Atrius India Core FHIR Implementation Guide
0.1.0 - ci-build

Atrius India Core FHIR Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Atrius India Core Claim

Official URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-claim Version: 0.1.0
Draft as of 2026-08-30 Computable Name: AtriusInClaim
Other Identifiers: OID:1.3.6.1.4.1.66219.1.42.25

Atrius India Core profile. Parent: FHIR R4. Structurally aligned with QI-Core. India terminology via NDHM ValueSets where noted. Legacy QI-Core projection: runtime-mapper.

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim 0..* Claim(4.0.1) Claim, Pre-determination or Pre-authorization
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
.... extension:placeOfSupply S 0..1 string Atrius Place of Supply State
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-place-of-supply-state
Constraints: ext-1
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
... type Σ 1..1 CodeableConcept Category or discipline
Binding: ClaimType (6.5.0) (extensible)
... use Σ 1..1 code claim | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
... patient Σ 1..1 Reference(Atrius India Core Patient(0.1.0)) The recipient of the products and services
... created Σ 1..1 dateTime Resource creation date
... enterer 0..1 Reference(Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0)) Author of the claim
... insurer SΣ 1..1 Reference(Atrius India Core Organization(0.1.0)) Target
... provider Σ 1..1 Reference(Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0) | Atrius India Core Organization(0.1.0)) Party responsible for the claim
... priority Σ 1..1 CodeableConcept Desired processing ugency
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
... prescription 0..1 Reference(Atrius India Core DeviceRequest(0.1.0) | Atrius India Core Device Requested(0.1.0) | Atrius India Core Device Prohibited(0.1.0) | Atrius India Core MedicationRequest(0.1.0) | Atrius India Core Medication Requested(0.1.0) | Atrius India Core Medication Prohibited(0.1.0)) Prescription authorizing services and products
... referral 0..1 Reference(Atrius India Core ServiceRequest(0.1.0) | Atrius India Core Service Not Requested(0.1.0)) Treatment referral
... facility 0..1 Reference(Atrius India Core Location(0.1.0)) Servicing facility
... supportingInfo S 0..* BackboneElement Supporting information
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Information instance identifier
.... category 1..1 CodeableConcept Classification of the supplied information
Binding: SupportingInfoCategory (6.5.0) (preferred)
.... code S 1..1 CodeableConcept Type of information
Binding: SupportingInfoCode (6.5.0) (preferred)
... diagnosis S 1..* BackboneElement Pertinent diagnosis information
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Diagnosis instance identifier
.... Slices for diagnosis[x] 1..1 Nature of illness or problem
Slice: Unordered, Open by type:$this
Binding: ICD10Diagnosticcodes (6.5.0) (example)
..... diagnosisCodeableConcept CodeableConcept
..... diagnosisReference Reference(Condition)
..... diagnosis[x]:diagnosisReference 0..1 Reference(Atrius India Core Condition(0.1.0)) Nature of illness or problem
.... type S 1..* CodeableConcept Timing or nature of the diagnosis
Binding: DiagnosticType (6.5.0) (example)
... insurance SΣ 1..* BackboneElement Patient insurance information
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence Σ 1..1 positiveInt Insurance instance identifier
.... focal Σ 1..1 boolean Coverage to be used for adjudication
.... coverage Σ 1..1 Reference(Atrius India Core Coverage(0.1.0)) Insurance information
.... claimResponse 0..1 Reference(Atrius India Core ClaimResponse(0.1.0)) Adjudication results
... item S 1..* BackboneElement Product or service provided
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:hsnSac 0..1 CodeableConcept Atrius HSN or SAC Code
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-hsn-sac-code
Binding: AtriusHsnSacVS (0.1.0) (example)
Constraints: ext-1
..... extension:gstBreakdown 0..1 (Complex) Atrius GST Line Breakdown
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-gst-line-breakdown
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Item instance identifier
.... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategory (6.5.0) (example)
.... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: ProductorService (6.5.0) (example)
.... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ProgramCode (6.5.0) (example)
.... location[x] 0..1 Place of service or where product was supplied
Binding: EncounterTypes (6.5.0) (example)
..... locationCodeableConcept CodeableConcept
..... locationAddress Address
..... locationReference Reference(Location)
.... encounter 0..* Reference(Atrius India Core Encounter(0.1.0)) Encounters related to this billed item

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Claim.status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
Claim.type Base extensible Claim Type 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.use Base required Use 📍4.0.1 FHIR Std.
Claim.priority Base example Process Priority Codes 📍4.0.1 FHIR Std.
Claim.supportingInfo.​category Base preferred SupportingInfo Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.supportingInfo.​code Base preferred SupportingInfo Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.diagnosis.diagnosis[x] Base example ICD10 Diagnostic codes 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.diagnosis.type Base example Diagnostic Type 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.category Base example Benefit Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.productOrService Base example ProductorService 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.programCode Base example Program Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.location[x] Base example EncounterTypes 📍6.5.0 FHIR Implementation Guide for ABDM v6.5

Constraints

Id Grade Path(s) Description Expression
dom-2 error Claim If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Claim If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Claim If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Claim If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Claim A resource should have narrative for robust management text.`div`.exists()
ele-1 error Claim.implicitRules, Claim.extension, Claim.extension:placeOfSupply, Claim.modifierExtension, Claim.identifier, Claim.status, Claim.type, Claim.use, Claim.patient, Claim.created, Claim.enterer, Claim.insurer, Claim.provider, Claim.priority, Claim.prescription, Claim.referral, Claim.facility, Claim.supportingInfo, Claim.supportingInfo.modifierExtension, Claim.supportingInfo.sequence, Claim.supportingInfo.category, Claim.supportingInfo.code, Claim.diagnosis, Claim.diagnosis.modifierExtension, Claim.diagnosis.sequence, Claim.diagnosis.diagnosis[x], Claim.diagnosis.diagnosis[x]:diagnosisReference, Claim.diagnosis.type, Claim.insurance, Claim.insurance.modifierExtension, Claim.insurance.sequence, Claim.insurance.focal, Claim.insurance.coverage, Claim.insurance.claimResponse, Claim.item, Claim.item.extension, Claim.item.extension:hsnSac, Claim.item.extension:gstBreakdown, Claim.item.modifierExtension, Claim.item.sequence, Claim.item.category, Claim.item.productOrService, Claim.item.programCode, Claim.item.location[x], Claim.item.encounter All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error Claim.extension, Claim.extension:placeOfSupply, Claim.modifierExtension, Claim.supportingInfo.modifierExtension, Claim.diagnosis.modifierExtension, Claim.insurance.modifierExtension, Claim.item.extension, Claim.item.extension:hsnSac, Claim.item.extension:gstBreakdown, Claim.item.modifierExtension Must have either extensions or value[x], not both extension.exists() != value.exists()

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim Claim(4.0.1)
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:placeOfSupply S 0..1 string Atrius Place of Supply State
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-place-of-supply-state
... identifier S 1..* Identifier Business Identifier for claim
... type 1..1 CodeableConcept Category or discipline
Binding: ClaimType (6.5.0) (extensible)
... enterer 0..1 Reference(Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0)) Author of the claim
... insurer S 1..1 Reference(Atrius India Core Organization(0.1.0)) Target
... provider 1..1 Reference(Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0) | Atrius India Core Organization(0.1.0)) Party responsible for the claim
... related
.... claim 0..1 Reference(Atrius India Core Claim(0.1.0)) Reference to the related claim
.... relationship 0..1 CodeableConcept How the reference claim is related
Binding: RelatedClaimRelationship (6.5.0) (example)
..... coding 0..1 Coding Code defined by a terminology system
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
... prescription 0..1 Reference(Atrius India Core DeviceRequest(0.1.0) | Atrius India Core Device Requested(0.1.0) | Atrius India Core Device Prohibited(0.1.0) | Atrius India Core MedicationRequest(0.1.0) | Atrius India Core Medication Requested(0.1.0) | Atrius India Core Medication Prohibited(0.1.0)) Prescription authorizing services and products
... payee
.... party 0..1 Reference(Atrius India Core Patient(0.1.0) | Atrius India Core RelatedPerson(0.1.0) | Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0) | Atrius India Core Organization(0.1.0)) Recipient reference
... referral 0..1 Reference(Atrius India Core ServiceRequest(0.1.0) | Atrius India Core Service Not Requested(0.1.0)) Treatment referral
... facility 0..1 Reference(Atrius India Core Location(0.1.0)) Servicing facility
... careTeam
.... provider 1..1 Reference(Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0) | Atrius India Core Organization(0.1.0)) Practitioner or organization
.... role 0..1 CodeableConcept Function within the team
Binding: CareTeamRole (6.5.0) (example)
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
.... qualification 0..1 CodeableConcept Practitioner credential or specialization
Binding: CareTeamQualification (6.5.0) (example)
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
... supportingInfo S 0..* BackboneElement Supporting information
.... category 1..1 CodeableConcept Classification of the supplied information
Binding: SupportingInfoCategory (6.5.0) (preferred)
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
.... code S 1..1 CodeableConcept Type of information
Binding: SupportingInfoCode (6.5.0) (preferred)
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
... diagnosis S 1..* BackboneElement Pertinent diagnosis information
.... Slices for diagnosis[x] 1..1 CodeableConcept, Reference(Condition) Nature of illness or problem
Slice: Unordered, Open by type:$this
Binding: ICD10Diagnosticcodes (6.5.0) (example)
..... diagnosis[x]:diagnosisReference 0..1 Reference(Atrius India Core Condition(0.1.0)) Nature of illness or problem
.... type S 1..* CodeableConcept Timing or nature of the diagnosis
Binding: DiagnosticType (6.5.0) (example)
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
... procedure
.... Slices for procedure[x] 1..1 CodeableConcept, Reference(Procedure) Specific clinical procedure
Slice: Unordered, Open by type:$this
Binding: ProcedureCodes(SNOMEDCT) (example)
..... procedure[x]:procedureReference 0..1 Reference(Atrius India Core Procedure(0.1.0) | Atrius India Core Procedure Not Done(0.1.0)) Specific clinical procedure
... insurance S 1..* BackboneElement Patient insurance information
.... coverage 1..1 Reference(Atrius India Core Coverage(0.1.0)) Insurance information
.... claimResponse 0..1 Reference(Atrius India Core ClaimResponse(0.1.0)) Adjudication results
... item S 1..* BackboneElement Product or service provided
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:hsnSac 0..1 CodeableConcept Atrius HSN or SAC Code
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-hsn-sac-code
Binding: AtriusHsnSacVS (0.1.0) (example)
..... extension:gstBreakdown 0..1 (Complex) Atrius GST Line Breakdown
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-gst-line-breakdown
.... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategory (6.5.0) (example)
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
.... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: ProductorService (6.5.0) (example)
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
.... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ProgramCode (6.5.0) (example)
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
.... location[x] 0..1 CodeableConcept, Address, Reference(Location) Place of service or where product was supplied
Binding: EncounterTypes (6.5.0) (example)
.... encounter 0..* Reference(Atrius India Core Encounter(0.1.0)) Encounters related to this billed item
.... detail
..... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategory (6.5.0) (example)
...... coding
....... system 1..1 uri Identity of the terminology system
....... code 1..1 code Symbol in syntax defined by the system
....... display 1..1 string Representation defined by the system
..... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: ProductorService (6.5.0) (example)
...... coding
....... system 1..1 uri Identity of the terminology system
....... code 1..1 code Symbol in syntax defined by the system
....... display 1..1 string Representation defined by the system
..... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ProgramCode (6.5.0) (example)
...... coding
....... system 1..1 uri Identity of the terminology system
....... code 1..1 code Symbol in syntax defined by the system
....... display 1..1 string Representation defined by the system
..... subDetail
...... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategory (6.5.0) (example)
....... coding
........ system 1..1 uri Identity of the terminology system
........ code 1..1 code Symbol in syntax defined by the system
........ display 1..1 string Representation defined by the system
...... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: ProductorService (6.5.0) (example)
....... coding
........ system 1..1 uri Identity of the terminology system
........ code 1..1 code Symbol in syntax defined by the system
........ display 1..1 string Representation defined by the system
...... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ProgramCode (6.5.0) (example)
....... coding
........ system 1..1 uri Identity of the terminology system
........ code 1..1 code Symbol in syntax defined by the system
........ display 1..1 string Representation defined by the system

