O‘zbekiston Raqamli sog‘liqni saqlash platformasi
0.11.1 - ci-build Uzbekistan bayroqcha

Uzbekistan Digital Health Platform, Ministry of Health of the Republic of Uzbekistan tomonidan e’lon qilingan. Ushbu qo‘llanma rasmiy nashr emas; u FHIR (HL7® FHIR® Standard) CI Build tomonidan yaratilgan 0.11.1 versiyasi uchun uzluksiz yig‘ma hisoblanadi. Ushbu versiya https://github.com/uzinfocom-org/digital-health-ig/ dagi joriy kontentga asoslangan va muntazam ravishda o‘zgarib turadi. Nashr etilgan versiyalar katalogini ko‘ring

Resurss profili: UZ Core ClaimResponse ( Eksperimental )

Rasmiy URL: https://dhp.uz/fhir/core/StructureDefinition/uz-core-claim-response Versiya: 0.11.1
Active 2026-06-22 holatiga ko‘ra Kompyuterda qayta ishlanadigan nom: UZCoreClaimResponse

Uzbekistan Core ClaimResponse profile, used to represent claim adjudication and reimbursement responses

Foydalanishlar:

You can also check for usages in the FHIR IG Statistics

Profil mazmunining rasmiy ko‘rinishlari

Profillar, differentsiyalar, snapshotlar va ularning tasvirlari ta’rifi.

NomiBelgilarCard.TuriTavsif va cheklovlar    Filter: doco
ClaimResponse 0..* ClaimResponse(5.0.0) Response to a claim predetermination or preauthorization
ClaimResponse.implicitRules Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..1 uri A set of rules under which this content was created
ClaimResponse.contained 0..* Resource Contained, inline Resources
ClaimResponse.extension uchun slices 0..* Extension Extension
Slice: value:url tomonidan Tartibsiz, Ochiq
Constraints: ext-1

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
ClaimResponse.extension uchun slices.extension:cancellationReason Ushbu element qo‘llab-quvvatlanishi shart. 0..1 CodeableConcept Reason for cancellation
URL: https://dhp.uz/fhir/core/StructureDefinition/claim-response-cancellation-reason
Bogʻlanish: CancellationReasonVS (0.11.1) (required)
Constraints: ext-1
ClaimResponse.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
ClaimResponse.identifier Ushbu element qo‘llab-quvvatlanishi shart. 0..* Identifier Business identifier for the claim response
ClaimResponse.status Ushbu element modifikator element hisoblanadi. Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 code Current status of the claim response
Bogʻlanish: FMStatusVS (0.11.1) (required)
ClaimResponse.type Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 CodeableConcept Category or discipline of the claim
Bogʻlanish: ClaimTypeVS (0.11.1) (required)
ClaimResponse.use Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 code Purpose of the claim response
Bogʻlanish: ClaimUseVS (0.11.1) (required)
ClaimResponse.patient Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 Reference(UZ Core Patient(0.11.1)) Patient associated with the claim
ClaimResponse.created Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 dateTime Date the claim response was created
ClaimResponse.insurer Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 0..1 Reference(UZ Core Organization(0.11.1)) Organization responsible for reimbursement
ClaimResponse.request Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 0..1 Reference(UZ Core Claim(0.11.1)) Reference to the original claim
ClaimResponse.outcome Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 code Processing outcome of the claim
Bogʻlanish: ClaimResponseOutcomeVS (0.11.1) (required)
ClaimResponse.decision Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 0..1 CodeableConcept Adjudication decision
Bogʻlanish: ClaimResponseDecisionVS (0.11.1) (required)
ClaimResponse.preAuthRef Ushbu element qo‘llab-quvvatlanishi shart. 0..1 string Reference to a prior authorization
ClaimResponse.preAuthPeriod Ushbu element qo‘llab-quvvatlanishi shart. 0..1 Period Validity period of the prior authorization
ClaimResponse.preAuthPeriod.start Ushbu element xulosalarga kiritiladi. C 0..1 dateTime Authorization start date
ClaimResponse.preAuthPeriod.end Ushbu element xulosalarga kiritiladi. C 0..1 dateTime Authorization end date
ClaimResponse.total Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 0..* BackboneElement Summary adjudication amounts
ClaimResponse.total.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.total.category Ushbu element xulosalarga kiritiladi. 1..1 CodeableConcept Type of adjudication information
Bogʻlanish: ClaimResponseCategoryVS (0.11.1) (required)
ClaimResponse.total.amount Ushbu element xulosalarga kiritiladi. 1..1 Money Total amount for the category

doco Ushbu format bo‘yicha hujjatlar

Terminologiya bog‘lanishlari

Yoʻl Holat Foydalanish ValueSet Version Manba
ClaimResponse.status Base required Financial Management Status Value set 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.type Base required Claim Type VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.use Base required Claim Use Value set 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.outcome Base required Claim Response Outcome VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.decision Base required Claim Response Decision VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.total.​category Base required Claim Response Category VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi

Cheklovlar

Id Daraja Yoʻl(lar) Tavsif Ifoda

Ushbu tuzilma ClaimResponse asosida yaratilgan

NomiBelgilarCard.TuriTavsif va cheklovlar    Filter: doco
ClaimResponse 0..* ClaimResponse(5.0.0) Response to a claim predetermination or preauthorization
ClaimResponse.extension uchun slices 0..* Extension Extension
Slice: value:url tomonidan Tartibsiz, Ochiq
Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
ClaimResponse.extension uchun slices.extension:cancellationReason Ushbu element qo‘llab-quvvatlanishi shart. 0..1 CodeableConcept Reason for cancellation
URL: https://dhp.uz/fhir/core/StructureDefinition/claim-response-cancellation-reason
Bogʻlanish: CancellationReasonVS (0.11.1) (required)
ClaimResponse.identifier Ushbu element qo‘llab-quvvatlanishi shart. 0..* Identifier Business identifier for the claim response
ClaimResponse.status Ushbu element qo‘llab-quvvatlanishi shart. 1..1 code Current status of the claim response
Bogʻlanish: FMStatusVS (0.11.1) (required)
ClaimResponse.use Ushbu element qo‘llab-quvvatlanishi shart. 1..1 code Purpose of the claim response
Bogʻlanish: ClaimUseVS (0.11.1) (required)
ClaimResponse.patient Ushbu element qo‘llab-quvvatlanishi shart. 1..1 Reference(UZ Core Patient(0.11.1)) Patient associated with the claim
ClaimResponse.created Ushbu element qo‘llab-quvvatlanishi shart. 1..1 dateTime Date the claim response was created
ClaimResponse.insurer Ushbu element qo‘llab-quvvatlanishi shart. 0..1 Reference(UZ Core Organization(0.11.1)) Organization responsible for reimbursement
ClaimResponse.request Ushbu element qo‘llab-quvvatlanishi shart. 0..1 Reference(UZ Core Claim(0.11.1)) Reference to the original claim
ClaimResponse.outcome Ushbu element qo‘llab-quvvatlanishi shart. 1..1 code Processing outcome of the claim
Bogʻlanish: ClaimResponseOutcomeVS (0.11.1) (required)
ClaimResponse.decision Ushbu element qo‘llab-quvvatlanishi shart. 0..1 CodeableConcept Adjudication decision
Bogʻlanish: ClaimResponseDecisionVS (0.11.1) (required)
ClaimResponse.preAuthRef Ushbu element qo‘llab-quvvatlanishi shart. 0..1 string Reference to a prior authorization
ClaimResponse.preAuthPeriod Ushbu element qo‘llab-quvvatlanishi shart. 0..1 Period Validity period of the prior authorization
ClaimResponse.preAuthPeriod.start 0..1 dateTime Authorization start date
ClaimResponse.preAuthPeriod.end 0..1 dateTime Authorization end date
ClaimResponse.total Ushbu element qo‘llab-quvvatlanishi shart. 0..* BackboneElement Summary adjudication amounts
ClaimResponse.total.category 1..1 CodeableConcept Type of adjudication information
Bogʻlanish: ClaimResponseCategoryVS (0.11.1) (required)
ClaimResponse.total.amount 1..1 Money Total amount for the category

doco Ushbu format bo‘yicha hujjatlar

Terminologiya bog‘lanishlari (Differensial)

