Belgian MyCareNet Profiles
2.1.0 - STU Belgium flag

Belgian MyCareNet Profiles, published by eHealth Platform. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-be/mycarenet/ and changes regularly. See the Directory of published versions

: ex02 - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="ex02"/>
  <meta>
    <profile
             value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementdemand"/>
  </meta>
  <type value="message"/>
  <timestamp value="2015-07-14T11:15:33+02:00"/>
  <entry>
    <fullUrl value="urn:uuid:267b18ce-3d37-4581-9baa-6fada338038b"/>
    <resource>
      <MessageHeader>
        <id value="267b18ce-3d37-4581-9baa-6fada338038b"/>
        <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_267b18ce-3d37-4581-9baa-6fada338038b"> </a><p class="res-header-id"><b>Generated Narrative: MessageHeader 267b18ce-3d37-4581-9baa-6fada338038b</b></p><a name="267b18ce-3d37-4581-9baa-6fada338038b"> </a><a name="hc267b18ce-3d37-4581-9baa-6fada338038b"> </a><a name="267b18ce-3d37-4581-9baa-6fada338038b-en-US"> </a><p><b>event</b>: <a href="CodeSystem-message-events.html#message-events-claim-ask">CodeSystem message events</a> claim-ask: claim-ask</p><h3>Destinations</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td style="display: none">*</td><td>MyCareNet</td><td>urn:be:fgov:kbo-bce:organization:cbe-number:0820563481</td></tr></table><p><b>sender</b>: <a href="Bundle-ex11.html#urn-uuid-1dc5d974-5447-4afe-a4ab-57081ca518c3">Bundle: type = message; timestamp = 2015-07-14 11:15:33+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:person:ssin:ehealth:1.0:physiotherapist:nihii11:54263481527</td></tr></table><p><b>focus</b>: <a href="Bundle-ex11.html#urn-uuid-e85173bc-6f0d-480b-a2cd-2b70d9ffff7a">Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200</a></p></div>
        </text>
        <eventCoding>
          <system
                  value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/message-events"/>
          <code value="claim-ask"/>
        </eventCoding>
        <destination>
          <name value="MyCareNet"/>
          <endpoint
                    value="urn:be:fgov:kbo-bce:organization:cbe-number:0820563481"/>
        </destination>
        <sender>
          <reference value="urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"/>
        </sender>
        <source>
          <endpoint
                    value="urn:be:fgov:person:ssin:ehealth:1.0:physiotherapist:nihii11:54263481527"/>
        </source>
        <focus>
          <reference value="urn:uuid:e85173bc-6f0d-480b-a2cd-2b70d9ffff7a"/>
        </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-ex11.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 persphysiotherapist}">physiotherapist</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="persphysiotherapist"/>
          </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>: <code>https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi</code>/54263481527</p><p><b>name</b>: John Smith </p></div>
        </text>
        <identifier>
          <system
                  value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi"/>
          <value value="54263481527"/>
        </identifier>
        <name>
          <family value="Smith"/>
          <given value="John"/>
        </name>
      </Practitioner>
    </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/insurancymembership#n° inscription mutualiste)</p><hr/></div>
        </text>
        <identifier>
          <system
                  value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/insurancymembership"/>
          <value value="n° inscription mutualiste"/>
          <assigner>
            <identifier>
              <system
                      value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/insurancenumber"/>
              <value value="n° mutualité"/>
            </identifier>
          </assigner>
        </identifier>
        <name>
          <family value="Dupont"/>
          <given value="Jean"/>
        </name>
        <gender value="male"/>
      </Patient>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:035e3de4-011f-48a4-92c9-15b2bbcec321"/>
    <resource>
      <PractitionerRole>
        <id value="035e3de4-011f-48a4-92c9-15b2bbcec321"/>
