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

benefit-example-01
type: CoverageEligibilityRequest
id:
  v: benefit-example-01
meta:
  profile:
    v: https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest
    link: https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest
language:
  v: en
text:
  status:
    v: generated
  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)
identifier:
  system:
    v: https://www.tmh.in/coverage-eligibility-request
status:
  v: active
priority:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/processpriority
    code:
      v: normal
    display:
      v: Normal
purpose:
  v: benefits
patient:
  link: https://nrces.in/ndhm/fhir/r4/Patient/Patient-example-01
  reference:
    v: Patient/Patient-example-01
created:
  v: 2022-12-20T11:01:00+05:00
enterer:
  link: https://nrces.in/ndhm/fhir/r4/Practitioner/Practitioner-example-01
  reference:
    v: Practitioner/Practitioner-example-01
provider:
  link: https://nrces.in/ndhm/fhir/r4/Organization/Organization-example-02
  reference:
    v: Organization/Organization-example-02
insurer:
  link: https://nrces.in/ndhm/fhir/r4/Organization/Organization-example-01
  reference:
    v: Organization/Organization-example-01
facility:
  link: https://nrces.in/ndhm/fhir/r4/Location/Location-example-01
  reference:
    v: Location/Location-example-01
supporting info:
  sequence:
    v: 1
  information:
    link: https://nrces.in/ndhm/fhir/r4/DocumentReference/DocumentReference-example-01
    reference:
      v: DocumentReference/DocumentReference-example-01
  applies to all:
    v: true
insurance:
  focal:
    v: true
  coverage:
    link: https://nrces.in/ndhm/fhir/r4/Coverage/Coverage-example-01
    reference:
      v: Coverage/Coverage-example-01
item:
  supporting info sequence:
    v: 1
  product or service:
    coding: http://snomed.info/id/10849003
      system:
        v: http://snomed.info/sct
      code:
        v: 10849003
      display:
        v: Removal of foreign body
  unit price:
    value:
      v: 40000
    currency:
      v: INR
  diagnosis:
    diagnosis: Reference
      link: https://nrces.in/ndhm/fhir/r4/Condition/Condition-example-01
      reference:
        v: Condition/Condition-example-01

Patient-example-01
type: Patient
id:
  v: Patient-example-01
meta:
  version id:
    v: 1
  last updated:
    v: 2020-07-09T14:58:58.181+05:30
  profile:
    v: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient
    link: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient
text:
  status:
    v: generated
  div: Generated Narrative: Patient Resource Patient "Patient-example-01" Version "1" Updated "2020-07-09 14:58:58+0530" Profile: Patient identifier: Adhaar number: 5555-7225-4829 name: Ayush Sharma telecom: +919818512600 gender: male birthDate: 1981-01-12
identifier:
  type:
    coding:
      system:
        v: https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code
      code:
        v: ADN
      display:
        v: Adhaar number
  system:
    v: https://uidai.gov.in/
  value:
    v: 5555-7225-4829
name:
  text:
    v: Ayush Sharma
telecom:
  system:
    v: phone
  value:
    v: +919818512600
  use:
    v: home
gender:
  v: male
birth date:
  v: 1981-01-12

Practitioner-example-01
type: Practitioner
id:
  v: Practitioner-example-01
meta:
  version id:
    v: 1
  last updated:
    v: 2019-05-29T14:58:58.181+05:30
  profile:
    v: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner
    link: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner
text:
  status:
    v: generated
  div: Generated Narrative: Practitioner Resource Practitioner "Practitioner-example-01" Version "1" Updated "2019-05-29 14:58:58+0530" Profile: Practitioner identifier: Medical License number: 21-1521-3828-3227 name: Dr. Suresh Sharma
identifier:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: MD
      display:
        v: Medical License number
  system:
    v: https://doctor.ndhm.gov.in
  value:
    v: 21-1521-3828-3227
name:
  text:
    v: Dr. Suresh Sharma

Organization-example-01
type: Organization
id:
  v: Organization-example-01
meta:
  profile:
    v: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization
    link: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization
text:
  status:
    v: generated
  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
identifier:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: PRN
      display:
        v: Provider number
  system:
    v: https://facility.ndhm.gov.in
  value:
    v: 4567878
name:
  v: Appolo Hospital
telecom:
  system:
    v: phone
  value:
    v: +91 243 2634 1234
  use:
    v: work
telecom:
  system:
    v: email
  use:
    v: work

