HL7 Vietnam VN Core FHIR Implementation Guide

Hướng dẫn triển khai FHIR cốt lõi Việt Nam — VN Core FHIR Implementation Guide
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Hướng dẫn triển khai FHIR cốt lõi Việt Nam — VN Core FHIR Implementation Guide - Draft for Community Review (v0.9.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Ví dụ: Giải trình bảng kê chi phí KCB đổi mức hưởng — Example: Itemized healthcare cost EOB with a mid-encounter benefit change

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{
  "resourceType" : "ExplanationOfBenefit",
  "id" : "ExampleExplanationOfBenefitItemizedMultiStage",
  "meta" : {
    "profile" : [
      🔗 "http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-itemized-healthcare-cost-explanation-of-benefit"
    ]
  },
  "language" : "vi",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ExplanationOfBenefit ExampleExplanationOfBenefitItemizedMultiStage</b></p><a name=\"ExampleExplanationOfBenefitItemizedMultiStage\"> </a><a name=\"hcExampleExplanationOfBenefitItemizedMultiStage\"> </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-itemized-healthcare-cost-explanation-of-benefit.html\">Giải trình bảng kê chi phí KCB chi tiết — VN Core Itemized Healthcare Cost Explanation of Benefit</a></p></div><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>billablePeriod</b>: 2026-03-01 --&gt; 2026-03-07</p><p><b>created</b>: 2026-03-12</p><p><b>insurer</b>: <a href=\"Organization-ExampleOrganizationBHXH.html\">Bảo hiểm xã hội Việt Nam</a></p><p><b>provider</b>: <a href=\"Organization-ExampleOrganizationChoRay.html\">Bệnh viện Chợ Rẫy</a></p><p><b>claim</b>: <a href=\"Claim-ExampleClaimItemizedMultiStage.html\">Bảng kê chi phí KCB chi tiết LK-ITEMIZED-2026-0001</a></p><p><b>claimResponse</b>: <a href=\"ClaimResponse-ExampleClaimResponseItemizedMultiStage.html\">Kết quả giám định đầy đủ cho bảng kê LK-ITEMIZED-2026-0001</a></p><p><b>outcome</b>: Processing Complete</p><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://hl7.org/fhir/sid/icd-10 K35.8}\">Acute appendicitis, other and unspecified</span></td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-diagnosistype principal}\">Principal Diagnosis</span></td></tr></table><blockquote><p><b>insurance</b></p><blockquote><p><b>Giai đoạn hưởng bảo hiểm — Coverage Benefit Stage</b></p><ul><li>sequence: 1</li><li>period: 2026-03-01 --&gt; 2026-03-04</li><li>benefitLevel: 80</li></ul></blockquote><blockquote><p><b>Giai đoạn hưởng bảo hiểm — Coverage Benefit Stage</b></p><ul><li>sequence: 2</li><li>period: 2026-03-05 --&gt; 2026-03-07</li><li>benefitLevel: 100</li></ul></blockquote><p><b>focal</b>: true</p><p><b>coverage</b>: <a href=\"Coverage-ExampleCoverageBHYTNew.html\">Thẻ BHYT Nguyễn Văn An được giám định</a></p></blockquote><blockquote><p><b>item</b></p><p><b>Liên kết dòng chi phí với giai đoạn hưởng — Item Benefit Stage Sequence</b>: 1</p><blockquote><p><b>Thông tin chi phí BHYT — Insurance Cost Info Extension</b></p><ul><li>scope: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs 1}\">Trong phạm vi hưởng BHYT</span></li><li>paymentRatio: 100</li><li>benefitLevel: 80</li><li>servicePaymentRatio: 100</li><li>insuranceUnitPrice: <span title=\"Vietnamese Dong\">₫200.000</span> (VND)</li><li>insuranceLineAmount: <span title=\"Vietnamese Dong\">₫200.000</span> (VND)</li></ul></blockquote><p><b>sequence</b>: 1</p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs 1}\">Khám bệnh</span></p><p><b>productOrService</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-examination-code-cs 10.22}\">Khám chuyên khoa Ngoại tiêu hóa</span></p><p><b>serviced</b>: 2026-03-02</p><p><b>quantity</b>: 1 lần</p><h3>UnitPrices</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>200000</td><td>Vietnamese đồng</td></tr></table><h3>Nets</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>200000</td><td>Vietnamese đồng</td></tr></table><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>200000</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>200000</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>160000</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>40000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs other-fund}\">Nguồn khác</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>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs patient-self-pay}\">Người bệnh tự trả</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>Vietnamese đồng</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>Liên kết dòng chi phí với giai đoạn hưởng — Item Benefit Stage Sequence</b>: 1</p><blockquote><p><b>Thông tin chi phí BHYT — Insurance Cost Info Extension</b></p><ul><li>scope: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs 1}\">Trong phạm vi hưởng BHYT</span></li><li>paymentRatio: 