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Claim.type Base extensible Claim Type 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.related.relationship Base example Related Claim Relationship 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.careTeam.role Base example Care Team Role 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.careTeam.qualification Base example Care Team Qualification 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.supportingInfo.​category Base preferred SupportingInfo Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.supportingInfo.​code Base preferred SupportingInfo Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.diagnosis.diagnosis[x] Base example ICD10 Diagnostic codes 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.diagnosis.type Base example Diagnostic Type 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.procedure.procedure[x] Base example Procedure Codes (SNOMED CT) 📍4.0.1 FHIR Std.
Claim.item.category Base example Benefit Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.productOrService Base example ProductorService 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.programCode Base example Program Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.location[x] Base example EncounterTypes 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.category Base example Benefit Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.productOrService Base example ProductorService 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.programCode Base example Program Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.subDetail.​category Base example Benefit Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.subDetail.​productOrService Base example ProductorService 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.subDetail.​programCode Base example Program Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim 0..* Claim(4.0.1) Claim, Pre-determination or Pre-authorization
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
.... extension:placeOfSupply S 0..1 string Atrius Place of Supply State
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-place-of-supply-state
Constraints: ext-1
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... identifier S 1..* Identifier Business Identifier for claim
... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
... type Σ 1..1 CodeableConcept Category or discipline
Binding: ClaimType (6.5.0) (extensible)
... subType 0..1 CodeableConcept More granular claim type
Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode.
... use Σ 1..1 code claim | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
... patient Σ 1..1 Reference(Atrius India Core Patient(0.1.0)) The recipient of the products and services
... billablePeriod Σ 0..1 Period Relevant time frame for the claim
... created Σ 1..1 dateTime Resource creation date
... enterer 0..1 Reference(Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0)) Author of the claim
... insurer SΣ 1..1 Reference(Atrius India Core Organization(0.1.0)) Target
... provider Σ 1..1 Reference(Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0) | Atrius India Core Organization(0.1.0)) Party responsible for the claim
... priority Σ 1..1 CodeableConcept Desired processing ugency
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
... fundsReserve 0..1 CodeableConcept For whom to reserve funds
Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).
... related 0..* BackboneElement Prior or corollary claims
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... claim 0..1 Reference(Atrius India Core Claim(0.1.0)) Reference to the related claim
.... relationship 0..1 CodeableConcept How the reference claim is related
Binding: RelatedClaimRelationship (6.5.0) (example)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..1 Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... reference 0..1 Identifier File or case reference
... prescription 0..1 Reference(Atrius India Core DeviceRequest(0.1.0) | Atrius India Core Device Requested(0.1.0) | Atrius India Core Device Prohibited(0.1.0) | Atrius India Core MedicationRequest(0.1.0) | Atrius India Core Medication Requested(0.1.0) | Atrius India Core Medication Prohibited(0.1.0)) Prescription authorizing services and products
... originalPrescription 0..1 Reference(DeviceRequest | MedicationRequest | VisionPrescription) Original prescription if superseded by fulfiller
... payee 0..1 BackboneElement Recipient of benefits payable
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... type 1..1 CodeableConcept Category of recipient
Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.
.... party 0..1 Reference(Atrius India Core Patient(0.1.0) | Atrius India Core RelatedPerson(0.1.0) | Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0) | Atrius India Core Organization(0.1.0)) Recipient reference
... referral 0..1 Reference(Atrius India Core ServiceRequest(0.1.0) | Atrius India Core Service Not Requested(0.1.0)) Treatment referral
... facility 0..1 Reference(Atrius India Core Location(0.1.0)) Servicing facility
... careTeam 0..* BackboneElement Members of the care team
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Order of care team
.... provider 1..1 Reference(Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0) | Atrius India Core Organization(0.1.0)) Practitioner or organization
.... responsible 0..1 boolean Indicator of the lead practitioner
.... role 0..1 CodeableConcept Function within the team
Binding: CareTeamRole (6.5.0) (example)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... qualification 0..1 CodeableConcept Practitioner credential or specialization
Binding: CareTeamQualification (6.5.0) (example)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
... supportingInfo S 0..* BackboneElement Supporting information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Information instance identifier
.... category 1..1 CodeableConcept Classification of the supplied information
Binding: SupportingInfoCategory (6.5.0) (preferred)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... code S 1..1 CodeableConcept Type of information
Binding: SupportingInfoCode (6.5.0) (preferred)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... timing[x] 0..1 When it occurred
..... timingDate date
..... timingPeriod Period
.... value[x] 0..1 Data to be provided
..... valueBoolean boolean
..... valueString string
..... valueQuantity Quantity
..... valueAttachment Attachment
..... valueReference Reference(Resource)
.... reason 0..1 CodeableConcept Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
... diagnosis S 1..* BackboneElement Pertinent diagnosis information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Diagnosis instance identifier
.... Slices for diagnosis[x] 1..1 Nature of illness or problem
Slice: Unordered, Open by type:$this
Binding: ICD10Diagnosticcodes (6.5.0) (example)
..... diagnosisCodeableConcept CodeableConcept
..... diagnosisReference Reference(Condition)
..... diagnosis[x]:diagnosisReference 0..1 Reference(Atrius India Core Condition(0.1.0)) Nature of illness or problem
.... type S 1..* CodeableConcept Timing or nature of the diagnosis
Binding: DiagnosticType (6.5.0) (example)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... onAdmission 0..1 CodeableConcept Present on admission
Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
.... packageCode 0..1 CodeableConcept Package billing code
Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
... procedure 0..* BackboneElement Clinical procedures performed
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Procedure instance identifier
.... type 0..* CodeableConcept Category of Procedure
Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.
.... date 0..1 dateTime When the procedure was performed
.... Slices for procedure[x] 1..1 Specific clinical procedure
Slice: Unordered, Open by type:$this
Binding: ProcedureCodes(SNOMEDCT) (example)
..... procedureCodeableConcept CodeableConcept
..... procedureReference Reference(Procedure)
..... procedure[x]:procedureReference 0..1 Reference(Atrius India Core Procedure(0.1.0) | Atrius India Core Procedure Not Done(0.1.0)) Specific clinical procedure
.... udi 0..* Reference(Device) Unique device identifier
... insurance SΣ 1..* BackboneElement Patient insurance information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence Σ 1..1 positiveInt Insurance instance identifier
.... focal Σ 1..1 boolean Coverage to be used for adjudication
.... identifier 0..1 Identifier Pre-assigned Claim number
.... coverage Σ 1..1 Reference(Atrius India Core Coverage(0.1.0)) Insurance information
.... businessArrangement 0..1 string Additional provider contract number
.... preAuthRef 0..* string Prior authorization reference number
.... claimResponse 0..1 Reference(Atrius India Core ClaimResponse(0.1.0)) Adjudication results
... accident 0..1 BackboneElement Details of the event
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... date 1..1 date When the incident occurred
.... type 0..1 CodeableConcept The nature of the accident
Binding: ActIncidentCode (3.0.0) (extensible): Type of accident: work place, auto, etc.
.... location[x] 0..1 Where the event occurred
..... locationAddress Address
..... locationReference Reference(Location)
... item S 1..* BackboneElement Product or service provided
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:hsnSac 0..1 CodeableConcept Atrius HSN or SAC Code
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-hsn-sac-code
Binding: AtriusHsnSacVS (0.1.0) (example)
Constraints: ext-1
..... extension:gstBreakdown 0..1 (Complex) Atrius GST Line Breakdown
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-gst-line-breakdown
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Item instance identifier
.... careTeamSequence 0..* positiveInt Applicable careTeam members
.... diagnosisSequence 0..* positiveInt Applicable diagnoses
.... procedureSequence 0..* positiveInt Applicable procedures
.... informationSequence 0..* positiveInt Applicable exception and supporting information
.... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
.... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategory (6.5.0) (example)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: ProductorService (6.5.0) (example)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... modifier 0..* CodeableConcept Product or service billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
.... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ProgramCode (6.5.0) (example)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... serviced[x] 0..1 Date or dates of service or product delivery
..... servicedDate date
..... servicedPeriod Period
.... location[x] 0..1 Place of service or where product was supplied
Binding: EncounterTypes (6.5.0) (example)
..... locationCodeableConcept CodeableConcept
..... locationAddress Address
..... locationReference Reference(Location)
.... quantity 0..1 SimpleQuantity(4.0.1) Count of products or services
.... unitPrice 0..1 Money Fee, charge or cost per item
.... factor 0..1 decimal Price scaling factor
.... net 0..1 Money Total item cost
.... udi 0..* Reference(Device) Unique device identifier
.... bodySite 0..1 CodeableConcept Anatomical location
Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.
.... subSite 0..* CodeableConcept Anatomical sub-location
Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.
.... encounter 0..* Reference(Atrius India Core Encounter(0.1.0)) Encounters related to this billed item
.... detail 0..* BackboneElement Product or service provided
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
..... sequence 1..1 positiveInt Item instance identifier
..... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
..... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategory (6.5.0) (example)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... coding Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 1..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: ProductorService (6.5.0) (example)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... coding Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 1..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... modifier 0..* CodeableConcept Service/Product billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
..... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ProgramCode (6.5.0) (example)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... coding Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 1..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... quantity 0..1 SimpleQuantity(4.0.1) Count of products or services
..... unitPrice 0..1 Money Fee, charge or cost per item
..... factor 0..1 decimal Price scaling factor
..... net 0..1 Money Total item cost
..... udi 0..* Reference(Device) Unique device identifier
..... subDetail 0..* BackboneElement Product or service provided
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
...... sequence 1..1 positiveInt Item instance identifier
...... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
...... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategory (6.5.0) (example)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
....... coding Σ 0..* Coding Code defined by a terminology system
........ id 0..1 string Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
........ system Σ 1..1 uri Identity of the terminology system
........ version Σ 0..1 string Version of the system - if relevant
........ code Σ 1..1 code Symbol in syntax defined by the system
........ display Σ 1..1 string Representation defined by the system
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
....... text Σ 0..1 string Plain text representation of the concept
...... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: ProductorService (6.5.0) (example)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
....... coding Σ 0..* Coding Code defined by a terminology system
........ id 0..1 string Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
........ system Σ 1..1 uri Identity of the terminology system
........ version Σ 0..1 string Version of the system - if relevant
........ code Σ 1..1 code Symbol in syntax defined by the system
........ display Σ 1..1 string Representation defined by the system
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
....... text Σ 0..1 string Plain text representation of the concept
...... modifier 0..* CodeableConcept Service/Product billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
...... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ProgramCode (6.5.0) (example)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
....... coding Σ 0..* Coding Code defined by a terminology system
........ id 0..1 string Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
........ system Σ 1..1 uri Identity of the terminology system
........ version Σ 0..1 string Version of the system - if relevant
........ code Σ 1..1 code Symbol in syntax defined by the system
........ display Σ 1..1 string Representation defined by the system
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
....... text Σ 0..1 string Plain text representation of the concept
...... quantity 0..1 SimpleQuantity(4.0.1) Count of products or services
...... unitPrice 0..1 Money Fee, charge or cost per item
...... factor 0..1 decimal Price scaling factor
...... net 0..1 Money Total item cost
...... udi 0..* Reference(Device) Unique device identifier
... total 0..1 Money Total claim cost

