{ "description": null, "_filename": "NHSDigital-Claim.StructureDefinition.json", "package_name": "uk.nhsdigital.medicines.r4", "date": null, "derivation": "constraint", "publisher": null, "fhirVersion": "4.0.1", "name": "NHSDigital-Claim", "mapping": [ { "uri": "http://hl7.org/fhir/workflow", "name": "Workflow Pattern", "identity": "workflow" }, { "uri": "http://hl7.org/fhir/fivews", "name": "FiveWs Pattern Mapping", "identity": "w5" }, { "uri": "http://hl7.org/v3", "name": "RIM Mapping", "identity": "rim" } ], "abstract": false, "type": "Claim", "experimental": null, "resourceType": "StructureDefinition", "title": null, "package_version": "2.1.12-alpha", "status": "draft", "id": "38501401-e2bc-4abb-972c-220471061b32", "kind": "resource", "url": "https://fhir.nhs.uk/StructureDefinition/NHSDigital-Claim", "version": null, "differential": { "element": [ { "id": "Claim.provider", "path": "Claim.provider", "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.nhs.uk/StructureDefinition/NHSDigital-PractitionerRole" ] } ] }, { "id": "Claim.prescription", "min": 1, "path": "Claim.prescription" }, { "id": "Claim.prescription.extension", "path": "Claim.prescription.extension", "slicing": { "rules": "open", "discriminator": [ { "path": "url", "type": "value" } ] } }, { "id": "Claim.prescription.extension:groupIdentifier", "max": "1", "min": 1, "path": "Claim.prescription.extension", "type": [ { "code": "Extension", "profile": [ "https://fhir.nhs.uk/StructureDefinition/Extension-DM-GroupIdentifier" ] } ], "sliceName": "groupIdentifier" }, { "id": "Claim.prescription.identifier.system", "min": 1, "path": "Claim.prescription.identifier.system", "fixedUri": "https://fhir.nhs.uk/Id/prescription-order-item-number" }, { "id": "Claim.prescription.identifier.value", "min": 1, "path": "Claim.prescription.identifier.value" }, { "id": "Claim.originalPrescription.extension", "path": "Claim.originalPrescription.extension", "slicing": { "rules": "open", "discriminator": [ { "path": "url", "type": "value" } ] } }, { "id": "Claim.originalPrescription.extension:groupIdentifier", "max": "1", "min": 1, "path": "Claim.originalPrescription.extension", "type": [ { "code": "Extension", "profile": [ "https://fhir.nhs.uk/StructureDefinition/Extension-DM-GroupIdentifier" ] } ], "sliceName": "groupIdentifier" }, { "id": "Claim.originalPrescription.identifier.system", "min": 1, "path": "Claim.originalPrescription.identifier.system" }, { "id": "Claim.originalPrescription.identifier.value", "min": 1, "path": "Claim.originalPrescription.identifier.value" }, { "id": "Claim.item.extension", "path": "Claim.item.extension", "slicing": { "rules": "open", "discriminator": [ { "path": "url", "type": "value" } ] } }, { "id": "Claim.item.extension:lineItemIdentifier", "max": "1", "min": 1, "path": "Claim.item.extension", "type": [ { "code": "Extension", "profile": [ "https://fhir.nhs.uk/StructureDefinition/Extension-DM-SuppliedItemIdentifier" ] } ], "short": "UUID for HL7v3 Message", "sliceName": "lineItemIdentifier", "definition": "SuppliedLineItem.id" }, { "id": "Claim.item.extension:prescriptionStatus", "max": "1", "min": 1, "path": "Claim.item.extension", "type": [ { "code": "Extension", "profile": [ "https://fhir.nhs.uk/StructureDefinition/Extension-EPS-TaskBusinessStatus" ] } ], "sliceName": "prescriptionStatus" }, { "id": "Claim.item.extension:prescriptionStatusReasson", "max": "1", "min": 0, "path": "Claim.item.extension", "type": [ { "code": "Extension", "profile": [ "https://fhir.nhs.uk/StructureDefinition/Extension-EPS-TaskBusinessStatusReason" ] } ], "sliceName": "prescriptionStatusReasson" }, { "id": "Claim.item.productOrService", "path": "Claim.item.productOrService", "binding": { "strength": "required", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode", "description": "DMD Medication Code" } }, { "id": "Claim.item.modifier", "path": "Claim.item.modifier", "binding": { "strength": "required", "valueSet": "https://fhir.nhs.uk/ValueSet/DM-medicationdispense-type", "description": "Prescription status" } }, { "id": "Claim.item.programCode", "max": "1", "min": 1, "path": "Claim.item.programCode", "short": "PrescriptionChargeExemption", "binding": { "strength": "extensible", "valueSet": "https://fhir.nhs.uk/ValueSet/DM-prescription-charge-exemption", "description": "Prescription Charge Exemption" }, "definition": "Describes possible reasons for someone not having to pay prescription charges." }, { "id": "Claim.item.detail.productOrService", "path": "Claim.item.detail.productOrService", "binding": { "strength": "required", "valueSet": "https://fhir.hl7.org.uk/ValueSet/UKCore-MedicationCode", "description": "DMD Medication Code" } }, { "id": "Claim.item.detail.programCode", "path": "Claim.item.detail.programCode", "short": "Dispensing Endorsement and Charge Payment", "slicing": { "rules": "open", "discriminator": [ { "path": "coding.system", "type": "value" } ] }, "definition": "Dispensing Endorsement - Details of the endorsement(s) to support the claim for this medication item. \r\n\r\nCharge Payment - Details on whether a prescription charge was paid for the medication treatment." }, { "id": "Claim.item.detail.programCode:exemptionEvidence", "max": "1", "path": "Claim.item.detail.programCode", "binding": { "strength": "extensible", "valueSet": "https://fhir.nhs.uk/ValueSet/DM-vs-exemption-evidence" }, "sliceName": "exemptionEvidence" }, { "id": "Claim.item.detail.programCode:exemptionEvidence.coding.system", "path": "Claim.item.detail.programCode.coding.system", "fixedUri": "https://fhir.nhs.uk/CodeSystem/DM-exemption-evidence" }, { "id": "Claim.item.detail.programCode:prescriptionCharge", "max": "1", "path": "Claim.item.detail.programCode", "binding": { "strength": "extensible", "valueSet": "https://fhir.nhs.uk/ValueSet/DM-vs-prescription-charge" }, "sliceName": "prescriptionCharge" }, { "id": "Claim.item.detail.programCode:prescriptionCharge.coding.system", "path": "Claim.item.detail.programCode.coding.system", "fixedUri": "https://fhir.nhs.uk/CodeSystem/DM-prescription-charge" }, { "id": "Claim.item.detail.programCode:dispensingEndorsement", "max": "1", "path": "Claim.item.detail.programCode", "binding": { "strength": "extensible", "valueSet": "https://fhir.nhs.uk/ValueSet/DM-dispensing-endorsement", "description": "Program specific reason codes" }, "sliceName": "dispensingEndorsement" }, { "id": "Claim.item.detail.programCode:dispensingEndorsement.coding.system", "path": "Claim.item.detail.programCode.coding.system", "fixedUri": "https://fhir.nhs.uk/CodeSystem/medicationdispense-endorsement" }, { "id": "Claim.item.detail.quantity.extension", "path": "Claim.item.detail.quantity.extension", "slicing": { "rules": "open", "discriminator": [ { "path": "url", "type": "value" } ] } }, { "id": "Claim.item.detail.quantity.extension:runningTotal", "max": "1", "path": "Claim.item.detail.quantity.extension", "type": [ { "code": "Extension", "profile": [ "https://fhir.nhs.uk/StructureDefinition/Extension-DM-RunningTotal" ] } ], "sliceName": "runningTotal" } ] }, "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Claim" }