<ClaimResponse xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../input-cache/schemas/R5/fhir-single.xsd">
  <!-- This would normally be the portion following 'Scen3d-' -->
  <id value="example-ClaimResponse-Scen3d-RB497867223-2023-08-01-2" />
  <status value="draft" />
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/claim-type" />
      <code value="pharmacy" />
    </coding>
  </type>
  <use value="claim" />
  <patient>
    <extension url="https://bpcs.exchange/fhir/StructureDefinition/ext-Resource-Subject">
      <valueReference>
        <reference value="Group/RB497867223" />
      </valueReference>
    </extension>
    <display value="Family RB497867223" />
  </patient>
  <created value="2024-05-02" />
  <!-- Current date -->
  <insurer>
    <reference value="Organization/bpcs" />
  </insurer>
  <outcome value="queued" />
  <item>
    <extension url="https://bpcs.exchange/fhir/StructureDefinition/ext-Resource-ReceiptPlan">
      <valueCoding>
        <system value="https://bpcs.exchange/fhir/CodeSystem/cs-ProgramPlan" />
        <code value="A" />
      </valueCoding>
    </extension>
    <!-- This will mirror the Claim.item.sequence for the receipt being responded to -->
    <itemSequence value="1" />
    <reviewOutcome>
      <decision>
        <coding>
          <system value="http://hl7.org/fhir/claim-decision" />
          <code value="approved" />
          <!-- currentStatus-->
        </coding>
      </decision>
    </reviewOutcome>
    <adjudication>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/adjudication" />
          <code value="eligible" />
        </coding>
      </category>
      <amount>
        <value value="5" />
        <currency value="CAD" />
      </amount>
    </adjudication>
    <adjudication>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/adjudication" />
          <code value="benefit" />
        </coding>
      </category>
      <amount>
        <value value="5" />
        <currency value="CAD" />
      </amount>
    </adjudication>
  </item>
</ClaimResponse>