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Claim.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Claim.status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
Claim.type Base extensible Claim Type 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.subType Base example Example Claim SubType Codes 📍4.0.1 FHIR Std.
Claim.use Base required Use 📍4.0.1 FHIR Std.
Claim.priority Base example Process Priority Codes 📍4.0.1 FHIR Std.
Claim.fundsReserve Base example FundsReserve 📍4.0.1 FHIR Std.
Claim.related.relationship Base example Related Claim Relationship 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.payee.type Base example PayeeType 📍4.0.1 FHIR Std.
Claim.careTeam.role Base example Care Team Role 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.careTeam.qualification Base example Care Team Qualification 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.supportingInfo.​category Base preferred SupportingInfo Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.supportingInfo.​code Base preferred SupportingInfo Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.supportingInfo.​reason Base example Missing Tooth Reason Codes 📍4.0.1 FHIR Std.
Claim.diagnosis.diagnosis[x] Base example ICD10 Diagnostic codes 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.diagnosis.type Base example Diagnostic Type 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.diagnosis.onAdmission Base example Example Diagnosis on Admission Codes 📍4.0.1 FHIR Std.
Claim.diagnosis.packageCode Base example Example Diagnosis Related Group Codes 📍4.0.1 FHIR Std.
Claim.procedure.type Base example Example Procedure Type Codes 📍4.0.1 FHIR Std.
Claim.procedure.procedure[x] Base example Procedure Codes (SNOMED CT) 📍4.0.1 FHIR Std.
Claim.accident.type Base extensible ActIncidentCode 📍3.0.0 THO v7.2
Claim.item.revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
Claim.item.category Base example Benefit Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.productOrService Base example ProductorService 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
Claim.item.programCode Base example Program Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.location[x] Base example EncounterTypes 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.bodySite Base example Oral Site Codes 📍4.0.1 FHIR Std.
Claim.item.subSite Base example Surface Codes 📍4.0.1 FHIR Std.
Claim.item.detail.revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
Claim.item.detail.category Base example Benefit Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.productOrService Base example ProductorService 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
Claim.item.detail.programCode Base example Program Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.subDetail.​revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
Claim.item.detail.subDetail.​category Base example Benefit Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.subDetail.​productOrService Base example ProductorService 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.subDetail.​modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
Claim.item.detail.subDetail.​programCode Base example Program Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5

