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="CoverageEligibilityRequestBundle-auth-requirement-example-01"/>
<meta>
<profile
value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequestBundle"/>
</meta>
<identifier>
<value value="bc3c6c57-2053-4d0e-ac40-139ccccff645"/>
</identifier>
<type value="collection"/>
<timestamp value="2025-03-07T15:32:26.605+05:30"/>
<entry>
<fullUrl value="urn:uuid:a752531b-67ad-4b33-9a8b-e1b9229d1505"/>
<resource>
<CoverageEligibilityRequest>
<id value="a752531b-67ad-4b33-9a8b-e1b9229d1505"/>
<meta>
<profile
value="https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest"/>
</meta>
<language value="en"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"><a name="CoverageEligibilityRequest_a752531b-67ad-4b33-9a8b-e1b9229d1505"> </a><p class="res-header-id"><b>Generated Narrative: CoverageEligibilityRequest a752531b-67ad-4b33-9a8b-e1b9229d1505</b></p><a name="a752531b-67ad-4b33-9a8b-e1b9229d1505"> </a><a name="hca752531b-67ad-4b33-9a8b-e1b9229d1505"> </a><a name="a752531b-67ad-4b33-9a8b-e1b9229d1505-hi-IN"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Language: en</p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-CoverageEligibilityRequest.html">CoverageEligibilityRequest</a></p></div><p><b>identifier</b>: 7612345</p><p><b>status</b>: Active</p><p><b>priority</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}">Normal</span></p><p><b>purpose</b>: Coverage auth-requirements</p><p><b>patient</b>: <a href="Bundle-CoverageEligibilityRequestBundle-auth-requirement-example-01.html#urn-uuid-a4dbd17d-35f8-4f36-9dac-f276fa75a4c8">Patient</a></p><p><b>created</b>: 2025-03-07 11:01:00+0500</p><p><b>enterer</b>: <a href="Bundle-CoverageEligibilityRequestBundle-auth-requirement-example-01.html#urn-uuid-9ee37afe-e35a-4ee8-80b1-7f4786cdd507">Practitioner</a></p><p><b>provider</b>: <a href="Bundle-CoverageEligibilityRequestBundle-auth-requirement-example-01.html#urn-uuid-48d6ee22-e2bf-427e-878a-19b5f264f46a">Organization</a></p><p><b>insurer</b>: <a href="Bundle-CoverageEligibilityRequestBundle-auth-requirement-example-01.html#urn-uuid-66ec8a06-3a04-454e-bace-0ad07f70405a">Organization</a></p><p><b>facility</b>: <a href="Bundle-CoverageEligibilityRequestBundle-auth-requirement-example-01.html#urn-uuid-ea4f766b-b7c1-476a-8f19-095928b65ca5">Location</a></p><h3>Insurances</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style="display: none">*</td><td>true</td><td><a href="Bundle-CoverageEligibilityRequestBundle-auth-requirement-example-01.html#urn-uuid-462d36b1-4171-4ebb-871d-94fdb3f7eb11">Coverage</a></td></tr></table><blockquote><p><b>item</b></p><p><b>productOrService</b>: <span title="Codes:{http://snomed.info/sct 768839008}">Consultant</span></p><h3>Diagnoses</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Diagnosis[x]</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://hl7.org/fhir/sid/icd-10 E11.9}">Type 2 diabetes mellitus : Without complications</span></td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>productOrService</b>: <span title="Codes:{http://snomed.info/sct 765507008}">Metformin hydrochloride 500 mg prolonged-release oral tablet</span></p><h3>Diagnoses</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Diagnosis[x]</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://hl7.org/fhir/sid/icd-10 E11.9}">Type 2 diabetes mellitus : Without complications</span></td></tr></table></blockquote></div>
</text>
<identifier>
<value value="7612345"/>
</identifier>
<status value="active"/>
<priority>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/processpriority"/>
<code value="normal"/>
<display value="Normal"/>
</coding>
</priority>
<purpose value="auth-requirements"/>
<patient>
<reference value="urn:uuid:a4dbd17d-35f8-4f36-9dac-f276fa75a4c8"/>
<display value="Patient"/>
</patient>
<created value="2025-03-07T11:01:00+05:00"/>
<enterer>
<reference value="urn:uuid:9ee37afe-e35a-4ee8-80b1-7f4786cdd507"/>
