CoverageEligibilityRequestBundle-benefit-example-01
type: Bundle
node role: treeRoot
resource.id:
  value: CoverageEligibilityRequestBundle-benefit-example-01
resource.meta:
  meta.version id:
    value: 1
  meta.profile:
    value: https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequestBundle
    index: 0
    link: https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequestBundle
bundle.identifier:
  identifier.system:
    value: http://hip.in
bundle.type:
  value: collection
bundle.timestamp:
  value: 2020-07-09T15:32:26.605+05:30
bundle.entry:
  index: 0
  bundle.entry.full url:
    value: CoverageEligibilityRequest/benefit-example-01
  bundle.entry.resource: benefit-example-01
bundle.entry:
  index: 1
  bundle.entry.full url:
    value: Patient/Patient-example-01
  bundle.entry.resource: Patient-example-01
bundle.entry:
  index: 2
  bundle.entry.full url:
    value: Practitioner/Practitioner-example-01
  bundle.entry.resource: Practitioner-example-01
bundle.entry:
  index: 3
  bundle.entry.full url:
    value: Organization/Organization-example-01
  bundle.entry.resource: Organization-example-01
bundle.entry:
  index: 4
  bundle.entry.full url:
    value: Organization/Organization-example-02
  bundle.entry.resource: Organization-example-02
bundle.entry:
  index: 5
  bundle.entry.full url:
    value: Location/Location-example-01
  bundle.entry.resource: Location-example-01
bundle.entry:
  index: 6
  bundle.entry.full url:
    value: Coverage/Coverage-example-01
  bundle.entry.resource: Coverage-example-01
bundle.entry:
  index: 7
  bundle.entry.full url:
    value: DocumentReference/DocumentReference-example-01
  bundle.entry.resource: DocumentReference-example-01
bundle.entry:
  index: 8
  bundle.entry.full url:
    value: Condition/Condition-example-01
  bundle.entry.resource: Condition-example-01