Constraints

Id Grade Path(s) Description Expression
dom-2 error Claim If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Claim If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Claim If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Claim If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Claim A resource should have narrative for robust management text.`div`.exists()
ele-1 error Claim.meta, Claim.implicitRules, Claim.language, Claim.text, Claim.extension, Claim.extension:placeOfSupply, Claim.modifierExtension, Claim.identifier, Claim.status, Claim.type, Claim.subType, Claim.use, Claim.patient, Claim.billablePeriod, Claim.created, Claim.enterer, Claim.insurer, Claim.provider, Claim.priority, Claim.fundsReserve, Claim.related, Claim.related.extension, Claim.related.modifierExtension, Claim.related.claim, Claim.related.relationship, Claim.related.relationship.extension, Claim.related.relationship.coding, Claim.related.relationship.coding.extension, Claim.related.relationship.coding.system, Claim.related.relationship.coding.version, Claim.related.relationship.coding.code, Claim.related.relationship.coding.display, Claim.related.relationship.coding.userSelected, Claim.related.relationship.text, Claim.related.reference, Claim.prescription, Claim.originalPrescription, Claim.payee, Claim.payee.extension, Claim.payee.modifierExtension, Claim.payee.type, Claim.payee.party, Claim.referral, Claim.facility, Claim.careTeam, Claim.careTeam.extension, Claim.careTeam.modifierExtension, Claim.careTeam.sequence, Claim.careTeam.provider, Claim.careTeam.responsible, Claim.careTeam.role, Claim.careTeam.role.extension, Claim.careTeam.role.coding, Claim.careTeam.role.coding.extension, Claim.careTeam.role.coding.system, Claim.careTeam.role.coding.version, Claim.careTeam.role.coding.code, Claim.careTeam.role.coding.display, Claim.careTeam.role.coding.userSelected, Claim.careTeam.role.text, Claim.careTeam.qualification, Claim.careTeam.qualification.extension, Claim.careTeam.qualification.coding, Claim.careTeam.qualification.coding.extension, Claim.careTeam.qualification.coding.system, Claim.careTeam.qualification.coding.version, Claim.careTeam.qualification.coding.code, Claim.careTeam.qualification.coding.display, Claim.careTeam.qualification.coding.userSelected, Claim.careTeam.qualification.text, Claim.supportingInfo, Claim.supportingInfo.extension, Claim.supportingInfo.modifierExtension, Claim.supportingInfo.sequence, Claim.supportingInfo.category, Claim.supportingInfo.category.extension, Claim.supportingInfo.category.coding, Claim.supportingInfo.category.coding.extension, Claim.supportingInfo.category.coding.system, Claim.supportingInfo.category.coding.version, Claim.supportingInfo.category.coding.code, Claim.supportingInfo.category.coding.display, Claim.supportingInfo.category.coding.userSelected, Claim.supportingInfo.category.text, Claim.supportingInfo.code, Claim.supportingInfo.code.extension, Claim.supportingInfo.code.coding, Claim.supportingInfo.code.coding.extension, Claim.supportingInfo.code.coding.system, Claim.supportingInfo.code.coding.version, Claim.supportingInfo.code.coding.code, Claim.supportingInfo.code.coding.display, Claim.supportingInfo.code.coding.userSelected, Claim.supportingInfo.code.text, Claim.supportingInfo.timing[x], Claim.supportingInfo.value[x], Claim.supportingInfo.reason, Claim.diagnosis, Claim.diagnosis.extension, Claim.diagnosis.modifierExtension, Claim.diagnosis.sequence, Claim.diagnosis.diagnosis[x], Claim.diagnosis.diagnosis[x]:diagnosisReference, Claim.diagnosis.type, Claim.diagnosis.type.extension, Claim.diagnosis.type.coding, Claim.diagnosis.type.coding.extension, Claim.diagnosis.type.coding.system, Claim.diagnosis.type.coding.version, Claim.diagnosis.type.coding.code, Claim.diagnosis.type.coding.display, Claim.diagnosis.type.coding.userSelected, Claim.diagnosis.type.text, Claim.diagnosis.onAdmission, Claim.diagnosis.packageCode, Claim.procedure, Claim.procedure.extension, Claim.procedure.modifierExtension, Claim.procedure.sequence, Claim.procedure.type, Claim.procedure.date, Claim.procedure.procedure[x], Claim.procedure.procedure[x]:procedureReference, Claim.procedure.udi, Claim.insurance, Claim.insurance.extension, Claim.insurance.modifierExtension, Claim.insurance.sequence, Claim.insurance.focal, Claim.insurance.identifier, Claim.insurance.coverage, Claim.insurance.businessArrangement, Claim.insurance.preAuthRef, Claim.insurance.claimResponse, Claim.accident, Claim.accident.extension, Claim.accident.modifierExtension, Claim.accident.date, Claim.accident.type, Claim.accident.location[x], Claim.item, Claim.item.extension, Claim.item.extension:hsnSac, Claim.item.extension:gstBreakdown, Claim.item.modifierExtension, Claim.item.sequence, Claim.item.careTeamSequence, Claim.item.diagnosisSequence, Claim.item.procedureSequence, Claim.item.informationSequence, Claim.item.revenue, Claim.item.category, Claim.item.category.extension, Claim.item.category.coding, Claim.item.category.coding.extension, Claim.item.category.coding.system, Claim.item.category.coding.version, Claim.item.category.coding.code, Claim.item.category.coding.display, Claim.item.category.coding.userSelected, Claim.item.category.text, Claim.item.productOrService, Claim.item.productOrService.extension, Claim.item.productOrService.coding, Claim.item.productOrService.coding.extension, Claim.item.productOrService.coding.system, Claim.item.productOrService.coding.version, Claim.item.productOrService.coding.code, Claim.item.productOrService.coding.display, Claim.item.productOrService.coding.userSelected, Claim.item.productOrService.text, Claim.item.modifier, Claim.item.programCode, Claim.item.programCode.extension, Claim.item.programCode.coding, Claim.item.programCode.coding.extension, Claim.item.programCode.coding.system, Claim.item.programCode.coding.version, Claim.item.programCode.coding.code, Claim.item.programCode.coding.display, Claim.item.programCode.coding.userSelected, Claim.item.programCode.text, Claim.item.serviced[x], Claim.item.location[x], Claim.item.quantity, Claim.item.unitPrice, Claim.item.factor, Claim.item.net, Claim.item.udi, Claim.item.bodySite, Claim.item.subSite, Claim.item.encounter, Claim.item.detail, Claim.item.detail.extension, Claim.item.detail.modifierExtension, Claim.item.detail.sequence, Claim.item.detail.revenue, Claim.item.detail.category, Claim.item.detail.category.extension, Claim.item.detail.category.coding, Claim.item.detail.category.coding.extension, Claim.item.detail.category.coding.system, Claim.item.detail.category.coding.version, Claim.item.detail.category.coding.code, Claim.item.detail.category.coding.display, Claim.item.detail.category.coding.userSelected, Claim.item.detail.category.text, Claim.item.detail.productOrService, Claim.item.detail.productOrService.extension, Claim.item.detail.productOrService.coding, Claim.item.detail.productOrService.coding.extension, Claim.item.detail.productOrService.coding.system, Claim.item.detail.productOrService.coding.version, Claim.item.detail.productOrService.coding.code, Claim.item.detail.productOrService.coding.display, Claim.item.detail.productOrService.coding.userSelected, Claim.item.detail.productOrService.text, Claim.item.detail.modifier, Claim.item.detail.programCode, Claim.item.detail.programCode.extension, Claim.item.detail.programCode.coding, Claim.item.detail.programCode.coding.extension, Claim.item.detail.programCode.coding.system, Claim.item.detail.programCode.coding.version, Claim.item.detail.programCode.coding.code, Claim.item.detail.programCode.coding.display, Claim.item.detail.programCode.coding.userSelected, Claim.item.detail.programCode.text, Claim.item.detail.quantity, Claim.item.detail.unitPrice, Claim.item.detail.factor, Claim.item.detail.net, Claim.item.detail.udi, Claim.item.detail.subDetail, Claim.item.detail.subDetail.extension, Claim.item.detail.subDetail.modifierExtension, Claim.item.detail.subDetail.sequence, Claim.item.detail.subDetail.revenue, Claim.item.detail.subDetail.category, Claim.item.detail.subDetail.category.extension, Claim.item.detail.subDetail.category.coding, Claim.item.detail.subDetail.category.coding.extension, Claim.item.detail.subDetail.category.coding.system, Claim.item.detail.subDetail.category.coding.version, Claim.item.detail.subDetail.category.coding.code, Claim.item.detail.subDetail.category.coding.display, Claim.item.detail.subDetail.category.coding.userSelected, Claim.item.detail.subDetail.category.text, Claim.item.detail.subDetail.productOrService, Claim.item.detail.subDetail.productOrService.extension, Claim.item.detail.subDetail.productOrService.coding, Claim.item.detail.subDetail.productOrService.coding.extension, Claim.item.detail.subDetail.productOrService.coding.system, Claim.item.detail.subDetail.productOrService.coding.version, Claim.item.detail.subDetail.productOrService.coding.code, Claim.item.detail.subDetail.productOrService.coding.display, Claim.item.detail.subDetail.productOrService.coding.userSelected, Claim.item.detail.subDetail.productOrService.text, Claim.item.detail.subDetail.modifier, Claim.item.detail.subDetail.programCode, Claim.item.detail.subDetail.programCode.extension, Claim.item.detail.subDetail.programCode.coding, Claim.item.detail.subDetail.programCode.coding.extension, Claim.item.detail.subDetail.programCode.coding.system, Claim.item.detail.subDetail.programCode.coding.version, Claim.item.detail.subDetail.programCode.coding.code, Claim.item.detail.subDetail.programCode.coding.display, Claim.item.detail.subDetail.programCode.coding.userSelected, Claim.item.detail.subDetail.programCode.text, Claim.item.detail.subDetail.quantity, Claim.item.detail.subDetail.unitPrice, Claim.item.detail.subDetail.factor, Claim.item.detail.subDetail.net, Claim.item.detail.subDetail.udi, Claim.total All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error Claim.extension, Claim.extension:placeOfSupply, Claim.modifierExtension, Claim.related.extension, Claim.related.modifierExtension, Claim.related.relationship.extension, Claim.related.relationship.coding.extension, Claim.payee.extension, Claim.payee.modifierExtension, Claim.careTeam.extension, Claim.careTeam.modifierExtension, Claim.careTeam.role.extension, Claim.careTeam.role.coding.extension, Claim.careTeam.qualification.extension, Claim.careTeam.qualification.coding.extension, Claim.supportingInfo.extension, Claim.supportingInfo.modifierExtension, Claim.supportingInfo.category.extension, Claim.supportingInfo.category.coding.extension, Claim.supportingInfo.code.extension, Claim.supportingInfo.code.coding.extension, Claim.diagnosis.extension, Claim.diagnosis.modifierExtension, Claim.diagnosis.type.extension, Claim.diagnosis.type.coding.extension, Claim.procedure.extension, Claim.procedure.modifierExtension, Claim.insurance.extension, Claim.insurance.modifierExtension, Claim.accident.extension, Claim.accident.modifierExtension, Claim.item.extension, Claim.item.extension:hsnSac, Claim.item.extension:gstBreakdown, Claim.item.modifierExtension, Claim.item.category.extension, Claim.item.category.coding.extension, Claim.item.productOrService.extension, Claim.item.productOrService.coding.extension, Claim.item.programCode.extension, Claim.item.programCode.coding.extension, Claim.item.detail.extension, Claim.item.detail.modifierExtension, Claim.item.detail.category.extension, Claim.item.detail.category.coding.extension, Claim.item.detail.productOrService.extension, Claim.item.detail.productOrService.coding.extension, Claim.item.detail.programCode.extension, Claim.item.detail.programCode.coding.extension, Claim.item.detail.subDetail.extension, Claim.item.detail.subDetail.modifierExtension, Claim.item.detail.subDetail.category.extension, Claim.item.detail.subDetail.category.coding.extension, Claim.item.detail.subDetail.productOrService.extension, Claim.item.detail.subDetail.productOrService.coding.extension, Claim.item.detail.subDetail.programCode.extension, Claim.item.detail.subDetail.programCode.coding.extension Must have either extensions or value[x], not both extension.exists() != value.exists()

Summary

Mandatory: 5 elements(46 nested mandatory elements)
Must-Support: 9 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Claim.diagnosis.diagnosis[x]
  • The element 1 is sliced based on the value of Claim.procedure.procedure[x]

