{
  "resourceType" : "Bundle",
  "id" : "ClaimResponseBundle-enhancement-example-01",
  "meta" : {
    "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/ClaimResponseBundle"],
    "security" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/v3-Confidentiality",
      "code" : "V",
      "display" : "very restricted"
    }]
  },
  "identifier" : {
    "value" : "bc3c6c57-2053-4d0e-ac40-139ccccff645"
  },
  "type" : "collection",
  "timestamp" : "2025-03-13T15:32:26.605+05:30",
  "entry" : [{
    "fullUrl" : "urn:uuid:b56a1f6e-c46e-4d06-95e4-aeaf9ecf5562",
    "resource" : {
      "resourceType" : "ClaimResponse",
      "id" : "b56a1f6e-c46e-4d06-95e4-aeaf9ecf5562",
      "meta" : {
        "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/ClaimResponse"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClaimResponse_b56a1f6e-c46e-4d06-95e4-aeaf9ecf5562\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse b56a1f6e-c46e-4d06-95e4-aeaf9ecf5562</b></p><a name=\"b56a1f6e-c46e-4d06-95e4-aeaf9ecf5562\"> </a><a name=\"hcb56a1f6e-c46e-4d06-95e4-aeaf9ecf5562\"> </a><a name=\"b56a1f6e-c46e-4d06-95e4-aeaf9ecf5562-hi-IN\"> </a><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 737481003}\">Inpatient care management (procedure)</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-d16be93a-0881-422f-a9f1-b49808449395\">Patient</a></p><p><b>created</b>: 2025-03-07 15:32:26+0530</p><p><b>insurer</b>: <a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-344de91a-0662-43a5-b88e-c2cd00887244\">Organization</a></p><p><b>requestor</b>: <a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-de3a873e-3d69-44de-bf2b-4cb18384b07d\">Organization</a></p><p><b>request</b>: <a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-cd1e58c5-08fa-4cac-8a46-c12d26d57f21\">Claim-enhancement</a></p><p><b>outcome</b>: Processing Complete</p><p><b>disposition</b>: The enclosed services are authorized for your provision within 30 days of this notice.</p><p><b>preAuthRef</b>: 98765432</p><p><b>preAuthPeriod</b>: 2025-03-12 15:32:26+0530 --&gt; 2025-04-12 15:32:26+0530</p><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 1</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted Amount</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>10000</td><td>Indian rupee</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligpercent}\">Eligible %</span></p><p><b>reason</b>: <span title=\"Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-adjudication-reason covered}\">Product or Service requested is covered by the policy.</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>10000</td><td>Indian rupee</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 2</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted Amount</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>10000</td><td>Indian rupee</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligpercent}\">Eligible %</span></p><p><b>reason</b>: <span title=\"Codes:{https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-adjudication-reason covered}\">Product or Service requested is covered by the policy.</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>10000</td><td>Indian rupee</td></tr></table></blockquote></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted Amount</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>20000</td><td>Indian rupee</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligpercent}\">Eligible %</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>20000</td><td>Indian rupee</td></tr></table></blockquote><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-02461bcb-aeaa-45ad-b24c-66b94272103c\">Coverage</a></td></tr></table></div>"
      },
      "status" : "active",
      "type" : {
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "737481003",
          "display" : "Inpatient care management (procedure)"
        }]
      },
      "use" : "preauthorization",
      "patient" : {
        "reference" : "urn:uuid:d16be93a-0881-422f-a9f1-b49808449395",
        "display" : "Patient"
      },
      "created" : "2025-03-07T15:32:26.605+05:30",
      "insurer" : {
        "reference" : "urn:uuid:344de91a-0662-43a5-b88e-c2cd00887244",
        "display" : "Organization"
      },
      "requestor" : {
        "reference" : "urn:uuid:de3a873e-3d69-44de-bf2b-4cb18384b07d",
        "display" : "Organization"
      },
      "request" : {
        "reference" : "urn:uuid:cd1e58c5-08fa-4cac-8a46-c12d26d57f21",
        "display" : "Claim-enhancement"
      },
      "outcome" : "complete",
      "disposition" : "The enclosed services are authorized for your provision within 30 days of this notice.",
      "preAuthRef" : "98765432",
      "preAuthPeriod" : {
        "start" : "2025-03-12T15:32:26.605+05:30",
        "end" : "2025-04-12T15:32:26.605+05:30"
      },
      "item" : [{
        "itemSequence" : 1,
        "adjudication" : [{
          "category" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
              "code" : "submitted",
              "display" : "Submitted Amount"
            }]
          },
          "amount" : {
            "value" : 10000,
            "currency" : "INR"
          }
        },
        {
          "category" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
              "code" : "eligpercent",
              "display" : "Eligible %"
            }]
          },
          "reason" : {
            "coding" : [{
              "system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-adjudication-reason",
              "code" : "covered",
              "display" : "Product or Service requested is covered by the policy."
