DHIN 2025Connectathon FHIR IG
0.2.0 - ci-build
DHIN 2025Connectathon FHIR IG
0.2.0 - ci-build
DHIN 2025Connectathon FHIR IG, published by DHIN. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Nigeria-FHIR-Community/2025Connectathon/ and changes regularly. See the Directory of published versions
@prefix fhir: <http://hl7.org/fhir/> . @prefix owl: <http://www.w3.org/2002/07/owl#> . @prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- a fhir:Bundle ; fhir:nodeRole fhir:treeRoot ; fhir:id [ fhir:v "ClaimSubmission-Response"] ; # fhir:meta [ ( fhir:profile [ fhir:v "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-claim-submission-bundle"^^xsd:anyURI ; fhir:l <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-claim-submission-bundle> ] ) ] ; # fhir:type [ fhir:v "transaction"] ; # fhir:entry ( [ fhir:fullUrl [ fhir:v "urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef"^^xsd:anyURI ; fhir:l <urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef> ] ; ( fhir:resource <urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef> ) ; fhir:request [ fhir:method [ fhir:v "POST" ] ; fhir:url [ fhir:v "Patient"^^xsd:anyURI ; fhir:l fhir:Patient ] ] ] [ fhir:fullUrl [ fhir:v "urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef"^^xsd:anyURI ; fhir:l <urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef> ] ; ( fhir:resource <urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef> ) ; fhir:request [ fhir:method [ fhir:v "POST" ] ; fhir:url [ fhir:v "Organization"^^xsd:anyURI ; fhir:l fhir:Organization ] ] ] [ fhir:fullUrl [ fhir:v "urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef"^^xsd:anyURI ; fhir:l <urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef> ] ; ( fhir:resource <urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef> ) ; fhir:request [ fhir:method [ fhir:v "POST" ] ; fhir:url [ fhir:v "Organization"^^xsd:anyURI ; fhir:l fhir:Organization ] ] ] [ fhir:fullUrl [ fhir:v "urn:uuid:eee55566-e5f6-4789-a123-456789abcdef"^^xsd:anyURI ; fhir:l <urn:uuid:eee55566-e5f6-4789-a123-456789abcdef> ] ; ( fhir:resource <urn:uuid:eee55566-e5f6-4789-a123-456789abcdef> ) ; fhir:request [ fhir:method [ fhir:v "POST" ] ; fhir:url [ fhir:v "Coverage"^^xsd:anyURI ; fhir:l fhir:Coverage ] ] ] [ fhir:fullUrl [ fhir:v "urn:uuid:aaa77788-e5f6-4789-a123-456789abcdef"^^xsd:anyURI ; fhir:l <urn:uuid:aaa77788-e5f6-4789-a123-456789abcdef> ] ; ( fhir:resource <urn:uuid:aaa77788-e5f6-4789-a123-456789abcdef> ) ; fhir:request [ fhir:method [ fhir:v "POST" ] ; fhir:url [ fhir:v "ClaimResponse"^^xsd:anyURI ; fhir:l fhir:ClaimResponse ] ] ] [ fhir:fullUrl [ fhir:v "urn:uuid:bbb88899-e5f6-4789-a123-456789abcdef"^^xsd:anyURI ; fhir:l <urn:uuid:bbb88899-e5f6-4789-a123-456789abcdef> ] ; ( fhir:resource <urn:uuid:bbb88899-e5f6-4789-a123-456789abcdef> ) ; fhir:request [ fhir:method [ fhir:v "POST" ] ; fhir:url [ fhir:v "ExplanationOfBenefit"^^xsd:anyURI ; fhir:l fhir:ExplanationOfBenefit ] ] ] ) . # <urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef> a fhir:Patient ; fhir:id [ fhir:v "NgPatient-Claim-001"] ; # fhir:meta [ fhir:lastUpdated [ fhir:v "2025-10-25T14:30:00+01:00"^^xsd:dateTime ] ; ( fhir:profile [ fhir:v "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-patient"^^xsd:anyURI ; fhir:l <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-patient> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_NgPatient-Claim-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient NgPatient-Claim-001</b></p><a name=\"NgPatient-Claim-001\"> </a><a name=\"hcNgPatient-Claim-001\"> </a><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\">Last updated: 2025-10-25 14:30:00+0100</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ng-patient.html\">NG Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Amaka Nwosu Female, DoB: 1992-07-15 ( mobile: 08045678901)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td colspan=\"3\">true</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\">22 River Road Port Harcourt RI </td></tr></table></div>"^^rdf:XMLLiteral ] ] ; # fhir:identifier ( [ fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "https://sandbox.dhin-hie.org/ig/CodeSystem/patient-identifier-cs"^^xsd:anyURI ; fhir:l <https://sandbox.dhin-hie.org/ig/CodeSystem/patient-identifier-cs> ] ; fhir:code [ fhir:v "MOBILE" ] ; fhir:display [ fhir:v "mobile" ] ] ) ] ; fhir:system [ fhir:v "https://sandbox.dhin-hie.org/ig/CodeSystem/patient-identifier-cs"^^xsd:anyURI ; fhir:l <https://sandbox.dhin-hie.org/ig/CodeSystem/patient-identifier-cs> ] ; fhir:value [ fhir:v "08045678901" ] ] ) ; # fhir:active [ fhir:v true] ; # fhir:name ( [ fhir:family [ fhir:v "Nwosu" ] ; ( fhir:given [ fhir:v "Amaka" ] ) ] ) ; # fhir:gender [ fhir:v "female"] ; # fhir:birthDate [ fhir:v "1992-07-15"^^xsd:date] ; # fhir:address ( [ ( fhir:line [ fhir:v "22 River Road" ] ) ; fhir:city [ fhir:v "Port Harcourt" ] ; fhir:district [ fhir:v "ri-oyigbo" ] ; fhir:state [ fhir:v "RI" ] ] ) . # <urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef> a fhir:Organization ; fhir:id [ fhir:v "NgOrganization-Provider-Claim-001"] ; # fhir:meta [ ( fhir:profile [ fhir:v "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-provider-organization"^^xsd:anyURI ; fhir:l <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-provider-organization> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "extensions" ] ; fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_NgOrganization-Provider-Claim-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization NgOrganization-Provider-Claim-001</b></p><a name=\"NgOrganization-Provider-Claim-001\"> </a><a name=\"hcNgOrganization-Provider-Claim-001\"> </a><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\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ng-provider-organization.html\">NG Provider Organization</a></p></div><p><b>NG Owner of Facility</b>: <span title=\"Codes:{https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-location-owner-cs public}\">Public Health Institution Location</span></p><p><b>identifier</b>: <code>https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry</code>/HCF-RS-5678</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: Rivers State Teaching Hospital</p><p><b>telecom</b>: ph: 084-234-5678</p><p><b>address</b>: 100 Hospital Boulevard Port Harcourt RI </p></div>"^^rdf:XMLLiteral ] ] ; # fhir:extension ( [ fhir:url [ fhir:v "https://sandbox.dhin-hie.org/ig/StructureDefinition/organization-owner"^^xsd:anyURI ; fhir:l <https://sandbox.dhin-hie.org/ig/StructureDefinition/organization-owner> ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-location-owner-cs"^^xsd:anyURI ; fhir:l <https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-location-owner-cs> ] ; fhir:code [ fhir:v "public" ] ] ) ] ] ) ; # fhir:identifier ( [ fhir:system [ fhir:v "https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry"^^xsd:anyURI ; fhir:l <https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry> ] ; fhir:value [ fhir:v "HCF-RS-5678" ] ] ) ; # fhir:active [ fhir:v true] ; # fhir:type ( [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/organization-type"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/organization-type> ] ; fhir:code [ fhir:v "prov" ] ; fhir:display [ fhir:v "Healthcare Provider" ] ] ) ] ) ; # fhir:name [ fhir:v "Rivers State Teaching Hospital"] ; # fhir:telecom ( [ fhir:system [ fhir:v "phone" ] ; fhir:value [ fhir:v "084-234-5678" ] ] ) ; # fhir:address ( [ ( fhir:line [ fhir:v "100 Hospital Boulevard" ] ) ; fhir:city [ fhir:v "Port Harcourt" ] ; fhir:district [ fhir:v "ri-oyigbo" ] ; fhir:state [ fhir:v "RI" ] ] ) . # <urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef> a fhir:Organization ; fhir:id [ fhir:v "NgOrganization-Insurer-Claim-001"] ; # fhir:meta [ ( fhir:profile [ fhir:v "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-insurer-organization"^^xsd:anyURI ; fhir:l <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-insurer-organization> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_NgOrganization-Insurer-Claim-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization NgOrganization-Insurer-Claim-001</b></p><a name=\"NgOrganization-Insurer-Claim-001\"> </a><a name=\"hcNgOrganization-Insurer-Claim-001\"> </a><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\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ng-insurer-organization.html\">NG Insurer Organization</a></p></div><p><b>identifier</b>: <code>https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry</code>/HMO-MC-9988</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type ins}\">Insurance Company</span></p><p><b>name</b>: MediCare Plus HMO</p><p><b>telecom</b>: ph: 0700-MEDICARE</p><p><b>address</b>: 15 Insurance Plaza Port Harcourt RI </p></div>"^^rdf:XMLLiteral ] ] ; # fhir:identifier ( [ fhir:system [ fhir:v "https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry"^^xsd:anyURI ; fhir:l <https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry> ] ; fhir:value [ fhir:v "HMO-MC-9988" ] ] ) ; # fhir:active [ fhir:v