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim 0..* Claim(4.0.1) Claim, Pre-determination or Pre-authorization
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
.... extension:placeOfSupply S 0..1 string Atrius Place of Supply State
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-place-of-supply-state
Constraints: ext-1
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
... type Σ 1..1 CodeableConcept Category or discipline
Binding: ClaimType (6.5.0) (extensible)
... use Σ 1..1 code claim | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
... patient Σ 1..1 Reference(Atrius India Core Patient(0.1.0)) The recipient of the products and services
... created Σ 1..1 dateTime Resource creation date
... enterer 0..1 Reference(Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0)) Author of the claim
... insurer SΣ 1..1 Reference(Atrius India Core Organization(0.1.0)) Target
... provider Σ 1..1 Reference(Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0) | Atrius India Core Organization(0.1.0)) Party responsible for the claim
... priority Σ 1..1 CodeableConcept Desired processing ugency
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
... prescription 0..1 Reference(Atrius India Core DeviceRequest(0.1.0) | Atrius India Core Device Requested(0.1.0) | Atrius India Core Device Prohibited(0.1.0) | Atrius India Core MedicationRequest(0.1.0) | Atrius India Core Medication Requested(0.1.0) | Atrius India Core Medication Prohibited(0.1.0)) Prescription authorizing services and products
... referral 0..1 Reference(Atrius India Core ServiceRequest(0.1.0) | Atrius India Core Service Not Requested(0.1.0)) Treatment referral
... facility 0..1 Reference(Atrius India Core Location(0.1.0)) Servicing facility
... supportingInfo S 0..* BackboneElement Supporting information
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Information instance identifier
.... category 1..1 CodeableConcept Classification of the supplied information
Binding: SupportingInfoCategory (6.5.0) (preferred)
.... code S 1..1 CodeableConcept Type of information
Binding: SupportingInfoCode (6.5.0) (preferred)
... diagnosis S 1..* BackboneElement Pertinent diagnosis information
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Diagnosis instance identifier
.... Slices for diagnosis[x] 1..1 Nature of illness or problem
Slice: Unordered, Open by type:$this
Binding: ICD10Diagnosticcodes (6.5.0) (example)
..... diagnosisCodeableConcept CodeableConcept
..... diagnosisReference Reference(Condition)
..... diagnosis[x]:diagnosisReference 0..1 Reference(Atrius India Core Condition(0.1.0)) Nature of illness or problem
.... type S 1..* CodeableConcept Timing or nature of the diagnosis
Binding: DiagnosticType (6.5.0) (example)
... insurance SΣ 1..* BackboneElement Patient insurance information
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence Σ 1..1 positiveInt Insurance instance identifier
.... focal Σ 1..1 boolean Coverage to be used for adjudication
.... coverage Σ 1..1 Reference(Atrius India Core Coverage(0.1.0)) Insurance information
.... claimResponse 0..1 Reference(Atrius India Core ClaimResponse(0.1.0)) Adjudication results
... item S 1..* BackboneElement Product or service provided
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:hsnSac 0..1 CodeableConcept Atrius HSN or SAC Code
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-hsn-sac-code
Binding: AtriusHsnSacVS (0.1.0) (example)
Constraints: ext-1
..... extension:gstBreakdown 0..1 (Complex) Atrius GST Line Breakdown
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-gst-line-breakdown
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Item instance identifier
.... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategory (6.5.0) (example)
.... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: ProductorService (6.5.0) (example)
.... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ProgramCode (6.5.0) (example)
.... location[x] 0..1 Place of service or where product was supplied
Binding: EncounterTypes (6.5.0) (example)
..... locationCodeableConcept CodeableConcept
..... locationAddress Address
..... locationReference Reference(Location)
.... encounter 0..* Reference(Atrius India Core Encounter(0.1.0)) Encounters related to this billed item

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Claim.status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
Claim.type Base extensible Claim Type 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.use Base required Use 📍4.0.1 FHIR Std.
Claim.priority Base example Process Priority Codes 📍4.0.1 FHIR Std.
Claim.supportingInfo.​category Base preferred SupportingInfo Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.supportingInfo.​code Base preferred SupportingInfo Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.diagnosis.diagnosis[x] Base example ICD10 Diagnostic codes 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.diagnosis.type Base example Diagnostic Type 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.category Base example Benefit Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.productOrService Base example ProductorService 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.programCode Base example Program Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.location[x] Base example EncounterTypes 📍6.5.0 FHIR Implementation Guide for ABDM v6.5

Constraints

Id Grade Path(s) Description Expression
dom-2 error Claim If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Claim If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Claim If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Claim If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Claim A resource should have narrative for robust management text.`div`.exists()
ele-1 error Claim.implicitRules, Claim.extension, Claim.extension:placeOfSupply, Claim.modifierExtension, Claim.identifier, Claim.status, Claim.type, Claim.use, Claim.patient, Claim.created, Claim.enterer, Claim.insurer, Claim.provider, Claim.priority, Claim.prescription, Claim.referral, Claim.facility, Claim.supportingInfo, Claim.supportingInfo.modifierExtension, Claim.supportingInfo.sequence, Claim.supportingInfo.category, Claim.supportingInfo.code, Claim.diagnosis, Claim.diagnosis.modifierExtension, Claim.diagnosis.sequence, Claim.diagnosis.diagnosis[x], Claim.diagnosis.diagnosis[x]:diagnosisReference, Claim.diagnosis.type, Claim.insurance, Claim.insurance.modifierExtension, Claim.insurance.sequence, Claim.insurance.focal, Claim.insurance.coverage, Claim.insurance.claimResponse, Claim.item, Claim.item.extension, Claim.item.extension:hsnSac, Claim.item.extension:gstBreakdown, Claim.item.modifierExtension, Claim.item.sequence, Claim.item.category, Claim.item.productOrService, Claim.item.programCode, Claim.item.location[x], Claim.item.encounter All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error Claim.extension, Claim.extension:placeOfSupply, Claim.modifierExtension, Claim.supportingInfo.modifierExtension, Claim.diagnosis.modifierExtension, Claim.insurance.modifierExtension, Claim.item.extension, Claim.item.extension:hsnSac, Claim.item.extension:gstBreakdown, Claim.item.modifierExtension Must have either extensions or value[x], not both extension.exists() != value.exists()

Differential View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim Claim(4.0.1)
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:placeOfSupply S 0..1 string Atrius Place of Supply State
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-place-of-supply-state
... identifier S 1..* Identifier Business Identifier for claim
... type 1..1 CodeableConcept Category or discipline
Binding: ClaimType (6.5.0) (extensible)
... enterer 0..1 Reference(Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0)) Author of the claim
... insurer S 1..1 Reference(Atrius India Core Organization(0.1.0)) Target
... provider 1..1 Reference(Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0) | Atrius India Core Organization(0.1.0)) Party responsible for the claim
... related
.... claim 0..1 Reference(Atrius India Core Claim(0.1.0)) Reference to the related claim
.... relationship 0..1 CodeableConcept How the reference claim is related
Binding: RelatedClaimRelationship (6.5.0) (example)
..... coding 0..1 Coding Code defined by a terminology system
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
... prescription 0..1 Reference(Atrius India Core DeviceRequest(0.1.0) | Atrius India Core Device Requested(0.1.0) | Atrius India Core Device Prohibited(0.1.0) | Atrius India Core MedicationRequest(0.1.0) | Atrius India Core Medication Requested(0.1.0) | Atrius India Core Medication Prohibited(0.1.0)) Prescription authorizing services and products
... payee
.... party 0..1 Reference(Atrius India Core Patient(0.1.0) | Atrius India Core RelatedPerson(0.1.0) | Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0) | Atrius India Core Organization(0.1.0)) Recipient reference
... referral 0..1 Reference(Atrius India Core ServiceRequest(0.1.0) | Atrius India Core Service Not Requested(0.1.0)) Treatment referral
... facility 0..1 Reference(Atrius India Core Location(0.1.0)) Servicing facility
... careTeam
.... provider 1..1 Reference(Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0) | Atrius India Core Organization(0.1.0)) Practitioner or organization
.... role 0..1 CodeableConcept Function within the team
Binding: CareTeamRole (6.5.0) (example)
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
.... qualification 0..1 CodeableConcept Practitioner credential or specialization
Binding: CareTeamQualification (6.5.0) (example)
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
... supportingInfo S 0..* BackboneElement Supporting information
.... category 1..1 CodeableConcept Classification of the supplied information
Binding: SupportingInfoCategory (6.5.0) (preferred)
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
.... code S 1..1 CodeableConcept Type of information
Binding: SupportingInfoCode (6.5.0) (preferred)
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
... diagnosis S 1..* BackboneElement Pertinent diagnosis information
.... Slices for diagnosis[x] 1..1 CodeableConcept, Reference(Condition) Nature of illness or problem
Slice: Unordered, Open by type:$this
Binding: ICD10Diagnosticcodes (6.5.0) (example)
..... diagnosis[x]:diagnosisReference 0..1 Reference(Atrius India Core Condition(0.1.0)) Nature of illness or problem
.... type S 1..* CodeableConcept Timing or nature of the diagnosis
Binding: DiagnosticType (6.5.0) (example)
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
... procedure
.... Slices for procedure[x] 1..1 CodeableConcept, Reference(Procedure) Specific clinical procedure
Slice: Unordered, Open by type:$this
Binding: ProcedureCodes(SNOMEDCT) (example)
..... procedure[x]:procedureReference 0..1 Reference(Atrius India Core Procedure(0.1.0) | Atrius India Core Procedure Not Done(0.1.0)) Specific clinical procedure
... insurance S 1..* BackboneElement Patient insurance information
.... coverage 1..1 Reference(Atrius India Core Coverage(0.1.0)) Insurance information
.... claimResponse 0..1 Reference(Atrius India Core ClaimResponse(0.1.0)) Adjudication results
... item S 1..* BackboneElement Product or service provided
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
..... extension:hsnSac 0..1 CodeableConcept Atrius HSN or SAC Code
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-hsn-sac-code
Binding: AtriusHsnSacVS (0.1.0) (example)
..... extension:gstBreakdown 0..1 (Complex) Atrius GST Line Breakdown
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-gst-line-breakdown
.... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategory (6.5.0) (example)
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
.... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: ProductorService (6.5.0) (example)
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
.... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ProgramCode (6.5.0) (example)
..... coding
...... system 1..1 uri Identity of the terminology system
...... code 1..1 code Symbol in syntax defined by the system
...... display 1..1 string Representation defined by the system
.... location[x] 0..1 CodeableConcept, Address, Reference(Location) Place of service or where product was supplied
Binding: EncounterTypes (6.5.0) (example)
.... encounter 0..* Reference(Atrius India Core Encounter(0.1.0)) Encounters related to this billed item
.... detail
..... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategory (6.5.0) (example)
...... coding
....... system 1..1 uri Identity of the terminology system
....... code 1..1 code Symbol in syntax defined by the system
....... display 1..1 string Representation defined by the system
..... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: ProductorService (6.5.0) (example)
...... coding
....... system 1..1 uri Identity of the terminology system
....... code 1..1 code Symbol in syntax defined by the system
....... display 1..1 string Representation defined by the system
..... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ProgramCode (6.5.0) (example)
...... coding
....... system 1..1 uri Identity of the terminology system
....... code 1..1 code Symbol in syntax defined by the system
....... display 1..1 string Representation defined by the system
..... subDetail
...... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategory (6.5.0) (example)
....... coding
........ system 1..1 uri Identity of the terminology system
........ code 1..1 code Symbol in syntax defined by the system
........ display 1..1 string Representation defined by the system
...... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: ProductorService (6.5.0) (example)
....... coding
........ system 1..1 uri Identity of the terminology system
........ code 1..1 code Symbol in syntax defined by the system
........ display 1..1 string Representation defined by the system
...... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ProgramCode (6.5.0) (example)
....... coding
........ system 1..1 uri Identity of the terminology system
........ code 1..1 code Symbol in syntax defined by the system
........ display 1..1 string Representation defined by the system

