FHIR Implementation Guide for ABDM
6.5.0 - active
FHIR Implementation Guide for ABDM
6.5.0 - active
This page is part of the FHIR Implementation Guide for ABDM (v6.5.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
<Bundle xmlns="http://hl7.org/fhir">
<id value="ClaimBundle-predetermination-example-01"/>
<meta>
<profile
value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/ClaimBundle"/>
<security>
<system
value="http://terminology.hl7.org/CodeSystem/v3-Confidentiality"/>
<code value="V"/>
<display value="very restricted"/>
</security>
</meta>
<identifier>
<value value="ac3c6c57-2053-4d0e-ac40-139ccccff876"/>
</identifier>
<type value="collection"/>
<timestamp value="2025-03-07T11:32:26.605+05:30"/>
<entry>
<fullUrl value="urn:uuid:253934fe-510d-49eb-98a5-6040665e9d47"/>
<resource>
<Claim>
<id value="253934fe-510d-49eb-98a5-6040665e9d47"/>
<meta>
<profile
value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Claim_253934fe-510d-49eb-98a5-6040665e9d47"> </a><p class="res-header-id"><b>Generated Narrative: Claim 253934fe-510d-49eb-98a5-6040665e9d47</b></p><a name="253934fe-510d-49eb-98a5-6040665e9d47"> </a><a name="hc253934fe-510d-49eb-98a5-6040665e9d47"> </a><a name="253934fe-510d-49eb-98a5-6040665e9d47-hi-IN"> </a><p><b>identifier</b>: 7612345</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://snomed.info/sct 737481003}">Inpatient care management (procedure)</span></p><p><b>use</b>: Predetermination</p><p><b>patient</b>: <a href="Bundle-ClaimBundle-predetermination-example-01.html#urn-uuid-56656117-b031-4d82-97f4-d30d699fb40a">Patient</a></p><p><b>billablePeriod</b>: 2025-03-07 11:01:00+0500 --> 2025-04-07 11:01:00+0500</p><p><b>created</b>: 2025-03-07 11:01:00+0500</p><p><b>insurer</b>: <a href="Bundle-ClaimBundle-predetermination-example-01.html#urn-uuid-1fe25aff-9fa9-4b44-acfb-f114187fd9c7">Organization</a></p><p><b>provider</b>: <a href="Bundle-ClaimBundle-predetermination-example-01.html#urn-uuid-97f8790a-89bc-45af-b7e0-2e103cb571f4">Organization</a></p><p><b>priority</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}">Normal</span></p><h3>CareTeams</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>Provider</b></td><td><b>Role</b></td><td><b>Qualification</b></td></tr><tr><td style="display: none">*</td><td>1</td><td><a href="Bundle-ClaimBundle-predetermination-example-01.html#urn-uuid-1837911c-9b5f-4564-872e-fc696b49986d">Practitioner</a></td><td><span title="Codes:{http://snomed.info/sct 223366009}">Healthcare professional (occupation)</span></td><td><span title="Codes:{http://snomed.info/sct 394658006}">Clinical specialty (qualifier value)</span></td></tr></table><h3>Diagnoses</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td><td><b>Type</b></td></tr><tr><td style="display: none">*</td><td>1</td><td><span title="Codes:{http://hl7.org/fhir/sid/icd-10 I46.9}">Cardiac arrest, unspecified</span></td><td><span title="Codes:{http://snomed.info/sct 89100005}">Final diagnosis (discharge) (contextual qualifier) (qualifier value)</span></td></tr></table><blockquote><p><b>procedure</b></p><p><b>sequence</b>: 1</p><p><b>procedure</b>: <span title="Codes:{http://snomed.info/sct 77343006}">Angiography</span></p></blockquote><blockquote><p><b>procedure</b></p><p><b>sequence</b>: 2</p><p><b>procedure</b>: <span title="Codes:{http://snomed.info/sct 418285008}">Angioplasty of blood vessel</span></p></blockquote><h3>Insurances</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style="display: none">*</td><td>1</td><td>true</td><td><a href="Bundle-ClaimBundle-predetermination-example-01.html#urn-uuid-4ed8a29b-0a08-45d3-8f70-f3769c3e1c03">Coverage</a></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>careTeamSequence</b>: 1</p><p><b>productOrService</b>: <span title="Codes:{http://snomed.info/sct 77343006}">Angiography</span></p><h3>UnitPrices</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>10000</td><td>Indian rupee</td></tr></table><h3>Nets</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>10000</td><td>Indian