DHIN 2025Connectathon FHIR IG
            
            0.1.0 - draft
            
          
DHIN 2025Connectathon FHIR IG, published by DHIN. This guide is not an authorized publication; it is the continuous build for version 0.1.0 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
{
  "resourceType" : "ExplanationOfBenefit",
  "id" : "NgExplanationOfBenefit-002",
  "meta" : {
    "profile" : [
      🔗 "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-explanationofbenefit"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ExplanationOfBenefit NgExplanationOfBenefit-002</b></p><a name=\"NgExplanationOfBenefit-002\"> </a><a name=\"hcNgExplanationOfBenefit-002\"> </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-explanationofbenefit.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 pharmacy}\">Pharmacy</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: <a href=\"Patient-NgPatient-002.html\">Musa Abdullahi  Male, DoB: 1987-07-06 ( nin)</a></p><p><b>created</b>: 2025-11-04 12:51:00+0000</p><p><b>insurer</b>: <a href=\"Organization-NgOrganization-001.html\">Organization Asokoro District Hospital</a></p><p><b>provider</b>: <a href=\"Organization-NgOrganization-001.html\">Organization Asokoro District Hospital</a></p><p><b>claim</b>: <a href=\"Claim-NgClaim-001.html\">Claim: identifier = https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry#CLM-2025-0001; status = active; type = Pharmacy; use = claim; created = 2025-11-04 12:30:00+0000; priority = Normal</a></p><p><b>claimResponse</b>: <a href=\"ClaimResponse-NgClaimResponse-002.html\">ClaimResponse: status = active; type = Pharmacy; use = claim; created = 2025-11-04 12:50:00+0000; outcome = partial; disposition = Partially approved; copay applied.</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=\"Coverage-NgCoverage-001.html\">Coverage: status = active; type = Emergency; period = 2025-01-01 --> 2025-12-31</a></td></tr></table><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>12000</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>3000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>payment</b></p><p><b>date</b>: 2025-11-05</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>12000</td><td>Nigerian naira</td></tr></table></blockquote><p><b>benefitPeriod</b>: 2025-01-01 --> 2025-12-31</p></div>"
  },
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
        "code" : "pharmacy"
      }
    ]
  },
  "use" : "claim",
  "patient" : {
    🔗 "reference" : "Patient/NgPatient-002"
  },
  "created" : "2025-11-04T12:51:00Z",
  "insurer" : {
    🔗 "reference" : "Organization/NgOrganization-001"
  },
  "provider" : {
    🔗 "reference" : "Organization/NgOrganization-001"
  },
  "claim" : {
    🔗 "reference" : "Claim/NgClaim-001"
  },
  "claimResponse" : {
    🔗 "reference" : "ClaimResponse/NgClaimResponse-002"
  },
  "outcome" : "partial",
  "insurance" : [
    {
      "focal" : true,
      "coverage" : {
        🔗 "reference" : "Coverage/NgCoverage-001"
      }
    }
  ],
  "total" : [
    {
      "category" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
            "code" : "benefit",
            "display" : "Benefit Amount"
          }
        ]
      },
      "amount" : {
        "value" : 12000,
        "currency" : "NGN"
      }
    },
    {
      "category" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
            "code" : "copay",
            "display" : "Copay"
          }
        ]
      },
      "amount" : {
        "value" : 3000,
        "currency" : "NGN"
      }
    }
  ],
  "payment" : {
    "date" : "2025-11-05",
    "amount" : {
      "value" : 12000,
      "currency" : "NGN"
    }
  },
  "benefitPeriod" : {
    "start" : "2025-01-01",
    "end" : "2025-12-31"
  }
}