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
Claim.type Base extensible Claim Type 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.related.relationship Base example Related Claim Relationship 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.careTeam.role Base example Care Team Role 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.careTeam.qualification Base example Care Team Qualification 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.supportingInfo.​category Base preferred SupportingInfo Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.supportingInfo.​code Base preferred SupportingInfo Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.diagnosis.diagnosis[x] Base example ICD10 Diagnostic codes 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.diagnosis.type Base example Diagnostic Type 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.procedure.procedure[x] Base example Procedure Codes (SNOMED CT) 📍4.0.1 FHIR Std.
Claim.item.category Base example Benefit Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.productOrService Base example ProductorService 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.programCode Base example Program Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.location[x] Base example EncounterTypes 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.category Base example Benefit Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.productOrService Base example ProductorService 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.programCode Base example Program Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.subDetail.​category Base example Benefit Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.subDetail.​productOrService Base example ProductorService 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.subDetail.​programCode Base example Program Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5

Snapshot ViewView

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Claim 0..* Claim(4.0.1) Claim, Pre-determination or Pre-authorization
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
.... extension:placeOfSupply S 0..1 string Atrius Place of Supply State
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-place-of-supply-state
Constraints: ext-1
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... identifier S 1..* Identifier Business Identifier for claim
... status ?!Σ 1..1 code active | cancelled | draft | entered-in-error
Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
... type Σ 1..1 CodeableConcept Category or discipline
Binding: ClaimType (6.5.0) (extensible)
... subType 0..1 CodeableConcept More granular claim type
Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode.
... use Σ 1..1 code claim | preauthorization | predetermination
Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
... patient Σ 1..1 Reference(Atrius India Core Patient(0.1.0)) The recipient of the products and services
... billablePeriod Σ 0..1 Period Relevant time frame for the claim
... created Σ 1..1 dateTime Resource creation date
... enterer 0..1 Reference(Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0)) Author of the claim
... insurer SΣ 1..1 Reference(Atrius India Core Organization(0.1.0)) Target
... provider Σ 1..1 Reference(Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0) | Atrius India Core Organization(0.1.0)) Party responsible for the claim
... priority Σ 1..1 CodeableConcept Desired processing ugency
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
... fundsReserve 0..1 CodeableConcept For whom to reserve funds
Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).
... related 0..* BackboneElement Prior or corollary claims
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... claim 0..1 Reference(Atrius India Core Claim(0.1.0)) Reference to the related claim
.... relationship 0..1 CodeableConcept How the reference claim is related
Binding: RelatedClaimRelationship (6.5.0) (example)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..1 Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... reference 0..1 Identifier File or case reference
... prescription 0..1 Reference(Atrius India Core DeviceRequest(0.1.0) | Atrius India Core Device Requested(0.1.0) | Atrius India Core Device Prohibited(0.1.0) | Atrius India Core MedicationRequest(0.1.0) | Atrius India Core Medication Requested(0.1.0) | Atrius India Core Medication Prohibited(0.1.0)) Prescription authorizing services and products
... originalPrescription 0..1 Reference(DeviceRequest | MedicationRequest | VisionPrescription) Original prescription if superseded by fulfiller
... payee 0..1 BackboneElement Recipient of benefits payable
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... type 1..1 CodeableConcept Category of recipient
Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.
.... party 0..1 Reference(Atrius India Core Patient(0.1.0) | Atrius India Core RelatedPerson(0.1.0) | Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0) | Atrius India Core Organization(0.1.0)) Recipient reference
... referral 0..1 Reference(Atrius India Core ServiceRequest(0.1.0) | Atrius India Core Service Not Requested(0.1.0)) Treatment referral
... facility 0..1 Reference(Atrius India Core Location(0.1.0)) Servicing facility
... careTeam 0..* BackboneElement Members of the care team
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Order of care team
.... provider 1..1 Reference(Atrius India Core Practitioner(0.1.0) | Atrius India Core PractitionerRole(0.1.0) | Atrius India Core Organization(0.1.0)) Practitioner or organization
.... responsible 0..1 boolean Indicator of the lead practitioner
.... role 0..1 CodeableConcept Function within the team
Binding: CareTeamRole (6.5.0) (example)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... qualification 0..1 CodeableConcept Practitioner credential or specialization
Binding: CareTeamQualification (6.5.0) (example)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
... supportingInfo S 0..* BackboneElement Supporting information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Information instance identifier
.... category 1..1 CodeableConcept Classification of the supplied information
Binding: SupportingInfoCategory (6.5.0) (preferred)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... code S 1..1 CodeableConcept Type of information
Binding: SupportingInfoCode (6.5.0) (preferred)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... timing[x] 0..1 When it occurred
..... timingDate date
..... timingPeriod Period
.... value[x] 0..1 Data to be provided
..... valueBoolean boolean
..... valueString string
..... valueQuantity Quantity
..... valueAttachment Attachment
..... valueReference Reference(Resource)
.... reason 0..1 CodeableConcept Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
... diagnosis S 1..* BackboneElement Pertinent diagnosis information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Diagnosis instance identifier
.... Slices for diagnosis[x] 1..1 Nature of illness or problem
Slice: Unordered, Open by type:$this
Binding: ICD10Diagnosticcodes (6.5.0) (example)
..... diagnosisCodeableConcept CodeableConcept
..... diagnosisReference Reference(Condition)
..... diagnosis[x]:diagnosisReference 0..1 Reference(Atrius India Core Condition(0.1.0)) Nature of illness or problem
.... type S 1..* CodeableConcept Timing or nature of the diagnosis
Binding: DiagnosticType (6.5.0) (example)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... onAdmission 0..1 CodeableConcept Present on admission
Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
.... packageCode 0..1 CodeableConcept Package billing code
Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
... procedure 0..* BackboneElement Clinical procedures performed
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Procedure instance identifier
.... type 0..* CodeableConcept Category of Procedure
Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.
.... date 0..1 dateTime When the procedure was performed
.... Slices for procedure[x] 1..1 Specific clinical procedure
Slice: Unordered, Open by type:$this
Binding: ProcedureCodes(SNOMEDCT) (example)
..... procedureCodeableConcept CodeableConcept
..... procedureReference Reference(Procedure)
..... procedure[x]:procedureReference 0..1 Reference(Atrius India Core Procedure(0.1.0) | Atrius India Core Procedure Not Done(0.1.0)) Specific clinical procedure
.... udi 0..* Reference(Device) Unique device identifier
... insurance SΣ 1..* BackboneElement Patient insurance information
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence Σ 1..1 positiveInt Insurance instance identifier
.... focal Σ 1..1 boolean Coverage to be used for adjudication
.... identifier 0..1 Identifier Pre-assigned Claim number
.... coverage Σ 1..1 Reference(Atrius India Core Coverage(0.1.0)) Insurance information
.... businessArrangement 0..1 string Additional provider contract number
.... preAuthRef 0..* string Prior authorization reference number
.... claimResponse 0..1 Reference(Atrius India Core ClaimResponse(0.1.0)) Adjudication results
... accident 0..1 BackboneElement Details of the event
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... date 1..1 date When the incident occurred
.... type 0..1 CodeableConcept The nature of the accident
Binding: ActIncidentCode (3.0.0) (extensible): Type of accident: work place, auto, etc.
.... location[x] 0..1 Where the event occurred
..... locationAddress Address
..... locationReference Reference(Location)
... item S 1..* BackboneElement Product or service provided
.... id 0..1 string Unique id for inter-element referencing
.... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
Constraints: ext-1
..... extension:hsnSac 0..1 CodeableConcept Atrius HSN or SAC Code
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-hsn-sac-code
Binding: AtriusHsnSacVS (0.1.0) (example)
Constraints: ext-1
..... extension:gstBreakdown 0..1 (Complex) Atrius GST Line Breakdown
URL: https://atrius.in/fhir/r4/atrius-in/StructureDefinition/atrius-in-gst-line-breakdown
Constraints: ext-1
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
.... sequence 1..1 positiveInt Item instance identifier
.... careTeamSequence 0..* positiveInt Applicable careTeam members
.... diagnosisSequence 0..* positiveInt Applicable diagnoses
.... procedureSequence 0..* positiveInt Applicable procedures
.... informationSequence 0..* positiveInt Applicable exception and supporting information
.... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
.... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategory (6.5.0) (example)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: ProductorService (6.5.0) (example)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... modifier 0..* CodeableConcept Product or service billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
.... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ProgramCode (6.5.0) (example)
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
..... coding Σ 0..* Coding Code defined by a terminology system
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... system Σ 1..1 uri Identity of the terminology system
...... version Σ 0..1 string Version of the system - if relevant
...... code Σ 1..1 code Symbol in syntax defined by the system
...... display Σ 1..1 string Representation defined by the system
...... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
..... text Σ 0..1 string Plain text representation of the concept
.... serviced[x] 0..1 Date or dates of service or product delivery
..... servicedDate date
..... servicedPeriod Period
.... location[x] 0..1 Place of service or where product was supplied
Binding: EncounterTypes (6.5.0) (example)
..... locationCodeableConcept CodeableConcept
..... locationAddress Address
..... locationReference Reference(Location)
.... quantity 0..1 SimpleQuantity(4.0.1) Count of products or services
.... unitPrice 0..1 Money Fee, charge or cost per item
.... factor 0..1 decimal Price scaling factor
.... net 0..1 Money Total item cost
.... udi 0..* Reference(Device) Unique device identifier
.... bodySite 0..1 CodeableConcept Anatomical location
Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.
.... subSite 0..* CodeableConcept Anatomical sub-location
Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.
.... encounter 0..* Reference(Atrius India Core Encounter(0.1.0)) Encounters related to this billed item
.... detail 0..* BackboneElement Product or service provided
..... id 0..1 string Unique id for inter-element referencing
..... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
..... sequence 1..1 positiveInt Item instance identifier
..... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
..... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategory (6.5.0) (example)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... coding Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 1..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: ProductorService (6.5.0) (example)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... coding Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 1..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... modifier 0..* CodeableConcept Service/Product billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
..... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ProgramCode (6.5.0) (example)
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
...... coding Σ 0..* Coding Code defined by a terminology system
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
....... system Σ 1..1 uri Identity of the terminology system
....... version Σ 0..1 string Version of the system - if relevant
....... code Σ 1..1 code Symbol in syntax defined by the system
....... display Σ 1..1 string Representation defined by the system
....... userSelected Σ 0..1 boolean If this coding was chosen directly by the user
...... text Σ 0..1 string Plain text representation of the concept
..... quantity 0..1 SimpleQuantity(4.0.1) Count of products or services
..... unitPrice 0..1 Money Fee, charge or cost per item
..... factor 0..1 decimal Price scaling factor
..... net 0..1 Money Total item cost
..... udi 0..* Reference(Device) Unique device identifier
..... subDetail 0..* BackboneElement Product or service provided
...... id 0..1 string Unique id for inter-element referencing
...... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
...... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
...... sequence 1..1 positiveInt Item instance identifier
...... revenue 0..1 CodeableConcept Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
...... category 0..1 CodeableConcept Benefit classification
Binding: BenefitCategory (6.5.0) (example)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
....... coding Σ 0..* Coding Code defined by a terminology system
........ id 0..1 string Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
........ system Σ 1..1 uri Identity of the terminology system
........ version Σ 0..1 string Version of the system - if relevant
........ code Σ 1..1 code Symbol in syntax defined by the system
........ display Σ 1..1 string Representation defined by the system
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
....... text Σ 0..1 string Plain text representation of the concept
...... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: ProductorService (6.5.0) (example)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
....... coding Σ 0..* Coding Code defined by a terminology system
........ id 0..1 string Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
........ system Σ 1..1 uri Identity of the terminology system
........ version Σ 0..1 string Version of the system - if relevant
........ code Σ 1..1 code Symbol in syntax defined by the system
........ display Σ 1..1 string Representation defined by the system
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
....... text Σ 0..1 string Plain text representation of the concept
...... modifier 0..* CodeableConcept Service/Product billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
...... programCode 0..* CodeableConcept Program the product or service is provided under
Binding: ProgramCode (6.5.0) (example)
....... id 0..1 string Unique id for inter-element referencing
....... extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
....... coding Σ 0..* Coding Code defined by a terminology system
........ id 0..1 string Unique id for inter-element referencing
........ extension 0..* Extension Additional content defined by implementations
Slice: Unordered, Open by value:url
Constraints: ext-1
........ system Σ 1..1 uri Identity of the terminology system
........ version Σ 0..1 string Version of the system - if relevant
........ code Σ 1..1 code Symbol in syntax defined by the system
........ display Σ 1..1 string Representation defined by the system
........ userSelected Σ 0..1 boolean If this coding was chosen directly by the user
....... text Σ 0..1 string Plain text representation of the concept
...... quantity 0..1 SimpleQuantity(4.0.1) Count of products or services
...... unitPrice 0..1 Money Fee, charge or cost per item
...... factor 0..1 decimal Price scaling factor
...... net 0..1 Money Total item cost
...... udi 0..* Reference(Device) Unique device identifier
... total 0..1 Money Total claim cost

