FHIR Implementation Guide for ABDM
3.0.1 - CI Build
FHIR Implementation Guide for ABDM
3.0.1 - CI Build
FHIR Implementation Guide for ABDM - Local Development build (v3.0.1). See the Directory of published versions
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:Bundle;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "ClaimResponseBundle-example-01"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "https://nrces.in/ndhm/fhir/r4/StructureDefinition/ClaimResponseBundle";
fhir:index 0;
fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/ClaimResponseBundle> ];
fhir:Meta.security [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-Confidentiality" ];
fhir:Coding.code [ fhir:value "V" ];
fhir:Coding.display [ fhir:value "very restricted" ] ]
];
fhir:Bundle.identifier [
fhir:Identifier.system [ fhir:value "http://hip.in" ];
fhir:Identifier.value [ fhir:value "bc3c6c57-2053-4d0e-ac40-139ccccff645" ]
];
fhir:Bundle.type [ fhir:value "collection"];
fhir:Bundle.timestamp [ fhir:value "2020-07-09T15:32:26.605+05:30"^^xsd:dateTime];
fhir:Bundle.entry [
fhir:index 0;
fhir:Bundle.entry.fullUrl [ fhir:value "ClaimResponse/example-01" ];
fhir:Bundle.entry.resource <ClaimResponse/example-01>
], [
fhir:index 1;
fhir:Bundle.entry.fullUrl [ fhir:value "Patient/Patient-example-01" ];
fhir:Bundle.entry.resource <Patient/Patient-example-01>
], [
fhir:index 2;
fhir:Bundle.entry.fullUrl [ fhir:value "Organization/Organization-example-01" ];
fhir:Bundle.entry.resource <Organization/Organization-example-01>
], [
fhir:index 3;
fhir:Bundle.entry.fullUrl [ fhir:value "Organization/Organization-example-02" ];
fhir:Bundle.entry.resource <Organization/Organization-example-02>
], [
fhir:index 4;
fhir:Bundle.entry.fullUrl [ fhir:value "Claim/preauth-example-01" ];
fhir:Bundle.entry.resource <Claim/preauth-example-01>
], [
fhir:index 5;
fhir:Bundle.entry.fullUrl [ fhir:value "Coverage/Coverage-example-01" ];
fhir:Bundle.entry.resource <Coverage/Coverage-example-01>
], [
fhir:index 6;
fhir:Bundle.entry.fullUrl [ fhir:value "Condition/Condition-example-01" ];
fhir:Bundle.entry.resource <Condition/Condition-example-01>
], [
fhir:index 7;
fhir:Bundle.entry.fullUrl [ fhir:value "Condition/Condition-example-02" ];
fhir:Bundle.entry.resource <Condition/Condition-example-02>
].
<ClaimResponse/example-01> a fhir:ClaimResponse;
fhir:Resource.id [ fhir:value "example-01"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "https://nrces.in/ndhm/fhir/r4/StructureDefinition/ClaimResponse";
fhir:index 0;
fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/ClaimResponse> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.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_Patient-example-01\">See above (Patient/Patient-example-01)</a></p><p><b>created</b>: 2022-12-20 03:32:26+0530</p><p><b>insurer</b>: <a href=\"#Organization_Organization-example-01\">See above (Organization/Organization-example-01)</a></p><p><b>requestor</b>: <a href=\"#Organization_Organization-example-01\">See above (Organization/Organization-example-01)</a></p><p><b>request</b>: <a href=\"#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_Coverage-example-01\">See above (Coverage/Coverage-example-01)</a></td></tr></table></div>"
];
fhir:ClaimResponse.status [ fhir:value "active"];
fhir:ClaimResponse.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ];
fhir:Coding.code [ fhir:value "oral" ] ]
];
fhir:ClaimResponse.use [ fhir:value "preauthorization"];
fhir:ClaimResponse.patient [
fhir:Reference.reference [ fhir:value "Patient/Patient-example-01" ]
];
fhir:ClaimResponse.created [ fhir:value "2022-12-20T15:32:26.605+05:30"^^xsd:dateTime];
fhir:ClaimResponse.insurer [
