FHIR Implementation Guide for ABDM
3.0.0 - CI Build
FHIR Implementation Guide for ABDM
3.0.0 - CI Build
FHIR Implementation Guide for ABDM - Local Development build (v3.0.0). See the Directory of published versions
{
"resourceType" : "Bundle",
"id" : "ClaimResponseBundle-example-01",
"meta" : {
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/ClaimResponseBundle"
],
"security" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-Confidentiality",
"code" : "V",
"display" : "very restricted"
}
]
},
"identifier" : {
"system" : "http://hip.in",
"value" : "bc3c6c57-2053-4d0e-ac40-139ccccff645"
},
"type" : "collection",
"timestamp" : "2020-07-09T15:32:26.605+05:30",
"entry" : [
{
"fullUrl" : "ClaimResponse/example-01",
"resource" : {
"resourceType" : "ClaimResponse",
"id" : "example-01",
"meta" : {
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/ClaimResponse"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ClaimResponse</b><a name=\"example-01\"> </a></p><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\">Resource ClaimResponse \"example-01\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ClaimResponse.html\">ClaimResponse</a></p></div><p><b>status</b>: active</p><p><b>type</b>: Oral <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#oral)</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: <a href=\"#Patient_example-01\">See above (Patient/example-01)</a></p><p><b>created</b>: 2022-12-20 03:32:26+0530</p><p><b>insurer</b>: <a href=\"#Organization_example-01\">See above (Organization/example-01)</a></p><p><b>requestor</b>: <a href=\"#Organization_example-01\">See above (Organization/example-01)</a></p><p><b>request</b>: <a href=\"#Claim_Claim-preauth-example-01\">See above (Claim/preauth-example-01)</a></p><p><b>outcome</b>: complete</p><p><b>disposition</b>: The enclosed services are authorized for your provision within 30 days of this notice.</p><p><b>preAuthRef</b>: 18SS12345</p><p><b>payeeType</b>: Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-payeetype.html\">Claim Payee Type Codes</a>#provider)</span></p><blockquote><p><b>addItem</b></p><p><b>itemSequence</b>: 1</p><p><b>productOrService</b>: Dengue <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#38362002)</span></p><p><b>programCode</b>: Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-ndhm-program-code.html\">Program Code</a>#AB-PMJAY)</span></p><h3>Nets</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td>*</td><td>25000</td><td>INR</td></tr></table><blockquote><p><b>adjudication</b></p><p><b>category</b>: eligible <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ([not stated]#eligible)</span></p></blockquote></blockquote><blockquote><p><b>addItem</b></p><p><b>itemSequence</b>: 2</p><p><b>productOrService</b>: Chronic diarrhea <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#236071009)</span></p><p><b>programCode</b>: Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-ndhm-program-code.html\">Program Code</a>#AB-PMJAY)</span></p><h3>Nets</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td>*</td><td>15000</td><td>INR</td></tr></table><blockquote><p><b>adjudication</b></p><p><b>category</b>: eligible <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ([not stated]#eligible)</span></p></blockquote></blockquote><h3>ProcessNotes</h3><table class=\"grid\"><tr><td>-</td><td><b>Number</b></td><td><b>Type</b></td><td><b>Text</b></td><td><b>Language</b></td></tr><tr><td>*</td><td>101</td><td>print</td><td>Please submit a Pre-Authorization request if a more extensive examination or urgent services are required.</td><td>English (Region=India) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-v3-ietf3066.html\">Tags for the Identification of Languages</a>#en-IN)</span></td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td>*</td><td>1</td><td>true</td><td><a href=\"#Coverage_example-01\">See above (Coverage/example-01)</a></td></tr></table></div>"
},
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claim-type",
"code" : "oral"
}
]
},
"use" : "preauthorization",
"patient" : {
"reference" : "Patient/example-01"
},
"created" : "2022-12-20T15:32:26.605+05:30",
"insurer" : {
"reference" : "Organization/example-01"
},
"requestor" : {
"reference" : "Organization/example-01"
},
"request" : {
"reference" : "Claim/preauth-example-01"
},
"outcome" : "complete",
"disposition" : "The enclosed services are authorized for your provision within 30 days of this notice.",
"preAuthRef" : "18SS12345",
"payeeType" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/payeetype",