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
Claim.language Base preferred Common Languages 📍4.0.1 FHIR Std.
Claim.status Base required Financial Resource Status Codes 📍4.0.1 FHIR Std.
Claim.type Base extensible Claim Type 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.subType Base example Example Claim SubType Codes 📍4.0.1 FHIR Std.
Claim.use Base required Use 📍4.0.1 FHIR Std.
Claim.priority Base example Process Priority Codes 📍4.0.1 FHIR Std.
Claim.fundsReserve Base example FundsReserve 📍4.0.1 FHIR Std.
Claim.related.relationship Base example Related Claim Relationship 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.payee.type Base example PayeeType 📍4.0.1 FHIR Std.
Claim.careTeam.role Base example Care Team Role 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.careTeam.qualification Base example Care Team Qualification 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.supportingInfo.​category Base preferred SupportingInfo Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.supportingInfo.​code Base preferred SupportingInfo Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.supportingInfo.​reason Base example Missing Tooth Reason Codes 📍4.0.1 FHIR Std.
Claim.diagnosis.diagnosis[x] Base example ICD10 Diagnostic codes 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.diagnosis.type Base example Diagnostic Type 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.diagnosis.onAdmission Base example Example Diagnosis on Admission Codes 📍4.0.1 FHIR Std.
Claim.diagnosis.packageCode Base example Example Diagnosis Related Group Codes 📍4.0.1 FHIR Std.
Claim.procedure.type Base example Example Procedure Type Codes 📍4.0.1 FHIR Std.
Claim.procedure.procedure[x] Base example Procedure Codes (SNOMED CT) 📍4.0.1 FHIR Std.
Claim.accident.type Base extensible ActIncidentCode 📍3.0.0 THO v7.2
Claim.item.revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
Claim.item.category Base example Benefit Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.productOrService Base example ProductorService 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
Claim.item.programCode Base example Program Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.location[x] Base example EncounterTypes 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.bodySite Base example Oral Site Codes 📍4.0.1 FHIR Std.
Claim.item.subSite Base example Surface Codes 📍4.0.1 FHIR Std.
Claim.item.detail.revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
Claim.item.detail.category Base example Benefit Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.productOrService Base example ProductorService 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
Claim.item.detail.programCode Base example Program Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.subDetail.​revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
Claim.item.detail.subDetail.​category Base example Benefit Category 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.subDetail.​productOrService Base example ProductorService 📍6.5.0 FHIR Implementation Guide for ABDM v6.5
Claim.item.detail.subDetail.​modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
Claim.item.detail.subDetail.​programCode Base example Program Code 📍6.5.0 FHIR Implementation Guide for ABDM v6.5

