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{
  "resourceType": "StructureDefinition",
  "id": "c7a6e6f2-4e97-48b9-9ec2-bd4f220e8a5d",
  "url": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Claim",
  "name": "NHSDigitalClaim",
  "status": "draft",
  "fhirVersion": "4.0.1",
  "mapping": [
    {
      "identity": "workflow",
      "uri": "http://hl7.org/fhir/workflow",
      "name": "Workflow Pattern"
    },
    {
      "identity": "w5",
      "uri": "http://hl7.org/fhir/fivews",
      "name": "FiveWs Pattern Mapping"
    },
    {
      "identity": "rim",
      "uri": "http://hl7.org/v3",
      "name": "RIM Mapping"
    }
  ],
  "kind": "resource",
  "abstract": false,
  "type": "Claim",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Claim",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Claim.extension",
        "path": "Claim.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "Claim.extension:replacementOf",
        "path": "Claim.extension",
        "sliceName": "replacementOf",
        "short": "Used to reference a previous Claim",
        "definition": "Used for replacement Claims, this should reference the Claim.identifier of the Claim being replaced.\r\n\r\n```json\r\n\r\n  \"extension\":  [\r\n        {\r\n            \"url\": \"https://fhir.nhs.uk/StructureDefinition/Extension-replacementOf\",\r\n            \"valueIdentifier\": {\r\n                \"value\": \"46055273-3001-41bd-86a0-f8dba7f2161a\"\r\n            }\r\n        }\r\n    ],\r\n\r\n```",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.nhs.uk/StructureDefinition/Extension-replacementOf"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Claim.extension:agent",
        "path": "Claim.extension",
        "sliceName": "agent",
        "short": "Provenance of the resource",
        "definition": "The person submitting/authoring the Claim\r\n\r\n```json\r\n\r\n   \"extension\":  [\r\n        {\r\n            \"url\": \"https://fhir.nhs.uk/StructureDefinition/Extension-Provenance-agent\",\r\n            \"valueReference\": {\r\n                \"identifier\": {\r\n                    \"system\": \"https://fhir.nhs.uk/Id/sds-role-profile-id\",\r\n                    \"value\": \"884562163557\"\r\n                },\r\n                \"display\": \"dummy full name\"\r\n            }\r\n        }\r\n    ],\r\n```",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.nhs.uk/StructureDefinition/Extension-Provenance-agent"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Claim.identifier",
        "path": "Claim.identifier",
        "definition": "**MUST** be unique for each Claim. In EPS this must be a UUID with a system of `https://fhir.nhs.uk/Id/prescription-dispense-item-number`\r\n\r\n```json\r\n\r\n      \"identifier\":  [\r\n          {\r\n              \"system\": \"https://fhir.nhs.uk/Id/prescription-dispense-item-number\",\r\n              \"value\": \"4509B70D-D8B8-EA03-1105-64557CB54A29\"\r\n          }\r\n      ],\r\n\r\n```",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Claim.identifier.system",
        "path": "Claim.identifier.system",
        "min": 1
      },
      {
        "id": "Claim.identifier.value",
        "path": "Claim.identifier.value",
        "min": 1
      },
      {
        "id": "Claim.status",
        "path": "Claim.status",
        "definition": "For EPS the following **MUST** be used.\r\n\r\n```json\r\n\r\n      \"status\": \"active\",\r\n      \"type\": {\r\n          \"coding\":  [\r\n              {\r\n                   \"system\": \"http://terminology.hl7.org/CodeSystem/claim-type\",\r\n                    \"code\": \"pharmacy\",\r\n                    \"display\": \"Pharmacy\"\r\n             }             \r\n          ]\r\n      },\r\n      \"use\": \"claim\",\r\n\r\n```",
        "mustSupport": true
      },
      {
        "id": "Claim.type",
        "path": "Claim.type",
        "mustSupport": true
      },
      {
        "id": "Claim.type.coding",
        "path": "Claim.type.coding",
        "min": 1
      },
      {
        "id": "Claim.type.coding.system",
        "path": "Claim.type.coding.system",
        "min": 1,
        "fixedUri": "http://terminology.hl7.org/CodeSystem/claim-type"
      },
      {
        "id": "Claim.type.coding.code",
        "path": "Claim.type.coding.code",
        "min": 1,
        "fixedCode": "pharmacy"
      },
      {
        "id": "Claim.use",
        "path": "Claim.use",
        "fixedCode": "claim"
      },
      {
        "id": "Claim.patient",
        "path": "Claim.patient",
        "definition": "**MUST** be an identifier reference using the Patients NHS Number.\r\n\r\n```json\r\n\r\n      \"patient\": {\r\n          \"identifier\": {\r\n              \"system\": \"https://fhir.nhs.uk/Id/nhs-number\",\r\n              \"value\": \"2300992742\"\r\n          }\r\n      },\r\n\r\n```",
