Единая платформа цифрового здравоохранения Узбекистана
0.7.0 - ci-build Uzbekistan флаг

Uzbekistan Digital Health Platform - Локальная сборка (v0.7.0), построенная FHIR (HL7® FHIR® Стандартные инструменты сборки. Смотрите каталог опубликованных версий

Профиль ресурса: UZ Core Claim ( Экспериментальный )

Официальный URL: https://dhp.uz/fhir/core/StructureDefinition/uz-core-claim Версия: 0.7.0
Draft по состоянию на 2026-06-22 Вычисляемое имя: UZCoreClaim

Uzbekistan Core Claim profile, used for insurance claims, pre-authorization and predetermination processes.

Использование:

You can also check for usages in the FHIR IG Statistics

Формальные представления содержимого профиля

Описание профилей, дифференциалов, снимков и их представлений.

НаименованиеФлагиКарта.ТипОписание и ограничения    Filter: Filtersdoco
.. Claim 0..* Claim(5.0.0) Claim, Pre-determination or Pre-authorization
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... contained 0..* Resource Contained, inline Resources
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... status ?!SΣ 1..1 code Status of current claim
Привязка: FMStatusVS (0.7.0) (required)
... type SΣ 1..1 CodeableConcept Category or discipline
Привязка: ClaimTypeVS (0.7.0) (required)
... use SΣ 1..1 code preauthorization | predetermination | claim
Привязка: ClaimUseVS (0.7.0) (required)
... patient SΣ 1..1 Reference(UZ Core Patient(0.7.0)) The recipient of the products and services
... created SΣ 1..1 dateTime Resource creation date
... insurer SΣ 0..1 Reference(UZ Core Organization(0.7.0)) Target
... provider SΣ 0..1 Reference(UZ Core Organization(0.7.0)) Party responsible for the claim
... prescription S 0..1 Reference(MedicationRequest) Refers to the reimbursement prescription.
... referral S 0..1 Reference(ServiceRequest) Treatment referral
... facility S 0..1 Reference(UZ Core Location(0.7.0) | UZ Core Organization(0.7.0)) Servicing facility
... diagnosis S 0..* 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
.... diagnosis[x] S 1..1 Nature of illness or problem
Привязка: ICD10Codes (example): Example ICD10 Diagnostic codes.
..... diagnosisCodeableConcept CodeableConcept
..... diagnosisReference Reference(Condition)
... insurance SΣ 0..* 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 SΣ 1..1 boolean Coverage to be used for adjudication
.... coverage SΣ 1..1 Reference(Coverage) Insurance information
... total S 0..1 Money Total claim cost
.... value SΣ 0..1 decimal Numerical value (with implicit precision)
.... currency SΣ 0..1 code ISO 4217 currency code
Привязка: Currencies (required)

doco Документация для этого формата

Привязки к терминологии

Путь Статус Использование ValueSet Версия Источник
Claim.status Base required Financial Management Status Value set 📍0.7.0 этот IG
Claim.type Base required Claim Type VS 📍0.7.0 этот IG
Claim.use Base required Claim Use Value set 📍0.7.0 этот IG
Claim.diagnosis.diagnosis[x] Base example ICD-10 Codes 📍5.0.0 Стандарт FHIR
Claim.total.currency Base required Currencies 📍5.0.0 Стандарт FHIR

Ограничения

Id Градация Путь(и) Описание Выражение

НаименованиеФлагиКарта.ТипОписание и ограничения    Filter: Filtersdoco
.. Claim 0..* Claim(5.0.0) Claim, Pre-determination or Pre-authorization
... identifier S 0..* Identifier Business Identifier for claim
... status S 1..1 code Status of current claim
Привязка: FMStatusVS (0.7.0) (required)
... type S 1..1 CodeableConcept Category or discipline
Привязка: ClaimTypeVS (0.7.0) (required)
... patient S 1..1 Reference(UZ Core Patient(0.7.0)) The recipient of the products and services
... created S 1..1 dateTime Resource creation date
... insurer S 0..1 Reference(UZ Core Organization(0.7.0)) Target
... provider S 0..1 Reference(UZ Core Organization(0.7.0)) Party responsible for the claim
... prescription S 0..1 Reference(MedicationRequest) Refers to the reimbursement prescription.
... referral S 0..1 Reference(ServiceRequest) Treatment referral
... facility S 0..1 Reference(UZ Core Location(0.7.0) | UZ Core Organization(0.7.0)) Servicing facility
... diagnosis S 0..* BackboneElement Pertinent diagnosis information
.... diagnosis[x] S 1..1 CodeableConcept, Reference(Condition) Nature of illness or problem
... insurance S 0..* BackboneElement Patient insurance information
.... focal S 1..1 boolean Coverage to be used for adjudication
.... coverage S 1..1 Reference(Coverage) Insurance information
... total S 0..1 Money Total claim cost
.... value S 0..1 decimal Numerical value (with implicit precision)
.... currency S 0..1 code ISO 4217 currency code
Привязка: Currencies (required)

