Healthcare Financial Services IG Edition 1
0.3.0 - STU-Ballot Saudi Arabia flag

Healthcare Financial Services IG Edition 1 - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Message: Payment Notice #1 - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "06b80922-b538-4ab3-9176-a80b51249001",
  "meta" : {
    "profile" : [
      🔗 "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|0.3.0"
    ]
  },
  "type" : "message",
  "timestamp" : "2023-12-07T18:30:29.683Z",
  "entry" : [
    {
      "fullUrl" : "urn:uuid:000739e8-c8d0-44f8-b0e0-f89310ea9061",
      "resource" : {
        "resourceType" : "MessageHeader",
        "id" : "000739e8-c8d0-44f8-b0e0-f89310ea9061",
        "meta" : {
          "profile" : [
            🔗 "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/message-header|0.3.0"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_000739e8-c8d0-44f8-b0e0-f89310ea9061\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader 000739e8-c8d0-44f8-b0e0-f89310ea9061</b></p><a name=\"000739e8-c8d0-44f8-b0e0-f89310ea9061\"> </a><a name=\"hc000739e8-c8d0-44f8-b0e0-f89310ea9061\"> </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-message-header.html\">Nphies MessageHeaderversion: null0.3.0)</a></p></div><p><b>event</b>: <a href=\"CodeSystem-ksa-message-events.html#ksa-message-events-payment-notice\">KSA Message Events payment-notice</a>: Payment Notice</p><h3>Destinations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Endpoint</b></td><td><b>Receiver</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"http://nphies.sa\">http://nphies.sa</a></td><td>Identifier: <code>http://nphies.sa/license/nphies</code>/NPHIES</td></tr></table><p><b>sender</b>: Identifier: <code>http://nphies.sa/license/provider-license</code>/PR-FHIR</p><h3>Sources</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Endpoint</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"http://saudidentalclinic.com.sa\">http://saudidentalclinic.com.sa</a></td></tr></table><p><b>focus</b>: <a href=\"Bundle-06b80922-b538-4ab3-9176-a80b51249001.html#http-//saudidentalclinic.com.sa/PaymentNotice/99061\">Bundle: type = message; timestamp = 2023-12-07 18:30:29+0000</a></p></div>"
        },
        "eventCoding" : {
          "system" : "http://nphies.sa/terminology/CodeSystem/ksa-message-events",
          "code" : "payment-notice"
        },
        "destination" : [
          {
            "endpoint" : "http://nphies.sa",
            "receiver" : {
              "type" : "Organization",
              "identifier" : {
                "system" : "http://nphies.sa/license/nphies",
                "value" : "NPHIES"
              }
            }
          }
        ],
        "sender" : {
          "type" : "Organization",
          "identifier" : {
            "system" : "http://nphies.sa/license/provider-license",
            "value" : "PR-FHIR"
          }
        },
        "source" : {
          "endpoint" : "http://saudidentalclinic.com.sa"
        },
        "focus" : [
          {
            "reference" : "http://saudidentalclinic.com.sa/PaymentNotice/99061"
          }
        ]
      }
    },
    {
      "fullUrl" : "http://saudidentalclinic.com.sa/PaymentNotice/99061",
      "resource" : {
        "resourceType" : "PaymentNotice",
        "id" : "99061",
        "meta" : {
          "profile" : [
            🔗 "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/payment-notice|0.3.0"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"PaymentNotice_99061\"> </a><p class=\"res-header-id\"><b>Generated Narrative: PaymentNotice 99061</b></p><a name=\"99061\"> </a><a name=\"hc99061\"> </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-payment-notice.html\">Nphies Payment Noticeversion: null0.3.0)</a></p></div><p><b>identifier</b>: <code>http://sni.com.sa/identifiers/paymentnotice</code>/9290894061</p><p><b>status</b>: Active</p><p><b>created</b>: 2023-12-06</p><p><b>provider</b>: <a href=\"Bundle-06b80922-b538-4ab3-9176-a80b51249001.html#http-//saudidentalclinic.com.sa/Organization/215\">Bundle: type = message; timestamp = 2023-12-07 18:30:29+0000</a></p><p><b>payment</b>: Identifier: <code>http://sni.com.sa/identifiers/paymentreconciliation</code>/90581</p><p><b>paymentDate</b>: 2023-12-06</p><p><b>payee</b>: <a href=\"Bundle-06b80922-b538-4ab3-9176-a80b51249001.html#http-//saudidentalclinic.com.sa/Organization/215\">Bundle: type = message; timestamp = 2023-12-07 18:30:29+0000</a></p><p><b>recipient</b>: Identifier: Other/NPHIES</p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>239.55</td><td>Saudi riyal</td></tr></table><p><b>paymentStatus</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/paymentstatus cleared}\">Cleared</span></p></div>"