true] ; # fhir:type ( [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/organization-type"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/organization-type> ] ; fhir:code [ fhir:v "ins" ] ; fhir:display [ fhir:v "Insurance Company" ] ] ) ] ) ; # fhir:name [ fhir:v "MediCare Plus HMO"] ; # fhir:telecom ( [ fhir:system [ fhir:v "phone" ] ; fhir:value [ fhir:v "0700-MEDICARE" ] ] ) ; # fhir:address ( [ ( fhir:line [ fhir:v "15 Insurance Plaza" ] ) ; fhir:city [ fhir:v "Port Harcourt" ] ; fhir:district [ fhir:v "ri-oyigbo" ] ; fhir:state [ fhir:v "RI" ] ] ) . # <urn:uuid:eee55566-e5f6-4789-a123-456789abcdef> a fhir:Coverage ; fhir:id [ fhir:v "NgCoverage-Claim-001"] ; # fhir:meta [ ( fhir:profile [ fhir:v "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-coverage"^^xsd:anyURI ; fhir:l <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-coverage> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_NgCoverage-Claim-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage NgCoverage-Claim-001</b></p><a name=\"NgCoverage-Claim-001\"> </a><a name=\"hcNgCoverage-Claim-001\"> </a><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\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ng-coverage.html\">NG Claim Coverage</a></p></div><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode EHCPOL}\">extended healthcare</span></p><p><b>beneficiary</b>: <a href=\"Bundle-ClaimSubmission-Request.html#urn-uuid-aaabbbc2-e5f6-4789-a123-456789abcdef\">Amaka Nwosu Female, DoB: 1992-07-15 ( mobile: 08045678901)</a></p><p><b>period</b>: 2025-01-01 --> 2025-12-31</p><p><b>payor</b>: <a href=\"Bundle-ClaimSubmission-Request.html#urn-uuid-ddd44455-e5f6-4789-a123-456789abcdef\">Organization MediCare Plus HMO</a></p></div>"^^rdf:XMLLiteral ] ] ; # fhir:status [ fhir:v "active"] ; # fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActCode> ] ; fhir:code [ fhir:v "EHCPOL" ] ; fhir:display [ fhir:v "extended healthcare" ] ] ) ] ; # fhir:beneficiary [ fhir:l <urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef> ; fhir:reference [ fhir:v "urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef" ] ] ; # fhir:period [ fhir:start [ fhir:v "2025-01-01"^^xsd:date ] ; fhir:end [ fhir:v "2025-12-31"^^xsd:date ] ] ; # fhir:payor ( [ fhir:l <urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef> ; fhir:reference [ fhir:v "urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef" ] ] ) . # <urn:uuid:aaa77788-e5f6-4789-a123-456789abcdef> a fhir:ClaimResponse ; fhir:id [ fhir:v "NgClaimResponse-Claim-001"] ; # fhir:meta [ ( fhir:profile [ fhir:v "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-claim-response"^^xsd:anyURI ; fhir:l <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-claim-response> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClaimResponse_NgClaimResponse-Claim-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse NgClaimResponse-Claim-001</b></p><a name=\"NgClaimResponse-Claim-001\"> </a><a name=\"hcNgClaimResponse-Claim-001\"> </a><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\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ng-claim-response.html\">NG ClaimResponse</a></p></div><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>use</b>: Claim</p><p><b>patient</b>: <a href=\"Bundle-ClaimSubmission-Request.html#urn-uuid-aaabbbc2-e5f6-4789-a123-456789abcdef\">Amaka Nwosu Female, DoB: 1992-07-15 ( mobile: 08045678901)</a></p><p><b>created</b>: 2025-10-26 09:15:00+0100</p><p><b>insurer</b>: <a href=\"Bundle-ClaimSubmission-Request.html#urn-uuid-ddd44455-e5f6-4789-a123-456789abcdef\">Organization MediCare Plus HMO</a></p><p><b>outcome</b>: Partial Processing</p><p><b>disposition</b>: Claim partially approved. Patient responsible for co-pay and non-covered items.</p><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 1</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligible}\">Eligible Amount</span></p><h3>Amounts</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>5000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}\">Benefit Amount</span></p><h3>Amounts</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>4500</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication copay}\">CoPay</span></p><h3>Amounts</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>500</td><td>Nigerian naira</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 2</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligible}\">Eligible Amount</span></p><h3>Amounts</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>3000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}\">Benefit