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 rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- <http://hl7.org/fhir/Bundle/ClaimSubmission-Response> a fhir:Bundle ; fhir:nodeRole fhir:treeRoot ; fhir:Resource.id [ fhir:value "ClaimSubmission-Response"] ; fhir:Resource.meta [ fhir:Meta.profile [ fhir:value "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-claim-submission-bundle" ; fhir:index 0 ; fhir:link <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-claim-submission-bundle> ] ] ; fhir:Bundle.type [ fhir:value "transaction"] ; fhir:Bundle.entry [ fhir:index 0 ; fhir:Bundle.entry.fullUrl [ fhir:value "urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef" ] ; fhir:Bundle.entry.resource <urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef> ; fhir:Bundle.entry.request [ fhir:Bundle.entry.request.method [ fhir:value "POST" ] ; fhir:Bundle.entry.request.url [ fhir:value "Patient" ] ] ], [ fhir:index 1 ; fhir:Bundle.entry.fullUrl [ fhir:value "urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef" ] ; fhir:Bundle.entry.resource <urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef> ; fhir:Bundle.entry.request [ fhir:Bundle.entry.request.method [ fhir:value "POST" ] ; fhir:Bundle.entry.request.url [ fhir:value "Organization" ] ] ], [ fhir:index 2 ; fhir:Bundle.entry.fullUrl [ fhir:value "urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef" ] ; fhir:Bundle.entry.resource <urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef> ; fhir:Bundle.entry.request [ fhir:Bundle.entry.request.method [ fhir:value "POST" ] ; fhir:Bundle.entry.request.url [ fhir:value "Organization" ] ] ], [ fhir:index 3 ; fhir:Bundle.entry.fullUrl [ fhir:value "urn:uuid:eee55566-e5f6-4789-a123-456789abcdef" ] ; fhir:Bundle.entry.resource <urn:uuid:eee55566-e5f6-4789-a123-456789abcdef> ; fhir:Bundle.entry.request [ fhir:Bundle.entry.request.method [ fhir:value "POST" ] ; fhir:Bundle.entry.request.url [ fhir:value "Coverage" ] ] ], [ fhir:index 4 ; fhir:Bundle.entry.fullUrl [ fhir:value "urn:uuid:aaa77788-e5f6-4789-a123-456789abcdef" ] ; fhir:Bundle.entry.resource <urn:uuid:aaa77788-e5f6-4789-a123-456789abcdef> ; fhir:Bundle.entry.request [ fhir:Bundle.entry.request.method [ fhir:value "POST" ] ; fhir:Bundle.entry.request.url [ fhir:value "ClaimResponse" ] ] ], [ fhir:index 5 ; fhir:Bundle.entry.fullUrl [ fhir:value "urn:uuid:bbb88899-e5f6-4789-a123-456789abcdef" ] ; fhir:Bundle.entry.resource <urn:uuid:bbb88899-e5f6-4789-a123-456789abcdef> ; fhir:Bundle.entry.request [ fhir:Bundle.entry.request.method [ fhir:value "POST" ] ; fhir:Bundle.entry.request.url [ fhir:value "ExplanationOfBenefit" ] ] ] . <urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef> a fhir:Patient ; fhir:Resource.id [ fhir:value "NgPatient-Claim-001"] ; fhir:Resource.meta [ fhir:Meta.lastUpdated [ fhir:value "2025-10-25T14:30:00+01:00"^^xsd:dateTime ] ; fhir:Meta.profile [ fhir:value "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-patient" ; fhir:index 0 ; fhir:link <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-patient> ] ] ; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "generated" ] ; fhir:Narrative.div "<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>" ] ; fhir:Patient.identifier [ fhir:index 0 ; fhir:Identifier.type [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "https://sandbox.dhin-hie.org/ig/CodeSystem/patient-identifier-cs" ] ; fhir:Coding.code [ fhir:value "MOBILE" ] ; fhir:Coding.display [ fhir:value "mobile" ] ] ] ; fhir:Identifier.system [ fhir:value "https://sandbox.dhin-hie.org/ig/CodeSystem/patient-identifier-cs" ] ; fhir:Identifier.value [ fhir:value "08045678901" ] ] ; fhir:Patient.active [ fhir:value "true"^^xsd:boolean] ; fhir:Patient.name [ fhir:index 0 ; fhir:HumanName.family [ fhir:value "Nwosu" ] ; fhir:HumanName.given [ fhir:value "Amaka" ; fhir:index 0 ] ] ; fhir:Patient.gender [ fhir:value "female"] ; fhir:Patient.birthDate [ fhir:value "1992-07-15"^^xsd:date] ; fhir:Patient.address [ fhir:index 0 ; fhir:Address.line [ fhir:value "22 River Road" ; fhir:index 0 ] ; fhir:Address.city [ fhir:value "Port Harcourt" ] ; fhir:Address.district [ fhir:value "ri-oyigbo" ] ; fhir:Address.state [ fhir:value "RI" ] ] . <urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef> a fhir:Organization ; fhir:Resource.id [ fhir:value "NgOrganization-Provider-Claim-001"] ; fhir:Resource.meta [ fhir:Meta.profile [ fhir:value "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-provider-organization" ; fhir:index 0 ; fhir:link <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-provider-organization> ] ] ; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "extensions" ] ; fhir:Narrative.div "<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>" ] ; fhir:DomainResource.extension [ fhir:index 0 ; fhir:Extension.url [ fhir:value "https://sandbox.dhin-hie.org/ig/StructureDefinition/organization-owner" ] ; fhir:Extension.valueCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-location-owner-cs" ] ; fhir:Coding.code [ fhir:value "public" ] ] ] ] ; fhir:Organization.identifier [ fhir:index 0 ; fhir:Identifier.system [ fhir:value "https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry" ] ; fhir:Identifier.value [ fhir:value "HCF-RS-5678" ] ] ; fhir:Organization.active [ fhir:value "true"^^xsd:boolean] ; fhir:Organization.type [ fhir:index 0 ; fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/organization-type" ] ; fhir:Coding.code [ fhir:value "prov" ] ; fhir:Coding.display [ fhir:value "Healthcare Provider" ] ] ] ; fhir:Organization.name [ fhir:value "Rivers State Teaching Hospital"] ; fhir:Organization.telecom [ fhir:index 0 ; fhir:ContactPoint.system [ fhir:value "phone" ] ; fhir:ContactPoint.value [ fhir:value "084-234-5678" ] ] ; fhir:Organization.address [ fhir:index 0 ; fhir:Address.line [ fhir:value "100 Hospital Boulevard" ; fhir:index 0 ] ; fhir:Address.city [ fhir:value "Port Harcourt" ] ; fhir:Address.district [ fhir:value "ri-oyigbo" ] ; fhir:Address.state [ fhir:value "RI" ] ] . <urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef> a fhir:Organization ; fhir:Resource.id [ fhir:value "NgOrganization-Insurer-Claim-001"] ; fhir:Resource.meta [ fhir:Meta.profile [ fhir:value "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-insurer-organization" ; fhir:index 0 ; fhir:link <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-insurer-organization> ] ] ; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "generated" ] ; fhir:Narrative.div "<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>" ] ; fhir:Organization.identifier [ fhir:index 0 ; fhir:Identifier.system [ fhir:value "https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry" ] ; fhir:Identifier.value [ fhir:value "HMO-MC-9988" ] ] ; fhir:Organization.active [ fhir:value "true"^^xsd:boolean] ; fhir:Organization.type [ fhir:index 0 ; fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/organization-type" ] ; fhir:Coding.code [ fhir:value "ins" ] ; fhir:Coding.display [ fhir:value "Insurance Company" ] ] ] ; fhir:Organization.name [ fhir:value "MediCare Plus HMO"] ; fhir:Organization.telecom [ fhir:index 0 ; fhir:ContactPoint.system [ fhir:value "phone" ] ; fhir:ContactPoint.value [ fhir:value "0700-MEDICARE" ] ] ; fhir:Organization.address [ fhir:index 0 ; fhir:Address.line [ fhir:value "15 Insurance Plaza" ; fhir:index 0 ] ; fhir:Address.city [ fhir:value "Port Harcourt" ] ; fhir:Address.district [ fhir:value "ri-oyigbo" ] ; fhir:Address.state [ fhir:value "RI" ] ] . <urn:uuid:eee55566-e5f6-4789-a123-456789abcdef> a fhir:Coverage ; fhir:Resource.id [ fhir:value "NgCoverage-Claim-001"] ; fhir:Resource.meta [ fhir:Meta.profile [ fhir:value "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-coverage" ; fhir:index 0 ; fhir:link <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-coverage> ] ] ; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "generated" ] ; fhir:Narrative.div "<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>" ] ; fhir:Coverage.status [ fhir:value "active"] ; fhir:Coverage.type [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-ActCode" ] ; fhir:Coding.code [ fhir:value "EHCPOL" ] ; fhir:Coding.display [ fhir:value "extended healthcare" ] ] ] ; fhir:Coverage.beneficiary [ fhir:Reference.reference [ fhir:value "urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef" ] ] ; fhir:Coverage.period [ fhir:Period.start [ fhir:value "2025-01-01"^^xsd:date ] ; fhir:Period.end [ fhir:value "2025-12-31"^^xsd:date ] ] ; fhir:Coverage.payor [ fhir:index 0 ; fhir:Reference.reference [ fhir:value "urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef" ] ] . <urn:uuid:aaa77788-e5f6-4789-a123-456789abcdef> a fhir:ClaimResponse ; fhir:Resource.id [ fhir:value "NgClaimResponse-Claim-001"] ; fhir:Resource.meta [ fhir:Meta.profile [ fhir:value "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-claim-response" ; fhir:index 0 ; fhir:link <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-claim-response> ] ] ; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "generated" ] ; fhir:Narrative.div "<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>" ] ; fhir:ClaimResponse.status [ fhir:value "active"] ; fhir:ClaimResponse.type [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ] ; fhir:Coding.code [ fhir:value "institutional" ] ; fhir:Coding.display [ fhir:value "Institutional" ] ] ] ; fhir:ClaimResponse.use [ fhir:value "claim"] ; fhir:ClaimResponse.patient [ fhir:Reference.reference [ fhir:value "urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef" ] ] ; fhir:ClaimResponse.created [ fhir:value "2025-10-26T09:15:00+01:00"^^xsd:dateTime] ; fhir:ClaimResponse.insurer [ fhir:Reference.reference [ fhir:value "urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef" ] ] ; fhir:ClaimResponse.outcome [ fhir:value "partial"] ; fhir:ClaimResponse.disposition [ fhir:value "Claim partially approved. Patient responsible for co-pay and non-covered items."] ; fhir:ClaimResponse.item [ fhir:index 0 ; fhir:ClaimResponse.item.itemSequence [ fhir:value "1"^^xsd:positiveInteger ] ; fhir:ClaimResponse.item.adjudication [ fhir:index 0 ; fhir:ClaimResponse.item.adjudication.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "eligible" ] ] ] ; fhir:ClaimResponse.item.adjudication.amount [ fhir:Money.value [ fhir:value "5000"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ], [ fhir:index 1 ; fhir:ClaimResponse.item.adjudication.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "benefit" ] ] ] ; fhir:ClaimResponse.item.adjudication.amount [ fhir:Money.value [ fhir:value "4500"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ], [ fhir:index 2 ; fhir:ClaimResponse.item.adjudication.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "copay" ] ] ] ; fhir:ClaimResponse.item.adjudication.amount [ fhir:Money.value [ fhir:value "500"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ] ], [ fhir:index 1 ; fhir:ClaimResponse.item.itemSequence [ fhir:value "2"^^xsd:positiveInteger ] ; fhir:ClaimResponse.item.adjudication [ fhir:index 0 ; fhir:ClaimResponse.item.adjudication.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "eligible" ] ] ] ; fhir:ClaimResponse.item.adjudication.amount [ fhir:Money.value [ fhir:value "3000"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ], [ fhir:index 1 ; fhir:ClaimResponse.item.adjudication.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "benefit" ] ] ] ; fhir:ClaimResponse.item.adjudication.amount [ fhir:Money.value [ fhir:value "3000"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ] ], [ fhir:index 2 ; fhir:ClaimResponse.item.itemSequence [ fhir:value "3"^^xsd:positiveInteger ] ; fhir:ClaimResponse.item.adjudication [ fhir:index 0 ; fhir:ClaimResponse.item.adjudication.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "eligible" ] ] ] ; fhir:ClaimResponse.item.adjudication.amount [ fhir:Money.value [ fhir:value "15000"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ], [ fhir:index 1 ; fhir:ClaimResponse.item.adjudication.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "benefit" ] ] ] ; fhir:ClaimResponse.item.adjudication.amount [ fhir:Money.value [ fhir:value "1500"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ], [ fhir:index 2 ; fhir:ClaimResponse.item.adjudication.