        <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_035e3de4-011f-48a4-92c9-15b2bbcec321"> </a><p class="res-header-id"><b>Generated Narrative: PractitionerRole 035e3de4-011f-48a4-92c9-15b2bbcec321</b></p><a name="035e3de4-011f-48a4-92c9-15b2bbcec321"> </a><a name="hc035e3de4-011f-48a4-92c9-15b2bbcec321"> </a><a name="035e3de4-011f-48a4-92c9-15b2bbcec321-en-US"> </a><p><b>practitioner</b>: <a href="Bundle-ex02.html#urn-uuid-8fc72085-d349-4bd7-ba84-91a935a4e3c6">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:8fc72085-d349-4bd7-ba84-91a935a4e3c6"/>
        </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:8fc72085-d349-4bd7-ba84-91a935a4e3c6"/>
    <resource>
      <Practitioner>
        <id value="8fc72085-d349-4bd7-ba84-91a935a4e3c6"/>
        <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_8fc72085-d349-4bd7-ba84-91a935a4e3c6"> </a><p class="res-header-id"><b>Generated Narrative: Practitioner 8fc72085-d349-4bd7-ba84-91a935a4e3c6</b></p><a name="8fc72085-d349-4bd7-ba84-91a935a4e3c6"> </a><a name="hc8fc72085-d349-4bd7-ba84-91a935a4e3c6"> </a><a name="8fc72085-d349-4bd7-ba84-91a935a4e3c6-en-US"> </a><p><b>identifier</b>: <code>https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi</code>/19234011004</p><p><b>name</b>: Prénom du prescripteur Nom du prescripteur </p></div>
        </text>
        <identifier>
          <system
                  value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/nihdi"/>
          <value value="19234011004"/>
        </identifier>
        <name>
          <family value="Nom du prescripteur"/>
          <given value="Prénom du prescripteur"/>
        </name>
      </Practitioner>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:b3586cda-f1e5-4c58-a389-94249957d87a"/>
    <resource>
      <ServiceRequest>
        <id value="b3586cda-f1e5-4c58-a389-94249957d87a"/>
        <meta>
          <profile
                   value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementservicerequest"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_b3586cda-f1e5-4c58-a389-94249957d87a"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest b3586cda-f1e5-4c58-a389-94249957d87a</b></p><a name="b3586cda-f1e5-4c58-a389-94249957d87a"> </a><a name="hcb3586cda-f1e5-4c58-a389-94249957d87a"> </a><a name="b3586cda-f1e5-4c58-a389-94249957d87a-en-US"> </a><p><b>status</b>: Active</p><p><b>intent</b>: Order</p><p><b>category</b>: <span title="Codes:{http://snomed.info/sct 91251008}">Physical therapy procedure</span></p><p><b>code</b>: <span title="Codes:{http://snomed.info/sct 91251008}">Physical therapy procedure</span></p><p><b>quantity</b>: 15</p><p><b>subject</b>: <a href="Bundle-ex11.html#urn-uuid-a52efcb6-1f81-4333-a115-d45bd3183686">Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200</a></p><p><b>authoredOn</b>: 2015-07-10</p><p><b>requester</b>: <a href="Bundle-ex02.html#urn-uuid-035e3de4-011f-48a4-92c9-15b2bbcec321">Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200</a></p><p><b>supportingInfo</b>: <a href="#hcb3586cda-f1e5-4c58-a389-94249957d87a/annexSR1">Binary: 32 chars (base64)</a></p><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Binary  #annexSR1</b></p><a name="b3586cda-f1e5-4c58-a389-94249957d87a/annexSR1"> </a><a name="hcb3586cda-f1e5-4c58-a389-94249957d87a/annexSR1"> </a><a name="b3586cda-f1e5-4c58-a389-94249957d87a/annexSR1-en-US"> </a><p><b>contentType</b>: application/pdf</p><p><b>data</b>: <code>QW5uZXhlIGlubGluZSwgYmFzZTY0ZWQ=</code></p></blockquote></div>
        </text>
        <contained>
          <Binary>
            <id value="annexSR1"/>
            <contentType value="application/pdf"/>
            <data value="QW5uZXhlIGlubGluZSwgYmFzZTY0ZWQ="/>
          </Binary>
        </contained>
        <status value="active"/>
        <intent value="order"/>
        <category>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="91251008"/>
            <display value="Physical therapy procedure"/>
          </coding>
        </category>
        <code>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="91251008"/>
            <display value="Physical therapy procedure"/>
          </coding>
        </code>
        <quantityQuantity>
          <value value="15"/>
        </quantityQuantity>
        <subject>
          <reference value="urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686"/>
        </subject>
        <authoredOn value="2015-07-10"/>
        <requester>
          <reference value="urn:uuid:035e3de4-011f-48a4-92c9-15b2bbcec321"/>
        </requester>
        <supportingInfo>