        "constraint": [
          {
            "key": "patient-reference",
            "severity": "error",
            "human": "An identifier reference or resource reference must be provided",
            "expression": "(reference.exists() or identifier.exists())",
            "source": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Claim"
          },
          {
            "key": "patient-nhs",
            "severity": "error",
            "human": "Supplied NHS Number is outside the English and Welsh NHS Number range or length of the number is wrong.",
            "expression": "identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists().not() or (identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').exists()  and identifier.where(system='https://fhir.nhs.uk/Id/nhs-number').value.matches('^([456789]{1}[0-9]{9})$'))",
            "source": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Claim"
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Claim.patient.identifier",
        "path": "Claim.patient.identifier",
        "min": 1
      },
      {
        "id": "Claim.patient.identifier.system",
        "path": "Claim.patient.identifier.system",
        "min": 1,
        "fixedUri": "https://fhir.nhs.uk/Id/nhs-number"
      },
      {
        "id": "Claim.patient.identifier.value",
        "path": "Claim.patient.identifier.value",
        "min": 1
      },
      {
        "id": "Claim.created",
        "path": "Claim.created",
        "definition": "The date of the Claim\r\n\r\n```json\r\n\r\n  \"created\": \"2004-09-16T16:30:00+00:00\",\r\n\r\n```",
        "mustSupport": true
      },
      {
        "id": "Claim.provider",
        "path": "Claim.provider",
        "definition": "The organisation responsible for the claim, this must be a reference to a contained PractitoinerRole\r\n\r\n```json\r\n \"provider\": {\r\n        \"reference\" : \"#provider\"\r\n    },\r\n```\r\n\r\nThe contained PractitionerRole\r\n\r\n```json\r\n{\r\n    \"resourceType\": \"Claim\",\r\n    \"id\": \"258E153F-567B-4D60-B045-BA315A6B8DB0\",\r\n    \"contained\": [\r\n  {\r\n      \"resourceType\": \"PractitionerRole\",\r\n      \"id\": \"provider\",\r\n      \"identifier\": [\r\n        {\r\n          \"system\": \"https://fhir.nhs.uk/Id/sds-role-profile-id\",\r\n          \"value\": \"454567759542\"\r\n        }\r\n      ],\r\n      \"code\": [\r\n        {\r\n          \"coding\": [\r\n            {\r\n              \"system\": \"https://fhir.nhs.uk/CodeSystem/NHSDigital-SDS-JobRoleCode\",\r\n              \"code\": \"S0030:G0100:R0620\"\r\n            }\r\n          ]\r\n        }\r\n      ],\r\n      \"practitioner\": {\r\n        \"identifier\": {\r\n          \"system\": \"https://fhir.nhs.uk/Id/sds-user-id\",\r\n          \"value\": \"7654321\"\r\n        },\r\n        \"display\": \"Mr Peter Potion\"\r\n      },\r\n      \"organization\": {\r\n        \"reference\": \"#organisation\"\r\n      },\r\n      \"telecom\": [\r\n        {\r\n          \"system\": \"phone\",\r\n          \"use\": \"work\",\r\n          \"value\": \"01234567890\"\r\n        }\r\n      ]\r\n    },\r\n    {\r\n      \"resourceType\": \"Organization\",\r\n      \"id\": \"organisation\",\r\n      \"identifier\": [\r\n        {\r\n          \"system\": \"https://fhir.nhs.uk/Id/ods-organization-code\",\r\n          \"value\": \"VNE51\"\r\n        }\r\n      ],\r\n      \"address\": [\r\n        {\r\n          \"city\": \"West Yorkshire\",\r\n          \"use\": \"work\",\r\n          \"line\": [\r\n            \"17 Austhorpe Road\",\r\n            \"Crossgates\",\r\n            \"Leeds\"\r\n          ],\r\n          \"postalCode\": \"LS15 8BA\"\r\n        }\r\n      ],\r\n      \"active\": true,\r\n      \"type\": [\r\n        {\r\n          \"coding\": [\r\n            {\r\n              \"system\": \"https://fhir.nhs.uk/CodeSystem/organisation-role\",\r\n              \"code\": \"182\",\r\n              \"display\": \"PHARMACY\"\r\n            }\r\n          ]\r\n        }\r\n      ],\r\n      \"name\": \"The Simple Pharmacy\",\r\n      \"telecom\": [\r\n        {\r\n          \"system\": \"phone\",\r\n          \"use\": \"work\",\r\n          \"value\": \"0113 3180277\"\r\n        }\r\n      ]\r\n    }        \r\n    ],\r\n```",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole-SDS"
            ],
            "aggregation": [
              "contained"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Claim.provider.reference",
        "path": "Claim.provider.reference",
        "min": 1
      },
      {
        "id": "Claim.provider.identifier.system",
        "path": "Claim.provider.identifier.system",
