{
  "resourceType" : "Invoice",
  "id" : "polaris-invoice-example",
  "meta" : {
    "profile" : ["https://fhir.apps.health/StructureDefinition/polaris-core-invoice"]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">OHIP bill for Avery Linwood, April 8, 2026 visit — general assessment A007 ($37.95) with chronic care premium K030. Total $61.45.</div>"
  },
  "extension" : [{
    "url" : "https://fhir.apps.health/StructureDefinition/oscar-billing-status-extension",
    "valueCode" : "O"
  },
  {
    "url" : "https://fhir.apps.health/StructureDefinition/oscar-billing-shadow-bill-extension",
    "valueBoolean" : false
  },
  {
    "url" : "https://fhir.apps.health/StructureDefinition/oscar-service-location-extension",
    "valueReference" : {
      "reference" : "Location/cedarbrook-site-a"
    }
  }],
  "identifier" : [{
    "use" : "official",
    "system" : "https://fhir.apps.health/NamingSystem/cedarbrook-clinic-invoice-identifier",
    "value" : "INV-avery-20250408-001"
  },
  {
    "use" : "secondary",
    "system" : "https://fhir.apps.health/NamingSystem/cedarbrook-clinic-invoice-header-id",
    "value" : "78234"
  }],
  "status" : "issued",
  "type" : {
    "coding" : [{
      "system" : "https://fhir.apps.health/CodeSystem/oscar-pay-program-cs",
      "code" : "HCP",
      "display" : "OHIP HCP"
    }]
  },
  "subject" : {
    "reference" : "Patient/avery-linwood"
  },
  "date" : "2026-04-08T10:15:00-04:00",
  "participant" : [{
    "role" : {
      "text" : "billing"
    },
    "actor" : {
      "reference" : "Practitioner/dr-navarro"
    }
  }],
  "issuer" : {
    "reference" : "Organization/cedarbrook-clinic"
  },
  "lineItem" : [{
    "extension" : [{
      "url" : "https://apps.health/InvoiceLineItem/diagnostic1",
      "valueCodeableConcept" : {
        "coding" : [{
          "system" : "http://hl7.org/fhir/sid/icd-9-cm",
          "code" : "250"
        }],
        "text" : "Diabetes mellitus"
      }
    }],
    "sequence" : 1,
    "chargeItemCodeableConcept" : {
      "coding" : [{
        "system" : "https://fhir.apps.health/CodeSystem/on-ohip-schedule-of-benefits",
        "code" : "A007",
        "display" : "General Assessment"
      }],
      "text" : "General Assessment"
    },
    "priceComponent" : [{
      "type" : "base",
      "factor" : 1,
      "amount" : {
        "value" : 37.95,
        "currency" : "CAD"
      }
    }]
  },
  {
    "extension" : [{
      "url" : "https://apps.health/InvoiceLineItem/diagnostic1",
      "valueCodeableConcept" : {
        "coding" : [{
          "system" : "http://hl7.org/fhir/sid/icd-9-cm",
          "code" : "250"
        }],
        "text" : "Diabetes mellitus"
      }
    }],
    "sequence" : 2,
    "chargeItemCodeableConcept" : {
      "coding" : [{
        "system" : "https://fhir.apps.health/CodeSystem/on-ohip-schedule-of-benefits",
        "code" : "K030",
        "display" : "Chronic Disease Management Premium"
      }],
      "text" : "Chronic Disease Management Premium"
    },
    "priceComponent" : [{
      "type" : "base",
      "factor" : 1,
      "amount" : {
        "value" : 23.50,
        "currency" : "CAD"
      }
    }]
  }],
  "totalGross" : {
    "value" : 61.45,
    "currency" : "CAD"
  },
  "note" : [{
    "text" : "15-minute visit, diabetes management discussion"
  }]
}