doco Документация для этого формата

Терминологические привязки (дифференциал)

Путь Статус Использование ValueSet Версия Источник
Claim.status Base required Financial Management Status Value set 📍0.7.0 этот IG
Claim.type Base required Claim Type VS 📍0.7.0 этот IG
Claim.use Base required Claim Use Value set 📍0.7.0 этот IG
Claim.total.currency Base required Currencies 📍5.0.0 Стандарт FHIR
НаименованиеФлагиКарта.ТипОписание и ограничения    Filter: Filtersdoco
.. Claim 0..* Claim(5.0.0) 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
Привязка: AllLanguages (required): IETF language tag for a human language
Дополнительные привязкиЦель
CommonLanguages Старт
... 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
... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... identifier S 0..* Identifier Business Identifier for claim
... traceNumber 0..* Identifier Number for tracking
... status ?!SΣ 1..1 code Status of current claim
Привязка: FMStatusVS (0.7.0) (required)
... type SΣ 1..1 CodeableConcept Category or discipline
Привязка: ClaimTypeVS (0.7.0) (required)
... subType 0..1 CodeableConcept More granular claim type
Привязка: ExampleClaimSubTypeCodes (example): A more granular claim typecode.
... use SΣ 1..1 code preauthorization | predetermination | claim
Привязка: ClaimUseVS (0.7.0) (required)
... patient SΣ 1..1 Reference(UZ Core Patient(0.7.0)) The recipient of the products and services
... billablePeriod Σ 0..1 Period Relevant time frame for the claim
... created SΣ 1..1 dateTime Resource creation date
... enterer 0..1 Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) Author of the claim
... insurer SΣ 0..1 Reference(UZ Core Organization(0.7.0)) Target
... provider SΣ 0..1 Reference(UZ Core Organization(0.7.0)) Party responsible for the claim
... priority Σ 0..1 CodeableConcept Desired processing urgency
Привязка: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
... fundsReserve 0..1 CodeableConcept For whom to reserve funds
Привязка: FundsReservationCodes (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(Claim) Reference to the related claim
.... relationship 0..1 CodeableConcept How the reference claim is related
Привязка: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.
.... reference 0..1 Identifier File or case reference
... prescription S 0..1 Reference(MedicationRequest) Refers to the reimbursement prescription.
... 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
Привязка: ClaimPayeeTypeCodes (example): A code for the party to be reimbursed.
.... party 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson) Recipient reference
... referral S 0..1 Reference(ServiceRequest) Treatment referral
... encounter 0..* Reference(Encounter) Encounters associated with the listed treatments
... facility S 0..1 Reference(UZ Core Location(0.7.0) | UZ Core Organization(0.7.0)) Servicing facility
... diagnosisRelatedGroup 0..1 CodeableConcept Package billing code
Привязка: ExampleDiagnosisRelatedGroupCodes (example)
... event 0..* BackboneElement Event 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
.... type 1..1 CodeableConcept Specific event
Привязка: DatesTypeCodes (example)
.... when[x] 1..1 Occurance date or period
..... whenDateTime dateTime
..... whenPeriod Period
... 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(Practitioner | PractitionerRole | Organization) Practitioner or organization
.... responsible 0..1 boolean Indicator of the lead practitioner
.... role 0..1 CodeableConcept Function within the team
Привязка: ClaimCareTeamRoleCodes (example): The role codes for the care team members.
.... specialty 0..1 CodeableConcept Practitioner or provider specialization
Привязка: ExampleProviderQualificationCodes (example)
... supportingInfo 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
Привязка: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
.... code 0..1 CodeableConcept Type of information
Привязка: ExceptionCodes (example): The valuset used for additional information codes.
.... 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)
..... valueIdentifier Identifier
.... reason 0..1 CodeableConcept Explanation for the information
Привязка: MissingToothReasonCodes (example): Reason codes for the missing teeth.
... diagnosis S 0..* 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
.... diagnosis[x] S 1..1 Nature of illness or problem
Привязка: ICD10Codes (example): Example ICD10 Diagnostic codes.
..... diagnosisCodeableConcept CodeableConcept
..... diagnosisReference Reference(Condition)
.... type 0..* CodeableConcept Timing or nature of the diagnosis
Привязка: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
.... onAdmission 0..1 CodeableConcept Present on admission
Привязка: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
... 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
Привязка: ExampleProcedureTypeCodes (example): Example procedure type codes.
.... date 0..1 dateTime When the procedure was performed
.... procedure[x] 1..1 Specific clinical procedure
Привязка: ICD10ProcedureCodes (example): Example ICD10 Procedure codes.
..... procedureCodeableConcept CodeableConcept
