Belgian MyCareNet eAttestation Profiles
1.0.0 - STU Belgium flag

Belgian MyCareNet eAttestation Profiles, published by eHealth Platform. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/eattestation/ and changes regularly. See the Directory of published versions

: ex07 - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "ex07",
  "meta" : {
    "profile" : [
      🔗 "https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-eattestation-request"
    ]
  },
  "type" : "message",
  "timestamp" : "2015-07-14T11:15:33+02:00",
  "entry" : [
    {
      "fullUrl" : "urn:uuid:267b18ce-3d37-4581-9baa-6fada338038b",
      "resource" : {
        "resourceType" : "MessageHeader",
        "id" : "267b18ce-3d37-4581-9baa-6fada338038b",
        "meta" : {
          "profile" : [
            🔗 "https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-messageheader"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_267b18ce-3d37-4581-9baa-6fada338038b\"> </a><p><b>Generated Narrative: MessageHeader</b><a name=\"267b18ce-3d37-4581-9baa-6fada338038b\"> </a><a name=\"hc267b18ce-3d37-4581-9baa-6fada338038b\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MessageHeader &quot;267b18ce-3d37-4581-9baa-6fada338038b&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://build.fhir.org/ig/hl7-be/mycarenet//StructureDefinition-be-messageheader.html\">MyCareNet MessageHeader BE profile</a></p></div><p><b>event</b>: eattest-create (Details: https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/message-events code eattest-create = 'eattest-create', stated as 'null')</p><h3>Destinations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td style=\"display: none\">*</td><td>MyCareNet</td><td><code>urn:be:fgov:kbo-bce:organization:cbe-number:0820563481</code></td></tr></table><p><b>sender</b>: <a href=\"#Organization_e2c6f73a-74d8-40f2-af0b-a61ad20c53d4\">See above (urn:uuid:e2c6f73a-74d8-40f2-af0b-a61ad20c53d4)</a></p><h3>Sources</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Endpoint</b></td></tr><tr><td style=\"display: none\">*</td><td><code>urn:be:fgov:ehealth:1.0:hospital:nihii-number:71040622000</code></td></tr></table><p><b>focus</b>: <a href=\"#Claim_e85173bc-6f0d-480b-a2cd-2b70d9ffff7a\">See above (urn:uuid:e85173bc-6f0d-480b-a2cd-2b70d9ffff7a)</a></p></div>"
        },
        "eventCoding" : {
          "system" : "https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/message-events",
          "code" : "eattest-create"
        },
        "destination" : [
          {
            "name" : "MyCareNet",
            "endpoint" : "urn:be:fgov:kbo-bce:organization:cbe-number:0820563481"
          }
        ],
        "sender" : {
          "reference" : "urn:uuid:e2c6f73a-74d8-40f2-af0b-a61ad20c53d4"
        },
        "source" : //  serviceProvider 
        {
          "endpoint" : "urn:be:fgov:ehealth:1.0:hospital:nihii-number:71040622000"
        },
        "focus" : [
          {
            "reference" : "urn:uuid:e85173bc-6f0d-480b-a2cd-2b70d9ffff7a"
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:e2c6f73a-74d8-40f2-af0b-a61ad20c53d4",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "e2c6f73a-74d8-40f2-af0b-a61ad20c53d4",
        "meta" : {
          "profile" : [
            🔗 "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-organization"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_e2c6f73a-74d8-40f2-af0b-a61ad20c53d4\"> </a><p><b>Generated Narrative: Organization</b><a name=\"e2c6f73a-74d8-40f2-af0b-a61ad20c53d4\"> </a><a name=\"hce2c6f73a-74d8-40f2-af0b-a61ad20c53d4\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Organization &quot;e2c6f73a-74d8-40f2-af0b-a61ad20c53d4&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://build.fhir.org/ig/hl7-be/core//StructureDefinition-be-organization.html\">BeOrganization</a></p></div><p><b>identifier</b>: <a href=\"https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-nihdi.html\" title=\"RIZIV/INAMI\">BeNIHDINamingSystem</a>/71040622000, <a href=\"https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-cbe.html\" title=\"BCE/KBO\">BeCBENamingSystem</a>/0941792893</p><p><b>type</b>: hospital <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/core//CodeSystem-cd-hcparty.html\">BeCdHcParty</a>#orghospital)</span></p></div>"
        },
        "identifier" : [
          {
            "system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi",
            "value" : "71040622000"
          },
          {
            "system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/cbe",
            "value" : "0941792893"
          }
        ],
        "type" : [
          {
            "coding" : [
              {
                "system" : "https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty",
                "code" : "orghospital"
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:62c7bfad-0cb3-4a39-9abb-3a62e06de834",
      "resource" : {
        "resourceType" : "PractitionerRole",
        "id" : "62c7bfad-0cb3-4a39-9abb-3a62e06de834",
        "meta" : {
          "profile" : [
