Nphies Authorization Professional - Healthcare Financial Services IG Edition 1 v0.3.0

Healthcare Financial Services IG Edition 1 - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Nphies Authorization Professional

Official URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/professional-priorauth				Version: 0.3.0
Draft as of 2025-07-30				Computable Name: NphiesProfessionalAuthorization
Copyright/Legal: Used by permission of HL7 International, all rights reserved Creative Commons License

Nphies Professional Authorization Profile

Usages:

Refer to this Profile: Nphies Authorization Professional
Examples for this Profile: Claim/173086

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

Key Elements Table
Differential Table
Snapshot Table
Statistics/References
All

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Claim	C	0..*	NphiesAuthorizationBase	Claim, Pre-determination or Pre-authorization Constraints: BV-00002, BV-00044, BV-00054, BV-00057, BV-00137, BV-00330, BV-00453, BV-00454, BV-00365, BV-00803, BV-00804, BV-00805, BV-00806, BV-00752, BV-00771, BV-00772, BV-00773, BV-00774, BV-00775, BV-00776, BV-00777, BV-00778, BV-00779, BV-00780
id	Σ	1..1	id	Logical id of this artifact Max Length:64
meta	Σ	1..1	Meta	Metadata about the resource
profile	Σ	1..*	DP_canonical(StructureDefinition)	Profiles this resource claims to conform to
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:eligibilityResponse	S	0..1	DP_Reference_3a(Nphies CoverageEligibilityResponse)	Eligibility Response URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-eligibility-response
extension:eligibilityOffLine	S	0..1	DP_string	Eligibility Offline Reference URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-eligibility-offline-reference
extension:eligibilityOffLineDate	SC	0..1	DP_dateTime	Eligibility Offline Date URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-eligibility-offline-date Constraints: BV-00347
extension:newborn	S	0..1	boolean	Newborn URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-newborn
extension:transfer	S	0..1	boolean	Transfer URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-transfer
extension:transferAuthorizationProvider	S	0..1	DP_Reference_1or4(Nphies Provider Organization \| Nphies Practitioner)	Transfer Authorization Provider URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-transferAuthorizationProvider
extension:transferAuthorizationPeriod	S	0..1	DP_Period_2	Transfer Authorization Period URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-transferAuthorizationPeriod
extension:transferAuthorizationNumber	S	0..1	DP_string	Transfer Authorization Number URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-transferAuthorizationNumber
extension:encounter		1..1	(Complex)	Encounter URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-encounter
extension		0..0
url		1..1	uri	"http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-encounter"
value[x]		1..1	DP_Reference_1(Nphies Encounter AMB (Auth) \| Nphies Encounter EMER (Auth) \| Nphies Encounter HH (Auth) \| Nphies Encounter VR (Auth))	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	DP_Identifier_A	Business Identifier for claim
status	?!Σ	1..1	DP_code	active \| cancelled \| draft \| entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Required Pattern: active
type	Σ	1..1	DP_CodeableConcept	Category or discipline Binding: Claim Type Codes (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: professional
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subType	C	1..1	DP_CodeableConcept	More granular claim type Binding: Claim SubType (required) Constraints: P-Auth-1
use	Σ	1..1	DP_code	claim \| preauthorization \| predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim. Required Pattern: preauthorization
patient	Σ	1..1	DP_Reference_1or2a(Nphies Patient)	The recipient of the products and services
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL Max Length:250
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual \| official \| temp \| secondary \| old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	DP_CodeableConcept	Description of identifier Binding: Patient Identifier Type (required)
system	Σ	1..1	DP_uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456 Max Length:50
display	Σ	0..1	string	Text alternative for the resource Max Length:200
created	Σ	1..1	DP_dateTime	Resource creation date
insurer	Σ	1..1	DP_Reference_1or2a(Nphies Insurer Organization)	Target
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL Max Length:250
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual \| official \| temp \| secondary \| old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	DP_CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: NII
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	DP_uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456 Max Length:50
display	Σ	0..1	string	Text alternative for the resource Max Length:200
provider	Σ	1..1	DP_Reference_1or2a(Nphies Provider Organization)	Party responsible for the claim
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL Max Length:250
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual \| official \| temp \| secondary \| old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	DP_CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PRN
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	DP_uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456 Max Length:50
display	Σ	0..1	string	Text alternative for the resource Max Length:200
priority	Σ	1..1	DP_CodeableConcept	Desired processing ugency Binding: ProcessPriorityCodes (required)
fundsReserve	S	0..1	DP_CodeableConcept	For whom to reserve funds Binding: Funds Reservation Codes (required)
related	S	0..*	BackboneElement	Prior or corollary claims
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
claim		1..1	DP_Reference_1or3a(Nphies Authorization Professional)	Reference to the related claim
relationship		1..1	DP_CodeableConcept	How the reference claim is related Binding: Related Claim Relationship (required)
payee	C	1..1	BackboneElement	Recipient of benefits payable Constraints: BV-00056, BV-00494
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	DP_CodeableConcept	Category of recipient Binding: Claim Payee Type Codes (required)
party	S	0..1	DP_Reference_1or2b(Nphies Organization \| Nphies Patient)	Recipient reference
referral	S	0..1	DP_Reference_3a(ServiceRequest)	Treatment referral
facility	S	0..1	DP_Reference_1(Nphies Location)	Servicing facility
careTeam		1..*	BackboneElement	Members of the care team
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Order of care team
provider		1..1	DP_Reference_1or2a(Nphies Practitioner)	Practitioner or organization
role		1..1	DP_CodeableConcept	Function within the team Binding: ClaimCareTeamRoleCodes (required)
qualification		1..1	DP_CodeableConcept	Practitioner credential or specialization Binding: Practice Codes (required)
Slices for supportingInfo	SC	13..*	BackboneElement	Supporting information Slice: Unordered, Closed by value:category Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531
supportingInfo:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required)
supportingInfo:attachment	SC	0..*	BackboneElement	Attachment Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00404
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: attachment
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]		1..1	DP_Attachment	Data to be provided
supportingInfo:birth-weight	SC	0..1	BackboneElement	Birth Weight Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00509
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: birth-weight
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]		1..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: kg
value	Σ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
supportingInfo:chiefComplaint	SC	1..1	BackboneElement	Chief Complaint Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00429
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: chief-complaint
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code		1..1	DP_CodeableConcept_1	Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes.