Yoʻl Holat Foydalanish ValueSet Version Manba
ClaimResponse.status Base required Financial Management Status Value set 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.type Base required Claim Type VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.use Base required Claim Use Value set 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.outcome Base required Claim Response Outcome VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.decision Base required Claim Response Decision VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.total.​category Base required Claim Response Category VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
NomiBelgilarCard.TuriTavsif va cheklovlar    Filter: doco
ClaimResponse 0..* ClaimResponse(5.0.0) Response to a claim predetermination or preauthorization
ClaimResponse.id Ushbu element xulosalarga kiritiladi. 0..1 id Logical id of this artifact
ClaimResponse.meta Ushbu element xulosalarga kiritiladi. 0..1 Meta Metadata about the resource
ClaimResponse.implicitRules Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..1 uri A set of rules under which this content was created
ClaimResponse.language 0..1 code Language of the resource content
Bogʻlanish: AllLanguages (required): IETF language tag for a human language
Qo'shimcha bog'lashlarPurpose
CommonLanguages Boshlang'ich
ClaimResponse.text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
ClaimResponse.contained 0..* Resource Contained, inline Resources
ClaimResponse.extension uchun slices 0..* Extension Extension
Slice: value:url tomonidan Tartibsiz, Ochiq
Constraints: ext-1