Organization-example-02
type: Organization
id:
  v: Organization-example-02
meta:
  profile:
    v: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization
    link: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization
text:
  status:
    v: generated
  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
identifier:
  type:
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/v2-0203
      code:
        v: PRN
      display:
        v: Provider number
  system:
    v: http://irdai.gov.in/insurers
  value:
    v: 555511
name:
  v: Star Health Corporation.
telecom:
  system:
    v: phone
  value:
    v: +91 555 2634 888
  use:
    v: work
telecom:
  system:
    v: email
  use:
    v: work

Location-example-01
type: Location
id:
  v: Location-example-01
text:
  status:
    v: generated
  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."
identifier:
  value:
    v: B1-S.F2
status:
  v: active
name:
  v: South Wing, second floor
alias:
  v: University Medical Center, South Wing, second floor
description:
  v: Second floor of the Old South Wing, formerly in use by Psychiatry
mode:
  v: instance
telecom:
  system:
    v: phone
  value:
    v: 2328
  use:
    v: work
telecom:
  system:
    v: fax
  value:
    v: 2329
  use:
    v: work
telecom:
  system:
    v: url
  value:
    v: http://sampleorg.com/southwing
  use:
    v: work
address:
  use:
    v: work
  line:
    v: Galapagosweg 91, Building A
  city:
    v: New Delhi
  postal code:
    v: 411058
  country:
    v: IND
physical type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/location-physical-type
    code:
      v: wi
    display:
      v: Wing
position:
  longitude:
    v: -83.6945691
  latitude:
    v: 42.25475478
  altitude:
    v: 0
managing organization:
  link: https://nrces.in/ndhm/fhir/r4/Organization/example-01
  reference:
    v: Organization/example-01

Coverage-example-01
type: Coverage
id:
  v: Coverage-example-01
text:
  status:
    v: generated
  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 ""
identifier:
  system:
    v: https://www.gicofIndia.in/policies
  value:
    v: policy-RVH1003
status:
  v: active
type:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/coverage-selfpay
    code:
      v: pay
    display:
      v: PAY
subscriber:
  link: https://nrces.in/ndhm/fhir/r4/Patient/example-01
  reference:
    v: Patient/example-01
beneficiary:
  link: https://nrces.in/ndhm/fhir/r4/Patient/example-01
  reference:
    v: Patient/example-01
relationship:
  coding:
    system:
      v: http://terminology.hl7.org/CodeSystem/subscriber-relationship
    code:
      v: self
period:
  end:
    v: 2023-03-17
payor:
  link: https://nrces.in/ndhm/fhir/r4/Patient/example-01
  reference:
    v: Patient/example-01

DocumentReference-example-01
type: DocumentReference
id:
  v: DocumentReference-example-01
meta:
  profile:
    v: https://nrces.in/ndhm/fhir/r4/StructureDefinition/DocumentReference
    link: https://nrces.in/ndhm/fhir/r4/StructureDefinition/DocumentReference
text:
  status:
    v: generated
  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 (base64 data - 80793 bytes) Adhar Card PDF 2019-05-29 14:58:58+0530
status:
  v: current
doc status:
  v: final
subject:
  link: https://nrces.in/ndhm/fhir/r4/Patient/example-01
  reference:
    v: Patient/example-01
content:
  attachment:
    content type:
      v: application/pdf
    language:
      v: en-IN
    title:
      v: Adhar Card PDF
    creation:
      v: 2019-05-29T14:58:58.181+05:30

Condition-example-01
type: Condition
id:
  v: Condition-example-01
meta:
  profile:
    v: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Condition
    link: https://nrces.in/ndhm/fhir/r4/StructureDefinition/Condition
text:
  status:
    v: generated
  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 ""
code:
  coding: http://snomed.info/id/4989003
    system:
      v: http://snomed.info/sct
    code:
      v: 4989003
    display:
      v: Electrical burns to skin
  text:
    v: Exposure to electric current, with passage of current through tissue
subject:
  link: https://nrces.in/ndhm/fhir/r4/Patient/example-01
  reference:
    v: Patient/example-01