          <reference value="#annexSR1"/>
        </supportingInfo>
      </ServiceRequest>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:3b8e1245-b480-4af6-90c0-f67037ef276b"/>
    <resource>
      <ServiceRequest>
        <id value="3b8e1245-b480-4af6-90c0-f67037ef276b"/>
        <meta>
          <profile
                   value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementservicerequest"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="ServiceRequest_3b8e1245-b480-4af6-90c0-f67037ef276b"> </a><p class="res-header-id"><b>Generated Narrative: ServiceRequest 3b8e1245-b480-4af6-90c0-f67037ef276b</b></p><a name="3b8e1245-b480-4af6-90c0-f67037ef276b"> </a><a name="hc3b8e1245-b480-4af6-90c0-f67037ef276b"> </a><a name="3b8e1245-b480-4af6-90c0-f67037ef276b-en-US"> </a><p><b>identifier</b>: <code>https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/uhmep</code>/n° de la prescription</p><p><b>status</b>: Active</p><p><b>intent</b>: Order</p><p><b>category</b>: <span title="Codes:{http://snomed.info/sct 91251008}">Physical therapy procedure</span></p><p><b>code</b>: <span title="Codes:{http://snomed.info/sct 91251008}">Physical therapy procedure</span></p><p><b>subject</b>: <a href="Bundle-ex11.html#urn-uuid-a52efcb6-1f81-4333-a115-d45bd3183686">Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200</a></p><p><b>authoredOn</b>: 2015-07-08</p><p><b>requester</b>: <a href="Bundle-ex02.html#urn-uuid-035e3de4-011f-48a4-92c9-15b2bbcec321">Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200</a></p></div>
        </text>
        <identifier>
          <system
                  value="https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/uhmep"/>
          <value value="n° de la prescription"/>
        </identifier>
        <status value="active"/>
        <intent value="order"/>
        <category>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="91251008"/>
            <display value="Physical therapy procedure"/>
          </coding>
        </category>
        <code>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="91251008"/>
            <display value="Physical therapy procedure"/>
          </coding>
        </code>
        <subject>
          <reference value="urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686"/>
        </subject>
        <authoredOn value="2015-07-08"/>
        <requester>
          <reference value="urn:uuid:035e3de4-011f-48a4-92c9-15b2bbcec321"/>
        </requester>
      </ServiceRequest>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:e85173bc-6f0d-480b-a2cd-2b70d9ffff7a"/>
    <resource>
      <Claim>
        <id value="e85173bc-6f0d-480b-a2cd-2b70d9ffff7a"/>
        <meta>
          <profile
                   value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/StructureDefinition/be-eagreementclaim-kine"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Claim_e85173bc-6f0d-480b-a2cd-2b70d9ffff7a"> </a><p class="res-header-id"><b>Generated Narrative: Claim e85173bc-6f0d-480b-a2cd-2b70d9ffff7a</b></p><a name="e85173bc-6f0d-480b-a2cd-2b70d9ffff7a"> </a><a name="hce85173bc-6f0d-480b-a2cd-2b70d9ffff7a"> </a><a name="e85173bc-6f0d-480b-a2cd-2b70d9ffff7a-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/mycarenet/CodeSystem/agreement-types physiotherapy-fb}">physiotherapy-fb</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href="Bundle-ex11.html#urn-uuid-a52efcb6-1f81-4333-a115-d45bd3183686">Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200</a></p><p><b>billablePeriod</b>: 2020-01-15 --&gt; (ongoing)</p><p><b>created</b>: 2015-07-14 11:15:30+0200</p><p><b>enterer</b>: <a href="Bundle-ex11.html#urn-uuid-1dc5d974-5447-4afe-a4ab-57081ca518c3">Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200</a></p><p><b>provider</b>: <a href="Bundle-ex11.html#urn-uuid-1dc5d974-5447-4afe-a4ab-57081ca518c3">Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200</a></p><p><b>priority</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/processpriority stat}">Immediate</span></p><p><b>referral</b>: <a href="Bundle-ex02.html#urn-uuid-b3586cda-f1e5-4c58-a389-94249957d87a">Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200</a></p><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 1</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/claiminformationcategory attachment}">Attachment</span></p><p><b>code</b>: <span title="Codes:{https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/annex-types