Tanzania NHIF → ZHSF Claims Submission FHIR IG
0.1.0 - ci-build
Tanzania
Tanzania NHIF → ZHSF Claims Submission FHIR IG, published by Speedykom GmbH. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Speedykom/tanzania-nhif-zhsf-claims-ig/ and changes regularly. See the Directory of published versions
| Active as of 2026-01-12 |
XML representation of the tz-claim-submission-request logical model.
<StructureDefinition xmlns="http://hl7.org/fhir">
<id value="tz-claim-submission-request"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition tz-claim-submission-request</b></p><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px; width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description & Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-tz-claim-submission-request-definitions.html#tz-claim-submission-request" title="Logical model representing the ZHSF Claim Submission JSON request payload.
This model defines the facade contract and is validated before transformation
to FHIR R5 resources.">tz-claim-submission-request</a><a name="tz-claim-submission-request"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/types.html#Base">Base</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">TZ Claim Submission Request (ZHSF JSON)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-tz-claim-submission-request-definitions.html#tz-claim-submission-request.facilityCode" title="ZHSF facility identifier code">facilityCode</a><a name="tz-claim-submission-request.facilityCode"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Facility code</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-tz-claim-submission-request-definitions.html#tz-claim-submission-request.practitionerRegistrationNo" title="Registered practitioner identifier">practitionerRegistrationNo</a><a name="tz-claim-submission-request.practitionerRegistrationNo"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Practitioner registration number</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-tz-claim-submission-request-definitions.html#tz-claim-submission-request.authorizationNumber" title="Authorization number issued during eligibility/approval">authorizationNumber</a><a name="tz-claim-submission-request.authorizationNumber"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Authorization number</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-tz-claim-submission-request-definitions.html#tz-claim-submission-request.clinicalNotes" title="Optional free-text clinical notes">clinicalNotes</a><a name="tz-claim-submission-request.clinicalNotes"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Clinical notes</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-tz-claim-submission-request-definitions.html#tz-claim-submission-request.referralNo" title="Referral number if applicable (often 0)">referralNo</a><a name="tz-claim-submission-request.referralNo"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#integer">integer</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Referral number</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-tz-claim-submission-request-definitions.html#tz-claim-submission-request.isAdmited" title="Admission flag (true if inpatient)">isAdmited</a><a name="tz-claim-submission-request.isAdmited"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#boolean">boolean</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Is admitted</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-tz-claim-submission-request-definitions.html#tz-claim-submission-request.mrn" title="Facility medical record number">mrn</a><a name="tz-claim-submission-request.mrn"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Medical Record Number</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-tz-claim-submission-request-definitions.html#tz-claim-submission-request.claimsItems" title="List of claim line items">claimsItems</a><a name="tz-claim-submission-request.claimsItems"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..*</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/types.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Claim items<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-tz-claim-submission-request-definitions.html#tz-claim-submission-request.claimsItems.itemCode" title="Service, medication, or procedure code">itemCode</a><a name="tz-claim-submission-request.claimsItems.itemCode"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Item code</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-tz-claim-submission-request-definitions.html#tz-claim-submission-request.claimsItems.itemQuantity" title="Quantity for the claim item">itemQuantity</a><a name="tz-claim-submission-request.claimsItems.itemQuantity"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#integer">integer</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Item quantity</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-tz-claim-submission-request-definitions.html#tz-claim-submission-request.claimsItems.frequency" title="Optional frequency information">frequency</a><a name="tz-claim-submission-request.claimsItems.frequency"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Frequency</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-tz-claim-submission-request-definitions.html#tz-claim-submission-request.claimsItems.issuedNo" title="Issued number when pre-approval is required">issuedNo</a><a name="tz-claim-submission-request.claimsItems.issuedNo"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#integer">integer</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Issued number</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-tz-claim-submission-request-definitions.html#tz-claim-submission-request.preliminaryDiagnosisCode" title="Diagnosis codes captured during encounter">preliminaryDiagnosisCode</a><a name="tz-claim-submission-request.preliminaryDiagnosisCode"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Preliminary diagnosis codes<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-tz-claim-submission-request-definitions.html#tz-claim-submission-request.finalDiagnosisCode" title="Diagnosis codes confirmed after encounter">finalDiagnosisCode</a><a name="tz-claim-submission-request.finalDiagnosisCode"> </a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R5/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Final diagnosis codes<br/></td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
</text>
<url
value="https://build.fhir.org/ig/speedykom/tanzania-nhif-zhsf-claims-ig/StructureDefinition/tz-claim-submission-request"/>
<version value="0.1.0"/>
<name value="TZClaimSubmissionRequest"/>
<title value="TZ Claim Submission Request (ZHSF JSON)"/>
<status value="active"/>
<date value="2026-01-12T12:56:31+00:00"/>
<publisher value="Speedykom GmbH"/>
<contact>
<name value="Speedykom GmbH"/>
<telecom>
<system value="url"/>
<value value="https://www.speedykom.de"/>
</telecom>
</contact>
<contact>
<name value="Ahmed Amri"/>
<telecom>
<system value="email"/>
<value value="ahmed.amri@speedykom.de"/>
<use value="work"/>
</telecom>
</contact>
<description
value="Logical model representing the ZHSF Claim Submission JSON request payload.