            }]
          },
          "amount" : {
            "value" : 10000,
            "currency" : "INR"
          }
        }]
      },
      {
        "itemSequence" : 2,
        "adjudication" : [{
          "category" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
              "code" : "submitted",
              "display" : "Submitted Amount"
            }]
          },
          "amount" : {
            "value" : 10000,
            "currency" : "INR"
          }
        },
        {
          "category" : {
            "coding" : [{
              "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
              "code" : "eligpercent",
              "display" : "Eligible %"
            }]
          },
          "reason" : {
            "coding" : [{
              "system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-adjudication-reason",
              "code" : "covered",
              "display" : "Product or Service requested is covered by the policy."
            }]
          },
          "amount" : {
            "value" : 10000,
            "currency" : "INR"
          }
        }]
      }],
      "total" : [{
        "category" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
            "code" : "submitted",
            "display" : "Submitted Amount"
          }]
        },
        "amount" : {
          "value" : 20000,
          "currency" : "INR"
        }
      },
      {
        "category" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/adjudication",
            "code" : "eligpercent",
            "display" : "Eligible %"
          }]
        },
        "amount" : {
          "value" : 20000,
          "currency" : "INR"
        }
      }],
      "insurance" : [{
        "sequence" : 1,
        "focal" : true,
        "coverage" : {
          "reference" : "urn:uuid:02461bcb-aeaa-45ad-b24c-66b94272103c",
          "display" : "Coverage"
        }
      }]
    }
  },
  {
    "fullUrl" : "urn:uuid:cd1e58c5-08fa-4cac-8a46-c12d26d57f21",
    "resource" : {
      "resourceType" : "Claim",
      "id" : "cd1e58c5-08fa-4cac-8a46-c12d26d57f21",
      "meta" : {
        "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_cd1e58c5-08fa-4cac-8a46-c12d26d57f21\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim cd1e58c5-08fa-4cac-8a46-c12d26d57f21</b></p><a name=\"cd1e58c5-08fa-4cac-8a46-c12d26d57f21\"> </a><a name=\"hccd1e58c5-08fa-4cac-8a46-c12d26d57f21\"> </a><a name=\"cd1e58c5-08fa-4cac-8a46-c12d26d57f21-hi-IN\"> </a><p><b>identifier</b>: 7612345, 96785763</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 737481003}\">Inpatient care management (procedure)</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-d16be93a-0881-422f-a9f1-b49808449395\">Patient</a></p><p><b>billablePeriod</b>: 2025-03-07 11:01:00+0500 --&gt; 2025-04-07 11:01:00+0500</p><p><b>created</b>: 2025-03-13 11:01:00+0500</p><p><b>insurer</b>: <a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-344de91a-0662-43a5-b88e-c2cd00887244\">Organization</a></p><p><b>provider</b>: <a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-de3a873e-3d69-44de-bf2b-4cb18384b07d\">Organization</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><h3>Relateds</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Claim</b></td><td><b>Relationship</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-66748b1f-0dac-47da-9ded-d8908ef42338\">Claim-preauth</a></td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-relatedclaimrelationship prior}\">Prior Claim</span></td></tr></table><h3>CareTeams</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Provider</b></td><td><b>Role</b></td><td><b>Qualification</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-04c47993-b2bc-4912-849b-65ee63883f2e\">Practitioner</a></td><td><span title=\"Codes:{http://snomed.info/sct 223366009}\">Healthcare professional (occupation)</span></td><td><span title=\"Codes:{http://snomed.info/sct 394658006}\">Clinical specialty (qualifier value)</span></td></tr></table><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://hl7.org/fhir/sid/icd-10 I46.9}\">Cardiac arrest, unspecified</span></td><td><span title=\"Codes:{http://snomed.info/sct 89100005}\">Final diagnosis (discharge) (contextual qualifier) (qualifier value)</span></td></tr></table><blockquote><p><b>procedure</b></p><p><b>sequence</b>: 1</p><p><b>procedure</b>: <span title=\"Codes:{http://snomed.info/sct 