        "min": 1
      },
      {
        "id": "Claim.provider.identifier.value",
        "path": "Claim.provider.identifier.value",
        "min": 1
      },
      {
        "id": "Claim.priority",
        "path": "Claim.priority",
        "definition": "Desired processing ugency. Fixed value.\r\n\r\n```json\r\n\"priority\": {\r\n        \"coding\": [\r\n            {\r\n                \"system\": \"http://terminology.hl7.org/CodeSystem/processpriority\",\r\n                \"code\": \"normal\"\r\n            }\r\n        ]\r\n    }\r\n```",
        "mustSupport": true
      },
      {
        "id": "Claim.priority.coding",
        "path": "Claim.priority.coding",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Claim.priority.coding.system",
        "path": "Claim.priority.coding.system",
        "min": 1,
        "fixedUri": "http://terminology.hl7.org/CodeSystem/processpriority"
      },
      {
        "id": "Claim.priority.coding.code",
        "path": "Claim.priority.coding.code",
        "min": 1,
        "fixedCode": "normal"
      },
      {
        "id": "Claim.prescription",
        "path": "Claim.prescription",
        "definition": "References to the original prescription, the `groupIdentifier` contains both the ShortForm prescription id and long form UUID variant. See [NHSDigital-MedicationRequest](https://simplifier.net/resolve?target=simplifier&scope=uk.nhsdigital.r4&canonical=https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationRequest) for more details.\r\n\r\nThis MUST not be used to reference the MedicationRequest.\r\n\r\n```json\r\n\r\n\"prescription\": {\r\n    \"extension\": [\r\n        {\r\n            \"url\": \"https://fhir.nhs.uk/StructureDefinition/Extension-DM-GroupIdentifier\",\r\n            \"extension\": [\r\n                {\r\n                    \"url\": \"shortForm\",\r\n                    \"valueIdentifier\": {\r\n                        \"system\": \"https://fhir.nhs.uk/Id/prescription-order-number\",\r\n                        \"value\": \"82D996-C81010-11DB12\"\r\n                    }\r\n                },\r\n                {\r\n                    \"url\": \"UUID\",\r\n                    \"valueIdentifier\": {\r\n                        \"system\": \"https://fhir.nhs.uk/Id/prescription\",\r\n                        \"value\": \"b2fc79f0-2793-4736-9b2d-0976c21e73a5\"\r\n                    }\r\n                }\r\n            ]\r\n        }\r\n    ]\r\n},\r\n\r\n```",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Claim.prescription.extension",
        "path": "Claim.prescription.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 1
      },
      {
        "id": "Claim.prescription.extension:groupIdentifier",
        "path": "Claim.prescription.extension",
        "sliceName": "groupIdentifier",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.nhs.uk/StructureDefinition/Extension-DM-GroupIdentifier"
            ]
          }
        ]
      },
      {
        "id": "Claim.prescription.reference",
        "path": "Claim.prescription.reference",
        "max": "0"
      },
      {
        "id": "Claim.prescription.identifier",
        "path": "Claim.prescription.identifier",
        "max": "0"
      },
      {
        "id": "Claim.prescription.identifier.system",
        "path": "Claim.prescription.identifier.system",
        "min": 1,
        "fixedUri": "https://fhir.nhs.uk/Id/prescription-order-item-number"
      },
      {
        "id": "Claim.prescription.identifier.value",
        "path": "Claim.prescription.identifier.value",
        "min": 1
      },
      {
        "id": "Claim.originalPrescription.extension",
        "path": "Claim.originalPrescription.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 1
      },
      {
        "id": "Claim.originalPrescription.extension:groupIdentifier",
        "path": "Claim.originalPrescription.extension",
        "sliceName": "groupIdentifier",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.nhs.uk/StructureDefinition/Extension-DM-GroupIdentifier"
            ]
          }
        ]
      },
      {
        "id": "Claim.originalPrescription.identifier.system",
        "path": "Claim.originalPrescription.identifier.system",
        "min": 1
      },
      {
        "id": "Claim.originalPrescription.identifier.value",
        "path": "Claim.originalPrescription.identifier.value",
        "min": 1
      },
      {
        "id": "Claim.payee",
        "path": "Claim.payee",