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
ClaimResponse.extension uchun slices.extension:cancellationReason Ushbu element qo‘llab-quvvatlanishi shart. 0..1 CodeableConcept Reason for cancellation
URL: https://dhp.uz/fhir/core/StructureDefinition/claim-response-cancellation-reason
Bogʻlanish: CancellationReasonVS (0.11.1) (required)
Constraints: ext-1
ClaimResponse.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
ClaimResponse.identifier Ushbu element qo‘llab-quvvatlanishi shart. 0..* Identifier Business identifier for the claim response
ClaimResponse.traceNumber 0..* Identifier Number for tracking
ClaimResponse.status Ushbu element modifikator element hisoblanadi. Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 code Current status of the claim response
Bogʻlanish: FMStatusVS (0.11.1) (required)
ClaimResponse.type Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 CodeableConcept Category or discipline of the claim
Bogʻlanish: ClaimTypeVS (0.11.1) (required)
ClaimResponse.subType 0..1 CodeableConcept More granular claim type
Bogʻlanish: ExampleClaimSubTypeCodes (example): A more granular claim typecode.
ClaimResponse.use Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 code Purpose of the claim response
Bogʻlanish: ClaimUseVS (0.11.1) (required)
ClaimResponse.patient Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 Reference(UZ Core Patient(0.11.1)) Patient associated with the claim
ClaimResponse.created Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 dateTime Date the claim response was created
ClaimResponse.insurer Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 0..1 Reference(UZ Core Organization(0.11.1)) Organization responsible for reimbursement
ClaimResponse.requestor 0..1 Reference(Practitioner | PractitionerRole | Organization) Party responsible for the claim
ClaimResponse.request Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 0..1 Reference(UZ Core Claim(0.11.1)) Reference to the original claim
ClaimResponse.outcome Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 code Processing outcome of the claim
Bogʻlanish: ClaimResponseOutcomeVS (0.11.1) (required)
ClaimResponse.decision Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 0..1 CodeableConcept Adjudication decision
Bogʻlanish: ClaimResponseDecisionVS (0.11.1) (required)
ClaimResponse.disposition 0..1 string Disposition Message
ClaimResponse.preAuthRef Ushbu element qo‘llab-quvvatlanishi shart. 0..1 string Reference to a prior authorization
ClaimResponse.preAuthPeriod Ushbu element qo‘llab-quvvatlanishi shart. 0..1 Period Validity period of the prior authorization
ClaimResponse.preAuthPeriod.id 0..1 id Unique id for inter-element referencing
ClaimResponse.preAuthPeriod.extension 0..* Extension Additional content defined by implementations
Slice: value:url tomonidan Tartibsiz, Ochiq
Constraints: ext-1
ClaimResponse.preAuthPeriod.start Ushbu element xulosalarga kiritiladi. C 0..1 dateTime Authorization start date
ClaimResponse.preAuthPeriod.end Ushbu element xulosalarga kiritiladi. C 0..1 dateTime Authorization end date
ClaimResponse.event 0..* BackboneElement Event information
ClaimResponse.event.id 0..1 string Unique id for inter-element referencing
ClaimResponse.event.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.event.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.event.type 1..1 CodeableConcept Specific event
Bogʻlanish: DatesTypeCodes (example)
ClaimResponse.event.when[x] 1..1 Occurance date or period
ClaimResponse.event.when[x].whenDateTime dateTime
ClaimResponse.event.when[x].whenPeriod Period
ClaimResponse.payeeType 0..1 CodeableConcept Party to be paid any benefits payable
Bogʻlanish: ClaimPayeeTypeCodes (example): A code for the party to be reimbursed.
ClaimResponse.encounter 0..* Reference(Encounter) Encounters associated with the listed treatments
ClaimResponse.diagnosisRelatedGroup 0..1 CodeableConcept Package billing code
Bogʻlanish: ExampleDiagnosisRelatedGroupCodes (example)
ClaimResponse.item 0..* BackboneElement Adjudication for claim line items
ClaimResponse.item.id 0..1 string Unique id for inter-element referencing
ClaimResponse.item.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.item.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.item.itemSequence 1..1 positiveInt Claim item instance identifier
ClaimResponse.item.traceNumber 0..* Identifier Number for tracking
ClaimResponse.item.noteNumber 0..* positiveInt Applicable note numbers
ClaimResponse.item.reviewOutcome 0..1 BackboneElement Adjudication results
ClaimResponse.item.reviewOutcome.id 0..1 string Unique id for inter-element referencing
ClaimResponse.item.reviewOutcome.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.item.reviewOutcome.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.item.reviewOutcome.decision 0..1 CodeableConcept Result of the adjudication
Bogʻlanish: ClaimAdjudicationDecisionsCodes (example)
ClaimResponse.item.reviewOutcome.reason 0..* CodeableConcept Reason for result of the adjudication
Bogʻlanish: ClaimAdjudicationDecisionReasonCodes (example)
ClaimResponse.item.reviewOutcome.preAuthRef 0..1 string Preauthorization reference
ClaimResponse.item.reviewOutcome.preAuthPeriod 0..1 Period Preauthorization reference effective period
ClaimResponse.item.adjudication 0..* BackboneElement Adjudication details
ClaimResponse.item.adjudication.id 0..1 string Unique id for inter-element referencing
ClaimResponse.item.adjudication.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.item.adjudication.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.item.adjudication.category 1..1 CodeableConcept Type of adjudication information
Bogʻlanish: AdjudicationValueCodes (example): The adjudication codes.
ClaimResponse.item.adjudication.reason 0..1 CodeableConcept Explanation of adjudication outcome
Bogʻlanish: AdjudicationReasonCodes (example): The adjudication reason codes.
ClaimResponse.item.adjudication.amount 0..1 Money Monetary amount
ClaimResponse.item.adjudication.quantity 0..1 Quantity Non-monetary value
ClaimResponse.item.detail 0..* BackboneElement Adjudication for claim details
ClaimResponse.item.detail.id 0..1 string Unique id for inter-element referencing
ClaimResponse.item.detail.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.item.detail.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.item.detail.detailSequence 1..1 positiveInt Claim detail instance identifier
ClaimResponse.item.detail.traceNumber 0..* Identifier Number for tracking
ClaimResponse.item.detail.noteNumber 0..* positiveInt Applicable note numbers
ClaimResponse.item.detail.reviewOutcome 0..1 Qarang reviewOutcome (ClaimResponse) Detail level adjudication results
ClaimResponse.item.detail.adjudication 0..* Qarang adjudication (ClaimResponse) Detail level adjudication details
ClaimResponse.item.detail.subDetail 0..* BackboneElement Adjudication for claim sub-details
ClaimResponse.item.detail.subDetail.id 0..1 string Unique id for inter-element referencing
ClaimResponse.item.detail.subDetail.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.item.detail.subDetail.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.item.detail.subDetail.subDetailSequence 1..1 positiveInt Claim sub-detail instance identifier
ClaimResponse.item.detail.subDetail.traceNumber 0..* Identifier Number for tracking
ClaimResponse.item.detail.subDetail.noteNumber 0..* positiveInt Applicable note numbers
ClaimResponse.item.detail.subDetail.reviewOutcome 0..1 Qarang reviewOutcome (ClaimResponse) Subdetail level adjudication results
ClaimResponse.item.detail.subDetail.adjudication 0..* Qarang adjudication (ClaimResponse) Subdetail level adjudication details
ClaimResponse.addItem 0..* BackboneElement Insurer added line items
ClaimResponse.addItem.id 0..1 string Unique id for inter-element referencing
ClaimResponse.addItem.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.addItem.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.addItem.itemSequence 0..* positiveInt Item sequence number
ClaimResponse.addItem.detailSequence 0..* positiveInt Detail sequence number
ClaimResponse.addItem.subdetailSequence 0..* positiveInt Subdetail sequence number
ClaimResponse.addItem.traceNumber 0..* Identifier Number for tracking
ClaimResponse.addItem.provider 0..* Reference(Practitioner | PractitionerRole | Organization) Authorized providers
ClaimResponse.addItem.revenue 0..1 CodeableConcept Revenue or cost center code
Bogʻlanish: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
ClaimResponse.addItem.productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Bogʻlanish: USCLSCodes (example): Allowable service and product codes.
ClaimResponse.addItem.productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Bogʻlanish: USCLSCodes (example)
ClaimResponse.addItem.request 0..* Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription) Request or Referral for Service
ClaimResponse.addItem.modifier 0..* CodeableConcept Service/Product billing modifiers
Bogʻlanish: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
ClaimResponse.addItem.programCode 0..* CodeableConcept Program the product or service is provided under
Bogʻlanish: ExampleProgramReasonCodes (example): Program specific reason codes.
ClaimResponse.addItem.serviced[x] 0..1 Date or dates of service or product delivery
ClaimResponse.addItem.serviced[x].servicedDate date
ClaimResponse.addItem.serviced[x].servicedPeriod Period
ClaimResponse.addItem.location[x] 0..1 Place of service or where product was supplied
Bogʻlanish: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
ClaimResponse.addItem.location[x].locationCodeableConcept CodeableConcept
ClaimResponse.addItem.location[x].locationAddress Address
ClaimResponse.addItem.location[x].locationReference Reference(Location)
ClaimResponse.addItem.quantity C 0..1 SimpleQuantity(5.0.0) Count of products or services
Constraints: sqty-1
ClaimResponse.addItem.unitPrice 0..1 Money Fee, charge or cost per item
ClaimResponse.addItem.factor 0..1 decimal Price scaling factor
ClaimResponse.addItem.tax 0..1 Money Total tax
ClaimResponse.addItem.net 0..1 Money Total item cost
ClaimResponse.addItem.bodySite 0..* BackboneElement Anatomical location
ClaimResponse.addItem.bodySite.id 0..1 string Unique id for inter-element referencing
ClaimResponse.addItem.bodySite.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.addItem.bodySite.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.addItem.bodySite.site 1..* CodeableReference(BodyStructure) Location
Bogʻlanish: OralSiteCodes (example)
ClaimResponse.addItem.bodySite.subSite 0..* CodeableConcept Sub-location
Bogʻlanish: SurfaceCodes (example)
ClaimResponse.addItem.noteNumber 0..* positiveInt Applicable note numbers
ClaimResponse.addItem.reviewOutcome 0..1 Qarang reviewOutcome (ClaimResponse) Added items adjudication results
ClaimResponse.addItem.adjudication 0..* Qarang adjudication (ClaimResponse) Added items adjudication
ClaimResponse.addItem.detail 0..* BackboneElement Insurer added line details
ClaimResponse.addItem.detail.id 0..1 string Unique id for inter-element referencing
ClaimResponse.addItem.detail.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.addItem.detail.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.addItem.detail.traceNumber 0..* Identifier Number for tracking
ClaimResponse.addItem.detail.revenue 0..1 CodeableConcept Revenue or cost center code
Bogʻlanish: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
ClaimResponse.addItem.detail.productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Bogʻlanish: USCLSCodes (example): Allowable service and product codes.
ClaimResponse.addItem.detail.productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Bogʻlanish: USCLSCodes (example)
ClaimResponse.addItem.detail.modifier 0..* CodeableConcept Service/Product billing modifiers
Bogʻlanish: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
ClaimResponse.addItem.detail.quantity C 0..1 SimpleQuantity(5.0.0) Count of products or services
Constraints: sqty-1
ClaimResponse.addItem.detail.unitPrice 0..1 Money Fee, charge or cost per item
ClaimResponse.addItem.detail.factor 0..1 decimal Price scaling factor
ClaimResponse.addItem.detail.tax 0..1 Money Total tax
ClaimResponse.addItem.detail.net 0..1 Money Total item cost
ClaimResponse.addItem.detail.noteNumber 0..* positiveInt Applicable note numbers
ClaimResponse.addItem.detail.reviewOutcome 0..1 Qarang reviewOutcome (ClaimResponse) Added items detail level adjudication results
ClaimResponse.addItem.detail.adjudication 0..* Qarang adjudication (ClaimResponse) Added items detail adjudication
ClaimResponse.addItem.detail.subDetail 0..* BackboneElement Insurer added line items
ClaimResponse.addItem.detail.subDetail.id 0..1 string Unique id for inter-element referencing
ClaimResponse.addItem.detail.subDetail.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.addItem.detail.subDetail.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.addItem.detail.subDetail.traceNumber 0..* Identifier Number for tracking
ClaimResponse.addItem.detail.subDetail.revenue 0..1 CodeableConcept Revenue or cost center code
Bogʻlanish: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
ClaimResponse.addItem.detail.subDetail.productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Bogʻlanish: USCLSCodes (example): Allowable service and product codes.
ClaimResponse.addItem.detail.subDetail.productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Bogʻlanish: USCLSCodes (example)
ClaimResponse.addItem.detail.subDetail.modifier 0..* CodeableConcept Service/Product billing modifiers
Bogʻlanish: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
ClaimResponse.addItem.detail.subDetail.quantity C 0..1 SimpleQuantity(5.0.0) Count of products or services
Constraints: sqty-1
ClaimResponse.addItem.detail.subDetail.unitPrice 0..1 Money Fee, charge or cost per item
ClaimResponse.addItem.detail.subDetail.factor 0..1 decimal Price scaling factor
ClaimResponse.addItem.detail.subDetail.tax 0..1 Money Total tax
ClaimResponse.addItem.detail.subDetail.net 0..1 Money Total item cost
ClaimResponse.addItem.detail.subDetail.noteNumber 0..* positiveInt Applicable note numbers
ClaimResponse.addItem.detail.subDetail.reviewOutcome 0..1 Qarang reviewOutcome (ClaimResponse) Added items subdetail level adjudication results
ClaimResponse.addItem.detail.subDetail.adjudication 0..* Qarang adjudication (ClaimResponse) Added items subdetail adjudication
ClaimResponse.adjudication 0..* Qarang adjudication (ClaimResponse) Header-level adjudication
ClaimResponse.total Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 0..* BackboneElement Summary adjudication amounts
ClaimResponse.total.id 0..1 string Unique id for inter-element referencing
ClaimResponse.total.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.total.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.total.category Ushbu element xulosalarga kiritiladi. 1..1 CodeableConcept Type of adjudication information
Bogʻlanish: ClaimResponseCategoryVS (0.11.1) (required)
ClaimResponse.total.amount Ushbu element xulosalarga kiritiladi. 1..1 Money Total amount for the category
ClaimResponse.payment 0..1 BackboneElement Payment Details
ClaimResponse.payment.id 0..1 string Unique id for inter-element referencing
ClaimResponse.payment.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.payment.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.payment.type 1..1 CodeableConcept Partial or complete payment
Bogʻlanish: ExamplePaymentTypeCodes (example): The type (partial, complete) of the payment.
ClaimResponse.payment.adjustment 0..1 Money Payment adjustment for non-claim issues
ClaimResponse.payment.adjustmentReason 0..1 CodeableConcept Explanation for the adjustment
Bogʻlanish: PaymentAdjustmentReasonCodes (example): Payment Adjustment reason codes.
ClaimResponse.payment.date 0..1 date Expected date of payment
ClaimResponse.payment.amount 1..1 Money Payable amount after adjustment
ClaimResponse.payment.identifier 0..1 Identifier Business identifier for the payment
ClaimResponse.fundsReserve 0..1 CodeableConcept Funds reserved status
Bogʻlanish: FundsReservationCodes (example): For whom funds are to be reserved: (Patient, Provider, None).
ClaimResponse.formCode 0..1 CodeableConcept Printed form identifier
Bogʻlanish: FormCodes (example): The forms codes.
ClaimResponse.form 0..1 Attachment Printed reference or actual form
ClaimResponse.processNote 0..* BackboneElement Note concerning adjudication
ClaimResponse.processNote.id 0..1 string Unique id for inter-element referencing
ClaimResponse.processNote.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.processNote.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.processNote.number 0..1 positiveInt Note instance identifier
ClaimResponse.processNote.type 0..1 CodeableConcept Note purpose
Bogʻlanish: NoteType (extensible): The presentation types of notes.
ClaimResponse.processNote.text 1..1 string Note explanatory text
ClaimResponse.processNote.language 0..1 CodeableConcept Language of the text
Bogʻlanish: AllLanguages (required): IETF language tag for a human language
Qo'shimcha bog'lashlarPurpose
CommonLanguages Boshlang'ich
ClaimResponse.communicationRequest 0..* Reference(CommunicationRequest) Request for additional information
ClaimResponse.insurance 0..* BackboneElement Patient insurance information
ClaimResponse.insurance.id 0..1 string Unique id for inter-element referencing
ClaimResponse.insurance.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.insurance.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.insurance.sequence 1..1 positiveInt Insurance instance identifier
ClaimResponse.insurance.focal 1..1 boolean Coverage to be used for adjudication
ClaimResponse.insurance.coverage 1..1 Reference(Coverage) Insurance information
ClaimResponse.insurance.businessArrangement 0..1 string Additional provider contract number
ClaimResponse.insurance.claimResponse 0..1 Reference(ClaimResponse) Adjudication results
ClaimResponse.error 0..* BackboneElement Processing errors
ClaimResponse.error.id 0..1 string Unique id for inter-element referencing
ClaimResponse.error.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.error.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.error.itemSequence 0..1 positiveInt Item sequence number
ClaimResponse.error.detailSequence 0..1 positiveInt Detail sequence number
ClaimResponse.error.subDetailSequence 0..1 positiveInt Subdetail sequence number
ClaimResponse.error.code Ushbu element xulosalarga kiritiladi. 1..1 CodeableConcept Error code detailing processing issues
Bogʻlanish: AdjudicationErrorCodes (example): The adjudication error codes.
ClaimResponse.error.expression Ushbu element xulosalarga kiritiladi. 0..* string FHIRPath of element(s) related to issue