coding	SΣ	0..*	DP_Coding	Code defined by a terminology system Binding: SNOMEDCTClinicalFindings (required)
text	SΣ	0..1	string	Plain text representation of the concept Max Length:250
supportingInfo:daysSupply	SC	0..*	BackboneElement	Days Supply Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00413
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: days-supply
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for value[x]		1..1		Data to be provided Slice: Unordered, Open by type:$this
valueBoolean			boolean
valueString			string
valueQuantity			Quantity
valueAttachment			Attachment
valueReference			Reference(Resource)
value[x]:valueQuantity		0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: d
value	Σ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
supportingInfo:employmentImpacted	SC	0..1	BackboneElement	Employment impacted Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00409
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: employmentImpacted
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_1	When it occurred
supportingInfo:history-of-present-illness	SC	1..1	BackboneElement	History of Present Illness Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: history-of-present-illness
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]		1..1	DP_string	Data to be provided
supportingInfo:info	SC	0..*	BackboneElement	Information Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00402
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: info
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]		1..1	DP_string	Data to be provided
supportingInfo:investigation-result	SC	0..*	BackboneElement	Investigation Result Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00753, BV-00846
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: investigation-result
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code		1..1	DP_CodeableConcept	Type of information Binding: Investigation Result (required)
Slices for value[x]	S	0..1		Data to be provided Slice: Unordered, Closed by type:$this
valueString			string(DP_string)
valueAttachment			Attachment(DP_Attachment)
value[x]:valueAttachment	S	0..1	DP_Attachment	Data to be provided
value[x]:valueString	S	0..1	DP_string	Data to be provided
supportingInfo:labTest	SC	0..*	BackboneElement	Lab Test Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00410, BV-00411
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: lab-test
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code		1..1	DP_CodeableConcept	Type of information Binding: LOINCCodes (required)
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]		1..1	DP_Quantity_2	Data to be provided
value	Σ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	Σ	1..1	DP_code	Coded form of the unit
supportingInfo:last-menstrual-period	SC	0..1	BackboneElement	Last Menstrual Period Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00490
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: last-menstrual-period
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	date	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingDate		1..1	DP_date	When it occurred
supportingInfo:onset	SC	0..*	BackboneElement	Onset of symptoms Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00428
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: onset
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code		1..1	DP_CodeableConcept	Type of information Binding: ICD-10-AM (required)
Slices for timing[x]		1..1	date	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingDate		1..1	DP_date	When it occurred
supportingInfo:oxygen-saturation	SC	1..1	BackboneElement	Patient Oxygen Saturation Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-7, BV-00488, BV-00818, BV-00826
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: oxygen-saturation
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: %
value	SΣ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Oxygen Saturation Absence Reason (required)
supportingInfo:patient-history	SC	1..1	BackboneElement	Patient History Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: patient-history
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]		1..1	DP_string	Data to be provided
supportingInfo:physical-examination	SC	1..1	BackboneElement	Physical Examination Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: physical-examination
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]		1..1	DP_string	Data to be provided
supportingInfo:pulse	SC	1..1	BackboneElement	Patient pulse Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-6, BV-00487, BV-00817, BV-00825
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: pulse
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: /min
value	SΣ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Pulse Absence Reason (required)
supportingInfo:reasonForVisit	SC	0..1	BackboneElement	Reason for visit Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00412
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: reason-for-visit
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code		1..1	DP_CodeableConcept	Type of information Binding: Visit Reason (required)
supportingInfo:respiratory-rate	SC	1..1	BackboneElement	Patient Respiratory Rate Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-8, BV-00489, BV-00819, BV-00827
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: respiratory-rate
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: /min
value	SΣ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Respiratory Rate Absence Reason (required)
supportingInfo:temperature	SC	1..1	BackboneElement	Temperature Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-5, BV-00486, BV-00816, BV-00824
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: temperature
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: Cel
value	SΣ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Temperature Absence Reason (required)
supportingInfo:treatment-plan	SC	1..1	BackboneElement	Treatment Plan Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: treatment-plan
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]		1..1	DP_string	Data to be provided
supportingInfo:vitalSignDiastolic	SC	1..1	BackboneElement	Diastolic Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-3, BV-00416, BV-00814, BV-00822
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-sign-diastolic
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: mm[Hg]
value	SΣ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Blood Pressure Absence Reason (required)
supportingInfo:vitalSignHeight	SC	1..1	BackboneElement	Patient height Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-4, BV-00417, BV-00815, BV-00823
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-sign-height
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: cm
value	SΣ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Height Absence Reason (required)
supportingInfo:vitalSignSystolic	SC	1..1	BackboneElement	Systolic Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-2, BV-00415, BV-00813, BV-00821
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-sign-systolic
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: mm[Hg]
value	SΣ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Blood Pressure Absence Reason (required)
supportingInfo:vitalSignWeight	SC	1..1	BackboneElement	Patient weight Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-1, BV-00414, BV-00812, BV-00820
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-sign-weight
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: kg
value	SΣ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Weight Absence Reason (required)
diagnosis		1..*	BackboneElement	Pertinent diagnosis information
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Diagnosis instance identifier
Slices for diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Slice: Unordered, Closed by type:$this Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.
