{ "resourceType": "StructureDefinition", "id": "srx-fhir-profile-claim-drug", "meta": { "versionId": "7", "lastUpdated": "2018-04-18T18:22:14.739+00:00" }, "url": "http://fhir-es.transcendinsights.com/stu3/StructureDefinition/srx-fhir-profile-claim-drug", "version": "2.1", "name": "srx-fhir-profile-claim-drug", "status": "draft", "date": "2017-11-27T23:04:09.586+00:00", "description": "This profile may be used as a) an entry of the FHIR Bundle consumed by the near real-time request, b) an entry of the contained bundle in the FHIR MeasureReport resource, c) as an entry of the FHIR patient bundle.", "fhirVersion": "3.0.1", "mapping": [ { "identity": "PHARMACY-CLAIMS", "name": "Pharmacy Claim" } ], "kind": "resource", "abstract": false, "type": "Claim", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Claim", "derivation": "constraint", "differential": { "element": [ { "id": "Claim", "path": "Claim", "definition": "Drug claim submitted for processing." }, { "id": "Claim.id", "path": "Claim.id", "max": "0", "mustSupport": true }, { "id": "Claim.meta", "path": "Claim.meta", "min": 1 }, { "id": "Claim.meta.id", "path": "Claim.meta.id", "max": "0" }, { "id": "Claim.meta.extension", "path": "Claim.meta.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "rules": "open" } }, { "id": "Claim.meta.extension:resource-date-created", "path": "Claim.meta.extension", "sliceName": "resource-date-created", "short": "Creation date", "definition": "The date this resource was created (not the latest update).", "min": 1, "type": [ { "code": "Extension", "profile": "http://fhir-es.transcendinsights.com/stu3/StructureDefinition/resource-date-created" } ] }, { "id": "Claim.meta.extension:data-source-entity", "path": "Claim.meta.extension", "sliceName": "data-source-entity", "short": "Source of data", "definition": "The entity producing the data e.g. Humana, Argus, EDW etc.", "type": [ { "code": "Extension", "profile": "http://fhir-es.transcendinsights.com/stu3/StructureDefinition/data-source-entity" } ] }, { "id": "Claim.meta.extension:source-filename", "path": "Claim.meta.extension", "sliceName": "source-filename", "short": "Source data file names", "definition": "The name of the files that contain the source data.", "type": [ { "code": "Extension", "profile": "http://fhir-es.transcendinsights.com/stu3/StructureDefinition/source-filename" } ] }, { "id": "Claim.implicitRules", "path": "Claim.implicitRules", "max": "0" }, { "id": "Claim.language", "path": "Claim.language", "max": "0" }, { "id": "Claim.text", "path": "Claim.text", "max": "0" }, { "id": "Claim.contained", "path": "Claim.contained", "max": "0" }, { "id": "Claim.identifier", "path": "Claim.identifier", "definition": "The business identifier for the instance: claim number", "min": 1, "max": "1", "mustSupport": true }, { "id": "Claim.identifier.id", "path": "Claim.identifier.id", "max": "0" }, { "id": "Claim.identifier.use", "path": "Claim.identifier.use", "max": "0", "fixedCode": "official" }, { "id": "Claim.identifier.type", "path": "Claim.identifier.type", "max": "0" }, { "id": "Claim.identifier.type.id", "path": "Claim.identifier.type.id", "max": "0" }, { "id": "Claim.identifier.type.coding.id", "path": "Claim.identifier.type.coding.id", "max": "0" }, { "id": "Claim.identifier.type.coding.system", "path": "Claim.identifier.type.coding.system", "min": 1 }, { "id": "Claim.identifier.type.coding.version", "path": "Claim.identifier.type.coding.version", "max": "0" }, { "id": "Claim.identifier.type.coding.code", "path": "Claim.identifier.type.coding.code", "min": 1 }, { "id": "Claim.identifier.type.coding.userSelected", "path": "Claim.identifier.type.coding.userSelected", "max": "0" }, { "id": "Claim.identifier.system", "path": "Claim.identifier.system", "min": 1, "fixedUri": "http://fhir-es.transcendinsights.com/stu3/NamingSystem/humana-claim-identifier" }, { "id": "Claim.identifier.value", "path": "Claim.identifier.value", "definition": "The Claim identifier.", "min": 1, "mapping": [ { "identity": "PHARMACY-CLAIMS", "map": "CLAIM_ID" } ] }, { "id": "Claim.identifier.period", "path": "Claim.identifier.period", "max": "0" }, { "id": "Claim.identifier.assigner", "path": "Claim.identifier.assigner", "max": "0" }, { "id": "Claim.status", "path": "Claim.status", "short": "active | cancelled | entered-in-error", "definition": "The