Belgian MyCareNet eTariff Profiles
1.0.0 - STU
Belgian MyCareNet eTariff Profiles
1.0.0 - STU
Belgian MyCareNet eTariff Profiles, published by eHealth Platform. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/etariff/ and changes regularly. See the Directory of published versions
<Bundle xmlns="http://hl7.org/fhir">
<id value="ex06"/>
<meta>
<profile
value="https://www.ehealth.fgov.be/standards/fhir/etariff/StructureDefinition/be-etariff-response"/>
</meta>
<type value="message"/>
<timestamp value="2015-07-14T11:15:37+02:00"/>
<entry>
<fullUrl value="urn:uuid:667b18ce-3d37-4581-9baa-6fada338038c"/>
<resource>
<MessageHeader>
<id value="667b18ce-3d37-4581-9baa-6fada338038c"/>
<meta>
<profile
value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-messageheader"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="MessageHeader_667b18ce-3d37-4581-9baa-6fada338038c"> </a><p class="res-header-id"><b>Generated Narrative: MessageHeader 667b18ce-3d37-4581-9baa-6fada338038c</b></p><a name="667b18ce-3d37-4581-9baa-6fada338038c"> </a><a name="hc667b18ce-3d37-4581-9baa-6fada338038c"> </a><a name="667b18ce-3d37-4581-9baa-6fada338038c-en-US"> </a><p><b>event</b>: <a href="https://build.fhir.org/ig/hl7-be/mycarenet/CodeSystem-message-events.html#message-events-etariffresponse-consult">CodeSystem message events</a> etariffresponse-consult: etariffresponse-consult</p><h3>Destinations</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Endpoint</b></td><td><b>Receiver</b></td></tr><tr><td style="display: none">*</td><td>urn:be:fgov:person:ssin:ehealth:1.0:doctor:nihii11:11530231003</td><td><a href="Bundle-ex02.html#urn-uuid-1dc5d974-5447-4afe-a4ab-57081ca518c3">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></td></tr></table><p><b>sender</b>: <a href="Bundle-ex02.html#urn-uuid-cfabb40d-a53f-4c56-bc19-725ea669b358">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></p><h3>Sources</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Endpoint</b></td></tr><tr><td style="display: none">*</td><td>urn:be:fgov:kbo-bce:organization:cbe-number:0411724220</td></tr></table><h3>Responses</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Identifier</b></td><td><b>Code</b></td></tr><tr><td style="display: none">*</td><td>267b18ce-3d37-4581-9baa-6fada338038b</td><td>OK</td></tr></table><p><b>focus</b>: <a href="Bundle-ex02.html#urn-uuid-0a0d60df-0340-45a6-a493-a5d67f74d693">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></p></div>
</text>
<eventCoding>
<system
value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/message-events"/>
<code value="etariffresponse-consult"/>
</eventCoding>
<destination>
<endpoint
value="urn:be:fgov:person:ssin:ehealth:1.0:doctor:nihii11:11530231003"/>
<receiver>
<reference value="urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"/>
</receiver>
</destination>
<sender>
<reference value="urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358"/>
</sender>
<source>
<endpoint
value="urn:be:fgov:kbo-bce:organization:cbe-number:0411724220"/>
</source>
<response>
<identifier value="267b18ce-3d37-4581-9baa-6fada338038b"/>
<code value="ok"/>
</response>
<focus>
<reference value="urn:uuid:0a0d60df-0340-45a6-a493-a5d67f74d693"/>
</focus>
</MessageHeader>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"/>
<resource>
<PractitionerRole>
<id value="1dc5d974-5447-4afe-a4ab-57081ca518c3"/>
<meta>
<profile
value="https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitionerrole"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="PractitionerRole_1dc5d974-5447-4afe-a4ab-57081ca518c3"> </a><p class="res-header-id"><b>Generated Narrative: PractitionerRole 1dc5d974-5447-4afe-a4ab-57081ca518c3</b></p><a name="1dc5d974-5447-4afe-a4ab-57081ca518c3"> </a><a name="hc1dc5d974-5447-4afe-a4ab-57081ca518c3"> </a><a name="1dc5d974-5447-4afe-a4ab-57081ca518c3-en-US"> </a><p><b>practitioner</b>: <a href="Bundle-ex01.html#urn-uuid-03972cc4-d781-4285-8d79-0f05810e1931">Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200</a></p><p><b>code</b>: <span title="Codes:{https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty persphysician}">physician</span></p></div>
</text>
<practitioner>
<reference value="urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931"/>
</practitioner>
<code>
<coding>
<system
value="https://www.ehealth.fgov.be/standards/fhir/core/CodeSystem/cd-hcparty"/>
<code value="persphysician"/>
</coding>
</code>
</PractitionerRole>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931"/>
<resource>
<Practitioner>
<id value="03972cc4-d781-4285-8d79-0f05810e1931"/>
<meta>
<profile
