# Giải trình quyền lợi BHYT VN Core — VN Core ExplanationOfBenefit Profile - Bộ Hướng dẫn Triển khai Core FHIR cho Việt Nam v0.5.0

## Hồ sơ tài nguyên: Giải trình quyền lợi BHYT VN Core — VN Core ExplanationOfBenefit Profile 

 
Profile ExplanationOfBenefit cho Việt Nam. Giải trình quyền lợi BHYT — kết quả giám định và thanh toán. Mapping từ chuẩn dữ liệu đầu ra phục vụ BHXH hiện hành (QĐ 130 → QĐ 4750 → QĐ 3176). Bảng kê chi phí theo QĐ 697/QĐ-BYT (19/3/2026) — 12 danh mục, 14 mã. Căn cứ: 
* QĐ 3176/QĐ-BYT (29/10/2024) — Chuẩn dữ liệu đầu ra phục vụ BHXH
* QĐ 697/QĐ-BYT (19/3/2026) — Mẫu bảng kê chi phí KCB
* Luật 51/2024/QH15 (27/11/2024) — sửa đổi Luật BHYT, hiệu lực 01/7/2025
* NĐ 188/2025/NĐ-CP — ban hành 01/7/2025, hiệu lực 15/8/2025 — Hướng dẫn thi hành Luật BHYT
* NĐ 90/2026/NĐ-CP (ban hành 30/03/2026, hiệu lực 15/05/2026 — future-effective) — xử phạt VPHC y tế, tham chiếu khi hồ sơ thanh toán/giải trình sai lệch
* Luật BHYT 2008 sửa đổi 2014
 

**Usages:**

* Examples for this Profile: [ExplanationOfBenefit/ExampleEOBChildUnder6](ExplanationOfBenefit-ExampleEOBChildUnder6.md), [ExplanationOfBenefit/ExampleEOBPartialCoverage](ExplanationOfBenefit-ExampleEOBPartialCoverage.md) and [ExplanationOfBenefit/ExampleExplanationOfBenefitBHYT](ExplanationOfBenefit-ExampleExplanationOfBenefitBHYT.md)
* CapabilityStatements using this Profile: [VN Core Server CapabilityStatement](CapabilityStatement-vn-core-server.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/hl7.fhir.vn.core|current/StructureDefinition/vn-core-explanation-of-benefit)

### Các dạng xem hình thức của nội dung hồ sơ

 [Mô tả profile, differential, snapshot và các biểu diễn liên quan](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

*  [Bảng phần tử chính](#tabs-key) 
*  [Bảng Differential](#tabs-diff) 
*  [Bảng Snapshot](#tabs-snap) 
*  [Thống kê/Tham chiếu](#tabs-summ) 
*  [Tất cả](#tabs-all) 

#### Terminology Bindings

#### Constraints

#### Terminology Bindings (Differential)

#### Terminology Bindings

#### Constraints

** Summary **

Must-Support: 27 elements

**Structures**

This structure refers to these other structures:

* [Bệnh nhân VN Core — VN Core Patient Profile (http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-patient)](StructureDefinition-vn-core-patient.md)
* [Cơ sở y tế VN Core — VN Core Organization Profile (http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-organization)](StructureDefinition-vn-core-organization.md)
* [Nhân viên y tế VN Core — VN Core Practitioner Profile (http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-practitioner)](StructureDefinition-vn-core-practitioner.md)
* [Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile (http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-practitioner-role)](StructureDefinition-vn-core-practitioner-role.md)
* [Thẻ BHYT VN Core — VN Core Coverage Profile (http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-coverage)](StructureDefinition-vn-core-coverage.md)

**Extensions**

This structure refers to these extensions:

* [http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary](StructureDefinition-vn-ext-claim-cost-summary.md)
* [http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period](StructureDefinition-vn-ext-claim-payment-period.md)
* [http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method](StructureDefinition-vn-ext-payment-method.md)
* [http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-source](StructureDefinition-vn-ext-payment-source.md)
* [http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-recurrent-wound-benefit](StructureDefinition-vn-ext-recurrent-wound-benefit.md)
* [http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-tender-info](StructureDefinition-vn-ext-tender-info.md)
* [http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-traditional-processing-method](StructureDefinition-vn-ext-traditional-processing-method.md)

