FHIR Implementation Guide for ABDM
3.1.0 - active
FHIR Implementation Guide for ABDM
3.1.0 - active
FHIR Implementation Guide for ABDM - Local Development build (v3.1.0). 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:id [ fhir:v "ClaimResponseBundle-example-01"] ; # fhir:meta [ ( fhir:profile [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/ClaimResponseBundle"^^xsd:anyURI ; fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/ClaimResponseBundle> ] ) ; ( fhir:security [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-Confidentiality"^^xsd:anyURI ] ; fhir:code [ fhir:v "V" ] ; fhir:display [ fhir:v "very restricted" ] ] ) ] ; # fhir:identifier [ fhir:system [ fhir:v "http://hip.in"^^xsd:anyURI ] ; fhir:value [ fhir:v "bc3c6c57-2053-4d0e-ac40-139ccccff645" ] ] ; # fhir:type [ fhir:v "collection"] ; # fhir:timestamp [ fhir:v "2020-07-09T15:32:26.605+05:30"^^xsd:dateTime] ; # fhir:entry ( [ fhir:fullUrl [ fhir:v "ClaimResponse/example-01"^^xsd:anyURI ] ; ( fhir:resource <ClaimResponse/example-01> ) ] [ fhir:fullUrl [ fhir:v "Patient/Patient-example-01"^^xsd:anyURI ] ; ( fhir:resource <Patient/Patient-example-01> ) ] [ fhir:fullUrl [ fhir:v "Organization/Organization-example-01"^^xsd:anyURI ] ; ( fhir:resource <Organization/Organization-example-01> ) ] [ fhir:fullUrl [ fhir:v "Organization/Organization-example-02"^^xsd:anyURI ] ; ( fhir:resource <Organization/Organization-example-02> ) ] [ fhir:fullUrl [ fhir:v "Claim/preauth-example-01"^^xsd:anyURI ] ; ( fhir:resource <Claim/preauth-example-01> ) ] [ fhir:fullUrl [ fhir:v "Coverage/Coverage-example-01"^^xsd:anyURI ] ; ( fhir:resource <Coverage/Coverage-example-01> ) ] [ fhir:fullUrl [ fhir:v "Condition/Condition-example-01"^^xsd:anyURI ] ; ( fhir:resource <Condition/Condition-example-01> ) ] [ fhir:fullUrl [ fhir:v "Condition/Condition-example-02"^^xsd:anyURI ] ; ( fhir:resource <Condition/Condition-example-02> ) ] ) . # <ClaimResponse/example-01> a fhir:ClaimResponse ; fhir:id [ fhir:v "example-01"] ; # fhir:meta [ ( fhir:profile [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/ClaimResponse"^^xsd:anyURI ; fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/ClaimResponse> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir: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 15:32:26+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 style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</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><p><b>amount</b></p><p><span title=\"Indian Rupee\">₹25,000.00</span> (INR)</p></blockquote></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 style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</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><p><b>amount</b></p><p><span title=\"Indian Rupee\">₹15,000.00</span> (INR)</p></blockquote></blockquote></blockquote><h3>ProcessNotes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Number</b></td><td><b>Type</b></td><td><b>Text</b></td><td><b>Language</b></td></tr><tr><td style=\"display: none\">*</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 style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</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:status [ fhir:v "active"] ; # fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ] ; fhir:code [ fhir:v "oral" ] ] ) ] ; # fhir:use [ fhir:v "preauthorization"] ; # fhir:patient [ fhir:reference [ fhir:v "Patient/Patient-example-01" ] ] ; # fhir:created [ fhir:v "2022-12-20T15:32:26.605+05:30"^^xsd:dateTime] ; # fhir:insurer [ fhir:reference [ fhir:v "Organization/Organization-example-01" ] ] ; # fhir:requestor [ fhir:reference [ fhir:v "Organization/Organization-example-01" ] ] ; # fhir:request [ fhir:reference [ fhir:v "Claim/preauth-example-01" ] ] ; # fhir:outcome [ fhir:v "complete"] ; # fhir:disposition [ fhir:v "The enclosed services are authorized for your provision within 30 days of this notice."] ; # fhir:preAuthRef [ fhir:v "18SS12345"] ; # fhir:payeeType [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/payeetype"^^xsd:anyURI ] ; fhir:code [ fhir:v "provider" ] ] ) ] ; # fhir:addItem ( [ ( fhir:itemSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ; fhir:productOrService [ ( fhir:coding [ a sct:38362002 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "38362002" ] ; fhir:display [ fhir:v "Dengue" ] ] ) ] ; ( fhir:programCode [ ( fhir:coding [ fhir:system [ fhir:v "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-program-code"^^xsd:anyURI ] ; fhir:code [ fhir:v "AB-PMJAY" ] ; fhir:display [ fhir:v "Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)" ] ] ) ] ) ; fhir:net [ fhir:value [ fhir:v "25000"^^xsd:decimal ] ; fhir:currency [ fhir:v "INR" ] ] ; ( fhir:adjudication [ fhir:category [ ( fhir:coding [ fhir:code [ fhir:v "eligible" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "25000"^^xsd:decimal ] ; fhir:currency [ fhir:v "INR" ] ] ] ) ] [ ( fhir:itemSequence [ fhir:v "2"^^xsd:positiveInteger ] ) ; fhir:productOrService [ ( fhir:coding [ a sct:236071009 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "236071009" ] ; fhir:display [ fhir:v "Chronic diarrhea" ] ] ) ] ; ( fhir:programCode [ ( fhir:coding [ fhir:system [ fhir:v "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-program-code"^^xsd:anyURI ] ; fhir:code [ fhir:v "AB-PMJAY" ] ; fhir:display [ fhir:v "Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)" ] ] ) ] ) ; fhir:net [ fhir:value [ fhir:v "15000"^^xsd:decimal ] ; fhir:currency [ fhir:v "INR" ] ] ; ( fhir:adjudication [ fhir:category [ ( fhir:coding [ fhir:code [ fhir:v "eligible" ] ] ) ] ; fhir:amount [ fhir:value [ fhir:v "15000"^^xsd:decimal ] ; fhir:currency [ fhir:v "INR" ] ] ] ) ] ) ; # fhir:processNote ( [ fhir:number [ fhir:v "101"^^xsd:positiveInteger ] ; fhir:type [ fhir:v "print" ] ; fhir:text [ fhir:v "Please submit a Pre-Authorization request if a more extensive examination or urgent services are required." ] ; fhir:language [ ( fhir:coding [ fhir:system [ fhir:v "urn:ietf:bcp:47"^^xsd:anyURI ] ; fhir:code [ fhir:v "en-IN" ] ] ) ] ] ) ; # fhir:insurance ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:focal [ fhir:v "true"^^xsd:boolean ] ; fhir:coverage [ fhir:reference [ fhir:v "Coverage/Coverage-example-01" ] ] ] ) . # <Patient/Patient-example-01> a fhir:Patient ; fhir:id [ fhir:v "Patient-example-01"] ; # fhir:meta [ fhir:versionId [ fhir:v "1" ] ; fhir:lastUpdated [ fhir:v "2020-07-09T14:58:58.181+05:30"^^xsd:dateTime ] ; ( fhir:profile [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient"^^xsd:anyURI ; fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir: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 14:58:58+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:identifier ( [ fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code"^^xsd:anyURI ] ; fhir:code [ fhir:v "ADN" ] ; fhir:display [ fhir:v "Adhaar number" ] ] ) ] ; fhir:system [ fhir:v "https://uidai.gov.in/"^^xsd:anyURI ] ; fhir:value [ fhir:v "7225-4829-5255" ] ] ) ; # fhir:name ( [ fhir:text [ fhir:v "Ayush Sharma" ] ] ) ; # fhir:telecom ( [ fhir:system [ fhir:v "phone" ] ; fhir:value [ fhir:v "+919818512600" ] ; fhir:use [ fhir:v "home" ] ] ) ; # fhir:gender [ fhir:v "male"] ; # fhir:birthDate [ fhir:v "1981-01-12"^^xsd:date] . # <Organization/Organization-example-01> a fhir:Organization ; fhir:id [ fhir:v "Organization-example-01"] ; # fhir:meta [ ( fhir:profile [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"^^xsd:anyURI ; fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir: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:identifier ( [ fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ; fhir:code [ fhir:v "PRN" ] ; fhir:display [ fhir:v "Provider number" ] ] ) ] ; fhir:system [ fhir:v "https://facility.ndhm.gov.in"^^xsd:anyURI ] ; fhir:value [ fhir:v "4567878" ] ] ) ; # fhir:name [ fhir:v "Appolo