaded from MBS Medicare repository if in Bundle | If single post is 'document identifier' stored in ExplanationOfBenefit.identifier
        {
          "system" : "urn:ietf:rfc:3986",
          "value" : "urn:uuid:a7b64195-3553-4708-957e-04d571c7db92"
        }
      ],
      "status" : "active",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
            "code" : "institutional"
          }
        ]
      },
      "subType" : {
        "coding" : [
          {
            "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1",
            "code" : "mbs"
          }
        ]
      },
      "use" : "claim",
      "patient" : {
        "identifier" : {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                "code" : "NI"
              }
            ],
            "text" : "IHI"
          },
          "system" : "http://ns.electronichealth.net.au/id/hi/ihi/1.0",
          "value" : "8003608000228437"
        }
      },
      "created" : "2019-02-07",
      "insurer" : {
        🔗 "reference" : "Organization/healthau",
        "identifier" : {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                "code" : "XX"
              }
            ],
            "text" : "ABN"
          },
          "system" : "http://hl7.org.au/id/abn",
          "value" : "83605426759"
        },
        "display" : "Australian Government Department of Health"
      },
      "provider" : {
        "identifier" : {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                "code" : "NPI",
                "display" : "National provider identifier"
              }
            ],
            "text" : "HPI-I"
          },
          "system" : "http://ns.electronichealth.net.au/id/hi/hpii/1.0",
          "value" : "8003614900041243"
        }
      },
      "outcome" : "complete",
      "insurance" : [
        // <referral>
    		<reference value="#claim-mbs-01"/>
    	</referral>
        {
          "focal" : true,
          "coverage" : {
            "identifier" : {
              "type" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                    "code" : "MC"
                  }
                ],
                "text" : "Medicare Number"
              },
              "system" : "http://ns.electronichealth.net.au/id/medicare-number",
              "value" : "29533070311"
            }
          }
        }
      ],
      "item" : [
        {
          "sequence" : 1,
          "category" : {
            "coding" : [
              {
                "system" : "https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1",
                "code" : "mbs",
                "display" : "MBS"
              }
            ],
            "text" : "Medicare Benefits Schedule"
          },
          "productOrService" : {
            "coding" : [
              {
                "system" : "urn:oid:1.2.36.1.2001.1005.21",
                "code" : "15275",
                "display" : "Radiation oncology treatment"
              }
            ]
          },
          "servicedDate" : "2019-02-07",
          "locationCodeableConcept" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
                "code" : "HOSP",
                "display" : "Hospital"
              },
              {
                "system" : "http://snomed.info/sct",
                "code" : "22232009",
                "display" : "Hospital"
              }
            ]
          }
        }
      ]
    }