<?xml version="1.0" encoding="UTF-8"?>

<ChargeItem xmlns="http://hl7.org/fhir">
  <id value="ExampleBemaChargeItem"/>
  <meta>
    <profile value="https://fhir.cognovis.de/dental/StructureDefinition/bema-charge-item"/>
  </meta>
  <text>
    <status value="extensions"/><div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: ChargeItem ExampleBemaChargeItem</b></p><a name="ExampleBemaChargeItem"> </a><a name="hcExampleBemaChargeItem"> </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-bema-charge-item.html">BEMA Leistungsposition (DE)</a></p></div><p><b>Steuerkategorie</b>: <span title="Codes:{urn:un:unece:uncefact:codelist:standard:5305 E}">Steuerfrei</span></p><p><b>Umsatzsteuerbefreiungsgrund</b>: <span title="Codes:{https://fhir.cognovis.de/praxis/CodeSystem/ust-befreiungsgrund para4-nr14a}">§ 4 Nr. 14a UStG</span></p><p><b>FDI Zahnnummer</b>: 36</p><p><b>Zahnflächen</b>: <span title="Codes:{https://fhir.cognovis.de/dental/CodeSystem/tooth-surfaces M}">Mesial</span></p><p><b>Zahnflächen</b>: <span title="Codes:{https://fhir.cognovis.de/dental/CodeSystem/tooth-surfaces O}">Okklusal</span></p><p><b>Zahnflächen</b>: <span title="Codes:{https://fhir.cognovis.de/dental/CodeSystem/tooth-surfaces D}">Distal</span></p><p><b>BEMA Befundklasse</b>: c</p><p><b>status</b>: Billable</p><p><b>code</b>: <span title="Codes:{http://fhir.de/CodeSystem/kzbv/bema 13c}">Kompositfüllung dreiflächig</span></p><p><b>subject</b>: <a href="Patient-pat-gkv-01.html">Klaus Bergmann (official) (no stated gender), DoB: 1962-04-17 ( Krankenversichertennummer)</a></p><p><b>context</b>: <a href="Encounter-enc-dental-01-kassenschein.html">Encounter: identifier = https://example-dental-practice.de/fall-id#DENTAL-2026-0001; status = finished; class = ambulatory (v3 Code System ActCode#AMB); period = 2026-01-10 --&gt; 2026-01-10</a></p><p><b>occurrence</b>: 2026-01-10</p><p><b>quantity</b>: 25 Punkte</p><p><b>bodysite</b>: <span title="Codes:{https://fhir.cognovis.de/dental/CodeSystem/tooth-identification-fdi 36}">Zahn 36</span></p><h3>PriceOverrides</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>26.65</td><td>Euro</td></tr></table><p><b>account</b>: <a href="Account-acct-dental-01-gkv-q1.html">Account: identifier = https://fhir.cognovis.de/praxis/sid/scheinNummer#ScheinNummer#GKV-2026-Q1-00001; status = active; type = GKV; servicePeriod = 2026-01-01 --&gt; 2026-03-31</a></p></div>
  </text>
  <extension url="https://fhir.cognovis.de/praxis/StructureDefinition/ext-tax-category">
    <valueCodeableConcept>
      <coding>
        <system value="urn:un:unece:uncefact:codelist:standard:5305"/>
        <code value="E"/>
        <display value="Steuerfrei"/>
      </coding>
    </valueCodeableConcept>
  </extension>
  <extension url="https://fhir.cognovis.de/praxis/StructureDefinition/ext-tax-exemption-reason">
    <valueCodeableConcept>
      <coding>
        <system value="https://fhir.cognovis.de/praxis/CodeSystem/ust-befreiungsgrund"/>
        <code value="para4-nr14a"/>
        <display value="§ 4 Nr. 14a UStG"/>
      </coding>
    </valueCodeableConcept>
  </extension>
  <extension url="https://fhir.cognovis.de/dental/StructureDefinition/fdi-tooth-number">
    <valueCode value="36"/>
  </extension>
  <extension url="https://fhir.cognovis.de/dental/StructureDefinition/tooth-surfaces">
    <valueCodeableConcept>
      <coding>
        <system value="https://fhir.cognovis.de/dental/CodeSystem/tooth-surfaces"/>
        <code value="M"/>
        <display value="Mesial"/>
      </coding>
    </valueCodeableConcept>
  </extension>
  <extension url="https://fhir.cognovis.de/dental/StructureDefinition/tooth-surfaces">
    <valueCodeableConcept>
      <coding>
        <system value="https://fhir.cognovis.de/dental/CodeSystem/tooth-surfaces"/>
        <code value="O"/>
        <display value="Okklusal"/>
      </coding>
    </valueCodeableConcept>
  </extension>
  <extension url="https://fhir.cognovis.de/dental/StructureDefinition/tooth-surfaces">
    <valueCodeableConcept>
      <coding>
        <system value="https://fhir.cognovis.de/dental/CodeSystem/tooth-surfaces"/>
        <code value="D"/>
        <display value="Distal"/>
      </coding>
    </valueCodeableConcept>
  </extension>
  <extension url="https://fhir.cognovis.de/dental/StructureDefinition/bema-befundklasse">
    <valueCode value="c"/>
  </extension>
  <status value="billable"/>
  <code>
    <coding>
      <system value="http://fhir.de/CodeSystem/kzbv/bema"/>
      <code value="13c"/>
      <display value="Kompositfüllung dreiflächig"/>
    </coding>
  </code>
  <subject>
    <reference value="Patient/pat-gkv-01"/>
  </subject>
  <context>
    <reference value="Encounter/enc-dental-01-kassenschein"/>
  </context>
  <occurrenceDateTime value="2026-01-10"/>
  <quantity>
    <value value="25"/>
    <unit value="Punkte"/>
  </quantity>
  <bodysite>
    <coding>
      <system value="https://fhir.cognovis.de/dental/CodeSystem/tooth-identification-fdi"/>
      <code value="36"/>
      <display value="36"/>
    </coding>
    <text value="Zahn 36"/>
  </bodysite>
  <priceOverride>
    <value value="26.65"/>
    <currency value="EUR"/>
  </priceOverride>
  <account>
    <reference value="Account/acct-dental-01-gkv-q1"/>
  </account>
</ChargeItem>