{
  "resourceType" : "ClaimResponse",
  "id" : "ExampleClaimResponsePartialDeny",
  "meta" : {
    "profile" : ["http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-claim-response"]
  },
  "language" : "vi",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse ExampleClaimResponsePartialDeny</b></p><a name=\"ExampleClaimResponsePartialDeny\"> </a><a name=\"hcExampleClaimResponsePartialDeny\"> </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-vn-core-claim-response.html\">Kết quả giải quyết BHYT VN Core — VN Core ClaimResponse Profile</a></p></div><p><b>identifier</b>: Mã phản hồi XML1 của Cổng tiếp nhận BHYT/XML1-20260322-000042</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>use</b>: Claim</p><p><b>patient</b>: <a href=\"Patient-ExamplePatientNguyenVanAn.html\">Nguyễn Văn An</a></p><p><b>created</b>: 2026-03-22</p><p><b>insurer</b>: <a href=\"Organization-ExampleOrganizationBHXH.html\">Bảo hiểm xã hội Việt Nam</a></p><p><b>request</b>: <a href=\"Claim-ExampleClaimBHYT.html\">Claim: extension = ,,Phí dịch vụ (FFS); identifier = Mã liên kết hồ sơ BHYT: VNMALK#LK-2026-000101; status = active; type = Institutional; subType = KCB đúng cơ sở nơi đăng ký KCB BHYT ban đầu; use = claim; created = 2026-03-17; priority = Normal</a></p><p><b>outcome</b>: Partial Processing</p><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 1</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted 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>150000</td><td>Vietnamese đồng</td></tr></table></blockquote><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>150000</td><td>Vietnamese đồng</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>30000</td><td>Vietnamese đồng</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>120000</td><td>Vietnamese đồng</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 2</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted 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>850000</td><td>Vietnamese đồng</td></tr></table></blockquote><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>850000</td><td>Vietnamese đồng</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>170000</td><td>Vietnamese đồng</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>680000</td><td>Vietnamese đồng</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 3</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted 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>3200000</td><td>Vietnamese đồng</td></tr></table></blockquote><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>2400000</td><td>Vietnamese đồng</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>480000</td><td>Vietnamese đồng</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>1920000</td><td>Vietnamese đồng</td></tr></table></blockquote></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted 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>4200000</td><td>Vietnamese đồng</td></tr></table></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>3400000</td><td>Vietnamese đồng</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>680000</td><td>Vietnamese đồng</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>2720000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>payment</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-paymenttype partial}\">Partial</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>2720000</td><td>Vietnamese đồng</td></tr></table></blockquote><h3>Errors</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>ItemSequence</b></td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td>3</td><td><span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-review-issue-cs LEGAL_NON_COMPLIANT_COST}\">Chi phí không đúng quy định pháp luật</span></td></tr></table></div>"
  },
  "identifier" : [{
    "type" : {
      "coding" : [{
        "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-identifier-type-cs",
        "code" : "BHYT_XML1_ID"
      }]
    },
    "system" : "http://fhir.hl7.org.vn/core/sid/bhyt-gateway-response-id",
    "value" : "XML1-20260322-000042"
  }],
  "status" : "active",
  "type" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
      "code" : "institutional",
      "display" : "Institutional"
    }]
  },
  "use" : "claim",
  "patient" : {
    "reference" : "Patient/ExamplePatientNguyenVanAn",
    "display" : "Nguyễn Văn An"
  },
  "created" : "2026-03-22",
  "insurer" : {
    "reference" : "Organization/ExampleOrganizationBHXH",
    "display" : "Bảo hiểm xã hội Việt Nam"
  },
  "request" : {
    "reference" : "Claim/ExampleClaimBHYT"
  },
  "outcome" : "partial",
  "item" : [{
    "itemSequence" : 1,
    "adjudication" : [{
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "submitted",
          "display" : "Submitted Amount"
        }]
      },
      "amount" : {
        "value" : 150000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "eligible",
          "display" : "Eligible Amount"
        }]
      },
      "amount" : {
        "value" : 150000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "copay",
          "display" : "CoPay"
        }]
      },
      "amount" : {
        "value" : 30000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "benefit",
          "display" : "Benefit Amount"
        }]
      },
      "amount" : {
        "value" : 120000,
        "currency" : "VND"
      }
    }]
  },
  {
    "itemSequence" : 2,
    "adjudication" : [{
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "submitted",
          "display" : "Submitted Amount"
        }]
      },
      "amount" : {
        "value" : 850000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "eligible",
          "display" : "Eligible Amount"
        }]
      },
      "amount" : {
        "value" : 850000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "copay",
          "display" : "CoPay"
        }]
      },
      "amount" : {
        "value" : 170000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "benefit",
          "display" : "Benefit Amount"
        }]
      },
      "amount" : {
        "value" : 680000,
        "currency" : "VND"
      }
    }]
  },
  {
    "itemSequence" : 3,
    "adjudication" : [{
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "submitted",
          "display" : "Submitted Amount"
        }]
      },
      "amount" : {
        "value" : 3200000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "eligible",
          "display" : "Eligible Amount"
        }]
      },
      "amount" : {
        "value" : 2400000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "copay",
          "display" : "CoPay"
        }]
      },
      "amount" : {
        "value" : 480000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
          "code" : "benefit",
          "display" : "Benefit Amount"
        }]
      },
      "amount" : {
        "value" : 1920000,
        "currency" : "VND"
      }
    }]
  }],
  "total" : [{
    "category" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
        "code" : "submitted",
        "display" : "Submitted Amount"
      }]
    },
    "amount" : {
      "value" : 4200000,
      "currency" : "VND"
    }
  },
  {
    "category" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
        "code" : "eligible",
        "display" : "Eligible Amount"
      }]
    },
    "amount" : {
      "value" : 3400000,
      "currency" : "VND"
    }
  },
  {
    "category" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
        "code" : "copay",
        "display" : "CoPay"
      }]
    },
    "amount" : {
      "value" : 680000,
      "currency" : "VND"
    }
  },
  {
    "category" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
        "code" : "benefit",
        "display" : "Benefit Amount"
      }]
    },
    "amount" : {
      "value" : 2720000,
      "currency" : "VND"
    }
  }],
  "payment" : {
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/ex-paymenttype",
        "code" : "partial",
        "display" : "Partial"
      }]
    },
    "amount" : {
      "value" : 2720000,
      "currency" : "VND"
    }
  },
  "error" : [{
    "itemSequence" : 3,
    "code" : {
      "coding" : [{
        "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-review-issue-cs",
        "code" : "LEGAL_NON_COMPLIANT_COST",
        "display" : "Chi phí không đúng quy định pháp luật"
      }]
    }
  }]
}