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: Authorization Advanced Response #1 - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="dccc9ae9-e640-4fe1-b3fd-5af3c1c12210"/>
  <meta>
    <profile
             value="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|0.3.0"/>
  </meta>
  <type value="message"/>
  <timestamp value="2023-12-04T13:39:58.099+00:00"/>
  <entry>
    <fullUrl value="urn:uuid:c7150958-640a-456b-8252-265675d12300"/>
    <resource>
      <MessageHeader>
        <id value="c7150958-640a-456b-8252-265675d12300"/>
        <meta>
          <profile
                   value="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/message-header|0.3.0"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="MessageHeader_c7150958-640a-456b-8252-265675d12300"> </a><p class="res-header-id"><b>Generated Narrative: MessageHeader c7150958-640a-456b-8252-265675d12300</b></p><a name="c7150958-640a-456b-8252-265675d12300"> </a><a name="hcc7150958-640a-456b-8252-265675d12300"> </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-advanced-authorization">KSA Message Events advanced-authorization</a>: Advanced Authorization</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://saudigeneralhospital.com.sa">http://saudigeneralhospital.com.sa</a></td><td>Identifier: <code>http://nphies.sa/license/provider-license</code>/PR-FHIR</td></tr></table><p><b>sender</b>: Identifier: <code>http://nphies.sa/license/payer-license</code>/INS-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://sni.com.sa">http://sni.com.sa</a></td></tr></table><p><b>focus</b>: <a href="Bundle-dccc9ae9-e640-4fe1-b3fd-5af3c1c12210.html#http-//sni.com.sa/ClaimResponse/142298">Bundle: type = message; timestamp = 2023-12-04 13:39:58+0000</a></p></div>
        </text>
        <eventCoding>
          <system
                  value="http://nphies.sa/terminology/CodeSystem/ksa-message-events"/>
          <code value="advanced-authorization"/>
        </eventCoding>
        <destination>
          <endpoint value="http://saudigeneralhospital.com.sa"/>
          <receiver>
            <type value="Organization"/>
            <identifier>
              <system value="http://nphies.sa/license/provider-license"/>
              <value value="PR-FHIR"/>
            </identifier>
          </receiver>
        </destination>
        <sender>
          <type value="Organization"/>
          <identifier>
            <system value="http://nphies.sa/license/payer-license"/>
            <value value="INS-FHIR"/>
          </identifier>
        </sender>
        <source>
          <endpoint value="http://sni.com.sa"/>
        </source>
        <focus>
          <reference value="http://sni.com.sa/ClaimResponse/142298"/>
        </focus>
      </MessageHeader>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://sni.com.sa/ClaimResponse/142298"/>
    <resource>
      <ClaimResponse>
        <id value="142298"/>
        <meta>
          <profile
                   value="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/advanced-authorization|0.3.0"/>
        </meta>
        <text>
          <status value="extensions"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="ClaimResponse_142298"> </a><p class="res-header-id"><b>Generated Narrative: ClaimResponse 142298</b></p><a name="142298"> </a><a name="hc142298"> </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-advanced-authorization.html">Nphies Advanced Authorizationversion: null0.3.0)</a></p></div><p><b>Adjudication Outcome</b>: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/adjudication-outcome approved}">Approved</span></p><p><b>Advanced Auth Reason</b>: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/advancedAuth-reason referral}">Referral</span></p><p><b>Newborn</b>: false</p><p><b>Service Provider Extension</b>: <a href="Bundle-16b80922-b538-4ab3-0176-a80b33242163.html#http-//sni.com.sa/Organization/b1b3432921324f97af3be9fd0b1a14ae">Bundle: type = message; timestamp = 2024-12-02 19:36:29+0000</a></p><p><b>Referring Provider Extension</b>: Dr. Test Doctor outside npies (wave3)</p><blockquote><p><b>Supporting Info Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence: 1</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/claim-information-category info}">Information</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueString: Advanced authorization for providing mentioned services to the patient</li></ul></blockquote><blockquote><p><b>Diagnosis Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis-sequence: 1</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis-diagnosisCodeableConcept: <span title="Codes:{http://hl7.org/fhir/sid/icd-10-am K01.1}">K01.1</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis-type: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/diagnosis-type principal}">Principal Diagnosis</span></li></ul></blockquote><blockquote><p><b>Diagnosis Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis-sequence: 2</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis-diagnosisCodeableConcept: <span title="Codes:{http://hl7.org/fhir/sid/icd-10-am