diagnosis[x]:diagnosisCodeableConcept		1..1	DP_CodeableConcept	Nature of illness or problem Binding: ICD-10-AM (required)
type		1..1	DP_CodeableConcept	Timing or nature of the diagnosis Binding: Diagnosis Type (required)
insurance	Σ	1..*	BackboneElement	Patient insurance information
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	1..1	DP_positiveInt	Insurance instance identifier
focal	Σ	1..1	boolean	Coverage to be used for adjudication
coverage	Σ	1..1	DP_Reference_1(Nphies Coverage)	Insurance information
preAuthRef	S	0..*	string	Prior authorization reference number
claimResponse	S	0..1	DP_Reference_1or3a(Nphies Authorization Response)	Adjudication results
accident	S	0..1	BackboneElement	Details of the event
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
date		1..1	DP_date	When the incident occurred
type		1..1	DP_CodeableConcept	The nature of the accident Binding: ActIncidentCode (required)
Slices for location[x]		0..1		Where the event occurred Slice: Unordered, Open by type:$this
locationAddress			Address
locationReference			Reference(Location)
location[x]:locationAddress	S	0..1	DP_Address	Where the event occurred
item	C	1..*	BackboneElement	Product or service provided Constraints: BV-00036, BV-00042, BV-00123, BV-00439, BV-00482, BV-00484, BV-00502
Slices for extension	S	1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:package	S	0..1	boolean	Package Code URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-package
extension:tax	S	0..1	DP_Money_SAR	Tax URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-tax
extension:patientShare	S	0..1	DP_Money_SAR	Patient Share URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-share
extension:payerShare	S	0..1	DP_Money_SAR	Payer Share URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-payer-share
extension:maternity	S	1..1	boolean	Maternity URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-maternity
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Item instance identifier
careTeamSequence		1..*	DP_positiveInt	Applicable careTeam members
diagnosisSequence	S	0..*	DP_positiveInt	Applicable diagnoses
informationSequence	S	0..*	DP_positiveInt	Applicable exception and supporting information
productOrService		1..1	DP_CodeableConcept_2	Billing, service, product, or drug code Binding: Professional Billing (required)
Slices for serviced[x]		1..1		Date or dates of service or product delivery Slice: Unordered, Closed by type:$this
servicedDate			date
servicedPeriod			Period
serviced[x]:servicedDate	S	0..1	DP_date	Date or dates of service or product delivery
serviced[x]:servicedPeriod	S	0..1	DP_Period_2	Date or dates of service or product delivery
quantity		1..1	DP_SimpleQuantity_1	Count of products or services
unitPrice	C	1..1	DP_Money_SAR	Fee, charge or cost per item Constraints: BV-00092
factor	S	0..1	DP_decimal	Price scaling factor
net	C	1..1	DP_Money_SAR	Total item cost Constraints: BV-00093
udi	S	0..*	DP_Reference_1or3a(Device)	Unique device identifier
bodySite	S	0..1	DP_CodeableConcept	Anatomical location Binding: SNOMEDCTBodyStructures (required)
subSite	S	0..1	DP_CodeableConcept	Anatomical sub-location Binding: Sub Site (required)
detail	SC	0..*	BackboneElement	Product or service provided Constraints: BV-00043
Slices for extension				Content/Rules for all slices
extension:tax	S	0..1	DP_Money_SAR	Tax URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-tax
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Item instance identifier
productOrService		1..1	DP_CodeableConcept_2	Billing, service, product, or drug code Binding: Professional Billing (required)
quantity		1..1	DP_SimpleQuantity_1	Count of products or services
unitPrice	C	1..1	DP_Money_SAR	Fee, charge or cost per item Constraints: BV-00094
factor	S	0..1	DP_decimal	Price scaling factor
net	C	1..1	DP_Money_SAR	Total item cost Constraints: BV-00095
udi	S	0..*	DP_Reference_1or3a(Device)	Unique device identifier
subDetail	S	0..*	BackboneElement	Product or service provided
Slices for extension				Content/Rules for all slices
extension:tax	S	0..1	DP_Money_SAR	Tax URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-tax
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Item instance identifier
productOrService		1..1	DP_CodeableConcept_2	Billing, service, product, or drug code Binding: Professional Billing (required)
quantity		1..1	DP_SimpleQuantity_1	Count of products or services
unitPrice		1..1	DP_Money_SAR	Fee, charge or cost per item
factor	S	0..1	DP_decimal	Price scaling factor
net		1..1	DP_Money_SAR	Total item cost
udi	S	0..*	DP_Reference_1or3a(Device)	Unique device identifier
total	C	1..1	DP_Money_SAR	Total claim cost Constraints: BV-00096
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Claim.status	required	Pattern Value: active `http://hl7.org/fhir/ValueSet/fm-status\|4.0.1` From the FHIR Standard
Claim.type	required	Pattern Value: professional `http://nphies.sa/terminology/ValueSet/claim-type` From this IG
Claim.subType	required	ClaimSubType(a valid code from Claim SubType) `http://nphies.sa/terminology/ValueSet/claim-subtype` From this IG
Claim.use	required	Pattern Value: preauthorization `http://hl7.org/fhir/ValueSet/claim-use\|4.0.1` From the FHIR Standard
Claim.patient.identifier.use	required	IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use\|4.0.1` From the FHIR Standard
Claim.patient.identifier.type	required	PatientIdentifierType `http://nphies.sa/terminology/ValueSet/patient-identifier-type` From this IG
Claim.insurer.identifier.use	required	IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use\|4.0.1` From the FHIR Standard
Claim.insurer.identifier.type	extensible	Pattern Value: NII `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
Claim.provider.identifier.use	required	IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use\|4.0.1` From the FHIR Standard
Claim.provider.identifier.type	extensible	Pattern Value: PRN `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
Claim.priority	required	ProcessPriorityCodes `http://hl7.org/fhir/ValueSet/process-priority` From the FHIR Standard
Claim.fundsReserve	required	Funds Reservation Codes `http://hl7.org/fhir/ValueSet/fundsreserve` From the FHIR Standard