..... procedureReference Reference(Procedure)
.... udi 0..* Reference(Device) Unique device identifier
... insurance SΣ 0..* 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 SΣ 1..1 boolean Coverage to be used for adjudication
.... identifier 0..1 Identifier Pre-assigned Claim number
.... coverage SΣ 1..1 Reference(Coverage) Insurance information
.... businessArrangement 0..1 string Additional provider contract number
.... preAuthRef 0..* string Prior authorization reference number
.... claimResponse 0..1 Reference(ClaimResponse) 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
Привязка: 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)
... patientPaid 0..1 Money Paid by the patient
... item 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
.... traceNumber 0..* Identifier Number for tracking
.... 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
Привязка: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
.... category 0..1 CodeableConcept Benefit classification
Привязка: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
.... productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Привязка: USCLSCodes (example): Allowable service and product codes.
.... productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Привязка: USCLSCodes (example)
.... request 0..* Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription) Request or Referral for Service
.... modifier 0..* CodeableConcept Product or service billing modifiers
Привязка: 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
Привязка: ExampleProgramReasonCodes (example): Program specific reason codes.
.... 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
Привязка: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
..... locationCodeableConcept CodeableConcept
..... locationAddress Address
..... locationReference Reference(Location)
.... patientPaid 0..1 Money Paid by the patient
.... quantity 0..1 SimpleQuantity(5.0.0) Count of products or services
.... unitPrice 0..1 Money Fee, charge or cost per item
.... factor 0..1 decimal Price scaling factor
.... tax 0..1 Money Total tax
.... net 0..1 Money Total item cost
.... udi 0..* Reference(Device) Unique device identifier
.... bodySite 0..* BackboneElement Anatomical location
..... 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
..... site 1..* CodeableReference(BodyStructure) Location
Привязка: OralSiteCodes (example)
..... subSite 0..* CodeableConcept Sub-location
Привязка: SurfaceCodes (example)
.... encounter 0..* Reference(Encounter) Encounters associated with the listed treatments
.... 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
..... traceNumber 0..* Identifier Number for tracking
..... revenue 0..1 CodeableConcept Revenue or cost center code
Привязка: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
..... category 0..1 CodeableConcept Benefit classification
Привязка: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
..... productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Привязка: USCLSCodes (example): Allowable service and product codes.
..... productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Привязка: USCLSCodes (example)
..... modifier 0..* CodeableConcept Service/Product billing modifiers
Привязка: 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
Привязка: ExampleProgramReasonCodes (example): Program specific reason codes.
..... patientPaid 0..1 Money Paid by the patient
..... quantity 0..1 SimpleQuantity(5.0.0) Count of products or services
..... unitPrice 0..1 Money Fee, charge or cost per item
..... factor 0..1 decimal Price scaling factor
..... tax 0..1 Money Total tax
..... 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
...... traceNumber 0..* Identifier Number for tracking
...... revenue 0..1 CodeableConcept Revenue or cost center code
Привязка: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
...... category 0..1 CodeableConcept Benefit classification
Привязка: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
...... productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Привязка: USCLSCodes (example): Allowable service and product codes.
...... productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Привязка: USCLSCodes (example)
...... modifier 0..* CodeableConcept Service/Product billing modifiers
Привязка: 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
Привязка: ExampleProgramReasonCodes (example): Program specific reason codes.
...... patientPaid 0..1 Money Paid by the patient
...... quantity 0..1 SimpleQuantity(5.0.0) Count of products or services
...... unitPrice 0..1 Money Fee, charge or cost per item
...... factor 0..1 decimal Price scaling factor
...... tax 0..1 Money Total tax
...... net 0..1 Money Total item cost
...... udi 0..* Reference(Device) Unique device identifier
... total S 0..1 Money Total claim cost
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Разрез: Не упорядочено, Открыто от value:url
Constraints: ext-1
.... value SΣ 0..1 decimal Numerical value (with implicit precision)
.... currency SΣ 0..1 code ISO 4217 currency code
Привязка: Currencies (required)

