Healthcare Financial Services IG Edition 1
0.3.0 - STU-Ballot
Healthcare Financial Services IG Edition 1
0.3.0 - STU-Ballot
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
@prefix fhir: <http://hl7.org/fhir/> . @prefix owl: <http://www.w3.org/2002/07/owl#> . @prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix sct: <http://snomed.info/id/> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- a fhir:ClaimResponse ; fhir:nodeRole fhir:treeRoot ; fhir:id [ fhir:v "964567"] ; # fhir:meta [ ( fhir:profile [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/advanced-authorization|0.3.0"^^xsd:anyURI ; fhir:link <http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/advanced-authorization|0.3.0> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "extensions" ] ; fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse 964567</b></p><a name=\"964567\"> </a><a name=\"hc964567\"> </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 medication-dispense}\">Medication dispense</span></p><p><b>Newborn</b>: false</p><p><b>Service Provider Extension</b>: <a href=\"Organization-b1b3432921324f97af3be9fd0b1a14ae.html\">Organization Saudi General Hospital</a></p><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 I70.0}\">Atherosclerosis of aorta</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>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 vital-sign-systolic}\">Systolic</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueQuantity: 120 mm[Hg]<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM codemm[Hg] = 'mm[Hg]')</span></li></ul></blockquote><blockquote><p><b>Supporting Info Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence: 2</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-information-category vital-sign-diastolic}\">Diastolic</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueQuantity: 80 mm[Hg]<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM codemm[Hg] = 'mm[Hg]')</span></li></ul></blockquote><blockquote><p><b>Supporting Info Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence: 3</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-information-category vital-sign-height}\">Height</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueQuantity: 133 cm<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM codecm = 'cm')</span></li></ul></blockquote><blockquote><p><b>Supporting Info Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence: 4</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-information-category vital-sign-weight}\">Weight</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-reason: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/weight-absence-reason 999.9}\">Not Collected</span></li></ul></blockquote><blockquote><p><b>Supporting Info Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence: 5</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-information-category pulse}\">Pulse</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueQuantity: 100 /min<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code/min = '/min')</span></li></ul></blockquote><blockquote><p><b>Supporting Info Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence: 6</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-information-category temperature}\">Temperature</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueQuantity: 70 Cel<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM codeCel = 'Cel')</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-timingPeriod: 2023-12-05 09:20:15+0300 --> 2023-12-05 09:20:15+0300</li></ul></blockquote><blockquote><p><b>Supporting Info Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence: 7</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-information-category chief-complaint}\">chief complaint</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-code: <span title=\"Codes:{http://snomed.info/sct 81817003}\">Atherosclerosis of aorta</span></li></ul></blockquote><blockquote><p><b>Supporting Info Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence: 8</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-information-category oxygen-saturation}\">Oxygen Saturation</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueQuantity: 100 %<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code% = '%')</span></li></ul></blockquote><blockquote><p><b>Supporting Info Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence: 9</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-information-category respiratory-rate}\">Respiratory Rate</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueQuantity: 18 /min<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code/min = '/min')</span></li></ul></blockquote><blockquote><p><b>Supporting Info Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence: 10</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-information-category admission-weight}\">Admission Weight</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueQuantity: 100 kg<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM codekg = 'kg')</span></li></ul></blockquote><blockquote><p><b>Supporting Info Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence: 11</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-information-category patient-history}\">patient history</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueString: No systemic disease</li></ul></blockquote><blockquote><p><b>Supporting Info Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence: 12</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-information-category investigation-result}\">Investigation Result</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-code: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/investigation-result INP}\">Investigation(s) not performed</span></li></ul></blockquote><blockquote><p><b>Supporting Info Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence: 13</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-information-category treatment-plan}\">Treatment Plan</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueString: Surgery</li></ul></blockquote><blockquote><p><b>Supporting Info Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence: 14</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-information-category physical-examination}\">Physical Examination</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueString: Stable</li></ul></blockquote><blockquote><p><b>Supporting Info Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence: 15</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-information-category history-of-present-illness}\">history Of Present Illness</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueString: No