NHS Digital FHIR Medicines

claim example 2

{
    "resourceType": "Claim",
    "id": "a76599c5-bbdd-4581-bb4d-377b348dd1e4",
    "extension":  [
        {
            "url": "https://fhir.nhs.uk/StructureDefinition/Extension-Provenance-agent",
            "valueReference": {
                "identifier": {
                    "system": "https://fhir.nhs.uk/Id/sds-user-id",
                    "value": "7654321"
                },
                "display": "Mr Peter Potion"
            }
        }
    ],
    "contained":  [
        {
            "resourceType": "PractitionerRole",
            "id": "provider",
            "identifier":  [
                {
                    "system": "https://fhir.nhs.uk/Id/sds-role-profile-id",
                    "value": "454567759542"
                }
            ],
            "code":  [
                {
                    "coding":  [
                        {
                            "system": "https://fhir.nhs.uk/CodeSystem/NHSDigital-SDS-JobRoleCode",
                            "code": "S0030:G0100:R0620"
                        }
                    ]
                }
            ],
            "practitioner": {
                "identifier": {
                    "system": "https://fhir.nhs.uk/Id/sds-user-id",
                    "value": "7654321"
                },
                "display": "Mr Peter Potion"
            },
            "organization": {
                "reference": "#organisation"
            },
            "telecom":  [
                {
                    "system": "phone",
                    "use": "work",
                    "value": "01234567890"
                }
            ]
        },
        {
            "resourceType": "Organization",
            "id": "organisation",
            "identifier":  [
                {
                    "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                    "value": "VNE51"
                }
            ],
            "address":  [
                {
                    "city": "West Yorkshire",
                    "use": "work",
                    "line":  [
                        "17 Austhorpe Road",
                        "Crossgates",
                        "Leeds"
                    ],
                    "postalCode": "LS15 8BA"
                }
            ],
            "active": true,
            "type":  [
                {
                    "coding":  [
                        {
                            "system": "https://fhir.nhs.uk/CodeSystem/organisation-role",
                            "code": "182",
                            "display": "PHARMACY"
                        }
                    ]
                }
            ],
            "name": "The Simple Pharmacy",
            "telecom":  [
                {
                    "system": "phone",
                    "use": "work",
                    "value": "0113 3180277"
                }
            ]
        }
    ],
    "created": "2021-11-24T09:54:07.246Z",
    "identifier":  [
        {
            "system": "https://tools.ietf.org/html/rfc4122",
            "value": "737dcf8d-fc7a-436d-b692-7d3c4f258083"
        }
    ],
    "status": "active",
    "type": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/claim-type",
                "code": "pharmacy",
                "display": "Pharmacy"
            }
        ]
    },
    "use": "claim",
    "patient": {
        "identifier": {
            "system": "https://fhir.nhs.uk/Id/nhs-number",
            "value": "9449304130"
        }
    },
    "provider": {
        "reference": "#provider"
    },
    "priority": {
        "coding":  [
            {
                "system": "http://terminology.hl7.org/CodeSystem/processpriority",
                "code": "normal"
            }
        ]
    },
    "insurance":  [
        {
            "sequence": 1,
            "focal": true,
            "coverage": {
                "identifier": {
                    "system": "https://fhir.nhs.uk/Id/ods-organization-code",
                    "value": "T1450"
                },
                "display": "NHS BUSINESS SERVICES AUTHORITY"
            }
        }
    ],
    "payee": {
        "type": {
            "coding":  [
                {
                    "system": "http://terminology.hl7.org/CodeSystem/payeetype",
                    "code": "provider",
                    "display": "Provider"
                }
            ]
        },
        "party": {
            "reference": "#organisation"
        }
    },
    "prescription": {
        "extension":  [
            {
                "url": "https://fhir.nhs.uk/StructureDefinition/Extension-DM-GroupIdentifier",
                "extension":  [
                    {
                        "url": "shortForm",
                        "valueIdentifier": {
                            "system": "https://fhir.nhs.uk/Id/prescription-order-number",
                            "value": "6C804A-A83008-0F81DA"
                        }
                    },
                    {
                        "url": "UUID",
                        "valueIdentifier": {