Claim.related.relationship	required	RelatedClaimRelationship(a valid code from Related Claim Relationship) `http://nphies.sa/terminology/ValueSet/related-claim-relationship` From this IG
Claim.payee.type	required	Claim Payee Type Codes `http://hl7.org/fhir/ValueSet/payeetype` From the FHIR Standard
Claim.careTeam.role	required	ClaimCareTeamRoleCodes `http://hl7.org/fhir/ValueSet/claim-careteamrole` From the FHIR Standard
Claim.careTeam.qualification	required	PracticeCodes `http://nphies.sa/terminology/ValueSet/practice-codes` From this IG
Claim.supportingInfo.category	required	ClaimInformationCategory(a valid code from Claim Information Category) `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:attachment.category	required	Pattern Value: attachment `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:birth-weight.category	required	Pattern Value: birth-weight `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:birth-weight.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:chiefComplaint.category	required	Pattern Value: chief-complaint `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:chiefComplaint.code	example	ExceptionCodes `http://hl7.org/fhir/ValueSet/claim-exception` From the FHIR Standard
Claim.supportingInfo:chiefComplaint.code.coding	required	SNOMEDCTClinicalFindings `http://hl7.org/fhir/ValueSet/clinical-findings` From the FHIR Standard
Claim.supportingInfo:daysSupply.category	required	Pattern Value: days-supply `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:daysSupply.value[x]:valueQuantity.comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:employmentImpacted.category	required	Pattern Value: employmentImpacted `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:history-of-present-illness.category	required	Pattern Value: history-of-present-illness `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:info.category	required	Pattern Value: info `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:investigation-result.category	required	Pattern Value: investigation-result `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:investigation-result.code	required	InvestigationResult(a valid code from Investigation Result) `http://nphies.sa/terminology/ValueSet/investigation-result` From this IG
Claim.supportingInfo:labTest.category	required	Pattern Value: lab-test `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:labTest.code	required	LOINCCodes(a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` From the FHIR Standard
Claim.supportingInfo:labTest.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:last-menstrual-period.category	required	Pattern Value: last-menstrual-period `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:onset.category	required	Pattern Value: onset `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:onset.code	required	ICD_10_AM(a valid code from `http://hl7.org/fhir/sid/icd-10-am`) `http://nphies.sa/terminology/ValueSet/diagnosis-icd-10-am` From this IG
Claim.supportingInfo:oxygen-saturation.category	required	Pattern Value: oxygen-saturation `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:oxygen-saturation.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:oxygen-saturation.reason	required	OxygenSaturationAbsenceReason(a valid code from Oxygen Saturation Absence Reason) `http://nphies.sa/terminology/ValueSet/oxygen-saturation-absence-reason` From this IG
Claim.supportingInfo:patient-history.category	required	Pattern Value: patient-history `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:physical-examination.category	required	Pattern Value: physical-examination `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:pulse.category	required	Pattern Value: pulse `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:pulse.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:pulse.reason	required	PulseAbsenceReason(a valid code from Pulse Absence Reason) `http://nphies.sa/terminology/ValueSet/pulse-absence-reason` From this IG
Claim.supportingInfo:reasonForVisit.category	required	Pattern Value: reason-for-visit `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:reasonForVisit.code	required	VisitReason(a valid code from Visit Reason) `http://nphies.sa/terminology/ValueSet/visit-reason` From this IG
Claim.supportingInfo:respiratory-rate.category	required	Pattern Value: respiratory-rate `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:respiratory-rate.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:respiratory-rate.reason	required	RespiratoryRateAbsenceReason(a valid code from Respiratory Rate Absence Reason) `http://nphies.sa/terminology/ValueSet/respiratory-rate-absence-reason` From this IG
Claim.supportingInfo:temperature.category	required	Pattern Value: temperature `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:temperature.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:temperature.reason	required	TemperatureAbsenceReason(a valid code from Temperature Absence Reason) `http://nphies.sa/terminology/ValueSet/temperature-absence-reason` From this IG
Claim.supportingInfo:treatment-plan.category	required	Pattern Value: treatment-plan `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:vitalSignDiastolic.category	required	Pattern Value: vital-sign-diastolic `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:vitalSignDiastolic.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:vitalSignDiastolic.reason	required	BloodPressureAbsenceReason(a valid code from Blood Pressure Absence Reason) `http://nphies.sa/terminology/ValueSet/blood-pressure-absence-reason` From this IG
Claim.supportingInfo:vitalSignHeight.category	required	Pattern Value: vital-sign-height `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:vitalSignHeight.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:vitalSignHeight.reason	required	HeightAbsenceReason(a valid code from Height Absence Reason) `http://nphies.sa/terminology/ValueSet/height-absence-reason` From this IG
Claim.supportingInfo:vitalSignSystolic.category	required	Pattern Value: vital-sign-systolic `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:vitalSignSystolic.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:vitalSignSystolic.reason	required	BloodPressureAbsenceReason(a valid code from Blood Pressure Absence Reason) `http://nphies.sa/terminology/ValueSet/blood-pressure-absence-reason` From this IG
