mbs-02
type: ExplanationOfBenefit
node role: treeRoot
id:
  v: mbs-02
meta:
  profile:
    v: http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-mbs-mhr-1
    link: http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-mbs-mhr-1
text:
  status:
    v: generated
  div: Generated Narrative: ExplanationOfBenefit mbs-02 Profile: MHR Record of Claim against MBS or DVA identifier: <a href="http://terminology.hl7.org/6.2.0/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 #xD;#xA;#xD;#xA;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: #xD;#xA;#xD;#xA;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.#xD;#xA;#xD;#xA;This OID may also be used in CD.codeSystem.">Uniform Resource Identifier (URI)/urn:uuid:79a8b5a5-1631-4eec-b031-815156c9a47b status: Active type: Professional subType: MBS use: Claim patient: Sally FIELD Female, DoB: 1999-02-14 ( National unique individual identifier: Austalian Healthcare Identifier - Individual#8003608333563104 (use: official, )) created: 2017-12-04 insurer: Australian Government Department of Health provider: Dr. Jeong-Hoon Kim (Identifier: HPI-I/8003614900041243) outcome: Processing Complete Insurances - Focal Coverage * true Identifier: Medicare Number/3951032981 Items - Sequence Category ProductOrService Serviced[x] * 1 Medicare Benefits Schedule Palmar or plantar warts (10 or more), definitive removal of, excluding ablative methods alone, not being a service to which item 30186 or 30187 applies (Anaes.) 2017-12-04
identifier:
  system:
    v: urn:ietf:rfc:3986
status:
  v: active
type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/claim-type
    code:
      v: professional
sub type:
  coding:
    system:
      v: https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1
    code:
      v: mbs
use:
  v: claim
patient:
  link: http://ns.electronichealth.net.au/fhir/Patient/mhr-field-sally
  reference:
    v: Patient/mhr-field-sally
  identifier:
    type:
      text:
        v: IHI
    system:
      v: http://ns.electronichealth.net.au/id/hi/ihi/1.0
    value:
      v: 8003608833357361
created:
  v: 2017-12-04
insurer:
  link: http://ns.electronichealth.net.au/fhir/Organization/healthau
  reference:
    v: Organization/healthau
  identifier:
    type:
      text:
        v: ABN
    system:
      v: http://hl7.org.au/id/abn
    value:
      v: 83605426759
  display:
    v: Australian Government Department of Health
provider:
  identifier:
    type:
      text:
        v: HPI-I
    system:
      v: http://ns.electronichealth.net.au/id/hi/hpii/1.0
    value:
      v: 8003614900041243
  display:
    v: Dr. Jeong-Hoon Kim
outcome:
  v: complete
insurance:
  focal:
    v: true
  coverage:
    identifier:
      system:
        v: http://ns.electronichealth.net.au/id/medicare-number
      value:
        v: 3951032981
item:
  sequence:
    v: 1
  category:
    coding:
      system:
        v: https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1
      code:
        v: mbs
      display:
        v: MBS
    text:
      v: Medicare Benefits Schedule
  product or service:
    coding:
      system:
        v: urn:oid:1.2.36.1.2001.1005.21
      code:
        v: 30185
      display:
        v: Palmar or plantar warts (10 or more), definitive removal of, excluding ablative methods alone, not being a service to which item 30186 or 30187 applies (Anaes.)
  serviced: date
    v: 2017-12-04

v: NI

v: National unique individual identifier

v: XX

v: NPI

v: National provider identifier

system:
  v: http://terminology.hl7.org/CodeSystem/v2-0203
code:
  v: MC

v: Medicare Number