                            "system": "https://fhir.nhs.uk/Id/prescription",
                            "value": "461e4d5e-b5b5-4fcb-8f28-306cbe698bc9"
                        }
                    }
                ]
            }
        ],
        "display": "A prescription order"
    },
    "item":  [
        {
            "extension":  [
                {
                    "url": "https://fhir.nhs.uk/StructureDefinition/Extension-EPS-TaskBusinessStatus",
                    "valueCoding": {
                        "code": "0006",
                        "system": "https://fhir.nhs.uk/CodeSystem/EPS-task-business-status",
                        "display": "Dispensed"
                    }
                }
            ],
            "sequence": 1,
            "productOrService": {
                "coding":  [
                    {
                        "system": "http://snomed.info/sct",
                        "code": "16076005",
                        "display": "Prescription"
                    }
                ]
            },
            "programCode":  [
                {
                    "coding":  [
                        {
                            "code": "0001",
                            "system": "https://fhir.nhs.uk/CodeSystem/prescription-charge-exemption",
                            "display": "Patient has paid appropriate charges"
                        }
                    ]
                },
                {
                    "coding":  [
                        {
                            "system": "https://fhir.nhs.uk/CodeSystem/DM-exemption-evidence",
                            "code": "no-evidence-seen",
                            "display": "No Evidence Seen"
                        }
                    ]
                }
            ],
            "detail":  [
                {
                    "extension":  [
                        {
                            "url": "https://fhir.nhs.uk/StructureDefinition/Extension-ClaimSequenceIdentifier",
                            "valueIdentifier": {
                                "system": "https://fhir.nhs.uk/Id/claim-sequence-identifier",
                                "value": "be948cf8-5db1-4c39-8f9b-c7e049d55acb"
                            }
                        },
                        {
                            "url": "https://fhir.nhs.uk/StructureDefinition/Extension-ClaimMedicationRequestReference",
                            "valueReference": {
                                "identifier": {
                                    "system": "https://fhir.nhs.uk/Id/prescription-order-item-number",
                                    "value": "8ec3e2fc-2761-42d9-b8d5-b57453f0ea27"
                                }
                            }
                        }
                    ],
                    "sequence": 1,
                    "productOrService": {
                        "coding":  [
                            {
                                "system": "http://snomed.info/sct",
                                "code": "39720311000001101",
                                "display": "Paracetamol 500mg soluble tablets"
                            }
                        ]
                    },
                    "modifier":  [
                        {
                            "coding":  [
                                {
                                    "code": "0002",
                                    "system": "https://fhir.nhs.uk/CodeSystem/medicationdispense-type",
                                    "display": "Item not dispensed"
                                }
                            ]
                        }
                    ],
                    "programCode":  [
                        {
                            "coding":  [
                                {
                                    "system": "https://fhir.nhs.uk/CodeSystem/DM-prescription-charge",
                                    "code": "not-paid",
                                    "display": "Not Paid"
                                }
                            ]
                        },
                        {
                            "coding":  [
                                {
                                    "system": "https://fhir.nhs.uk/CodeSystem/medicationdispense-endorsement",
                                    "code": "NDEC",
                                    "display": "No Dispenser Endorsement Code"
                                }
                            ]
                        }
                    ],
                    "quantity": {
                        "value": 100,
                        "unit": "tablet",
                        "system": "http://snomed.info/sct",
                        "code": "428673006"
                    },
                    "subDetail":  [
                        {
                            "sequence": 1,
                            "productOrService": {
                                "coding":  [
                                    {