doco Документация для этого формата

Привязки к терминологии

Путь Статус Использование ValueSet Версия Источник
Claim.language Base required All Languages 📍5.0.0 Стандарт FHIR
Claim.status Base required Financial Management Status Value set 📍0.7.0 этот IG
Claim.type Base required Claim Type VS 📍0.7.0 этот IG
Claim.subType Base example Example Claim SubType Codes 📍5.0.0 Стандарт FHIR
Claim.use Base required Claim Use Value set 📍0.7.0 этот IG
Claim.priority Base example Process Priority Codes 📍5.0.0 Стандарт FHIR
Claim.fundsReserve Base example Funds Reservation Codes 📍5.0.0 Стандарт FHIR
Claim.related.relationship Base example Example Related Claim Relationship Codes 📍5.0.0 Стандарт FHIR
Claim.payee.type Base example Claim Payee Type Codes 📍5.0.0 Стандарт FHIR
Claim.diagnosisRelatedGroup Base example Example Diagnosis Related Group Codes 📍5.0.0 Стандарт FHIR
Claim.event.type Base example Dates Type Codes 📍5.0.0 Стандарт FHIR
Claim.careTeam.role Base example Claim Care Team Role Codes 📍5.0.0 Стандарт FHIR
Claim.careTeam.specialty Base example Example Provider Qualification Codes 📍5.0.0 Стандарт FHIR
Claim.supportingInfo.​category Base example Claim Information Category Codes 📍5.0.0 Стандарт FHIR
Claim.supportingInfo.​code Base example Exception Codes 📍5.0.0 Стандарт FHIR
Claim.supportingInfo.​reason Base example Missing Tooth Reason Codes 📍5.0.0 Стандарт FHIR
Claim.diagnosis.diagnosis[x] Base example ICD-10 Codes 📍5.0.0 Стандарт FHIR
Claim.diagnosis.type Base example Example Diagnosis Type Codes 📍5.0.0 Стандарт FHIR
Claim.diagnosis.onAdmission Base example Example Diagnosis on Admission Codes 📍5.0.0 Стандарт FHIR
Claim.procedure.type Base example Example Procedure Type Codes 📍5.0.0 Стандарт FHIR
Claim.procedure.procedure[x] Base example ICD-10 Procedure Codes 📍5.0.0 Стандарт FHIR
Claim.accident.type Base extensible ActIncidentCode 📍3.0.0 THO v7.3
Claim.item.revenue Base example Example Revenue Center Codes 📍5.0.0 Стандарт FHIR
Claim.item.category Base example Benefit Category Codes 📍5.0.0 Стандарт FHIR
Claim.item.productOrService Base example USCLS Codes 📍5.0.0 Стандарт FHIR
Claim.item.productOrServiceEnd Base example USCLS Codes 📍5.0.0 Стандарт FHIR
Claim.item.modifier Base example Modifier type Codes 📍5.0.0 Стандарт FHIR
Claim.item.programCode Base example Example Program Reason Codes 📍5.0.0 Стандарт FHIR
Claim.item.location[x] Base example Example Service Place Codes 📍5.0.0 Стандарт FHIR
Claim.item.bodySite.​site Base example Oral Site Codes 📍5.0.0 Стандарт FHIR
Claim.item.bodySite.​subSite Base example Surface Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.revenue Base example Example Revenue Center Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.category Base example Benefit Category Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.productOrService Base example USCLS Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.productOrServiceEnd Base example USCLS Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.modifier Base example Modifier type Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.programCode Base example Example Program Reason Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.subDetail.​revenue Base example Example Revenue Center Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.subDetail.​category Base example Benefit Category Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.subDetail.​productOrService Base example USCLS Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.subDetail.​productOrServiceEnd Base example USCLS Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.subDetail.​modifier Base example Modifier type Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.subDetail.​programCode Base example Example Program Reason Codes 📍5.0.0 Стандарт FHIR
Claim.total.currency Base required Currencies 📍5.0.0 Стандарт FHIR

