Invoice
Defines the ID Core constraints and extensions on the Invoice resource for the minimal set of data to query and retrieve the invoices charged to patient.
Usage
This profile is used by providers and payors, insurers, to exchange the detail of service and patient payment for service provided by healthcare provider.
The primary uses of this resource is to support verification of electronic claims, the exchange of information relating to the proposed or actual provision of healthcare-related goods and services for patients to their benefit payors, insurers and national health programs, for treatment payment planning and reimbursement.
URL
Type | URL |
---|---|
Canonical | https://fhir.kemkes.go.id/r4/StructureDefinition/Invoice |
Structure
Snapshot
Invoice | I | DomainResource | |
id | Σ | 0..1 | string |
meta | Σ | 0..1 | Meta |
implicitRules | Σ ?! | 0..1 | uri |
language | 0..1 | codeBinding | |
text | 0..1 | Narrative | |
contained | 0..* | Resource | |
extension | I | 0..* | Extension |
modifierExtension | ?! I | 0..* | Extension |
identifier | Σ | 0..* | Identifier |
status | Σ ?! | 1..1 | codeBinding |
cancelledReason | 0..1 | string | |
type | Σ | 0..1 | CodeableConcept |
subject | Σ I | 0..1 | Reference(Patient | https://fhir.kemkes.go.id/r4/StructureDefinition/Group) |
recipient | Σ I | 0..1 | Reference(Organization | Patient | RelatedPerson) |
date | Σ | 0..1 | dateTime |
participant | 0..* | BackboneElement | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
role | 0..1 | CodeableConcept | |
actor | I | 1..1 | Reference(Practitioner | Organization | Patient | PractitionerRole | https://fhir.kemkes.go.id/r4/StructureDefinition/Device | RelatedPerson) |
issuer | I | 0..1 | Reference(Organization) |
account | I | 0..1 | Reference(Account) |
lineItem | 0..* | BackboneElement | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
sequence | 0..1 | positiveInt | |
chargeItem[x] | 1..1 | ||
chargeItemCodeableConcept | CodeableConcept | ||
chargeItemReference | Reference(ChargeItem) | ||
priceComponent | 0..* | BackboneElement | |
id | 0..1 | string | |
extension | I | 0..* | Extension |
modifierExtension | Σ ?! I | 0..* | Extension |
type | 1..1 | codeBinding | |
code | 0..1 | CodeableConcept | |
factor | 0..1 | decimal | |
amount | 0..1 | Money | |
totalPriceComponent | 0..* | see (priceComponent) | |
totalNet | Σ | 0..1 | Money |
totalGross | Σ | 0..1 | Money |
paymentTerms | 0..1 | markdown | |
note | 0..* | Annotation |
Examples
Dictionary
Invoice | |
Definition | Invoice containing collected ChargeItems from an Account with calculated individual and total price for Billing purpose. |
Cardinality | 0...* |
Invariants |
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Mappings |
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Invoice.id | |
Definition | The logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. |
Cardinality | 0...1 |
Type | string |
Summary | True |
Comments | The only time that a resource does not have an id is when it is being submitted to the server using a create operation. |
Invoice.meta | |
Definition | The metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content might not always be associated with version changes to the resource. |
Cardinality | 0...1 |
Type | Meta |
Summary | True |
Invariants |
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Mappings |
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Invoice.implicitRules | |
Definition | A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc. |
Cardinality | 0...1 |
Type | uri |
Modifier | True |
Summary | True |
Comments | Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc. |
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Mappings |
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Invoice.language | |
Definition | The base language in which the resource is written. |
Cardinality | 0...1 |
Type | code |
Binding | A human language. |
Comments | Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). |
Invariants |
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Mappings |
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Invoice.text | |
Definition | A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. |
Cardinality | 0...1 |
Type | Narrative |
Alias | narrative, html, xhtml, display |
Comments | Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded information is added later. |
Invariants |
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Mappings |
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Invoice.contained | |
Definition | These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. |
Cardinality | 0...* |
Type | Resource |
Alias | inline resources, anonymous resources, contained resources |
Comments | This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels. |
Mappings |
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Invoice.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Invoice.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Alias | extensions, user content |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Invoice.identifier | |
Definition | Identifier of this Invoice, often used for reference in correspondence about this invoice or for tracking of payments. |
Cardinality | 0...* |
Type | Identifier |
Summary | True |
Requirements | Allows Identification of this Invoice instance. |
Invariants |
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Mappings |
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Invoice.status | |
Definition | The current state of the Invoice. |
Cardinality | 1...1 |
Type | code |
Binding | Codes identifying the lifecycle stage of an Invoice. |
Modifier | True |
Summary | True |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
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Mappings |
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Invoice.cancelledReason | |
Definition | In case of Invoice cancellation a reason must be given (entered in error, superseded by corrected invoice etc.). |
Cardinality | 0...1 |
Type | string |
Comments | Derived Profiles may choose to add invariants requiring this field to be populated if either priceOverride or factorOverride have been filled. |