                                        "system": "http://snomed.info/sct",
                                        "code": "39720311000001101",
                                        "display": "Paracetamol 500mg soluble tablets"
                                    }
                                ]
                            },
                            "quantity": {
                                "value": 0,
                                "unit": "tablet",
                                "system": "http://snomed.info/sct",
                                "code": "428673006"
                            }
                        }
                    ]
                },
                {
                    "extension":  [
                        {
                            "url": "https://fhir.nhs.uk/StructureDefinition/Extension-ClaimSequenceIdentifier",
                            "valueIdentifier": {
                                "system": "https://fhir.nhs.uk/Id/claim-sequence-identifier",
                                "value": "b001a051-b597-4c8d-9ea5-7dc2a56861ea"
                            }
                        },
                        {
                            "url": "https://fhir.nhs.uk/StructureDefinition/Extension-ClaimMedicationRequestReference",
                            "valueReference": {
                                "identifier": {
                                    "system": "https://fhir.nhs.uk/Id/prescription-order-item-number",
                                    "value": "5962ea5f-d1e9-4a17-af12-e11b009603cf"
                                }
                            }
                        }
                    ],
                    "sequence": 2,
                    "productOrService": {
                        "coding":  [
                            {
                                "system": "http://snomed.info/sct",
                                "code": "39113611000001102",
                                "display": "Salbutamol 100micrograms/dose inhaler CFC free"
                            }
                        ]
                    },
                    "modifier":  [
                        {
                            "coding":  [
                                {
                                    "code": "0001",
                                    "system": "https://fhir.nhs.uk/CodeSystem/medicationdispense-type",
                                    "display": "Item fully dispensed"
                                }
                            ]
                        }
                    ],
                    "programCode":  [
                        {
                            "coding":  [
                                {
                                    "system": "https://fhir.nhs.uk/CodeSystem/DM-prescription-charge",
                                    "code": "paid-once",
                                    "display": "Paid Once"
                                }
                            ]
                        },
                        {
                            "coding":  [
                                {
                                    "system": "https://fhir.nhs.uk/CodeSystem/medicationdispense-endorsement",
                                    "code": "NDEC",
                                    "display": "No Dispenser Endorsement Code"
                                }
                            ]
                        }
                    ],
                    "quantity": {
                        "value": 200,
                        "unit": "dose",
                        "system": "http://snomed.info/sct",
                        "code": "3317411000001100"
                    }
                }
            ]
        }
    ]
}
<Claim xmlns="http://hl7.org/fhir">
    <id value="a76599c5-bbdd-4581-bb4d-377b348dd1e4" />
    <contained>
        <PractitionerRole>
            <id value="provider" />
            <identifier>
                <system value="https://fhir.nhs.uk/Id/sds-role-profile-id" />
                <value value="454567759542" />
            </identifier>
            <practitioner>
                <identifier>
                    <system value="https://fhir.nhs.uk/Id/sds-user-id" />
                    <value value="7654321" />
                </identifier>
                <display value="Mr Peter Potion" />
            </practitioner>
            <organization>
                <reference value="#organisation" />
            </organization>
            <code>
                <coding>
                    <system value="https://fhir.nhs.uk/CodeSystem/NHSDigital-SDS-JobRoleCode" />
                    <code value="S0030:G0100:R0620" />
                </coding>
            </code>
            <telecom>
                <system value="phone" />
                <value value="01234567890" />
                <use value="work" />
            </telecom>
        </PractitionerRole>
    </contained>
    <contained>
        <Organization>
            <id value="organisation" />
            <identifier>
                <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