**Slices**

This structure defines the following [Slices](http://hl7.org/fhir/R4/profiling.html#slices):

* The element 1 is sliced based on the values of ExplanationOfBenefit.diagnosis.diagnosis[x]
* The element 1 is sliced based on the values of ExplanationOfBenefit.procedure.procedure[x]

 **Dạng xem phần tử chính** 

#### Terminology Bindings

#### Constraints

 **Dạng xem Differential** 

#### Terminology Bindings (Differential)

 **Dạng xem SnapshotView** 

#### Terminology Bindings

#### Constraints

** Summary **

Must-Support: 27 elements

**Structures**

This structure refers to these other structures:

* [Bệnh nhân VN Core — VN Core Patient Profile (http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-patient)](StructureDefinition-vn-core-patient.md)
* [Cơ sở y tế VN Core — VN Core Organization Profile (http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-organization)](StructureDefinition-vn-core-organization.md)
* [Nhân viên y tế VN Core — VN Core Practitioner Profile (http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-practitioner)](StructureDefinition-vn-core-practitioner.md)
* [Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile (http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-practitioner-role)](StructureDefinition-vn-core-practitioner-role.md)
* [Thẻ BHYT VN Core — VN Core Coverage Profile (http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-coverage)](StructureDefinition-vn-core-coverage.md)

**Extensions**

This structure refers to these extensions:

* [http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary](StructureDefinition-vn-ext-claim-cost-summary.md)
* [http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period](StructureDefinition-vn-ext-claim-payment-period.md)
* [http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method](StructureDefinition-vn-ext-payment-method.md)
* [http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-source](StructureDefinition-vn-ext-payment-source.md)
* [http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-recurrent-wound-benefit](StructureDefinition-vn-ext-recurrent-wound-benefit.md)
* [http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-tender-info](StructureDefinition-vn-ext-tender-info.md)
* [http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-traditional-processing-method](StructureDefinition-vn-ext-traditional-processing-method.md)

**Slices**

This structure defines the following [Slices](http://hl7.org/fhir/R4/profiling.html#slices):

* The element 1 is sliced based on the values of ExplanationOfBenefit.diagnosis.diagnosis[x]
* The element 1 is sliced based on the values of ExplanationOfBenefit.procedure.procedure[x]

 

Biểu diễn khác của hồ sơ: [CSV](../StructureDefinition-vn-core-explanation-of-benefit.csv), [Excel](../StructureDefinition-vn-core-explanation-of-benefit.xlsx), [Schematron](../StructureDefinition-vn-core-explanation-of-benefit.sch) 