77343006}\">Angiography</span></p></blockquote><blockquote><p><b>procedure</b></p><p><b>sequence</b>: 2</p><p><b>procedure</b>: <span title=\"Codes:{http://snomed.info/sct 418285008}\">Angioplasty of blood vessel</span></p></blockquote><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td><td><b>PreAuthRef</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-02461bcb-aeaa-45ad-b24c-66b94272103c\">Coverage</a></td><td>123456</td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>careTeamSequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://snomed.info/sct 77343006}\">Angiography</span></p><p><b>serviced</b>: 2023-12-09</p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>10000</td><td>Indian rupee</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>10000</td><td>Indian rupee</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>careTeamSequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://snomed.info/sct 418285008}\">Angioplasty of blood vessel</span></p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>10000</td><td>Indian rupee</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>10000</td><td>Indian rupee</td></tr></table></blockquote><h3>Totals</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>20000</td><td>Indian rupee</td></tr></table></div>"
      },
      "identifier" : [{
        "value" : "7612345"
      },
      {
        "value" : "96785763"
      }],
      "status" : "active",
      "type" : {
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "737481003",
          "display" : "Inpatient care management (procedure)"
        }]
      },
      "use" : "preauthorization",
      "patient" : {
        "reference" : "urn:uuid:d16be93a-0881-422f-a9f1-b49808449395",
        "display" : "Patient"
      },
      "billablePeriod" : {
        "start" : "2025-03-07T11:01:00+05:00",
        "end" : "2025-04-07T11:01:00+05:00"
      },
      "created" : "2025-03-13T11:01:00+05:00",
      "insurer" : {
        "reference" : "urn:uuid:344de91a-0662-43a5-b88e-c2cd00887244",
        "display" : "Organization"
      },
      "provider" : {
        "reference" : "urn:uuid:de3a873e-3d69-44de-bf2b-4cb18384b07d",
        "display" : "Organization"
      },
      "priority" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
          "code" : "normal"
        }]
      },
      "related" : [{
        "claim" : {
          "reference" : "urn:uuid:66748b1f-0dac-47da-9ded-d8908ef42338",
          "display" : "Claim-preauth"
        },
        "relationship" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/ex-relatedclaimrelationship",
            "code" : "prior",
            "display" : "Prior Claim"
          }]
        }
      }],
      "careTeam" : [{
        "sequence" : 1,
        "provider" : {
          "reference" : "urn:uuid:04c47993-b2bc-4912-849b-65ee63883f2e",
          "display" : "Practitioner"
        },
        "role" : {
          "coding" : [{
            "system" : "http://snomed.info/sct",
            "code" : "223366009",
            "display" : "Healthcare professional (occupation)"
          }]
        },
        "qualification" : {
          "coding" : [{
            "system" : "http://snomed.info/sct",
            "code" : "394658006",
            "display" : "Clinical specialty (qualifier value)"
          }]
        }
      }],
      "diagnosis" : [{
        "sequence" : 1,
        "diagnosisCodeableConcept" : {
          "coding" : [{
            "system" : "http://hl7.org/fhir/sid/icd-10",
            "code" : "I46.9",
            "display" : "Cardiac arrest, unspecified"
          }]
        },
        "type" : [{
          "coding" : [{
            "system" : "http://snomed.info/sct",
            "code" : "89100005",
            "display" : "Final diagnosis (discharge) (contextual qualifier) (qualifier value)"
          }]
        }]
      }],
      "procedure" : [{
        "sequence" : 1,
        "procedureCodeableConcept" : {
          "coding" : [{
            "system" : "http://snomed.info/sct",
            "code" : "77343006",
            "display" : "Angiography"
          }]
        }
      },
      {
        "sequence" : 2,
        "procedureCodeableConcept" : {
          "coding" : [{
            "system" : "http://snomed.info/sct",
            "code" : "418285008",
            "display" : "Angioplasty of blood vessel"
          }]
        }
      }],
      "insurance" : [{
        "sequence" : 1,