doco Ushbu format bo‘yicha hujjatlar

Terminologiya bog‘lanishlari

Yoʻl Holat Foydalanish ValueSet Version Manba
ClaimResponse.language Base required All Languages 📍5.0.0 FHIR standarti.
ClaimResponse.status Base required Financial Management Status Value set 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.type Base required Claim Type VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.subType Base example Example Claim SubType Codes 📍5.0.0 FHIR standarti.
ClaimResponse.use Base required Claim Use Value set 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.outcome Base required Claim Response Outcome VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.decision Base required Claim Response Decision VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.event.​type Base example Dates Type Codes 📍5.0.0 FHIR standarti.
ClaimResponse.payeeType Base example Claim Payee Type Codes 📍5.0.0 FHIR standarti.
ClaimResponse.diagnosisRelatedGroup Base example Example Diagnosis Related Group Codes 📍5.0.0 FHIR standarti.
ClaimResponse.item.reviewOutcome.​decision Base example Claim Adjudication Decision Codes 📍5.0.0 FHIR standarti.
ClaimResponse.item.reviewOutcome.​reason Base example Claim Adjudication Decision Reason Codes 📍5.0.0 FHIR standarti.
ClaimResponse.item.adjudication.​category Base example Adjudication Value Codes 📍5.0.0 FHIR standarti.
ClaimResponse.item.adjudication.​reason Base example Adjudication Reason Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​revenue Base example Example Revenue Center Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​productOrService Base example USCLS Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​productOrServiceEnd Base example USCLS Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​modifier Base example Modifier type Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​programCode Base example Example Program Reason Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​location[x] Base example Example Service Place Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​bodySite.site Base example Oral Site Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​bodySite.subSite Base example Surface Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​detail.revenue Base example Example Revenue Center Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​detail.productOrService Base example USCLS Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​detail.productOrServiceEnd Base example USCLS Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​detail.modifier Base example Modifier type Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​detail.subDetail.revenue Base example Example Revenue Center Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​detail.subDetail.productOrService Base example USCLS Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​detail.subDetail.productOrServiceEnd Base example USCLS Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​detail.subDetail.modifier Base example Modifier type Codes 📍5.0.0 FHIR standarti.
ClaimResponse.total.​category Base required Claim Response Category VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.payment.​type Base example Example Payment Type Codes 📍5.0.0 FHIR standarti.
ClaimResponse.payment.​adjustmentReason Base example Payment Adjustment Reason Codes 📍5.0.0 FHIR standarti.
ClaimResponse.fundsReserve Base example Funds Reservation Codes 📍5.0.0 FHIR standarti.
ClaimResponse.formCode Base example Form Codes 📍5.0.0 FHIR standarti.
ClaimResponse.processNote.​type Base extensible NoteType 📍5.0.0 FHIR standarti.
ClaimResponse.processNote.​language Base required All Languages 📍5.0.0 FHIR standarti.
ClaimResponse.error.​code Base example Adjudication Error Codes 📍5.0.0 FHIR standarti.