rupee</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>careTeamSequence</b>: 1</p><p><b>productOrService</b>: <span title="Codes:{http://snomed.info/sct 418285008}">Angioplasty of blood vessel</span></p><h3>UnitPrices</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>40000</td><td>Indian rupee</td></tr></table><h3>Nets</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>40000</td><td>Indian rupee</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 3</p><p><b>careTeamSequence</b>: 1</p><p><b>productOrService</b>: <span title="Codes:{http://snomed.info/sct 309904001}">Intensive care unit</span></p><h3>UnitPrices</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>2000</td><td>Indian rupee</td></tr></table><h3>Nets</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>20000</td><td>Indian rupee</td></tr></table></blockquote><h3>Totals</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style="display: none">*</td><td>70000</td><td>Indian rupee</td></tr></table></div>
</text>
<identifier>
<value value="7612345"/>
</identifier>
<status value="active"/>
<type>
<coding>
<system value="http://snomed.info/sct"/>
<code value="737481003"/>
<display value="Inpatient care management (procedure)"/>
</coding>
</type>
<use value="predetermination"/>
<patient>
<reference value="urn:uuid:56656117-b031-4d82-97f4-d30d699fb40a"/>
<display value="Patient"/>
</patient>
<billablePeriod>
<start value="2025-03-07T11:01:00+05:00"/>
<end value="2025-04-07T11:01:00+05:00"/>
</billablePeriod>
<created value="2025-03-07T11:01:00+05:00"/>
<insurer>
<reference value="urn:uuid:1fe25aff-9fa9-4b44-acfb-f114187fd9c7"/>
<display value="Organization"/>
</insurer>
<provider>
<reference value="urn:uuid:97f8790a-89bc-45af-b7e0-2e103cb571f4"/>
<display value="Organization"/>
</provider>
<priority>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/processpriority"/>
<code value="normal"/>
</coding>
</priority>
<careTeam>
<sequence value="1"/>
<provider>
<reference value="urn:uuid:1837911c-9b5f-4564-872e-fc696b49986d"/>
<display value="Practitioner"/>
</provider>
<role>
<coding>
<system value="http://snomed.info/sct"/>
<code value="223366009"/>
<display value="Healthcare professional (occupation)"/>
</coding>
</role>
<qualification>
<coding>
<system value="http://snomed.info/sct"/>
<code value="394658006"/>
<display value="Clinical specialty (qualifier value)"/>
</coding>
</qualification>
</careTeam>
<diagnosis>
<sequence value="1"/>
<diagnosisCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/sid/icd-10"/>
<code value="I46.9"/>
<display value="Cardiac arrest, unspecified"/>
</coding>
</diagnosisCodeableConcept>
<type>
<coding>
<system value="http://snomed.info/sct"/>
<code value="89100005"/>
<display
value="Final diagnosis (discharge) (contextual qualifier) (qualifier value)"/>
</coding>
</type>
</diagnosis>
<procedure>
<sequence value="1"/>
<procedureCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="77343006"/>
<display value="Angiography"/>
</coding>
</procedureCodeableConcept>
</procedure>
<procedure>
<sequence value="2"/>
<procedureCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="418285008"/>
<display value="Angioplasty of blood vessel"/>
</coding>
</procedureCodeableConcept>
</procedure>
<insurance>
<sequence value="1"/>
<focal value="true"/>
<coverage>
<reference value="urn:uuid:4ed8a29b-0a08-45d3-8f70-f3769c3e1c03"/>
<display value="Coverage"/>
</coverage>
</insurance>
<item>
<sequence value="1"/>
<careTeamSequence value="1"/>
<productOrService>
<coding>
<system value="http://snomed.info/sct"/>
<code value="77343006"/>
<display value="Angiography"/>
</coding>
</productOrService>
<unitPrice>
<value value="10000"/>
<currency value="INR"/>
</unitPrice>
<net>
<value value="10000"/>
<currency value="INR"/>
</net>
</item>
<item>
<sequence value="2"/>
<careTeamSequence value="1"/>
<productOrService>
<coding>
<system value="http://snomed.info/sct"/>
<code value="418285008"/>
<display value="Angioplasty of blood vessel"/>
</coding>
</productOrService>
<unitPrice>
<value value="40000"/>
<currency value="INR"/>