100</li><li>benefitLevel: 80</li><li>servicePaymentRatio: 100</li><li>insuranceUnitPrice: <span title=\"Vietnamese Dong\">₫300.000</span> (VND)</li><li>insuranceLineAmount: <span title=\"Vietnamese Dong\">₫300.000</span> (VND)</li></ul></blockquote><p><b>sequence</b>: 2</p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs 3}\">Xét nghiệm</span></p><p><b>productOrService</b>: <span title=\"Codes:\">Xét nghiệm công thức máu toàn phần</span></p><p><b>serviced</b>: 2026-03-04</p><p><b>quantity</b>: 1 lần</p><h3>UnitPrices</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>300000</td><td>Vietnamese đồng</td></tr></table><h3>Nets</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>300000</td><td>Vietnamese đồng</td></tr></table><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>300000</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>300000</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>240000</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>60000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs other-fund}\">Nguồn khác</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>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs patient-self-pay}\">Người bệnh tự trả</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>Vietnamese đồng</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>Liên kết dòng chi phí với giai đoạn hưởng — Item Benefit Stage Sequence</b>: 2</p><blockquote><p><b>Thông tin chi phí BHYT — Insurance Cost Info Extension</b></p><ul><li>scope: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs 1}\">Trong phạm vi hưởng BHYT</span></li><li>paymentRatio: 100</li><li>benefitLevel: 100</li><li>servicePaymentRatio: 100</li><li>insuranceUnitPrice: <span title=\"Vietnamese Dong\">₫1.000.000</span> (VND)</li><li>insuranceLineAmount: <span title=\"Vietnamese Dong\">₫1.000.000</span> (VND)</li></ul></blockquote><p><b>sequence</b>: 3</p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs 9}\">Thiết bị y tế</span></p><p><b>productOrService</b>: <span title=\"Codes:\">Gói thiết bị y tế can thiệp mạch</span></p><p><b>serviced</b>: 2026-03-05</p><p><b>quantity</b>: 1 lần</p><h3>UnitPrices</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>1000000</td><td>Vietnamese đồng</td></tr></table><h3>Nets</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>1000000</td><td>Vietnamese đồng</td></tr></table><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>1000000</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>1000000</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>1000000</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>0</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs other-fund}\">Nguồn khác</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>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs patient-self-pay}\">Người bệnh tự trả</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>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>detail</b></p><blockquote><p><b>Thông tin chi phí BHYT — Insurance Cost Info Extension</b></p><ul><li>scope: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs 1}\">Trong phạm vi hưởng BHYT</span></li><li>paymentRatio: 100</li><li>servicePaymentRatio: 100</li><li>insuranceUnitPrice: <span title=\"Vietnamese Dong\">₫800.000</span> (VND)</li><li>insuranceLineAmount: <span title=\"Vietnamese Dong\">₫800.000</span> (VND)</li></ul></blockquote><p><b>sequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:\">Stent mạch vành</span></p><p><b>quantity</b>: 1 cái</p><h3>UnitPrices</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>800000</td><td>Vietnamese đồng</td></tr></table><h3>Nets</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>800000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>detail</b></p><blockquote><p><b>Thông tin chi phí BHYT — Insurance Cost Info Extension</b></p><ul><li>scope: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs 1}\">Trong phạm vi hưởng BHYT</span></li><li>paymentRatio: 100</li><li>servicePaymentRatio: 100</li><li>insuranceUnitPrice: <span title=\"Vietnamese Dong\">₫200.000</span> (VND)</li><li>insuranceLineAmount: <span title=\"Vietnamese Dong\">₫200.000</span> (VND)</li></ul></blockquote><p><b>sequence</b>: 2</p><p><b>productOrService</b>: <span title=\"Codes:\">Bóng nong mạch vành</span></p><p><b>quantity</b>: 1 cái</p><h3>UnitPrices</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>200000</td><td>Vietnamese đồng</td></tr></table><h3>Nets</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>200000</td><td>Vietnamese đồng</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>Liên kết dòng chi phí với giai đoạn hưởng — Item Benefit Stage Sequence</b>: 2</p><blockquote><p><b>Thông tin chi phí BHYT — Insurance Cost Info