Constraints

Id Grade Path(s) Description Expression
dom-2 error Claim If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error Claim If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4 error Claim If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5 error Claim If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice Claim A resource should have narrative for robust management text.`div`.exists()
ele-1 error Claim.meta, Claim.implicitRules, Claim.language, Claim.text, Claim.extension, Claim.extension:placeOfSupply, Claim.modifierExtension, Claim.identifier, Claim.status, Claim.type, Claim.subType, Claim.use, Claim.patient, Claim.billablePeriod, Claim.created, Claim.enterer, Claim.insurer, Claim.provider, Claim.priority, Claim.fundsReserve, Claim.related, Claim.related.extension, Claim.related.modifierExtension, Claim.related.claim, Claim.related.relationship, Claim.related.relationship.extension, Claim.related.relationship.coding, Claim.related.relationship.coding.extension, Claim.related.relationship.coding.system, Claim.related.relationship.coding.version, Claim.related.relationship.coding.code, Claim.related.relationship.coding.display, Claim.related.relationship.coding.userSelected, Claim.related.relationship.text, Claim.related.reference, Claim.prescription, Claim.originalPrescription, Claim.payee, Claim.payee.extension, Claim.payee.modifierExtension, Claim.payee.type, Claim.payee.party, Claim.referral, Claim.facility, Claim.careTeam, Claim.careTeam.extension, Claim.careTeam.modifierExtension, Claim.careTeam.sequence, Claim.careTeam.provider, Claim.careTeam.responsible, Claim.careTeam.role, Claim.careTeam.role.extension, Claim.careTeam.role.coding, Claim.careTeam.role.coding.extension, Claim.careTeam.role.coding.system, Claim.careTeam.role.coding.version, Claim.careTeam.role.coding.code, Claim.careTeam.role.coding.display, Claim.careTeam.role.coding.userSelected, Claim.careTeam.role.text, Claim.careTeam.qualification, Claim.careTeam.qualification.extension, Claim.careTeam.qualification.coding, Claim.careTeam.qualification.coding.extension, Claim.careTeam.qualification.coding.system, Claim.careTeam.qualification.coding.version, Claim.careTeam.qualification.coding.code, Claim.careTeam.qualification.coding.display, Claim.careTeam.qualification.coding.userSelected, Claim.careTeam.qualification.text, Claim.supportingInfo, Claim.supportingInfo.extension, Claim.supportingInfo.modifierExtension, Claim.supportingInfo.sequence, Claim.supportingInfo.category, Claim.supportingInfo.category.extension, Claim.supportingInfo.category.coding, Claim.supportingInfo.category.coding.extension, Claim.supportingInfo.category.coding.system, Claim.supportingInfo.category.coding.version, Claim.supportingInfo.category.coding.code, Claim.supportingInfo.category.coding.display, Claim.supportingInfo.category.coding.userSelected, Claim.supportingInfo.category.text, Claim.supportingInfo.code, Claim.supportingInfo.code.extension, Claim.supportingInfo.code.coding, Claim.supportingInfo.code.coding.extension, Claim.supportingInfo.code.coding.system, Claim.supportingInfo.code.coding.version, Claim.supportingInfo.code.coding.code, Claim.supportingInfo.code.coding.display, Claim.supportingInfo.code.coding.userSelected, Claim.supportingInfo.code.text, Claim.supportingInfo.timing[x], Claim.supportingInfo.value[x], Claim.supportingInfo.reason, Claim.diagnosis, Claim.diagnosis.extension, Claim.diagnosis.modifierExtension, Claim.diagnosis.sequence, Claim.diagnosis.diagnosis[x], Claim.diagnosis.diagnosis[x]:diagnosisReference, Claim.diagnosis.type, Claim.diagnosis.type.extension, Claim.diagnosis.type.coding, Claim.diagnosis.type.coding.extension, Claim.diagnosis.type.coding.system, Claim.diagnosis.type.coding.version, Claim.diagnosis.type.coding.code, Claim.diagnosis.type.coding.display, Claim.diagnosis.type.coding.userSelected, Claim.diagnosis.type.text, Claim.diagnosis.onAdmission, Claim.diagnosis.packageCode, Claim.procedure, Claim.procedure.extension, Claim.procedure.modifierExtension, Claim.procedure.sequence, Claim.procedure.type, Claim.procedure.date, Claim.procedure.procedure[x], Claim.procedure.procedure[x]:procedureReference, Claim.procedure.udi, Claim.insurance, Claim.insurance.extension, Claim.insurance.modifierExtension, Claim.insurance.sequence, Claim.insurance.focal, Claim.insurance.identifier, Claim.insurance.coverage, Claim.insurance.businessArrangement, Claim.insurance.preAuthRef, Claim.insurance.claimResponse, Claim.accident, Claim.accident.extension, Claim.accident.modifierExtension, Claim.accident.date, Claim.accident.type, Claim.accident.location[x], Claim.item, Claim.item.extension, Claim.item.extension:hsnSac, Claim.item.extension:gstBreakdown, Claim.item.modifierExtension, Claim.item.sequence, Claim.item.careTeamSequence, Claim.item.diagnosisSequence, Claim.item.procedureSequence, Claim.item.informationSequence, Claim.item.revenue, Claim.item.category, Claim.item.category.extension, Claim.item.category.coding, Claim.item.category.coding.extension, Claim.item.category.coding.system, Claim.item.category.coding.version, Claim.item.category.coding.code, Claim.item.category.coding.display, Claim.item.category.coding.userSelected, Claim.item.category.text, Claim.item.productOrService, Claim.item.productOrService.extension, Claim.item.productOrService.coding, Claim.item.productOrService.coding.extension, Claim.item.productOrService.coding.system, Claim.item.productOrService.coding.version, Claim.item.productOrService.coding.code, Claim.item.productOrService.coding.display, Claim.item.productOrService.coding.userSelected, Claim.item.productOrService.text, Claim.item.modifier, Claim.item.programCode, Claim.item.programCode.extension, Claim.item.programCode.coding, Claim.item.programCode.coding.extension, Claim.item.programCode.coding.system, Claim.item.programCode.coding.version, Claim.item.programCode.coding.code, Claim.item.programCode.coding.display, Claim.item.programCode.coding.userSelected, Claim.item.programCode.text, Claim.item.serviced[x], Claim.item.location[x], Claim.item.quantity, Claim.item.unitPrice, Claim.item.factor, Claim.item.net, Claim.item.udi, Claim.item.bodySite, Claim.item.subSite, Claim.item.encounter, Claim.item.detail, Claim.item.detail.extension, Claim.item.detail.modifierExtension, Claim.item.detail.sequence, Claim.item.detail.revenue, Claim.item.detail.category, Claim.item.detail.category.extension, Claim.item.detail.category.coding, Claim.item.detail.category.coding.extension, Claim.item.detail.category.coding.system, Claim.item.detail.category.coding.version, Claim.item.detail.category.coding.code, Claim.item.detail.category.coding.display, Claim.item.detail.category.coding.userSelected, Claim.item.detail.category.text, Claim.item.detail.productOrService, Claim.item.detail.productOrService.extension, Claim.item.detail.productOrService.coding, Claim.item.detail.productOrService.coding.extension, Claim.item.detail.productOrService.coding.system, Claim.item.detail.productOrService.coding.version, Claim.item.detail.productOrService.coding.code, Claim.item.detail.productOrService.coding.display, Claim.item.detail.productOrService.coding.userSelected, Claim.item.detail.productOrService.text, Claim.item.detail.modifier, Claim.item.detail.programCode, Claim.item.detail.programCode.extension, Claim.item.detail.programCode.coding, Claim.item.detail.programCode.coding.extension, Claim.item.detail.programCode.coding.system, Claim.item.detail.programCode.coding.version, Claim.item.detail.programCode.coding.code, Claim.item.detail.programCode.coding.display, Claim.item.detail.programCode.coding.userSelected, Claim.item.detail.programCode.text, Claim.item.detail.quantity, Claim.item.detail.unitPrice, Claim.item.detail.factor, Claim.item.detail.net, Claim.item.detail.udi, Claim.item.detail.subDetail, Claim.item.detail.subDetail.extension, Claim.item.detail.subDetail.modifierExtension, Claim.item.detail.subDetail.sequence, Claim.item.detail.subDetail.revenue, Claim.item.detail.subDetail.category, Claim.item.detail.subDetail.category.extension, Claim.item.detail.subDetail.category.coding, Claim.item.detail.subDetail.category.coding.extension, Claim.item.detail.subDetail.category.coding.system, Claim.item.detail.subDetail.category.coding.version, Claim.item.detail.subDetail.category.coding.code, Claim.item.detail.subDetail.category.coding.display, Claim.item.detail.subDetail.category.coding.userSelected, Claim.item.detail.subDetail.category.text, Claim.item.detail.subDetail.productOrService, Claim.item.detail.subDetail.productOrService.extension, Claim.item.detail.subDetail.productOrService.coding, Claim.item.detail.subDetail.productOrService.coding.extension, Claim.item.detail.subDetail.productOrService.coding.system, Claim.item.detail.subDetail.productOrService.coding.version, Claim.item.detail.subDetail.productOrService.coding.code, Claim.item.detail.subDetail.productOrService.coding.display, Claim.item.detail.subDetail.productOrService.coding.userSelected, Claim.item.detail.subDetail.productOrService.text, Claim.item.detail.subDetail.modifier, Claim.item.detail.subDetail.programCode, Claim.item.detail.subDetail.programCode.extension, Claim.item.detail.subDetail.programCode.coding, Claim.item.detail.subDetail.programCode.coding.extension, Claim.item.detail.subDetail.programCode.coding.system, Claim.item.detail.subDetail.programCode.coding.version, Claim.item.detail.subDetail.programCode.coding.code, Claim.item.detail.subDetail.programCode.coding.display, Claim.item.detail.subDetail.programCode.coding.userSelected, Claim.item.detail.subDetail.programCode.text, Claim.item.detail.subDetail.quantity, Claim.item.detail.subDetail.unitPrice, Claim.item.detail.subDetail.factor, Claim.item.detail.subDetail.net, Claim.item.detail.subDetail.udi, Claim.total All FHIR elements must have a @value or children hasValue() or (children().count() > id.count())
ext-1 error Claim.extension, Claim.extension:placeOfSupply, Claim.modifierExtension, Claim.related.extension, Claim.related.modifierExtension, Claim.related.relationship.extension, Claim.related.relationship.coding.extension, Claim.payee.extension, Claim.payee.modifierExtension, Claim.careTeam.extension, Claim.careTeam.modifierExtension, Claim.careTeam.role.extension, Claim.careTeam.role.coding.extension, Claim.careTeam.qualification.extension, Claim.careTeam.qualification.coding.extension, Claim.supportingInfo.extension, Claim.supportingInfo.modifierExtension, Claim.supportingInfo.category.extension, Claim.supportingInfo.category.coding.extension, Claim.supportingInfo.code.extension, Claim.supportingInfo.code.coding.extension, Claim.diagnosis.extension, Claim.diagnosis.modifierExtension, Claim.diagnosis.type.extension, Claim.diagnosis.type.coding.extension, Claim.procedure.extension, Claim.procedure.modifierExtension, Claim.insurance.extension, Claim.insurance.modifierExtension, Claim.accident.extension, Claim.accident.modifierExtension, Claim.item.extension, Claim.item.extension:hsnSac, Claim.item.extension:gstBreakdown, Claim.item.modifierExtension, Claim.item.category.extension, Claim.item.category.coding.extension, Claim.item.productOrService.extension, Claim.item.productOrService.coding.extension, Claim.item.programCode.extension, Claim.item.programCode.coding.extension, Claim.item.detail.extension, Claim.item.detail.modifierExtension, Claim.item.detail.category.extension, Claim.item.detail.category.coding.extension, Claim.item.detail.productOrService.extension, Claim.item.detail.productOrService.coding.extension, Claim.item.detail.programCode.extension, Claim.item.detail.programCode.coding.extension, Claim.item.detail.subDetail.extension, Claim.item.detail.subDetail.modifierExtension, Claim.item.detail.subDetail.category.extension, Claim.item.detail.subDetail.category.coding.extension, Claim.item.detail.subDetail.productOrService.extension, Claim.item.detail.subDetail.productOrService.coding.extension, Claim.item.detail.subDetail.programCode.extension, Claim.item.detail.subDetail.programCode.coding.extension Must have either extensions or value[x], not both extension.exists() != value.exists()

Summary

Mandatory: 5 elements(46 nested mandatory elements)
Must-Support: 9 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

  • The element 1 is sliced based on the value of Claim.diagnosis.diagnosis[x]
  • The element 1 is sliced based on the value of Claim.procedure.procedure[x]

 

Other representations of profile: CSV, Excel, Schematron