        "definition": "The recipient of benefits payable. This is the ODS Code of the Pharmacy (provider) making the Claim.\r\n\r\nSee provider for example of a contained Organization.\r\n\r\n```json\r\n\r\n\"payee\": {\r\n    \"type\": {\r\n        \"coding\": [\r\n            {\r\n                \"system\": \"http://terminology.hl7.org/CodeSystem/payeetype\",\r\n                \"value\": \"provider\",\r\n                \"display\": \"Provider\"\r\n            }\r\n        ]\r\n    },\r\n    \"party\": {\r\n        \"reference\": \"#organisation\",\r\n        \"display\": \"The Simple Pharmacy\"\r\n    }\r\n}\r\n```",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Claim.payee.type.coding",
        "path": "Claim.payee.type.coding",
        "min": 1
      },
      {
        "id": "Claim.payee.type.coding.system",
        "path": "Claim.payee.type.coding.system",
        "min": 1,
        "fixedUri": "http://terminology.hl7.org/CodeSystem/payeetype"
      },
      {
        "id": "Claim.payee.type.coding.code",
        "path": "Claim.payee.type.coding.code",
        "min": 1,
        "fixedCode": "provider"
      },
      {
        "id": "Claim.payee.type.coding.display",
        "path": "Claim.payee.type.coding.display",
        "min": 1,
        "fixedString": "Provider"
      },
      {
        "id": "Claim.payee.party",
        "path": "Claim.payee.party",
        "min": 1,
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Organization"
            ]
          }
        ],
        "constraint": [
          {
            "key": "nhsd-claim-party",
            "severity": "error",
            "human": "party - An identifier reference or resource reference must be provided",
            "expression": "(reference.exists() or (identifier.exists()))",
            "source": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Claim"
          }
        ]
      },
      {
        "id": "Claim.payee.party.identifier.system",
        "path": "Claim.payee.party.identifier.system",
        "min": 1,
        "fixedUri": "https://fhir.nhs.uk/Id/ods-organization-code"
      },
      {
        "id": "Claim.payee.party.identifier.value",
        "path": "Claim.payee.party.identifier.value",
        "min": 1
      },
      {
        "id": "Claim.insurance",
        "path": "Claim.insurance",
        "definition": "For EPS this is the NHS Business Services Authority. The sequence value must always be 1.\r\n\r\n```json\r\n\r\n\"insurance\":  [\r\n    {\r\n        \"sequence\": 1,\r\n        \"focal\": true,\r\n        \"coverage\": {\r\n            \"identifier\": {\r\n                \"system\": \"https://fhir.nhs.uk/Id/ods-organization-code\",\r\n                \"value\": \"T1450\"\r\n            },\r\n            \"display\": \"NHS BUSINESS SERVICES AUTHORITY\"\r\n        }\r\n    }\r\n],\r\n```",
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Claim.insurance.coverage.identifier",
        "path": "Claim.insurance.coverage.identifier",
        "min": 1
      },
      {
        "id": "Claim.insurance.coverage.identifier.system",
        "path": "Claim.insurance.coverage.identifier.system",
        "min": 1,
        "fixedUri": "https://fhir.nhs.uk/Id/ods-organization-code"
      },
      {
        "id": "Claim.insurance.coverage.identifier.value",
        "path": "Claim.insurance.coverage.identifier.value",
        "min": 1,
        "fixedString": "T1450"
      },
      {
        "id": "Claim.item",
        "path": "Claim.item",
        "definition": "<table class=\"regular\" style=\"width:100%\">\r\n <thead>\r\n   <tr>\r\n     <th data-no-sort width=\"25%\"></th>\r\n     <th data-no-sort width=\"25%\">item (prescription)</th>\r\n     <th data-no-sort width=\"25%\">detail (requested medication)</th>\r\n     <th data-no-sort width=\"25%\">subDetail (dispensed medication)</th>\r\n   </tr>\r\n </thead>\r\n <tbody>\r\n  <tr>\r\n    <td>\r\n    productOrService\r\n    </td>\r\n    <td>\r\n    16076005 Prescription\r\n    </td>\r\n    <td>\r\n    dm+d code of requested medication\r\n    </td>\r\n    <td>\r\n    dm+d code of dispensed medication\r\n    </td>\r\n   </tr>\r\n   <tr>\r\n    <td>\r\n    programCode\r\n    </td>\r\n    <td>\r\n    exemptionEvidence\r\n    prescriptionChargeExemption\r\n    </td>\r\n    <td>\r\n    prescriptionCharge\r\n    dispensingEndorsement\r\n    additionalInstructions\r\n    </td>\r\n    <td>\r\n    </td>\r\n   </tr>\r\n   <tr>\r\n   <tr>\r\n    <td>\r\n    modifier\r\n    </td>\r\n    <td>\r\n    </td>\r\n    <td>\r\n    MedicationDispenseType\r\n    </td>\r\n    <td>\r\n    </td>\r\n   </tr>\r\n   <tr>\r\n     <tr>\r\n    <td>\r\n    quantity\r\n    </td>\r\n    <td>\r\n    </td>\r\n    <td>\r\n    MedicationRequest.quantity\r\n    </td>\r\n    <td>\r\n    MedicationDispense.quantity\r\n    </td>\r\n   </tr>\r\n   <tr>\r\n   </tbody>\r\n</table>",
        "min": 1,
        "max": "1",
        "mustSupport": true
      },
      {
        "id": "Claim.item.extension",
        "path": "Claim.item.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 1