V49.4}">V49.4</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis-type: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/diagnosis-type secondary}">Secondary Diagnosis</span></li></ul></blockquote><p><b>identifier</b>: <code>http://sni.com.sa/identifiers/advanced-priorauth</code>/AdvAuth-300982300</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/claim-type oral}">Oral</span></p><p><b>subType</b>: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/claim-subtype op}">OutPatient</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href="Bundle-16b80922-b538-4ab3-0176-a80b33242163.html#http-//sni.com.sa/Patient/123454186">Bundle: type = message; timestamp = 2024-12-02 19:36:29+0000</a></p><p><b>created</b>: 2022-07-18</p><p><b>insurer</b>: <a href="Bundle-16b80922-b538-4ab3-0176-a80b33242163.html#http-//sni.com.sa/Organization/bff3aa1fbd3648619ac082357bf135db">Bundle: type = message; timestamp = 2024-12-02 19:36:29+0000</a></p><p><b>outcome</b>: Processing Complete</p><p><b>preAuthRef</b>: AdAuth-150123-1530</p><p><b>preAuthPeriod</b>: 2022-09-15 18:10:44+0000 --&gt; 2022-10-15 18:10:44+0000</p><blockquote><p><b>addItem</b></p><p><b>Maternity</b>: false</p><p><b>Adjudication Outcome</b>: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/adjudication-outcome approved}">Approved</span></p><p><b>Sequence Extension</b>: 1</p><p><b>Information Sequence Extension</b>: 1</p><p><b>Package Code</b>: false</p><p><b>productOrService</b>: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/oral-health-op 658}">The extraoral repair of a crown, bridge or splint.</span></p><p><b>quantity</b>: 1</p><p><b>bodySite</b>: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/fdi-oral-region 25}">UPPER LEFT; PERMANENT TEETH # 5</span></p><p><b>subSite</b>: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/fdi-tooth-surface V}">Ventral</span></p><p><b>noteNumber</b>: 1</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligible}">Eligible Amount</span></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>100</td><td>Saudi riyal</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication copay}">CoPay</span></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>0</td><td>Saudi riyal</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/ksa-adjudication approved-quantity}">Approved Quantity</span></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>1</td><td>Saudi riyal</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication tax}">Tax</span></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>15</td><td>Saudi riyal</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}">Benefit Amount</span></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>100</td><td>Saudi riyal</td></tr></table></blockquote></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}">Benefit Amount</span></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>100</td><td>Saudi riyal</td></tr></table></blockquote><h3>ProcessNotes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Number</b></td><td><b>Type</b></td><td><b>Text</b></td></tr><tr><td style="display: none">*</td><td>1</td><td>Display</td><td>Process Note Text to give more general information or direction</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>false</td><td><a href="Bundle-43c68545-8e37-4744-b8ea-9a1e3c1ada84.html#http-//sni.com.sa/Coverage/1333">Bundle: type = message; timestamp = 2023-12-19 08:20:29+0000</a></td></tr></table></div>
        </text>
        <extension
                   url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://nphies.sa/terminology/CodeSystem/adjudication-outcome"/>
              <code value="approved"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-advancedAuth-reason">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://nphies.sa/terminology/CodeSystem/advancedAuth-reason"/>
              <code value="referral"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <extension
                   url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-newborn">
          <valueBoolean value="false"/>
        </extension>
        <extension
                   url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-serviceProvider">
          <valueReference>
            <reference
                       value="http://sni.com.sa/Organization/b1b3432921324f97af3be9fd0b1a14ae"/>
          </valueReference>
        </extension>
        <extension
                   url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-referringProvider">
          <valueReference>
            <display value="Dr. Test Doctor outside npies (wave3)"/>
          </valueReference>
        </extension>
        <extension
                   url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo">
          <extension
                     url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence">
            <valuePositiveInt value="1"/>
          </extension>
          <extension
                     url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://nphies.sa/terminology/CodeSystem/claim-information-category"/>