value="https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-practitioner"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Practitioner_03972cc4-d781-4285-8d79-0f05810e1931"> </a><p class="res-header-id"><b>Generated Narrative: Practitioner 03972cc4-d781-4285-8d79-0f05810e1931</b></p><a name="03972cc4-d781-4285-8d79-0f05810e1931"> </a><a name="hc03972cc4-d781-4285-8d79-0f05810e1931"> </a><a name="03972cc4-d781-4285-8d79-0f05810e1931-en-US"> </a><p><b>identifier</b>: <a href="https://build.fhir.org/ig/hl7-be/core/NamingSystem-be-nihdi.html" title="RIZIV/INAMI">BeNIHDINamingSystem</a>/11530231003</p><p><b>name</b>: Pierre Durand </p></div>
</text>
<identifier>
<system
value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi"/>
<value value="11530231003"/>
</identifier>
<name>
<family value="Durand"/>
<given value="Pierre"/>
</name>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358"/>
<resource>
<Organization>
<id value="cfabb40d-a53f-4c56-bc19-725ea669b358"/>
<meta>
<profile
value="https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-organization"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_cfabb40d-a53f-4c56-bc19-725ea669b358"> </a><p class="res-header-id"><b>Generated Narrative: Organization cfabb40d-a53f-4c56-bc19-725ea669b358</b></p><a name="cfabb40d-a53f-4c56-bc19-725ea669b358"> </a><a name="hccfabb40d-a53f-4c56-bc19-725ea669b358"> </a><a name="cfabb40d-a53f-4c56-bc19-725ea669b358-en-US"> </a><p><b>identifier</b>: <a href="https://build.fhir.org/ig/hl7-be/core/NamingSystem-be-insurancenumber.html" title="the identification number of a mutual insurance association (mutualité) as “a not-for-profit association, which, with foresight, assistance and solidarity aims to promote the physical, mental and social well-being of its members” (The Belgian law of 6 August 1990)">BeInsuranceNumberNamingSystem</a>/300</p><p><b>name</b>: Union Nationale des Mutualités Socialistes - Nationaal Verbond van de Socialistische Mutualiteiten</p></div>
</text>
<identifier>
<system
value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/insurancenumber"/>
<value value="300"/>
</identifier>
<name
value="Union Nationale des Mutualités Socialistes - Nationaal Verbond van de Socialistische Mutualiteiten"/>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686"/>
<resource>
<Patient>
<id value="a52efcb6-1f81-4333-a115-d45bd3183686"/>
<meta>
<profile
value="https://www.ehealth.fgov.be/standards/fhir/core/StructureDefinition/be-patient"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Patient_a52efcb6-1f81-4333-a115-d45bd3183686"> </a><p class="res-header-id"><b>Generated Narrative: Patient a52efcb6-1f81-4333-a115-d45bd3183686</b></p><a name="a52efcb6-1f81-4333-a115-d45bd3183686"> </a><a name="hca52efcb6-1f81-4333-a115-d45bd3183686"> </a><a name="a52efcb6-1f81-4333-a115-d45bd3183686-en-US"> </a><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Jean Dupont Male, DoB Unknown ( https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/ssin#BeSSINNamingSystem#70319666960)</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Other Id (see the one above)">Other Id:</td><td colspan="3"><a href="https://build.fhir.org/ig/hl7-be/core/NamingSystem-be-insurancymembership.html" title="Membership number of a patient with an insurance organization">BeInsurancymembershipNamingSystem</a>/1234567890123</td></tr></table></div>
</text>
<identifier>
<system
value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/ssin"/>
<value value="70319666960"/>
</identifier>
<identifier>
<system
value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/insurancymembership"/>
<value value="1234567890123"/>
<assigner>
<identifier>
<system
value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/insurancenumber"/>
<value value="301"/>
</identifier>
</assigner>
</identifier>
<name>
<family value="Dupont"/>
<given value="Jean"/>
</name>
<gender value="male"/>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:5330da7f-db68-4380-a265-d364aeed8653"/>
<resource>
<Coverage>
<id value="5330da7f-db68-4380-a265-d364aeed8653"/>
<meta>
<profile
value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-mycarenet-coverage"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Coverage_5330da7f-db68-4380-a265-d364aeed8653"> </a><p class="res-header-id"><b>Generated Narrative: Coverage 5330da7f-db68-4380-a265-d364aeed8653</b></p><a name="5330da7f-db68-4380-a265-d364aeed8653"> </a><a name="hc5330da7f-db68-4380-a265-d364aeed8653"> </a><a name="5330da7f-db68-4380-a265-d364aeed8653-en-US"> </a><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode PUBLICPOL}">public healthcare</span></p><p><b>beneficiary</b>: <a href="Bundle-ex01.html#urn-uuid-a52efcb6-1f81-4333-a115-d45bd3183686">Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200</a></p><p><b>payor</b>: <a href="Bundle-ex02.html#urn-uuid-cfabb40d-a53f-4c56-bc19-725ea669b358">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></p><blockquote><p><b>class</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/coverage-class plan}">Plan</span></p><p><b>value</b>: Mandatory Health Insurance</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/coverage-class subplan}">SubPlan</span></p><p><b>value</b>: 110</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/coverage-class subplan}">SubPlan</span></p><p><b>value</b>: 150</p></blockquote></div>