      },
      {
        "id": "Claim.item.extension:prescriptionStatus",
        "path": "Claim.item.extension",
        "sliceName": "prescriptionStatus",
        "definition": "This will generally match the value of the last `dispense-notification` message.\r\n\r\nThis should match the `status` of the associated [NHSDigital-Task](https://simplifier.net/resolve?target=simplifier&scope=uk.nhsdigital.r4&canonical=https://fhir.nhs.uk/StructureDefinition/NHSDigital-Task)\r\n\r\n```json\r\n\r\n\"extension\": [\r\n    {\r\n        \"url\": \"https://fhir.nhs.uk/StructureDefinition/Extension-EPS-TaskBusinessStatus\",\r\n        \"valueCoding\": {\r\n            \"system\": \"https://fhir.nhs.uk/CodeSystem/EPS-task-business-status\",\r\n            \"code\": \"0006\",\r\n            \"display\": \"Dispensed\"\r\n        }\r\n    }\r\n], ```",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.nhs.uk/StructureDefinition/Extension-EPS-TaskBusinessStatus"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Claim.item.extension:prescriptionStatusReason",
        "path": "Claim.item.extension",
        "sliceName": "prescriptionStatusReason",
        "short": "Prescription Status Reason",
        "definition": "Mandatory if the medication was not dispensed. \r\nThis should match the `statusReason` of the associated [NHSDigital-Task](https://simplifier.net/resolve?target=simplifier&scope=uk.nhsdigital.r4&canonical=https://fhir.nhs.uk/StructureDefinition/NHSDigital-Task)\r\n\r\n```json\r\n\r\n\"extension\": [\r\n    {\r\n        \"url\": \"https://fhir.nhs.uk/StructureDefinition/Extension-EPS-TaskBusinessStatusReason\",\r\n        \"valueCoding\": {\r\n            \"system\": \"https://fhir.nhs.uk/ValueSet/DM-medicationdispense-status-reason\",\r\n            \"code\": \"0001\",\r\n            \"display\": \"Not required as instructed by the patient\"\r\n        }\r\n    }\r\n],\r\n\r\n```",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.nhs.uk/StructureDefinition/Extension-EPS-TaskBusinessStatusReason"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Claim.item.sequence",
        "path": "Claim.item.sequence",
        "fixedPositiveInt": 1
      },
      {
        "id": "Claim.item.productOrService",
        "path": "Claim.item.productOrService",
        "definition": "Mandatory fixed value.\r\n\r\n```json\r\n\r\n\"productOrService\": {\r\n    \"coding\":  [\r\n        {\r\n            \"system\": \"http://snomed.info/sct\",\r\n            \"code\": \"16076005\",\r\n            \"display\": \"Prescription\"\r\n        }\r\n    ]\r\n},\r\n\r\n```",
        "comment": "To be expanded. At present a fixed SNOMED CT value"
      },
      {
        "id": "Claim.item.productOrService.coding",
        "path": "Claim.item.productOrService.coding",
        "min": 1,
        "max": "1"
      },
      {
        "id": "Claim.item.productOrService.coding.system",
        "path": "Claim.item.productOrService.coding.system",
        "min": 1,
        "fixedUri": "http://snomed.info/sct"
      },
      {
        "id": "Claim.item.productOrService.coding.code",
        "path": "Claim.item.productOrService.coding.code",
        "min": 1,
        "fixedCode": "16076005"
      },
      {
        "id": "Claim.item.productOrService.coding.display",
        "path": "Claim.item.productOrService.coding.display",
        "min": 1,
        "fixedString": "Prescription"
      },
      {
        "id": "Claim.item.programCode",
        "path": "Claim.item.programCode",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "coding.system"
            }
          ],
          "rules": "open"
        },
        "short": "PrescriptionChargeExemption",
        "definition": "Exemption evidence - code to denote which evidence for exemption has been seen.\r\n\r\nPrescription Charge Exemption - code to denote the exemption reason ```json  \r\n\r\n\"programCode\": [\r\n    {\r\n        \"coding\": [\r\n              {\r\n                \"code\": \"0001\",\r\n                \"system\": \"https://fhir.nhs.uk/CodeSystem/prescription-charge-exemption\",\r\n                \"display\": \"Patient has paid appropriate charges\"\r\n              }\r\n            ]\r\n          },\r\n          {\r\n            \"coding\": [\r\n              {\r\n                \"system\": \"https://fhir.nhs.uk/CodeSystem/DM-exemption-evidence\",\r\n                \"code\": \"no-evidence-seen\",\r\n                \"display\": \"No Evidence Seen\"\r\n              }\r\n            ]\r\n          }\r\n        ]\r\n\r\n```",
        "mustSupport": true,
        "binding": {
          "strength": "example",
          "description": "Prescription Charge Exemption"
        }
      },
      {
        "id": "Claim.item.programCode.coding",
