FHIR Implementation Guide for ABDM
5.0.0 - active
India
FHIR Implementation Guide for ABDM
5.0.0 - active
India
FHIR Implementation Guide for ABDM - Local Development build (v5.0.0). See the Directory of published versions
{
"resourceType" : "Bundle",
"id" : "CoverageEligibilityResponseBundle-auth-requirements-example-01",
"meta" : {
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponseBundle"
]
},
"identifier" : {
"system" : "http://hip.in",
"value" : "bc3c6c57-2053-4d0e-ac40-139ccccff645"
},
"type" : "collection",
"timestamp" : "2023-09-07T15:32:26.605+05:30",
"entry" : [
{
"fullUrl" : "CoverageEligibilityResponse/CoverageEligibilityResponse-auth-requirements-example-01",
"resource" : {
"resourceType" : "CoverageEligibilityResponse",
"id" : "CoverageEligibilityResponse-auth-requirements-example-01",
"meta" : {
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponse"
]
},
"language" : "en",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p><b>Generated Narrative: CoverageEligibilityResponse</b><a name=\"CoverageEligibilityResponse-auth-requirements-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 CoverageEligibilityResponse "CoverageEligibilityResponse-auth-requirements-example-01" (Language "en") </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-CoverageEligibilityResponse.html\">CoverageEligibilityResponse</a></p></div><p><b>status</b>: active</p><p><b>purpose</b>: auth-requirements</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>requestor</b>: <a href=\"#Practitioner_Practitioner-example-01\">See above (Practitioner/Practitioner-example-01)</a></p><p><b>request</b>: <a href=\"#CoverageEligibilityRequest_CoverageEligibilityRequest-auth-requirement-example-01\">See above (CoverageEligibilityRequest/CoverageEligibilityRequest-auth-requirement-example-01)</a></p><p><b>outcome</b>: complete</p><p><b>disposition</b>: Policy is currently in-force.</p><p><b>insurer</b>: <a href=\"#Organization_Organization-example-01\">See above (Organization/Organization-example-01)</a></p><blockquote><p><b>insurance</b></p><p><b>coverage</b>: <a href=\"#Coverage_Coverage-example-01\">See above (Coverage/Coverage-example-01)</a></p><p><b>inforce</b>: true</p><p><b>benefitPeriod</b>: 2023-09-07 --> 2026-08-07</p><blockquote><p><b>item</b></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></blockquote><blockquote><p><b>item</b></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></blockquote></blockquote></div>"
},
"status" : "active",
"purpose" : [
"auth-requirements"
],
"patient" : {
"reference" : "Patient/Patient-example-01"
},
"created" : "2023-09-07",
"requestor" : {
"reference" : "Practitioner/Practitioner-example-01"
},
"request" : {
"reference" : "CoverageEligibilityRequest/CoverageEligibilityRequest-auth-requirement-example-01"
},
"outcome" : "complete",
"disposition" : "Policy is currently in-force.",
"insurer" : {
"reference" : "Organization/Organization-example-01"
},
"insurance" : [
{
"coverage" : {
"reference" : "Coverage/Coverage-example-01"
},
"inforce" : true,
"benefitPeriod" : {
"start" : "2023-09-07",
"end" : "2026-08-07"
},
"item" : [
{
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "768839008",
"display" : "Consultant"
}
]
}
},
{
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "765507008",
"display" : "Metformin hydrochloride 500 mg prolonged-release oral tablet"
}
]
}
}
]
}
]
}
},
{
"fullUrl" : "Patient/Patient-example-01",
"resource" : {
"resourceType" : "Patient",
"id" : "Patient-example-01",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2023-09-07T14:58:58.181+05:30",
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient"
]
},
"text" : {
"status" : "generated",
"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>"
},
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code",
"code" : "ADN",
"display" : "Adhaar number"
}
]
},
"system" : "https://uidai.gov.in/",
"value" : "7225-4829-5255"
}
],
"name" : [
{
"text" : "Adarsh Agrawal"
}
],
"telecom" : [
{
"system" : "phone",
"value" : "+919818512600",
"use" : "home"
}
],
"gender" : "male",
"birthDate" : "1981-01-12"
}
},
{
"fullUrl" : "Practitioner/Practitioner-example-01",
"resource" : {
"resourceType" : "Practitioner",
"id" : "Practitioner-example-01",
"meta" : {
"versionId" : "1",
"lastUpdated" : "2023-09-07T14:58:58.181+05:30",