        "focal" : true,
        "coverage" : {
          "reference" : "urn:uuid:02461bcb-aeaa-45ad-b24c-66b94272103c",
          "display" : "Coverage"
        },
        "preAuthRef" : ["123456"]
      }],
      "item" : [{
        "sequence" : 1,
        "careTeamSequence" : [1],
        "productOrService" : {
          "coding" : [{
            "system" : "http://snomed.info/sct",
            "code" : "77343006",
            "display" : "Angiography"
          }]
        },
        "servicedDate" : "2023-12-09",
        "unitPrice" : {
          "value" : 10000,
          "currency" : "INR"
        },
        "net" : {
          "value" : 10000,
          "currency" : "INR"
        }
      },
      {
        "sequence" : 2,
        "careTeamSequence" : [1],
        "productOrService" : {
          "coding" : [{
            "system" : "http://snomed.info/sct",
            "code" : "418285008",
            "display" : "Angioplasty of blood vessel"
          }]
        },
        "unitPrice" : {
          "value" : 10000,
          "currency" : "INR"
        },
        "net" : {
          "value" : 10000,
          "currency" : "INR"
        }
      }],
      "total" : {
        "value" : 20000,
        "currency" : "INR"
      }
    }
  },
  {
    "fullUrl" : "urn:uuid:d16be93a-0881-422f-a9f1-b49808449395",
    "resource" : {
      "resourceType" : "Patient",
      "id" : "d16be93a-0881-422f-a9f1-b49808449395",
      "meta" : {
        "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_d16be93a-0881-422f-a9f1-b49808449395\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient d16be93a-0881-422f-a9f1-b49808449395</b></p><a name=\"d16be93a-0881-422f-a9f1-b49808449395\"> </a><a name=\"hcd16be93a-0881-422f-a9f1-b49808449395\"> </a><a name=\"d16be93a-0881-422f-a9f1-b49808449395-hi-IN\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Adarsh Agrawal Male, DoB: 1981-01-12 ( Adhaar number: 7225-4829-5255)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\"><a href=\"tel:+919818512600\">+919818512600</a></td></tr></table></div>"
      },
      "identifier" : [{
        "type" : {
          "coding" : [{
            "system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code",
            "code" : "ADN",
            "display" : "Adhaar number"
          }]
        },
        "system" : "https://uidai.gov.in/",
        "value" : "7225-4829-5255"
      }],
      "name" : [{
        "text" : "Adarsh Agrawal"
      }],
      "telecom" : [{
        "system" : "phone",
        "value" : "+919818512600",
        "use" : "home"
      }],
      "gender" : "male",
      "birthDate" : "1981-01-12"
    }
  },
  {
    "fullUrl" : "urn:uuid:344de91a-0662-43a5-b88e-c2cd00887244",
    "resource" : {
      "resourceType" : "Organization",
      "id" : "344de91a-0662-43a5-b88e-c2cd00887244",
      "meta" : {
        "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_344de91a-0662-43a5-b88e-c2cd00887244\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization 344de91a-0662-43a5-b88e-c2cd00887244</b></p><a name=\"344de91a-0662-43a5-b88e-c2cd00887244\"> </a><a name=\"hc344de91a-0662-43a5-b88e-c2cd00887244\"> </a><a name=\"344de91a-0662-43a5-b88e-c2cd00887244-hi-IN\"> </a><p><b>identifier</b>: Registry of Hospitals in Network of Insurance (ROHINI) ID/4567878</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type ins}\">Insurance Company</span></p><p><b>name</b>: XYZ Insurance Co. Ltd.</p><p><b>telecom</b>: <a href=\"tel:+9124326341234\">+91 243 2634 1234</a>, <a href=\"mailto:contact@xyz.org\">contact@xyz.org</a></p></div>"
      },
      "identifier" : [{
        "type" : {
          "coding" : [{
            "system" : "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code",
            "code" : "ROHINI",
            "display" : "Registry of Hospitals in Network of Insurance (ROHINI) ID"
          }]
        },
        "system" : "https://rohini.iib.gov.in/",
        "value" : "4567878"
      }],
      "type" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
          "code" : "ins",
          "display" : "Insurance Company"
        }]
      }],
      "name" : "XYZ Insurance Co. Ltd.",
      "telecom" : [{
        "system" : "phone",
        "value" : "+91 243 2634 1234",
        "use" : "work"
      },
      {
        "system" : "email",
        "value" : "contact@xyz.org",
        "use" : "work"
      }]
    }
  },
  {