                <code value="info"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <extension
                     url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueString">
            <valueString
                         value="Advanced authorization for providing mentioned services to the patient"/>
          </extension>
        </extension>
        <extension
                   url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis">
          <extension
                     url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis-sequence">
            <valuePositiveInt value="1"/>
          </extension>
          <extension
                     url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis-diagnosisCodeableConcept">
            <valueCodeableConcept>
              <coding>
                <system value="http://hl7.org/fhir/sid/icd-10-am"/>
                <code value="K01.1"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <extension
                     url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis-type">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://nphies.sa/terminology/CodeSystem/diagnosis-type"/>
                <code value="principal"/>
              </coding>
            </valueCodeableConcept>
          </extension>
        </extension>
        <extension
                   url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis">
          <extension
                     url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis-sequence">
            <valuePositiveInt value="2"/>
          </extension>
          <extension
                     url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis-diagnosisCodeableConcept">
            <valueCodeableConcept>
              <coding>
                <system value="http://hl7.org/fhir/sid/icd-10-am"/>
                <code value="V49.4"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <extension
                     url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis-type">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://nphies.sa/terminology/CodeSystem/diagnosis-type"/>
                <code value="secondary"/>
              </coding>
            </valueCodeableConcept>
          </extension>
        </extension>
        <identifier>
          <system value="http://sni.com.sa/identifiers/advanced-priorauth"/>
          <value value="AdvAuth-300982300"/>
        </identifier>
        <status value="active"/>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
            <code value="oral"/>
          </coding>
        </type>
        <subType>
          <coding>
            <system
                    value="http://nphies.sa/terminology/CodeSystem/claim-subtype"/>
            <code value="op"/>
          </coding>
        </subType>
        <use value="preauthorization"/>
        <patient>
          <reference value="http://sni.com.sa/Patient/123454186"/>
        </patient>
        <created value="2022-07-18"/>
        <insurer>
          <reference
                     value="http://sni.com.sa/Organization/bff3aa1fbd3648619ac082357bf135db"/>
        </insurer>
        <outcome value="complete"/>
        <preAuthRef value="AdAuth-150123-1530"/>
        <preAuthPeriod>
          <start value="2022-09-15T18:10:44.732+00:00"/>
          <end value="2022-10-15T18:10:44.732+00:00"/>
        </preAuthPeriod>
        <addItem>
          <extension
                     url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-maternity">
            <valueBoolean value="false"/>
          </extension>
          <extension
                     url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://nphies.sa/terminology/CodeSystem/adjudication-outcome"/>
                <code value="approved"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <extension
                     url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-sequence">
            <valuePositiveInt value="1"/>
          </extension>
          <extension
                     url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-informationSequence">
            <valuePositiveInt value="1"/>
          </extension>
          <extension
                     url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-package">
            <valueBoolean value="false"/>
          </extension>
          <productOrService>
            <coding>
              <system
                      value="http://nphies.sa/terminology/CodeSystem/oral-health-op"/>
              <code value="658"/>
            </coding>
          </productOrService>
          <quantity>
            <value value="1"/>
          </quantity>
          <bodySite>
            <coding>
              <system
                      value="http://nphies.sa/terminology/CodeSystem/fdi-oral-region"/>
              <code value="25"/>
            </coding>
          </bodySite>
          <subSite>
            <coding>
              <system
                      value="http://nphies.sa/terminology/CodeSystem/fdi-tooth-surface"/>
              <code value="V"/>
            </coding>
