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
<Bundle xmlns="http://hl7.org/fhir">
<id value="CoverageEligibilityResponseBundle-auth-requirements-example-01"/>
<meta>
<profile
value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponseBundle"/>
</meta>
<identifier>
<system value="http://hip.in"/>
<value value="bc3c6c57-2053-4d0e-ac40-139ccccff645"/>
</identifier>
<type value="collection"/>
<timestamp value="2023-09-07T15:32:26.605+05:30"/>
<entry>
<fullUrl
value="CoverageEligibilityResponse/CoverageEligibilityResponse-auth-requirements-example-01"/>
<resource>
<CoverageEligibilityResponse>
<id value="CoverageEligibilityResponse-auth-requirements-example-01"/>
<meta>
<profile
value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponse"/>
</meta>
<language value="en"/>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<purpose value="auth-requirements"/>
<patient>
<reference value="Patient/Patient-example-01"/>
</patient>
<created value="2023-09-07"/>
<requestor>
<reference value="Practitioner/Practitioner-example-01"/>
</requestor>
<request>
<reference
value="CoverageEligibilityRequest/CoverageEligibilityRequest-auth-requirement-example-01"/>
</request>
<outcome value="complete"/>
<disposition value="Policy is currently in-force."/>
<insurer>
<reference value="Organization/Organization-example-01"/>
</insurer>
<insurance>
<coverage>
<reference value="Coverage/Coverage-example-01"/>
</coverage>
<inforce value="true"/>
<benefitPeriod>
<start value="2023-09-07"/>
<end value="2026-08-07"/>
</benefitPeriod>
<item>
<productOrService>
<coding>
<system value="http://snomed.info/sct"/>
<code value="768839008"/>
<display value="Consultant"/>
</coding>
</productOrService>
</item>
<item>
<productOrService>
<coding>
<system value="http://snomed.info/sct"/>
<code value="765507008"/>
<display
value="Metformin hydrochloride 500 mg prolonged-release oral tablet"/>
</coding>
</productOrService>
</item>
</insurance>
</CoverageEligibilityResponse>
</resource>
</entry>
<entry>
<fullUrl value="Patient/Patient-example-01"/>
<resource>
<Patient>
<id value="Patient-example-01"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2023-09-07T14:58:58.181+05:30"/>
<profile
value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<type>
<coding>
<system
value="https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code"/>
<code value="ADN"/>
<display value="Adhaar number"/>
</coding>
</type>
<system value="https://uidai.gov.in/"/>
<value value="7225-4829-5255"/>
</identifier>
<name>
<text value="Adarsh Agrawal"/>
</name>
<telecom>
<system value="phone"/>
<value value="+919818512600"/>
<use value="home"/>
</telecom>
<gender value="male"/>
<birthDate value="1981-01-12"/>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="Practitioner/Practitioner-example-01"/>
<resource>
<Practitioner>
<id value="Practitioner-example-01"/>
<meta>
<versionId value="1"/>
<lastUpdated value="2023-09-07T14:58:58.181+05:30"/>
<profile
value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MD"/>
<display value="Medical License number"/>
</coding>
</type>
<system value="https://doctor.ndhm.gov.in"/>
<value value="21-1521-3828-3227"/>
</identifier>
<name>
<text value="Dr. Aayush Agrawal"/>
</name>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="Organization/Organization-example-01"/>
<resource>
<Organization>
<id value="Organization-example-01"/>
<meta>
<profile
value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="PRN"/>
<display value="Provider number"/>
</coding>
</type>
<system value="https://facility.ndhm.gov.in"/>
<value value="4567878"/>
</identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="ins"/>
<display value="Insurance Company"/>
</coding>
</type>
<name value="XYZ Insurance Co. Ltd."/>
<telecom>
<system value="phone"/>
<value value="+91 243 2634 1234"/>
<use value="work"/>
</telecom>
<telecom>
<system value="email"/>
<value value="contact@xyz.org"/>
<use value="work"/>
</telecom>
</Organization>
</resource>
</entry>
<entry>
<fullUrl
value="CoverageEligibilityRequest/CoverageEligibilityRequest-auth-requirement-example-01"/>
<resource>
<CoverageEligibilityRequest>
<id value="CoverageEligibilityRequest-auth-requirement-example-01"/>
<meta>
<profile
value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest"/>
</meta>
<language value="en"/>
<text>
<status value="generated"/>
<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: 7612345</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>