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "copay" ] ] ] ; fhir:ClaimResponse.item.adjudication.amount [ fhir:Money.value [ fhir:value "0"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ] ], [ fhir:index 3 ; fhir:ClaimResponse.item.itemSequence [ fhir:value "4"^^xsd:positiveInteger ] ; fhir:ClaimResponse.item.adjudication [ fhir:index 0 ; fhir:ClaimResponse.item.adjudication.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "eligible" ] ] ] ; fhir:ClaimResponse.item.adjudication.amount [ fhir:Money.value [ fhir:value "2000"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ], [ fhir:index 1 ; fhir:ClaimResponse.item.adjudication.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "benefit" ] ] ] ; fhir:ClaimResponse.item.adjudication.amount [ fhir:Money.value [ fhir:value "2000"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ], [ fhir:index 2 ; fhir:ClaimResponse.item.adjudication.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "copay" ] ] ] ; fhir:ClaimResponse.item.adjudication.amount [ fhir:Money.value [ fhir:value "0"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ] ] ; fhir:ClaimResponse.total [ fhir:index 0 ; fhir:ClaimResponse.total.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "submitted" ] ] ] ; fhir:ClaimResponse.total.amount [ fhir:Money.value [ fhir:value "25000"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ], [ fhir:index 1 ; fhir:ClaimResponse.total.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "benefit" ] ] ] ; fhir:ClaimResponse.total.amount [ fhir:Money.value [ fhir:value "23000"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ], [ fhir:index 2 ; fhir:ClaimResponse.total.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "copay" ] ] ] ; fhir:ClaimResponse.total.amount [ fhir:Money.value [ fhir:value "2000"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ] ; fhir:ClaimResponse.payment [ fhir:ClaimResponse.payment.type [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/ex-paymenttype" ] ; fhir:Coding.code [ fhir:value "complete" ] ] ] ; fhir:ClaimResponse.payment.date [ fhir:value "2025-10-30"^^xsd:date ] ; fhir:ClaimResponse.payment.amount [ fhir:Money.value [ fhir:value "25000"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ] . <urn:uuid:bbb88899-e5f6-4789-a123-456789abcdef> a fhir:ExplanationOfBenefit ; fhir:Resource.id [ fhir:value "NgEOB-Claim-001"] ; fhir:Resource.meta [ fhir:Meta.profile [ fhir:value "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-explanation-of-benefit" ; fhir:index 0 ; fhir:link <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-explanation-of-benefit> ] ] ; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "generated" ] ; fhir:Narrative.div "<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>" ] ; fhir:ExplanationOfBenefit.status [ fhir:value "active"] ; fhir:ExplanationOfBenefit.type [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ] ; fhir:Coding.code [ fhir:value "institutional" ] ] ] ; fhir:ExplanationOfBenefit.use [ fhir:value "claim"] ; fhir:ExplanationOfBenefit.patient [ fhir:Reference.reference [ fhir:value "urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef" ] ] ; fhir:ExplanationOfBenefit.created [ fhir:value "2025-10-26T09:15:00+01:00"^^xsd:dateTime] ; fhir:ExplanationOfBenefit.insurer [ fhir:Reference.reference [ fhir:value "urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef" ] ] ; fhir:ExplanationOfBenefit.provider [ fhir:Reference.reference [ fhir:value "urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef" ] ] ; fhir:ExplanationOfBenefit.outcome [ fhir:value "partial"] ; fhir:ExplanationOfBenefit.insurance [ fhir:index 0 ; fhir:ExplanationOfBenefit.insurance.focal [ fhir:value "true"^^xsd:boolean ] ; fhir:ExplanationOfBenefit.insurance.coverage [ fhir:Reference.reference [ fhir:value "urn:uuid:eee55566-e5f6-4789-a123-456789abcdef" ] ] ] ; fhir:ExplanationOfBenefit.item [ fhir:index 0 ; fhir:ExplanationOfBenefit.item.sequence [ fhir:value "1"^^xsd:positiveInteger ] ; fhir:ExplanationOfBenefit.item.productOrService [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/ex-USCLS" ] ; fhir:Coding.code [ fhir:value "1205" ] ] ] ; fhir:ExplanationOfBenefit.item.servicedDate [ fhir:value "2025-10-22"^^xsd:date ] ; fhir:ExplanationOfBenefit.item.adjudication [ fhir:index 0 ; fhir:ExplanationOfBenefit.item.adjudication.