FHIR IG analytics| Package | ndhm.in |
| Resource Type | Bundle |
| Id | Bundle-CoverageEligibilityRequestBundle-benefits-example-01.json |
| FHIR Version | R4 |
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No resources found
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FHIR
FHIRsmith{
"resourceType": "Bundle",
"id": "CoverageEligibilityRequestBundle-benefits-example-01",
"meta": {
"versionId": "1",
"profile": [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequestBundle"
]
},
"identifier": {
"value": "bc3c6c57-2053-4d0e-ac40-139ccccff645"
},
"type": "collection",
"timestamp": "2025-03-07T15:32:26.605+05:30",
"entry": [
{
"fullUrl": "urn:uuid:6eceece0-b8eb-412a-b80b-c1649ea0a738",
"resource": {
"resourceType": "CoverageEligibilityRequest",
"id": "6eceece0-b8eb-412a-b80b-c1649ea0a738",
"meta": {
"profile": [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/CoverageEligibilityRequest"
]
},
"language": "en",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><a name=\"CoverageEligibilityRequest_6eceece0-b8eb-412a-b80b-c1649ea0a738\"> </a><p class=\"res-header-id\"><b>Generated Narrative: CoverageEligibilityRequest 6eceece0-b8eb-412a-b80b-c1649ea0a738</b></p><a name=\"6eceece0-b8eb-412a-b80b-c1649ea0a738\"> </a><a name=\"hc6eceece0-b8eb-412a-b80b-c1649ea0a738\"> </a><a name=\"6eceece0-b8eb-412a-b80b-c1649ea0a738-hi-IN\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Language: en</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-CoverageEligibilityRequest.html\">CoverageEligibilityRequest</a></p></div><p><b>identifier</b>: 7612345</p><p><b>status</b>: Active</p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><p><b>purpose</b>: Coverage benefits</p><p><b>patient</b>: <a href=\"Bundle-CoverageEligibilityRequestBundle-benefits-example-01.html#urn-uuid-00c9295b-14b4-44c4-994b-2b16421b6890\">Patient</a></p><p><b>created</b>: 2025-03-07 15:32:26+0530</p><p><b>enterer</b>: <a href=\"Bundle-CoverageEligibilityRequestBundle-benefits-example-01.html#urn-uuid-012f6df9-5848-4e9b-9a5a-b52294668c58\">Practitioner</a></p><p><b>provider</b>: <a href=\"Bundle-CoverageEligibilityRequestBundle-benefits-example-01.html#urn-uuid-97efda8f-eb46-46d2-92d7-ba3c070b73a5\">Organization</a></p><p><b>insurer</b>: <a href=\"Bundle-CoverageEligibilityRequestBundle-benefits-example-01.html#urn-uuid-1d0c29a5-09fd-4710-8d95-1e8890af97d4\">Organization</a></p><p><b>facility</b>: <a href=\"Bundle-CoverageEligibilityRequestBundle-benefits-example-01.html#urn-uuid-2bdf8689-b5b8-4b16-81a1-f51ee7a6a639\">Location</a></p><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>true</td><td><a href=\"Bundle-CoverageEligibilityRequestBundle-benefits-example-01.html#urn-uuid-0055335e-a525-46bd-872c-78b94d4f4591\">Coverage</a></td></tr></table><blockquote><p><b>item</b></p><p><b>productOrService</b>: <span title=\"Codes:{http://snomed.info/sct 768839008}\">Consultant</span></p><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://hl7.org/fhir/sid/icd-10 E11.9}\">Type 2 diabetes mellitus : Without complications</span></td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>productOrService</b>: <span title=\"Codes:{http://snomed.info/sct 765507008}\">Metformin hydrochloride 500 mg prolonged-release oral tablet</span></p><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://hl7.org/fhir/sid/icd-10 E11.9}\">Type 2 diabetes mellitus : Without complications</span></td></tr></table></blockquote></div>"
},
"identifier": [
{
"value": "7612345"
}
],
"status": "active",
"priority": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal",
"display": "Normal"
}
]
},
"purpose": [