Cheklovlar

Id Daraja Yoʻl(lar) Tavsif Ifoda

Asosiy elementlar ko'rinishi

NomiBelgilarCard.TuriTavsif va cheklovlar    Filter: doco
ClaimResponse 0..* ClaimResponse(5.0.0) Response to a claim predetermination or preauthorization
ClaimResponse.implicitRules Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..1 uri A set of rules under which this content was created
ClaimResponse.contained 0..* Resource Contained, inline Resources
ClaimResponse.extension uchun slices 0..* Extension Extension
Slice: value:url tomonidan Tartibsiz, Ochiq
Constraints: ext-1

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
ClaimResponse.extension uchun slices.extension:cancellationReason Ushbu element qo‘llab-quvvatlanishi shart. 0..1 CodeableConcept Reason for cancellation
URL: https://dhp.uz/fhir/core/StructureDefinition/claim-response-cancellation-reason
Bogʻlanish: CancellationReasonVS (0.11.1) (required)
Constraints: ext-1
ClaimResponse.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
ClaimResponse.identifier Ushbu element qo‘llab-quvvatlanishi shart. 0..* Identifier Business identifier for the claim response
ClaimResponse.status Ushbu element modifikator element hisoblanadi. Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 code Current status of the claim response
Bogʻlanish: FMStatusVS (0.11.1) (required)
ClaimResponse.type Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 CodeableConcept Category or discipline of the claim
Bogʻlanish: ClaimTypeVS (0.11.1) (required)
ClaimResponse.use Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 code Purpose of the claim response
Bogʻlanish: ClaimUseVS (0.11.1) (required)
ClaimResponse.patient Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 Reference(UZ Core Patient(0.11.1)) Patient associated with the claim
ClaimResponse.created Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 dateTime Date the claim response was created
ClaimResponse.insurer Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 0..1 Reference(UZ Core Organization(0.11.1)) Organization responsible for reimbursement
ClaimResponse.request Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 0..1 Reference(UZ Core Claim(0.11.1)) Reference to the original claim
ClaimResponse.outcome Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 code Processing outcome of the claim
Bogʻlanish: ClaimResponseOutcomeVS (0.11.1) (required)
ClaimResponse.decision Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 0..1 CodeableConcept Adjudication decision
Bogʻlanish: ClaimResponseDecisionVS (0.11.1) (required)
ClaimResponse.preAuthRef Ushbu element qo‘llab-quvvatlanishi shart. 0..1 string Reference to a prior authorization
ClaimResponse.preAuthPeriod Ushbu element qo‘llab-quvvatlanishi shart. 0..1 Period Validity period of the prior authorization
ClaimResponse.preAuthPeriod.start Ushbu element xulosalarga kiritiladi. C 0..1 dateTime Authorization start date
ClaimResponse.preAuthPeriod.end Ushbu element xulosalarga kiritiladi. C 0..1 dateTime Authorization end date
ClaimResponse.total Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 0..* BackboneElement Summary adjudication amounts
ClaimResponse.total.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.total.category Ushbu element xulosalarga kiritiladi. 1..1 CodeableConcept Type of adjudication information
Bogʻlanish: ClaimResponseCategoryVS (0.11.1) (required)
ClaimResponse.total.amount Ushbu element xulosalarga kiritiladi. 1..1 Money Total amount for the category

doco Ushbu format bo‘yicha hujjatlar

Terminologiya bog‘lanishlari

Yoʻl Holat Foydalanish ValueSet Version Manba
ClaimResponse.status Base required Financial Management Status Value set 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.type Base required Claim Type VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.use Base required Claim Use Value set 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.outcome Base required Claim Response Outcome VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.decision Base required Claim Response Decision VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.total.​category Base required Claim Response Category VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi

Cheklovlar

Id Daraja Yoʻl(lar) Tavsif Ifoda

Differensial ko‘rinish

Ushbu tuzilma ClaimResponse asosida yaratilgan

NomiBelgilarCard.TuriTavsif va cheklovlar    Filter: doco
ClaimResponse 0..* ClaimResponse(5.0.0) Response to a claim predetermination or preauthorization
ClaimResponse.extension uchun slices 0..* Extension Extension
Slice: value:url tomonidan Tartibsiz, Ochiq
Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
ClaimResponse.extension uchun slices.extension:cancellationReason Ushbu element qo‘llab-quvvatlanishi shart. 0..1 CodeableConcept Reason for cancellation
URL: https://dhp.uz/fhir/core/StructureDefinition/claim-response-cancellation-reason
Bogʻlanish: CancellationReasonVS (0.11.1) (required)
ClaimResponse.identifier Ushbu element qo‘llab-quvvatlanishi shart. 0..* Identifier Business identifier for the claim response
ClaimResponse.status Ushbu element qo‘llab-quvvatlanishi shart. 1..1 code Current status of the claim response
Bogʻlanish: FMStatusVS (0.11.1) (required)
ClaimResponse.type Ushbu element qo‘llab-quvvatlanishi shart. 1..1 CodeableConcept Category or discipline of the claim
Bogʻlanish: ClaimTypeVS (0.11.1) (required)
ClaimResponse.use Ushbu element qo‘llab-quvvatlanishi shart. 1..1 code Purpose of the claim response
Bogʻlanish: ClaimUseVS (0.11.1) (required)
ClaimResponse.patient Ushbu element qo‘llab-quvvatlanishi shart. 1..1 Reference(UZ Core Patient(0.11.1)) Patient associated with the claim
ClaimResponse.created Ushbu element qo‘llab-quvvatlanishi shart. 1..1 dateTime Date the claim response was created
ClaimResponse.insurer Ushbu element qo‘llab-quvvatlanishi shart. 0..1 Reference(UZ Core Organization(0.11.1)) Organization responsible for reimbursement
ClaimResponse.request Ushbu element qo‘llab-quvvatlanishi shart. 0..1 Reference(UZ Core Claim(0.11.1)) Reference to the original claim
ClaimResponse.outcome Ushbu element qo‘llab-quvvatlanishi shart. 1..1 code Processing outcome of the claim
Bogʻlanish: ClaimResponseOutcomeVS (0.11.1) (required)
ClaimResponse.decision Ushbu element qo‘llab-quvvatlanishi shart. 0..1 CodeableConcept Adjudication decision
Bogʻlanish: ClaimResponseDecisionVS (0.11.1) (required)
ClaimResponse.preAuthRef Ushbu element qo‘llab-quvvatlanishi shart. 0..1 string Reference to a prior authorization
ClaimResponse.preAuthPeriod Ushbu element qo‘llab-quvvatlanishi shart. 0..1 Period Validity period of the prior authorization
ClaimResponse.preAuthPeriod.start 0..1 dateTime Authorization start date
ClaimResponse.preAuthPeriod.end 0..1 dateTime Authorization end date
ClaimResponse.total Ushbu element qo‘llab-quvvatlanishi shart. 0..* BackboneElement Summary adjudication amounts
ClaimResponse.total.category 1..1 CodeableConcept Type of adjudication information
Bogʻlanish: ClaimResponseCategoryVS (0.11.1) (required)
ClaimResponse.total.amount 1..1 Money Total amount for the category

doco Ushbu format bo‘yicha hujjatlar

Terminologiya bog‘lanishlari (Differensial)

Yoʻl Holat Foydalanish ValueSet Version Manba
ClaimResponse.status Base required Financial Management Status Value set 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.type Base required Claim Type VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.use Base required Claim Use Value set 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.outcome Base required Claim Response Outcome VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.decision Base required Claim Response Decision VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.total.​category Base required Claim Response Category VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi

Snapshot ko‘rinishiView

NomiBelgilarCard.TuriTavsif va cheklovlar    Filter: doco
ClaimResponse 0..* ClaimResponse(5.0.0) Response to a claim predetermination or preauthorization
ClaimResponse.id Ushbu element xulosalarga kiritiladi. 0..1 id Logical id of this artifact
ClaimResponse.meta Ushbu element xulosalarga kiritiladi. 0..1 Meta Metadata about the resource
ClaimResponse.implicitRules Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..1 uri A set of rules under which this content was created
ClaimResponse.language 0..1 code Language of the resource content
Bogʻlanish: AllLanguages (required): IETF language tag for a human language
Qo'shimcha bog'lashlarPurpose
CommonLanguages Boshlang'ich
ClaimResponse.text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
ClaimResponse.contained 0..* Resource Contained, inline Resources
ClaimResponse.extension uchun slices 0..* Extension Extension
Slice: value:url tomonidan Tartibsiz, Ochiq
Constraints: ext-1

Slicing Note: The rules on this element (including its children) apply to all the slices, but are not repeated in them
ClaimResponse.extension uchun slices.extension:cancellationReason Ushbu element qo‘llab-quvvatlanishi shart. 0..1 CodeableConcept Reason for cancellation
URL: https://dhp.uz/fhir/core/StructureDefinition/claim-response-cancellation-reason
Bogʻlanish: CancellationReasonVS (0.11.1) (required)
Constraints: ext-1
ClaimResponse.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored
Constraints: ext-1
ClaimResponse.identifier Ushbu element qo‘llab-quvvatlanishi shart. 0..* Identifier Business identifier for the claim response
ClaimResponse.traceNumber 0..* Identifier Number for tracking
ClaimResponse.status Ushbu element modifikator element hisoblanadi. Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 code Current status of the claim response
Bogʻlanish: FMStatusVS (0.11.1) (required)
ClaimResponse.type Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 CodeableConcept Category or discipline of the claim
Bogʻlanish: ClaimTypeVS (0.11.1) (required)
ClaimResponse.subType 0..1 CodeableConcept More granular claim type
Bogʻlanish: ExampleClaimSubTypeCodes (example): A more granular claim typecode.
ClaimResponse.use Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 code Purpose of the claim response
Bogʻlanish: ClaimUseVS (0.11.1) (required)
ClaimResponse.patient Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 Reference(UZ Core Patient(0.11.1)) Patient associated with the claim
ClaimResponse.created Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 dateTime Date the claim response was created
ClaimResponse.insurer Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 0..1 Reference(UZ Core Organization(0.11.1)) Organization responsible for reimbursement
ClaimResponse.requestor 0..1 Reference(Practitioner | PractitionerRole | Organization) Party responsible for the claim
ClaimResponse.request Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 0..1 Reference(UZ Core Claim(0.11.1)) Reference to the original claim
ClaimResponse.outcome Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 1..1 code Processing outcome of the claim
Bogʻlanish: ClaimResponseOutcomeVS (0.11.1) (required)
ClaimResponse.decision Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 0..1 CodeableConcept Adjudication decision
Bogʻlanish: ClaimResponseDecisionVS (0.11.1) (required)
ClaimResponse.disposition 0..1 string Disposition Message
ClaimResponse.preAuthRef Ushbu element qo‘llab-quvvatlanishi shart. 0..1 string Reference to a prior authorization
ClaimResponse.preAuthPeriod Ushbu element qo‘llab-quvvatlanishi shart. 0..1 Period Validity period of the prior authorization
ClaimResponse.preAuthPeriod.id 0..1 id Unique id for inter-element referencing
ClaimResponse.preAuthPeriod.extension 0..* Extension Additional content defined by implementations
Slice: value:url tomonidan Tartibsiz, Ochiq
Constraints: ext-1
ClaimResponse.preAuthPeriod.start Ushbu element xulosalarga kiritiladi. C 0..1 dateTime Authorization start date
ClaimResponse.preAuthPeriod.end Ushbu element xulosalarga kiritiladi. C 0..1 dateTime Authorization end date
ClaimResponse.event 0..* BackboneElement Event information
ClaimResponse.event.id 0..1 string Unique id for inter-element referencing
ClaimResponse.event.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.event.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.event.type 1..1 CodeableConcept Specific event
Bogʻlanish: DatesTypeCodes (example)
ClaimResponse.event.when[x] 1..1 Occurance date or period
ClaimResponse.event.when[x].whenDateTime dateTime
ClaimResponse.event.when[x].whenPeriod Period
ClaimResponse.payeeType 0..1 CodeableConcept Party to be paid any benefits payable
Bogʻlanish: ClaimPayeeTypeCodes (example): A code for the party to be reimbursed.
ClaimResponse.encounter 0..* Reference(Encounter) Encounters associated with the listed treatments
ClaimResponse.diagnosisRelatedGroup 0..1 CodeableConcept Package billing code
Bogʻlanish: ExampleDiagnosisRelatedGroupCodes (example)
ClaimResponse.item 0..* BackboneElement Adjudication for claim line items
ClaimResponse.item.id 0..1 string Unique id for inter-element referencing
ClaimResponse.item.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.item.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.item.itemSequence 1..1 positiveInt Claim item instance identifier
ClaimResponse.item.traceNumber 0..* Identifier Number for tracking
ClaimResponse.item.noteNumber 0..* positiveInt Applicable note numbers
ClaimResponse.item.reviewOutcome 0..1 BackboneElement Adjudication results
ClaimResponse.item.reviewOutcome.id 0..1 string Unique id for inter-element referencing
ClaimResponse.item.reviewOutcome.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.item.reviewOutcome.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.item.reviewOutcome.decision 0..1 CodeableConcept Result of the adjudication
Bogʻlanish: ClaimAdjudicationDecisionsCodes (example)
ClaimResponse.item.reviewOutcome.reason 0..* CodeableConcept Reason for result of the adjudication
Bogʻlanish: ClaimAdjudicationDecisionReasonCodes (example)
ClaimResponse.item.reviewOutcome.preAuthRef 0..1 string Preauthorization reference
ClaimResponse.item.reviewOutcome.preAuthPeriod 0..1 Period Preauthorization reference effective period
ClaimResponse.item.adjudication 0..* BackboneElement Adjudication details
ClaimResponse.item.adjudication.id 0..1 string Unique id for inter-element referencing
ClaimResponse.item.adjudication.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.item.adjudication.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.item.adjudication.category 1..1 CodeableConcept Type of adjudication information
Bogʻlanish: AdjudicationValueCodes (example): The adjudication codes.
ClaimResponse.item.adjudication.reason 0..1 CodeableConcept Explanation of adjudication outcome
Bogʻlanish: AdjudicationReasonCodes (example): The adjudication reason codes.
ClaimResponse.item.adjudication.amount 0..1 Money Monetary amount
ClaimResponse.item.adjudication.quantity 0..1 Quantity Non-monetary value
ClaimResponse.item.detail 0..* BackboneElement Adjudication for claim details
ClaimResponse.item.detail.id 0..1 string Unique id for inter-element referencing
ClaimResponse.item.detail.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.item.detail.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.item.detail.detailSequence 1..1 positiveInt Claim detail instance identifier
ClaimResponse.item.detail.traceNumber 0..* Identifier Number for tracking
ClaimResponse.item.detail.noteNumber 0..* positiveInt Applicable note numbers
ClaimResponse.item.detail.reviewOutcome 0..1 Qarang reviewOutcome (ClaimResponse) Detail level adjudication results
ClaimResponse.item.detail.adjudication 0..* Qarang adjudication (ClaimResponse) Detail level adjudication details
ClaimResponse.item.detail.subDetail 0..* BackboneElement Adjudication for claim sub-details
ClaimResponse.item.detail.subDetail.id 0..1 string Unique id for inter-element referencing
ClaimResponse.item.detail.subDetail.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.item.detail.subDetail.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.item.detail.subDetail.subDetailSequence 1..1 positiveInt Claim sub-detail instance identifier
ClaimResponse.item.detail.subDetail.traceNumber 0..* Identifier Number for tracking
ClaimResponse.item.detail.subDetail.noteNumber 0..* positiveInt Applicable note numbers
ClaimResponse.item.detail.subDetail.reviewOutcome 0..1 Qarang reviewOutcome (ClaimResponse) Subdetail level adjudication results
ClaimResponse.item.detail.subDetail.adjudication 0..* Qarang adjudication (ClaimResponse) Subdetail level adjudication details
ClaimResponse.addItem 0..* BackboneElement Insurer added line items
ClaimResponse.addItem.id 0..1 string Unique id for inter-element referencing
ClaimResponse.addItem.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.addItem.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.addItem.itemSequence 0..* positiveInt Item sequence number
ClaimResponse.addItem.detailSequence 0..* positiveInt Detail sequence number
ClaimResponse.addItem.subdetailSequence 0..* positiveInt Subdetail sequence number
ClaimResponse.addItem.traceNumber 0..* Identifier Number for tracking
ClaimResponse.addItem.provider 0..* Reference(Practitioner | PractitionerRole | Organization) Authorized providers
ClaimResponse.addItem.revenue 0..1 CodeableConcept Revenue or cost center code
Bogʻlanish: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
ClaimResponse.addItem.productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Bogʻlanish: USCLSCodes (example): Allowable service and product codes.
ClaimResponse.addItem.productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Bogʻlanish: USCLSCodes (example)
ClaimResponse.addItem.request 0..* Reference(DeviceRequest | MedicationRequest | NutritionOrder | ServiceRequest | SupplyRequest | VisionPrescription) Request or Referral for Service
ClaimResponse.addItem.modifier 0..* CodeableConcept Service/Product billing modifiers