            🔗 "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitionerrole"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"PractitionerRole_62c7bfad-0cb3-4a39-9abb-3a62e06de834\"> </a><p><b>Generated Narrative: PractitionerRole</b><a name=\"62c7bfad-0cb3-4a39-9abb-3a62e06de834\"> </a><a name=\"hc62c7bfad-0cb3-4a39-9abb-3a62e06de834\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource PractitionerRole &quot;62c7bfad-0cb3-4a39-9abb-3a62e06de834&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://build.fhir.org/ig/hl7-be/core//StructureDefinition-be-practitionerrole.html\">BePractitionerRole</a></p></div><p><b>practitioner</b>: <a href=\"#Practitioner_03972cc4-d781-4285-8d79-0f05810e1931\">See above (urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931)</a></p><p><b>code</b>: physician <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/core//CodeSystem-cd-hcparty.html\">BeCdHcParty</a>#persphysician)</span></p></div>"
        },
        "practitioner" : {
          "reference" : "urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931"
        },
        "code" : [
          {
            "coding" : [
              {
                "system" : "https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty",
                "code" : "persphysician"
              }
            ]
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931",
      "resource" : {
        "resourceType" : "Practitioner",
        "id" : "03972cc4-d781-4285-8d79-0f05810e1931",
        "meta" : {
          "profile" : [
            🔗 "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitioner"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_03972cc4-d781-4285-8d79-0f05810e1931\"> </a><p><b>Generated Narrative: Practitioner</b><a name=\"03972cc4-d781-4285-8d79-0f05810e1931\"> </a><a name=\"hc03972cc4-d781-4285-8d79-0f05810e1931\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Practitioner &quot;03972cc4-d781-4285-8d79-0f05810e1931&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://build.fhir.org/ig/hl7-be/core//StructureDefinition-be-practitioner.html\">BePractitioner</a></p></div><p><b>identifier</b>: <a href=\"https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-nihdi.html\" title=\"RIZIV/INAMI\">BeNIHDINamingSystem</a>/12898723580</p><p><b>name</b>: John Smith </p></div>"
        },
        "identifier" : [
          {
            "system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi",
            "value" : "12898723580"
          }
        ],
        "name" : [
          //  serviceProvider for attest (and in this case also the provider for item)
          {
            "family" : "Smith",
            "given" : [
              "John"
            ]
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "a52efcb6-1f81-4333-a115-d45bd3183686",
        "meta" : {
          "profile" : [
            🔗 "https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-patient"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_a52efcb6-1f81-4333-a115-d45bd3183686\"> </a><p><b>Generated Narrative: Patient</b><a name=\"a52efcb6-1f81-4333-a115-d45bd3183686\"> </a><a name=\"hca52efcb6-1f81-4333-a115-d45bd3183686\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Patient &quot;a52efcb6-1f81-4333-a115-d45bd3183686&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"https://build.fhir.org/ig/hl7-be/core//StructureDefinition-be-patient.html\">BePatient</a></p></div><p><b>identifier</b>: <a href=\"https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-ssin.html\" title=\"NISS/INSZ\">BeSSINNamingSystem</a>/73031805784</p><p><b>name</b>: Jean Dupont </p><p><b>gender</b>: male</p></div>"
        },
        "identifier" : [
          {
            "system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/ssin",
            "value" : "73031805784"
          }
        ],
        "name" : [
          //  patient 
          {
            "family" : "Dupont",
            "given" : [
              "Jean"
            ]
          }
        ],
        "gender" : "male"
      }
    },
    {
      "fullUrl" : "urn:uuid:e85173bc-6f0d-480b-a2cd-2b70d9ffff7a",
      "resource" : {
        "resourceType" : "Claim",
        "id" : "e85173bc-6f0d-480b-a2cd-2b70d9ffff7a",
        "meta" : {
          "profile" : [
            🔗 "https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-eattestation-claim"
          ]
        },
        "text" : //  new profile to create for the request 
        {
          "status" : "extensions",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_e85173bc-6f0d-480b-a2cd-2b70d9ffff7a\"> </a><p><b>Generated Narrative: Claim</b><a name=\"e85173bc-6f0d-480b-a2cd-2b70d9ffff7a\"> </a><a name=\"hce85173bc-6f0d-480b-a2cd-2b70d9ffff7a\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Claim &quot;e85173bc-6f0d-480b-a2cd-2b70d9ffff7a&quot; </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-be-eattestation-claim.html\">MyCareNet eAttestation Claim BE profile</a></p></div><p><b>BeExtEAttestationSupplement</b>: <span title=\"Euro\">€2.00</span> (EUR)</p><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#professional)</span></p><p><b>subType</b>: specializedmedicine <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-be-cs-eattestation-types.html\">Attestation types</a>#specializedmedicine)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: <a href=\"#Patient_a52efcb6-1f81-4333-a115-d45bd3183686\">See above (urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686)</a></p><p><b>created</b>: 2015-07-14 11:15:30+0200</p><p><b>enterer</b>: <a href=\"#PractitionerRole_62c7bfad-0cb3-4a39-9abb-3a62e06de834\">See above (urn:uuid:62c7bfad-0cb3-4a39-9abb-3a62e06de834)</a></p><p><b>provider</b>: <a href=\"#PractitionerRole_62c7bfad-0cb3-4a39-9abb-3a62e06de834\">See