Ограничения

Id Градация Путь(и) Описание Выражение

Просмотр ключевых элементов

НаименованиеФлагиКарта.ТипОписание и ограничения    Filter: Filtersdoco
.. Claim 0..* Claim(5.0.0) Claim, Pre-determination or Pre-authorization
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... contained 0..* Resource Contained, inline Resources
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... status ?!SΣ 1..1 code Status of current claim
Привязка: FMStatusVS (0.7.0) (required)
... type SΣ 1..1 CodeableConcept Category or discipline
Привязка: ClaimTypeVS (0.7.0) (required)
... use SΣ 1..1 code preauthorization | predetermination | claim
Привязка: ClaimUseVS (0.7.0) (required)
... patient SΣ 1..1 Reference(UZ Core Patient(0.7.0)) The recipient of the products and services
... created SΣ 1..1 dateTime Resource creation date
... insurer SΣ 0..1 Reference(UZ Core Organization(0.7.0)) Target
... provider SΣ 0..1 Reference(UZ Core Organization(0.7.0)) Party responsible for the claim
... prescription S 0..1 Reference(MedicationRequest) Refers to the reimbursement prescription.
... referral S 0..1 Reference(ServiceRequest) Treatment referral
... facility S 0..1 Reference(UZ Core Location(0.7.0) | UZ Core Organization(0.7.0)) Servicing facility
... diagnosis S 0..* 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
.... diagnosis[x] S 1..1 Nature of illness or problem
Привязка: ICD10Codes (example): Example ICD10 Diagnostic codes.
..... diagnosisCodeableConcept CodeableConcept
..... diagnosisReference Reference(Condition)
... insurance SΣ 0..* 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 SΣ 1..1 boolean Coverage to be used for adjudication
.... coverage SΣ 1..1 Reference(Coverage) Insurance information
... total S 0..1 Money Total claim cost
.... value SΣ 0..1 decimal Numerical value (with implicit precision)
.... currency SΣ 0..1 code ISO 4217 currency code
Привязка: Currencies (required)

doco Документация для этого формата

Привязки к терминологии

Путь Статус Использование ValueSet Версия Источник
Claim.status Base required Financial Management Status Value set 📍0.7.0 этот IG
Claim.type Base required Claim Type VS 📍0.7.0 этот IG
Claim.use Base required Claim Use Value set 📍0.7.0 этот IG
Claim.diagnosis.diagnosis[x] Base example ICD-10 Codes 📍5.0.0 Стандарт FHIR
Claim.total.currency Base required Currencies 📍5.0.0 Стандарт FHIR

Ограничения

Id Градация Путь(и) Описание Выражение

Дифференциальный вид

НаименованиеФлагиКарта.ТипОписание и ограничения    Filter: Filtersdoco
.. Claim 0..* Claim(5.0.0) Claim, Pre-determination or Pre-authorization
... identifier S 0..* Identifier Business Identifier for claim
... status S 1..1 code Status of current claim
Привязка: FMStatusVS (0.7.0) (required)
... type S 1..1 CodeableConcept Category or discipline
Привязка: ClaimTypeVS (0.7.0) (required)
... patient S 1..1 Reference(UZ Core Patient(0.7.0)) The recipient of the products and services
... created S 1..1 dateTime Resource creation date
... insurer S 0..1 Reference(UZ Core Organization(0.7.0)) Target
... provider S 0..1 Reference(UZ Core Organization(0.7.0)) Party responsible for the claim
... prescription S 0..1 Reference(MedicationRequest) Refers to the reimbursement prescription.
... referral S 0..1 Reference(ServiceRequest) Treatment referral
... facility S 0..1 Reference(UZ Core Location(0.7.0) | UZ Core Organization(0.7.0)) Servicing facility
... diagnosis S 0..* BackboneElement Pertinent diagnosis information
.... diagnosis[x] S 1..1 CodeableConcept, Reference(Condition) Nature of illness or problem
... insurance S 0..* BackboneElement Patient insurance information
.... focal S 1..1 boolean Coverage to be used for adjudication
.... coverage S 1..1 Reference(Coverage) Insurance information
... total S 0..1 Money Total claim cost
.... value S 0..1 decimal Numerical value (with implicit precision)
.... currency S 0..1 code ISO 4217 currency code
Привязка: Currencies (required)

doco Документация для этого формата

Терминологические привязки (дифференциал)