Invariants |
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Mappings |
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Invoice.type | |
Definition | Type of Invoice depending on domain, realm an usage (e.g. internal/external, dental, preliminary). |
Cardinality | 0...1 |
Type | CodeableConcept |
Summary | True |
Alias | type |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
Invariants |
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Mappings |
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Invoice.subject | |
Definition | The individual or set of individuals receiving the goods and services billed in this invoice. |
Cardinality | 0...1 |
Type | Reference(Patient | https://fhir.kemkes.go.id/r4/StructureDefinition/Group) |
Summary | True |
Alias | patient |
Requirements | Links the event to the Patient context. |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
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Mappings |
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Invoice.recipient | |
Definition | The individual or Organization responsible for balancing of this invoice. |
Cardinality | 0...1 |
Type | Reference(Organization | Patient | RelatedPerson) |
Summary | True |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
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Mappings |
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Invoice.date | |
Definition | Date/time(s) of when this Invoice was posted. |
Cardinality | 0...1 |
Type | dateTime |
Summary | True |
Comments | The list of types may be constrained as appropriate for the type of charge item. |
Invariants |
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Mappings |
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Invoice.participant | |
Definition | Indicates who or what performed or participated in the charged service. |
Cardinality | 0...* |
Type | BackboneElement |
Invariants |
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Mappings |
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Invoice.participant.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
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Invoice.participant.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Invoice.participant.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants |
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Mappings |
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Invoice.participant.role | |
Definition | Describes the type of involvement (e.g. transcriptionist, creator etc.). If the invoice has been created automatically, the Participant may be a billing engine or another kind of device. |
Cardinality | 0...1 |
Type | CodeableConcept |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
Invariants |
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Mappings |
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Invoice.participant.actor | |
Definition | The device, practitioner, etc. who performed or participated in the service. |
Cardinality | 1...1 |
Type | Reference(Practitioner | Organization | Patient | PractitionerRole | https://fhir.kemkes.go.id/r4/StructureDefinition/Device | RelatedPerson) |
Comments | References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc.). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. |
Invariants |
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Mappings |
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Invoice.issuer | |
Definition | The organizationissuing the Invoice. |
Cardinality | 0...1 |
Type | Reference(Organization) |
Comments | Practitioners and Devices can be associated with multiple organizations. It has to be made clear, on behalf of which Organization the services have been rendered. |
Invariants |
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Mappings |
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Invoice.account | |
Definition | Account which is supposed to be balanced with this Invoice. |
Cardinality | 0...1 |
Type | Reference(Account) |
Comments | Systems posting the ChargeItems might not always be able to determine, which accounts the Items need to be places into. It is up to the potprocessing Financial System to apply internal rules to decide based on the Encounter/EpisodeOfCare/Patient/Coverage context and the type of ChargeItem, which Account is appropriate. |
Invariants |
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Mappings |
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Invoice.lineItem | |
Definition | Each line item represents one charge for goods and services rendered. Details such as date, code and amount are found in the referenced ChargeItem resource. |
Cardinality | 0...* |
Type | BackboneElement |
Invariants |
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Mappings |
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Invoice.lineItem.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
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Invoice.lineItem.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Invoice.lineItem.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants |
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Mappings |
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Invoice.lineItem.sequence | |
Definition | Sequence in which the items appear on the invoice. |
Cardinality | 0...1 |
Type | positiveInt |
Comments | 32 bit number; for values larger than this, use decimal |
Invariants |
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Mappings |
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Invoice.lineItem.chargeItem[x] | |
Definition | The ChargeItem contains information such as the billing code, date, amount etc. If no further details are required for the lineItem, inline billing codes can be added using the CodeableConcept data type instead of the Reference. |
Cardinality | 1...1 |
Type | Reference(ChargeItem) |
Invariants |
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Mappings |
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Invoice.lineItem.priceComponent | |