                <value value="VNE51" />
            </identifier>
            <active value="true" />
            <type>
                <coding>
                    <system value="https://fhir.nhs.uk/CodeSystem/organisation-role" />
                    <code value="182" />
                    <display value="PHARMACY" />
                </coding>
            </type>
            <name value="The Simple Pharmacy" />
            <telecom>
                <system value="phone" />
                <value value="0113 3180277" />
                <use value="work" />
            </telecom>
            <address>
                <use value="work" />
                <line value="17 Austhorpe Road" />
                <line value="Crossgates" />
                <line value="Leeds" />
                <city value="West Yorkshire" />
                <postalCode value="LS15 8BA" />
            </address>
        </Organization>
    </contained>
    <extension url="https://fhir.nhs.uk/StructureDefinition/Extension-Provenance-agent">
        <valueReference>
            <identifier>
                <system value="https://fhir.nhs.uk/Id/sds-user-id" />
                <value value="7654321" />
            </identifier>
            <display value="Mr Peter Potion" />
        </valueReference>
    </extension>
    <identifier>
        <system value="https://tools.ietf.org/html/rfc4122" />
        <value value="737dcf8d-fc7a-436d-b692-7d3c4f258083" />
    </identifier>
    <status value="active" />
    <type>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/claim-type" />
            <code value="pharmacy" />
            <display value="Pharmacy" />
        </coding>
    </type>
    <use value="claim" />
    <patient>
        <identifier>
            <system value="https://fhir.nhs.uk/Id/nhs-number" />
            <value value="9449304130" />
        </identifier>
    </patient>
    <created value="2021-11-24T09:54:07.246Z" />
    <provider>
        <reference value="#provider" />
    </provider>
    <priority>
        <coding>
            <system value="http://terminology.hl7.org/CodeSystem/processpriority" />
            <code value="normal" />
        </coding>
    </priority>
    <prescription>
        <extension url="https://fhir.nhs.uk/StructureDefinition/Extension-DM-GroupIdentifier">
            <extension url="shortForm">
                <valueIdentifier>
                    <system value="https://fhir.nhs.uk/Id/prescription-order-number" />
                    <value value="6C804A-A83008-0F81DA" />
                </valueIdentifier>
            </extension>
            <extension url="UUID">
                <valueIdentifier>
                    <system value="https://fhir.nhs.uk/Id/prescription" />
                    <value value="461e4d5e-b5b5-4fcb-8f28-306cbe698bc9" />
                </valueIdentifier>
            </extension>
        </extension>
        <display value="A prescription order" />
    </prescription>
    <payee>
        <type>
            <coding>
                <system value="http://terminology.hl7.org/CodeSystem/payeetype" />
                <code value="provider" />
                <display value="Provider" />
            </coding>
        </type>
        <party>
            <reference value="#organisation" />
        </party>
    </payee>
    <insurance>
        <sequence value="1" />
        <focal value="true" />
        <coverage>
            <identifier>
                <system value="https://fhir.nhs.uk/Id/ods-organization-code" />
                <value value="T1450" />
            </identifier>
            <display value="NHS BUSINESS SERVICES AUTHORITY" />
        </coverage>
    </insurance>
    <item>
        <extension url="https://fhir.nhs.uk/StructureDefinition/Extension-EPS-TaskBusinessStatus">
            <valueCoding>
                <system value="https://fhir.nhs.uk/CodeSystem/EPS-task-business-status" />
                <code value="0006" />
                <display value="Dispensed" />
            </valueCoding>
        </extension>
        <sequence value="1" />
        <productOrService>
            <coding>
                <system value="http://snomed.info/sct" />
                <code value="16076005" />
                <display value="Prescription" />
            </coding>
        </productOrService>
        <programCode>
            <coding>
                <system value="https://fhir.nhs.uk/CodeSystem/prescription-charge-exemption" />
                <code value="0001" />
                <display value="Patient has paid appropriate charges" />
            </coding>
        </programCode>
        <programCode>
            <coding>
                <system value="https://fhir.nhs.uk/CodeSystem/DM-exemption-evidence" />
                <code value="no-evidence-seen" />
                <display value="No Evidence Seen" />
            </coding>
        </programCode>
        <detail>
            <extension url="https://fhir.nhs.uk/StructureDefinition/Extension-ClaimSequenceIdentifier">
                <valueIdentifier>
                    <system value="https://fhir.nhs.uk/Id/claim-sequence-identifier" />