Путь Статус Использование ValueSet Версия Источник
Claim.status Base required Financial Management Status Value set 📍0.7.0 этот IG
Claim.type Base required Claim Type VS 📍0.7.0 этот IG
Claim.use Base required Claim Use Value set 📍0.7.0 этот IG
Claim.total.currency Base required Currencies 📍5.0.0 Стандарт FHIR

Обзор моментальных снимковView

НаименованиеФлагиКарта.ТипОписание и ограничения    Filter: Filtersdoco
.. Claim 0..* Claim(5.0.0) 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
Привязка: AllLanguages (required): IETF language tag for a human language
Дополнительные привязкиЦель
CommonLanguages Старт
... 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
... extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
... identifier S 0..* Identifier Business Identifier for claim
... traceNumber 0..* Identifier Number for tracking
... status ?!SΣ 1..1 code Status of current claim
Привязка: FMStatusVS (0.7.0) (required)
... type SΣ 1..1 CodeableConcept Category or discipline
Привязка: ClaimTypeVS (0.7.0) (required)
... subType 0..1 CodeableConcept More granular claim type
Привязка: ExampleClaimSubTypeCodes (example): A more granular claim typecode.
... use SΣ 1..1 code preauthorization | predetermination | claim
Привязка: ClaimUseVS (0.7.0) (required)
... patient SΣ 1..1 Reference(UZ Core Patient(0.7.0)) The recipient of the products and services
... billablePeriod Σ 0..1 Period Relevant time frame for the claim
... created SΣ 1..1 dateTime Resource creation date
... enterer 0..1 Reference(Practitioner | PractitionerRole | Patient | RelatedPerson) Author of the claim
... insurer SΣ 0..1 Reference(UZ Core Organization(0.7.0)) Target
... provider SΣ 0..1 Reference(UZ Core Organization(0.7.0)) Party responsible for the claim
... priority Σ 0..1 CodeableConcept Desired processing urgency
Привязка: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
... fundsReserve 0..1 CodeableConcept For whom to reserve funds
Привязка: FundsReservationCodes (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(Claim) Reference to the related claim
.... relationship 0..1 CodeableConcept How the reference claim is related
Привязка: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.
.... reference 0..1 Identifier File or case reference
... prescription S 0..1 Reference(MedicationRequest) Refers to the reimbursement prescription.
... 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
Привязка: ClaimPayeeTypeCodes (example): A code for the party to be reimbursed.
.... party 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson) Recipient reference
... referral S 0..1 Reference(ServiceRequest) Treatment referral
... encounter 0..* Reference(Encounter) Encounters associated with the listed treatments
... facility S 0..1 Reference(UZ Core Location(0.7.0) | UZ Core Organization(0.7.0)) Servicing facility
... diagnosisRelatedGroup 0..1 CodeableConcept Package billing code
Привязка: ExampleDiagnosisRelatedGroupCodes (example)
... event 0..* BackboneElement Event 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
.... type 1..1 CodeableConcept Specific event
Привязка: DatesTypeCodes (example)
.... when[x] 1..1 Occurance date or period
..... whenDateTime dateTime
..... whenPeriod Period
... 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(Practitioner | PractitionerRole | Organization) Practitioner or organization
.... responsible 0..1 boolean Indicator of the lead practitioner
.... role 0..1 CodeableConcept Function within the team
Привязка: ClaimCareTeamRoleCodes (example): The role codes for the care team members.
.... specialty 0..1 CodeableConcept Practitioner or provider specialization
Привязка: ExampleProviderQualificationCodes (example)
... supportingInfo 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
Привязка: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
.... code 0..1 CodeableConcept Type of information
Привязка: ExceptionCodes (example): The valuset used for additional information codes.
.... 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)
..... valueIdentifier Identifier
.... reason 0..1 CodeableConcept Explanation for the information
Привязка: MissingToothReasonCodes (example): Reason codes for the missing teeth.
... diagnosis S 0..* 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
.... diagnosis[x] S 1..1 Nature of illness or problem
Привязка: ICD10Codes (example): Example ICD10 Diagnostic codes.
..... diagnosisCodeableConcept CodeableConcept
..... diagnosisReference Reference(Condition)
.... type 0..* CodeableConcept Timing or nature of the diagnosis
Привязка: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
.... onAdmission 0..1 CodeableConcept Present on admission
Привязка: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
... 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
Привязка: ExampleProcedureTypeCodes (example): Example procedure type codes.
.... date 0..1 dateTime When the procedure was performed
.... procedure[x] 1..1 Specific clinical procedure
Привязка: ICD10ProcedureCodes (example): Example ICD10 Procedure codes.
..... procedureCodeableConcept CodeableConcept