    "fullUrl" : "urn:uuid:de3a873e-3d69-44de-bf2b-4cb18384b07d",
    "resource" : {
      "resourceType" : "Organization",
      "id" : "de3a873e-3d69-44de-bf2b-4cb18384b07d",
      "meta" : {
        "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_de3a873e-3d69-44de-bf2b-4cb18384b07d\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization de3a873e-3d69-44de-bf2b-4cb18384b07d</b></p><a name=\"de3a873e-3d69-44de-bf2b-4cb18384b07d\"> </a><a name=\"hcde3a873e-3d69-44de-bf2b-4cb18384b07d\"> </a><a name=\"de3a873e-3d69-44de-bf2b-4cb18384b07d-hi-IN\"> </a><p><b>identifier</b>: Provider number/45675454</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: XYZ Hospital Co. Ltd.</p><p><b>telecom</b>: <a href=\"tel:+9124326341278\">+91 243 2634 1278</a>, <a href=\"mailto:contact@xyz.org\">contact@xyz.org</a></p></div>"
      },
      "identifier" : [{
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "PRN",
            "display" : "Provider number"
          }]
        },
        "system" : "https://facility.ndhm.gov.in",
        "value" : "45675454"
      }],
      "type" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/organization-type",
          "code" : "prov",
          "display" : "Healthcare Provider"
        }]
      }],
      "name" : "XYZ Hospital Co. Ltd.",
      "telecom" : [{
        "system" : "phone",
        "value" : "+91 243 2634 1278",
        "use" : "work"
      },
      {
        "system" : "email",
        "value" : "contact@xyz.org",
        "use" : "work"
      }]
    }
  },
  {
    "fullUrl" : "urn:uuid:04c47993-b2bc-4912-849b-65ee63883f2e",
    "resource" : {
      "resourceType" : "Practitioner",
      "id" : "04c47993-b2bc-4912-849b-65ee63883f2e",
      "meta" : {
        "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_04c47993-b2bc-4912-849b-65ee63883f2e\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner 04c47993-b2bc-4912-849b-65ee63883f2e</b></p><a name=\"04c47993-b2bc-4912-849b-65ee63883f2e\"> </a><a name=\"hc04c47993-b2bc-4912-849b-65ee63883f2e\"> </a><a name=\"04c47993-b2bc-4912-849b-65ee63883f2e-hi-IN\"> </a><p><b>identifier</b>: Medical License number/21-1521-3828-3227</p><p><b>name</b>: Dr. Aayush Agrawal</p></div>"
      },
      "identifier" : [{
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code" : "MD",
            "display" : "Medical License number"
          }]
        },
        "system" : "https://doctor.ndhm.gov.in",
        "value" : "21-1521-3828-3227"
      }],
      "name" : [{
        "text" : "Dr. Aayush Agrawal"
      }]
    }
  },
  {
    "fullUrl" : "urn:uuid:02461bcb-aeaa-45ad-b24c-66b94272103c",
    "resource" : {
      "resourceType" : "Coverage",
      "id" : "02461bcb-aeaa-45ad-b24c-66b94272103c",
      "meta" : {
        "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Coverage"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_02461bcb-aeaa-45ad-b24c-66b94272103c\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage 02461bcb-aeaa-45ad-b24c-66b94272103c</b></p><a name=\"02461bcb-aeaa-45ad-b24c-66b94272103c\"> </a><a name=\"hc02461bcb-aeaa-45ad-b24c-66b94272103c\"> </a><a name=\"02461bcb-aeaa-45ad-b24c-66b94272103c-hi-IN\"> </a><p><b>identifier</b>: <code>https://xyzinsurance.in/policynumber/</code>/235037120</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode HIP}\">health insurance plan policy</span></p><p><b>subscriber</b>: <a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-d16be93a-0881-422f-a9f1-b49808449395\">Patient</a></p><p><b>subscriberId</b>: ABC123456BI007</p><p><b>beneficiary</b>: <a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-d16be93a-0881-422f-a9f1-b49808449395\">Patient</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>period</b>: ?? --&gt; 2026-03-17</p><p><b>payor</b>: <a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-344de91a-0662-43a5-b88e-c2cd00887244\">Organization</a></p></div>"
      },
      "identifier" : [{
        "system" : "https://xyzinsurance.in/policynumber/",
        "value" : "235037120"
      }],
      "status" : "active",
      "type" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code" : "HIP",
          "display" : "health insurance plan policy"
        }]
      },
      "subscriber" : {
        "reference" : "urn:uuid:d16be93a-0881-422f-a9f1-b49808449395",
        "display" : "Patient"
      },
      "subscriberId" : "ABC123456BI007",
      "beneficiary" : {
        "reference" : "urn:uuid:d16be93a-0881-422f-a9f1-b49808449395",