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "vn-core-explanation-of-benefit",
  "url" : "http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-explanation-of-benefit",
  "version" : "0.5.0",
  "name" : "VNCoreExplanationOfBenefit",
  "title" : "Giải trình quyền lợi BHYT VN Core — VN Core ExplanationOfBenefit Profile",
  "status" : "draft",
  "date" : "2026-03-21",
  "publisher" : "Omi HealthTech / VN Core FHIR Community Initiative",
  "contact" : [{
    "name" : "Omi HealthTech / VN Core FHIR Community Initiative",
    "telecom" : [{
      "system" : "url",
      "value" : "https://hl7.org.vn"
    },
    {
      "system" : "email",
      "value" : "info@hl7.org.vn"
    }]
  },
  {
    "name" : "Omi HealthTech (OmiGroup)",
    "telecom" : [{
      "system" : "url",
      "value" : "https://omihealthtech.vn"
    },
    {
      "system" : "url",
      "value" : "https://omigroup.vn"
    },
    {
      "system" : "email",
      "value" : "healthtech@omigroup.vn"
    }]
  }],
  "description" : "Profile ExplanationOfBenefit cho Việt Nam. Giải trình quyền lợi BHYT — kết quả giám định và thanh toán.\nMapping từ chuẩn dữ liệu đầu ra phục vụ BHXH hiện hành (QĐ 130 → QĐ 4750 → QĐ 3176).\nBảng kê chi phí theo QĐ 697/QĐ-BYT (19/3/2026) — 12 danh mục, 14 mã.\nCăn cứ:\n- QĐ 3176/QĐ-BYT (29/10/2024) — Chuẩn dữ liệu đầu ra phục vụ BHXH\n- QĐ 697/QĐ-BYT (19/3/2026) — Mẫu bảng kê chi phí KCB\n- Luật 51/2024/QH15 (27/11/2024) — sửa đổi Luật BHYT, hiệu lực 01/7/2025\n- NĐ 188/2025/NĐ-CP — ban hành 01/7/2025, hiệu lực 15/8/2025 — Hướng dẫn thi hành Luật BHYT\n- NĐ 90/2026/NĐ-CP (ban hành 30/03/2026, hiệu lực 15/05/2026 — future-effective) — xử phạt VPHC y tế, tham chiếu khi hồ sơ thanh toán/giải trình sai lệch\n- Luật BHYT 2008 sửa đổi 2014",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "VN",
      "display" : "Viet Nam"
    }]
  }],
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "workflow",
    "uri" : "http://hl7.org/fhir/workflow",
    "name" : "Workflow Pattern"
  },
  {
    "identity" : "w5",
    "uri" : "http://hl7.org/fhir/fivews",
    "name" : "FiveWs Pattern Mapping"
  },
  {
    "identity" : "v2",
    "uri" : "http://hl7.org/v2",
    "name" : "HL7 v2 Mapping"
  },
  {
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  }],
  "kind" : "resource",
  "abstract" : false,
  "type" : "ExplanationOfBenefit",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/ExplanationOfBenefit",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "ExplanationOfBenefit",
      "path" : "ExplanationOfBenefit"
    },
    {
      "id" : "ExplanationOfBenefit.extension",
      "path" : "ExplanationOfBenefit.extension",
      "slicing" : {
        "discriminator" : [{
          "type" : "value",
          "path" : "url"
        }],
        "ordered" : false,
        "rules" : "open"
      }
    },
    {
      "id" : "ExplanationOfBenefit.extension:costSummary",
      "path" : "ExplanationOfBenefit.extension",
      "sliceName" : "costSummary",
      "short" : "Tổng chi phí theo nhóm: thuốc, VTYT, BHYT, tự trả, cùng chi trả, nguồn khác",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary"]
      }],
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.extension:paymentPeriod",
      "path" : "ExplanationOfBenefit.extension",
      "sliceName" : "paymentPeriod",
      "short" : "Kỳ thanh toán BHYT (năm/tháng) — NAM_QT, THANG_QT",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period"]
      }]
    },
    {
      "id" : "ExplanationOfBenefit.extension:paymentMethod",
      "path" : "ExplanationOfBenefit.extension",
      "sliceName" : "paymentMethod",
      "short" : "Phương thức thanh toán (FFS/Capitation/DRG) — MA_PTTT_QT",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method"]
      }]
    },
    {
      "id" : "ExplanationOfBenefit.status",
      "path" : "ExplanationOfBenefit.status",
      "short" : "Trạng thái giải trình",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.type",
      "path" : "ExplanationOfBenefit.type",
      "short" : "Loại: institutional (nội trú), professional (ngoại trú)",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.use",
      "path" : "ExplanationOfBenefit.use",
      "short" : "Mục đích: claim (thanh toán)",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.patient",
      "path" : "ExplanationOfBenefit.patient",
      "short" : "Bệnh nhân",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-patient"]
      }],
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.created",
      "path" : "ExplanationOfBenefit.created",