Extension</b></p><ul><li>scope: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs 1}\">Trong phạm vi hưởng BHYT</span></li><li>paymentRatio: 80</li><li>benefitLevel: 100</li><li>servicePaymentRatio: 100</li><li>insuranceUnitPrice: <span title=\"Vietnamese Dong\">₫50.000</span> (VND)</li><li>insuranceLineAmount: <span title=\"Vietnamese Dong\">₫400.000</span> (VND)</li></ul></blockquote><blockquote><p><b>Chi tiết nguồn khác chi trả theo dòng — Other Fund Breakdown Extension</b></p><ul><li>stateBudget: <span title=\"Vietnamese Dong\">₫50.000</span> (VND)</li></ul></blockquote><p><b>sequence</b>: 4</p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs 8}\">Thuốc, dịch truyền</span></p><p><b>productOrService</b>: <span title=\"Codes:{http://www.whocc.no/atc J01DD04}\">Ceftriaxone 2 g bột pha tiêm</span></p><p><b>serviced</b>: 2026-03-06</p><p><b>quantity</b>: 10 lọ</p><h3>UnitPrices</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>50000</td><td>Vietnamese đồng</td></tr></table><h3>Nets</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>500000</td><td>Vietnamese đồng</td></tr></table><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>500000</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>400000</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>400000</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>0</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs other-fund}\">Nguồn khác</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>50000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs patient-self-pay}\">Người bệnh tự trả</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>50000</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>2000000</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>1900000</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>1800000</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>100000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs other-fund}\">Nguồn khác</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>50000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs patient-self-pay}\">Người bệnh tự trả</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>50000</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 complete}\">Complete</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>1800000</td><td>Vietnamese đồng</td></tr></table></blockquote><p><b>benefitPeriod</b>: 2026-01-01 --&gt; 2026-12-31</p></div>"
  },
  "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"
  },
  "billablePeriod" : {
    "start" : "2026-03-01",
    "end" : "2026-03-07"
  },
  "created" : "2026-03-12",
  "insurer" : {
    🔗 "reference" : "Organization/ExampleOrganizationBHXH",
    "display" : "Bảo hiểm xã hội Việt Nam"
  },
  "provider" : {
    🔗 "reference" : "Organization/ExampleOrganizationChoRay",
    "display" : "Bệnh viện Chợ Rẫy"
  },
  "claim" : {
    🔗 "reference" : "Claim/ExampleClaimItemizedMultiStage",
    "display" : "Bảng kê chi phí KCB chi tiết LK-ITEMIZED-2026-0001"
  },
  "claimResponse" : {
    🔗 "reference" : "ClaimResponse/ExampleClaimResponseItemizedMultiStage",
    "display" : "Kết quả giám định đầy đủ cho bảng kê LK-ITEMIZED-2026-0001"
  },
  "outcome" : "complete",
  "diagnosis" : [
    {
      "sequence" : 1,
      "diagnosisCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://hl7.org/fhir/sid/icd-10",
            "code" : "K35.8",
            "display" : "Acute appendicitis, other and unspecified"
          }
        ]
      },
      "type" : [
        {
          "coding" : [
            {
              "system" : "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
              "code" : "principal",
              "display" : "Principal Diagnosis"
            }
          ]
        }
      ]
    }
  ],
  "insurance" : [
    {
      "extension" : [
        {
          "extension" : [
            {
              "url" : "sequence",
              "valuePositiveInt" : 1
            },
            {
              "url" : "period",
              "valuePeriod" : {
                "start" : "2026-03-01",
                "end" : "2026-03-04"
              }
            },
            {
              "url" : "benefitLevel",
              "valueDecimal" : 80
            }
          ],
          "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage"
        },
        {
          "extension" : [
            {
              "url" : "sequence",
              "valuePositiveInt" : 2
            },
            {
              "url" : "period",
              "valuePeriod" : {
                "start" : "2026-03-05",
                "end" : "2026-03-07"
              }
            },
            {
              "url" : "benefitLevel",
              "valueDecimal" : 100
            }
          ],