        "display" : "Patient"
      },
      "relationship" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
          "code" : "self"
        }]
      },
      "period" : {
        "end" : "2026-03-17"
      },
      "payor" : [{
        "reference" : "urn:uuid:344de91a-0662-43a5-b88e-c2cd00887244",
        "display" : "Organization"
      }]
    }
  },
  {
    "fullUrl" : "urn:uuid:66748b1f-0dac-47da-9ded-d8908ef42338",
    "resource" : {
      "resourceType" : "Claim",
      "id" : "66748b1f-0dac-47da-9ded-d8908ef42338",
      "meta" : {
        "profile" : ["https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_66748b1f-0dac-47da-9ded-d8908ef42338\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim 66748b1f-0dac-47da-9ded-d8908ef42338</b></p><a name=\"66748b1f-0dac-47da-9ded-d8908ef42338\"> </a><a name=\"hc66748b1f-0dac-47da-9ded-d8908ef42338\"> </a><a name=\"66748b1f-0dac-47da-9ded-d8908ef42338-hi-IN\"> </a><p><b>identifier</b>: 7612345, 96785763</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://snomed.info/sct 737481003}\">Inpatient care management (procedure)</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-d16be93a-0881-422f-a9f1-b49808449395\">Patient</a></p><p><b>billablePeriod</b>: 2025-03-07 11:01:00+0500 --&gt; 2025-04-07 11:01:00+0500</p><p><b>created</b>: 2023-12-11 11:01:00+0500</p><p><b>insurer</b>: <a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-344de91a-0662-43a5-b88e-c2cd00887244\">Organization</a></p><p><b>provider</b>: <a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-de3a873e-3d69-44de-bf2b-4cb18384b07d\">Organization</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><h3>CareTeams</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Provider</b></td><td><b>Role</b></td><td><b>Qualification</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-04c47993-b2bc-4912-849b-65ee63883f2e\">Practitioner</a></td><td><span title=\"Codes:{http://snomed.info/sct 223366009}\">Healthcare professional (occupation)</span></td><td><span title=\"Codes:{http://snomed.info/sct 394658006}\">Clinical specialty (qualifier value)</span></td></tr></table><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://hl7.org/fhir/sid/icd-10 I46.9}\">Cardiac arrest, unspecified</span></td><td><span title=\"Codes:{http://snomed.info/sct 89100005}\">Final diagnosis (discharge) (contextual qualifier) (qualifier value)</span></td></tr></table><blockquote><p><b>procedure</b></p><p><b>sequence</b>: 1</p><p><b>procedure</b>: <span title=\"Codes:{http://snomed.info/sct 77343006}\">Angiography</span></p></blockquote><blockquote><p><b>procedure</b></p><p><b>sequence</b>: 2</p><p><b>procedure</b>: <span title=\"Codes:{http://snomed.info/sct 418285008}\">Angioplasty of blood vessel</span></p></blockquote><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"Bundle-ClaimResponseBundle-enhancement-example-01.html#urn-uuid-02461bcb-aeaa-45ad-b24c-66b94272103c\">Coverage</a></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>careTeamSequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://snomed.info/sct 77343006}\">Angiography</span></p><p><b>serviced</b>: 2023-12-09</p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>10000</td><td>Indian rupee</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>10000</td><td>Indian rupee</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>careTeamSequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://snomed.info/sct 418285008}\">Angioplasty of blood vessel</span></p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>40000</td><td>Indian rupee</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>40000</td><td>Indian rupee</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 3</p><p><b>careTeamSequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://snomed.info/sct 309904001}\">Intensive care unit</span></p><p><b>serviced</b>: 2023-12-11</p><p><b>quantity</b>: 10 day</p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>2000</td><td>Indian rupee</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>20000</td><td>Indian rupee</td></tr></table></blockquote><h3>Totals</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>70000</td><td>Indian rupee</td></tr></table></div>"
      },
      "identifier" : [{
        "value" : "7612345"
      },
      {
        "value" : "96785763"
      }],
      "status" : "active",
      "type" : {
        "coding" : [{