</text>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="PUBLICPOL"/>
</coding>
</type>
<beneficiary>
<reference value="urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686"/>
</beneficiary>
<payor>
<reference value="urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358"/>
</payor>
<class>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="plan"/>
</coding>
</type>
<value value="Mandatory Health Insurance"/>
</class>
<class>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="subplan"/>
</coding>
</type>
<value value="110">
<extension
url="https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system">
<valueUri
value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-1"/>
</extension>
</value>
</class>
<class>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="subplan"/>
</coding>
</type>
<value value="150">
<extension
url="https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-system">
<valueUri
value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/be-cs-holder-code-2"/>
</extension>
</value>
</class>
</Coverage>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:0a0d60df-0340-45a6-a493-a5d67f74d693"/>
<resource>
<ClaimResponse>
<id value="0a0d60df-0340-45a6-a493-a5d67f74d693"/>
<meta>
<profile
value="https://www.ehealth.fgov.be/standards/fhir/etariff/StructureDefinition/be-etariff-claimresponse"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="ClaimResponse_0a0d60df-0340-45a6-a493-a5d67f74d693"> </a><p class="res-header-id"><b>Generated Narrative: ClaimResponse 0a0d60df-0340-45a6-a493-a5d67f74d693</b></p><a name="0a0d60df-0340-45a6-a493-a5d67f74d693"> </a><a name="hc0a0d60df-0340-45a6-a493-a5d67f74d693"> </a><a name="0a0d60df-0340-45a6-a493-a5d67f74d693-en-US"> </a><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/claim-type professional}">Professional</span></p><p><b>subType</b>: <span title="Codes:{https://www.ehealth.fgov.be/standards/fhir/etariff/CodeSystem/be-cs-etariff-types generalpractice}">generalpractice</span></p><p><b>use</b>: Predetermination</p><p><b>patient</b>: <a href="Bundle-ex01.html#urn-uuid-a52efcb6-1f81-4333-a115-d45bd3183686">Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200</a></p><p><b>created</b>: 2015-07-14 11:15:30+0200</p><p><b>insurer</b>: <a href="Bundle-ex02.html#urn-uuid-cfabb40d-a53f-4c56-bc19-725ea669b358">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></p><p><b>requestor</b>: <a href="Bundle-ex02.html#urn-uuid-1dc5d974-5447-4afe-a4ab-57081ca518c3">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></p><p><b>outcome</b>: Processing Complete</p><blockquote><p><b>addItem</b></p><p><b>BeExtItemReimbursement</b>: <span title="Euro">€15.00</span> (EUR)</p><p><b>BeExtItemPatientFee</b>: <span title="Euro">€10.00</span> (EUR)</p><p><b>BeExtEtariffItemCommitment</b>: 123456789012345678901234567890120000000000002000</p><p><b>itemSequence</b>: 1</p><p><b>provider</b>: <a href="Bundle-ex02.html#urn-uuid-1dc5d974-5447-4afe-a4ab-57081ca518c3">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></p><p><b>productOrService</b>: <span title="Codes:{https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature 101010}">101010</span></p><p><b>serviced</b>: 2013-01-12</p><p><b>quantity</b>: 1</p><h3>UnitPrices</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>25</td><td>Euro</td></tr></table><h3>Nets</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>25</td><td>Euro</td></tr></table><h3>Adjudications</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Category</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/decision-values tariff}">tariff</span></td></tr></table></blockquote><blockquote><p><b>addItem</b></p><p><b>BeExtItemReimbursement</b>: <span title="Euro">€15.00</span> (EUR)</p><p><b>BeExtItemPatientFee</b>: <span title="Euro">€10.00</span> (EUR)</p><p><b>BeExtEtariffItemCommitment</b>: 123456789012345678901234567890120000000000002000</p><p><b>itemSequence</b>: 2</p><p><b>provider</b>: <a href="Bundle-ex02.html#urn-uuid-1dc5d974-5447-4afe-a4ab-57081ca518c3">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></p><p><b>productOrService</b>: <span title="Codes:{https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature 101021}">101021</span></p><p><b>serviced</b>: 2013-01-12</p><p><b>quantity</b>: 1</p><h3>UnitPrices</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>25</td><td>Euro</td></tr></table><h3>Nets</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>25</td><td>Euro</td></tr></table><h3>Adjudications</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Category</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/decision-values tariff}">tariff</span></td></tr></table></blockquote><h3>Insurances</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style="display: none">*</td><td>1</td><td>true</td><td><a href="Bundle-ex02.html#urn-uuid-5330da7f-db68-4380-a265-d364aeed8653">Bundle: type = message; timestamp = 2015-07-14 11:15:37+0200</a></td></tr></table></div>