          "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage"
        }
      ],
      "focal" : true,
      "coverage" : {
        🔗 "reference" : "Coverage/ExampleCoverageBHYTNew",
        "display" : "Thẻ BHYT Nguyễn Văn An được giám định"
      }
    }
  ],
  "item" : [
    {
      "extension" : [
        {
          "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence",
          "valuePositiveInt" : 1
        },
        {
          "extension" : [
            {
              "url" : "scope",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs",
                    "code" : "1",
                    "display" : "Trong phạm vi hưởng BHYT"
                  }
                ]
              }
            },
            {
              "url" : "paymentRatio",
              "valueDecimal" : 100
            },
            {
              "url" : "benefitLevel",
              "valueDecimal" : 80
            },
            {
              "url" : "servicePaymentRatio",
              "valueDecimal" : 100
            },
            {
              "url" : "insuranceUnitPrice",
              "valueMoney" : {
                "value" : 200000,
                "currency" : "VND"
              }
            },
            {
              "url" : "insuranceLineAmount",
              "valueMoney" : {
                "value" : 200000,
                "currency" : "VND"
              }
            }
          ],
          "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
        }
      ],
      "sequence" : 1,
      "category" : {
        "coding" : [
          {
            "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs",
            "code" : "1",
            "display" : "Khám bệnh"
          }
        ]
      },
      "productOrService" : {
        "coding" : [
          {
            "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-examination-code-cs",
            "code" : "10.22",
            "display" : "Ngoại tiêu hóa"
          }
        ],
        "text" : "Khám chuyên khoa Ngoại tiêu hóa"
      },
      "servicedDate" : "2026-03-02",
      "quantity" : {
        "value" : 1,
        "unit" : "lần"
      },
      "unitPrice" : {
        "value" : 200000,
        "currency" : "VND"
      },
      "net" : {
        "value" : 200000,
        "currency" : "VND"
      },
      "adjudication" : [
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "submitted",
                "display" : "Submitted Amount"
              }
            ]
          },
          "amount" : {
            "value" : 200000,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "eligible",
                "display" : "Eligible Amount"
              }
            ]
          },
          "amount" : {
            "value" : 200000,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "benefit",
                "display" : "Benefit Amount"
              }
            ]
          },
          "amount" : {
            "value" : 160000,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "copay",
                "display" : "CoPay"
              }
            ]
          },
          "amount" : {
            "value" : 40000,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs",
                "code" : "other-fund",
                "display" : "Nguồn khác"
              }
            ]
          },
          "amount" : {
            "value" : 0,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs",
                "code" : "patient-self-pay",
                "display" : "Người bệnh tự trả"
              }
            ]
          },
          "amount" : {
            "value" : 0,
            "currency" : "VND"
          }
        }
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence",
          "valuePositiveInt" : 1
        },
        {
          "extension" : [
            {
              "url" : "scope",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs",
                    "code" : "1",
                    "display" : "Trong phạm vi hưởng BHYT"
                  }
                ]
              }
            },
            {
              "url" : "paymentRatio",
              "valueDecimal" : 100
            },
            {
              "url" : "benefitLevel",
              "valueDecimal" : 80
            },
            {
              "url" : "servicePaymentRatio",
              "valueDecimal" : 100
            },
            {
              "url" : "insuranceUnitPrice",
              "valueMoney" : {
                "value" : 300000,
                "currency" : "VND"
              }
            },
            {
              "url" : "insuranceLineAmount",
              "valueMoney" : {
                "value" : 300000,
                "currency" : "VND"
              }
            }
          ],