          </subSite>
          <noteNumber value="1"/>
          <adjudication>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/adjudication"/>
                <code value="eligible"/>
              </coding>
            </category>
            <amount>
              <value value="100"/>
              <currency value="SAR"/>
            </amount>
          </adjudication>
          <adjudication>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/adjudication"/>
                <code value="copay"/>
              </coding>
            </category>
            <amount>
              <value value="0"/>
              <currency value="SAR"/>
            </amount>
          </adjudication>
          <adjudication>
            <category>
              <coding>
                <system
                        value="http://nphies.sa/terminology/CodeSystem/ksa-adjudication"/>
                <code value="approved-quantity"/>
              </coding>
            </category>
            <amount>
              <value value="1"/>
              <currency value="SAR"/>
            </amount>
          </adjudication>
          <adjudication>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/adjudication"/>
                <code value="tax"/>
              </coding>
            </category>
            <amount>
              <value value="15"/>
              <currency value="SAR"/>
            </amount>
          </adjudication>
          <adjudication>
            <category>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/adjudication"/>
                <code value="benefit"/>
              </coding>
            </category>
            <amount>
              <value value="100"/>
              <currency value="SAR"/>
            </amount>
          </adjudication>
        </addItem>
        <total>
          <category>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/adjudication"/>
              <code value="benefit"/>
            </coding>
          </category>
          <amount>
            <value value="100"/>
            <currency value="SAR"/>
          </amount>
        </total>
        <processNote>
          <number value="1"/>
          <type value="display"/>
          <text
                value="Process Note Text to give more general information or direction"/>
        </processNote>
        <insurance>
          <sequence value="1"/>
          <focal value="false"/>
          <coverage>
            <reference value="http://sni.com.sa/Coverage/1333"/>
          </coverage>
        </insurance>
      </ClaimResponse>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://sni.com.sa/Coverage/1333"/>
    <resource>
      <Coverage>
        <id value="1333"/>
        <meta>
          <profile
                   value="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|0.3.0"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Coverage_1333"> </a><p class="res-header-id"><b>Generated Narrative: Coverage 1333</b></p><a name="1333"> </a><a name="hc1333"> </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-coverage.html">Nphies Coverageversion: null0.3.0)</a></p></div><p><b>identifier</b>: <code>http://sni.com.sa/identifiers/memberid</code>/0000000001</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/coverage-type EHCPOL}">extended healthcare</span></p><p><b>policyHolder</b>: <a href="Organization-13.html">Organization Policy Holder Organization</a></p><p><b>subscriber</b>: <a href="Patient-123454186.html">Ahmad Khaled Abbas(official) Male, DoB: 1984-12-25 ( Passport Number: G12345678)</a></p><p><b>beneficiary</b>: <a href="Patient-123454186.html">Ahmad Khaled Abbas(official) Male, DoB: 1984-12-25 ( Passport Number: G12345678)</a></p><p><b>dependent</b>: 01</p><p><b>relationship</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}">Self</span></p><p><b>payor</b>: <a href="Organization-bff3aa1fbd3648619ac082357bf135db.html">Organization Saudi National Insurance</a></p><h3>Classes</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Value</b></td><td><b>Name</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/coverage-class plan}">Plan</span></td><td>CB135</td><td>Insurance Plan A</td></tr></table><p><b>network</b>: Golden C</p></div>
        </text>
        <identifier>
          <system value="http://sni.com.sa/identifiers/memberid"/>
          <value value="0000000001"/>
        </identifier>
        <status value="active"/>
        <type>
          <coding>
            <system
                    value="http://nphies.sa/terminology/CodeSystem/coverage-type"/>
            <code value="EHCPOL"/>
            <display value="extended healthcare"/>
          </coding>
        </type>
        <policyHolder>🔗 
          <reference value="Organization/13"/>
        </policyHolder>
        <subscriber>🔗 
          <reference value="Patient/123454186"/>
        </subscriber>
        <beneficiary>🔗 
          <reference value="Patient/123454186"/>
        </beneficiary>
        <dependent value="01"/>
        <relationship>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
            <code value="self"/>
