FHIR Implementation Guide for ABDM
7.0.0 - active
FHIR Implementation Guide for ABDM
7.0.0 - active
FHIR Implementation Guide for ABDM - Local Development build (v7.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
<http://hl7.org/fhir/CoverageEligibilityResponse/benefits-example-01> a fhir:CoverageEligibilityResponse ;
fhir:nodeRole fhir:treeRoot ;
fhir:Resource.id [ fhir:value "benefits-example-01"] ;
fhir:Resource.meta [
fhir:Meta.profile [
fhir:value "https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponse" ;
fhir:index 0 ;
fhir:link <https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityResponse>
]
] ;
fhir:Resource.language [ fhir:value "en"] ;
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ] ;
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p class=\"res-header-id\"><b>Generated Narrative: CoverageEligibilityResponse benefits-example-01</b></p><a name=\"benefits-example-01\"> </a><a name=\"hcbenefits-example-01\"> </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-CoverageEligibilityResponse.html\">CoverageEligibilityResponse</a></p></div><p><b>status</b>: Active</p><p><b>purpose</b>: Coverage benefits</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</p><p><b>requestor</b>: <a href=\"Practitioner-example-01.html\">Practitioner Dr. DEF</a></p><p><b>request</b>: <a href=\"CoverageEligibilityRequest-benefits-example-01.html\">CoverageEligibilityRequest: identifier = 7612345; status = active; priority = Normal; purpose = benefits; created = 2023-09-07 11:01:00+0500</a></p><p><b>outcome</b>: Processing Complete</p><p><b>disposition</b>: Policy is currently in-force.</p><p><b>insurer</b>: <a href=\"Organization-example-02.html\">Organization XYZ Insurance Co. Ltd.</a></p><blockquote><p><b>insurance</b></p><p><b>coverage</b>: <a href=\"Coverage-example-01.html\">Coverage: identifier = https://xyzinsurance.in/policynumber/#235037120; status = active; type = PAY; subscriberId = ABC123456BI007; relationship = Self; period = (?) --> 2026-03-17</a></p><p><b>inforce</b>: true</p><p><b>benefitPeriod</b>: 2023-09-07 --> 2026-08-07</p><blockquote><p><b>item</b></p><p><b>productOrService</b>: <span title=\"Codes:{http://snomed.info/sct 768839008}\">Consultant</span></p><h3>Benefits</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Allowed[x]</b></td><td><b>Used[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/benefit-type benefit}\">Benefit</span></td><td><span title=\"Indian Rupee\">₹50,000.00</span> (INR)</td><td><span title=\"Indian Rupee\">₹0.00</span> (INR)</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>Benefits</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Allowed[x]</b></td><td><b>Used[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/benefit-type benefit}\">Benefit</span></td><td><span title=\"Indian Rupee\">₹50,000.00</span> (INR)</td><td><span title=\"Indian Rupee\">₹0.00</span> (INR)</td></tr></table></blockquote></blockquote></div>"
] ;
fhir:CoverageEligibilityResponse.status [ fhir:value "active"] ;
fhir:CoverageEligibilityResponse.purpose [
fhir:value "benefits" ;
fhir:index 0
] ;
fhir:CoverageEligibilityResponse.patient [
fhir:link <http://hl7.org/fhir/Patient/example-01> ;
fhir:Reference.reference [ fhir:value "Patient/example-01" ]
] ;
fhir:CoverageEligibilityResponse.created [ fhir:value "2023-09-07"^^xsd:date] ;
fhir:CoverageEligibilityResponse.requestor [
fhir:link <http://hl7.org/fhir/Practitioner/example-01> ;
fhir:Reference.reference [ fhir:value "Practitioner/example-01" ]
] ;
fhir:CoverageEligibilityResponse.request [
fhir:link <http://hl7.org/fhir/CoverageEligibilityRequest/benefits-example-01> ;
fhir:Reference.reference [ fhir:value "CoverageEligibilityRequest/benefits-example-01" ]