Claim.supportingInfo:vitalSignWeight.category	required	Pattern Value: vital-sign-weight `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:vitalSignWeight.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:vitalSignWeight.reason	required	WeightAbsenceReason(a valid code from Weight Absence Reason) `http://nphies.sa/terminology/ValueSet/weight-absence-reason` From this IG
Claim.diagnosis.diagnosis[x]	example	ICD-10Codes `http://hl7.org/fhir/ValueSet/icd-10` From the FHIR Standard
Claim.diagnosis.diagnosis[x]:diagnosisCodeableConcept	required	ICD_10_AM(a valid code from `http://hl7.org/fhir/sid/icd-10-am`) `http://nphies.sa/terminology/ValueSet/diagnosis-icd-10-am` From this IG
Claim.diagnosis.type	required	DiagnosisType(a valid code from Diagnosis Type) `http://nphies.sa/terminology/ValueSet/diagnosis-type` From this IG
Claim.accident.type	required	ActIncidentCode `http://terminology.hl7.org/ValueSet/v3-ActIncidentCode`
Claim.item.productOrService	required	ProfessionalBilling `http://nphies.sa/terminology/ValueSet/professional-billing` From this IG
Claim.item.bodySite	required	SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` From the FHIR Standard
Claim.item.subSite	required	SubSite(a valid code from Sub Site) `http://nphies.sa/terminology/ValueSet/subsite` From this IG
Claim.item.detail.productOrService	required	ProfessionalBilling `http://nphies.sa/terminology/ValueSet/professional-billing` From this IG
Claim.item.detail.subDetail.productOrService	required	ProfessionalBilling `http://nphies.sa/terminology/ValueSet/professional-billing` From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
BV-00002	error	Claim	Claim care team sequence is not unique within the submitted claim resource. : careTeam.exists() implies careTeam.sequence.isDistinct()
BV-00036	error	Claim.item	No Claim item detail provided when Claim item package = true. : extension('http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-package').exists() implies extension('http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-package').first().value = true implies detail.exists().not()
BV-00042	error	Claim.item	Claim item detail sequence in not unique within the Claim item. : detail.sequence.exists() implies detail.sequence.isDistinct()
BV-00043	error	Claim.item.detail	Claim item subDetail sequence in not unique within the Claim item detail. : subDetail.sequence.exists() implies subDetail.sequence.isDistinct()
BV-00044	error	Claim	Item sequence value is not unique within the Claim resource. : item.sequence.exists() implies item.sequence.isDistinct()
BV-00054	error	Claim	One and only one principal diagnosis is required. : diagnosis.type.coding.where(code='principal').count() = 1
BV-00056	error	Claim.payee	Payee party is not provided when payee type='other'. : type.coding.where(code='other').count() > 0 implies party.exists()
BV-00057	error	Claim	Diagnosis is not unique in the submitted request. : diagnosis.diagnosis.ofType(CodeableConcept).isDistinct()
BV-00092	error	Claim.item.unitPrice	Claim Item UnitPrice Currency is not SAR. : currency = 'SAR'
BV-00093	error	Claim.item.net	Claim Item Net Currency is not SAR. : currency = 'SAR'
BV-00094	error	Claim.item.detail.unitPrice	Claim Item Detail UnitPrice Currency is not SAR. : currency = 'SAR'
BV-00095	error	Claim.item.detail.net	Claim Item Detail Net Currency is not SAR. : currency = 'SAR'
BV-00096	error	Claim.total	Claim Total Net Currency is not SAR. : currency = 'SAR'
BV-00123	error	Claim.item	Claim servicedate is not using a correct data type. : serviced.ofType(date).exists() or serviced.ofType(Period).exists()
BV-00137	error	Claim	The claim identifier does not exist. : identifier.exists()
BV-00316	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Claim supportingInfo valueString value length is longer than the maximum specified length of 250 English characters and 125 Arabic characters. : value.ofType(string).exists() implies value.ofType(string).length() <= 250
BV-00330	error	Claim	Claim status is not using the specified value 'active'. : status.exists() implies status='active'
BV-00347	error	Claim.extension:eligibilityOffLineDate	Claim eligibility OfflineDate is greater than current date. : value.ofType(dateTime) <= now()
BV-00365	error	Claim	Claim subtype is using an incorrect value when Claim type is 'Professional'. : subType.coding.first().code = 'op' or subType.coding.first().code = 'emr'
BV-00402	error	Claim.supportingInfo:info	Supporting information 'info' requires textual information in valueString. : value.ofType(string).exists()
BV-00404	error	Claim.supportingInfo:attachment	Supporting information 'attachment' requires the content to be provided. : value.ofType(Attachment).exists()
BV-00409	error	Claim.supportingInfo:employmentImpacted	Supporting information 'employmentImpacted' requires the period during which the employment was impacted. : timing.ofType(Period).exists()
BV-00410	error	Claim.supportingInfo:labTest	Supporting information 'lab-test' requires a valid LOINC code. : code.exists()
BV-00411	error	Claim.supportingInfo:labTest	If supporting information is 'lab-test' then valueQuantity SHALL exist and SHALL use a value specified in the UCUM code-system. : value.ofType(Quantity).exists()
BV-00412	error	Claim.supportingInfo:reasonForVisit	Supporting information 'reason-for-visit' requires a value from the specified NPHIES CodeSystem mentioning the reason for the visit. : code.exists()
BV-00413	error	Claim.supportingInfo:daysSupply	If Supporting information is 'days-supply' then valueQuantity SHALL exist and number of days SHALL use UCUM code 'd'. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'd'
BV-00414	error	Claim.supportingInfo:vitalSignWeight	If Supporting information is 'vital-sign-weight' and valueQuantity exist then it should use 'kg' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'kg'
BV-00415	error	Claim.supportingInfo:vitalSignSystolic	If Supporting information is 'vital-sign-systolic' and valueQuantity exist then it should use 'mm[Hg]'' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'mm[Hg]'
