{
  "resourceType" : "ClaimResponse",
  "meta" : {
    "profile" : ["https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/NzPharmacyClaimResponse"]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse NzPharmacyClaimResponseExample</b></p><a name=\"NzPharmacyClaimResponseExample\"> </a><a name=\"hcNzPharmacyClaimResponseExample\"> </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-NzPharmacyClaimResponse.html\">New Zealand Pharmacy Claim Response</a></p></div><p><b>Shared Care Claim Trace Number</b>: <code>https://example.com/system</code>/TRN-123456789</p><p><b>identifier</b>: 123456789123456789</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>: Claim</p><p><b>patient</b>: <a href=\"Patient/example\">Patient/example</a></p><p><b>created</b>: 2025-01-01 00:00:00+0000</p><p><b>insurer</b>: <a href=\"Organization/pharmac\">Organization/pharmac</a></p><p><b>requestor</b>: <a href=\"Organization/pharmacy\">Organization/pharmacy</a></p><p><b>request</b>: <a href=\"Claim/123456789123456789\">Claim/123456789123456789</a></p><p><b>outcome</b>: Processing Complete</p><blockquote><p><b>item</b></p><p><b>Shared Care Product Or Service</b>: <span title=\"Codes:{https://standards.digital.health.nz/ns/purchase-unit PU1234}\">PU1234</span></p><p><b>itemSequence</b>: 1</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{https://standards.digital.health.nz/ns/pharmacy-adjudication-category amountpaid}\">Amount Paid</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>New Zealand dollar</td></tr></table></blockquote><blockquote><p><b>detail</b></p><p><b>detailSequence</b>: 1</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{https://standards.digital.health.nz/ns/pharmacy-adjudication-category drugcost}\">Drug Cost</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>50</td><td>New Zealand dollar</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{https://standards.digital.health.nz/ns/pharmacy-adjudication-category pharmaceuticalsubsidy}\">Pharmaceutical Subsidy</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>30</td><td>New Zealand dollar</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{https://standards.digital.health.nz/ns/pharmacy-adjudication-category amountpaid}\">Amount Paid</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>New Zealand dollar</td></tr></table></blockquote></blockquote></blockquote><blockquote><p><b>payment</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-paymenttype complete}\">Complete</span></p><p><b>date</b>: 2025-01-01</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>New Zealand dollar</td></tr></table></blockquote><h3>Errors</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ItemSequence</b></td><td><b>DetailSequence</b></td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>1</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication-error a002}\">Missing Creation Date</span></td></tr></table></div>"
  },
  "extension" : [{
    "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/shared-care-trace-number",
    "valueIdentifier" : {
      "system" : "https://example.com/system",
      "value" : "TRN-123456789"
    }
  }],
  "identifier" : [{
    "value" : "123456789123456789"
  }],
  "status" : "active",
  "type" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
      "code" : "pharmacy"
    }]
  },
  "use" : "claim",
  "patient" : {
    "reference" : "Patient/example"
  },
  "created" : "2025-01-01T00:00:00-00:00",
  "insurer" : {
    "reference" : "Organization/pharmac"
  },
  "requestor" : {
    "reference" : "Organization/pharmacy"
  },
  "request" : {
    "reference" : "Claim/123456789123456789"
  },
  "outcome" : "complete",
  "item" : [{
    "extension" : [{
      "url" : "https://fhir-ig.digital.health.nz/shared-care/StructureDefinition/shared-care-product-or-service",
      "valueCodeableConcept" : {
        "coding" : [{
          "system" : "https://standards.digital.health.nz/ns/purchase-unit",
          "code" : "PU1234"
        }]
      }
    }],
    "itemSequence" : 1,
    "adjudication" : [{
      "category" : {
        "coding" : [{
          "system" : "https://standards.digital.health.nz/ns/pharmacy-adjudication-category",
          "code" : "amountpaid"
        }]
      },
      "amount" : {
        "value" : 100,
        "currency" : "NZD"
      }
    }],
    "detail" : [{
      "detailSequence" : 1,
      "adjudication" : [{
        "category" : {
          "coding" : [{
            "system" : "https://standards.digital.health.nz/ns/pharmacy-adjudication-category",
            "code" : "drugcost"
          }]
        },
        "amount" : {
          "value" : 50,
          "currency" : "NZD"
        }
      },
      {
        "category" : {
          "coding" : [{
            "system" : "https://standards.digital.health.nz/ns/pharmacy-adjudication-category",
            "code" : "pharmaceuticalsubsidy"
          }]
        },
        "amount" : {
          "value" : 30,
          "currency" : "NZD"
        }
      },
      {
        "category" : {
          "coding" : [{
            "system" : "https://standards.digital.health.nz/ns/pharmacy-adjudication-category",
            "code" : "amountpaid"
          }]
        },
        "amount" : {
          "value" : 100,
          "currency" : "NZD"
        }
      }]
    }]
  }],
  "payment" : {
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/ex-paymenttype",
        "code" : "complete"
      }]
    },
    "date" : "2025-01-01",
    "amount" : {
      "value" : 100,
      "currency" : "NZD"
    }
  },
  "error" : [{
    "itemSequence" : 1,
    "detailSequence" : 1,
    "code" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/adjudication-error",
        "code" : "a002"
      }]
    }
  }]
}