above (urn:uuid:62c7bfad-0cb3-4a39-9abb-3a62e06de834)</a></p><p><b>priority</b>: Immediate <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#stat)</span></p><h3>Payees</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Party</b></td></tr><tr><td style=\"display: none\">*</td><td>Subscriber <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-payeetype.html\">Payee Type Codes</a>#subscriber)</span></td><td><a href=\"#Patient_a52efcb6-1f81-4333-a115-d45bd3183686\">See above (urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686)</a></td></tr></table><h3>CareTeams</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Provider</b></td><td><b>Role</b></td><td><b>Qualification</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span><a href=\"https://build.fhir.org/ig/hl7-be/core//NamingSystem-be-nihdi.html\" title=\"RIZIV/INAMI\">BeNIHDINamingSystem</a>/12471131580</span></td><td>Primary provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claimcareteamrole.html\">Claim Care Team Role Codes</a>#primary)</span></td><td>physician <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/core//CodeSystem-cd-hcparty.html\">BeCdHcParty</a>#persphysician)</span></td></tr></table><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 1</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>code</b>: 0070 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/nihdi-terminology//CodeSystem-be-cs-treatment-reason.html\">Treatment Reason</a>#0070)</span></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 2</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>code</b>: 0 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/nihdi-terminology//CodeSystem-be-cs-claim-norm-code.html\">Claim Norm Code</a>#0)</span></p></blockquote><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><span>: use of mandatory insurance coverage, no further details provided here.</span></td></tr></table><blockquote><p><b>item</b></p><p><b>BeExtEAttestationItemSupplement</b>: <span title=\"Euro\">€2.00</span> (EUR)</p><blockquote><p><b>BeExtPatientIdentityDocument</b></p><blockquote><p><b>url</b></p><code>readingDate</code></blockquote><p><b>value</b>: 2017-01-27</p><blockquote><p><b>url</b></p><code>readingTime</code></blockquote><p><b>value</b>: 11:20:00</p><blockquote><p><b>url</b></p><code>entryType</code></blockquote><p><b>value</b>: 4 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/nihdi-terminology//CodeSystem-be-cs-id-doc-input-type.html\">Id Doc Input Type</a>#4)</span></p><blockquote><p><b>url</b></p><code>reasonManual</code></blockquote><p><b>value</b>: 2 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/nihdi-terminology//CodeSystem-be-cs-id-doc-manual-input-justification.html\">Id Doc Manual Input Justification</a>#2)</span></p><blockquote><p><b>url</b></p><code>medium</code></blockquote><p><b>value</b>: 1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://build.fhir.org/ig/hl7-be/nihdi-terminology//CodeSystem-be-cs-id-doc-media-type.html\">Id Doc Media Type</a>#1)</span></p><blockquote><p><b>url</b></p><code>serialNumber</code></blockquote><p><b>value</b>: actual cardnumber as string</p></blockquote><p><b>sequence</b>: 1</p><p><b>careTeamSequence</b>: 1</p><p><b>informationSequence</b>: 2</p><p><b>productOrService</b>: 102034 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (be-ns-nihdi-nomenclature#102034)</span></p><p><b>serviced</b>: 2017-01-27</p><p><b>quantity</b>: 1</p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>38.86</td><td>EUR</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>38.86</td><td>EUR</td></tr></table></blockquote><h3>Totals</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>38.86</td><td>EUR</td></tr></table></div>"
        },
        "extension" : [
          {
            "url" : "https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-supplement",
            "valueMoney" : //  supplement for eattest 
            {
              "value" : 2.00,
              "currency" : "EUR"
            }
          }
        ],
        "status" : "active",
        "type" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
              "code" : "professional"
            }
          ]
        },
        "subType" : {
          "coding" : [
            //  attestationType 
            {
              "system" : "https://www.ehealth.fgov.be/standards/fhir/eattestation/CodeSystem/be-cs-eattestation-types",
              "code" : "specializedmedicine"
            }
          ]
        },
        "use" : "claim",
        "patient" : {
          "reference" : "urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686"
        },
        "created" : "2015-07-14T11:15:30+02:00",
        "enterer" : {
          "reference" : "urn:uuid:62c7bfad-0cb3-4a39-9abb-3a62e06de834"
        },
        "provider" : {
          "reference" : "urn:uuid:62c7bfad-0cb3-4a39-9abb-3a62e06de834"
        },
        "priority" : //  provider for item 
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
              "code" : "stat"
            }
          ]
        },
        "payee" : {
          "type" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/payeetype",
                "code" : "subscriber"
              }
            ]
          },
          "party" : {
            "reference" : "urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686"
          }
        },
        "careTeam" : [