BV-00416	error	Claim.supportingInfo:vitalSignDiastolic	If Supporting information is 'vital-sign-diastolic' and valueQuantity exist then it should use 'mm[Hg]' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'mm[Hg]'
BV-00417	error	Claim.supportingInfo:vitalSignHeight	If Supporting information is 'vital-sign-height' and valueQuantity exist then it should use 'cm' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'cm'
BV-00428	error	Claim.supportingInfo:onset	Supporting information 'onset' requires the starting date and the ICD 10 code for the symptoms / illness. : code.exists() and timing.ofType(date).exists()
BV-00429	error	Claim.supportingInfo:chiefComplaint	Supporting information 'chief-complaint' requires the ICD 10 code for the symptoms / illness if a code is supplied. : code.exists()
BV-00439	error	Claim.item	If period is provided then Claim.item.servicedDate must not be used. : serviced.exists() implies (serviced.ofType(date).exists() xor serviced.ofType(Period).exists())
BV-00453	error	Claim	Claim supportingInfo sequence value is not unique within the claim request. : supportingInfo.sequence.exists() implies supportingInfo.sequence.isDistinct()
BV-00454	error	Claim	Claim diagnosis sequence value is not unique within the claim request. : diagnosis.sequence.isDistinct()
BV-00482	error	Claim.item	Item factor must be a positive decimal value. : factor.exists() implies factor >= 0
BV-00484	error	Claim.item	The subSite shall not be allowed if the bodySite is not provided. : subSite.exists() implies bodySite.exists()
BV-00486	error	Claim.supportingInfo:temperature	If Supporting information is 'temperature' and valueQuantity exist then it should use 'Cel' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'Cel'
BV-00487	error	Claim.supportingInfo:pulse	If Supporting information is 'pulse' and valueQuantity exist then it should use '/min' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '/min'
BV-00488	error	Claim.supportingInfo:oxygen-saturation	If Supporting information is 'oxygen-saturation' and valueQuantity exist then it should use '%' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '%'
BV-00489	error	Claim.supportingInfo:respiratory-rate	If Supporting information is 'respiratory-rate' and valueQuantity exist then it should use '/min' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '/min'
BV-00490	error	Claim.supportingInfo:last-menstrual-period	Supporting information 'last-menstrual-period' requires the date of start of last menstrual period. : timing.ofType(date).exists()
BV-00494	error	Claim.payee	Claim payee party must not provided when Claim payee type value is not 'other'. : type.coding.where(code!='other').count() > 0 implies party.exists().not()
BV-00502	error	Claim.item	Claim item informationSequence is not unique within the Claim item. : informationSequence.isDistinct()
BV-00509	error	Claim.supportingInfo:birth-weight	If Supporting information is 'birth-weight' then valueQuantity shall exist and should use 'kg' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'kg'
BV-00530	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	If supportingInfo code element is provided and the category is not 'chief-complaint' then a code is required. : (code.exists() and category.coding.first().code != 'chief-complaint') implies code.coding.code.exists()
BV-00531	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	The supportingInfo code element is required if supportingInfo category is 'chief-complaint'. : category.exists() implies (category.coding.first().code = 'chief-complaint') implies code.exists()
BV-00752	error	Claim	Supporting information 'investigation-result' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'investigation-result').exists()
BV-00753	error	Claim.supportingInfo:investigation-result	Investigation Result ('Text' - value[x] valueString' Shall be Provided when Investigation Result Supporting info is selected with Code = 'other'. : ((code.coding.where(code='other').count() > 0) and value.exists()) implies value.ofType(string).exists()
BV-00771	error	Claim	Oxygen-saturation SHALL be provided in institutional claim or authorization. : supportingInfo.category.coding.where(code='oxygen-saturation').count() > 0
BV-00772	error	Claim	Diastolic SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-diastolic').count() > 0
BV-00773	error	Claim	Systolic SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-systolic').count() > 0
BV-00774	error	Claim	Pulse SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='pulse').count() > 0
BV-00775	error	Claim	Temperature SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='temperature').count() > 0
BV-00776	error	Claim	Height SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-height').count() > 0
BV-00777	error	Claim	Respiratory-rate SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='respiratory-rate').count() > 0
BV-00778	error	Claim	Weight SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-weight').count() > 0
BV-00779	error	Claim	Chief-complaint SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='chief-complaint').count() > 0
BV-00780	error	Claim	Oxygen-saturation SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='oxygen-saturation').count() > 0
BV-00782	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Supporting information 'treatment-plan' requires textual information. : category.coding.where(code='treatment-plan').count() > 0 implies value.ofType(string).exists()
BV-00783	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Supporting information 'patient-history' requires textual information. : category.coding.where(code='patient-history').count() > 0 implies value.ofType(string).exists()
BV-00784	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Supporting information 'physical-examination' requires textual information . : category.coding.where(code='physical-examination').count() > 0 implies value.ofType(string).exists()
BV-00785	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Supporting information 'history-of-present-illness' requires textual information . : category.coding.where(code='history-of-present-illness').count() > 0 implies value.ofType(string).exists()
