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
Resource Claim "Claim-settlement-example-01"
Profile: Claim
identifier: id: 7612345
status: active
type: Inpatient care management (procedure) (SNOMED CT#737481003)
subType: Emergency Claim (Example Claim SubType Codes#emergency)
use: claim
patient: Patient/example-01 ""
billablePeriod: 2023-12-09 11:01:00+0500 --> 2023-12-30 11:01:00+0500
created: 2023-12-30 11:01:00+0500
insurer: Organization/example-02 "XYZ Insurance Co. Ltd."
provider: Organization/example-03 "Maharashtra State Government"
priority: Normal (Process Priority Codes#normal)
Claim | Relationship |
Claim/Claim-enhancement-example-01 | Settlement (Related Claim Relationship Code#settlement) |
prescription: MedicationRequest/example-03
Sequence | Provider | Role | Qualification |
1 | Practitioner/example-01 "" | Healthcare professional (occupation) (SNOMED CT#223366009) | Clinical specialty (qualifier value) (SNOMED CT#394658006) |
supportingInfo
sequence: 1
category: Document Type - Investigation (SupportingInfo Category#INV)
code: Angiography (SNOMED CT#77343006)
value: DocumentReference/example-03
supportingInfo
sequence: 2
category: Document Type - Investigation (SupportingInfo Category#INV)
code: Angiography (SNOMED CT#77343006)
value: DocumentReference/example-03
Sequence | Diagnosis[x] | Type |
1 | Cardiac arrest, unspecified (ICD-10#I46.9) | Final diagnosis (discharge) (contextual qualifier) (qualifier value) (SNOMED CT#89100005) |
procedure
sequence: 1
procedure: Angiography (SNOMED CT#77343006)
procedure
sequence: 2
procedure: Angioplasty of blood vessel (SNOMED CT#418285008)
Sequence | Focal | Coverage | PreAuthRef |
1 | true | Coverage/example-02 | 123456 |
item
sequence: 1
careTeamSequence: 1
productOrService: Angiography (SNOMED CT#77343006)
serviced: 2023-12-09
quantity: 2 Angiography
UnitPrices
Value Currency 10000.00 INR Nets
Value Currency 20000.00 INR
item
sequence: 2
careTeamSequence: 1
productOrService: Angioplasty of blood vessel (SNOMED CT#418285008)
UnitPrices
Value Currency 50000 INR Nets
Value Currency 50000 INR
item
sequence: 3
careTeamSequence: 1
productOrService: Intensive care unit (SNOMED CT#309904001)
serviced: 2023-12-11
quantity: 10 day
UnitPrices
Value Currency 2000 INR Nets
Value Currency 20000 INR
item
sequence: 4
careTeamSequence: 1
productOrService: Aspirin 75 mg oral tablet (SNOMED CT#319775004)
quantity: 10 tablet
UnitPrices
Value Currency 10 INR Nets
Value Currency 100 INR
Value | Currency |
90100 | INR |