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

: Example Ng EOB (Partial with Copay) - XML Representation

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<ExplanationOfBenefit xmlns="http://hl7.org/fhir">
  <id value="NgExplanationOfBenefit-002"/>
  <meta>
    <profile
             value="https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-explanationofbenefit"/>
  </meta>
  <text>
    <status value="generated"/>
    <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 --&gt; 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 --&gt; 2025-12-31</p></div>
  </text>
  <status value="active"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
      <code value="pharmacy"/>
    </coding>
  </type>
  <use value="claim"/>
  <patient>🔗 
    <reference value="Patient/NgPatient-002"/>
  </patient>
  <created value="2025-11-04T12:51:00Z"/>
  <insurer>🔗 
    <reference value="Organization/NgOrganization-001"/>
  </insurer>
  <provider>🔗 
    <reference value="Organization/NgOrganization-001"/>
  </provider>
  <claim>🔗 
    <reference value="Claim/NgClaim-001"/>
  </claim>
  <claimResponse>🔗 
    <reference value="ClaimResponse/NgClaimResponse-002"/>
  </claimResponse>
  <outcome value="partial"/>
  <insurance>
    <focal value="true"/>
    <coverage>🔗 
      <reference value="Coverage/NgCoverage-001"/>
    </coverage>
  </insurance>
  <total>
    <category>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
        <code value="benefit"/>
        <display value="Benefit Amount"/>
      </coding>
    </category>
    <amount>
      <value value="12000"/>
      <currency value="NGN"/>
    </amount>
  </total>
  <total>
    <category>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/adjudication"/>
        <code value="copay"/>
        <display value="Copay"/>
      </coding>
    </category>
    <amount>
      <value value="3000"/>
      <currency value="NGN"/>
    </amount>
  </total>
  <payment>
    <date value="2025-11-05"/>
    <amount>
      <value value="12000"/>
      <currency value="NGN"/>
    </amount>
  </payment>
  <benefitPeriod>
    <start value="2025-01-01"/>
    <end value="2025-12-31"/>
  </benefitPeriod>
</ExplanationOfBenefit>