          "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
        }
      ],
      "sequence" : 2,
      "category" : {
        "coding" : [
          {
            "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs",
            "code" : "3",
            "display" : "Xét nghiệm"
          }
        ]
      },
      "productOrService" : {
        "text" : "Xét nghiệm công thức máu toàn phần"
      },
      "servicedDate" : "2026-03-04",
      "quantity" : {
        "value" : 1,
        "unit" : "lần"
      },
      "unitPrice" : {
        "value" : 300000,
        "currency" : "VND"
      },
      "net" : {
        "value" : 300000,
        "currency" : "VND"
      },
      "adjudication" : [
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "submitted",
                "display" : "Submitted Amount"
              }
            ]
          },
          "amount" : {
            "value" : 300000,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "eligible",
                "display" : "Eligible Amount"
              }
            ]
          },
          "amount" : {
            "value" : 300000,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "benefit",
                "display" : "Benefit Amount"
              }
            ]
          },
          "amount" : {
            "value" : 240000,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "copay",
                "display" : "CoPay"
              }
            ]
          },
          "amount" : {
            "value" : 60000,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs",
                "code" : "other-fund",
                "display" : "Nguồn khác"
              }
            ]
          },
          "amount" : {
            "value" : 0,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs",
                "code" : "patient-self-pay",
                "display" : "Người bệnh tự trả"
              }
            ]
          },
          "amount" : {
            "value" : 0,
            "currency" : "VND"
          }
        }
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence",
          "valuePositiveInt" : 2
        },
        {
          "extension" : [
            {
              "url" : "scope",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs",
                    "code" : "1",
                    "display" : "Trong phạm vi hưởng BHYT"
                  }
                ]
              }
            },
            {
              "url" : "paymentRatio",
              "valueDecimal" : 100
            },
            {
              "url" : "benefitLevel",
              "valueDecimal" : 100
            },
            {
              "url" : "servicePaymentRatio",
              "valueDecimal" : 100
            },
            {
              "url" : "insuranceUnitPrice",
              "valueMoney" : {
                "value" : 1000000,
                "currency" : "VND"
              }
            },
            {
              "url" : "insuranceLineAmount",
              "valueMoney" : {
                "value" : 1000000,
                "currency" : "VND"
              }
            }
          ],
          "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
        }
      ],
      "sequence" : 3,
      "category" : {
        "coding" : [
          {
            "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs",
            "code" : "9",
            "display" : "Thiết bị y tế"
          }
        ]
      },
      "productOrService" : {
        "text" : "Gói thiết bị y tế can thiệp mạch"
      },
      "servicedDate" : "2026-03-05",
      "quantity" : {
        "value" : 1,
        "unit" : "lần"
      },
      "unitPrice" : {
        "value" : 1000000,
        "currency" : "VND"
      },
      "net" : {
        "value" : 1000000,
        "currency" : "VND"
      },
      "adjudication" : [
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "submitted",
                "display" : "Submitted Amount"
              }
            ]
          },
          "amount" : {
            "value" : 1000000,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "eligible",
                "display" : "Eligible Amount"
              }
            ]
          },
          "amount" : {
            "value" : 1000000,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "benefit",
                "display" : "Benefit Amount"
              }
            ]
          },
          "amount" : {
            "value" : 1000000,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "copay",
                "display" : "CoPay"
              }
            ]
          },
          "amount" : {
            "value" : 0,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs",
                "code" : "other-fund",
                "display" : "Nguồn khác"