"benefits"
],
"patient": {
"reference": "urn:uuid:00c9295b-14b4-44c4-994b-2b16421b6890",
"display": "Patient"
},
"created": "2025-03-07T15:32:26.605+05:30",
"enterer": {
"reference": "urn:uuid:012f6df9-5848-4e9b-9a5a-b52294668c58",
"display": "Practitioner"
},
"provider": {
"reference": "urn:uuid:97efda8f-eb46-46d2-92d7-ba3c070b73a5",
"display": "Organization"
},
"insurer": {
"reference": "urn:uuid:1d0c29a5-09fd-4710-8d95-1e8890af97d4",
"display": "Organization"
},
"facility": {
"reference": "urn:uuid:2bdf8689-b5b8-4b16-81a1-f51ee7a6a639",
"display": "Location"
},
"insurance": [
{
"focal": true,
"coverage": {
"reference": "urn:uuid:0055335e-a525-46bd-872c-78b94d4f4591",
"display": "Coverage"
}
}
],
"item": [
{
"productOrService": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "768839008",
"display": "Consultant"
}
]
},
"diagnosis": [
{
"diagnosisCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/sid/icd-10",
"code": "E11.9",
"display": "Type 2 diabetes mellitus : Without complications"
}
]
}
}
]
},
{
"productOrService": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "765507008",
"display": "Metformin hydrochloride 500 mg prolonged-release oral tablet"
}
]
},
"diagnosis": [
{
"diagnosisCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/sid/icd-10",
"code": "E11.9",
"display": "Type 2 diabetes mellitus : Without complications"
}
]
}
}
]
}
]
}
},
{
"fullUrl": "urn:uuid:00c9295b-14b4-44c4-994b-2b16421b6890",
"resource": {
"resourceType": "Patient",
"id": "00c9295b-14b4-44c4-994b-2b16421b6890",
"meta": {
"profile": [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_00c9295b-14b4-44c4-994b-2b16421b6890\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient 00c9295b-14b4-44c4-994b-2b16421b6890</b></p><a name=\"00c9295b-14b4-44c4-994b-2b16421b6890\"> </a><a name=\"hc00c9295b-14b4-44c4-994b-2b16421b6890\"> </a><a name=\"00c9295b-14b4-44c4-994b-2b16421b6890-hi-IN\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Adarsh Agrawal Male, DoB: 1981-01-12 ( Adhaar number: 7225-4829-5255)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\"><a href=\"tel:+919818512600\">+919818512600</a></td></tr></table></div>"
},
"identifier": [
{
"type": {
"coding": [
{
"system": "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code",
"code": "ADN",
"display": "Adhaar number"
}
]
},
"system": "https://uidai.gov.in/",
"value": "7225-4829-5255"
}
],
"name": [
{
"text": "Adarsh Agrawal"
}
],
"telecom": [
{
"system": "phone",
"value": "+919818512600",
"use": "home"
}
],
"gender": "male",
"birthDate": "1981-01-12"
}
},
{
"fullUrl": "urn:uuid:012f6df9-5848-4e9b-9a5a-b52294668c58",
"resource": {
"resourceType": "Practitioner",
"id": "012f6df9-5848-4e9b-9a5a-b52294668c58",
"meta": {
"profile": [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_012f6df9-5848-4e9b-9a5a-b52294668c58\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner 012f6df9-5848-4e9b-9a5a-b52294668c58</b></p><a name=\"012f6df9-5848-4e9b-9a5a-b52294668c58\"> </a><a name=\"hc012f6df9-5848-4e9b-9a5a-b52294668c58\"> </a><a name=\"012f6df9-5848-4e9b-9a5a-b52294668c58-hi-IN\"> </a><p><b>identifier</b>: Medical License number/21-1521-3828-3227</p><p><b>name</b>: Dr. Aayush Agrawal</p></div>"
},
"identifier": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "MD",
"display": "Medical License number"
}
]
},
"system": "https://doctor.ndhm.gov.in",
"value": "21-1521-3828-3227"
}
],
"name": [
{
"text": "Dr. Aayush Agrawal"
}
]
}
},
{
"fullUrl": "urn:uuid:1d0c29a5-09fd-4710-8d95-1e8890af97d4",
"resource": {
"resourceType": "Organization",
"id": "1d0c29a5-09fd-4710-8d95-1e8890af97d4",
"meta": {