fhir:Reference.reference [ fhir:value "Organization/Organization-example-01" ]
];
fhir:ClaimResponse.requestor [
fhir:Reference.reference [ fhir:value "Organization/Organization-example-01" ]
];
fhir:ClaimResponse.request [
fhir:Reference.reference [ fhir:value "Claim/preauth-example-01" ]
];
fhir:ClaimResponse.outcome [ fhir:value "complete"];
fhir:ClaimResponse.disposition [ fhir:value "The enclosed services are authorized for your provision within 30 days of this notice."];
fhir:ClaimResponse.preAuthRef [ fhir:value "18SS12345"];
fhir:ClaimResponse.payeeType [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/payeetype" ];
fhir:Coding.code [ fhir:value "provider" ] ]
];
fhir:ClaimResponse.addItem [
fhir:index 0;
fhir:ClaimResponse.addItem.itemSequence [
fhir:value "1"^^xsd:positiveInteger;
fhir:index 0 ];
fhir:ClaimResponse.addItem.productOrService [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:38362002;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "38362002" ];
fhir:Coding.display [ fhir:value "Dengue" ] ] ];
fhir:ClaimResponse.addItem.programCode [
fhir:index 0;
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-program-code" ];
fhir:Coding.code [ fhir:value "AB-PMJAY" ];
fhir:Coding.display [ fhir:value "Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)" ] ] ];
fhir:ClaimResponse.addItem.net [
fhir:Money.value [ fhir:value "25000"^^xsd:decimal ];
fhir:Money.currency [ fhir:value "INR" ] ];
fhir:ClaimResponse.addItem.adjudication [
fhir:index 0;
fhir:ClaimResponse.item.adjudication.category [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.code [ fhir:value "eligible" ] ] ];
fhir:ClaimResponse.item.adjudication.amount [
fhir:Money.value [ fhir:value "25000"^^xsd:decimal ];
fhir:Money.currency [ fhir:value "INR" ] ] ]
], [
fhir:index 1;
fhir:ClaimResponse.addItem.itemSequence [
fhir:value "2"^^xsd:positiveInteger;
fhir:index 0 ];
fhir:ClaimResponse.addItem.productOrService [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:236071009;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "236071009" ];
fhir:Coding.display [ fhir:value "Chronic diarrhea" ] ] ];
fhir:ClaimResponse.addItem.programCode [
fhir:index 0;
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-program-code" ];
fhir:Coding.code [ fhir:value "AB-PMJAY" ];
fhir:Coding.display [ fhir:value "Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)" ] ] ];
fhir:ClaimResponse.addItem.net [
fhir:Money.value [ fhir:value "15000"^^xsd:decimal ];
fhir:Money.currency [ fhir:value "INR" ] ];
fhir:ClaimResponse.addItem.adjudication [
fhir:index 0;
fhir:ClaimResponse.item.adjudication.category [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.code [ fhir:value "eligible" ] ] ];
fhir:ClaimResponse.item.adjudication.amount [
fhir:Money.value [ fhir:value "15000"^^xsd:decimal ];
fhir:Money.currency [ fhir:value "INR" ] ] ]
];
fhir:ClaimResponse.processNote [
fhir:index 0;
fhir:ClaimResponse.processNote.number [ fhir:value "101"^^xsd:positiveInteger ];
fhir:ClaimResponse.processNote.type [ fhir:value "print" ];
fhir:ClaimResponse.processNote.text [ fhir:value "Please submit a Pre-Authorization request if a more extensive examination or urgent services are required." ];
fhir:ClaimResponse.processNote.language [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "urn:ietf:bcp:47" ];
fhir:Coding.code [ fhir:value "en-IN" ] ] ]
];
fhir:ClaimResponse.insurance [
fhir:index 0;
fhir:ClaimResponse.insurance.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:ClaimResponse.insurance.focal [ fhir:value "true"^^xsd:boolean ];
fhir:ClaimResponse.insurance.coverage [
fhir:Reference.reference [ fhir:value "Coverage/Coverage-example-01" ] ]
].