"code" : "provider"
}
]
},
"addItem" : [
{
"itemSequence" : [
1
],
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "38362002",
"display" : "Dengue"
}
]
},
"programCode" : [
{
"coding" : [
{
"system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-program-code",
"code" : "AB-PMJAY",
"display" : "Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)"
}
]
}
],
"net" : {
"value" : 25000,
"currency" : "INR"
},
"adjudication" : [
{
"category" : {
"coding" : [
{
"code" : "eligible"
}
]
},
"amount" : {
"value" : 25000,
"currency" : "INR"
}
}
]
},
{
"itemSequence" : [
2
],
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "236071009",
"display" : "Chronic diarrhea"
}
]
},
"programCode" : [
{
"coding" : [
{
"system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-program-code",
"code" : "AB-PMJAY",
"display" : "Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)"
}
]
}
],
"net" : {
"value" : 15000,
"currency" : "INR"
},
"adjudication" : [
{
"category" : {
"coding" : [
{
"code" : "eligible"
}
]
},
"amount" : {
"value" : 15000,
"currency" : "INR"
}
}
]
}
],
"processNote" : [
{
"number" : 101,
"type" : "print",
"text" : "Please submit a Pre-Authorization request if a more extensive examination or urgent services are required.",
"language" : {
"coding" : [
{
"system" : "urn:ietf:bcp:47",
"code" : "en-IN"
}
]
}
}
],
"insurance" : [
{
"sequence" : 1,
"focal" : true,
"coverage" : {
"reference" : "Coverage/example-01"
}
}
]
}
},
{
"fullUrl" : "Patient/example-01",
"resource" : {
"resourceType" : "Patient",
"id" : "example-01",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2020-07-09T14:58:58.181+05:30",
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b><a name=\"example-01\"> </a></p><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\">Resource Patient \"example-01\" Version \"1\" Updated \"2020-07-09 02:58:58+0530\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Patient.html\">Patient</a></p></div><p><b>identifier</b>: Adhaar number: 7225-4829-5255</p><p><b>name</b>: Ayush Sharma</p><p><b>telecom</b>: <a href=\"tel:+919818512600\">+919818512600</a></p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1981-01-12</p></div>"
},
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code",
"code" : "ADN",
"display" : "Adhaar number"
}
]
},
"system" : "https://uidai.gov.in/",
"value" : "7225-4829-5255"
}
],
"name" : [
{
"text" : "Ayush Sharma"
}
],
"telecom" : [
{
"system" : "phone",
"value" : "+919818512600",
"use" : "home"
}
],
"gender" : "male",
"birthDate" : "1981-01-12"
}
},
{
"fullUrl" : "Organization/example-01",
"resource" : {
"resourceType" : "Organization",
"id" : "example-01",
"meta" : {
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b><a name=\"example-01\"> </a></p><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\">Resource Organization \"example-01\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Organization.html\">Organization</a></p></div><p><b>identifier</b>: Provider number: 4567878</p><p><b>name</b>: Appolo Hospital</p><p><b>telecom</b>: <a href=\"tel:+9124326341234\">+91 243 2634 1234</a>, <a href=\"mailto:contact@xyz.org\">contact@xyz.org</a></p></div>"
},
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "PRN",
"display" : "Provider number"
}
]
},
"system" : "https://facility.ndhm.gov.in",
"value" : "4567878"
}
],
"name" : "Appolo Hospital",
"telecom" : [
{
"system" : "phone",
"value" : "+91 243 2634 1234",
"use" : "work"
},
{
"system" : "email",
"value" : "contact@xyz.org",
"use" : "work"
}
]
}
},
{
"fullUrl" : "Organization/example-02",
"resource" : {
"resourceType" : "Organization",
"id" : "example-02",
"meta" : {
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b><a name=\"example-02\"> </a></p><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\">Resource Organization \"example-02\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Organization.html\">Organization</a></p></div><p><b>identifier</b>: Provider number: 555511</p><p><b>name</b>: Star Health Corporation.</p><p><b>telecom</b>: <a href=\"tel:+915552634888\">+91 555 2634 888</a>, <a href=\"mailto:contact@xyz.org\">contact@xyz.org</a></p></div>"
},
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "PRN",
"display" : "Provider number"
}
]
},
"system" : "https://facility.ndhm.gov.in",
"value" : "555511"
}
],
"name" : "Star Health Corporation.",
"telecom" : [
{
"system" : "phone",
"value" : "+91 555 2634 888",
"use" : "work"
},
{
"system" : "email",
"value" : "contact@xyz.org",
"use" : "work"