This model defines the facade contract and is validated before transformation
to FHIR R5 resources."/>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="TZ"/>
<display value="Tanzania"/>
</coding>
</jurisdiction>
<fhirVersion value="5.0.0"/>
<mapping>
<identity value="rim"/>
<uri value="http://hl7.org/v3"/>
<name value="RIM Mapping"/>
</mapping>
<kind value="logical"/>
<abstract value="false"/>
<type
value="https://build.fhir.org/ig/speedykom/tanzania-nhif-zhsf-claims-ig/StructureDefinition/tz-claim-submission-request"/>
<baseDefinition value="http://hl7.org/fhir/StructureDefinition/Base"/>
<derivation value="specialization"/>
<snapshot>
<extension
url="http://hl7.org/fhir/tools/StructureDefinition/snapshot-base-version">
<valueString value="5.0.0"/>
</extension>
<element id="tz-claim-submission-request">
<path value="tz-claim-submission-request"/>
<short value="TZ Claim Submission Request (ZHSF JSON)"/>
<definition
value="Logical model representing the ZHSF Claim Submission JSON request payload.
This model defines the facade contract and is validated before transformation
to FHIR R5 resources."/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Base"/>
<min value="0"/>
<max value="*"/>
</base>
<isModifier value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="tz-claim-submission-request.facilityCode">
<path value="tz-claim-submission-request.facilityCode"/>
<short value="Facility code"/>
<definition value="ZHSF facility identifier code"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="tz-claim-submission-request.facilityCode"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
</element>
<element id="tz-claim-submission-request.practitionerRegistrationNo">
<path value="tz-claim-submission-request.practitionerRegistrationNo"/>
<short value="Practitioner registration number"/>
<definition value="Registered practitioner identifier"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="tz-claim-submission-request.practitionerRegistrationNo"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
</element>
<element id="tz-claim-submission-request.authorizationNumber">
<path value="tz-claim-submission-request.authorizationNumber"/>
<short value="Authorization number"/>
<definition
value="Authorization number issued during eligibility/approval"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="tz-claim-submission-request.authorizationNumber"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
</element>
<element id="tz-claim-submission-request.clinicalNotes">
<path value="tz-claim-submission-request.clinicalNotes"/>
<short value="Clinical notes"/>
<definition value="Optional free-text clinical notes"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="tz-claim-submission-request.clinicalNotes"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
</element>
<element id="tz-claim-submission-request.referralNo">
<path value="tz-claim-submission-request.referralNo"/>
<short value="Referral number"/>
<definition value="Referral number if applicable (often 0)"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="tz-claim-submission-request.referralNo"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="integer"/>
</type>
</element>
<element id="tz-claim-submission-request.isAdmited">
<path value="tz-claim-submission-request.isAdmited"/>
<short value="Is admitted"/>
<definition value="Admission flag (true if inpatient)"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="tz-claim-submission-request.isAdmited"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="boolean"/>
</type>
</element>
<element id="tz-claim-submission-request.mrn">
<path value="tz-claim-submission-request.mrn"/>
<short value="Medical Record Number"/>
<definition value="Facility medical record number"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="tz-claim-submission-request.mrn"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
</element>
<element id="tz-claim-submission-request.claimsItems">
<path value="tz-claim-submission-request.claimsItems"/>
<short value="Claim items"/>
<definition value="List of claim line items"/>
<min value="1"/>
<max value="*"/>
<base>
<path value="tz-claim-submission-request.claimsItems"/>
<min value="1"/>
<max value="*"/>
</base>
<type>
<code value="BackboneElement"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
</element>
<element id="tz-claim-submission-request.claimsItems.id">
<path value="tz-claim-submission-request.claimsItems.id"/>
<representation value="xmlAttr"/>
<short value="Unique id for inter-element referencing"/>
<definition
value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
<min value="0"/>
<max value="1"/>
<base>
<path value="Element.id"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<extension
url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
<valueUrl value="id"/>
</extension>
<code value="http://hl7.org/fhirpath/System.String"/>
</type>
<condition value="ele-1"/>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="tz-claim-submission-request.claimsItems.extension">
<path value="tz-claim-submission-request.claimsItems.extension"/>
<slicing>
<discriminator>
<type value="value"/>
<path value="url"/>
</discriminator>
<description value="Extensions are always sliced by (at least) url"/>
<rules value="open"/>
</slicing>
<short value="Additional content defined by implementations"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
<comment
value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
<alias value="extensions"/>
<alias value="user content"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="Element.extension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="false"/>
<isSummary value="false"/>
<mapping>
<identity value="rim"/>
<map value="n/a"/>
</mapping>
</element>
<element id="tz-claim-submission-request.claimsItems.modifierExtension">
<path
value="tz-claim-submission-request.claimsItems.modifierExtension"/>
<short value="Extensions that cannot be ignored even if unrecognized"/>
<definition
value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and managable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.
Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
<comment
value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
<requirements
value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R5/extensibility.html#modifierExtension)."/>
<alias value="extensions"/>
<alias value="user content"/>
<alias value="modifiers"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="BackboneElement.modifierExtension"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="Extension"/>
</type>
<constraint>
<key value="ele-1"/>
<severity value="error"/>
<human value="All FHIR elements must have a @value or children"/>
<expression
value="hasValue() or (children().count() > id.count())"/>
<source value="http://hl7.org/fhir/StructureDefinition/Element"/>
</constraint>
<constraint>
<key value="ext-1"/>
<severity value="error"/>
<human value="Must have either extensions or value[x], not both"/>
<expression value="extension.exists() != value.exists()"/>
<source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
</constraint>
<isModifier value="true"/>
<isModifierReason
value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
<isSummary value="true"/>
<mapping>
<identity value="rim"/>
<map value="N/A"/>
</mapping>
</element>
<element id="tz-claim-submission-request.claimsItems.itemCode">
<path value="tz-claim-submission-request.claimsItems.itemCode"/>
<short value="Item code"/>
<definition value="Service, medication, or procedure code"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="tz-claim-submission-request.claimsItems.itemCode"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
</element>
<element id="tz-claim-submission-request.claimsItems.itemQuantity">
<path value="tz-claim-submission-request.claimsItems.itemQuantity"/>
<short value="Item quantity"/>
<definition value="Quantity for the claim item"/>
<min value="1"/>
<max value="1"/>
<base>
<path value="tz-claim-submission-request.claimsItems.itemQuantity"/>
<min value="1"/>
<max value="1"/>
</base>
<type>
<code value="integer"/>
</type>
</element>
<element id="tz-claim-submission-request.claimsItems.frequency">
<path value="tz-claim-submission-request.claimsItems.frequency"/>
<short value="Frequency"/>
<definition value="Optional frequency information"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="tz-claim-submission-request.claimsItems.frequency"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="string"/>
</type>
</element>
<element id="tz-claim-submission-request.claimsItems.issuedNo">
<path value="tz-claim-submission-request.claimsItems.issuedNo"/>
<short value="Issued number"/>
<definition value="Issued number when pre-approval is required"/>
<min value="0"/>
<max value="1"/>
<base>
<path value="tz-claim-submission-request.claimsItems.issuedNo"/>
<min value="0"/>
<max value="1"/>
</base>
<type>
<code value="integer"/>
</type>
</element>
<element id="tz-claim-submission-request.preliminaryDiagnosisCode">
<path value="tz-claim-submission-request.preliminaryDiagnosisCode"/>
<short value="Preliminary diagnosis codes"/>
<definition value="Diagnosis codes captured during encounter"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="tz-claim-submission-request.preliminaryDiagnosisCode"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="string"/>
</type>
</element>
<element id="tz-claim-submission-request.finalDiagnosisCode">
<path value="tz-claim-submission-request.finalDiagnosisCode"/>
<short value="Final diagnosis codes"/>
<definition value="Diagnosis codes confirmed after encounter"/>
<min value="0"/>
<max value="*"/>
<base>
<path value="tz-claim-submission-request.finalDiagnosisCode"/>
<min value="0"/>
<max value="*"/>
</base>
<type>
<code value="string"/>
</type>
</element>
</snapshot>
<differential>
<element id="tz-claim-submission-request">
<path value="tz-claim-submission-request"/>
<short value="TZ Claim Submission Request (ZHSF JSON)"/>
<definition
value="Logical model representing the ZHSF Claim Submission JSON request payload.