status of the Claim. \r\n01=Paid on Rx claim or ACTIVE in NRT FHIR Bundle\r\n02= Denied on Rx claim or CANCELLED in FHIR Bundle\r\n03=Reversed on Rx claim or ENTERED IN ERROR in FHIR Bundle.", "min": 1, "mustSupport": true, "mapping": [ { "identity": "PHARMACY-CLAIMS", "map": "CLAIM_STATUS" } ] }, { "id": "Claim.type", "path": "Claim.type", "definition": "The category of claim, eg, oral, pharmacy, vision, insitutional, professional. Fors SRX, drug claims must have a fixed type equal to pharmacy.", "min": 1 }, { "id": "Claim.type.id", "path": "Claim.type.id", "max": "0" }, { "id": "Claim.type.coding", "path": "Claim.type.coding", "min": 1, "max": "1" }, { "id": "Claim.type.coding.id", "path": "Claim.type.coding.id", "max": "0" }, { "id": "Claim.type.coding.system", "path": "Claim.type.coding.system", "min": 1, "fixedUri": "http://hl7.org/fhir/ex-claimtype" }, { "id": "Claim.type.coding.version", "path": "Claim.type.coding.version", "max": "0" }, { "id": "Claim.type.coding.code", "path": "Claim.type.coding.code", "short": "Claim type", "definition": "The type of claim e.g. pharmacy, institutional, professional, etc. See possible values defined in http://hl7.org/fhir/ValueSet/claim-type.", "min": 1, "fixedCode": "pharmacy" }, { "id": "Claim.type.coding.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Claim.type.coding.display", "max": "0" }, { "id": "Claim.type.coding.userSelected", "path": "Claim.type.coding.userSelected", "max": "0" }, { "id": "Claim.type.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Claim.type.text", "max": "0" }, { "id": "Claim.subType", "path": "Claim.subType", "max": "0" }, { "id": "Claim.use", "path": "Claim.use", "short": "complete | exploratory", "definition": "A claim must have a 'use' value equal to 'complete' or 'exploratory'. The exploratory status should only be used when the claim is part of the near-real time request or in the Measure Report, but not in the Patient bundle.", "min": 1, "mustSupport": true }, { "id": "Claim.patient", "path": "Claim.patient", "short": "The patient that this claim belongs to.", "min": 1 }, { "id": "Claim.patient.id", "path": "Claim.patient.id", "max": "0" }, { "id": "Claim.patient.reference", "path": "Claim.patient.reference", "short": "A reference to a location at which the patient resource is found.", "definition": "It is an internal reference that refers to the patient resource. If the patient resource is a contained resource, then the reference must start with '#'.", "min": 1, "example": [ { "label": "Contained reference example", "valueString": "#PAT-12345678" }, { "label": "Relative reference example (XML)", "valueString": "" } ], "mustSupport": true }, { "id": "Claim.patient.identifier", "path": "Claim.patient.identifier", "max": "0" }, { "id": "Claim.patient.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Claim.patient.display", "max": "0" }, { "id": "Claim.billablePeriod", "path": "Claim.billablePeriod", "max": "0" }, { "id": "Claim.created", "path": "Claim.created", "max": "0" }, { "id": "Claim.enterer", "path": "Claim.enterer", "max": "0" }, { "id": "Claim.insurer", "path": "Claim.insurer", "max": "0" }, { "id": "Claim.provider", "path": "Claim.provider", "max": "0" }, { "id": "Claim.organization", "path": "Claim.organization", "short": "Responsible organization (pharmacy)", "definition": "The organization responsible e.g. pharmacy for dispensing the medication.", "min": 1 }, { "id": "Claim.organization.id", "path": "Claim.organization.id", "max": "0" }, { "id": "Claim.organization.reference", "path": "Claim.organization.reference", "short": "Organization reference", "definition": "A reference to the Organization resource." }, { "id": "Claim.organization.identifier", "path": "Claim.organization.identifier", "max": "0" }, { "id": "Claim.organization.