</text>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
<code value="professional"/>
</coding>
</type>
<subType>
<!-- attestationType -->
<coding>
<system
value="https://www.ehealth.fgov.be/standards/fhir/etariff/CodeSystem/be-cs-etariff-types"/>
<code value="generalpractice"/>
</coding>
</subType>
<use value="predetermination"/>
<patient>
<reference value="urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686"/>
</patient>
<created value="2015-07-14T11:15:30+02:00"/>
<insurer>
<reference value="urn:uuid:cfabb40d-a53f-4c56-bc19-725ea669b358"/>
</insurer>
<requestor>
<reference value="urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"/>
</requestor>
<outcome value="complete"/>
<addItem>
<extension
url="https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-mycarenet-item-reimbursement">
<!-- reimbursement for item -->
<valueMoney>
<value value="15.00"/>
<currency value="EUR"/>
</valueMoney>
</extension>
<extension
url="https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-mycarenet-item-patientfee">
<!-- patientfee for item -->
<valueMoney>
<value value="10.00"/>
<currency value="EUR"/>
</valueMoney>
</extension>
<extension
url="https://www.ehealth.fgov.be/standards/fhir/etariff/StructureDefinition/be-ext-etariff-item-commitment">
<!-- commitment for item -->
<valueString
value="123456789012345678901234567890120000000000002000"/>
</extension>
<itemSequence value="1"/>
<provider>
<!-- healthcare provider -->
<reference value="urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"/>
</provider>
<productOrService>
<!-- service identifier for item -->
<coding>
<system
value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature"/>
<code value="101010"/>
</coding>
</productOrService>
<!-- date for item -->
<servicedDate value="2013-01-12"/>
<!-- count for item -->
<quantity>
<value value="1"/>
</quantity>
<unitPrice>
<value value="25"/>
<currency value="EUR"/>
</unitPrice>
<net>
<!-- fee for item -->
<value value="25"/>
<currency value="EUR"/>
</net>
<adjudication>
<category>
<coding>
<system
value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/decision-values"/>
<code value="tariff"/>
</coding>
</category>
</adjudication>
</addItem>
<addItem>
<extension
url="https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-mycarenet-item-reimbursement">
<!-- reimbursement for item -->
<valueMoney>
<value value="15.00"/>
<currency value="EUR"/>
</valueMoney>
</extension>
<extension
url="https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-ext-mycarenet-item-patientfee">
<!-- patientfee for item -->
<valueMoney>
<value value="10.00"/>
<currency value="EUR"/>
</valueMoney>
</extension>
<extension
url="https://www.ehealth.fgov.be/standards/fhir/etariff/StructureDefinition/be-ext-etariff-item-commitment">
<!-- commitment for item -->
<valueString
value="123456789012345678901234567890120000000000002000"/>
</extension>
<itemSequence value="2"/>
<provider>
<!-- healthcare provider -->
<reference value="urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"/>
</provider>
<productOrService>
<!-- service identifier for item -->
<coding>
<system
value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/be-ns-nihdi-nomenclature"/>
<code value="101021"/>
</coding>
</productOrService>
<!-- date for item -->
<servicedDate value="2013-01-12"/>
<!-- count for item -->
<quantity>
<value value="1"/>
</quantity>
<unitPrice>
<value value="25"/>
<currency value="EUR"/>
</unitPrice>
<net>
<!-- fee for item -->
<value value="25"/>
<currency value="EUR"/>
</net>
<adjudication>
<category>
<coding>
<system
value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/decision-values"/>
<code value="tariff"/>
</coding>
</category>
</adjudication>
</addItem>
<insurance>
<sequence value="1"/>
<focal value="true"/>
<coverage>
<reference value="urn:uuid:5330da7f-db68-4380-a265-d364aeed8653"/>
</coverage>
</insurance>
</ClaimResponse>
</resource>
</entry>
</Bundle>
IG © 2022+ eHealth Platform. Package hl7.fhir.be.etariff#1.0.0 based on FHIR 4.0.1. Generated 2024-10-02
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