benefit-example-01
type: CoverageEligibilityRequest
resource.id:
  value: benefit-example-01
resource.meta:
  meta.profile:
    value: https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest
    index: 0
    link: https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest
resource.language:
  value: en
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: CoverageEligibilityRequest Resource CoverageEligibilityRequest "benefit-example-01" (Language "en") Profile: CoverageEligibilityRequest identifier: id: dc82673b-8c71-48c2-8a17-16dcb3b035f6 status: active priority: Normal (Process Priority Codes#normal) purpose: benefits patient: See above (Patient/Patient-example-01) created: 2022-12-20 11:01:00+0500 enterer: See above (Practitioner/Practitioner-example-01) provider: See above (Organization/Organization-example-02) insurer: See above (Organization/Organization-example-01) facility: See above (Location/Location-example-01) SupportingInfos - Sequence Information AppliesToAll * 1 See above (DocumentReference/DocumentReference-example-01) true Insurances - Focal Coverage * true See above (Coverage/Coverage-example-01) item supportingInfoSequence: 1 productOrService: Removal of foreign body (SNOMED CT#10849003) UnitPrices - Value Currency * 40000 INR Diagnoses - Diagnosis[x] * See above (Condition/Condition-example-01)
coverage eligibility request.identifier:
  index: 0
  identifier.system:
    value: https://www.tmh.in/coverage-eligibility-request
coverage eligibility request.status:
  value: active
coverage eligibility request.priority:
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/processpriority
    coding.code:
      value: normal
    coding.display:
      value: Normal
coverage eligibility request.purpose:
  value: benefits
  index: 0
coverage eligibility request.patient:
  link: https://nrces.in/ndhm/fhir/r4/Patient/Patient-example-01
  reference.reference:
    value: Patient/Patient-example-01
coverage eligibility request.created:
  value: 2022-12-20T11:01:00+05:00
coverage eligibility request.enterer:
  link: https://nrces.in/ndhm/fhir/r4/Practitioner/Practitioner-example-01
  reference.reference:
    value: Practitioner/Practitioner-example-01
coverage eligibility request.provider:
  link: https://nrces.in/ndhm/fhir/r4/Organization/Organization-example-02
  reference.reference:
    value: Organization/Organization-example-02
coverage eligibility request.insurer:
  link: https://nrces.in/ndhm/fhir/r4/Organization/Organization-example-01
  reference.reference:
    value: Organization/Organization-example-01
coverage eligibility request.facility:
  link: https://nrces.in/ndhm/fhir/r4/Location/Location-example-01
  reference.reference:
    value: Location/Location-example-01
coverage eligibility request.supporting info:
  index: 0
  coverage eligibility request.supporting info.sequence:
    value: 1
  coverage eligibility request.supporting info.information:
    link: https://nrces.in/ndhm/fhir/r4/DocumentReference/DocumentReference-example-01
    reference.reference:
      value: DocumentReference/DocumentReference-example-01
  coverage eligibility request.supporting info.applies to all:
    value: true
coverage eligibility request.insurance:
  index: 0
  coverage eligibility request.insurance.focal:
    value: true
  coverage eligibility request.insurance.coverage:
    link: https://nrces.in/ndhm/fhir/r4/Coverage/Coverage-example-01
    reference.reference:
      value: Coverage/Coverage-example-01
coverage eligibility request.item:
  index: 0
  coverage eligibility request.item.supporting info sequence:
    value: 1
    index: 0
  coverage eligibility request.item.product or service:
    codeable concept.coding: http://snomed.info/id/10849003
      index: 0
      coding.system:
        value: http://snomed.info/sct
      coding.code:
        value: 10849003
      coding.display:
        value: Removal of foreign body
  coverage eligibility request.item.unit price:
    money.value:
      value: 40000
    money.currency:
      value: INR
  coverage eligibility request.item.diagnosis:
    index: 0
    coverage eligibility request.item.diagnosis.diagnosis reference:
      link: https://nrces.in/ndhm/fhir/r4/Condition/Condition-example-01
      reference.reference:
        value: Condition/Condition-example-01

Patient-example-01
type: Patient
resource.id:
  value: Patient-example-01
resource.meta:
  meta.version id:
    value: 1
  meta.last updated:
    value: 2020-07-09T14:58:58.181+05:30
  meta.profile:
    value: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient
    index: 0
    link: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: Patient Resource Patient "Patient-example-01" Version "1" Updated "2020-07-09 02:58:58+0530" Profile: Patient identifier: Adhaar number: 5555-7225-4829 name: Ayush Sharma telecom: +919818512600 gender: male birthDate: 1981-01-12
patient.identifier:
  index: 0
  identifier.type:
    codeable concept.coding:
      index: 0
      coding.system:
        value: https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code
      coding.code:
        value: ADN
      coding.display:
        value: Adhaar number
  identifier.system:
    value: https://uidai.gov.in/
  identifier.value:
    value: 5555-7225-4829
patient.name:
  index: 0
  human name.text:
    value: Ayush Sharma
patient.telecom:
  index: 0
  contact point.system:
    value: phone
  contact point.value:
    value: +919818512600
  contact point.use:
    value: home
patient.gender:
  value: male
patient.birth date:
  value: 1981-01-12

Practitioner-example-01
type: Practitioner
resource.id:
  value: Practitioner-example-01
resource.meta:
  meta.version id:
    value: 1
  meta.last updated:
    value: 2019-05-29T14:58:58.181+05:30
  meta.profile:
    value: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner
    index: 0
    link: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: Practitioner Resource Practitioner "Practitioner-example-01" Version "1" Updated "2019-05-29 02:58:58+0530" Profile: Practitioner identifier: Medical License number: 21-1521-3828-3227 name: Dr. Suresh Sharma
practitioner.identifier:
  index: 0
  identifier.type:
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/v2-0203
      coding.code:
        value: MD
      coding.display:
        value: Medical License number
  identifier.system:
    value: https://doctor.ndhm.gov.in
  identifier.value:
    value: 21-1521-3828-3227
practitioner.name:
  index: 0
  human name.text:
    value: Dr. Suresh Sharma