Bogʻlanish: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
ClaimResponse.addItem.programCode 0..* CodeableConcept Program the product or service is provided under
Bogʻlanish: ExampleProgramReasonCodes (example): Program specific reason codes.
ClaimResponse.addItem.serviced[x] 0..1 Date or dates of service or product delivery
ClaimResponse.addItem.serviced[x].servicedDate date
ClaimResponse.addItem.serviced[x].servicedPeriod Period
ClaimResponse.addItem.location[x] 0..1 Place of service or where product was supplied
Bogʻlanish: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
ClaimResponse.addItem.location[x].locationCodeableConcept CodeableConcept
ClaimResponse.addItem.location[x].locationAddress Address
ClaimResponse.addItem.location[x].locationReference Reference(Location)
ClaimResponse.addItem.quantity C 0..1 SimpleQuantity(5.0.0) Count of products or services
Constraints: sqty-1
ClaimResponse.addItem.unitPrice 0..1 Money Fee, charge or cost per item
ClaimResponse.addItem.factor 0..1 decimal Price scaling factor
ClaimResponse.addItem.tax 0..1 Money Total tax
ClaimResponse.addItem.net 0..1 Money Total item cost
ClaimResponse.addItem.bodySite 0..* BackboneElement Anatomical location
ClaimResponse.addItem.bodySite.id 0..1 string Unique id for inter-element referencing
ClaimResponse.addItem.bodySite.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.addItem.bodySite.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.addItem.bodySite.site 1..* CodeableReference(BodyStructure) Location
Bogʻlanish: OralSiteCodes (example)
ClaimResponse.addItem.bodySite.subSite 0..* CodeableConcept Sub-location
Bogʻlanish: SurfaceCodes (example)
ClaimResponse.addItem.noteNumber 0..* positiveInt Applicable note numbers
ClaimResponse.addItem.reviewOutcome 0..1 Qarang reviewOutcome (ClaimResponse) Added items adjudication results
ClaimResponse.addItem.adjudication 0..* Qarang adjudication (ClaimResponse) Added items adjudication
ClaimResponse.addItem.detail 0..* BackboneElement Insurer added line details
ClaimResponse.addItem.detail.id 0..1 string Unique id for inter-element referencing
ClaimResponse.addItem.detail.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.addItem.detail.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.addItem.detail.traceNumber 0..* Identifier Number for tracking
ClaimResponse.addItem.detail.revenue 0..1 CodeableConcept Revenue or cost center code
Bogʻlanish: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
ClaimResponse.addItem.detail.productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Bogʻlanish: USCLSCodes (example): Allowable service and product codes.
ClaimResponse.addItem.detail.productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Bogʻlanish: USCLSCodes (example)
ClaimResponse.addItem.detail.modifier 0..* CodeableConcept Service/Product billing modifiers
Bogʻlanish: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
ClaimResponse.addItem.detail.quantity C 0..1 SimpleQuantity(5.0.0) Count of products or services
Constraints: sqty-1
ClaimResponse.addItem.detail.unitPrice 0..1 Money Fee, charge or cost per item
ClaimResponse.addItem.detail.factor 0..1 decimal Price scaling factor
ClaimResponse.addItem.detail.tax 0..1 Money Total tax
ClaimResponse.addItem.detail.net 0..1 Money Total item cost
ClaimResponse.addItem.detail.noteNumber 0..* positiveInt Applicable note numbers
ClaimResponse.addItem.detail.reviewOutcome 0..1 Qarang reviewOutcome (ClaimResponse) Added items detail level adjudication results
ClaimResponse.addItem.detail.adjudication 0..* Qarang adjudication (ClaimResponse) Added items detail adjudication
ClaimResponse.addItem.detail.subDetail 0..* BackboneElement Insurer added line items
ClaimResponse.addItem.detail.subDetail.id 0..1 string Unique id for inter-element referencing
ClaimResponse.addItem.detail.subDetail.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.addItem.detail.subDetail.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.addItem.detail.subDetail.traceNumber 0..* Identifier Number for tracking
ClaimResponse.addItem.detail.subDetail.revenue 0..1 CodeableConcept Revenue or cost center code
Bogʻlanish: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
ClaimResponse.addItem.detail.subDetail.productOrService 0..1 CodeableConcept Billing, service, product, or drug code
Bogʻlanish: USCLSCodes (example): Allowable service and product codes.
ClaimResponse.addItem.detail.subDetail.productOrServiceEnd 0..1 CodeableConcept End of a range of codes
Bogʻlanish: USCLSCodes (example)
ClaimResponse.addItem.detail.subDetail.modifier 0..* CodeableConcept Service/Product billing modifiers
Bogʻlanish: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
ClaimResponse.addItem.detail.subDetail.quantity C 0..1 SimpleQuantity(5.0.0) Count of products or services
Constraints: sqty-1
ClaimResponse.addItem.detail.subDetail.unitPrice 0..1 Money Fee, charge or cost per item
ClaimResponse.addItem.detail.subDetail.factor 0..1 decimal Price scaling factor
ClaimResponse.addItem.detail.subDetail.tax 0..1 Money Total tax
ClaimResponse.addItem.detail.subDetail.net 0..1 Money Total item cost
ClaimResponse.addItem.detail.subDetail.noteNumber 0..* positiveInt Applicable note numbers
ClaimResponse.addItem.detail.subDetail.reviewOutcome 0..1 Qarang reviewOutcome (ClaimResponse) Added items subdetail level adjudication results
ClaimResponse.addItem.detail.subDetail.adjudication 0..* Qarang adjudication (ClaimResponse) Added items subdetail adjudication
ClaimResponse.adjudication 0..* Qarang adjudication (ClaimResponse) Header-level adjudication
ClaimResponse.total Ushbu element qo‘llab-quvvatlanishi shart. Ushbu element xulosalarga kiritiladi. 0..* BackboneElement Summary adjudication amounts
ClaimResponse.total.id 0..1 string Unique id for inter-element referencing
ClaimResponse.total.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.total.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.total.category Ushbu element xulosalarga kiritiladi. 1..1 CodeableConcept Type of adjudication information
Bogʻlanish: ClaimResponseCategoryVS (0.11.1) (required)
ClaimResponse.total.amount Ushbu element xulosalarga kiritiladi. 1..1 Money Total amount for the category
ClaimResponse.payment 0..1 BackboneElement Payment Details
ClaimResponse.payment.id 0..1 string Unique id for inter-element referencing
ClaimResponse.payment.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.payment.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.payment.type 1..1 CodeableConcept Partial or complete payment
Bogʻlanish: ExamplePaymentTypeCodes (example): The type (partial, complete) of the payment.
ClaimResponse.payment.adjustment 0..1 Money Payment adjustment for non-claim issues
ClaimResponse.payment.adjustmentReason 0..1 CodeableConcept Explanation for the adjustment
Bogʻlanish: PaymentAdjustmentReasonCodes (example): Payment Adjustment reason codes.
ClaimResponse.payment.date 0..1 date Expected date of payment
ClaimResponse.payment.amount 1..1 Money Payable amount after adjustment
ClaimResponse.payment.identifier 0..1 Identifier Business identifier for the payment
ClaimResponse.fundsReserve 0..1 CodeableConcept Funds reserved status
Bogʻlanish: FundsReservationCodes (example): For whom funds are to be reserved: (Patient, Provider, None).
ClaimResponse.formCode 0..1 CodeableConcept Printed form identifier
Bogʻlanish: FormCodes (example): The forms codes.
ClaimResponse.form 0..1 Attachment Printed reference or actual form
ClaimResponse.processNote 0..* BackboneElement Note concerning adjudication
ClaimResponse.processNote.id 0..1 string Unique id for inter-element referencing
ClaimResponse.processNote.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.processNote.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.processNote.number 0..1 positiveInt Note instance identifier
ClaimResponse.processNote.type 0..1 CodeableConcept Note purpose
Bogʻlanish: NoteType (extensible): The presentation types of notes.
ClaimResponse.processNote.text 1..1 string Note explanatory text
ClaimResponse.processNote.language 0..1 CodeableConcept Language of the text
Bogʻlanish: AllLanguages (required): IETF language tag for a human language
Qo'shimcha bog'lashlarPurpose
CommonLanguages Boshlang'ich
ClaimResponse.communicationRequest 0..* Reference(CommunicationRequest) Request for additional information
ClaimResponse.insurance 0..* BackboneElement Patient insurance information
ClaimResponse.insurance.id 0..1 string Unique id for inter-element referencing
ClaimResponse.insurance.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.insurance.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.insurance.sequence 1..1 positiveInt Insurance instance identifier
ClaimResponse.insurance.focal 1..1 boolean Coverage to be used for adjudication
ClaimResponse.insurance.coverage 1..1 Reference(Coverage) Insurance information
ClaimResponse.insurance.businessArrangement 0..1 string Additional provider contract number
ClaimResponse.insurance.claimResponse 0..1 Reference(ClaimResponse) Adjudication results
ClaimResponse.error 0..* BackboneElement Processing errors
ClaimResponse.error.id 0..1 string Unique id for inter-element referencing
ClaimResponse.error.extension 0..* Extension Additional content defined by implementations
Constraints: ext-1
ClaimResponse.error.modifierExtension Ushbu element modifikator element hisoblanadi. Ushbu element xulosalarga kiritiladi. 0..* Extension Extensions that cannot be ignored even if unrecognized
Constraints: ext-1
ClaimResponse.error.itemSequence 0..1 positiveInt Item sequence number
ClaimResponse.error.detailSequence 0..1 positiveInt Detail sequence number
ClaimResponse.error.subDetailSequence 0..1 positiveInt Subdetail sequence number
ClaimResponse.error.code Ushbu element xulosalarga kiritiladi. 1..1 CodeableConcept Error code detailing processing issues
Bogʻlanish: AdjudicationErrorCodes (example): The adjudication error codes.
ClaimResponse.error.expression Ushbu element xulosalarga kiritiladi. 0..* string FHIRPath of element(s) related to issue