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Practitioner</b><a name=\"Practitioner-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 Practitioner "Practitioner-example-01" Version "1" Updated "2023-09-07 14:58:58+0530" </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Practitioner.html\">Practitioner</a></p></div><p><b>identifier</b>: Medical License number: 21-1521-3828-3227</p><p><b>name</b>: Dr. Aayush Agrawal</p></div>"
},
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MD",
"display" : "Medical License number"
}
]
},
"system" : "https://doctor.ndhm.gov.in",
"value" : "21-1521-3828-3227"
}
],
"name" : [
{
"text" : "Dr. Aayush Agrawal"
}
]
}
},
{
"fullUrl" : "Organization/Organization-example-01",
"resource" : {
"resourceType" : "Organization",
"id" : "Organization-example-01",
"meta" : {
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"
]
},
"text" : {
"status" : "generated",
"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>"
},
"identifier" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "PRN",
"display" : "Provider number"
}
]
},
"system" : "https://facility.ndhm.gov.in",
"value" : "4567878"
}
],
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/organization-type",
"code" : "ins",
"display" : "Insurance Company"
}
]
}
],
"name" : "XYZ Insurance Co. Ltd.",
"telecom" : [
{
"system" : "phone",
"value" : "+91 243 2634 1234",
"use" : "work"
},
{
"system" : "email",
"value" : "contact@xyz.org",
"use" : "work"
}
]
}
},
{
"fullUrl" : "CoverageEligibilityRequest/CoverageEligibilityRequest-auth-requirement-example-01",
"resource" : {
"resourceType" : "CoverageEligibilityRequest",
"id" : "CoverageEligibilityRequest-auth-requirement-example-01",
"meta" : {
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest"
]
},
"language" : "en",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p><b>Generated Narrative: CoverageEligibilityRequest</b><a name=\"CoverageEligibilityRequest-auth-requirement-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 CoverageEligibilityRequest "CoverageEligibilityRequest-auth-requirement-example-01" (Language "en") </p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-CoverageEligibilityRequest.html\">CoverageEligibilityRequest</a></p></div><p><b>identifier</b>: id:\u00a07612345</p><p><b>status</b>: active</p><p><b>priority</b>: Normal <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>#normal)</span></p><p><b>purpose</b>: auth-requirements</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 11:01:00+0500</p><p><b>enterer</b>: <a href=\"#Practitioner_Practitioner-example-01\">See above (Practitioner/Practitioner-example-01)</a></p><p><b>provider</b>: <a href=\"#Practitioner_Practitioner-example-01\">See above (Practitioner/Practitioner-example-01)</a></p><p><b>insurer</b>: <a href=\"#Organization_Organization-example-01\">See above (Organization/Organization-example-01)</a></p><p><b>facility</b>: <a href=\"#Location_Location-example-01\">See above (Location/Location-example-01)</a></p><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>true</td><td><a href=\"#Coverage_Coverage-example-01\">See above (Coverage/Coverage-example-01)</a></td></tr></table><blockquote><p><b>item</b></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><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\"display: none\">*</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></tr></table></blockquote><blockquote><p><b>item</b></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><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\"display: none\">*</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></tr></table></blockquote></div>"
},
"identifier" : [
{
"system" : "https://irdai.gov.in",
"value" : "7612345"
}
],
"status" : "active",
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/processpriority",
"code" : "normal",
"display" : "Normal"
}
]
},
"purpose" : [
"auth-requirements"
],
"patient" : {
"reference" : "Patient/Patient-example-01"
},
"created" : "2023-09-07T11:01:00+05:00",
"enterer" : {
"reference" : "Practitioner/Practitioner-example-01"
},
"provider" : {
"reference" : "Practitioner/Practitioner-example-01"
},
"insurer" : {
"reference" : "Organization/Organization-example-01"
},
"facility" : {
"reference" : "Location/Location-example-01"