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Claim.organization.display", "max": "0" }, { "id": "Claim.priority", "path": "Claim.priority", "max": "0" }, { "id": "Claim.fundsReserve", "path": "Claim.fundsReserve", "max": "0" }, { "id": "Claim.related", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "RelatedClaim" } ], "path": "Claim.related", "max": "0" }, { "id": "Claim.prescription", "path": "Claim.prescription", "max": "0" }, { "id": "Claim.originalPrescription", "path": "Claim.originalPrescription", "max": "0" }, { "id": "Claim.payee", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Payee" } ], "path": "Claim.payee", "max": "0" }, { "id": "Claim.referral", "path": "Claim.referral", "max": "0" }, { "id": "Claim.facility", "path": "Claim.facility", "max": "0" }, { "id": "Claim.careTeam", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "CareTeam" } ], "path": "Claim.careTeam", "definition": "The physician, or other provider (pharmacy), who supplied the durg record element to the ).", "min": 1, "max": "1", "mustSupport": true }, { "id": "Claim.careTeam.id", "path": "Claim.careTeam.id", "max": "0" }, { "id": "Claim.careTeam.sequence", "path": "Claim.careTeam.sequence", "mustSupport": true }, { "id": "Claim.careTeam.provider.id", "path": "Claim.careTeam.provider.id", "max": "0" }, { "id": "Claim.careTeam.provider.reference", "path": "Claim.careTeam.provider.reference", "definition": "A reference to the internal ID of the physician, or other provider (pharmacy), who supplied the drug record element to the Cliam.", "mustSupport": true }, { "id": "Claim.careTeam.provider.identifier", "path": "Claim.careTeam.provider.identifier", "max": "0" }, { "id": "Claim.careTeam.provider.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Claim.careTeam.provider.display", "max": "0" }, { "id": "Claim.careTeam.responsible", "path": "Claim.careTeam.responsible", "max": "0" }, { "id": "Claim.careTeam.role", "path": "Claim.careTeam.role", "max": "0" }, { "id": "Claim.careTeam.role.id", "path": "Claim.careTeam.role.id", "max": "0" }, { "id": "Claim.careTeam.role.coding.id", "path": "Claim.careTeam.role.coding.id", "max": "0" }, { "id": "Claim.careTeam.role.coding.system", "path": "Claim.careTeam.role.coding.system", "min": 1 }, { "id": "Claim.careTeam.role.coding.code", "path": "Claim.careTeam.role.coding.code", "min": 1 }, { "id": "Claim.careTeam.role.coding.userSelected", "path": "Claim.careTeam.role.coding.userSelected", "max": "0" }, { "id": "Claim.careTeam.role.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Claim.careTeam.role.text", "max": "0" }, { "id": "Claim.careTeam.qualification", "path": "Claim.careTeam.qualification", "max": "0" }, { "id": "Claim.careTeam.qualification.id", "path": "Claim.careTeam.qualification.id", "max": "0" }, { "id": "Claim.careTeam.qualification.coding.id", "path": "Claim.careTeam.qualification.coding.id", "max": "0" }, { "id": "Claim.careTeam.qualification.coding.system", "path": "Claim.careTeam.qualification.coding.system", "min": 1 }, { "id": "Claim.careTeam.qualification.coding.code", "path": "Claim.careTeam.qualification.coding.code", "min": 1 }, { "id": "Claim.careTeam.qualification.coding.userSelected", "path": "Claim.careTeam.qualification.coding.userSelected", "max": "0" }, { "id": "Claim.careTeam.qualification.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Claim.careTeam.qualification.text", "max": "0" }, { "id": "Claim.information", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "SpecialCondition" } ], "path": "Claim.information", "slicing": { "discriminator": [ { "type": "value", "path": "category.coding.code" } ], "rules": "closed" }, "definition": "Additional information codes regarding the medication e.g. days supply (required) and rx-number (optional).", "min": 1, "max": "2" }, { "id": "Claim.information.id", "path": "Claim.information.id", "max": "0" }, { "id": "Claim.information.sequence", "path": "Claim.information.sequence", "mustSupport": true }, { "id": "Claim.information.category", "path": "Claim.information.category", "definition": "The general class of the information supplied: days supply, rx-number, etc.", "example": [ { "label": "Claim days supply example", "valueCodeableConcept": { "coding": [ { "code": "dayssupply", "display": "Days Supply" } ] } }, { "label": "Claim RX-Number example", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/pharmacy-information", "code": "rx-number" } ] } } ], "mustSupport": true }, { "id": "Claim.information.category.id", "path": "Claim.information.category.id", "max": "0" }, { "id": "Claim.information.category.coding.id", "path": "Claim.information.category.coding.id", "max": "0" }, { "id": "Claim.information.category.coding.system", "path": "Claim.information.category.coding.system", "min": 1 }, { "id": "Claim.information.category.coding.code", "path": "Claim.information.category.coding.code", "min": 1 }, { "id": "Claim.information.category.coding.userSelected", "path": "Claim.information.category.coding.userSelected", "max": "0" }, { "id": "Claim.information.category.