"profile": [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_1d0c29a5-09fd-4710-8d95-1e8890af97d4\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization 1d0c29a5-09fd-4710-8d95-1e8890af97d4</b></p><a name=\"1d0c29a5-09fd-4710-8d95-1e8890af97d4\"> </a><a name=\"hc1d0c29a5-09fd-4710-8d95-1e8890af97d4\"> </a><a name=\"1d0c29a5-09fd-4710-8d95-1e8890af97d4-hi-IN\"> </a><p><b>identifier</b>: Registry of Hospitals in Network of Insurance (ROHINI) ID/4567878</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type ins}\">Insurance Company</span></p><p><b>name</b>: XYZ Insurance Co. Ltd.</p><p><b>telecom</b>: <a href=\"tel:+9124326341234\">+91 243 2634 1234</a>, <a href=\"mailto:contact@xyz.org\">contact@xyz.org</a></p></div>"
},
"identifier": [
{
"type": {
"coding": [
{
"system": "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code",
"code": "ROHINI",
"display": "Registry of Hospitals in Network of Insurance (ROHINI) ID"
}
]
},
"system": "https://rohini.iib.gov.in/",
"value": "4567878"
}
],
"type": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/organization-type",
"code": "ins",
"display": "Insurance Company"
}
]
}
],
"name": "XYZ Insurance Co. Ltd.",
"telecom": [
{
"system": "phone",
"value": "+91 243 2634 1234",
"use": "work"
},
{
"system": "email",
"value": "contact@xyz.org",
"use": "work"
}
]
}
},
{
"fullUrl": "urn:uuid:97efda8f-eb46-46d2-92d7-ba3c070b73a5",
"resource": {
"resourceType": "Organization",
"id": "97efda8f-eb46-46d2-92d7-ba3c070b73a5",
"meta": {
"profile": [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_97efda8f-eb46-46d2-92d7-ba3c070b73a5\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization 97efda8f-eb46-46d2-92d7-ba3c070b73a5</b></p><a name=\"97efda8f-eb46-46d2-92d7-ba3c070b73a5\"> </a><a name=\"hc97efda8f-eb46-46d2-92d7-ba3c070b73a5\"> </a><a name=\"97efda8f-eb46-46d2-92d7-ba3c070b73a5-hi-IN\"> </a><p><b>identifier</b>: Provider number/1234567890</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: XYZ Hospital Co. Ltd.</p><p><b>telecom</b>: <a href=\"tel:+9124326341278\">+91 243 2634 1278</a>, <a href=\"mailto:contact@xyz.org\">contact@xyz.org</a></p></div>"
},
"identifier": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "PRN",
"display": "Provider number"
}
]
},
"system": "https://facility.ndhm.gov.in",
"value": "1234567890"
}
],
"type": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/organization-type",
"code": "prov",
"display": "Healthcare Provider"
}
]
}
],
"name": "XYZ Hospital Co. Ltd.",
"telecom": [
{
"system": "phone",
"value": "+91 243 2634 1278",
"use": "work"
},
{
"system": "email",
"value": "contact@xyz.org",
"use": "work"
}
]
}
},
{
"fullUrl": "urn:uuid:2bdf8689-b5b8-4b16-81a1-f51ee7a6a639",
"resource": {
"resourceType": "Location",
"id": "2bdf8689-b5b8-4b16-81a1-f51ee7a6a639",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Location_2bdf8689-b5b8-4b16-81a1-f51ee7a6a639\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Location 2bdf8689-b5b8-4b16-81a1-f51ee7a6a639</b></p><a name=\"2bdf8689-b5b8-4b16-81a1-f51ee7a6a639\"> </a><a name=\"hc2bdf8689-b5b8-4b16-81a1-f51ee7a6a639\"> </a><a name=\"2bdf8689-b5b8-4b16-81a1-f51ee7a6a639-hi-IN\"> </a><p><b>identifier</b>: B1-S.F2</p><p><b>status</b>: Active</p><p><b>name</b>: South Wing, second floor</p><p><b>alias</b>: XYZ Life Hospital Co. Ltd., South Wing, second floor</p><p><b>description</b>: Second floor of the Old South Wing, formerly in use by Psychiatry</p><p><b>mode</b>: Instance</p><p><b>telecom</b>: ph: 2328(Work), fax: 2329(Work), <a href=\"http://sampleorg.com/southwing\">http://sampleorg.com/southwing</a></p><p><b>address</b>: 