HSAAP Special Authority FHIR Implementation Guide - Local Development build (v0.1.1) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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: Example Approval - NPPA with explicit coverage and provider - JSON Representation

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{
  "resourceType" : "ClaimResponse",
  "id" : "sa-example-approval-nppa",
  "meta" : {
    "lastUpdated" : "2026-09-01T09:00:00+12:00",
    "profile" : [
      🔗 "https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/sa-approval-claimresponse"
    ]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse sa-example-approval-nppa</b></p><a name=\"sa-example-approval-nppa\"> </a><a name=\"hcsa-example-approval-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\">Last updated: 2026-09-01 09:00:00+1200</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-sa-approval-claimresponse.html\">SA Approval ClaimResponse</a></p></div><blockquote><p><b>Approval Detail</b></p><ul><li>approvalType: EXCP</li><li>status: ACTIVE</li><li>providerIdType: CLAIMANT_NUMBER</li><li>providerId: <a href=\"NamingSystem-sa-pharmacy-claimant-number.html\" title=\"Pharmacy claimant number. Identifies the provider (pharmacy) on an Approval and is the system used by the approval-provider-id search parameter.\">SAPharmacyClaimantNumber</a>/1234</li></ul></blockquote><blockquote><p><b>Approval Coverage</b></p><blockquote><p><b>url</b></p>type</blockquote><p><b>value</b>: EXPLICIT_PHARMACEUTICALS</p><p><b>ctppId</b>: 10000000000000</p><p><b>pharmacode</b>: 2000001</p><p><b>description</b>: Example medicine 10 mg tablet, 30</p><blockquote><p><b>url</b></p>pharmaceutical</blockquote></blockquote><p><b>identifier</b>: <a href=\"NamingSystem-sa-approval-number.html\" title=\"Special Authority Approval Number. Carried on ClaimResponse.identifier and ClaimResponse.preAuthRef (D23).\">SAApprovalNumber</a>/26NP0000088</p><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>: 2026-09-01 09:00:00+1200</p><p><b>insurer</b>: Health New Zealand | Te Whatu Ora</p><p><b>requestor</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>outcome</b>: Processing Complete</p><p><b>preAuthRef</b>: 26NP0000088</p><p><b>preAuthPeriod</b>: 2026-09-01 --&gt; 2027-03-01</p></div>"
  },
  "extension" : [
    {
      "extension" : [
        {
          "url" : "approvalType",
          "valueCode" : "EXCP"
        },
        {
          "url" : "status",
          "valueCode" : "ACTIVE"
        },
        {
          "url" : "providerIdType",
          "valueCode" : "CLAIMANT_NUMBER"
        },
        {
          "url" : "providerId",
          "valueIdentifier" : {
            "system" : "https://fhir-ig.digital.health.nz/special-authority/ns/pharmacy-claimant-number",
            "value" : "1234"
          }
        }
      ],
      "url" : "https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/approval-detail"
    },
    {
      "extension" : [
        {
          "url" : "type",
          "valueCode" : "EXPLICIT_PHARMACEUTICALS"
        },
        {
          "extension" : [
            {
              "url" : "ctppId",
              "valueString" : "10000000000000"
            },
            {
              "url" : "pharmacode",
              "valueString" : "2000001"
            },
            {
              "url" : "description",
              "valueString" : "Example medicine 10 mg tablet, 30"
            }
          ],
          "url" : "pharmaceutical"
        }
      ],
      "url" : "https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/approval-coverage"
    }
  ],
  "identifier" : [
    {
      "system" : "https://fhir-ig.digital.health.nz/special-authority/ns/approval-number",
      "value" : "26NP0000088"
    }
  ],
  "status" : "active",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
        "code" : "pharmacy"
      }
    ]
  },
  "use" : "preauthorization",
  "patient" : {
    🔗 "reference" : "Patient/sa-example-patient"
  },
  "created" : "2026-09-01T09:00:00+12:00",
  "insurer" : {
    "display" : "Health New Zealand | Te Whatu Ora"
  },
  "requestor" : {
    🔗 "reference" : "Practitioner/sa-example-applicant"
  },
  "outcome" : "complete",
  "preAuthRef" : "26NP0000088",
  "preAuthPeriod" : {
    "start" : "2026-09-01",
    "end" : "2027-03-01"
  }
}