13b - Payment Notice.json

{
	"resourceType": "Bundle",
	"id": "16b80922-b538-4ab3-9176-a80b51249060",
	"meta": {
		"profile": [
			"http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
		]
	},
	"type": "message",
	"timestamp": "2021-12-02T18:30:29.683Z",
	"entry": [
		{
			"fullUrl": "urn:uuid:790739e8-c8d0-44f8-b0e0-f89310ea9060",
			"resource": {
				"resourceType": "MessageHeader",
				"id": "790739e8-c8d0-44f8-b0e0-f89310ea9060",
				"meta": {
					"profile": [
						"http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/message-header|1.0.0"
					]
				},
				"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://nphies.sa/license/provider-license/PR-FHIR"
				},
				"response": {
					"identifier": "790739e8-c8d0-44f8-b0e0-f89310ea9060",
					"code": "ok"
				},
				"focus": [
					{
						"reference": "http://saudidentalclinic.com.sa/PaymentNotice/99060"
					}
				]
			}
		},
		{
			"fullUrl": "http://saudidentalclinic.com.sa/PaymentNotice/99060",
			"resource": {
				"resourceType": "PaymentNotice",
				"id": "99060",
				"meta": {
					"profile": [
						"http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/payment-notice|1.0.0"
					]
				},
				"identifier": [
					{
						"system": "http://sni.com.sa/paymentnotice",
						"value": "929060"
					}
				],
				"status": "active",
				"created": "2022-02-14",
				"provider": {
					"reference": "http://saudidentalclinic.com.sa/Organization/b1b3432921324f97af3be9fd0b1a14ae"
				},
				"payment": {
					"identifier": {
						"system": "http://sni.com.sa/paymentreconciliation",
						"value": "929060"
					}
				},
				"paymentDate": "2021-11-02",
				"payee": {
					"reference": "http://saudidentalclinic.com.sa/Organization/b1b3432921324f97af3be9fd0b1a14ae"
				},
				"recipient": {
					"type": "Organization",
					"identifier": {
						"system": "http://nphies.sa/license/nphies",
						"value": "NPHIES"
					}
				},
				"amount": {
					"value": 193.55,
					"currency": "SAR"
				},
				"paymentStatus": {
					"coding": [
						{
							"system": "http://terminology.hl7.org/CodeSystem/paymentstatus",
							"code": "cleared"
						}
					]
				}
			}
		},
		{
			"fullUrl": "http://saudidentalclinic.com.sa/Organization/b1b3432921324f97af3be9fd0b1a14ae",
			"resource": {
				"resourceType": "Organization",
				"id": "b1b3432921324f97af3be9fd0b1a14ae",
				"meta": {
					"profile": [
						"http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization|1.0.0"
					]
				},
				"identifier": [
					{
						"system": "http://nphies.sa/license/provider-license",
						"value": "PR-FHIR"
					}
				],
				"active": true,
				"type": [
					{
						"coding": [
							{
								"system": "http://nphies.sa/terminology/CodeSystem/organization-type",
								"code": "prov"
							}
						]
					}
				],
				"name": "Saudi Dentist Clinic"
			}
		}
	]
}