          "system" : "http://snomed.info/sct",
          "code" : "737481003",
          "display" : "Inpatient care management (procedure)"
        }]
      },
      "use" : "preauthorization",
      "patient" : {
        "reference" : "urn:uuid:d16be93a-0881-422f-a9f1-b49808449395",
        "display" : "Patient"
      },
      "billablePeriod" : {
        "start" : "2025-03-07T11:01:00+05:00",
        "end" : "2025-04-07T11:01:00+05:00"
      },
      "created" : "2023-12-11T11:01:00+05:00",
      "insurer" : {
        "reference" : "urn:uuid:344de91a-0662-43a5-b88e-c2cd00887244",
        "display" : "Organization"
      },
      "provider" : {
        "reference" : "urn:uuid:de3a873e-3d69-44de-bf2b-4cb18384b07d",
        "display" : "Organization"
      },
      "priority" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
          "code" : "normal"
        }]
      },
      "careTeam" : [{
        "sequence" : 1,
        "provider" : {
          "reference" : "urn:uuid:04c47993-b2bc-4912-849b-65ee63883f2e",
          "display" : "Practitioner"
        },
        "role" : {
          "coding" : [{
            "system" : "http://snomed.info/sct",
            "code" : "223366009",
            "display" : "Healthcare professional (occupation)"
          }]
        },
        "qualification" : {
          "coding" : [{
            "system" : "http://snomed.info/sct",
            "code" : "394658006",
            "display" : "Clinical specialty (qualifier value)"
          }]
        }
      }],
      "diagnosis" : [{
        "sequence" : 1,
        "diagnosisCodeableConcept" : {
          "coding" : [{
            "system" : "http://hl7.org/fhir/sid/icd-10",
            "code" : "I46.9",
            "display" : "Cardiac arrest, unspecified"
          }]
        },
        "type" : [{
          "coding" : [{
            "system" : "http://snomed.info/sct",
            "code" : "89100005",
            "display" : "Final diagnosis (discharge) (contextual qualifier) (qualifier value)"
          }]
        }]
      }],
      "procedure" : [{
        "sequence" : 1,
        "procedureCodeableConcept" : {
          "coding" : [{
            "system" : "http://snomed.info/sct",
            "code" : "77343006",
            "display" : "Angiography"
          }]
        }
      },
      {
        "sequence" : 2,
        "procedureCodeableConcept" : {
          "coding" : [{
            "system" : "http://snomed.info/sct",
            "code" : "418285008",
            "display" : "Angioplasty of blood vessel"
          }]
        }
      }],
      "insurance" : [{
        "sequence" : 1,
        "focal" : true,
        "coverage" : {
          "reference" : "urn:uuid:02461bcb-aeaa-45ad-b24c-66b94272103c",
          "display" : "Coverage"
        }
      }],
      "item" : [{
        "sequence" : 1,
        "careTeamSequence" : [1],
        "productOrService" : {
          "coding" : [{
            "system" : "http://snomed.info/sct",
            "code" : "77343006",
            "display" : "Angiography"
          }]
        },
        "servicedDate" : "2023-12-09",
        "unitPrice" : {
          "value" : 10000,
          "currency" : "INR"
        },
        "net" : {
          "value" : 10000,
          "currency" : "INR"
        }
      },
      {
        "sequence" : 2,
        "careTeamSequence" : [1],
        "productOrService" : {
          "coding" : [{
            "system" : "http://snomed.info/sct",
            "code" : "418285008",
            "display" : "Angioplasty of blood vessel"
          }]
        },
        "unitPrice" : {
          "value" : 40000,
          "currency" : "INR"
        },
        "net" : {
          "value" : 40000,
          "currency" : "INR"
        }
      },
      {
        "sequence" : 3,
        "careTeamSequence" : [1],
        "productOrService" : {
          "coding" : [{
            "system" : "http://snomed.info/sct",
            "code" : "309904001",
            "display" : "Intensive care unit"
          }]
        },
        "servicedDate" : "2023-12-11",
        "quantity" : {
          "value" : 10,
          "unit" : "day"
        },
        "unitPrice" : {
          "value" : 2000,
          "currency" : "INR"
        },
        "net" : {
          "value" : 20000,
          "currency" : "INR"
        }
      }],
      "total" : {
        "value" : 70000,
        "currency" : "INR"
      }
    }
  }]
}