FHIR Implementation Guide for ABDM
6.0.0 - active
FHIR Implementation Guide for ABDM
6.0.0 - active
This page is part of the FHIR Implementation Guide for ABDM (v6.0.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
Resource Claim "Claim-predetermination-example-01"
Profile: Claim
identifier: https://irdai.gov.in/7612345
status: active
type: Inpatient care management (procedure) (SNOMED CT#737481003)
subType: Emergency Claim (Example Claim SubType Codes#emergency)
use: predetermination
patient: Patient/example-01 ""
billablePeriod: 2023-12-09 11:01:00+0500 --> 2023-12-30 11:01:00+0500
created: 2023-12-11 11:01:00+0500
insurer: Organization/example-02 "XYZ Insurance Co. Ltd."
provider: Organization/example-03 "XYZ Hospital Co. Ltd."
priority: Normal (Process Priority Codes#normal)
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) |
| Sequence | Category | Code | Value[x] |
| 1 | Document Type - Investigation (SupportingInfo Category#INV) | Angiography (SNOMED CT#77343006) | 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-01 | 123456 |
item
sequence: 1
careTeamSequence: 1
productOrService: Angiography (SNOMED CT#77343006)
serviced: 2023-12-09
UnitPrices
Value Currency 10000.00 INR Nets
Value Currency 10000.00 INR
item
sequence: 2
careTeamSequence: 1
productOrService: Angioplasty of blood vessel (SNOMED CT#418285008)
UnitPrices
Value Currency 40000 INR Nets
Value Currency 40000 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)
UnitPrices
Value Currency 100 INR Nets
Value Currency 100 INR
| Value | Currency |
| 70100 | INR |