            <display value="Self"/>
          </coding>
        </relationship>
        <payor>🔗 
          <reference value="Organization/bff3aa1fbd3648619ac082357bf135db"/>
        </payor>
        <class>
          <type>
            <coding>
              <system
                      value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
              <code value="plan"/>
            </coding>
          </type>
          <value value="CB135"/>
          <name value="Insurance Plan A"/>
        </class>
        <network value="Golden C"/>
      </Coverage>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://sni.com.sa/Organization/13"/>
    <resource>
      <Organization>
        <id value="13"/>
        <meta>
          <profile
                   value="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/policyholder-organization|0.3.0"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_13"> </a><p class="res-header-id"><b>Generated Narrative: Organization 13</b></p><a name="13"> </a><a name="hc13"> </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-policyholder-organization.html">Nphies Policy Holder Organizationversion: null0.3.0)</a></p></div><p><b>identifier</b>: <code>http://nphies.sa/identifiers/organization</code>/5009</p><p><b>active</b>: true</p><p><b>name</b>: Policy Holder Organization</p></div>
        </text>
        <identifier>
          <system value="http://nphies.sa/identifiers/organization"/>
          <value value="5009"/>
        </identifier>
        <active value="true"/>
        <name value="Policy Holder Organization"/>
      </Organization>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://sni.com.sa/Organization/b1b3432921324f97af3be9fd0b1a14ae"/>
    <resource>
      <Organization>
        <id value="b1b3432921324f97af3be9fd0b1a14ae"/>
        <meta>
          <profile
                   value="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization|0.3.0"/>
        </meta>
        <text>
          <status value="extensions"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_b1b3432921324f97af3be9fd0b1a14ae"> </a><p class="res-header-id"><b>Generated Narrative: Organization b1b3432921324f97af3be9fd0b1a14ae</b></p><a name="b1b3432921324f97af3be9fd0b1a14ae"> </a><a name="hcb1b3432921324f97af3be9fd0b1a14ae"> </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 1}">Hospital</span></p><p><b>identifier</b>: <code>http://nphies.sa/license/provider-license</code>/PR-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 General Hospital</p><p><b>address</b>: Salamah Street, Building 25, Suite 2, Riyadh Saudi Arabia(work)</p></div>
        </text>
        <extension
                   url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-provider-type">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://nphies.sa/terminology/CodeSystem/provider-type"/>
              <code value="1"/>
              <display value="Hospital"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <identifier>
          <system value="http://nphies.sa/license/provider-license"/>
          <value value="PR-FHIR"/>
        </identifier>
        <active value="true"/>
        <type>
          <coding>
            <system
                    value="http://nphies.sa/terminology/CodeSystem/organization-type"/>
            <code value="prov"/>
          </coding>
        </type>
        <name value="Saudi General Hospital"/>
        <address>
          <use value="work"/>
          <text
                value="Salamah Street, Building 25, Suite 2, Riyadh Saudi Arabia"/>
          <line value="Salamah Street, Building 25, Suite 2"/>
          <line value="Al Malga District"/>
          <city value="Riyadh"/>
          <country value="Saudi Arabia"/>
        </address>
      </Organization>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://sni.com.sa/Patient/123454186"/>
    <resource>
      <Patient>
        <id value="123454186"/>
        <meta>
          <profile
                   value="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|0.3.0"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Patient_123454186"> </a><p class="res-header-id"><b>Generated Narrative: Patient 123454186</b></p><a name="123454186"> </a><a name="hc123454186"> </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-patient.html">Nphies Patientversion: null0.3.0)</a></p></div><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Ahmad Khaled Abbas(official) Male, DoB: 1984-12-25 ( Passport Number: G12345678)</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Record is active">Active:</td><td>true</td><td style="background-color: #f3f5da" title="Known status of Patient">Deceased:</td><td>false</td></tr><tr><td style="background-color: #f3f5da" title="Known Marital status of Patient">Marital Status:</td><td colspan="3"><span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-MaritalStatus M}">Married</span></td></tr><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Detail</td><td colspan="3"><ul><li><a href="tel:+966512345691">+966512345691</a></li><li>Salamah Street, Building 25, Suite 2, Saudi Arabia(home)</li></ul></td></tr><tr><td style="background-color: #f3f5da" title="Patient occupation as per the nphies adopted list of occupations."><a href="StructureDefinition-extension-occupation.html">Patient Occupation</a></td><td colspan="3"><span title="Codes:{http://nphies.sa/terminology/CodeSystem/occupation business}">Business</span></td></tr></table></div>