</text>
<identifier>
<system value="https://irdai.gov.in"/>
<value value="7612345"/>
</identifier>
<status value="active"/>
<priority>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/processpriority"/>
<code value="normal"/>
<display value="Normal"/>
</coding>
</priority>
<purpose value="auth-requirements"/>
<patient>
<reference value="Patient/Patient-example-01"/>
</patient>
<created value="2023-09-07T11:01:00+05:00"/>
<enterer>
<reference value="Practitioner/Practitioner-example-01"/>
</enterer>
<provider>
<reference value="Practitioner/Practitioner-example-01"/>
</provider>
<insurer>
<reference value="Organization/Organization-example-01"/>
</insurer>
<facility>
<reference value="Location/Location-example-01"/>
</facility>
<insurance>
<focal value="true"/>
<coverage>
<reference value="Coverage/Coverage-example-01"/>
</coverage>
</insurance>
<item>
<productOrService>
<coding>
<system value="http://snomed.info/sct"/>
<code value="768839008"/>
<display value="Consultant"/>
</coding>
</productOrService>
<diagnosis>
<diagnosisCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/sid/icd-10"/>
<code value="E11.9"/>
<display
value="Type 2 diabetes mellitus : Without complications"/>
</coding>
</diagnosisCodeableConcept>
</diagnosis>
</item>
<item>
<productOrService>
<coding>
<system value="http://snomed.info/sct"/>
<code value="765507008"/>
<display
value="Metformin hydrochloride 500 mg prolonged-release oral tablet"/>
</coding>
</productOrService>
<diagnosis>
<diagnosisCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/sid/icd-10"/>
<code value="E11.9"/>
<display
value="Type 2 diabetes mellitus : Without complications"/>
</coding>
</diagnosisCodeableConcept>
</diagnosis>
</item>
</CoverageEligibilityRequest>
</resource>
</entry>
<entry>
<fullUrl value="Location/Location-example-01"/>
<resource>
<Location>
<id value="Location-example-01"/>
<text>
<status value="generated"/>
<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: B1-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>
</text>
<identifier>
<value value="B1-S.F2"/>
</identifier>
<status value="active"/>
<name value="South Wing, second floor"/>
<alias
value="IndiaFirst Life Insurance Co. Ltd., South Wing, second floor"/>
<description
value="Second floor of the Old South Wing, formerly in use by Psychiatry"/>
<mode value="instance"/>
<telecom>
<system value="phone"/>
<value value="2328"/>
<use value="work"/>
</telecom>
<telecom>
<system value="fax"/>
<value value="2329"/>
<use value="work"/>
</telecom>
<telecom>
<system value="url"/>
<value value="http://sampleorg.com/southwing"/>
<use value="work"/>
</telecom>
<address>
<use value="work"/>
<line value="91, Building A"/>
<city value="Pune"/>
<postalCode value="451855"/>
<country value="IND"/>
</address>
<physicalType>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/location-physical-type"/>
<code value="wi"/>
<display value="Wing"/>
</coding>
</physicalType>
<position>
<longitude value="-83.6945691"/>
<latitude value="42.25475478"/>
<altitude value="0"/>
</position>
<managingOrganization>
<reference value="Organization/Organization-example-01"/>
</managingOrganization>
</Location>
</resource>
</entry>
<entry>
<fullUrl value="Coverage/Coverage-example-01"/>
<resource>
<Coverage>
<id value="Coverage-example-01"/>
<meta>
<profile
value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Coverage"/>
</meta>
<text>
<status value="generated"/>
<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: 235037120</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>
</text>
<identifier>
<system value="https://xyzinsurance.in/policynumber/"/>
<value value="235037120"/>
</identifier>
<status value="active"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-selfpay"/>
<code value="pay"/>
<display value="PAY"/>
</coding>
</type>
<subscriber>
<reference value="Patient/Patient-example-01"/>
</subscriber>
<subscriberId value="ABC123456BI007"/>
<beneficiary>
<reference value="Patient/Patient-example-01"/>
</beneficiary>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
<code value="self"/>
</coding>
</relationship>
<period>
<end value="2026-03-17"/>
</period>
<payor>
<reference value="Organization/Organization-example-01"/>
</payor>
</Coverage>
</resource>
</entry>
</Bundle>
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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