<Patient/Patient-example-01> a fhir:Patient;
fhir:Resource.id [ fhir:value "Patient-example-01"];
fhir:Resource.meta [
fhir:Meta.versionId [ fhir:value "1" ];
fhir:Meta.lastUpdated [ fhir:value "2020-07-09T14:58:58.181+05:30"^^xsd:dateTime ];
fhir:Meta.profile [
fhir:value "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient";
fhir:index 0;
fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b><a name=\"Patient-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 \"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>"
];
fhir:Patient.identifier [
fhir:index 0;
fhir:Identifier.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code" ];
fhir:Coding.code [ fhir:value "ADN" ];
fhir:Coding.display [ fhir:value "Adhaar number" ] ] ];
fhir:Identifier.system [ fhir:value "https://uidai.gov.in/" ];
fhir:Identifier.value [ fhir:value "7225-4829-5255" ]
];
fhir:Patient.name [
fhir:index 0;
fhir:HumanName.text [ fhir:value "Ayush Sharma" ]
];
fhir:Patient.telecom [
fhir:index 0;
fhir:ContactPoint.system [ fhir:value "phone" ];
fhir:ContactPoint.value [ fhir:value "+919818512600" ];
fhir:ContactPoint.use [ fhir:value "home" ]
];
fhir:Patient.gender [ fhir:value "male"];
fhir:Patient.birthDate [ fhir:value "1981-01-12"^^xsd:date].
<Organization/Organization-example-01> a fhir:Organization;
fhir:Resource.id [ fhir:value "Organization-example-01"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization";
fhir:index 0;
fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b><a name=\"Organization-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 \"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>"
];
fhir:Organization.identifier [
fhir:index 0;
fhir:Identifier.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0203" ];
fhir:Coding.code [ fhir:value "PRN" ];
fhir:Coding.display [ fhir:value "Provider number" ] ] ];
fhir:Identifier.system [ fhir:value "https://facility.ndhm.gov.in" ];
fhir:Identifier.value [ fhir:value "4567878" ]
];
fhir:Organization.name [ fhir:value "Appolo Hospital"];
fhir:Organization.telecom [
fhir:index 0;
fhir:ContactPoint.system [ fhir:value "phone" ];
fhir:ContactPoint.value [ fhir:value "+91 243 2634 1234" ];
fhir:ContactPoint.use [ fhir:value "work" ]
], [
fhir:index 1;
fhir:ContactPoint.system [ fhir:value "email" ];
fhir:ContactPoint.value [ fhir:value "contact@xyz.org" ];
fhir:ContactPoint.use [ fhir:value "work" ]
].
<Organization/Organization-example-02> a fhir:Organization;
fhir:Resource.id [ fhir:value "Organization-example-02"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization";
fhir:index 0;
fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Organization</b><a name=\"Organization-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 \"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>"
];
fhir:Organization.identifier [
fhir:index 0;
fhir:Identifier.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0203" ];
fhir:Coding.code [ fhir:value "PRN" ];
fhir:Coding.display [ fhir:value "Provider number" ] ] ];
fhir:Identifier.system [ fhir:value "https://facility.ndhm.gov.in" ];
fhir:Identifier.value [ fhir:value "555511" ]
];
fhir:Organization.name [ fhir:value "Star Health Corporation."];
fhir:Organization.telecom [
fhir:index 0;
fhir:ContactPoint.system [ fhir:value "phone" ];
fhir:ContactPoint.value [ fhir:value "+91 555 2634 888" ];
fhir:ContactPoint.use [ fhir:value "work" ]
], [
fhir:index 1;
fhir:ContactPoint.system [ fhir:value "email" ];
fhir:ContactPoint.value [ fhir:value "contact@xyz.org" ];
fhir:ContactPoint.use [ fhir:value "work" ]
].