                    <value value="be948cf8-5db1-4c39-8f9b-c7e049d55acb" />
                </valueIdentifier>
            </extension>
            <extension url="https://fhir.nhs.uk/StructureDefinition/Extension-ClaimMedicationRequestReference">
                <valueReference>
                    <identifier>
                        <system value="https://fhir.nhs.uk/Id/prescription-order-item-number" />
                        <value value="8ec3e2fc-2761-42d9-b8d5-b57453f0ea27" />
                    </identifier>
                </valueReference>
            </extension>
            <sequence value="1" />
            <productOrService>
                <coding>
                    <system value="http://snomed.info/sct" />
                    <code value="39720311000001101" />
                    <display value="Paracetamol 500mg soluble tablets" />
                </coding>
            </productOrService>
            <modifier>
                <coding>
                    <system value="https://fhir.nhs.uk/CodeSystem/medicationdispense-type" />
                    <code value="0002" />
                    <display value="Item not dispensed" />
                </coding>
            </modifier>
            <programCode>
                <coding>
                    <system value="https://fhir.nhs.uk/CodeSystem/DM-prescription-charge" />
                    <code value="not-paid" />
                    <display value="Not Paid" />
                </coding>
            </programCode>
            <programCode>
                <coding>
                    <system value="https://fhir.nhs.uk/CodeSystem/medicationdispense-endorsement" />
                    <code value="NDEC" />
                    <display value="No Dispenser Endorsement Code" />
                </coding>
            </programCode>
            <quantity>
                <value value="100" />
                <unit value="tablet" />
                <system value="http://snomed.info/sct" />
                <code value="428673006" />
            </quantity>
            <subDetail>
                <sequence value="1" />
                <productOrService>
                    <coding>
                        <system value="http://snomed.info/sct" />
                        <code value="39720311000001101" />
                        <display value="Paracetamol 500mg soluble tablets" />
                    </coding>
                </productOrService>
                <quantity>
                    <value value="0" />
                    <unit value="tablet" />
                    <system value="http://snomed.info/sct" />
                    <code value="428673006" />
                </quantity>
            </subDetail>
        </detail>
        <detail>
            <extension url="https://fhir.nhs.uk/StructureDefinition/Extension-ClaimSequenceIdentifier">
                <valueIdentifier>
                    <system value="https://fhir.nhs.uk/Id/claim-sequence-identifier" />
                    <value value="b001a051-b597-4c8d-9ea5-7dc2a56861ea" />
                </valueIdentifier>
            </extension>
            <extension url="https://fhir.nhs.uk/StructureDefinition/Extension-ClaimMedicationRequestReference">
                <valueReference>
                    <identifier>
                        <system value="https://fhir.nhs.uk/Id/prescription-order-item-number" />
                        <value value="5962ea5f-d1e9-4a17-af12-e11b009603cf" />
                    </identifier>
                </valueReference>
            </extension>
            <sequence value="2" />
            <productOrService>
                <coding>
                    <system value="http://snomed.info/sct" />
                    <code value="39113611000001102" />
                    <display value="Salbutamol 100micrograms/dose inhaler CFC free" />
                </coding>
            </productOrService>
            <modifier>
                <coding>
                    <system value="https://fhir.nhs.uk/CodeSystem/medicationdispense-type" />
                    <code value="0001" />
                    <display value="Item fully dispensed" />
                </coding>
            </modifier>
            <programCode>
                <coding>
                    <system value="https://fhir.nhs.uk/CodeSystem/DM-prescription-charge" />
                    <code value="paid-once" />
                    <display value="Paid Once" />
                </coding>
            </programCode>
            <programCode>
                <coding>
                    <system value="https://fhir.nhs.uk/CodeSystem/medicationdispense-endorsement" />
                    <code value="NDEC" />
                    <display value="No Dispenser Endorsement Code" />
                </coding>
            </programCode>
            <quantity>
                <value value="200" />
                <unit value="dose" />
                <system value="http://snomed.info/sct" />
                <code value="3317411000001100" />
            </quantity>
        </detail>
    </item>
</Claim>
Claim
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