This model defines the facade contract and is validated before transformation
to FHIR R5 resources."/>
</element>
<element id="tz-claim-submission-request.facilityCode">
<path value="tz-claim-submission-request.facilityCode"/>
<short value="Facility code"/>
<definition value="ZHSF facility identifier code"/>
<min value="1"/>
<max value="1"/>
<type>
<code value="string"/>
</type>
</element>
<element id="tz-claim-submission-request.practitionerRegistrationNo">
<path value="tz-claim-submission-request.practitionerRegistrationNo"/>
<short value="Practitioner registration number"/>
<definition value="Registered practitioner identifier"/>
<min value="1"/>
<max value="1"/>
<type>
<code value="string"/>
</type>
</element>
<element id="tz-claim-submission-request.authorizationNumber">
<path value="tz-claim-submission-request.authorizationNumber"/>
<short value="Authorization number"/>
<definition
value="Authorization number issued during eligibility/approval"/>
<min value="1"/>
<max value="1"/>
<type>
<code value="string"/>
</type>
</element>
<element id="tz-claim-submission-request.clinicalNotes">
<path value="tz-claim-submission-request.clinicalNotes"/>
<short value="Clinical notes"/>
<definition value="Optional free-text clinical notes"/>
<min value="0"/>
<max value="1"/>
<type>
<code value="string"/>
</type>
</element>
<element id="tz-claim-submission-request.referralNo">
<path value="tz-claim-submission-request.referralNo"/>
<short value="Referral number"/>
<definition value="Referral number if applicable (often 0)"/>
<min value="0"/>
<max value="1"/>
<type>
<code value="integer"/>
</type>
</element>
<element id="tz-claim-submission-request.isAdmited">
<path value="tz-claim-submission-request.isAdmited"/>
<short value="Is admitted"/>
<definition value="Admission flag (true if inpatient)"/>
<min value="1"/>
<max value="1"/>
<type>
<code value="boolean"/>
</type>
</element>
<element id="tz-claim-submission-request.mrn">
<path value="tz-claim-submission-request.mrn"/>
<short value="Medical Record Number"/>
<definition value="Facility medical record number"/>
<min value="1"/>
<max value="1"/>
<type>
<code value="string"/>
</type>
</element>
<element id="tz-claim-submission-request.claimsItems">
<path value="tz-claim-submission-request.claimsItems"/>
<short value="Claim items"/>
<definition value="List of claim line items"/>
<min value="1"/>
<max value="*"/>
<type>
<code value="BackboneElement"/>
</type>
</element>
<element id="tz-claim-submission-request.claimsItems.itemCode">
<path value="tz-claim-submission-request.claimsItems.itemCode"/>
<short value="Item code"/>
<definition value="Service, medication, or procedure code"/>
<min value="1"/>
<max value="1"/>
<type>
<code value="string"/>
</type>
</element>
<element id="tz-claim-submission-request.claimsItems.itemQuantity">
<path value="tz-claim-submission-request.claimsItems.itemQuantity"/>
<short value="Item quantity"/>
<definition value="Quantity for the claim item"/>
<min value="1"/>
<max value="1"/>
<type>
<code value="integer"/>
</type>
</element>
<element id="tz-claim-submission-request.claimsItems.frequency">
<path value="tz-claim-submission-request.claimsItems.frequency"/>
<short value="Frequency"/>
<definition value="Optional frequency information"/>
<min value="0"/>
<max value="1"/>
<type>
<code value="string"/>
</type>
</element>
<element id="tz-claim-submission-request.claimsItems.issuedNo">
<path value="tz-claim-submission-request.claimsItems.issuedNo"/>
<short value="Issued number"/>
<definition value="Issued number when pre-approval is required"/>
<min value="0"/>
<max value="1"/>
<type>
<code value="integer"/>
</type>
</element>
<element id="tz-claim-submission-request.preliminaryDiagnosisCode">
<path value="tz-claim-submission-request.preliminaryDiagnosisCode"/>
<short value="Preliminary diagnosis codes"/>
<definition value="Diagnosis codes captured during encounter"/>
<min value="0"/>
<max value="*"/>
<type>
<code value="string"/>
</type>
</element>
<element id="tz-claim-submission-request.finalDiagnosisCode">
<path value="tz-claim-submission-request.finalDiagnosisCode"/>
<short value="Final diagnosis codes"/>
<definition value="Diagnosis codes confirmed after encounter"/>
<min value="0"/>
<max value="*"/>
<type>
<code value="string"/>
</type>
</element>
</differential>
</StructureDefinition>