<Claim/preauth-example-01> a fhir:Claim;
fhir:Resource.id [ fhir:value "preauth-example-01"];
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim";
fhir:index 0;
fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Claim</b><a name=\"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 \"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.html\">Patient/example-01</a> \"\"</p><p><b>created</b>: 2022-07-20 11:01:00+0500</p><p><b>insurer</b>: <a href=\"#Organization_Organization-example-02\">See above (Organization/Organization-example-02)</a></p><p><b>provider</b>: <a href=\"#Organization_Organization-example-02\">See above (Organization/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.html\">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_Condition-example-02\">See above (Condition/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.html\">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>"
];
fhir:Claim.identifier [
fhir:index 0;
fhir:Identifier.system [ fhir:value "http://happypharma.com/claim" ];
fhir:Identifier.value [ fhir:value "7612345" ]
];
fhir:Claim.status [ fhir:value "active"];
fhir:Claim.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ];
fhir:Coding.code [ fhir:value "professional" ] ]
];
fhir:Claim.use [ fhir:value "preauthorization"];
fhir:Claim.patient [
fhir:Reference.reference [ fhir:value "Patient/example-01" ]
];
fhir:Claim.created [ fhir:value "2022-07-20T11:01:00+05:00"^^xsd:dateTime];
fhir:Claim.insurer [
fhir:Reference.reference [ fhir:value "Organization/Organization-example-02" ]
];
fhir:Claim.provider [
fhir:Reference.reference [ fhir:value "Organization/Organization-example-02" ]
];
fhir:Claim.priority [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/processpriority" ];
fhir:Coding.code [ fhir:value "normal" ] ]
];
fhir:Claim.supportingInfo [
fhir:index 0;
fhir:Claim.supportingInfo.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.supportingInfo.category [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-supportinginfo-category" ];
fhir:Coding.code [ fhir:value "POI" ];
fhir:Coding.display [ fhir:value "proof of identity" ] ] ];
fhir:Claim.supportingInfo.code [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code" ];
fhir:Coding.code [ fhir:value "ADN" ];
fhir:Coding.display [ fhir:value "Adhaar number" ] ] ];
fhir:Claim.supportingInfo.valueReference [
fhir:Reference.reference [ fhir:value "DocumentReference/example-01" ] ]
];
fhir:Claim.diagnosis [
fhir:index 0;
fhir:Claim.diagnosis.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.diagnosis.diagnosisReference [
fhir:Reference.reference [ fhir:value "Condition/example-01" ] ];
fhir:Claim.diagnosis.type [
fhir:index 0;
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/ex-diagnosistype" ];
fhir:Coding.code [ fhir:value "clinical" ];
fhir:Coding.display [ fhir:value "Clinical Diagnosis" ] ] ]
], [
fhir:index 1;
fhir:Claim.diagnosis.sequence [ fhir:value "2"^^xsd:positiveInteger ];
fhir:Claim.diagnosis.diagnosisReference [
fhir:Reference.reference [ fhir:value "Condition/Condition-example-02" ] ];
fhir:Claim.diagnosis.type [
fhir:index 0;
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/ex-diagnosistype" ];
fhir:Coding.code [ fhir:value "clinical" ];
fhir:Coding.display [ fhir:value "Clinical Diagnosis" ] ] ]
];
fhir:Claim.insurance [
fhir:index 0;
fhir:Claim.insurance.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.insurance.focal [ fhir:value "true"^^xsd:boolean ];
fhir:Claim.insurance.coverage [
fhir:Reference.reference [ fhir:value "Coverage/example-01" ] ];
fhir:Claim.insurance.preAuthRef [
fhir:value "12S52";
fhir:index 0 ]
];
fhir:Claim.item [
fhir:index 0;
fhir:Claim.item.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.item.category [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:781087000;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "781087000" ];
fhir:Coding.display [ fhir:value "Medical care" ] ] ];
fhir:Claim.item.productOrService [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:38362002;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "38362002" ];
fhir:Coding.display [ fhir:value "Dengue" ] ] ];
fhir:Claim.item.programCode [
fhir:index 0;
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-program-code" ];
fhir:Coding.code [ fhir:value "AB-PMJAY" ];
fhir:Coding.display [ fhir:value "Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)" ] ] ];
fhir:Claim.item.unitPrice [
fhir:Money.value [ fhir:value "25000"^^xsd:decimal ];
fhir:Money.currency [ fhir:value "INR" ] ]
], [
fhir:index 1;
fhir:Claim.item.sequence [ fhir:value "2"^^xsd:positiveInteger ];
fhir:Claim.item.category [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:781087000;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "781087000" ];
fhir:Coding.display [ fhir:value "Medical care" ] ] ];
fhir:Claim.item.productOrService [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:236071009;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "236071009" ];
fhir:Coding.display [ fhir:value "Chronic diarrhea" ] ] ];
fhir:Claim.item.programCode [
fhir:index 0;
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-program-code" ];
fhir:Coding.code [ fhir:value "AB-PMJAY" ];
fhir:Coding.display [ fhir:value "Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)" ] ] ];
fhir:Claim.item.unitPrice [
fhir:Money.value [ fhir:value "15000"^^xsd:decimal ];
fhir:Money.currency [ fhir:value "INR" ] ]
].