Organization-example-01
type: Organization
resource.id:
  value: Organization-example-01
resource.meta:
  meta.profile:
    value: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization
    index: 0
    link: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: Organization Resource Organization "Organization-example-01" Profile: Organization identifier: Provider number: 4567878 name: Appolo Hospital telecom: +91 243 2634 1234, contact@xyz.org
organization.identifier:
  index: 0
  identifier.type:
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/v2-0203
      coding.code:
        value: PRN
      coding.display:
        value: Provider number
  identifier.system:
    value: https://facility.ndhm.gov.in
  identifier.value:
    value: 4567878
organization.name:
  value: Appolo Hospital
organization.telecom:
  index: 0
  contact point.system:
    value: phone
  contact point.value:
    value: +91 243 2634 1234
  contact point.use:
    value: work
organization.telecom:
  index: 1
  contact point.system:
    value: email
  contact point.use:
    value: work

Organization-example-02
type: Organization
resource.id:
  value: Organization-example-02
resource.meta:
  meta.profile:
    value: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization
    index: 0
    link: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: Organization Resource Organization "Organization-example-02" Profile: Organization identifier: Provider number: 555511 name: Star Health Corporation. telecom: +91 555 2634 888, contact@xyz.org
organization.identifier:
  index: 0
  identifier.type:
    codeable concept.coding:
      index: 0
      coding.system:
        value: http://terminology.hl7.org/CodeSystem/v2-0203
      coding.code:
        value: PRN
      coding.display:
        value: Provider number
  identifier.system:
    value: http://irdai.gov.in/insurers
  identifier.value:
    value: 555511
organization.name:
  value: Star Health Corporation.
organization.telecom:
  index: 0
  contact point.system:
    value: phone
  contact point.value:
    value: +91 555 2634 888
  contact point.use:
    value: work
organization.telecom:
  index: 1
  contact point.system:
    value: email
  contact point.use:
    value: work

Location-example-01
type: Location
resource.id:
  value: Location-example-01
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: Location Resource Location "Location-example-01" identifier: id: B1-S.F2 status: active name: South Wing, second floor alias: University Medical Center, South Wing, second floor description: Second floor of the Old South Wing, formerly in use by Psychiatry mode: instance telecom: ph: 2328(WORK), fax: 2329(WORK), http://sampleorg.com/southwing address: Galapagosweg 91, Building A New Delhi 411058 IND (WORK) physicalType: Wing (Location type#wi) Positions - Longitude Latitude Altitude * -83.6945691 42.25475478 0 managingOrganization: Organization/example-01 "XYZ Lab Pvt.Ltd."
location.identifier:
  index: 0
  identifier.value:
    value: B1-S.F2
location.status:
  value: active
location.name:
  value: South Wing, second floor
location.alias:
  value: University Medical Center, South Wing, second floor
  index: 0
location.description:
  value: Second floor of the Old South Wing, formerly in use by Psychiatry
location.mode:
  value: instance
location.telecom:
  index: 0
  contact point.system:
    value: phone
  contact point.value:
    value: 2328
  contact point.use:
    value: work
location.telecom:
  index: 1
  contact point.system:
    value: fax
  contact point.value:
    value: 2329
  contact point.use:
    value: work
location.telecom:
  index: 2
  contact point.system:
    value: url
  contact point.value:
    value: http://sampleorg.com/southwing
  contact point.use:
    value: work
location.address:
  address.use:
    value: work
  address.line:
    value: Galapagosweg 91, Building A
    index: 0
  address.city:
    value: New Delhi
  address.postal code:
    value: 411058
  address.country:
    value: IND
location.physical type:
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/location-physical-type
    coding.code:
      value: wi
    coding.display:
      value: Wing
location.position:
  location.position.longitude:
    value: -83.6945691
  location.position.latitude:
    value: 42.25475478
  location.position.altitude:
    value: 0
location.managing organization:
  link: https://nrces.in/ndhm/fhir/r4/Organization/example-01
  reference.reference:
    value: Organization/example-01