..... procedureReference Reference(Procedure)
.... udi 0..* Reference(Device) Unique device identifier
... insurance SΣ 0..* 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 SΣ 1..1 boolean Coverage to be used for adjudication
.... identifier 0..1 Identifier Pre-assigned Claim number
.... coverage SΣ 1..1 Reference(Coverage) Insurance information
.... businessArrangement 0..1 string Additional provider contract number
.... preAuthRef 0..* string Prior authorization reference number
.... claimResponse 0..1 Reference(ClaimResponse) 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
Привязка: 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)
... patientPaid 0..1 Money Paid by the patient
... item 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
.... traceNumber 0..* Identifier Number for tracking
.... 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
Привязка: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
.... category 0..1 CodeableConcept Benefit classification
Привязка: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
.... productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Привязка: USCLSCodes (example): Allowable service and product codes.
.... productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Привязка: USCLSCodes (example)
.... request 0..* Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription) Request or Referral for Service
.... modifier 0..* CodeableConcept Product or service billing modifiers
Привязка: 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
Привязка: ExampleProgramReasonCodes (example): Program specific reason codes.
.... 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
Привязка: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
..... locationCodeableConcept CodeableConcept
..... locationAddress Address
..... locationReference Reference(Location)
.... patientPaid 0..1 Money Paid by the patient
.... quantity 0..1 SimpleQuantity(5.0.0) Count of products or services
.... unitPrice 0..1 Money Fee, charge or cost per item
.... factor 0..1 decimal Price scaling factor
.... tax 0..1 Money Total tax
.... net 0..1 Money Total item cost
.... udi 0..* Reference(Device) Unique device identifier
.... bodySite 0..* BackboneElement Anatomical location
..... 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
..... site 1..* CodeableReference(BodyStructure) Location
Привязка: OralSiteCodes (example)
..... subSite 0..* CodeableConcept Sub-location
Привязка: SurfaceCodes (example)
.... encounter 0..* Reference(Encounter) Encounters associated with the listed treatments
.... 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
..... traceNumber 0..* Identifier Number for tracking
..... revenue 0..1 CodeableConcept Revenue or cost center code
Привязка: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
..... category 0..1 CodeableConcept Benefit classification
Привязка: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
..... productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Привязка: USCLSCodes (example): Allowable service and product codes.
..... productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Привязка: USCLSCodes (example)
..... modifier 0..* CodeableConcept Service/Product billing modifiers
Привязка: 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
Привязка: ExampleProgramReasonCodes (example): Program specific reason codes.
..... patientPaid 0..1 Money Paid by the patient
..... quantity 0..1 SimpleQuantity(5.0.0) Count of products or services
..... unitPrice 0..1 Money Fee, charge or cost per item
..... factor 0..1 decimal Price scaling factor
..... tax 0..1 Money Total tax
..... 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
...... traceNumber 0..* Identifier Number for tracking
...... revenue 0..1 CodeableConcept Revenue or cost center code
Привязка: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
...... category 0..1 CodeableConcept Benefit classification
Привязка: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
...... productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Привязка: USCLSCodes (example): Allowable service and product codes.
...... productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Привязка: USCLSCodes (example)
...... modifier 0..* CodeableConcept Service/Product billing modifiers
Привязка: 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
Привязка: ExampleProgramReasonCodes (example): Program specific reason codes.
...... patientPaid 0..1 Money Paid by the patient
...... quantity 0..1 SimpleQuantity(5.0.0) Count of products or services
...... unitPrice 0..1 Money Fee, charge or cost per item
...... factor 0..1 decimal Price scaling factor
...... tax 0..1 Money Total tax
...... net 0..1 Money Total item cost
...... udi 0..* Reference(Device) Unique device identifier
... total S 0..1 Money Total claim cost
.... id 0..1 id Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
Разрез: Не упорядочено, Открыто от value:url
Constraints: ext-1
.... value SΣ 0..1 decimal Numerical value (with implicit precision)
.... currency SΣ 0..1 code ISO 4217 currency code
Привязка: Currencies (required)