              }
            ]
          },
          "amount" : {
            "value" : 0,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs",
                "code" : "patient-self-pay",
                "display" : "Người bệnh tự trả"
              }
            ]
          },
          "amount" : {
            "value" : 0,
            "currency" : "VND"
          }
        }
      ],
      "detail" : [
        {
          "extension" : [
            {
              "extension" : [
                {
                  "url" : "scope",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs",
                        "code" : "1",
                        "display" : "Trong phạm vi hưởng BHYT"
                      }
                    ]
                  }
                },
                {
                  "url" : "paymentRatio",
                  "valueDecimal" : 100
                },
                {
                  "url" : "servicePaymentRatio",
                  "valueDecimal" : 100
                },
                {
                  "url" : "insuranceUnitPrice",
                  "valueMoney" : {
                    "value" : 800000,
                    "currency" : "VND"
                  }
                },
                {
                  "url" : "insuranceLineAmount",
                  "valueMoney" : {
                    "value" : 800000,
                    "currency" : "VND"
                  }
                }
              ],
              "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
            }
          ],
          "sequence" : 1,
          "productOrService" : {
            "text" : "Stent mạch vành"
          },
          "quantity" : {
            "value" : 1,
            "unit" : "cái"
          },
          "unitPrice" : {
            "value" : 800000,
            "currency" : "VND"
          },
          "net" : {
            "value" : 800000,
            "currency" : "VND"
          }
        },
        {
          "extension" : [
            {
              "extension" : [
                {
                  "url" : "scope",
                  "valueCodeableConcept" : {
                    "coding" : [
                      {
                        "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs",
                        "code" : "1",
                        "display" : "Trong phạm vi hưởng BHYT"
                      }
                    ]
                  }
                },
                {
                  "url" : "paymentRatio",
                  "valueDecimal" : 100
                },
                {
                  "url" : "servicePaymentRatio",
                  "valueDecimal" : 100
                },
                {
                  "url" : "insuranceUnitPrice",
                  "valueMoney" : {
                    "value" : 200000,
                    "currency" : "VND"
                  }
                },
                {
                  "url" : "insuranceLineAmount",
                  "valueMoney" : {
                    "value" : 200000,
                    "currency" : "VND"
                  }
                }
              ],
              "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
            }
          ],
          "sequence" : 2,
          "productOrService" : {
            "text" : "Bóng nong mạch vành"
          },
          "quantity" : {
            "value" : 1,
            "unit" : "cái"
          },
          "unitPrice" : {
            "value" : 200000,
            "currency" : "VND"
          },
          "net" : {
            "value" : 200000,
            "currency" : "VND"
          }
        }
      ]
    },
    {
      "extension" : [
        {
          "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence",
          "valuePositiveInt" : 2
        },
        {
          "extension" : [
            {
              "url" : "scope",
              "valueCodeableConcept" : {
                "coding" : [
                  {
                    "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs",
                    "code" : "1",
                    "display" : "Trong phạm vi hưởng BHYT"
                  }
                ]
              }
            },
            {
              "url" : "paymentRatio",
              "valueDecimal" : 80
            },
            {
              "url" : "benefitLevel",
              "valueDecimal" : 100
            },
            {
              "url" : "servicePaymentRatio",
              "valueDecimal" : 100
            },
            {
              "url" : "insuranceUnitPrice",
              "valueMoney" : {
                "value" : 50000,
                "currency" : "VND"
              }
            },
            {