        "path": "Claim.item.programCode.coding",
        "min": 1
      },
      {
        "id": "Claim.item.programCode.coding.system",
        "path": "Claim.item.programCode.coding.system",
        "min": 1
      },
      {
        "id": "Claim.item.programCode.coding.code",
        "path": "Claim.item.programCode.coding.code",
        "min": 1
      },
      {
        "id": "Claim.item.programCode:exemptionEvidence",
        "path": "Claim.item.programCode",
        "sliceName": "exemptionEvidence",
        "max": "1",
        "mustSupport": true,
        "binding": {
          "strength": "extensible",
          "valueSet": "https://fhir.nhs.uk/ValueSet/DM-vs-exemption-evidence"
        }
      },
      {
        "id": "Claim.item.programCode:exemptionEvidence.coding.system",
        "path": "Claim.item.programCode.coding.system",
        "min": 1,
        "fixedUri": "https://fhir.nhs.uk/CodeSystem/DM-exemption-evidence"
      },
      {
        "id": "Claim.item.programCode:exemptionEvidence.coding.code",
        "path": "Claim.item.programCode.coding.code",
        "min": 1
      },
      {
        "id": "Claim.item.programCode:prescriptionChargeExemption",
        "path": "Claim.item.programCode",
        "sliceName": "prescriptionChargeExemption",
        "min": 1,
        "max": "1",
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "description": "Prescription Charge Exemption",
          "valueSet": "https://fhir.nhs.uk/ValueSet/DM-prescription-charge-exemption"
        }
      },
      {
        "id": "Claim.item.programCode:prescriptionChargeExemption.coding.system",
        "path": "Claim.item.programCode.coding.system",
        "min": 1,
        "fixedUri": "https://fhir.nhs.uk/CodeSystem/prescription-charge-exemption"
      },
      {
        "id": "Claim.item.programCode:prescriptionChargeExemption.coding.code",
        "path": "Claim.item.programCode.coding.code",
        "min": 1
      },
      {
        "id": "Claim.item.detail",
        "path": "Claim.item.detail",
        "definition": "A claim detail line. Relates to MedicationRequest",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Claim.item.detail.extension",
        "path": "Claim.item.detail.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 2
      },
      {
        "id": "Claim.item.detail.extension:medicationRequest",
        "path": "Claim.item.detail.extension",
        "sliceName": "medicationRequest",
        "short": "MedicationRequest reference",
        "definition": "This should match the `identifier` of the associated [NHSDigital-MedicationRequest](https://simplifier.net/resolve?target=simplifier&scope=uk.nhsdigital.r4&canonical=https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationRequest)\r\n\r\n```json\r\n\r\n\"extension\":  [\r\n    {\r\n        \"url\": \"https://fhir.nhs.uk/StructureDefinition/Extension-ClaimMedicationRequestReference\",\r\n        \"valueReference\": {\r\n            \"identifier\": {\r\n                \"system\": \"https://fhir.nhs.uk/Id/prescription-order-item-number\",\r\n                \"value\": \"33560bee-bc0c-4e3b-a155-71591eee9ca5\"\r\n            }\r\n        }\r\n    }\r\n],\r\n\r\n```",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.nhs.uk/StructureDefinition/Extension-ClaimMedicationRequestReference"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Claim.item.detail.extension:sequenceIdentifier",
        "path": "Claim.item.detail.extension",
        "sliceName": "sequenceIdentifier",
        "min": 1,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.nhs.uk/StructureDefinition/Extension-ClaimSequenceIdentifier"
            ]
          }
        ],
        "mustSupport": true
      },
      {
        "id": "Claim.item.detail.extension:repeatInformation",
        "path": "Claim.item.detail.extension",
        "sliceName": "repeatInformation",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.nhs.uk/StructureDefinition/Extension-EPS-RepeatInformation"
            ]
          }
        ]
      },
      {
        "id": "Claim.item.detail.sequence",
        "path": "Claim.item.detail.sequence",
        "definition": "An integer to identify the item within the resource. Fixed value.\r\n\r\n```json\r\n\r\n\"sequence\": 1,\r\n\r\n```",
        "mustSupport": true
      },
      {
        "id": "Claim.item.detail.productOrService",
        "path": "Claim.item.detail.productOrService",
        "definition": "This should match the `medicationCodeableConcept` of the associated [NHSDigital-MedicationRequest](https://simplifier.net/resolve?target=simplifier&scope=uk.nhsdigital.r4&canonical=https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationRequest)\r\n\r\n```json\r\n\r\n\"productOrService\": {\r\n    \"coding\":  [\r\n        {\r\n            \"system\": \"http://snomed.info/sct\",\r\n            \"code\": \"322237000\",\r\n            \"display\": \"Paracetamol 500mg soluble tablets\"\r\n        }\r\n    ]\r\n},\r\n\r\n```",
