FHIR Implementation Guide for ABDM
4.0.0 - active
FHIR Implementation Guide for ABDM
4.0.0 - active
FHIR Implementation Guide for ABDM - Local Development build (v4.0.0). 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 "ClaimBundle-predeter-example-01"] ; #
fhir:meta [
fhir:versionId [ fhir:v "1" ] ;
fhir:lastUpdated [ fhir:v "2022-12-20T15:32:26.605+05:30"^^xsd:dateTime ] ;
( fhir:profile [
fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/ClaimBundle"^^xsd:anyURI ;
fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/ClaimBundle> ] ) ;
( 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 "2022-12-20T15:32:26.605+05:30"^^xsd:dateTime] ; #
fhir:entry ( [
fhir:fullUrl [ fhir:v "Claim/Claim-predeter-example-01"^^xsd:anyURI ] ;
( fhir:resource <Claim/Claim-predeter-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 "Coverage/Coverage-example-01"^^xsd:anyURI ] ;
( fhir:resource <Coverage/Coverage-example-01> )
] ) . #
<Claim/Claim-predeter-example-01> a fhir:Claim ;
fhir:id [ fhir:v "Claim-predeter-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=\"Claim-predeter-example-01\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource Claim "Claim-predeter-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>: Management of health status after discharge from hospital (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#710967003)</span></p><p><b>subType</b>: Emergency Claim <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-ex-claimsubtype.html\">Example Claim SubType Codes</a>#emergency)</span></p><p><b>use</b>: predetermination</p><p><b>patient</b>: <a href=\"#Patient_Patient-example-01\">See above (Patient/Patient-example-01)</a></p><p><b>created</b>: 2023-09-07</p><p><b>insurer</b>: <a href=\"#Organization_Organization-example-01\">See above (Organization/Organization-example-01)</a></p><p><b>provider</b>: <a href=\"#Organization_Organization-example-01\">See above (Organization/Organization-example-01)</a></p><p><b>priority</b>: Immediate <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#stat)</span></p><h3>Payees</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>Provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-payeetype.html\">Payee Type Codes</a>#provider)</span></td></tr></table><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>Type 2 diabetes mellitus : Without complications <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-icd10.html\">ICD-10</a>#E11.9)</span></td><td>Final diagnosis (discharge) (contextual qualifier) (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#89100005)</span></td></tr></table><h3>Procedures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Procedure[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>Consultant <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#768839008)</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><td><b>PreAuthRef</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><td>12S52</td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>careTeamSequence</b>: 1</p><p><b>productOrService</b>: Consultant <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#768839008)</span></p><p><b>serviced</b>: 2023-09-07</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>500.00</td><td>INR</td></tr></table><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>500.00</td><td>INR</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>careTeamSequence</b>: 1</p><p><b>productOrService</b>: Metformin hydrochloride 500 mg prolonged-release oral tablet <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#765507008)</span></p><p><b>serviced</b>: 2023-09-07</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>910.28</td><td>INR</td></tr></table><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>910.28</td><td>INR</td></tr></table></blockquote></div>"
] ; #
fhir:identifier ( [
fhir:system [ fhir:v "https://irdai.gov.in"^^xsd:anyURI ] ;
fhir:value [ fhir:v "7612345" ]
] ) ; #
fhir:status [ fhir:v "active"] ; #
fhir:type [
( fhir:coding [
a sct:710967003 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "710967003" ] ;
fhir:display [ fhir:v "Management of health status after discharge from hospital (procedure)" ] ] )
] ; #
fhir:subType [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-claimsubtype"^^xsd:anyURI ] ;
fhir:code [ fhir:v "emergency" ] ;
fhir:display [ fhir:v "Emergency Claim" ] ] )
] ; #
fhir:use [ fhir:v "predetermination"] ; #
fhir:patient [
fhir:reference [ fhir:v "Patient/Patient-example-01" ]
] ; #
fhir:created [ fhir:v "2023-09-07"^^xsd:date] ; #
fhir:insurer [
fhir:reference [ fhir:v "Organization/Organization-example-01" ]
] ; #
fhir:provider [
fhir:reference [ fhir:v "Organization/Organization-example-01" ]
] ; #
fhir:priority [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/processpriority"^^xsd:anyURI ] ;
