{
  "resourceType": "StructureDefinition",
  "id": "il-core-claim",
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode": "draft"
    },
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger": 0
    }
  ],
  "url": "http://fhir.health.gov.il/StructureDefinition/il-core-claim",
  "version": "0.21.0",
  "name": "ILCoreClaim",
  "title": "ILCore Claim Profile",
  "status": "active",
  "date": "2026-03-23",
  "publisher": "Israel Core Team",
  "contact": [
    {
      "telecom": [
        {
          "system": "email",
          "value": "tal.primak@moh.gov.il"
        }
      ]
    }
  ],
  "description": "Israel Core proposed constraints and extensions on the Claim Resource",
  "fhirVersion": "4.0.1",
  "kind": "resource",
  "abstract": false,
  "type": "Claim",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Claim",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Claim",
        "path": "Claim",
        "short": "ILCore Claim Profile",
        "definition": "Israel Core proposed constraints and extensions on the Claim resource profile."
      },
      {
        "id": "Claim.identifier",
        "path": "Claim.identifier",
        "type": [
          {
            "code": "Identifier",
            "profile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-identifier"
            ]
          }
        ]
      },
      {
        "id": "Claim.patient",
        "path": "Claim.patient",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-patient"
            ]
          }
        ]
      },
      {
        "id": "Claim.enterer",
        "path": "Claim.enterer",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-practitioner",
              "http://fhir.health.gov.il/StructureDefinition/il-core-practitioner-role"
            ]
          }
        ]
      },
      {
        "id": "Claim.insurer",
        "path": "Claim.insurer",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-organization"
            ]
          }
        ]
      },
      {
        "id": "Claim.provider",
        "path": "Claim.provider",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-practitioner",
              "http://fhir.health.gov.il/StructureDefinition/il-core-practitioner-role",
              "http://fhir.health.gov.il/StructureDefinition/il-core-organization"
            ]
          }
        ]
      },
      {
        "id": "Claim.related.claim",
        "path": "Claim.related.claim",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-claim"
            ]
          }
        ]
      },
      {
        "id": "Claim.prescription",
        "path": "Claim.prescription",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-device-request",
              "http://fhir.health.gov.il/StructureDefinition/il-core-medication-request",
              "http://hl7.org/fhir/StructureDefinition/VisionPrescription"
            ]
          }
        ]
      },
      {
        "id": "Claim.originalPrescription",
        "path": "Claim.originalPrescription",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-device-request",
              "http://fhir.health.gov.il/StructureDefinition/il-core-medication-request",
              "http://hl7.org/fhir/StructureDefinition/VisionPrescription"
            ]
          }
        ]
      },
      {
        "id": "Claim.payee.party",
        "path": "Claim.payee.party",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-practitioner",
              "http://fhir.health.gov.il/StructureDefinition/il-core-practitioner-role",
              "http://fhir.health.gov.il/StructureDefinition/il-core-organization",
              "http://fhir.health.gov.il/StructureDefinition/il-core-patient",
              "http://fhir.health.gov.il/StructureDefinition/il-core-related-person"
            ]
          }
        ]
      },
      {
        "id": "Claim.referral",
        "path": "Claim.referral",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-service-request"
            ]
          }
        ]
      },
      {
        "id": "Claim.facility",
        "path": "Claim.facility",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-location"
            ]
          }
        ]
      },
      {
        "id": "Claim.careTeam.provider",
        "path": "Claim.careTeam.provider",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-practitioner",
              "http://fhir.health.gov.il/StructureDefinition/il-core-practitioner-role",
              "http://fhir.health.gov.il/StructureDefinition/il-core-organization"
            ]
          }
        ]
      },
      {
        "id": "Claim.diagnosis.diagnosis[x]",
        "path": "Claim.diagnosis.diagnosis[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Claim.diagnosis.diagnosis[x]:diagnosisReference",
        "path": "Claim.diagnosis.diagnosis[x]",
        "sliceName": "diagnosisReference",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-condition"
            ]
          }
        ]
      },
      {
        "id": "Claim.procedure.procedure[x]",
        "path": "Claim.procedure.procedure[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Claim.procedure.procedure[x]:procedureReference",
        "path": "Claim.procedure.procedure[x]",
        "sliceName": "procedureReference",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-procedure"
            ]
          }
        ]
      },
      {
        "id": "Claim.procedure.udi",
        "path": "Claim.procedure.udi",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-device"
            ]
          }
        ]
      },
      {
        "id": "Claim.accident.location[x]",
        "path": "Claim.accident.location[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Claim.accident.location[x]:locationReference",
        "path": "Claim.accident.location[x]",
        "sliceName": "locationReference",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-location"
            ]
          }
        ]
      },
      {
        "id": "Claim.item.location[x]",
        "path": "Claim.item.location[x]",
        "slicing": {
          "discriminator": [
            {
              "type": "type",
              "path": "$this"
            }
          ],
          "ordered": false,
          "rules": "open"
        }
      },
      {
        "id": "Claim.item.location[x]:locationReference",
        "path": "Claim.item.location[x]",
        "sliceName": "locationReference",
        "min": 0,
        "max": "1",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-location"
            ]
          }
        ]
      },
      {
        "id": "Claim.item.udi",
        "path": "Claim.item.udi",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-device"
            ]
          }
        ]
      },
      {
        "id": "Claim.item.encounter",
        "path": "Claim.item.encounter",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-encounter"
            ]
          }
        ]
      },
      {
        "id": "Claim.item.detail.udi",
        "path": "Claim.item.detail.udi",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-device"
            ]
          }
        ]
      },
      {
        "id": "Claim.item.detail.subDetail.udi",
        "path": "Claim.item.detail.subDetail.udi",
        "type": [
          {
            "code": "Reference",
            "targetProfile": [
              "http://fhir.health.gov.il/StructureDefinition/il-core-device"
            ]
          }
        ]
      }
    ]
  }
}