functional-report}">functional-report</span></p><p><b>value</b>: application/pdf: QW5uZXhlIGlubGluZSwgYmFzZTY0ZWQ=</p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 2</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/claiminformationcategory info}">Information</span></p><p><b>value</b>: additional Information</p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 3</p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/claiminformationcategory info}">Information</span></p><p><b>value</b>: <a href="Bundle-ex02.html#urn-uuid-3b8e1245-b480-4af6-90c0-f67037ef276b">Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200</a></p></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>use of mandatory insurance coverage, no further details provided here.</td></tr></table><h3>Items</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>ProductOrService</b></td><td><b>Serviced[x]</b></td></tr><tr><td style="display: none">*</td><td>1</td><td><span title="Codes:{https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/nihdi-physiotherapy-pathologysituationcode fb-51}">fb-51</span></td><td>2020-01-14</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>
          <coding>
            <system
                    value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/agreement-types"/>
            <code value="physiotherapy-fb"/>
          </coding>
        </subType>
        <use value="preauthorization"/>
        <patient>
          <reference value="urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686"/>
        </patient>
        <billablePeriod>
          <start value="2020-01-15"/>
        </billablePeriod>
        <created value="2015-07-14T11:15:30+02:00"/>
        <enterer>
          <reference value="urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"/>
        </enterer>
        <provider>
          <reference value="urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3"/>
        </provider>
        <priority>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/processpriority"/>
            <code value="stat"/>
          </coding>
        </priority>
        <referral>
          <reference value="urn:uuid:b3586cda-f1e5-4c58-a389-94249957d87a"/>
        </referral>
        <supportingInfo>
          <sequence value="1"/>
          <category>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/claiminformationcategory"/>
              <code value="attachment"/>
            </coding>
          </category>
          <code>
            <coding>
              <system
                      value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/annex-types"/>
              <code value="functional-report"/>
            </coding>
          </code>
          <valueAttachment>
            <contentType value="application/pdf"/>
            <data value="QW5uZXhlIGlubGluZSwgYmFzZTY0ZWQ="/>
            <title value="nom/description de l'annexe"/>
          </valueAttachment>
        </supportingInfo>
        <supportingInfo>
          <sequence value="2"/>
          <category>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/claiminformationcategory"/>
              <code value="info"/>
            </coding>
          </category>
          <valueString value="additional Information"/>
        </supportingInfo>
        <supportingInfo>
          <sequence value="3"/>
          <category>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/claiminformationcategory"/>
              <code value="info"/>
            </coding>
          </category>
          <valueReference>
            <reference value="urn:uuid:3b8e1245-b480-4af6-90c0-f67037ef276b"/>
          </valueReference>
        </supportingInfo>
        <insurance>
          <sequence value="1"/>
          <focal value="true"/>
          <coverage>
            <display
                     value="use of mandatory insurance coverage, no further details provided here."/>
          </coverage>
        </insurance>
        <item>
          <sequence value="1"/>
          <productOrService>
            <coding>
              <system
                      value="https://www.ehealth.fgov.be/standards/fhir/mycarenet/CodeSystem/nihdi-physiotherapy-pathologysituationcode"/>
              <code value="fb-51"/>
            </coding>
          </productOrService>
          <servicedDate value="2020-01-14"/>
        </item>
      </Claim>
    </resource>
  </entry>
</Bundle>