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Claim.information.category.text", "max": "0" }, { "id": "Claim.information.code", "path": "Claim.information.code", "max": "0" }, { "id": "Claim.information.timing[x]", "path": "Claim.information.timing[x]", "max": "0" }, { "id": "Claim.information.value[x]", "path": "Claim.information.value[x]", "definition": "Additional data or information e.g. days supply(valueQuantity) and rx-number (valueString).", "min": 1, "type": [ { "code": "string" }, { "code": "Quantity" } ] }, { "id": "Claim.information.reason", "path": "Claim.information.reason", "max": "0" }, { "id": "Claim.information:RxNumber", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "SpecialCondition" } ], "path": "Claim.information", "sliceName": "RxNumber", "short": "The Rx Number.", "definition": "The Rx Number assigned to the dispensed medication.", "max": "1" }, { "id": "Claim.information:RxNumber.id", "path": "Claim.information.id", "max": "0" }, { "id": "Claim.information:RxNumber.category.id", "path": "Claim.information.category.id", "max": "0" }, { "id": "Claim.information:RxNumber.category.coding", "path": "Claim.information.category.coding", "min": 1, "max": "1" }, { "id": "Claim.information:RxNumber.category.coding.id", "path": "Claim.information.category.coding.id", "max": "0" }, { "id": "Claim.information:RxNumber.category.coding.system", "path": "Claim.information.category.coding.system", "fixedUri": "http://hl7.org/fhir/pharmacy-information" }, { "id": "Claim.information:RxNumber.category.coding.version", "path": "Claim.information.category.coding.version", "max": "0" }, { "id": "Claim.information:RxNumber.category.coding.code", "path": "Claim.information.category.coding.code", "definition": "A symbol in syntax defined by the system.", "fixedCode": "rx-number" }, { "id": "Claim.information:RxNumber.category.coding.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Claim.information.category.coding.display", "max": "0" }, { "id": "Claim.information:RxNumber.category.coding.userSelected", "path": "Claim.information.category.coding.userSelected", "max": "0" }, { "id": "Claim.information:RxNumber.category.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Claim.information.category.text", "max": "0" }, { "id": "Claim.information:RxNumber.code", "path": "Claim.information.code", "max": "0" }, { "id": "Claim.information:RxNumber.timing[x]", "path": "Claim.information.timing[x]", "max": "0" }, { "id": "Claim.information:RxNumber.valueString:valueString", "path": "Claim.information.valueString", "sliceName": "valueString", "min": 1, "type": [ { "code": "string" } ], "mapping": [ { "identity": "PHARMACY-CLAIMS", "map": "RX_NUMBER (PK)" } ] }, { "id": "Claim.information:RxNumber.reason", "path": "Claim.information.reason", "max": "0" }, { "id": "Claim.information:daysSupply", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "SpecialCondition" } ], "path": "Claim.information", "sliceName": "daysSupply", "short": "The days supply of the medication", "definition": "Days supply information.", "min": 1, "max": "1" }, { "id": "Claim.information:daysSupply.id", "path": "Claim.information.id", "max": "0" }, { "id": "Claim.information:daysSupply.category", "path": "Claim.information.category", "example": [ { "label": "ifnormation category: days supply", "valueCodeableConcept": { "coding": [ { "code": "dayssupply", "display": "Days Supply" } ] } } ] }, { "id": "Claim.information:daysSupply.category.id", "path": "Claim.information.category.id", "max": "0" }, { "id": "Claim.information:daysSupply.category.coding", "path": "Claim.information.category.coding", "min": 1, "max": "1" }, { "id": "Claim.information:daysSupply.category.coding.id", "path": "Claim.information.category.coding.id", "max": "0" }, { "id": "Claim.information:daysSupply.category.coding.system", "path": "Claim.information.category.coding.system", "fixedUri": "http://hl7.org/fhir/pharmacy-information" }, { "id": "Claim.information:daysSupply.category.coding.version", "path": "Claim.information.category.coding.version", "max": "0" }, { "id": "Claim.information:daysSupply.category.coding.code", "path": "Claim.information.category.coding.code", "fixedCode": "dayssupply" }, { "id": "Claim.information:daysSupply.category.coding.