          {
            "sequence" : 1,
            "provider" : //  service - Provider 
            {
              "identifier" : {
                "system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi",
                "value" : "12471131580"
              }
            },
            "role" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/claimcareteamrole",
                  "code" : "primary"
                }
              ]
            },
            "qualification" : {
              "coding" : [
                {
                  "system" : "https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty",
                  "code" : "persphysician"
                }
              ]
            }
          }
        ],
        "supportingInfo" : [
          {
            "sequence" : 1,
            "category" : //  treatmentCauses for attest
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
                  "code" : "info"
                }
              ]
            },
            "code" : {
              "coding" : [
                {
                  "system" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-treatment-reason",
                  "code" : "0070"
                }
              ]
            }
          },
          {
            "sequence" : 2,
            "category" : //  standard (claim norm) for item 
            {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/claiminformationcategory",
                  "code" : "info"
                }
              ]
            },
            "code" : {
              "coding" : [
                {
                  "system" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-claim-norm-code",
                  "code" : "0"
                }
              ]
            }
          }
        ],
        "insurance" : [
          {
            "sequence" : 1,
            "focal" : true,
            "coverage" : {
              "display" : "use of mandatory insurance coverage, no further details provided here."
            }
          }
        ],
        "item" : [
          {
            "extension" : [
              {
                "url" : "https://www.ehealth.fgov.be/standards/fhir/eattestation/StructureDefinition/be-ext-eattestation-item-supplement",
                "valueMoney" : //  supplement for item 
                {
                  "value" : 2.00,
                  "currency" : "EUR"
                }
              },
              {
                "url" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/StructureDefinition/be-ext-patientidentitydocument",
                "extension" : [
                  //  patientIdentityDocument for item 
                  {
                    "url" : "readingDate",
                    "valueDate" : "2017-01-27"
                  },
                  {
                    "url" : "readingTime",
                    "valueTime" : "11:20:00"
                  },
                  {
                    "url" : "entryType",
                    "valueCodeableConcept" : {
                      "coding" : [
                        {
                          "system" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-id-doc-input-type",
                          "code" : "4"
                        }
                      ]
                    }
                  },
                  {
                    "url" : "reasonManual",
                    "valueCodeableConcept" : {
                      "coding" : [
                        {
                          "system" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-id-doc-manual-input-justification",
                          "code" : "2"
                        }
                      ]
                    }
                  },
                  {
                    "url" : "medium",
                    "valueCodeableConcept" : {
                      "coding" : [
                        {
                          "system" : "https://www.ehealth.fgov.be/standards/fhir/nihdi-terminology/CodeSystem/be-cs-id-doc-media-type",
                          "code" : "1"
                        }
                      ]
                    }
                  },
                  {
                    "url" : "serialNumber",
                    "valueString" : "actual cardnumber as string"
                  }
                ]
              }
            ],
            "sequence" : 1,
            "careTeamSequence" : [
              1
            ],
            "informationSequence" : [
              2
            ],
            "productOrService" : {
              "coding" : [
                //  identifier for item 
                {
                  "system" : "https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature",
                  "code" : "102034"
                }
              ]
            },
            "servicedDate" : "2017-01-27",
            "quantity" : //  date for item 
            //  count for item 
            {
              "value" : 1
            },
            "unitPrice" : {
              "value" : 38.86,
              "currency" : "EUR"
            },
            "net" : {
              "value" : 38.86,
              "currency" : "EUR"
            }
          }
        ],
        "total" : //  fee for item 
        {
          "value" : 38.86,
          "currency" : "EUR"
        }
      }
    }
  ]
}