      "short" : "Ngày tạo giải trình",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.insurer",
      "path" : "ExplanationOfBenefit.insurer",
      "short" : "Cơ quan BHXH thanh toán",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-organization"]
      }],
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.provider",
      "path" : "ExplanationOfBenefit.provider",
      "short" : "Cơ sở KCB thực hiện",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-organization",
        "http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-practitioner",
        "http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-practitioner-role"]
      }],
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.outcome",
      "path" : "ExplanationOfBenefit.outcome",
      "short" : "Kết quả giám định: complete | partial | error",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.diagnosis",
      "path" : "ExplanationOfBenefit.diagnosis",
      "short" : "Chẩn đoán — ICD-10 VN"
    },
    {
      "id" : "ExplanationOfBenefit.diagnosis.sequence",
      "path" : "ExplanationOfBenefit.diagnosis.sequence",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.diagnosis.diagnosis[x]",
      "path" : "ExplanationOfBenefit.diagnosis.diagnosis[x]",
      "slicing" : {
        "discriminator" : [{
          "type" : "type",
          "path" : "$this"
        }],
        "ordered" : false,
        "rules" : "open"
      }
    },
    {
      "id" : "ExplanationOfBenefit.diagnosis.diagnosis[x]:diagnosisCodeableConcept",
      "path" : "ExplanationOfBenefit.diagnosis.diagnosis[x]",
      "sliceName" : "diagnosisCodeableConcept",
      "short" : "Mã bệnh ICD-10 VN",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "mustSupport" : true,
      "binding" : {
        "strength" : "extensible",
        "valueSet" : "http://fhir.hl7.org.vn/core/ValueSet/vn-condition-code-vs"
      }
    },
    {
      "id" : "ExplanationOfBenefit.diagnosis.type",
      "path" : "ExplanationOfBenefit.diagnosis.type",
      "short" : "Loại chẩn đoán (chính/phụ)",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.procedure",
      "path" : "ExplanationOfBenefit.procedure",
      "short" : "Thủ thuật/phẫu thuật — ICD-9-CM"
    },
    {
      "id" : "ExplanationOfBenefit.procedure.procedure[x]",
      "path" : "ExplanationOfBenefit.procedure.procedure[x]",
      "slicing" : {
        "discriminator" : [{
          "type" : "type",
          "path" : "$this"
        }],
        "ordered" : false,
        "rules" : "open"
      }
    },
    {
      "id" : "ExplanationOfBenefit.procedure.procedure[x]:procedureCodeableConcept",
      "path" : "ExplanationOfBenefit.procedure.procedure[x]",
      "sliceName" : "procedureCodeableConcept",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "CodeableConcept"
      }],
      "binding" : {
        "strength" : "extensible",
        "valueSet" : "http://fhir.hl7.org.vn/core/ValueSet/vn-procedure-code-vs"
      }
    },
    {
      "id" : "ExplanationOfBenefit.insurance",
      "path" : "ExplanationOfBenefit.insurance",
      "short" : "Thông tin BHYT",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.insurance.focal",
      "path" : "ExplanationOfBenefit.insurance.focal",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.insurance.coverage",
      "path" : "ExplanationOfBenefit.insurance.coverage",
      "short" : "Thẻ BHYT (Coverage)",
      "type" : [{
        "code" : "Reference",
        "targetProfile" : ["http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-coverage"]
      }],
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.item",
      "path" : "ExplanationOfBenefit.item",
      "short" : "Chi tiết chi phí — 12 nhóm per QĐ 697/QĐ-BYT",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.item.extension",
      "path" : "ExplanationOfBenefit.item.extension",
      "slicing" : {
        "discriminator" : [{
          "type" : "value",
          "path" : "url"
        }],
        "ordered" : false,
        "rules" : "open"
      }
    },
    {
      "id" : "ExplanationOfBenefit.item.extension:paymentSource",
      "path" : "ExplanationOfBenefit.item.extension",
      "sliceName" : "paymentSource",
      "short" : "Nguồn chi trả dòng chi phí (NGUON_CTRA)",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-source"]
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.extension:recurrentWoundBenefit",
      "path" : "ExplanationOfBenefit.item.extension",
      "sliceName" : "recurrentWoundBenefit",
      "short" : "Flag VET_THUONG_TP cho dòng thuốc/DVKT/VTYT",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-recurrent-wound-benefit"]
