Generated Narrative: Bundle ex10

Bundle ex10 of type message

Entry 1 - fullUrl = urn:uuid:267b18ce-3d37-4581-9baa-6fada338038b

Resource MessageHeader:

Generated Narrative: MessageHeader 267b18ce-3d37-4581-9baa-6fada338038b

event: CodeSystem message events claim-extend: claim-extend

Destinations

-	Name
*	MyCareNet

sender: Bundle: type = message; timestamp = 2024-05-08 11:15:33+0200

source

focus: Bundle: type = message; timestamp = 2024-05-08 11:15:33+0200

Entry 2 - fullUrl = urn:uuid:1dc5d974-5447-4afe-a4ab-57081ca518c3

Resource PractitionerRole:

Generated Narrative: PractitionerRole 1dc5d974-5447-4afe-a4ab-57081ca518c3

practitioner: Bundle: type = message; timestamp = 2024-05-09 11:15:37+0200

code: physiotherapist

Entry 3 - fullUrl = urn:uuid:03972cc4-d781-4285-8d79-0f05810e1931

Resource Practitioner:

Generated Narrative: Practitioner 03972cc4-d781-4285-8d79-0f05810e1931

identifier: BeNIHDINamingSystem/54263481527

name: John Smith

Entry 4 - fullUrl = urn:uuid:a52efcb6-1f81-4333-a115-d45bd3183686

Resource Patient:

Generated Narrative: Patient a52efcb6-1f81-4333-a115-d45bd3183686

Jean Dupont Male, DoB Unknown ( https://www.ehealth.fgov.be/standards/fhir/core/NamingSystem/insurancymembership#BeInsurancymembershipNamingSystem#n° inscription mutualiste)

---

Entry 5 - fullUrl = urn:uuid:035e3de4-011f-48a4-92c9-15b2bbcec321

Resource PractitionerRole:

Generated Narrative: PractitionerRole 035e3de4-011f-48a4-92c9-15b2bbcec321

practitioner: Bundle: type = message; timestamp = 2024-05-08 11:15:33+0200

code: physician

Entry 6 - fullUrl = urn:uuid:8fc72085-d349-4bd7-ba84-91a935a4e3c6

Resource Practitioner:

Generated Narrative: Practitioner 8fc72085-d349-4bd7-ba84-91a935a4e3c6

identifier: BeNIHDINamingSystem/19234011004

name: Prénom du prescripteur Nom du prescripteur

Entry 7 - fullUrl = urn:uuid:b3586cda-f1e5-4c58-a389-94249957d87a

Resource ServiceRequest:

Generated Narrative: ServiceRequest b3586cda-f1e5-4c58-a389-94249957d87a

status: Active

intent: Order

category: Physical therapy procedure

code: No display for ServiceRequest.code (concept: Physical therapy procedure)

quantity: 15

subject: Bundle: type = message; timestamp = 2024-05-08 11:15:33+0200

authoredOn: 2015-07-13

requester: Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200

supportingInfo: No display for ServiceRequest.supportingInfo (reference: ->Binary: 32 chars (base64))

---

Generated Narrative: Binary #annexSR1

contentType: application/pdf

data: QW5uZXhlIGlubGluZSwgYmFzZTY0ZWQ=

Entry 8 - fullUrl = urn:uuid:e85173bc-6f0d-480b-a2cd-2b70d9ffff7a

Resource Claim:

Generated Narrative: Claim e85173bc-6f0d-480b-a2cd-2b70d9ffff7a

status: Active

type: Professional

subType: physiotherapy-fb

use: Preauthorization

patient: Bundle: type = message; timestamp = 2024-05-08 11:15:33+0200

billablePeriod: 2020-01-15 --> (ongoing)

created: 2015-07-14 11:15:30+0200

enterer: Bundle: type = message; timestamp = 2024-05-08 11:15:33+0200

provider: Bundle: type = message; timestamp = 2024-05-08 11:15:33+0200

priority: Immediate

referral: Bundle: type = message; timestamp = 2015-07-14 11:15:33+0200

SupportingInfos

-	Sequence	Category	Value[x]
*	1	Information	additional Information

Insurances

-	Sequence	Focal	Coverage	PreAuthRef
*	1	true	use of mandatory insurance coverage, no further details provided here.	identifiant business de la décision à prolonger

Items

-	Sequence	ProductOrService
*	1	fb-51