Australian Digital Health Agency FHIR Implementation Guide, published by Australian Digital Health Agency. This guide is not an authorized publication; it is the continuous build for version 1.2.0-ci-build built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/AuDigitalHealth/ci-fhir-r4/ and changes regularly. See the Directory of published versions

: Record of Claim against MBS for 15275 radiation oncology treatment for Mr. Zhang Wei - XML Representation

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<ExplanationOfBenefit xmlns="http://hl7.org/fhir">
  <id value="mbs-01"/>
  <meta>
    <profile
             value="http://ns.electronichealth.net.au/fhir/StructureDefinition/dh-explanationofbenefit-medicare-mbs-1"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ExplanationOfBenefit mbs-01</b></p><a name="mbs-01"> </a><a name="hcmbs-01"> </a><a name="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 

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: 

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.

This 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>: <a href="Patient-mhr-zhang-wei.html">Wei Zhang  Male, DoB: 1972-05-03 ( IHI: AustalianIHI#8003608000228437)</a></p><p><b>created</b>: 2019-02-07</p><p><b>insurer</b>: <a href="Organization-healthau.html">Organization 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>
  </text>
  <!-- identifier from Bundle uploaded from MBS Medicare repository if in Bundle | If single post is 'document identifier' stored in ExplanationOfBenefit.identifier -->
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:uuid:a7b64195-3553-4708-957e-04d571c7db92"/>
  </identifier>
  <status value="active"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
      <code value="institutional"/>
    </coding>
  </type>
  <subType>
    <coding>
      <system
              value="https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1"/>
      <code value="mbs"/>
    </coding>
  </subType>
  <use value="claim"/>
  <patient>🔗 
    <reference value="Patient/mhr-zhang-wei"/>
    <identifier>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <code value="NI"/>
        </coding>
        <text value="IHI"/>
      </type>
      <system value="http://ns.electronichealth.net.au/id/hi/ihi/1.0"/>
      <value value="8003608000228437"/>
    </identifier>
  </patient>
  <created value="2019-02-07"/>
  <insurer>🔗 
    <reference value="Organization/healthau"/>
    <identifier>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <code value="XX"/>
        </coding>
        <text value="ABN"/>
      </type>
      <system value="http://hl7.org.au/id/abn"/>
      <value value="83605426759"/>
    </identifier>
  </insurer>
  <provider>
    <identifier>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
          <code value="NPI"/>
          <display value="National provider identifier"/>
        </coding>
        <text value="HPI-I"/>
      </type>
      <system value="http://ns.electronichealth.net.au/id/hi/hpii/1.0"/>
      <value value="8003614900041243"/>
    </identifier>
  </provider>
  <outcome value="complete"/>
  <insurance>
    <focal value="true"/>
    <coverage>
      <identifier>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
            <code value="MC"/>
          </coding>
          <text value="Medicare Number"/>
        </type>
        <system value="http://ns.electronichealth.net.au/id/medicare-number"/>
        <value value="29533070311"/>
      </identifier>
    </coverage>
  </insurance>
  <item>
    <sequence value="1"/>
    <category>
      <coding>
        <system
                value="https://healthterminologies.gov.au/fhir/CodeSystem/australian-benefit-payment-category-1"/>
        <code value="mbs"/>
        <display value="MBS"/>
      </coding>
      <text value="Medicare Benefits Schedule"/>
    </category>
    <productOrService>
      <coding>
        <system value="urn:oid:1.2.36.1.2001.1005.21"/>
        <code value="15275"/>
        <display value="Radiation oncology treatment"/>
      </coding>
    </productOrService>
    <servicedDate value="2019-02-07"/>
    <locationCodeableConcept>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
        <code value="HOSP"/>
        <display value="Hospital"/>
      </coding>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="22232009"/>
        <display value="Hospital"/>
      </coding>
    </locationCodeableConcept>
  </item>
</ExplanationOfBenefit>