{
  "resourceType" : "Claim",
  "id" : "sa-example-claim-nppa",
  "meta" : {
    "profile" : ["https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/sa-claim"]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Claim sa-example-claim-nppa</b></p><a name=\"sa-example-claim-nppa\"> </a><a name=\"hcsa-example-claim-nppa\"> </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-sa-claim.html\">SA Claim</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>: Preauthorization</p><p><b>patient</b>: <a href=\"Patient-sa-example-patient.html\">Aroha Parata (official) (no stated gender), DoB: 1968-03-14 ( https://standards.digital.health.nz/ns/nhi-id#NHI#ZZZ0016\u00a0(use:\u00a0official))</a></p><p><b>created</b>: 2026-10-14 12:00:00+1300</p><p><b>provider</b>: <a href=\"Practitioner-sa-example-applicant.html\">Jane Smith (official) (https://standards.digital.health.nz/ns/hpi-person-id#HPIProvider#99ZZZZ\u00a0(use:\u00a0official))</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><h3>SupportingInfos</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{https://fhir-ig.digital.health.nz/special-authority/CodeSystem/sa-supporting-info-category questionnaire-response}\">Questionnaire response</span></td><td><a href=\"QuestionnaireResponse-sa-example-qr.html\">Response to Questionnaire '-&gt;Example Special Authority form SA9999 - Initial application' about '-&gt;Aroha Parata (official) (no stated gender), DoB: 1968-03-14 ( https://standards.digital.health.nz/ns/nhi-id#NHI#ZZZ0016\u00a0(use:\u00a0official))'</a></td></tr></table><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>Pharmaceutical Schedule</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></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://nzmt.org.nz 50002411000117100}, {https://fhir-ig.digital.health.nz/special-authority/ns/pharmacode 2000001}\">Myleran 2 mg tablet: film-coated, 100 tablets, bottle</span></td></tr></table></div>"
  },
  "status" : "active",
  "type" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
      "code" : "pharmacy"
    }]
  },
  "use" : "preauthorization",
  "patient" : {
    "reference" : "Patient/sa-example-patient"
  },
  "created" : "2026-10-14T12:00:00+13:00",
  "provider" : {
    "reference" : "Practitioner/sa-example-applicant"
  },
  "priority" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
      "code" : "normal"
    }]
  },
  "supportingInfo" : [{
    "sequence" : 1,
    "category" : {
      "coding" : [{
        "system" : "https://fhir-ig.digital.health.nz/special-authority/CodeSystem/sa-supporting-info-category",
        "code" : "questionnaire-response"
      }]
    },
    "valueReference" : {
      "reference" : "QuestionnaireResponse/sa-example-qr"
    }
  }],
  "insurance" : [{
    "sequence" : 1,
    "focal" : true,
    "coverage" : {
      "display" : "Pharmaceutical Schedule"
    }
  }],
  "item" : [{
    "sequence" : 1,
    "productOrService" : {
      "coding" : [{
        "system" : "http://nzmt.org.nz",
        "code" : "50002411000117100",
        "display" : "Myleran 2 mg tablet: film-coated, 100 tablets, bottle"
      },
      {
        "system" : "https://fhir-ig.digital.health.nz/special-authority/ns/pharmacode",
        "code" : "2000001",
        "display" : "Example medicine 10 mg tablet, 30"
      }]
    }
  }]
}