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "description": "DMD Medication Code",
          "valueSet": "https://fhir.nhs.uk/ValueSet/NHSDigital-MedicationRequest-Code"
        }
      },
      {
        "id": "Claim.item.detail.modifier",
        "path": "Claim.item.detail.modifier",
        "definition": "If the code is `0002 - Item not dispensed` then the extension `prescriptionStatusReason` is required.\r\n\r\nThis should match the `type` of the last associated [NHSDigital-MedicationDispense](https://simplifier.net/resolve?target=simplifier&scope=uk.nhsdigital.r4&canonical=https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationDispense)\r\n\r\n```json\r\n\r\n\"modifier\":  [\r\n    {\r\n        \"coding\":  [\r\n            {\r\n                \"system\": \"https://fhir.nhs.uk/CodeSystem/medicationdispense-type\",\r\n                \"code\": \"0001\",\r\n                \"display\": \"Item fully dispensed\"\r\n            }\r\n        ]\r\n    }\r\n],\r\n\r\n```",
        "min": 1,
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "description": "MedicationDispense Type",
          "valueSet": "https://fhir.nhs.uk/ValueSet/DM-medicationdispense-type"
        }
      },
      {
        "id": "Claim.item.detail.programCode",
        "path": "Claim.item.detail.programCode",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "coding.system"
            }
          ],
          "rules": "open"
        },
        "short": "Dispensing Endorsement and Charge Payment",
        "definition": "Dispensing Endorsement  - Details of the endorsement(s) to support the claim for this medication item. \r\n\r\nCharge Payment - Details on whether a prescription charge was paid for the medication treatment.\r\n\r\n```json\r\n\r\n\"programCode\":  [\r\n    {\r\n        \"coding\":  [\r\n            {\r\n                \"system\": \"https://fhir.nhs.uk/CodeSystem/DM-prescription-charge\",\r\n                \"code\": \"paid-once\",\r\n                \"display\": \"Paid Once\"\r\n            }\r\n        ]\r\n    },\r\n    {\r\n        \"coding\":  [\r\n            {\r\n                \"system\": \"https://fhir.nhs.uk/CodeSystem/medicationdispense-endorsement\",\r\n                \"code\": \"IP\",\r\n                \"display\": \"Invoice Price\"\r\n            }\r\n        ]\r\n    }\r\n],\r\n\r\n```",
        "mustSupport": true
      },
      {
        "id": "Claim.item.detail.programCode.coding",
        "path": "Claim.item.detail.programCode.coding",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Claim.item.detail.programCode.coding.system",
        "path": "Claim.item.detail.programCode.coding.system",
        "min": 1
      },
      {
        "id": "Claim.item.detail.programCode.coding.code",
        "path": "Claim.item.detail.programCode.coding.code",
        "min": 1
      },
      {
        "id": "Claim.item.detail.programCode:prescriptionCharge",
        "path": "Claim.item.detail.programCode",
        "sliceName": "prescriptionCharge",
        "min": 1,
        "max": "1",
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "valueSet": "https://fhir.nhs.uk/ValueSet/DM-vs-prescription-charge"
        }
      },
      {
        "id": "Claim.item.detail.programCode:prescriptionCharge.coding.system",
        "path": "Claim.item.detail.programCode.coding.system",
        "fixedUri": "https://fhir.nhs.uk/CodeSystem/DM-prescription-charge"
      },
      {
        "id": "Claim.item.detail.programCode:dispensingEndorsement",
        "path": "Claim.item.detail.programCode",
        "sliceName": "dispensingEndorsement",
        "mustSupport": true,
        "binding": {
          "strength": "required",
          "description": "Program specific reason codes",
          "valueSet": "https://fhir.nhs.uk/ValueSet/DM-dispensing-endorsement"
        }
      },
      {
        "id": "Claim.item.detail.programCode:dispensingEndorsement.coding.system",
        "path": "Claim.item.detail.programCode.coding.system",
        "fixedUri": "https://fhir.nhs.uk/CodeSystem/medicationdispense-endorsement"
      },
      {
        "id": "Claim.item.detail.programCode:dispensingEndorsement.text",
        "path": "Claim.item.detail.programCode.text",
        "short": "Additional Information for Dispensing Endorsements",