</unitPrice>
<net>
<value value="40000"/>
<currency value="INR"/>
</net>
</item>
<item>
<sequence value="3"/>
<careTeamSequence value="1"/>
<productOrService>
<coding>
<system value="http://snomed.info/sct"/>
<code value="309904001"/>
<display value="Intensive care unit"/>
</coding>
</productOrService>
<unitPrice>
<value value="2000"/>
<currency value="INR"/>
</unitPrice>
<net>
<value value="20000"/>
<currency value="INR"/>
</net>
</item>
<total>
<value value="70000"/>
<currency value="INR"/>
</total>
</Claim>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:56656117-b031-4d82-97f4-d30d699fb40a"/>
<resource>
<Patient>
<id value="56656117-b031-4d82-97f4-d30d699fb40a"/>
<meta>
<profile
value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Patient_56656117-b031-4d82-97f4-d30d699fb40a"> </a><p class="res-header-id"><b>Generated Narrative: Patient 56656117-b031-4d82-97f4-d30d699fb40a</b></p><a name="56656117-b031-4d82-97f4-d30d699fb40a"> </a><a name="hc56656117-b031-4d82-97f4-d30d699fb40a"> </a><a name="56656117-b031-4d82-97f4-d30d699fb40a-hi-IN"> </a><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Adarsh Agrawal Male, DoB: 1981-01-12 ( Adhaar number: 7225-4829-5255)</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Detail</td><td colspan="3"><a href="tel:+919818512600">+919818512600</a></td></tr></table></div>
</text>
<identifier>
<type>
<coding>
<system
value="https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code"/>
<code value="ADN"/>
<display value="Adhaar number"/>
</coding>
</type>
<system value="https://uidai.gov.in/"/>
<value value="7225-4829-5255"/>
</identifier>
<name>
<text value="Adarsh Agrawal"/>
</name>
<telecom>
<system value="phone"/>
<value value="+919818512600"/>
<use value="home"/>
</telecom>
<gender value="male"/>
<birthDate value="1981-01-12"/>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:1fe25aff-9fa9-4b44-acfb-f114187fd9c7"/>
<resource>
<Organization>
<id value="1fe25aff-9fa9-4b44-acfb-f114187fd9c7"/>
<meta>
<profile
value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_1fe25aff-9fa9-4b44-acfb-f114187fd9c7"> </a><p class="res-header-id"><b>Generated Narrative: Organization 1fe25aff-9fa9-4b44-acfb-f114187fd9c7</b></p><a name="1fe25aff-9fa9-4b44-acfb-f114187fd9c7"> </a><a name="hc1fe25aff-9fa9-4b44-acfb-f114187fd9c7"> </a><a name="1fe25aff-9fa9-4b44-acfb-f114187fd9c7-hi-IN"> </a><p><b>identifier</b>: Registry of Hospitals in Network of Insurance (ROHINI) ID/4567878</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/organization-type ins}">Insurance Company</span></p><p><b>name</b>: XYZ Insurance Co. Ltd.</p><p><b>telecom</b>: <a href="tel:+9124326341234">+91 243 2634 1234</a>, <a href="mailto:contact@xyz.org">contact@xyz.org</a></p></div>
</text>
<identifier>
<type>
<coding>
<system
value="https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code"/>
<code value="ROHINI"/>
<display
value="Registry of Hospitals in Network of Insurance (ROHINI) ID"/>
</coding>
</type>
<system value="https://rohini.iib.gov.in/"/>
<value value="4567878"/>
</identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="ins"/>
<display value="Insurance Company"/>
</coding>
</type>
<name value="XYZ Insurance Co. Ltd."/>
<telecom>
<system value="phone"/>
<value value="+91 243 2634 1234"/>
<use value="work"/>
</telecom>
<telecom>
<system value="email"/>
<value value="contact@xyz.org"/>
<use value="work"/>
</telecom>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:97f8790a-89bc-45af-b7e0-2e103cb571f4"/>
<resource>
<Organization>
<id value="97f8790a-89bc-45af-b7e0-2e103cb571f4"/>
<meta>
<profile
value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_97f8790a-89bc-45af-b7e0-2e103cb571f4"> </a><p class="res-header-id"><b>Generated Narrative: Organization 97f8790a-89bc-45af-b7e0-2e103cb571f4</b></p><a name="97f8790a-89bc-45af-b7e0-2e103cb571f4"> </a><a name="hc97f8790a-89bc-45af-b7e0-2e103cb571f4"> </a><a name="97f8790a-89bc-45af-b7e0-2e103cb571f4-hi-IN"> </a><p><b>identifier</b>: Provider number/45675454</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/organization-type prov}">Healthcare Provider</span></p><p><b>name</b>: XYZ Hospital Co. Ltd.</p><p><b>telecom</b>: <a href="tel:+9124326341278">+91 243 2634 1278</a>, <a href="mailto:contact@xyz.org">contact@xyz.org</a></p></div>