Coverage-example-01
type: Coverage
resource.id:
  value: Coverage-example-01
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: Coverage Resource Coverage "Coverage-example-01" identifier: id: policy-RVH1003 status: active type: PAY (Coverage SelfPay Codes#pay) subscriber: Patient/example-01 "" beneficiary: Patient/example-01 "" relationship: Self (SubscriberPolicyholder Relationship Codes#self) period: ?? --> 2023-03-17 payor: Patient/example-01 ""
coverage.identifier:
  index: 0
  identifier.system:
    value: https://www.gicofIndia.in/policies
  identifier.value:
    value: policy-RVH1003
coverage.status:
  value: active
coverage.type:
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/coverage-selfpay
    coding.code:
      value: pay
    coding.display:
      value: PAY
coverage.subscriber:
  link: https://nrces.in/ndhm/fhir/r4/Patient/example-01
  reference.reference:
    value: Patient/example-01
coverage.beneficiary:
  link: https://nrces.in/ndhm/fhir/r4/Patient/example-01
  reference.reference:
    value: Patient/example-01
coverage.relationship:
  codeable concept.coding:
    index: 0
    coding.system:
      value: http://terminology.hl7.org/CodeSystem/subscriber-relationship
    coding.code:
      value: self
coverage.period:
  period.end:
    value: 2023-03-17
coverage.payor:
  index: 0
  link: https://nrces.in/ndhm/fhir/r4/Patient/example-01
  reference.reference:
    value: Patient/example-01

DocumentReference-example-01
type: DocumentReference
resource.id:
  value: DocumentReference-example-01
resource.meta:
  meta.profile:
    value: https://nrces.in/ndhm/fhir/r4/StructureDefinition/DocumentReference
    index: 0
    link: https://nrces.in/ndhm/fhir/r4/StructureDefinition/DocumentReference
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: DocumentReference Resource DocumentReference "DocumentReference-example-01" Profile: DocumentReference status: current docStatus: final subject: Patient/example-01 "" content Attachments - ContentType Language Data Title Creation * application/pdf en-IN [binary] Adhar Card PDF 2019-05-29 02:58:58+0530
document reference.status:
  value: current
document reference.doc status:
  value: final
document reference.subject:
  link: https://nrces.in/ndhm/fhir/r4/Patient/example-01
  reference.reference:
    value: Patient/example-01
document reference.content:
  index: 0
  document reference.content.attachment:
    attachment.content type:
      value: application/pdf
    attachment.language:
      value: en-IN
    attachment.title:
      value: Adhar Card PDF
    attachment.creation:
      value: 2019-05-29T14:58:58.181+05:30

Condition-example-01
type: Condition
resource.id:
  value: Condition-example-01
resource.meta:
  meta.profile:
    value: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Condition
    index: 0
    link: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Condition
domain resource.text:
  narrative.status:
    value: generated
  narrative.div: Generated Narrative: Condition Resource Condition "Condition-example-01" Profile: Condition code: Exposure to electric current, with passage of current through tissue (SNOMED CT#4989003 "Electrical burns to skin") subject: Patient/example-01 ""
condition.code:
  codeable concept.coding: http://snomed.info/id/4989003
    index: 0
    coding.system:
      value: http://snomed.info/sct
    coding.code:
      value: 4989003
    coding.display:
      value: Electrical burns to skin
  codeable concept.text:
    value: Exposure to electric current, with passage of current through tissue
condition.subject:
  link: https://nrces.in/ndhm/fhir/r4/Patient/example-01
  reference.reference:
    value: Patient/example-01