history</li></ul></blockquote><blockquote><p><b>Supporting Info Extension</b></p><ul><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence: 16</li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-information-category onset}\">Onset</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-code: <span title=\"Codes:{http://hl7.org/fhir/sid/icd-10-am R07.1}\">Chest pain on breathing</span></li><li>http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-timingDate: 2023-12-05</li></ul></blockquote><p><b>identifier</b>: <code>http://sni.com.sa/identifiers/advanced-priorauth</code>/877b345a-c866-4cdd-9a99-d95da2969998</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type institutional}\">Institutional</span></p><p><b>subType</b>: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-subtype ip}\">InPatient</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href=\"Patient-123454186.html\">Ahmad Khaled Abbas(official) Male, DoB: 1984-12-25 ( Passport Number: G12345678)</a></p><p><b>created</b>: 2023-12-05</p><p><b>insurer</b>: <a href=\"Organization-bff3aa1fbd3648619ac082357bf135db.html\">Organization Saudi National Insurance</a></p><p><b>outcome</b>: Processing Complete</p><p><b>preAuthRef</b>: 23c6dc35-3b13-4837-be6a-fa68ed782a42</p><p><b>preAuthPeriod</b>: 2023-12-05 09:20:15+0300 --> 2023-12-05 09:20:15+0300</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>Diagnosis Sequence Extension</b>: 1</p><p><b>Information Sequence Extension</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/procedures 33509-00-00}\">Aorta endarterectomy</span></p><p><b>quantity</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>5000</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://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>5000</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>750</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><p><b>value</b>: 1</p></blockquote></blockquote><blockquote><p><b>total</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>5000</td><td>Saudi riyal</td></tr></table></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>5000</td><td>Saudi riyal</td></tr></table></blockquote><blockquote><p><b>total</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>total</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>750</td><td>Saudi riyal</td></tr></table></blockquote><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><a href=\"Coverage-1333.html\">Coverage: identifier = http://sni.com.sa/identifiers/memberid#0000000001; status = active; type = extended healthcare; dependent = 01; relationship = Self; network = Golden C</a></td></tr></table></div>"^^rdf:XMLLiteral ] ; # fhir:extension ( [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/adjudication-outcome"^^xsd:anyURI ] ; fhir:code [ fhir:v "approved" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-advancedAuth-reason"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/advancedAuth-reason"^^xsd:anyURI ] ; fhir:code [ fhir:v "medication-dispense" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-newborn"^^xsd:anyURI ] ; fhir:value [ a fhir:boolean ; fhir:v false ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-serviceProvider"^^xsd:anyURI ] ; fhir:value [ a fhir:Reference ; fhir:reference [ fhir:v "Organization/b1b3432921324f97af3be9fd0b1a14ae" ] ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "1"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis-diagnosisCodeableConcept"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://hl7.org/fhir/sid/icd-10-am"^^xsd:anyURI ] ; fhir:code [ fhir:v "I70.0" ] ; fhir:display [ fhir:v "Atherosclerosis of aorta" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis-type"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/diagnosis-type"^^xsd:anyURI ] ; fhir:code [ fhir:v "principal" ] ] ) ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "1"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "vital-sign-systolic" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueQuantity"^^xsd:anyURI ] ; fhir:value [ a fhir:Quantity ; fhir:value [ fhir:v "120"^^xsd:decimal ] ; fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "mm[Hg]" ] ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "2"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "vital-sign-diastolic" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueQuantity"^^xsd:anyURI ] ; fhir:value [ a fhir:Quantity ; fhir:value [ fhir:v "80"^^xsd:decimal ] ; fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "mm[Hg]" ] ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "3"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "vital-sign-height" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueQuantity"^^xsd:anyURI ] ; fhir:value [ a fhir:Quantity ; fhir:value [ fhir:v "133"^^xsd:decimal ] ; fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "cm" ] ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "4"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "vital-sign-weight" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-reason"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/weight-absence-reason"^^xsd:anyURI ] ; fhir:code [ fhir:v "999.9" ] ] ) ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "5"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "pulse" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueQuantity"^^xsd:anyURI ] ; fhir:value [ a fhir:Quantity ; fhir:value [ fhir:v "100"^^xsd:decimal ] ; fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "/min" ] ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "6"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "temperature" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueQuantity"^^xsd:anyURI ] ; fhir:value [ a fhir:Quantity ; fhir:value [ fhir:v "70"^^xsd:decimal ] ; fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "Cel" ] ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-timingPeriod"^^xsd:anyURI ] ; fhir:value [ a fhir:Period ; fhir:start [ fhir:v "2023-12-05T09:20:15.23+03:00"^^xsd:dateTime ] ; fhir:end [ fhir:v "2023-12-05T09:20:15.23+03:00"^^xsd:dateTime ] ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "7"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "chief-complaint" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-code"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ a sct:81817003 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "81817003" ] ; fhir:display [ fhir:v "Atherosclerosis of aorta" ] ] ) ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "8"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "oxygen-saturation" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueQuantity"^^xsd:anyURI ] ; fhir:value [ a fhir:Quantity ; fhir:value [ fhir:v "100"^^xsd:decimal ] ; fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "%" ] ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "9"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "respiratory-rate" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueQuantity"^^xsd:anyURI ] ; fhir:value [ a fhir:Quantity ; fhir:value [ fhir:v "18"^^xsd:decimal ] ; fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "/min" ] ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "10"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "admission-weight" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueQuantity"^^xsd:anyURI ] ; fhir:value [ a fhir:Quantity ; fhir:value [ fhir:v "100"^^xsd:decimal ] ; fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "kg" ] ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "11"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "patient-history" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueString"^^xsd:anyURI ] ; fhir:value [ a fhir:string ; fhir:v "No systemic disease" ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "12"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "investigation-result" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-code"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/investigation-result"^^xsd:anyURI ] ; fhir:code [ fhir:v "INP" ] ] ) ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "13"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "treatment-plan" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueString"^^xsd:anyURI ] ; fhir:value [ a fhir:string ; fhir:v "Surgery" ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "14"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "physical-examination" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueString"^^xsd:anyURI ] ; fhir:value [ a fhir:string ; fhir:v "Stable" ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "15"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "history-of-present-illness" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-valueString"^^xsd:anyURI ] ; fhir:value [ a fhir:string ; fhir:v "No history" ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo"^^xsd:anyURI ] ] [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "16"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-category"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "onset" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-code"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://hl7.org/fhir/sid/icd-10-am"^^xsd:anyURI ] ; fhir:code [ fhir:v "R07.1" ] ] ) ; fhir:text [ fhir:v "Chest pain on breathing" ] ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo-timingDate"^^xsd:anyURI ] ; fhir:value [ a fhir:date ; fhir:v "2023-12-05"^^xsd:date ] ] ) ; fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-supportingInfo"^^xsd:anyURI ] ] ) ; # fhir:identifier ( [ fhir:system [ fhir:v "http://sni.com.sa/identifiers/advanced-priorauth"^^xsd:anyURI ] ; fhir:value [ fhir:v "877b345a-c866-4cdd-9a99-d95da2969998" ] ] ) ; # fhir:status [ fhir:v "active"] ; # fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ] ; fhir:code [ fhir:v "institutional" ] ] ) ] ; # fhir:subType [ ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-subtype"^^xsd:anyURI ] ; fhir:code [ fhir:v "ip" ] ] ) ] ; # fhir:use [ fhir:v "preauthorization"] ; # fhir:patient [ fhir:reference [ fhir:v "Patient/123454186" ] ] ; # fhir:created [ fhir:v "2023-12-05"^^xsd:date] ; # fhir:insurer [ fhir:reference [ fhir:v "Organization/bff3aa1fbd3648619ac082357bf135db" ] ] ; # fhir:outcome [ fhir:v "complete"] ; # fhir:preAuthRef [ fhir:v "23c6dc35-3b13-4837-be6a-fa68ed782a42"] ; # fhir:preAuthPeriod [ fhir:start [ fhir:v "2023-12-05T09:20:15.23+03:00"^^xsd:dateTime ] ; fhir:end [ fhir:v "2023-12-05T09:20:15.23+03:00"^^xsd:dateTime ] ] ; # fhir:addItem ( [ ( fhir:extension [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-maternity"^^xsd:anyURI ] ; fhir:value [ a fhir:boolean ; fhir:v false ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/adjudication-outcome"^^xsd:anyURI ] ; fhir:code [ fhir:v "approved" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "1"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-diagnosis-sequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "1"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-informationSequence"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "1"^^xsd:positiveInteger ] ] ) ; fhir:productOrService [ ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/procedures"^^xsd:anyURI ] ; fhir:code [ fhir:v "33509-00-00" ] ; fhir:display [ fhir:v "Aorta endarterectomy" ] ] ) ] ; fhir:quantity [ fhir:value [ fhir:v "1"^^xsd:decimal ] ] ; ( fhir:adjudication [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ] ; fhir:code [ fhir:v "eligible" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "5000"^^xsd:decimal ] ; fhir:currency [ fhir:v "SAR" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ] ; fhir:code [ fhir:v "copay" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "0"^^xsd:decimal ] ; fhir:currency [ fhir:v "SAR" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ] ; fhir:code [ fhir:v "benefit" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "5000"^^xsd:decimal ] ; fhir:currency [ fhir:v "SAR" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ] ; fhir:code [ fhir:v "tax" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "750"^^xsd:decimal ] ; fhir:currency [ fhir:v "SAR" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/ksa-adjudication"^^xsd:anyURI ] ; fhir:code [ fhir:v "approved-quantity" ] ] ) ] ; fhir:value [ fhir:v "1"^^xsd:decimal ] ] ) ] ) ; # fhir:total ( [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ] ; fhir:code [ fhir:v "eligible" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "5000"^^xsd:decimal ] ; fhir:currency [ fhir:v "SAR" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ] ; fhir:code [ fhir:v "benefit" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "5000"^^xsd:decimal ] ; fhir:currency [ fhir:v "SAR" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ] ; fhir:code [ fhir:v "copay" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "0"^^xsd:decimal ] ; fhir:currency [ fhir:v "SAR" ] ] ] [ fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ] ; fhir:code [ fhir:v "tax" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "750"^^xsd:decimal ] ; fhir:currency [ fhir:v "SAR" ] ] ] ) ; # fhir:insurance ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:focal [ fhir:v true ] ; fhir:coverage [ fhir:reference [ fhir:v "Coverage/1333" ] ] ] ) . #
IG © 2024+ HL7 Saudi Arabia. Package nphies-fs#0.3.0 based on FHIR 4.0.1. Generated 2025-07-30
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