Definition | The price for a ChargeItem may be calculated as a base price with surcharges/deductions that apply in certain conditions. A ChargeItemDefinition resource that defines the prices, factors and conditions that apply to a billing code is currently under development. The priceComponent element can be used to offer transparency to the recipient of the Invoice as to how the prices have been calculated. |
Cardinality | 0...* |
Type | BackboneElement |
Invariants |
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Mappings |
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Invoice.lineItem.priceComponent.id | |
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
Cardinality | 0...1 |
Type | string |
Mappings |
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Invoice.lineItem.priceComponent.extension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. |
Cardinality | 0...* |
Type | Extension |
Alias | extensions, user content |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Slicing | Unordered, Open, by url(Value) |
Invariants |
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Mappings |
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Invoice.lineItem.priceComponent.modifierExtension | |
Definition | May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself). |
Cardinality | 0...* |
Type | Extension |
Modifier | True |
Summary | True |
Alias | extensions, user content, modifiers |
Requirements | Modifier extensions allow for extensions that cannot be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the definition of modifier extensions. |
Comments | There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. |
Invariants |
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Mappings |
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Invoice.lineItem.priceComponent.type | |
Definition | This code identifies the type of the component. |
Cardinality | 1...1 |
Type | code |
Binding | Codes indicating the kind of the price component. |
Comments | Note that FHIR strings SHALL NOT exceed 1MB in size |
Invariants |
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Mappings |
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Invoice.lineItem.priceComponent.code | |
Definition | A code that identifies the component. Codes may be used to differentiate between kinds of taxes, surcharges, discounts etc. |
Cardinality | 0...1 |
Type | CodeableConcept |
Comments | Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. |
Invariants |
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Mappings |
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Invoice.lineItem.priceComponent.factor | |
Definition | The factor that has been applied on the base price for calculating this component. |
Cardinality | 0...1 |
Type | decimal |
Comments | There is no reason to carry the price in the instance of a ChargeItem unless circumstances require a manual override. The list prices or are usually defined in a back catalogue of the billing codes (see ChargeItem.definition). Derived profiles may require a ChargeItem.overrideReason to be provided if either factor or price are manually overridden. |
Invariants |
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Mappings |
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Invoice.lineItem.priceComponent.amount | |
Definition | The amount calculated for this component. |
Cardinality | 0...1 |
Type | Money |
Comments | There is no reason to carry the price in the instance of a ChargeItem unless circumstances require a manual override. The list prices or are usually defined in a back catalogue of the billing codes (see ChargeItem.definition). Derived profiles may require a ChargeItem.overrideReason to be provided if either factor or price are manually overridden. |
Invariants |
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Mappings |
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Invoice.totalPriceComponent | |
Definition | The total amount for the Invoice may be calculated as the sum of the line items with surcharges/deductions that apply in certain conditions. The priceComponent element can be used to offer transparency to the recipient of the Invoice of how the total price was calculated. |
Cardinality | 0...* |
Type | see (priceComponent) |
Mappings |
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Invoice.totalNet | |
Definition | Invoice total , taxes excluded. |
Cardinality | 0...1 |
Type | Money |
Summary | True |
Comments | There is no reason to carry the price in the instance of a ChargeItem unless circumstances require a manual override. The list prices or are usually defined in a back catalogue of the billing codes (see ChargeItem.definition). Derived profiles may require a ChargeItem.overrideReason to be provided if either factor or price are manually overridden. |
Invariants |
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Mappings |
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Invoice.totalGross | |
Definition | Invoice total, tax included. |
Cardinality | 0...1 |
Type | Money |
Summary | True |
Comments | There is no reason to carry the price in the instance of a ChargeItem unless circumstances require a manual override. The list prices or are usually defined in a back catalogue of the billing codes (see ChargeItem.definition). Derived profiles may require a ChargeItem.overrideReason to be provided if either factor or price are manually overridden. |
Invariants |
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Mappings |
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Invoice.paymentTerms | |
Definition | Payment details such as banking details, period of payment, deductibles, methods of payment. |
Cardinality | 0...1 |
Type | markdown |
Comments | Derived Profiles may chose to add invariants requiring this field to be populated if either priceOverride or factorOverride have been filled. |
Invariants |
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Mappings |
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Invoice.note | |
Definition | Comments made about the invoice by the issuer, subject, or other participants. |
Cardinality | 0...* |
Type | Annotation |
Comments | For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible). |
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