Amount</span></p><h3>Amounts</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>3000</td><td>Nigerian naira</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 3</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligible}\">Eligible Amount</span></p><h3>Amounts</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>15000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}\">Benefit Amount</span></p><h3>Amounts</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>1500</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication copay}\">CoPay</span></p><h3>Amounts</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>0</td><td>Nigerian naira</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 4</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligible}\">Eligible Amount</span></p><h3>Amounts</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>2000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}\">Benefit Amount</span></p><h3>Amounts</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>2000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication copay}\">CoPay</span></p><h3>Amounts</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>0</td><td>Nigerian naira</td></tr></table></blockquote></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted Amount</span></p><h3>Amounts</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>25000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}\">Benefit Amount</span></p><h3>Amounts</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>23000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication copay}\">CoPay</span></p><h3>Amounts</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>2000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>payment</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-paymenttype complete}\">Complete</span></p><p><b>date</b>: 2025-10-30</p><h3>Amounts</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>25000</td><td>Nigerian naira</td></tr></table></blockquote></div>"^^rdf:XMLLiteral ] ] ; # fhir:status [ fhir:v "active"] ; # fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/claim-type> ] ; fhir:code [ fhir:v "institutional" ] ; fhir:display [ fhir:v "Institutional" ] ] ) ] ; # fhir:use [ fhir:v "claim"] ; # fhir:patient [ fhir:l <urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef> ; fhir:reference [ fhir:v "urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef" ] ] ; # fhir:created [ fhir:v "2025-10-26T09:15:00+01:00"^^xsd:dateTime] ; # fhir:insurer [ fhir:l <urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef> ; fhir:reference [ fhir:v "urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef" ] ] ; # fhir:outcome [ fhir:v "partial"] ; # fhir:disposition [ fhir:v "Claim partially approved. Patient responsible for co-pay and non-covered items."] ; # fhir:item ( [ fhir:itemSequence [ fhir:v "1"^^xsd:positiveInteger ] ; ( fhir:adjudication [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "eligible" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "5000"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "benefit" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "4500"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "copay" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "500"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] ) ] [ fhir:itemSequence [ fhir:v "2"^^xsd:positiveInteger ] ; ( fhir:adjudication [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "eligible" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "3000"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "benefit" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "3000"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] ) ] [ fhir:itemSequence [ fhir:v "3"^^xsd:positiveInteger ] ; ( fhir:adjudication [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "eligible" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "15000"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "benefit" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "1500"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "copay" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "0"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] ) ] [ fhir:itemSequence [ fhir:v "4"^^xsd:positiveInteger ] ; ( fhir:adjudication [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "eligible" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "2000"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "benefit" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "2000"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "copay" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "0"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] ) ] ) ; # fhir:total ( [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "submitted" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "25000"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "benefit" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "23000"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "copay" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "2000"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] ) ; # fhir:payment [ fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-paymenttype"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/ex-paymenttype> ] ; fhir:code [ fhir:v "complete" ] ] ) ] ; fhir:date [ fhir:v "2025-10-30"^^xsd:date ] ; fhir:amount [ fhir:value [ fhir:v "25000"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] . # <urn:uuid:bbb88899-e5f6-4789-a123-456789abcdef> a fhir:ExplanationOfBenefit ; fhir:id [ fhir:v "NgEOB-Claim-001"] ; # fhir:meta [ ( fhir:profile [ fhir:v "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-explanation-of-benefit"^^xsd:anyURI ; fhir:l <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-explanation-of-benefit> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ExplanationOfBenefit_NgEOB-Claim-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ExplanationOfBenefit NgEOB-Claim-001</b></p><a name=\"NgEOB-Claim-001\"> </a><a name=\"hcNgEOB-Claim-001\"> </a><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\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ng-explanation-of-benefit.html\">NG ExplanationOfBenefit</a></p></div><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>use</b>: Claim</p><p><b>patient</b>: <a href=\"Bundle-ClaimSubmission-Request.html#urn-uuid-aaabbbc2-e5f6-4789-a123-456789abcdef\">Amaka Nwosu Female, DoB: 1992-07-15 ( mobile: 08045678901)</a></p><p><b>created</b>: 2025-10-26 09:15:00+0100</p><p><b>insurer</b>: <a href=\"Bundle-ClaimSubmission-Request.html#urn-uuid-ddd44455-e5f6-4789-a123-456789abcdef\">Organization MediCare Plus HMO</a></p><p><b>provider</b>: <a href=\"Bundle-ClaimSubmission-Request.html#urn-uuid-ccc33344-e5f6-4789-a123-456789abcdef\">Organization Rivers State Teaching Hospital</a></p><p><b>outcome</b>: Partial Processing</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><a href=\"Bundle-ClaimSubmission-Request.html#urn-uuid-eee55566-e5f6-4789-a123-456789abcdef\">Coverage: status = active; type = extended healthcare; period = 2025-01-01 --> 2025-12-31</a></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-USCLS 1205}\">Exam, emergency</span></p><p><b>serviced</b>: 2025-10-22</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligible}\">Eligible Amount</span></p><h3>Amounts</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>15000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}\">Benefit Amount</span></p><h3>Amounts</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>13000</td><td>Nigerian naira</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>productOrService</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-USCLS 1201}\">Exam, recall</span></p><p><b>serviced</b>: 2025-10-22 --> 2025-10-25</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}\">Benefit Amount</span></p><h3>Amounts</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>6000</td><td>Nigerian naira</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 3</p><p><b>productOrService</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-USCLS 1101}\">Exam, comp, primary</span></p><p><b>serviced</b>: 2025-10-22</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}\">Benefit Amount</span></p><h3>Amounts</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>1500</td><td>Nigerian naira</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 4</p><p><b>productOrService</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-USCLS 1102}\">Exam, comp, mixed</span></p><p><b>serviced</b>: 2025-10-22</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}\">Benefit Amount</span></p><h3>Amounts</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>1500</td><td>Nigerian naira</td></tr></table></blockquote></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted Amount</span></p><h3>Amounts</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>2500</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}\">Benefit