},
"insurance" : [
{
"focal" : true,
"coverage" : {
"reference" : "Coverage/Coverage-example-01"
}
}
],
"item" : [
{
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "768839008",
"display" : "Consultant"
}
]
},
"diagnosis" : [
{
"diagnosisCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/sid/icd-10",
"code" : "E11.9",
"display" : "Type 2 diabetes mellitus : Without complications"
}
]
}
}
]
},
{
"productOrService" : {
"coding" : [
{
"system" : "http://snomed.info/sct",
"code" : "765507008",
"display" : "Metformin hydrochloride 500 mg prolonged-release oral tablet"
}
]
},
"diagnosis" : [
{
"diagnosisCodeableConcept" : {
"coding" : [
{
"system" : "http://hl7.org/fhir/sid/icd-10",
"code" : "E11.9",
"display" : "Type 2 diabetes mellitus : Without complications"
}
]
}
}
]
}
]
}
},
{
"fullUrl" : "Location/Location-example-01",
"resource" : {
"resourceType" : "Location",
"id" : "Location-example-01",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Location</b><a name=\"Location-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 Location "Location-example-01" </p></div><p><b>identifier</b>: id:\u00a0B1-S.F2</p><p><b>status</b>: active</p><p><b>name</b>: South Wing, second floor</p><p><b>alias</b>: IndiaFirst Life Insurance Co. Ltd., South Wing, second floor</p><p><b>description</b>: Second floor of the Old South Wing, formerly in use by Psychiatry</p><p><b>mode</b>: instance</p><p><b>telecom</b>: ph: 2328(WORK), fax: 2329(WORK), <a href=\"http://sampleorg.com/southwing\">http://sampleorg.com/southwing</a></p><p><b>address</b>: 91, Building A Pune 451855 IND (WORK)</p><p><b>physicalType</b>: Wing <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.3.0/CodeSystem-location-physical-type.html\">Location type</a>#wi)</span></p><h3>Positions</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Longitude</b></td><td><b>Latitude</b></td><td><b>Altitude</b></td></tr><tr><td style=\"display: none\">*</td><td>-83.6945691</td><td>42.25475478</td><td>0</td></tr></table><p><b>managingOrganization</b>: <a href=\"#Organization_Organization-example-01\">See above (Organization/Organization-example-01)</a></p></div>"
},
"identifier" : [
{
"value" : "B1-S.F2"
}
],
"status" : "active",
"name" : "South Wing, second floor",
"alias" : [
"IndiaFirst Life Insurance Co. Ltd., South Wing, second floor"
],
"description" : "Second floor of the Old South Wing, formerly in use by Psychiatry",
"mode" : "instance",
"telecom" : [
{
"system" : "phone",
"value" : "2328",
"use" : "work"
},
{
"system" : "fax",
"value" : "2329",
"use" : "work"
},
{
"system" : "url",
"value" : "http://sampleorg.com/southwing",
"use" : "work"
}
],
"address" : {
"use" : "work",
"line" : [
"91, Building A"
],
"city" : "Pune",
"postalCode" : "451855",
"country" : "IND"
},
"physicalType" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/location-physical-type",
"code" : "wi",
"display" : "Wing"
}
]
},
"position" : {
"longitude" : -83.6945691,
"latitude" : 42.25475478,
"altitude" : 0
},
"managingOrganization" : {
"reference" : "Organization/Organization-example-01"
}
}
},
{
"fullUrl" : "Coverage/Coverage-example-01",
"resource" : {
"resourceType" : "Coverage",
"id" : "Coverage-example-01",
"meta" : {
"profile" : [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Coverage"
]
},
"text" : {
"status" : "generated",
"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:\u00a0235037120</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>subscriberId</b>: ABC123456BI007</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>"
},
"identifier" : [
{
"system" : "https://xyzinsurance.in/policynumber/",
"value" : "235037120"
}
],
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/coverage-selfpay",
"code" : "pay",
"display" : "PAY"
}
]
},
"subscriber" : {
"reference" : "Patient/Patient-example-01"
},
"subscriberId" : "ABC123456BI007",
"beneficiary" : {
"reference" : "Patient/Patient-example-01"
},
"relationship" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
"code" : "self"
}
]
},
"period" : {
"end" : "2026-03-17"
},
"payor" : [
{
"reference" : "Organization/Organization-example-01"
}
]
}
}
]
}
IG © 2020+ National Resource Center for EHR Standards. Package ndhm.in#5.0.0 based on FHIR 4.0.1. Generated 2023-12-22
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