Hospital"] ; # fhir:telecom ( [ fhir:system [ fhir:v "phone" ] ; fhir:value [ fhir:v "+91 243 2634 1234" ] ; fhir:use [ fhir:v "work" ] ] [ fhir:system [ fhir:v "email" ] ; fhir:value [ fhir:v "contact@xyz.org" ] ; fhir:use [ fhir:v "work" ] ] ) . # <Organization/Organization-example-02> a fhir:Organization ; fhir:id [ fhir:v "Organization-example-02"] ; # fhir:meta [ ( fhir:profile [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"^^xsd:anyURI ; fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir: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:identifier ( [ fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ; fhir:code [ fhir:v "PRN" ] ; fhir:display [ fhir:v "Provider number" ] ] ) ] ; fhir:system [ fhir:v "https://facility.ndhm.gov.in"^^xsd:anyURI ] ; fhir:value [ fhir:v "555511" ] ] ) ; # fhir:name [ fhir:v "Star Health Corporation."] ; # fhir:telecom ( [ fhir:system [ fhir:v "phone" ] ; fhir:value [ fhir:v "+91 555 2634 888" ] ; fhir:use [ fhir:v "work" ] ] [ fhir:system [ fhir:v "email" ] ; fhir:value [ fhir:v "contact@xyz.org" ] ; fhir:use [ fhir:v "work" ] ] ) . # <Claim/preauth-example-01> a fhir:Claim ; fhir:id [ fhir:v "preauth-example-01"] ; # fhir:meta [ ( fhir:profile [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim"^^xsd:anyURI ; fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim> ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir: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 style=\"display: none\">-</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 style=\"display: none\">*</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 style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td><td><b>PreAuthRef</b></td></tr><tr><td style=\"display: none\">*</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 style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</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 style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>15000</td><td>INR</td></tr></table></blockquote></div>" ] ; # fhir:identifier ( [ fhir:system [ fhir:v "http://happypharma.com/claim"^^xsd:anyURI ] ; fhir:value [ fhir:v "7612345" ] ] ) ; # fhir:status [ fhir:v "active"] ; # fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ] ; fhir:code [ fhir:v "professional" ] ] ) ] ; # fhir:use [ fhir:v "preauthorization"] ; # fhir:patient [ fhir:reference [ fhir:v "Patient/example-01" ] ] ; # fhir:created [ fhir:v "2022-07-20T11:01:00+05:00"^^xsd:dateTime] ; # fhir:insurer [ fhir:reference [ fhir:v "Organization/Organization-example-02" ] ] ; # fhir:provider [ fhir:reference [ fhir:v "Organization/Organization-example-02" ] ] ; # fhir:priority [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/processpriority"^^xsd:anyURI ] ; fhir:code [ fhir:v "normal" ] ] ) ] ; # fhir:supportingInfo ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:category [ ( fhir:coding [ fhir:system [ fhir:v "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-supportinginfo-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "POI" ] ; fhir:display [ fhir:v "proof of identity" ] ] ) ] ; fhir:code [ ( fhir:coding [ fhir:system [ fhir:v "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code"^^xsd:anyURI ] ; fhir:code [ fhir:v "ADN" ] ; fhir:display [ fhir:v "Adhaar number" ] ] ) ] ; fhir:value [ a fhir:Reference ; fhir:reference [ fhir:v "DocumentReference/example-01" ] ] ] ) ; # fhir:diagnosis ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:diagnosis [ a fhir:Reference ; fhir:reference [ fhir:v "Condition/example-01" ] ] ; ( fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-diagnosistype"^^xsd:anyURI ] ; fhir:code [ fhir:v "clinical" ] ; fhir:display [ fhir:v "Clinical Diagnosis" ] ] ) ] ) ] [ fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ; fhir:diagnosis [ a fhir:Reference ; fhir:reference [ fhir:v "Condition/Condition-example-02" ] ] ; ( fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-diagnosistype"^^xsd:anyURI ] ; fhir:code [ fhir:v "clinical" ] ; fhir:display [ fhir:v "Clinical Diagnosis" ] ] ) ] ) ] ) ; # fhir:insurance ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:focal [ fhir:v "true"^^xsd:boolean ] ; fhir:coverage [ fhir:reference [ fhir:v "Coverage/example-01" ] ] ; ( fhir:preAuthRef [ fhir:v "12S52" ] ) ] ) ; # fhir:item ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:category [ ( fhir:coding [ a sct:781087000 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "781087000" ] ; fhir:display [ fhir:v "Medical care" ] ] ) ] ; fhir:productOrService [ ( fhir:coding [ a sct:38362002 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "38362002" ] ; fhir:display [ fhir:v "Dengue" ] ] ) ] ; ( fhir:programCode [ ( fhir:coding [ fhir:system [ fhir:v "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-program-code"^^xsd:anyURI ] ; fhir:code [ fhir:v "AB-PMJAY" ] ; fhir:display [ fhir:v "Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)" ] ] ) ] ) ; fhir:unitPrice [ fhir:value [ fhir:v "25000"^^xsd:decimal ] ; fhir:currency [ fhir:v "INR" ] ] ] [ fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ; fhir:category [ ( fhir:coding [ a sct:781087000 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "781087000" ] ; fhir:display [ fhir:v "Medical care" ] ] ) ] ; fhir:productOrService [ ( fhir:coding [ a sct:236071009 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "236071009" ] ; fhir:display [ fhir:v "Chronic diarrhea" ] ] ) ] ; ( fhir:programCode [ ( fhir:coding [ fhir:system [ fhir:v "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-program-code"^^xsd:anyURI ] ; fhir:code [ fhir:v "AB-PMJAY" ] ; fhir:display [ fhir:v "Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)" ] ] ) ] ) ; fhir:unitPrice [ fhir:value [ fhir:v "15000"^^xsd:decimal ] ; fhir:currency [ fhir:v "INR" ] ] ] ) . # <Coverage/Coverage-example-01> a fhir:Coverage ; fhir:id [ fhir:v "Coverage-example-01"] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir: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:identifier ( [ fhir:system [ fhir:v "http://hospitalx.com/selfpayagreement"^^xsd:anyURI ] ; fhir:value [ fhir:v "SP12345678" ] ] ) ; # fhir:status [ fhir:v "active"] ; # fhir:type [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-selfpay"^^xsd:anyURI ] ; fhir:code [ fhir:v "pay" ] ; fhir:display [ fhir:v "PAY" ] ] ) ] ; # fhir:subscriber [ fhir:reference [ fhir:v "Patient/example-01" ] ] ; # fhir:beneficiary [ fhir:reference [ fhir:v "Patient/example-01" ] ] ; # fhir:relationship [ ( fhir:coding [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/subscriber-relationship"^^xsd:anyURI ] ; fhir:code [ fhir:v "self" ] ] ) ] ; # fhir:period [ fhir:start [ fhir:v "2022-12-01"^^xsd:date ] ; fhir:end [ fhir:v "2025-03-17"^^xsd:date ] ] ; # fhir:payor ( [ fhir:reference [ fhir:v "Organization/example-01" ] ] ) . # <Condition/Condition-example-01> a fhir:Condition ; fhir:id [ fhir:v "Condition-example-01"] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir: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:code [ ( fhir:coding [ a sct:38362002 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "38362002" ] ; fhir:display [ fhir:v "Dengue (disorder)" ] ] ) ] ; # fhir:subject [ fhir:reference [ fhir:v "Patient/example-01" ] ] . # <Condition/Condition-example-02> a fhir:Condition ; fhir:id [ fhir:v "Condition-example-02"] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir: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:code [ ( fhir:coding [ a sct:17551007 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "17551007" ] ; fhir:display [ fhir:v "Chronic diarrhea of unknown origin (disorder)" ] ] ) ] ; # fhir:subject [ fhir:reference [ fhir:v "Patient/example-01" ] ] . #
IG © 2020+ National Resource Center for EHR Standards. Package ndhm.in#3.1.0 based on FHIR 4.0.1. Generated 2023-08-10
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