<Coverage/Coverage-example-01> a fhir:Coverage;
fhir:Resource.id [ fhir:value "Coverage-example-01"];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Coverage</b><a name=\"Coverage-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 \"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.html\">Patient/example-01</a> \"\"</p><p><b>beneficiary</b>: <a href=\"Patient-example-01.html\">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=\"Organization-example-01.html\">Organization/example-01</a> \"XYZ Lab Pvt.Ltd.\"</p></div>"
];
fhir:Coverage.identifier [
fhir:index 0;
fhir:Identifier.system [ fhir:value "http://hospitalx.com/selfpayagreement" ];
fhir:Identifier.value [ fhir:value "SP12345678" ]
];
fhir:Coverage.status [ fhir:value "active"];
fhir:Coverage.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/coverage-selfpay" ];
fhir:Coding.code [ fhir:value "pay" ];
fhir:Coding.display [ fhir:value "PAY" ] ]
];
fhir:Coverage.subscriber [
fhir:Reference.reference [ fhir:value "Patient/example-01" ]
];
fhir:Coverage.beneficiary [
fhir:Reference.reference [ fhir:value "Patient/example-01" ]
];
fhir:Coverage.relationship [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/subscriber-relationship" ];
fhir:Coding.code [ fhir:value "self" ] ]
];
fhir:Coverage.period [
fhir:Period.start [ fhir:value "2022-12-01"^^xsd:date ];
fhir:Period.end [ fhir:value "2025-03-17"^^xsd:date ]
];
fhir:Coverage.payor [
fhir:index 0;
fhir:Reference.reference [ fhir:value "Organization/example-01" ]
].
<Condition/Condition-example-01> a fhir:Condition;
fhir:Resource.id [ fhir:value "Condition-example-01"];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Condition</b><a name=\"Condition-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 \"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.html\">Patient/example-01</a> \"\"</p></div>"
];
fhir:Condition.code [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:38362002;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "38362002" ];
fhir:Coding.display [ fhir:value "Dengue (disorder)" ] ]
];
fhir:Condition.subject [
fhir:Reference.reference [ fhir:value "Patient/example-01" ]
].
<Condition/Condition-example-02> a fhir:Condition;
fhir:Resource.id [ fhir:value "Condition-example-02"];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Condition</b><a name=\"Condition-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 \"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.html\">Patient/example-01</a> \"\"</p></div>"
];
fhir:Condition.code [
fhir:CodeableConcept.coding [
fhir:index 0;
a sct:17551007;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
fhir:Coding.code [ fhir:value "17551007" ];
fhir:Coding.display [ fhir:value "Chronic diarrhea of unknown origin (disorder)" ] ]
];
fhir:Condition.subject [
fhir:Reference.reference [ fhir:value "Patient/example-01" ]
].
# - ontology header ------------------------------------------------------------
a owl:Ontology;
owl:imports fhir:fhir.ttl.
IG © 2020+ National Resource Center for EHR Standards. Package ndhm.in#3.0.1 based on FHIR 4.0.1. Generated 2023-07-05
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