BV-00803	error	Claim	Supporting information 'treatment-plan' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'treatment-plan').exists()
BV-00804	error	Claim	Supporting information 'patient-history' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'patient-history').exists()
BV-00805	error	Claim	Supporting information 'pphysical-examination' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'physical-examination').exists()
BV-00806	error	Claim	Supporting information 'history-of-present-illness' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'history-of-present-illness').exists()
BV-00812	error	Claim.supportingInfo:vitalSignWeight	If Claim supportingInfo category='vital-sign-weight' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00813	error	Claim.supportingInfo:vitalSignSystolic	If Claim supportingInfo category='vital-sign-systolic' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00814	error	Claim.supportingInfo:vitalSignDiastolic	If Claim supportingInfo category='vital-sign-diastolic' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00815	error	Claim.supportingInfo:vitalSignHeight	If Claim supportingInfo category='vital-sign-height' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00816	error	Claim.supportingInfo:temperature	If Claim supportingInfo category='temperature' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00817	error	Claim.supportingInfo:pulse	If Claim supportingInfo category='pulse' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00818	error	Claim.supportingInfo:oxygen-saturation	If Claim supportingInfo category='oxygen-saturation' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00819	error	Claim.supportingInfo:respiratory-rate	If Claim supportingInfo category='respiratory-rate' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00820	error	Claim.supportingInfo:vitalSignWeight	If Claim.supportingInfo.category.coding.code='vital-sign-weight' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/weight-absence-reason'
BV-00821	error	Claim.supportingInfo:vitalSignSystolic	If Claim.supportingInfo.category.coding.code='vital-sign-systolic' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/blood-pressure-absence-reason'
BV-00822	error	Claim.supportingInfo:vitalSignDiastolic	If Claim.supportingInfo.category.coding.code='vital-sign-diastolic' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/blood-pressure-absence-reason'
BV-00823	error	Claim.supportingInfo:vitalSignHeight	If Claim.supportingInfo.category.coding.code='vital-sign-height' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/height-absence-reason'
BV-00824	error	Claim.supportingInfo:temperature	If Claim.supportingInfo.category.coding.code='temperature' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/tempurature-absence-reason'
BV-00825	error	Claim.supportingInfo:pulse	If Claim.supportingInfo.category.coding.code='pulse' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/pulse-absence-reason'
BV-00826	error	Claim.supportingInfo:oxygen-saturation	If Claim.supportingInfo.category.coding.code='oxygen-saturation' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/oxygen-saturation-absence-reason'
BV-00827	error	Claim.supportingInfo:respiratory-rate	If Claim.supportingInfo.category.coding.code='respiratory-rate' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/respiratory-rate-absence-reason'
BV-00846	error	Claim.supportingInfo:investigation-result	Supporting information 'investigation-result' requires a attachment when attachment code is used with Code = 'IRA'. : (code.coding.where(code='IRA').count() > 0) implies value.ofType(Attachment).exists()
P-Auth-1	error	Claim.subType	SubType may only be OP or EMR : coding.first().code = 'op' or coding.first().code = 'emr'
P-Auth-SI-1	error	Claim.supportingInfo:vitalSignWeight	Patient weight must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-2	error	Claim.supportingInfo:vitalSignSystolic	Systolic blood pressure must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-3	error	Claim.supportingInfo:vitalSignDiastolic	Diastolic blood pressure must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-4	error	Claim.supportingInfo:vitalSignHeight	Patient height must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-5	error	Claim.supportingInfo:temperature	Patient temperature must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-6	error	Claim.supportingInfo:pulse	Patient pulse must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-7	error	Claim.supportingInfo:oxygen-saturation	Patient oxygen saturation must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-8	error	Claim.supportingInfo:respiratory-rate	Patient respiratory rate must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
dom-2	error	Claim	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Claim	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Claim	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Claim	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Claim	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from NphiesAuthorizationBase

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Claim	C	0..*	NphiesAuthorizationBase	Claim, Pre-determination or Pre-authorization Constraints: BV-00365, BV-00803, BV-00804, BV-00805, BV-00806, BV-00752, BV-00771, BV-00772, BV-00773, BV-00774, BV-00775, BV-00776, BV-00777, BV-00778, BV-00779, BV-00780
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:encounter		1..1	(Complex)	Encounter URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-encounter
value[x]		1..1	DP_Reference_1(Nphies Encounter AMB (Auth) \| Nphies Encounter EMER (Auth) \| Nphies Encounter HH (Auth) \| Nphies Encounter VR (Auth))	Value of extension
type		1..1	DP_CodeableConcept	Category or discipline Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: professional
subType	C	1..1	DP_CodeableConcept	More granular claim type Constraints: P-Auth-1
related
claim		1..1	DP_Reference_1or3a(Nphies Authorization Professional)	Reference to the related claim
careTeam		1..*	BackboneElement	Members of the care team
