description: Profile of Claim for decision support/quality metrics. Defines the core set of elements and extensions for quality rule and measure authors.
package_name: hl7.fhir.us.qicore
derivation: constraint
name: QICore-Claim
type: Claim
elements:
  patient:
    isModifier: false
    refers: ['http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient']
    type: Reference
    mustSupport: true
    index: 0
  diagnosis:
    type: BackboneElement
    isModifier: false
    mustSupport: false
    array: true
    index: 12
    elements:
      type: {isModifier: false, type: CodeableConcept, mustSupport: false, array: true, index: 13}
  item:
    min: 1
    isModifier: false
    index: 20
    type: BackboneElement
    mustSupport: true
    array: true
    elements:
      service: {isModifier: false, type: CodeableConcept, mustSupport: true, index: 21}
      serviced:
        isModifier: false
        mustSupport: true
        choices: []
        index: 23
      locationReference:
        isModifier: false
        refers: ['http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-location']
        type: Reference
        mustSupport: false
        index: 24
      udi:
        isModifier: false
        refers: ['http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device']
        type: Reference
        mustSupport: false
        array: true
        index: 25
      encounter:
        isModifier: false
        refers: ['http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-encounter']
        type: Reference
        mustSupport: true
        array: true
        index: 26
      detail:
        type: BackboneElement
        isModifier: false
        mustSupport: false
        array: true
        index: 27
        elements:
          udi:
            isModifier: false
            refers: ['http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device']
            type: Reference
            mustSupport: false
            array: true
            index: 28
          subDetail:
            type: BackboneElement
            isModifier: false
            mustSupport: false
            array: true
            index: 29
            elements:
              udi:
                isModifier: false
                refers: ['http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-device']
                type: Reference
                mustSupport: false
                index: 30
    required: [serviced, service]
  created: {type: dateTime, isModifier: false, mustSupport: true, index: 1}
  procedure:
    type: BackboneElement
    isModifier: false
    mustSupport: true
    array: true
    index: 14
    elements:
      sequence: {type: positiveInt, isModifier: false, mustSupport: true, index: 15}
      date: {type: dateTime, isModifier: false, mustSupport: true, index: 16}
      procedure:
        isModifier: false
        mustSupport: true
        choices: []
        index: 18
    required: [sequence, procedure]
  referral:
    isModifier: false
    refers: ['http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-referralrequest']
    type: Reference
    mustSupport: false
    index: 6
  payee:
    type: BackboneElement
    isModifier: false
    mustSupport: false
    index: 4
    elements:
      party:
        isModifier: false
        refers: ['http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization', 'http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-patient', 'http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner', 'http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-relatedperson']
        type: Reference
        mustSupport: false
        index: 5
  prescription:
    isModifier: false
    refers: ['http://hl7.org/fhir/StructureDefinition/VisionPrescription', 'http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-medicationrequest']
    type: Reference
    mustSupport: true
    index: 3
  hospitalization: {type: Period, isModifier: false, mustSupport: true, index: 19}
  information:
    type: BackboneElement
    isModifier: false
    mustSupport: false
    array: true
    index: 9
    elements:
      category: {isModifier: false, type: CodeableConcept, mustSupport: true, index: 10}
      code: {isModifier: false, type: CodeableConcept, mustSupport: true, index: 11}
    required: [category]
  provider:
    isModifier: false
    refers: ['http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner']
    type: Reference
    mustSupport: true
    index: 2
  careTeam:
    type: BackboneElement
    isModifier: false
    mustSupport: false
    array: true
    index: 7
    elements:
      provider:
        isModifier: false
        refers: ['http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-organization', 'http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-practitioner']
        type: Reference
        mustSupport: false
        index: 8
    required: [provider]
package_version: 3.2.0
class: profile
kind: resource
url: http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim
base: http://hl7.org/fhir/StructureDefinition/Claim
version: 3.2.0
required: [created, prescription, provider, item, patient]