Amount</span></p><h3>Amounts</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>22000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>payment</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-paymenttype complete}\">Complete</span></p><p><b>date</b>: 2025-10-30</p><h3>Amounts</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>2200</td><td>Nigerian naira</td></tr></table></blockquote></div>"^^rdf:XMLLiteral ] ] ; # fhir:status [ fhir:v "active"] ; # fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/claim-type> ] ; fhir:code [ fhir:v "institutional" ] ] ) ] ; # fhir:use [ fhir:v "claim"] ; # fhir:patient [ fhir:l <urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef> ; fhir:reference [ fhir:v "urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef" ] ] ; # fhir:created [ fhir:v "2025-10-26T09:15:00+01:00"^^xsd:dateTime] ; # fhir:insurer [ fhir:l <urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef> ; fhir:reference [ fhir:v "urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef" ] ] ; # fhir:provider [ fhir:l <urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef> ; fhir:reference [ fhir:v "urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef" ] ] ; # fhir:outcome [ fhir:v "partial"] ; # fhir:insurance ( [ fhir:focal [ fhir:v true ] ; fhir:coverage [ fhir:l <urn:uuid:eee55566-e5f6-4789-a123-456789abcdef> ; fhir:reference [ fhir:v "urn:uuid:eee55566-e5f6-4789-a123-456789abcdef" ] ] ] ) ; # fhir:item ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:productOrService [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-USCLS"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/ex-USCLS> ] ; fhir:code [ fhir:v "1205" ] ] ) ] ; fhir:serviced [ a fhir:Date ; fhir:v "2025-10-22"^^xsd:date ] ; ( fhir:adjudication [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "eligible" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "15000"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "benefit" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "13000"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] ) ] [ fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ; fhir:productOrService [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-USCLS"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/ex-USCLS> ] ; fhir:code [ fhir:v "1201" ] ] ) ] ; fhir:serviced [ a fhir:Period ; fhir:start [ fhir:v "2025-10-22"^^xsd:date ] ; fhir:end [ fhir:v "2025-10-25"^^xsd:date ] ] ; ( fhir:adjudication [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "benefit" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "6000"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] ) ] [ fhir:sequence [ fhir:v "3"^^xsd:positiveInteger ] ; fhir:productOrService [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-USCLS"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/ex-USCLS> ] ; fhir:code [ fhir:v "1101" ] ] ) ] ; fhir:serviced [ a fhir:Date ; fhir:v "2025-10-22"^^xsd:date ] ; ( fhir:adjudication [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "benefit" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "1500"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] ) ] [ fhir:sequence [ fhir:v "4"^^xsd:positiveInteger ] ; fhir:productOrService [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-USCLS"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/ex-USCLS> ] ; fhir:code [ fhir:v "1102" ] ] ) ] ; fhir:serviced [ a fhir:Date ; fhir:v "2025-10-22"^^xsd:date ] ; ( fhir:adjudication [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "benefit" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "1500"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] ) ] ) ; # fhir:total ( [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "submitted" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "2500"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/adjudication> ] ; fhir:code [ fhir:v "benefit" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "22000"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] ) ; # fhir:payment [ fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-paymenttype"^^xsd:anyURI ; fhir:l <http://terminology.hl7.org/CodeSystem/ex-paymenttype> ] ; fhir:code [ fhir:v "complete" ] ] ) ] ; fhir:date [ fhir:v "2025-10-30"^^xsd:date ] ; fhir:amount [ fhir:value [ fhir:v "2200"^^xsd:decimal ] ; fhir:currency [ fhir:v "NGN" ] ] ] . #
IG © 2025+ DHIN. Package org.dhin-hie.sandbox#0.2.0 based on FHIR 4.0.1. Generated 2025-11-25
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