}
]
}
},
{
"fullUrl" : "Claim/preauth-example-01",
"resource" : {
"resourceType" : "Claim",
"id" : "Claim-preauth-example-01",
"meta" : {
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Claim</b><a name=\"Claim-preauth-example-01\"> </a></p><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\">Resource Claim \"Claim-preauth-example-01\" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Claim.html\">Claim</a></p></div><p><b>identifier</b>: id: 7612345</p><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: preauthorization</p><p><b>patient</b>: <a href=\"#Patient_example-01\">See above (Patient/example-01)</a></p><p><b>created</b>: 2022-07-20 11:01:00+0500</p><p><b>insurer</b>: <a href=\"#Organization_example-01\">See above (Organization/example-01)</a></p><p><b>provider</b>: <a href=\"#Organization_example-02\">See above (Organization/example-02)</a></p><p><b>priority</b>: Normal <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#normal)</span></p><h3>SupportingInfos</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>1</td><td>proof of identity <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-ndhm-supportinginfo-category.html\">SupportingInfo Category</a>#POI)</span></td><td>Adhaar number <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-ndhm-identifier-type-code.html\">Identifier Type Code</a>#ADN)</span></td><td><a href=\"DocumentReference-example-01.html\">DocumentReference/example-01</a></td></tr></table><blockquote><p><b>diagnosis</b></p><p><b>sequence</b>: 1</p><p><b>diagnosis</b>: <a href=\"#Condition_example-01\">See above (Condition/example-01)</a></p><p><b>type</b>: Clinical Diagnosis <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-ex-diagnosistype.html\">Example Diagnosis Type Codes</a>#clinical)</span></p></blockquote><blockquote><p><b>diagnosis</b></p><p><b>sequence</b>: 2</p><p><b>diagnosis</b>: <a href=\"#Condition_example-02\">See above (Condition/example-02)</a></p><p><b>type</b>: Clinical Diagnosis <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-ex-diagnosistype.html\">Example Diagnosis Type Codes</a>#clinical)</span></p></blockquote><h3>Insurances</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td><td><b>PreAuthRef</b></td></tr><tr><td>*</td><td>1</td><td>true</td><td><a href=\"#Coverage_example-01\">See above (Coverage/example-01)</a></td><td>12S52</td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>category</b>: Medical care <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#781087000)</span></p><p><b>productOrService</b>: Dengue <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#38362002)</span></p><p><b>programCode</b>: Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-ndhm-program-code.html\">Program Code</a>#AB-PMJAY)</span></p><h3>UnitPrices</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td>*</td><td>25000</td><td>INR</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>category</b>: Medical care <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#781087000)</span></p><p><b>productOrService</b>: Chronic diarrhea <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#236071009)</span></p><p><b>programCode</b>: Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-ndhm-program-code.html\">Program Code</a>#AB-PMJAY)</span></p><h3>UnitPrices</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td>*</td><td>15000</td><td>INR</td></tr></table></blockquote></div>"
},
"identifier" : [
{
"system" : "http://happypharma.com/claim",
"value" : "7612345"
}
],
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claim-type",
"code" : "professional"
}
]
},
"use" : "preauthorization",
"patient" : {
"reference" : "Patient/example-01"
},
"created" : "2022-07-20T11:01:00+05:00",
"insurer" : {
"reference" : "Organization/example-01"
},
"provider" : {
"reference" : "Organization/example-02"
},
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/processpriority",
"code" : "normal"
}
]
},
"supportingInfo" : [
{
"sequence" : 1,
"category" : {
"coding" : [
{
"system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-supportinginfo-category",
"code" : "POI",
"display" : "proof of identity"
}
]
},
"code" : {
"coding" : [
{
"system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code",
"code" : "ADN",
"display" : "Adhaar number"
}
]
},
"valueReference" : {
"reference" : "DocumentReference/example-01"
}
}
],
"diagnosis" : [
{
"sequence" : 1,
"diagnosisReference" : {
"reference" : "Condition/example-01"
},
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code" : "clinical",