        </text>
        <extension
                   url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation">
          <valueCodeableConcept>
            <coding>
              <system
                      value="http://nphies.sa/terminology/CodeSystem/occupation"/>
              <code value="business"/>
            </coding>
          </valueCodeableConcept>
        </extension>
        <identifier>
          <extension
                     url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-identifier-country">
            <valueCodeableConcept>
              <coding>
                <system value="urn:iso:std:iso:3166"/>
                <code value="SAU"/>
                <display value="Saudi Arabia"/>
              </coding>
            </valueCodeableConcept>
          </extension>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="PPN"/>
              <display value="Passport Number"/>
            </coding>
          </type>
          <system value="http://nphies.sa/identifier/passportnumber"/>
          <value value="G12345678"/>
        </identifier>
        <active value="true"/>
        <name>
          <use value="official"/>
          <text value="Ahmad Khaled Abbas"/>
          <family value="Ahmad"/>
          <given value="Khaled"/>
          <given value="Abbas"/>
        </name>
        <telecom>
          <system value="phone"/>
          <value value="+966512345691"/>
        </telecom>
        <gender value="male">
          <extension
                     url="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender">
            <valueCodeableConcept>
              <coding>
                <system
                        value="http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender"/>
                <code value="male"/>
              </coding>
            </valueCodeableConcept>
          </extension>
        </gender>
        <birthDate value="1984-12-25"/>
        <deceasedBoolean value="false"/>
        <address>
          <use value="home"/>
          <text value="Salamah Street, Building 25, Suite 2, Saudi Arabia"/>
          <line value="Salamah Street, Building 25, Suite 2"/>
          <line value="Al Malga District"/>
          <city value="Riyadh"/>
          <country value="Saudi Arabia"/>
        </address>
        <maritalStatus>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/v3-MaritalStatus"/>
            <code value="M"/>
          </coding>
        </maritalStatus>
      </Patient>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://sni.com.sa/Organization/bff3aa1fbd3648619ac082357bf135db"/>
    <resource>
      <Organization>
        <id value="bff3aa1fbd3648619ac082357bf135db"/>
        <meta>
          <profile
                   value="http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/insurer-organization|0.3.0"/>
        </meta>
        <text>
          <status value="generated"/>
          <div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_bff3aa1fbd3648619ac082357bf135db"> </a><p class="res-header-id"><b>Generated Narrative: Organization bff3aa1fbd3648619ac082357bf135db</b></p><a name="bff3aa1fbd3648619ac082357bf135db"> </a><a name="hcbff3aa1fbd3648619ac082357bf135db"> </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-insurer-organization.html">Nphies Insurer Organizationversion: null0.3.0)</a></p></div><p><b>identifier</b>: National Insurance Organization Identifier/INS-FHIR (use: official, )</p><p><b>active</b>: true</p><p><b>type</b>: <span title="Codes:{http://nphies.sa/terminology/CodeSystem/organization-type ins}">Insurance Company</span></p><p><b>name</b>: Saudi National Insurance</p><p><b>address</b>: Olaya Street, Building 70, Riyadh Saudi Arabia(work)</p></div>
        </text>
        <identifier>
          <use value="official"/>
          <type>
            <coding>
              <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
              <code value="NII"/>
            </coding>
          </type>
          <system value="http://nphies.sa/license/payer-license"/>
          <value value="INS-FHIR"/>
        </identifier>
        <active value="true"/>
        <type>
          <coding>
            <system
                    value="http://nphies.sa/terminology/CodeSystem/organization-type"/>
            <code value="ins"/>
          </coding>
        </type>
        <name value="Saudi National Insurance"/>
        <address>
          <use value="work"/>
          <text value="Olaya Street, Building 70, Riyadh Saudi Arabia"/>
          <line value="Olaya Street, Building 70"/>
          <line value="Al Olaya District"/>
          <city value="Riyadh"/>
          <country value="Saudi Arabia"/>
        </address>
      </Organization>
    </resource>
  </entry>
</Bundle>