</text>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="PRN"/>
<display value="Provider number"/>
</coding>
</type>
<system value="https://facility.ndhm.gov.in"/>
<value value="45675454"/>
</identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="prov"/>
<display value="Healthcare Provider"/>
</coding>
</type>
<name value="XYZ Hospital Co. Ltd."/>
<telecom>
<system value="phone"/>
<value value="+91 243 2634 1278"/>
<use value="work"/>
</telecom>
<telecom>
<system value="email"/>
<value value="contact@xyz.org"/>
<use value="work"/>
</telecom>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:1837911c-9b5f-4564-872e-fc696b49986d"/>
<resource>
<Practitioner>
<id value="1837911c-9b5f-4564-872e-fc696b49986d"/>
<meta>
<profile
value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Practitioner_1837911c-9b5f-4564-872e-fc696b49986d"> </a><p class="res-header-id"><b>Generated Narrative: Practitioner 1837911c-9b5f-4564-872e-fc696b49986d</b></p><a name="1837911c-9b5f-4564-872e-fc696b49986d"> </a><a name="hc1837911c-9b5f-4564-872e-fc696b49986d"> </a><a name="1837911c-9b5f-4564-872e-fc696b49986d-hi-IN"> </a><p><b>identifier</b>: Medical License number/21-1521-3828-3227</p><p><b>name</b>: Dr. Aayush Agrawal</p></div>
</text>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="MD"/>
<display value="Medical License number"/>
</coding>
</type>
<system value="https://doctor.ndhm.gov.in"/>
<value value="21-1521-3828-3227"/>
</identifier>
<name>
<text value="Dr. Aayush Agrawal"/>
</name>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:4ed8a29b-0a08-45d3-8f70-f3769c3e1c03"/>
<resource>
<Coverage>
<id value="4ed8a29b-0a08-45d3-8f70-f3769c3e1c03"/>
<meta>
<profile
value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/Coverage"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Coverage_4ed8a29b-0a08-45d3-8f70-f3769c3e1c03"> </a><p class="res-header-id"><b>Generated Narrative: Coverage 4ed8a29b-0a08-45d3-8f70-f3769c3e1c03</b></p><a name="4ed8a29b-0a08-45d3-8f70-f3769c3e1c03"> </a><a name="hc4ed8a29b-0a08-45d3-8f70-f3769c3e1c03"> </a><a name="4ed8a29b-0a08-45d3-8f70-f3769c3e1c03-hi-IN"> </a><p><b>identifier</b>: <code>https://xyzinsurance.in/policynumber/</code>/235037120</p><p><b>status</b>: Active</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode HIP}">health insurance plan policy</span></p><p><b>subscriber</b>: <a href="Bundle-ClaimBundle-predetermination-example-01.html#urn-uuid-56656117-b031-4d82-97f4-d30d699fb40a">Patient</a></p><p><b>subscriberId</b>: ABC123456BI007</p><p><b>beneficiary</b>: <a href="Bundle-ClaimBundle-predetermination-example-01.html#urn-uuid-56656117-b031-4d82-97f4-d30d699fb40a">Patient</a></p><p><b>relationship</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}">Self</span></p><p><b>period</b>: ?? --> 2026-03-17</p><p><b>payor</b>: <a href="Bundle-ClaimBundle-predetermination-example-01.html#urn-uuid-1fe25aff-9fa9-4b44-acfb-f114187fd9c7">Organization</a></p></div>
</text>
<identifier>
<system value="https://xyzinsurance.in/policynumber/"/>
<value value="235037120"/>
</identifier>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="HIP"/>
<display value="health insurance plan policy"/>
</coding>
</type>
<subscriber>
<reference value="urn:uuid:56656117-b031-4d82-97f4-d30d699fb40a"/>
<display value="Patient"/>
</subscriber>
<subscriberId value="ABC123456BI007"/>
<beneficiary>
<reference value="urn:uuid:56656117-b031-4d82-97f4-d30d699fb40a"/>
<display value="Patient"/>
</beneficiary>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
<code value="self"/>
</coding>
</relationship>
<period>
<end value="2026-03-17"/>
</period>
<payor>
<reference value="urn:uuid:1fe25aff-9fa9-4b44-acfb-f114187fd9c7"/>
<display value="Organization"/>
</payor>
</Coverage>
</resource>
</entry>
</Bundle>