"display" : "Clinical Diagnosis"
}
]
}
]
},
{
"sequence" : 2,
"diagnosisReference" : {
"reference" : "Condition/example-02"
},
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/ex-diagnosistype",
"code" : "clinical",
"display" : "Clinical Diagnosis"
}
]
}
]
}
],
"insurance" : [
{
"sequence" : 1,
"focal" : true,
"coverage" : {
"reference" : "Coverage/example-01"
},
"preAuthRef" : [
"12S52"
]
}
],
"item" : [
{
"sequence" : 1,
"category" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "781087000",
"display" : "Medical care"
}
]
},
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "38362002",
"display" : "Dengue"
}
]
},
"programCode" : [
{
"coding" : [
{
"system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-program-code",
"code" : "AB-PMJAY",
"display" : "Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)"
}
]
}
],
"unitPrice" : {
"value" : 25000,
"currency" : "INR"
}
},
{
"sequence" : 2,
"category" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "781087000",
"display" : "Medical care"
}
]
},
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "236071009",
"display" : "Chronic diarrhea"
}
]
},
"programCode" : [
{
"coding" : [
{
"system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-program-code",
"code" : "AB-PMJAY",
"display" : "Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)"
}
]
}
],
"unitPrice" : {
"value" : 15000,
"currency" : "INR"
}
}
]
}
},
{
"fullUrl" : "Coverage/example-01",
"resource" : {
"resourceType" : "Coverage",
"id" : "example-01",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Coverage</b><a name=\"example-01\"> </a></p><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\">Resource Coverage \"example-01\" </p></div><p><b>identifier</b>: id: SP12345678</p><p><b>status</b>: active</p><p><b>type</b>: PAY <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-coverage-selfpay.html\">Coverage SelfPay Codes</a>#pay)</span></p><p><b>subscriber</b>: <a href=\"#Patient_example-01\">See above (Patient/example-01)</a></p><p><b>beneficiary</b>: <a href=\"#Patient_example-01\">See above (Patient/example-01)</a></p><p><b>relationship</b>: Self <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.0.0/CodeSystem-subscriber-relationship.html\">SubscriberPolicyholder Relationship Codes</a>#self)</span></p><p><b>period</b>: 2022-12-01 --> 2025-03-17</p><p><b>payor</b>: <a href=\"#Patient_example-01\">See above (Patient/example-01)</a></p></div>"
},
"identifier" : [
{
"system" : "http://hospitalx.com/selfpayagreement",
"value" : "SP12345678"
}
],
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/coverage-selfpay",
"code" : "pay",
"display" : "PAY"
}
]
},
"subscriber" : {
"reference" : "Patient/example-01"
},
"beneficiary" : {
"reference" : "Patient/example-01"
},
"relationship" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
"code" : "self"
}
]
},
"period" : {
"start" : "2022-12-01",
"end" : "2025-03-17"
},
"payor" : [
{
"reference" : "Patient/example-01"
}
]
}
},
{
"fullUrl" : "Condition/example-01",
"resource" : {
"resourceType" : "Condition",
"id" : "example-01",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Condition</b><a name=\"example-01\"> </a></p><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\">Resource Condition \"example-01\" </p></div><p><b>code</b>: Dengue (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#38362002)</span></p><p><b>subject</b>: <a href=\"#Patient_example-01\">See above (Patient/example-01)</a></p></div>"
},
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "38362002",
"display" : "Dengue (disorder)"
}
]
},
"subject" : {
"reference" : "Patient/example-01"
}
}
},
{
"fullUrl" : "Condition/example-02",
"resource" : {
"resourceType" : "Condition",
"id" : "example-02",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Condition</b><a name=\"example-02\"> </a></p><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\">Resource Condition \"example-02\" </p></div><p><b>code</b>: Chronic diarrhea of unknown origin (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#17551007)</span></p><p><b>subject</b>: <a href=\"#Patient_example-01\">See above (Patient/example-01)</a></p></div>"
},
"code" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "17551007",
"display" : "Chronic diarrhea of unknown origin (disorder)"
}
]
},
"subject" : {
"reference" : "Patient/example-01"
}
}
}
]
}
IG © 2020+ National Resource Center for EHR Standards. Package ndhm.in#3.0.0 based on FHIR 4.0.1. Generated 2023-04-20
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