doco Документация для этого формата

Привязки к терминологии

Путь Статус Использование ValueSet Версия Источник
Claim.language Base required All Languages 📍5.0.0 Стандарт FHIR
Claim.status Base required Financial Management Status Value set 📍0.7.0 этот IG
Claim.type Base required Claim Type VS 📍0.7.0 этот IG
Claim.subType Base example Example Claim SubType Codes 📍5.0.0 Стандарт FHIR
Claim.use Base required Claim Use Value set 📍0.7.0 этот IG
Claim.priority Base example Process Priority Codes 📍5.0.0 Стандарт FHIR
Claim.fundsReserve Base example Funds Reservation Codes 📍5.0.0 Стандарт FHIR
Claim.related.relationship Base example Example Related Claim Relationship Codes 📍5.0.0 Стандарт FHIR
Claim.payee.type Base example Claim Payee Type Codes 📍5.0.0 Стандарт FHIR
Claim.diagnosisRelatedGroup Base example Example Diagnosis Related Group Codes 📍5.0.0 Стандарт FHIR
Claim.event.type Base example Dates Type Codes 📍5.0.0 Стандарт FHIR
Claim.careTeam.role Base example Claim Care Team Role Codes 📍5.0.0 Стандарт FHIR
Claim.careTeam.specialty Base example Example Provider Qualification Codes 📍5.0.0 Стандарт FHIR
Claim.supportingInfo.​category Base example Claim Information Category Codes 📍5.0.0 Стандарт FHIR
Claim.supportingInfo.​code Base example Exception Codes 📍5.0.0 Стандарт FHIR
Claim.supportingInfo.​reason Base example Missing Tooth Reason Codes 📍5.0.0 Стандарт FHIR
Claim.diagnosis.diagnosis[x] Base example ICD-10 Codes 📍5.0.0 Стандарт FHIR
Claim.diagnosis.type Base example Example Diagnosis Type Codes 📍5.0.0 Стандарт FHIR
Claim.diagnosis.onAdmission Base example Example Diagnosis on Admission Codes 📍5.0.0 Стандарт FHIR
Claim.procedure.type Base example Example Procedure Type Codes 📍5.0.0 Стандарт FHIR
Claim.procedure.procedure[x] Base example ICD-10 Procedure Codes 📍5.0.0 Стандарт FHIR
Claim.accident.type Base extensible ActIncidentCode 📍3.0.0 THO v7.3
Claim.item.revenue Base example Example Revenue Center Codes 📍5.0.0 Стандарт FHIR
Claim.item.category Base example Benefit Category Codes 📍5.0.0 Стандарт FHIR
Claim.item.productOrService Base example USCLS Codes 📍5.0.0 Стандарт FHIR
Claim.item.productOrServiceEnd Base example USCLS Codes 📍5.0.0 Стандарт FHIR
Claim.item.modifier Base example Modifier type Codes 📍5.0.0 Стандарт FHIR
Claim.item.programCode Base example Example Program Reason Codes 📍5.0.0 Стандарт FHIR
Claim.item.location[x] Base example Example Service Place Codes 📍5.0.0 Стандарт FHIR
Claim.item.bodySite.​site Base example Oral Site Codes 📍5.0.0 Стандарт FHIR
Claim.item.bodySite.​subSite Base example Surface Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.revenue Base example Example Revenue Center Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.category Base example Benefit Category Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.productOrService Base example USCLS Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.productOrServiceEnd Base example USCLS Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.modifier Base example Modifier type Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.programCode Base example Example Program Reason Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.subDetail.​revenue Base example Example Revenue Center Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.subDetail.​category Base example Benefit Category Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.subDetail.​productOrService Base example USCLS Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.subDetail.​productOrServiceEnd Base example USCLS Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.subDetail.​modifier Base example Modifier type Codes 📍5.0.0 Стандарт FHIR
Claim.item.detail.subDetail.​programCode Base example Example Program Reason Codes 📍5.0.0 Стандарт FHIR
Claim.total.currency Base required Currencies 📍5.0.0 Стандарт FHIR

Ограничения

Id Градация Путь(и) Описание Выражение

 

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