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.extension:tenderInfo",
      "path" : "ExplanationOfBenefit.item.extension",
      "sliceName" : "tenderInfo",
      "short" : "Thông tin thầu dòng chi phí (TT_THAU)",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-tender-info"]
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.extension:processingMethod",
      "path" : "ExplanationOfBenefit.item.extension",
      "sliceName" : "processingMethod",
      "short" : "Phương pháp chế biến YHCT (MA_PP_CHEBIEN)",
      "min" : 0,
      "max" : "1",
      "type" : [{
        "code" : "Extension",
        "profile" : ["http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-traditional-processing-method"]
      }]
    },
    {
      "id" : "ExplanationOfBenefit.item.sequence",
      "path" : "ExplanationOfBenefit.item.sequence",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.item.category",
      "path" : "ExplanationOfBenefit.item.category",
      "short" : "Nhóm chi phí (QĐ 697)",
      "mustSupport" : true,
      "binding" : {
        "strength" : "extensible",
        "valueSet" : "http://fhir.hl7.org.vn/core/ValueSet/vn-cost-category-vs"
      }
    },
    {
      "id" : "ExplanationOfBenefit.item.productOrService",
      "path" : "ExplanationOfBenefit.item.productOrService",
      "short" : "Mã dịch vụ/thuốc/TBYT",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.item.quantity",
      "path" : "ExplanationOfBenefit.item.quantity",
      "short" : "Số lượng"
    },
    {
      "id" : "ExplanationOfBenefit.item.unitPrice",
      "path" : "ExplanationOfBenefit.item.unitPrice",
      "short" : "Đơn giá"
    },
    {
      "id" : "ExplanationOfBenefit.item.net",
      "path" : "ExplanationOfBenefit.item.net",
      "short" : "Thành tiền",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.item.adjudication",
      "path" : "ExplanationOfBenefit.item.adjudication",
      "short" : "Kết quả giám định từng dòng",
      "definition" : "Kết quả giám định từng dòng nếu hệ thống nguồn có line-level adjudication. EOB có thể chỉ mang total-level adjudication trong một số báo cáo/patient-facing use case, nên element này không bị bắt buộc như VNCoreClaimResponse."
    },
    {
      "id" : "ExplanationOfBenefit.item.adjudication.category",
      "path" : "ExplanationOfBenefit.item.adjudication.category",
      "definition" : "Category giám định từng dòng. Ưu tiên HL7 adjudication (`submitted`, `eligible`, `copay`, `benefit`) cho line-level adjudication; các subtotal cục bộ của VN Core không dùng ở line-level.",
      "mustSupport" : true,
      "binding" : {
        "strength" : "extensible",
        "valueSet" : "http://hl7.org/fhir/ValueSet/adjudication"
      }
    },
    {
      "id" : "ExplanationOfBenefit.item.adjudication.amount",
      "path" : "ExplanationOfBenefit.item.adjudication.amount",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.total",
      "path" : "ExplanationOfBenefit.total",
      "short" : "Tổng hợp theo nhóm giám định",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.total.category",
      "path" : "ExplanationOfBenefit.total.category",
      "short" : "Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ",
      "definition" : "Category tổng hợp tài chính/adjudication. Dùng ConceptMap `vn-cm-bhyt-financial-field-to-adjudication` để map các trường tổng tiền BHYT như `T_TONGCHI`, `T_TONGCHI_BH`, `T_BHTT`, `T_BNCCT`, `T_BNTT`, `T_NGUONKHAC`, `T_NGOAIDS`, `T_THUOC`, `T_VTYT`. Không encode công thức quyền lợi hoặc adjudication business rule tại profile.",
      "mustSupport" : true,
      "binding" : {
        "strength" : "extensible",
        "valueSet" : "http://fhir.hl7.org.vn/core/ValueSet/vn-bhyt-adjudication-category-vs"
      }
    },
    {
      "id" : "ExplanationOfBenefit.total.amount",
      "path" : "ExplanationOfBenefit.total.amount",
      "short" : "Số tiền",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.payment",
      "path" : "ExplanationOfBenefit.payment",
      "short" : "Thông tin thanh toán",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.payment.type",
      "path" : "ExplanationOfBenefit.payment.type",
      "short" : "Loại thanh toán"
    },
    {
      "id" : "ExplanationOfBenefit.payment.amount",
      "path" : "ExplanationOfBenefit.payment.amount",
      "short" : "Số tiền BHYT thanh toán",
      "mustSupport" : true
    },
    {
      "id" : "ExplanationOfBenefit.benefitPeriod",
      "path" : "ExplanationOfBenefit.benefitPeriod",
      "short" : "Kỳ quyền lợi BHYT"
    }]
  }
}

```