        },
        "identifier" : [
          {
            "system" : "http://sni.com.sa/identifiers/paymentnotice",
            "value" : "9290894061"
          }
        ],
        "status" : "active",
        "created" : "2023-12-06",
        "provider" : {
          "reference" : "http://saudidentalclinic.com.sa/Organization/215"
        },
        "payment" : {
          "identifier" : {
            "system" : "http://sni.com.sa/identifiers/paymentreconciliation",
            "value" : "90581"
          }
        },
        "paymentDate" : "2023-12-06",
        "payee" : {
          "reference" : "http://saudidentalclinic.com.sa/Organization/215"
        },
        "recipient" : {
          "type" : "Organization",
          "identifier" : {
            "type" : {
              "coding" : [
                {
                  "system" : "http://nphies.sa/terminology/CodeSystem/organization-type",
                  "code" : "other"
                }
              ]
            },
            "system" : "http://nphies.sa/license/nphies",
            "value" : "NPHIES"
          }
        },
        "amount" : {
          "value" : 239.55,
          "currency" : "SAR"
        },
        "paymentStatus" : {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/paymentstatus",
              "code" : "cleared"
            }
          ]
        }
      }
    },
    {
      "fullUrl" : "http://saudidentalclinic.com.sa/Organization/215",
      "resource" : {
        "resourceType" : "Organization",
        "id" : "215",
        "meta" : {
          "profile" : [
            🔗 "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization|0.3.0"
          ]
        },
        "text" : {
          "status" : "extensions",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_215\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization 215</b></p><a name=\"215\"> </a><a name=\"hc215\"> </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-provider-organization.html\">Nphies Provider Organizationversion: null0.3.0)</a></p></div><p><b>Provider Type</b>: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/provider-type 5}\">Clinic</span></p><p><b>identifier</b>: <code>http://nphies.sa/license/provider-license</code>/DC-FHIR</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: Saudi Dental Clinic</p><p><b>address</b>: Hajar Valley, Building 104, Riyadh Saudi Arabia(work)</p></div>"
        },
        "extension" : [
          {
            "url" : "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-provider-type",
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "http://nphies.sa/terminology/CodeSystem/provider-type",
                  "code" : "5",
                  "display" : "Clinic"
                }
              ]
            }
          }
        ],
        "identifier" : [
          {
            "system" : "http://nphies.sa/license/provider-license",
            "value" : "DC-FHIR"
          }
        ],
        "active" : true,
        "type" : [
          {
            "coding" : [
              {
                "system" : "http://nphies.sa/terminology/CodeSystem/organization-type",
                "code" : "prov"
              }
            ]
          }
        ],
        "name" : "Saudi Dental Clinic",
        "address" : [
          {
            "use" : "work",
            "text" : "Hajar Valley, Building 104, Riyadh Saudi Arabia",
            "line" : [
              "Hajar Valley, Building 104",
              "Al Malga District"
            ],
            "city" : "Riyadh",
            "country" : "Saudi Arabia"
          }
        ]
      }
    }
  ]
}