] ;
fhir:CoverageEligibilityResponse.outcome [ fhir:value "complete"] ;
fhir:CoverageEligibilityResponse.disposition [ fhir:value "Policy is currently in-force."] ;
fhir:CoverageEligibilityResponse.insurer [
fhir:link <http://hl7.org/fhir/Organization/example-02> ;
fhir:Reference.reference [ fhir:value "Organization/example-02" ]
] ;
fhir:CoverageEligibilityResponse.insurance [
fhir:index 0 ;
fhir:CoverageEligibilityResponse.insurance.coverage [
fhir:link <http://hl7.org/fhir/Coverage/example-01> ;
fhir:Reference.reference [ fhir:value "Coverage/example-01" ]
] ;
fhir:CoverageEligibilityResponse.insurance.inforce [ fhir:value "true"^^xsd:boolean ] ;
fhir:CoverageEligibilityResponse.insurance.benefitPeriod [
fhir:Period.start [ fhir:value "2023-09-07"^^xsd:date ] ;
fhir:Period.end [ fhir:value "2026-08-07"^^xsd:date ]
] ;
fhir:CoverageEligibilityResponse.insurance.item [
fhir:index 0 ;
fhir:CoverageEligibilityResponse.insurance.item.productOrService [
fhir:CodeableConcept.coding [
fhir:index 0 ;
a sct:768839008 ;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ;
fhir:Coding.code [ fhir:value "768839008" ] ;
fhir:Coding.display [ fhir:value "Consultant" ]
]
] ;
fhir:CoverageEligibilityResponse.insurance.item.benefit [
fhir:index 0 ;
fhir:CoverageEligibilityResponse.insurance.item.benefit.type [
fhir:CodeableConcept.coding [
fhir:index 0 ;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/benefit-type" ] ;
fhir:Coding.code [ fhir:value "benefit" ] ;
fhir:Coding.display [ fhir:value "Benefit" ]
]
] ;
fhir:CoverageEligibilityResponse.insurance.item.benefit.allowedMoney [
fhir:Money.value [ fhir:value "50000"^^xsd:decimal ] ;
fhir:Money.currency [ fhir:value "INR" ]
] ;
fhir:CoverageEligibilityResponse.insurance.item.benefit.usedMoney [
fhir:Money.value [ fhir:value "0"^^xsd:decimal ] ;
fhir:Money.currency [ fhir:value "INR" ]
]
]
], [
fhir:index 1 ;
fhir:CoverageEligibilityResponse.insurance.item.productOrService [
fhir:CodeableConcept.coding [
fhir:index 0 ;
a sct:765507008 ;
fhir:Coding.system [ fhir:value "http://snomed.info/sct" ] ;
fhir:Coding.code [ fhir:value "765507008" ] ;
fhir:Coding.display [ fhir:value "Metformin hydrochloride 500 mg prolonged-release oral tablet" ]
]
] ;
fhir:CoverageEligibilityResponse.insurance.item.benefit [
fhir:index 0 ;
fhir:CoverageEligibilityResponse.insurance.item.benefit.type [
fhir:CodeableConcept.coding [
fhir:index 0 ;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/benefit-type" ] ;
fhir:Coding.code [ fhir:value "benefit" ] ;
fhir:Coding.display [ fhir:value "Benefit" ]
]
] ;
fhir:CoverageEligibilityResponse.insurance.item.benefit.allowedMoney [
fhir:Money.value [ fhir:value "50000"^^xsd:decimal ] ;
fhir:Money.currency [ fhir:value "INR" ]
] ;
fhir:CoverageEligibilityResponse.insurance.item.benefit.usedMoney [
fhir:Money.value [ fhir:value "0"^^xsd:decimal ] ;
fhir:Money.currency [ fhir:value "INR" ]
]
]
]
] .
<http://hl7.org/fhir/Patient/example-01> a fhir:Patient .
<http://hl7.org/fhir/Practitioner/example-01> a fhir:Practitioner .
<http://hl7.org/fhir/CoverageEligibilityRequest/benefits-example-01> a fhir:CoverageEligibilityRequest .
<http://hl7.org/fhir/Organization/example-02> a fhir:Organization .
<http://hl7.org/fhir/Coverage/example-01> a fhir:Coverage .
# - ontology header ------------------------------------------------------------
<http://hl7.org/fhir/CoverageEligibilityResponse/benefits-example-01.ttl> a owl:Ontology ;
owl:imports fhir:fhir.ttl ;
owl:versionIRI <http://build.fhir.org/CoverageEligibilityResponse/benefits-example-01.ttl> .
IG © 2024+ National Resource Center for EHR Standards. Package ndhm.in#7.0.0 based on FHIR 4.0.1. Generated 2026-07-15
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