{ "resourceType" : "Claim", "meta" : { "source" : "https://standards.digital.health.nz/ns/hpi-facility-id/FZZ111-A", "profile" : ["https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/NzPharmacyClaim"], "tag" : [{ "system" : "https://hub.services.digital.health.nz/ns/correlation-id", "code" : "123e4567-e89b-12d3-a456-426614174000" }] }, "text" : { "status" : "extensions", "div" : "

Generated Narrative: Claim NzPharmacyClaimExample2

Information Source: https://standards.digital.health.nz/ns/hpi-facility-id/FZZ111-A

Profile: NZ Pharmacy Claim

Tag:

Claimant Number: AG12345

Patient Cohort: Community Residential Care

Originating Claimant Number: AG54321

identifier: https://provider-org-name.co.nz/ns/claim-identifier/C123456\u00a0(use:\u00a0official)

status: Active

type: pharmacy

subType: ICPSA

use: Claim

patient: Identifier: NHI/ZZZ0008

billablePeriod: 2025-01-01 --> 2025-01-01

created: 2025-01-01 00:00:00+1300

enterer: Identifier: HPIProvider/12345

provider: Identifier: HPIOrganization/GZZ999-9\u00a0(use:\u00a0official)

priority: Normal

Insurances

-SequenceFocalCoverage
*1falseNot applicable

item

Item Request: Identifier: https://provider-org-name.co.nz/ns/scriptno-local/RX123456-01

Transaction Category: Invoice

PSC Flag Extension: true

Extended Supply Flag: false

Patient Flag: true

Prescriber Flag: false

Prescription Flag: true

Dose Flag: false

Group ID: GRP001

sequence: 1

productOrService: PU1234

serviced: 2025-01-01 00:00:00+1300 --> 2025-01-01 23:59:59+1300

detail

Balance Owing: 0

Wastage Quantity: 5 Tablets

CBS Subsidy: $10.00 (NZD)

CBS Pack Size: 30 Tablets

sequence: 1

productOrService: 123456

quantity: 180 Tablets

Nets

-ValueCurrency
*500New Zealand dollar

Totals

-ValueCurrency
*500New Zealand dollar
" }, "extension" : [{ "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/claimant-number", "valueString" : "AG12345" }, { "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/patient-cohort", "valueCodeableConcept" : { "coding" : [{ "system" : "https://fhir-ig.digital.health.nz/shared-care/CodeSystem/pharmacy-claim-patient-cohort-codes", "code" : "CRC" }] } }, { "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/originating-claimant-number", "valueString" : "AG54321" }], "identifier" : [{ "use" : "official", "system" : "https://provider-org-name.co.nz/ns/claim-identifier", "value" : "C123456" }], "status" : "active", "type" : { "coding" : [{ "system" : "https://fhir-ig.digital.health.nz/shared-care/CodeSystem/nz-claim-type", "code" : "pharmacy" }] }, "subType" : { "coding" : [{ "system" : "https://fhir-ig.digital.health.nz/shared-care/CodeSystem/nz-claim-subtype", "code" : "ICPSA" }] }, "use" : "claim", "patient" : { "type" : "Patient", "identifier" : { "system" : "https://standards.digital.health.nz/ns/nhi-id", "value" : "ZZZ0008" } }, "billablePeriod" : { "start" : "2025-01-01", "end" : "2025-01-01" }, "created" : "2025-01-01T00:00:00+13:00", "enterer" : { "type" : "Practitioner", "identifier" : { "system" : "https://standards.digital.health.nz/ns/hpi-person-id", "value" : "12345" } }, "provider" : { "type" : "Organization", "identifier" : { "use" : "official", "system" : "https://standards.digital.health.nz/ns/hpi-organisation-id", "value" : "GZZ999-9" } }, "priority" : { "coding" : [{ "system" : "http://terminology.hl7.org/CodeSystem/processpriority", "code" : "normal" }] }, "insurance" : [{ "sequence" : 1, "focal" : false, "coverage" : { "extension" : [{ "url" : "http://hl7.org/fhir/StructureDefinition/data-absent-reason", "valueCode" : "not-applicable" }], "display" : "Not applicable" } }], "item" : [{ "extension" : [{ "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/item-request", "valueReference" : { "type" : "MedicationDispense", "identifier" : { "system" : "https://provider-org-name.co.nz/ns/scriptno-local", "value" : "RX123456-01" } } }, { "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/transaction-category", "valueCodeableConcept" : { "coding" : [{ "system" : "https://fhir-ig.digital.health.nz/shared-care/CodeSystem/nz-pharmacy-transaction-category", "code" : "I" }] } }, { "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/psc-flag", "valueBoolean" : true }, { "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/extended-supply-flag", "valueBoolean" : false }, { "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/patient-flag", "valueBoolean" : true }, { "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/prescriber-flag", "valueBoolean" : false }, { "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/prescription-flag", "valueBoolean" : true }, { "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/dose-flag", "valueBoolean" : false }, { "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/group-id", "valueString" : "GRP001" }], "sequence" : 1, "productOrService" : { "coding" : [{ "system" : "https://standards.digital.health.nz/ns/purchase-unit", "code" : "PU1234" }] }, "servicedPeriod" : { "start" : "2025-01-01T00:00:00+13:00", "end" : "2025-01-01T23:59:59+13:00" }, "detail" : [{ "extension" : [{ "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/hsaap-balance-owing", "valueString" : "0" }, { "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/wastageQuantity", "valueQuantity" : { "value" : 5, "unit" : "Tablets" } }, { "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/cbsSubsidy", "valueMoney" : { "value" : 10, "currency" : "NZD" } }, { "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/cbsPackSize", "valueQuantity" : { "value" : 30, "unit" : "Tablets" } }], "sequence" : 1, "productOrService" : { "coding" : [{ "system" : "https://standards.digital.health.nz/ns/pharmacode", "code" : "123456" }, { "system" : "https://standards.digital.health.nz/ns/nzulm", "code" : "NZULM789" }] }, "quantity" : { "value" : 180, "unit" : "Tablets" }, "net" : { "value" : 500, "currency" : "NZD" } }] }], "total" : { "value" : 500, "currency" : "NZD" } }