              "url" : "insuranceLineAmount",
              "valueMoney" : {
                "value" : 400000,
                "currency" : "VND"
              }
            }
          ],
          "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
        },
        {
          "extension" : [
            {
              "url" : "stateBudget",
              "valueMoney" : {
                "value" : 50000,
                "currency" : "VND"
              }
            }
          ],
          "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown"
        }
      ],
      "sequence" : 4,
      "category" : {
        "coding" : [
          {
            "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs",
            "code" : "8",
            "display" : "Thuốc, dịch truyền"
          }
        ]
      },
      "productOrService" : {
        "coding" : [
          {
            "system" : "http://www.whocc.no/atc",
            "code" : "J01DD04",
            "display" : "Ceftriaxone"
          }
        ],
        "text" : "Ceftriaxone 2 g bột pha tiêm"
      },
      "servicedDate" : "2026-03-06",
      "quantity" : {
        "value" : 10,
        "unit" : "lọ"
      },
      "unitPrice" : {
        "value" : 50000,
        "currency" : "VND"
      },
      "net" : {
        "value" : 500000,
        "currency" : "VND"
      },
      "adjudication" : [
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "submitted",
                "display" : "Submitted Amount"
              }
            ]
          },
          "amount" : {
            "value" : 500000,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "eligible",
                "display" : "Eligible Amount"
              }
            ]
          },
          "amount" : {
            "value" : 400000,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "benefit",
                "display" : "Benefit Amount"
              }
            ]
          },
          "amount" : {
            "value" : 400000,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
                "code" : "copay",
                "display" : "CoPay"
              }
            ]
          },
          "amount" : {
            "value" : 0,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs",
                "code" : "other-fund",
                "display" : "Nguồn khác"
              }
            ]
          },
          "amount" : {
            "value" : 50000,
            "currency" : "VND"
          }
        },
        {
          "category" : {
            "coding" : [
              {
                "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs",
                "code" : "patient-self-pay",
                "display" : "Người bệnh tự trả"
              }
            ]
          },
          "amount" : {
            "value" : 50000,
            "currency" : "VND"
          }
        }
      ]
    }
  ],
  "total" : [
    {
      "category" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
            "code" : "submitted",
            "display" : "Submitted Amount"
          }
        ]
      },
      "amount" : {
        "value" : 2000000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
            "code" : "eligible",
            "display" : "Eligible Amount"
          }
        ]
      },
      "amount" : {
        "value" : 1900000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
            "code" : "benefit",
            "display" : "Benefit Amount"
          }
        ]
      },
      "amount" : {
        "value" : 1800000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
            "code" : "copay",
            "display" : "CoPay"
          }
        ]
      },
      "amount" : {
        "value" : 100000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [
          {
            "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs",
            "code" : "other-fund",
            "display" : "Nguồn khác"
          }
        ]
      },
      "amount" : {
        "value" : 50000,
        "currency" : "VND"
      }
    },
    {
      "category" : {
        "coding" : [
          {
            "system" : "http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs",
            "code" : "patient-self-pay",
            "display" : "Người bệnh tự trả"
          }
        ]
      },
      "amount" : {
        "value" : 50000,
        "currency" : "VND"
      }
    }
  ],
  "payment" : {
    "type" : {
      "coding" : [
        {
          "system" : "http://terminology.hl7.org/CodeSystem/ex-paymenttype",
          "code" : "complete",
          "display" : "Complete"
        }
      ]
    },
    "amount" : {
      "value" : 1800000,
      "currency" : "VND"
    }
  },
  "benefitPeriod" : {
    "start" : "2026-01-01",
    "end" : "2026-12-31"
  }
}