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "eligible" ] ] ] ; fhir:ExplanationOfBenefit.item.adjudication.amount [ fhir:Money.value [ fhir:value "15000"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ], [ fhir:index 1 ; fhir:ExplanationOfBenefit.item.adjudication.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "benefit" ] ] ] ; fhir:ExplanationOfBenefit.item.adjudication.amount [ fhir:Money.value [ fhir:value "13000"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ] ], [ fhir:index 1 ; fhir:ExplanationOfBenefit.item.sequence [ fhir:value "2"^^xsd:positiveInteger ] ; fhir:ExplanationOfBenefit.item.productOrService [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/ex-USCLS" ] ; fhir:Coding.code [ fhir:value "1201" ] ] ] ; fhir:ExplanationOfBenefit.item.servicedPeriod [ fhir:Period.start [ fhir:value "2025-10-22"^^xsd:date ] ; fhir:Period.end [ fhir:value "2025-10-25"^^xsd:date ] ] ; fhir:ExplanationOfBenefit.item.adjudication [ fhir:index 0 ; fhir:ExplanationOfBenefit.item.adjudication.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "benefit" ] ] ] ; fhir:ExplanationOfBenefit.item.adjudication.amount [ fhir:Money.value [ fhir:value "6000"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ] ], [ fhir:index 2 ; fhir:ExplanationOfBenefit.item.sequence [ fhir:value "3"^^xsd:positiveInteger ] ; fhir:ExplanationOfBenefit.item.productOrService [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/ex-USCLS" ] ; fhir:Coding.code [ fhir:value "1101" ] ] ] ; fhir:ExplanationOfBenefit.item.servicedDate [ fhir:value "2025-10-22"^^xsd:date ] ; fhir:ExplanationOfBenefit.item.adjudication [ fhir:index 0 ; fhir:ExplanationOfBenefit.item.adjudication.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "benefit" ] ] ] ; fhir:ExplanationOfBenefit.item.adjudication.amount [ fhir:Money.value [ fhir:value "1500"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ] ], [ fhir:index 3 ; fhir:ExplanationOfBenefit.item.sequence [ fhir:value "4"^^xsd:positiveInteger ] ; fhir:ExplanationOfBenefit.item.productOrService [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/ex-USCLS" ] ; fhir:Coding.code [ fhir:value "1102" ] ] ] ; fhir:ExplanationOfBenefit.item.servicedDate [ fhir:value "2025-10-22"^^xsd:date ] ; fhir:ExplanationOfBenefit.item.adjudication [ fhir:index 0 ; fhir:ExplanationOfBenefit.item.adjudication.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "benefit" ] ] ] ; fhir:ExplanationOfBenefit.item.adjudication.amount [ fhir:Money.value [ fhir:value "1500"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ] ] ; fhir:ExplanationOfBenefit.total [ fhir:index 0 ; fhir:ExplanationOfBenefit.total.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "submitted" ] ] ] ; fhir:ExplanationOfBenefit.total.amount [ fhir:Money.value [ fhir:value "2500"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ], [ fhir:index 1 ; fhir:ExplanationOfBenefit.total.category [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/adjudication" ] ; fhir:Coding.code [ fhir:value "benefit" ] ] ] ; fhir:ExplanationOfBenefit.total.amount [ fhir:Money.value [ fhir:value "22000"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ] ; fhir:ExplanationOfBenefit.payment [ fhir:ExplanationOfBenefit.payment.type [ fhir:CodeableConcept.coding [ fhir:index 0 ; fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/ex-paymenttype" ] ; fhir:Coding.code [ fhir:value "complete" ] ] ] ; fhir:ExplanationOfBenefit.payment.date [ fhir:value "2025-10-30"^^xsd:date ] ; fhir:ExplanationOfBenefit.payment.amount [ fhir:Money.value [ fhir:value "2200"^^xsd:decimal ] ; fhir:Money.currency [ fhir:value "NGN" ] ] ] . # - ontology header ------------------------------------------------------------ <http://hl7.org/fhir/Bundle/ClaimSubmission-Response.ttl> a owl:Ontology ; owl:imports fhir:fhir.ttl ; owl:versionIRI <http://build.fhir.org/Bundle/ClaimSubmission-Response.ttl> .
IG © 2025+ DHIN. Package org.dhin-hie.sandbox#0.2.0 based on FHIR 4.0.1. Generated 2026-09-17
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