        "definition": "Additional Information for Dispensing Endorsements should be entered in this field. Details on the format of this text field can be found in `Requirements and Electronic Prescription Service Guidance for Endorsement (EPS)`\r\n\r\n```json\r\n       {\r\n                \"coding\": [\r\n                    {\r\n                       \"system\": \"https://fhir.nhs.uk/CodeSystem/medicationdispense-endorsement\",\r\n                       \"code\": \"IP\",\r\n                       \"display\": \"Invoice Price for less common products or special items\"\r\n                      }\r\n                   ],\r\n                  \"text\" : \"15gram,£12.34,EFGH Ltd\"\r\n          }\r\n```"
      },
      {
        "id": "Claim.item.detail.quantity",
        "path": "Claim.item.detail.quantity",
        "definition": "This should match the `quantity` of the associated [NHSDigital-MedicationRequest](https://simplifier.net/resolve?target=simplifier&scope=uk.nhsdigital.r4&canonical=https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationRequest)\r\n\r\n```json\r\n\r\n\"quantity\": {\r\n    \"value\": 200,\r\n    \"unit\": \"unit dose\",\r\n    \"system\": \"http://snomed.info/sct\",\r\n    \"code\": \"408102007\"\r\n},\r\n\r\n```",
        "mustSupport": true
      },
      {
        "id": "Claim.item.detail.subDetail",
        "path": "Claim.item.detail.subDetail",
        "definition": "subDetail is only present if the medication has been dispensed.",
        "mustSupport": true
      },
      {
        "id": "Claim.item.detail.subDetail.extension",
        "path": "Claim.item.detail.subDetail.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "Claim.item.detail.subDetail.extension:medicationDispense",
        "path": "Claim.item.detail.subDetail.extension",
        "sliceName": "medicationDispense",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.nhs.uk/StructureDefinition/Extension-ClaimMedicationDispenseReference"
            ]
          }
        ]
      },
      {
        "id": "Claim.item.detail.subDetail.extension:repeatInformation",
        "path": "Claim.item.detail.subDetail.extension",
        "sliceName": "repeatInformation",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.nhs.uk/StructureDefinition/Extension-EPS-RepeatInformation"
            ]
          }
        ]
      },
      {
        "id": "Claim.item.detail.subDetail.sequence",
        "path": "Claim.item.detail.subDetail.sequence",
        "definition": "An integer id for each medication dispense.\r\n\r\n```json\r\n\r\n\"sequence\": 1,\r\n\r\n\r\n```",
        "mustSupport": true
      },
      {
        "id": "Claim.item.detail.subDetail.productOrService",
        "path": "Claim.item.detail.subDetail.productOrService",
        "definition": "This should match the `medicationCodeableConcept` of the associated [NHSDigital-MedicationDispense](https://simplifier.net/resolve?target=simplifier&scope=uk.nhsdigital.r4&canonical=https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationDispense)\r\n\r\n```json\r\n\r\n\"productOrService\": {\r\n    \"coding\":  [\r\n        {\r\n            \"system\": \"http://snomed.info/sct\",\r\n            \"code\": \"3416211000001106\",\r\n            \"display\": \"Salbutamol 100micrograms/dose inhaler (Sandoz Ltd) 200 dose\"\r\n        }\r\n    ]\r\n},\r\n\r\n```",
        "mustSupport": true,
        "binding": {
          "strength": "extensible",
          "description": "DMD Medication Code",
          "valueSet": "https://fhir.nhs.uk/ValueSet/NHSDigital-MedicationDispense-Code"
        }
      },
      {
        "id": "Claim.item.detail.subDetail.quantity",
        "path": "Claim.item.detail.subDetail.quantity",
        "definition": "This should match the `quantity` of the associated [NHSDigital-MedicationDispense](https://simplifier.net/resolve?target=simplifier&scope=uk.nhsdigital.r4&canonical=https://fhir.nhs.uk/StructureDefinition/NHSDigital-MedicationDispense)\r\n\r\n```json\r\n\r\n\"quantity\": {\r\n    \"value\": 200,\r\n    \"unit\": \"unit dose\",\r\n    \"system\": \"http://snomed.info/sct\",\r\n    \"code\": \"408102007\"\r\n}\r\n\r\n```",
        "min": 1,
        "mustSupport": true
      },
      {
        "id": "Claim.item.detail.subDetail.quantity.extension",
        "path": "Claim.item.detail.subDetail.quantity.extension",
        "slicing": {
          "discriminator": [
            {
              "type": "value",
              "path": "url"
            }
          ],
          "rules": "open"
        },
        "min": 0
      },
      {
        "id": "Claim.item.detail.subDetail.quantity.extension:runningTotal",
        "path": "Claim.item.detail.subDetail.quantity.extension",
        "sliceName": "runningTotal",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Extension",
            "profile": [
              "https://fhir.nhs.uk/StructureDefinition/Extension-DM-RunningTotal"
            ]
          }
        ]
      }
    ]
  }
}

name : NHSDigitalClaim

{

}