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 - XML Representation

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<ClaimResponse xmlns="http://hl7.org/fhir">
  <id value="sa-example-approval-nppa"/>
  <meta>
    <lastUpdated value="2026-09-01T09:00:00+12:00"/>
    <profile
             value="https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/sa-approval-claimresponse"/>
  </meta>
  <text>
    <status value="extensions"/>
    <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 (use: official))</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 (use: official))</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>
  </text>
  <extension
             url="https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/approval-detail">
    <extension url="approvalType">
      <valueCode value="EXCP"/>
    </extension>
    <extension url="status">
      <valueCode value="ACTIVE"/>
    </extension>
    <extension url="providerIdType">
      <valueCode value="CLAIMANT_NUMBER"/>
    </extension>
    <extension url="providerId">
      <valueIdentifier>
        <system
                value="https://fhir-ig.digital.health.nz/special-authority/ns/pharmacy-claimant-number"/>
        <value value="1234"/>
      </valueIdentifier>
    </extension>
  </extension>
  <extension
             url="https://fhir-ig.digital.health.nz/special-authority/StructureDefinition/approval-coverage">
    <extension url="type">
      <valueCode value="EXPLICIT_PHARMACEUTICALS"/>
    </extension>
    <extension url="pharmaceutical">
      <extension url="ctppId">
        <valueString value="10000000000000"/>
      </extension>
      <extension url="pharmacode">
        <valueString value="2000001"/>
      </extension>
      <extension url="description">
        <valueString value="Example medicine 10 mg tablet, 30"/>
      </extension>
    </extension>
  </extension>
  <identifier>
    <system
            value="https://fhir-ig.digital.health.nz/special-authority/ns/approval-number"/>
    <value value="26NP0000088"/>
  </identifier>
  <status value="active"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
      <code value="pharmacy"/>
    </coding>
  </type>
  <use value="preauthorization"/>
  <patient>🔗 
    <reference value="Patient/sa-example-patient"/>
  </patient>
  <created value="2026-09-01T09:00:00+12:00"/>
  <insurer>
    <display value="Health New Zealand | Te Whatu Ora"/>
  </insurer>
  <requestor>🔗 
    <reference value="Practitioner/sa-example-applicant"/>
  </requestor>
  <outcome value="complete"/>
  <preAuthRef value="26NP0000088"/>
  <preAuthPeriod>
    <start value="2026-09-01"/>
    <end value="2027-03-01"/>
  </preAuthPeriod>
</ClaimResponse>