91, Building A Pune 451855 IND (work)</p><p><b>physicalType</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/location-physical-type wi}\">Wing</span></p><h3>Positions</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Longitude</b></td><td><b>Latitude</b></td><td><b>Altitude</b></td></tr><tr><td style=\"display: none\">*</td><td>-83.6945691</td><td>42.25475478</td><td>0</td></tr></table><p><b>managingOrganization</b>: <a href=\"Bundle-CoverageEligibilityRequestBundle-benefits-example-01.html#urn-uuid-97efda8f-eb46-46d2-92d7-ba3c070b73a5\">Organization</a></p></div>"
},
"identifier": [
{
"value": "B1-S.F2"
}
],
"status": "active",
"name": "South Wing, second floor",
"alias": [
"XYZ Life Hospital Co. Ltd., South Wing, second floor"
],
"description": "Second floor of the Old South Wing, formerly in use by Psychiatry",
"mode": "instance",
"telecom": [
{
"system": "phone",
"value": "2328",
"use": "work"
},
{
"system": "fax",
"value": "2329",
"use": "work"
},
{
"system": "url",
"value": "http://sampleorg.com/southwing",
"use": "work"
}
],
"address": {
"use": "work",
"line": [
"91, Building A"
],
"city": "Pune",
"postalCode": "451855",
"country": "IND"
},
"physicalType": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/location-physical-type",
"code": "wi",
"display": "Wing"
}
]
},
"position": {
"longitude": -83.6945691,
"latitude": 42.25475478,
"altitude": 0
},
"managingOrganization": {
"reference": "urn:uuid:97efda8f-eb46-46d2-92d7-ba3c070b73a5",
"display": "Organization"
}
}
},
{
"fullUrl": "urn:uuid:0055335e-a525-46bd-872c-78b94d4f4591",
"resource": {
"resourceType": "Coverage",
"id": "0055335e-a525-46bd-872c-78b94d4f4591",
"meta": {
"profile": [
"https://nrces.in/ndhm/fhir/r4/StructureDefinition/Coverage"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_0055335e-a525-46bd-872c-78b94d4f4591\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage 0055335e-a525-46bd-872c-78b94d4f4591</b></p><a name=\"0055335e-a525-46bd-872c-78b94d4f4591\"> </a><a name=\"hc0055335e-a525-46bd-872c-78b94d4f4591\"> </a><a name=\"0055335e-a525-46bd-872c-78b94d4f4591-hi-IN\"> </a><p><b>identifier</b>: <code>https://xyzinsurance.in/policynumber/</code>/235037120</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode HIP}\">health insurance plan policy</span></p><p><b>subscriber</b>: <a href=\"Bundle-CoverageEligibilityRequestBundle-benefits-example-01.html#urn-uuid-00c9295b-14b4-44c4-994b-2b16421b6890\">Patient</a></p><p><b>subscriberId</b>: ABC123456BI007</p><p><b>beneficiary</b>: <a href=\"Bundle-CoverageEligibilityRequestBundle-benefits-example-01.html#urn-uuid-00c9295b-14b4-44c4-994b-2b16421b6890\">Patient</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>period</b>: ?? --> 2026-03-17</p><p><b>payor</b>: <a href=\"Bundle-CoverageEligibilityRequestBundle-benefits-example-01.html#urn-uuid-1d0c29a5-09fd-4710-8d95-1e8890af97d4\">Organization</a></p></div>"
},
"identifier": [
{
"system": "https://xyzinsurance.in/policynumber/",
"value": "235037120"
}
],
"status": "active",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"code": "HIP",
"display": "health insurance plan policy"
}
]
},
"subscriber": {
"reference": "urn:uuid:00c9295b-14b4-44c4-994b-2b16421b6890",
"display": "Patient"
},
"subscriberId": "ABC123456BI007",
"beneficiary": {
"reference": "urn:uuid:00c9295b-14b4-44c4-994b-2b16421b6890",
"display": "Patient"
},
"relationship": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
"code": "self"
}
]
},
"period": {
"end": "2026-03-17"
},
"payor": [
{
"reference": "urn:uuid:1d0c29a5-09fd-4710-8d95-1e8890af97d4",
"display": "Organization"
}
]
}
}
]
}