fhir:code [ fhir:v "stat" ] ;
fhir:display [ fhir:v "Immediate" ] ] )
] ; #
fhir:payee [
fhir:type [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/payeetype"^^xsd:anyURI ] ;
fhir:code [ fhir:v "provider" ] ;
fhir:display [ fhir:v "Provider" ] ] ) ]
] ; #
fhir:diagnosis ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:diagnosis [
a fhir:CodeableConcept ;
( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/sid/icd-10"^^xsd:anyURI ] ;
fhir:code [ fhir:v "E11.9" ] ;
fhir:display [ fhir:v "Type 2 diabetes mellitus : Without complications" ] ] ) ] ;
( fhir:type [
( fhir:coding [
a sct:89100005 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "89100005" ] ;
fhir:display [ fhir:v "Final diagnosis (discharge) (contextual qualifier) (qualifier value)" ] ] ) ] )
] ) ; #
fhir:procedure ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:procedure [
a fhir:CodeableConcept ;
( fhir:coding [
a sct:768839008 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "768839008" ] ;
fhir:display [ fhir:v "Consultant" ] ] ) ]
] ) ; #
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" ] ] ;
( fhir:preAuthRef [ fhir:v "12S52" ] )
] ) ; #
fhir:item ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
( fhir:careTeamSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ;
fhir:productOrService [
( fhir:coding [
a sct:768839008 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "768839008" ] ;
fhir:display [ fhir:v "Consultant" ] ] ) ] ;
fhir:serviced [ fhir:v "2023-09-07"^^xsd:date ] ;
fhir:unitPrice [
fhir:value [ fhir:v "500.00"^^xsd:decimal ] ;
fhir:currency [ fhir:v "INR" ] ] ;
fhir:net [
fhir:value [ fhir:v "500.00"^^xsd:decimal ] ;
fhir:currency [ fhir:v "INR" ] ]
] [
fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ;
( fhir:careTeamSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ;
fhir:productOrService [
( fhir:coding [
a sct:765507008 ;
fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "765507008" ] ;
fhir:display [ fhir:v "Metformin hydrochloride 500 mg prolonged-release oral tablet" ] ] ) ] ;
fhir:serviced [ fhir:v "2023-09-07"^^xsd:date ] ;
fhir:unitPrice [
fhir:value [ fhir:v "910.28"^^xsd:decimal ] ;
fhir:currency [ fhir:v "INR" ] ] ;
fhir:net [
fhir:value [ fhir:v "910.28"^^xsd:decimal ] ;
fhir:currency [ fhir:v "INR" ] ]
] ) . #
<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 "2023-09-07T14:58:58.181+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 "2023-09-07 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>: Adarsh Agrawal</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 "Adarsh Agrawal" ]
] ) ; #
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>type</b>: Insurance Company <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-organization-type.html\">Organization type</a>#ins)</span></p><p><b>name</b>: XYZ Insurance Co. Ltd.</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:type ( [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/organization-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "ins" ] ;
fhir:display [ fhir:v "Insurance Company" ] ] )
] ) ; #
fhir:name [ fhir:v "XYZ Insurance Co. Ltd."] ; #
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" ]
] ) . #
<Coverage/Coverage-example-01> a fhir:Coverage ;
fhir:id [ fhir:v "Coverage-example-01"] ; #
fhir:meta [
( fhir:profile [
fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Coverage"^^xsd:anyURI ;
fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/Coverage> ] )
] ; #
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><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Coverage.html\">Coverage</a></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/5.3.0/CodeSystem-coverage-selfpay.html\">Coverage SelfPay Codes</a>#pay)</span></p><p><b>subscriber</b>: <a href=\"#Patient_Patient-example-01\">See above (Patient/Patient-example-01)</a></p><p><b>beneficiary</b>: <a href=\"#Patient_Patient-example-01\">See above (Patient/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/5.3.0/CodeSystem-subscriber-relationship.html\">SubscriberPolicyholder Relationship Codes</a>#self)</span></p><p><b>period</b>: ?? --> 2026-03-17</p><p><b>payor</b>: <a href=\"#Organization_Organization-example-01\">See above (Organization/Organization-example-01)</a></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/Patient-example-01" ]
] ; #
fhir:beneficiary [
fhir:reference [ fhir:v "Patient/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:end [ fhir:v "2026-03-17"^^xsd:date ]
] ; #
fhir:payor ( [
fhir:reference [ fhir:v "Organization/Organization-example-01" ]
] ) . #
IG © 2020+ National Resource Center for EHR Standards. Package ndhm.in#4.0.0 based on FHIR 4.0.1. Generated 2023-11-06
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