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Claim.information.category.coding.display", "max": "0" }, { "id": "Claim.information:daysSupply.category.coding.userSelected", "path": "Claim.information.category.coding.userSelected", "max": "0" }, { "id": "Claim.information:daysSupply.category.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Claim.information.category.text", "max": "0" }, { "id": "Claim.information:daysSupply.code", "path": "Claim.information.code", "max": "0" }, { "id": "Claim.information:daysSupply.timing[x]", "path": "Claim.information.timing[x]", "max": "0" }, { "id": "Claim.information:daysSupply.valueQuantity:valueQuantity", "path": "Claim.information.valueQuantity", "sliceName": "valueQuantity", "short": "Days supply value", "definition": "The value of days supply recorded either as a sting or a Quantity type.", "min": 1, "type": [ { "code": "Quantity" } ], "example": [ { "label": "quantity example" } ], "mapping": [ { "identity": "PHARMACY-CLAIMS", "map": "DAYS_SUPPLY" } ] }, { "id": "Claim.information:daysSupply.valueQuantity:valueQuantity.id", "path": "Claim.information.valueQuantity.id", "max": "0" }, { "id": "Claim.information:daysSupply.valueQuantity:valueQuantity.value", "path": "Claim.information.valueQuantity.value", "min": 1 }, { "id": "Claim.information:daysSupply.valueQuantity:valueQuantity.unit", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Claim.information.valueQuantity.unit", "min": 1 }, { "id": "Claim.information:daysSupply.valueQuantity:valueQuantity.system", "path": "Claim.information.valueQuantity.system", "min": 1 }, { "id": "Claim.information:daysSupply.valueQuantity:valueQuantity.code", "path": "Claim.information.valueQuantity.code", "min": 1 }, { "id": "Claim.information:daysSupply.reason", "path": "Claim.information.reason", "max": "0" }, { "id": "Claim.diagnosis", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Diagnosis" } ], "path": "Claim.diagnosis", "max": "0" }, { "id": "Claim.diagnosis.id", "path": "Claim.diagnosis.id", "max": "0" }, { "id": "Claim.diagnosis.type.id", "path": "Claim.diagnosis.type.id", "max": "0" }, { "id": "Claim.diagnosis.type.coding.id", "path": "Claim.diagnosis.type.coding.id", "max": "0" }, { "id": "Claim.diagnosis.type.coding.system", "path": "Claim.diagnosis.type.coding.system", "min": 1 }, { "id": "Claim.diagnosis.type.coding.code", "path": "Claim.diagnosis.type.coding.code", "min": 1 }, { "id": "Claim.diagnosis.type.coding.userSelected", "path": "Claim.diagnosis.type.coding.userSelected", "max": "0" }, { "id": "Claim.diagnosis.type.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Claim.diagnosis.type.text", "max": "0" }, { "id": "Claim.procedure", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Procedure" } ], "path": "Claim.procedure", "max": "0" }, { "id": "Claim.insurance", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Insurance" } ], "path": "Claim.insurance", "max": "0" }, { "id": "Claim.accident", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Accident" } ], "path": "Claim.accident", "max": "0" }, { "id": "Claim.employmentImpacted", "path": "Claim.employmentImpacted", "max": "0" }, { "id": "Claim.hospitalization", "path": "Claim.hospitalization", "max": "0" }, { "id": "Claim.item", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Item" } ], "path": "Claim.item", "definition": "The medication dispensed.", "min": 1, "max": "1", "mustSupport": true }, { "id": "Claim.item.id", "path": "Claim.item.id", "max": "0" }, { "id": "Claim.item.careTeamLinkId", "path": "Claim.item.careTeamLinkId", "short": "Link to the careTeam(Practitioner).", "definition": "The link id to the responsible provider/medication prescriber. The careTeamId value must match one of the values in CareTeam.sequence.", "min": 1, "max": "1", "mustSupport": true }, { "id": "Claim.item.diagnosisLinkId", "path": "Claim.item.diagnosisLinkId", "max": "0", "mustSupport": true }, { "id": "Claim.item.procedureLinkId", "path": "Claim.item.procedureLinkId", "max": "0" }, { "id": "Claim.item.informationLinkId", "path": "Claim.item.informationLinkId", "short": "Links to supporting information of this item.", "definition": "Link identifiers to supporting information