<display value="Practitioner"/>
</enterer>
<provider>
<reference value="urn:uuid:48d6ee22-e2bf-427e-878a-19b5f264f46a"/>
<display value="Organization"/>
</provider>
<insurer>
<reference value="urn:uuid:66ec8a06-3a04-454e-bace-0ad07f70405a"/>
<display value="Organization"/>
</insurer>
<facility>
<reference value="urn:uuid:ea4f766b-b7c1-476a-8f19-095928b65ca5"/>
<display value="Location"/>
</facility>
<insurance>
<focal value="true"/>
<coverage>
<reference value="urn:uuid:462d36b1-4171-4ebb-871d-94fdb3f7eb11"/>
<display value="Coverage"/>
</coverage>
</insurance>
<item>
<productOrService>
<coding>
<system value="http://snomed.info/sct"/>
<code value="768839008"/>
<display value="Consultant"/>
</coding>
</productOrService>
<diagnosis>
<diagnosisCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/sid/icd-10"/>
<code value="E11.9"/>
<display
value="Type 2 diabetes mellitus : Without complications"/>
</coding>
</diagnosisCodeableConcept>
</diagnosis>
</item>
<item>
<productOrService>
<coding>
<system value="http://snomed.info/sct"/>
<code value="765507008"/>
<display
value="Metformin hydrochloride 500 mg prolonged-release oral tablet"/>
</coding>
</productOrService>
<diagnosis>
<diagnosisCodeableConcept>
<coding>
<system value="http://hl7.org/fhir/sid/icd-10"/>
<code value="E11.9"/>
<display
value="Type 2 diabetes mellitus : Without complications"/>
</coding>
</diagnosisCodeableConcept>
</diagnosis>
</item>
</CoverageEligibilityRequest>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:a4dbd17d-35f8-4f36-9dac-f276fa75a4c8"/>
<resource>
<Patient>
<id value="a4dbd17d-35f8-4f36-9dac-f276fa75a4c8"/>
<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_a4dbd17d-35f8-4f36-9dac-f276fa75a4c8"> </a><p class="res-header-id"><b>Generated Narrative: Patient a4dbd17d-35f8-4f36-9dac-f276fa75a4c8</b></p><a name="a4dbd17d-35f8-4f36-9dac-f276fa75a4c8"> </a><a name="hca4dbd17d-35f8-4f36-9dac-f276fa75a4c8"> </a><a name="a4dbd17d-35f8-4f36-9dac-f276fa75a4c8-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:9ee37afe-e35a-4ee8-80b1-7f4786cdd507"/>
<resource>
<Practitioner>
<id value="9ee37afe-e35a-4ee8-80b1-7f4786cdd507"/>
<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_9ee37afe-e35a-4ee8-80b1-7f4786cdd507"> </a><p class="res-header-id"><b>Generated Narrative: Practitioner 9ee37afe-e35a-4ee8-80b1-7f4786cdd507</b></p><a name="9ee37afe-e35a-4ee8-80b1-7f4786cdd507"> </a><a name="hc9ee37afe-e35a-4ee8-80b1-7f4786cdd507"> </a><a name="9ee37afe-e35a-4ee8-80b1-7f4786cdd507-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:66ec8a06-3a04-454e-bace-0ad07f70405a"/>
<resource>
<Organization>
<id value="66ec8a06-3a04-454e-bace-0ad07f70405a"/>
<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_66ec8a06-3a04-454e-bace-0ad07f70405a"> </a><p class="res-header-id"><b>Generated Narrative: Organization 66ec8a06-3a04-454e-bace-0ad07f70405a</b></p><a name="66ec8a06-3a04-454e-bace-0ad07f70405a"> </a><a name="hc66ec8a06-3a04-454e-bace-0ad07f70405a"> </a><a name="66ec8a06-3a04-454e-bace-0ad07f70405a-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:48d6ee22-e2bf-427e-878a-19b5f264f46a"/>
<resource>
<Organization>
<id value="48d6ee22-e2bf-427e-878a-19b5f264f46a"/>
<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_48d6ee22-e2bf-427e-878a-19b5f264f46a"> </a><p class="res-header-id"><b>Generated Narrative: Organization 48d6ee22-e2bf-427e-878a-19b5f264f46a</b></p><a name="48d6ee22-e2bf-427e-878a-19b5f264f46a"> </a><a name="hc48d6ee22-e2bf-427e-878a-19b5f264f46a"> </a><a name="48d6ee22-e2bf-427e-878a-19b5f264f46a-hi-IN"> </a><p><b>identifier</b>: Provider number/1234567890</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="1234567890"/>
</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:ea4f766b-b7c1-476a-8f19-095928b65ca5"/>
<resource>
<Location>