doco Ushbu format bo‘yicha hujjatlar

Terminologiya bog‘lanishlari

Yoʻl Holat Foydalanish ValueSet Version Manba
ClaimResponse.language Base required All Languages 📍5.0.0 FHIR standarti.
ClaimResponse.status Base required Financial Management Status Value set 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.type Base required Claim Type VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.subType Base example Example Claim SubType Codes 📍5.0.0 FHIR standarti.
ClaimResponse.use Base required Claim Use Value set 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.outcome Base required Claim Response Outcome VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.decision Base required Claim Response Decision VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.event.​type Base example Dates Type Codes 📍5.0.0 FHIR standarti.
ClaimResponse.payeeType Base example Claim Payee Type Codes 📍5.0.0 FHIR standarti.
ClaimResponse.diagnosisRelatedGroup Base example Example Diagnosis Related Group Codes 📍5.0.0 FHIR standarti.
ClaimResponse.item.reviewOutcome.​decision Base example Claim Adjudication Decision Codes 📍5.0.0 FHIR standarti.
ClaimResponse.item.reviewOutcome.​reason Base example Claim Adjudication Decision Reason Codes 📍5.0.0 FHIR standarti.
ClaimResponse.item.adjudication.​category Base example Adjudication Value Codes 📍5.0.0 FHIR standarti.
ClaimResponse.item.adjudication.​reason Base example Adjudication Reason Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​revenue Base example Example Revenue Center Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​productOrService Base example USCLS Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​productOrServiceEnd Base example USCLS Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​modifier Base example Modifier type Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​programCode Base example Example Program Reason Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​location[x] Base example Example Service Place Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​bodySite.site Base example Oral Site Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​bodySite.subSite Base example Surface Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​detail.revenue Base example Example Revenue Center Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​detail.productOrService Base example USCLS Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​detail.productOrServiceEnd Base example USCLS Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​detail.modifier Base example Modifier type Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​detail.subDetail.revenue Base example Example Revenue Center Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​detail.subDetail.productOrService Base example USCLS Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​detail.subDetail.productOrServiceEnd Base example USCLS Codes 📍5.0.0 FHIR standarti.
ClaimResponse.addItem.​detail.subDetail.modifier Base example Modifier type Codes 📍5.0.0 FHIR standarti.
ClaimResponse.total.​category Base required Claim Response Category VS 📍0.11.1 Ushbu implementatsiya qo'llanmasi
ClaimResponse.payment.​type Base example Example Payment Type Codes 📍5.0.0 FHIR standarti.
ClaimResponse.payment.​adjustmentReason Base example Payment Adjustment Reason Codes 📍5.0.0 FHIR standarti.
ClaimResponse.fundsReserve Base example Funds Reservation Codes 📍5.0.0 FHIR standarti.
ClaimResponse.formCode Base example Form Codes 📍5.0.0 FHIR standarti.
ClaimResponse.processNote.​type Base extensible NoteType 📍5.0.0 FHIR standarti.
ClaimResponse.processNote.​language Base required All Languages 📍5.0.0 FHIR standarti.
ClaimResponse.error.​code Base example Adjudication Error Codes 📍5.0.0 FHIR standarti.

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