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

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: CoverageEligibilityRequest/discovery-example-01 - XML Representation

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<CoverageEligibilityRequest xmlns="http://hl7.org/fhir">
  <id value="discovery-example-01"/>
  <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"><p class="res-header-id"><b>Generated Narrative: CoverageEligibilityRequest discovery-example-01</b></p><a name="discovery-example-01"> </a><a name="hcdiscovery-example-01"> </a><a name="discovery-example-01-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 Discovery</p><p><b>patient</b>: <a href="Patient-example-01.html">ABC Male, DoB: 1981-01-12 ( Medical record number: 22-7225-4829-5255)</a></p><p><b>created</b>: 2023-09-07 11:01:00+0500</p><p><b>enterer</b>: <a href="Practitioner-example-01.html">Practitioner Dr. DEF</a></p><p><b>provider</b>: <a href="Practitioner-example-01.html">Practitioner Dr. DEF</a></p><p><b>insurer</b>: <a href="Organization-example-02.html">Organization XYZ Insurance Co. Ltd.</a></p><p><b>facility</b>: <a href="Location-example-03.html">Location South Wing, second floor</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="Coverage-example-01.html">Coverage: identifier = https://xyzinsurance.in/policynumber/#235037120; status = active; type = PAY; subscriberId = ABC123456BI007; relationship = Self; period = (?) --&gt; 2026-03-17</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="discovery"/>
  <patient>🔗 
    <reference value="Patient/example-01"/>
  </patient>
  <created value="2023-09-07T11:01:00+05:00"/>
  <enterer>🔗 
    <reference value="Practitioner/example-01"/>
  </enterer>
  <provider>🔗 
    <reference value="Practitioner/example-01"/>
  </provider>
  <insurer>🔗 
    <reference value="Organization/example-02"/>
  </insurer>
  <facility>🔗 
    <reference value="Location/example-03"/>
  </facility>
  <insurance>
    <focal value="true"/>
    <coverage>🔗 
      <reference value="Coverage/example-01"/>
    </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>