for this drug claim such as days supply and Rx number. The informationLinkId value must match one of the values in Information.sequence.", "min": 1, "max": "2", "mustSupport": true }, { "id": "Claim.item.revenue", "path": "Claim.item.revenue", "max": "0" }, { "id": "Claim.item.category", "path": "Claim.item.category", "max": "0" }, { "id": "Claim.item.service", "path": "Claim.item.service", "short": "A service(dispensed medication) that was billed in this claiim.", "definition": "A medication listed in this claim.", "min": 1, "example": [ { "label": "Claim service example", "valueCodeableConcept": { "coding": [ { "system": "http://hl7.org/fhir/sid/ndc", "code": "00002809101", "display": "Humatrope 24 mg (72 unit) injection cartridge" } ] } } ], "mustSupport": true }, { "id": "Claim.item.service.id", "path": "Claim.item.service.id", "max": "0" }, { "id": "Claim.item.service.coding", "path": "Claim.item.service.coding", "min": 1, "max": "1" }, { "id": "Claim.item.service.coding.id", "path": "Claim.item.service.coding.id", "max": "0" }, { "id": "Claim.item.service.coding.system", "path": "Claim.item.service.coding.system", "min": 1, "fixedUri": "http://hl7.org/fhir/sid/ndc" }, { "id": "Claim.item.service.coding.version", "path": "Claim.item.service.coding.version", "max": "0" }, { "id": "Claim.item.service.coding.code", "path": "Claim.item.service.coding.code", "short": "Medication code value.", "definition": "A code value within the defined system that identifies the medication listed in this claim.", "min": 1, "mapping": [ { "identity": "PHARMACY-CLAIMS", "map": "NDC" } ] }, { "id": "Claim.item.service.coding.display", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Claim.item.service.coding.display", "definition": "The drug/medication NDC description." }, { "id": "Claim.item.service.coding.userSelected", "path": "Claim.item.service.coding.userSelected", "max": "0" }, { "id": "Claim.item.service.text", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-translatable", "valueBoolean": true } ], "path": "Claim.item.service.text", "max": "0" }, { "id": "Claim.item.modifier", "path": "Claim.item.modifier", "max": "0" }, { "id": "Claim.item.programCode", "path": "Claim.item.programCode", "max": "0" }, { "id": "Claim.item.servicedDate:servicedDate", "path": "Claim.item.servicedDate", "sliceName": "servicedDate", "definition": "The date when the medication was dispensed.", "min": 1, "type": [ { "code": "date" } ], "mustSupport": true, "mapping": [ { "identity": "PHARMACY-CLAIMS", "map": "DATE_FILLED" } ] }, { "id": "Claim.item.location[x]", "path": "Claim.item.location[x]", "max": "0" }, { "id": "Claim.item.quantity:quantity", "path": "Claim.item.quantity", "sliceName": "quantity", "short": "The quantity dispensed.", "definition": "The quantity dispensed for this medication which must include the unit of measure.", "min": 1, "mustSupport": true, "mapping": [ { "identity": "PHARMACY-CLAIMS", "map": "DISPENSED_QTY" } ] }, { "id": "Claim.item.quantity:quantity.id", "path": "Claim.item.quantity.id", "max": "0" }, { "id": "Claim.item.quantity:quantity.value", "path": "Claim.item.quantity.value", "definition": "The value of quantity dispensed.", "min": 1, "mapping": [ { "identity": "PHARMACY-CLAIMS", "map": "DISPENSEND_QTY" } ] }, { "id": "Claim.item.quantity:quantity.system", "path": "Claim.item.quantity.system", "fixedUri": "http://unitsofmeasure.org" }, { "id": "Claim.item.quantity:quantity.code", "path": "Claim.item.quantity.code", "definition": "A computer processable form of the unit definied in http://unitsofmeasure.org e.g. TAB" }, { "id": "Claim.item.unitPrice", "path": "Claim.item.unitPrice", "max": "0" }, { "id": "Claim.item.factor", "path": "Claim.item.factor", "max": "0" }, { "id": "Claim.item.net", "path": "Claim.item.net", "max": "0" }, { "id": "Claim.item.udi", "path": "Claim.item.udi", "max": "0" }, { "id": "Claim.item.bodySite", "path": "Claim.item.bodySite", "max": "0" }, { "id": "Claim.item.subSite", "path": "Claim.item.subSite", "max": "0" }, { "id": "Claim.item.encounter", "path": "Claim.item.encounter", "max": "0" }, { "id": "Claim.item.detail", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-explicit-type-name", "valueString": "Detail" } ], "path": "Claim.item.detail", "max": "0" }, { "id": "Claim.total", "path": "Claim.total", "max": "0" } ] } }