<id value="ea4f766b-b7c1-476a-8f19-095928b65ca5"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Location_ea4f766b-b7c1-476a-8f19-095928b65ca5"> </a><p class="res-header-id"><b>Generated Narrative: Location ea4f766b-b7c1-476a-8f19-095928b65ca5</b></p><a name="ea4f766b-b7c1-476a-8f19-095928b65ca5"> </a><a name="hcea4f766b-b7c1-476a-8f19-095928b65ca5"> </a><a name="ea4f766b-b7c1-476a-8f19-095928b65ca5-hi-IN"> </a><p><b>identifier</b>: B1-S.F2</p><p><b>status</b>: Active</p><p><b>name</b>: South Wing, second floor</p><p><b>alias</b>: XYZ Life Hospital Co. Ltd., South Wing, second floor</p><p><b>description</b>: Second floor of the Old South Wing, formerly in use by Psychiatry</p><p><b>mode</b>: Instance</p><p><b>telecom</b>: ph: 2328(Work), fax: 2329(Work), <a href="http://sampleorg.com/southwing">http://sampleorg.com/southwing</a></p><p><b>address</b>: 91, Building A Pune 451855 IND (work)</p><p><b>physicalType</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/location-physical-type wi}">Wing</span></p><h3>Positions</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Longitude</b></td><td><b>Latitude</b></td><td><b>Altitude</b></td></tr><tr><td style="display: none">*</td><td>-83.6945691</td><td>42.25475478</td><td>0</td></tr></table><p><b>managingOrganization</b>: <a href="Bundle-CoverageEligibilityRequestBundle-auth-requirement-example-01.html#urn-uuid-48d6ee22-e2bf-427e-878a-19b5f264f46a">Organization</a></p></div>
</text>
<identifier>
<value value="B1-S.F2"/>
</identifier>
<status value="active"/>
<name value="South Wing, second floor"/>
<alias value="XYZ Life Hospital Co. Ltd., South Wing, second floor"/>
<description
value="Second floor of the Old South Wing, formerly in use by Psychiatry"/>
<mode value="instance"/>
<telecom>
<system value="phone"/>
<value value="2328"/>
<use value="work"/>
</telecom>
<telecom>
<system value="fax"/>
<value value="2329"/>
<use value="work"/>
</telecom>
<telecom>
<system value="url"/>
<value value="http://sampleorg.com/southwing"/>
<use value="work"/>
</telecom>
<address>
<use value="work"/>
<line value="91, Building A"/>
<city value="Pune"/>
<postalCode value="451855"/>
<country value="IND"/>
</address>
<physicalType>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/location-physical-type"/>
<code value="wi"/>
<display value="Wing"/>
</coding>
</physicalType>
<position>
<longitude value="-83.6945691"/>
<latitude value="42.25475478"/>
<altitude value="0"/>
</position>
<managingOrganization>
<reference value="urn:uuid:48d6ee22-e2bf-427e-878a-19b5f264f46a"/>
<display value="Organization"/>
</managingOrganization>
</Location>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:462d36b1-4171-4ebb-871d-94fdb3f7eb11"/>
<resource>
<Coverage>
<id value="462d36b1-4171-4ebb-871d-94fdb3f7eb11"/>
<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_462d36b1-4171-4ebb-871d-94fdb3f7eb11"> </a><p class="res-header-id"><b>Generated Narrative: Coverage 462d36b1-4171-4ebb-871d-94fdb3f7eb11</b></p><a name="462d36b1-4171-4ebb-871d-94fdb3f7eb11"> </a><a name="hc462d36b1-4171-4ebb-871d-94fdb3f7eb11"> </a><a name="462d36b1-4171-4ebb-871d-94fdb3f7eb11-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-CoverageEligibilityRequestBundle-auth-requirement-example-01.html#urn-uuid-a4dbd17d-35f8-4f36-9dac-f276fa75a4c8">Patient</a></p><p><b>subscriberId</b>: ABC123456BI007</p><p><b>beneficiary</b>: <a href="Bundle-CoverageEligibilityRequestBundle-auth-requirement-example-01.html#urn-uuid-a4dbd17d-35f8-4f36-9dac-f276fa75a4c8">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-CoverageEligibilityRequestBundle-auth-requirement-example-01.html#urn-uuid-66ec8a06-3a04-454e-bace-0ad07f70405a">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:a4dbd17d-35f8-4f36-9dac-f276fa75a4c8"/>
<display value="Patient"/>
</subscriber>
<subscriberId value="ABC123456BI007"/>
<beneficiary>
<reference value="urn:uuid:a4dbd17d-35f8-4f36-9dac-f276fa75a4c8"/>
<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:66ec8a06-3a04-454e-bace-0ad07f70405a"/>
<display value="Organization"/>
</payor>
</Coverage>
</resource>
</entry>
</Bundle>