provider		1..1	DP_Reference_1or2a(Nphies Practitioner)	Practitioner or organization
Slices for supportingInfo		13..*	BackboneElement	Supporting information Slice: Unordered, Closed by value:category
supportingInfo:attachment	C	0..*	BackboneElement	Attachment Constraints: BV-00404
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: attachment
value[x]		1..1	DP_Attachment	Data to be provided
supportingInfo:birth-weight	C	0..1	BackboneElement	Birth Weight Constraints: BV-00509
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: birth-weight
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]		1..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: kg
value		1..1	DP_decimal	Numerical value (with implicit precision)
supportingInfo:chiefComplaint	C	1..1	BackboneElement	Chief Complaint Constraints: BV-00429
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: chief-complaint
code		1..1	DP_CodeableConcept_1	Type of information
coding		0..*	DP_Coding	Code defined by a terminology system Binding: SNOMEDCTClinicalFindings (required)
supportingInfo:daysSupply	C	0..*	BackboneElement	Days Supply Constraints: BV-00413
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: days-supply
Slices for value[x]		1..1	boolean, string, Quantity, Attachment, Reference(Resource)	Data to be provided Slice: Unordered, Open by type:$this
value[x]:valueQuantity		0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: d
value		1..1	DP_decimal	Numerical value (with implicit precision)
supportingInfo:employmentImpacted	C	0..1	BackboneElement	Employment impacted Constraints: BV-00409
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: employmentImpacted
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_1	When it occurred
supportingInfo:history-of-present-illness		1..1	BackboneElement	History of Present Illness
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: history-of-present-illness
value[x]		1..1	DP_string	Data to be provided
supportingInfo:info	C	0..*	BackboneElement	Information Constraints: BV-00402
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: info
value[x]		1..1	DP_string	Data to be provided
supportingInfo:investigation-result	C	0..*	BackboneElement	Investigation Result Constraints: BV-00753, BV-00846
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: investigation-result
code		1..1	DP_CodeableConcept	Type of information Binding: Investigation Result (required)
Slices for value[x]	S	0..1		Data to be provided Slice: Unordered, Open by type:$this
valueString			string(DP_string)
valueAttachment			Attachment(DP_Attachment)
value[x]:valueAttachment	S	0..1	DP_Attachment	Data to be provided
value[x]:valueString	S	0..1	DP_string	Data to be provided
supportingInfo:labTest	C	0..*	BackboneElement	Lab Test Constraints: BV-00410, BV-00411
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: lab-test
code		1..1	DP_CodeableConcept	Type of information Binding: LOINCCodes (required)
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]		1..1	DP_Quantity_2	Data to be provided
system		1..1	DP_uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
supportingInfo:last-menstrual-period	C	0..1	BackboneElement	Last Menstrual Period Constraints: BV-00490
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: last-menstrual-period
Slices for timing[x]		1..1	date	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingDate		1..1	DP_date	When it occurred
supportingInfo:onset	C	0..*	BackboneElement	Onset of symptoms Constraints: BV-00428
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: onset
code		1..1	DP_CodeableConcept	Type of information Binding: ICD-10-AM (required)
Slices for timing[x]		1..1	date	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingDate		1..1	DP_date	When it occurred
supportingInfo:oxygen-saturation	C	1..1	BackboneElement	Patient Oxygen Saturation Constraints: P-Auth-SI-7, BV-00488, BV-00818, BV-00826
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: oxygen-saturation
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: %
value	S	1..1	DP_decimal	Numerical value (with implicit precision)
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Oxygen Saturation Absence Reason (required)
supportingInfo:patient-history		1..1	BackboneElement	Patient History
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: patient-history
value[x]		1..1	DP_string	Data to be provided
supportingInfo:physical-examination		1..1	BackboneElement	Physical Examination
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: physical-examination
value[x]		1..1	DP_string	Data to be provided
supportingInfo:pulse	C	1..1	BackboneElement	Patient pulse Constraints: P-Auth-SI-6, BV-00487, BV-00817, BV-00825
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: pulse
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: /min
value	S	1..1	DP_decimal	Numerical value (with implicit precision)
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Pulse Absence Reason (required)
supportingInfo:reasonForVisit	C	0..1	BackboneElement	Reason for visit Constraints: BV-00412
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: reason-for-visit
code		1..1	DP_CodeableConcept	Type of information Binding: Visit Reason (required)
supportingInfo:respiratory-rate	C	1..1	BackboneElement	Patient Respiratory Rate Constraints: P-Auth-SI-8, BV-00489, BV-00819, BV-00827
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: respiratory-rate
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: /min
value	S	1..1	DP_decimal	Numerical value (with implicit precision)
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Respiratory Rate Absence Reason (required)
supportingInfo:temperature	C	1..1	BackboneElement	Temperature Constraints: P-Auth-SI-5, BV-00486, BV-00816, BV-00824
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: temperature
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: Cel
value	S	1..1	DP_decimal	Numerical value (with implicit precision)
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Temperature Absence Reason (required)
supportingInfo:treatment-plan		1..1	BackboneElement	Treatment Plan
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: treatment-plan
value[x]		1..1	DP_string	Data to be provided
supportingInfo:vitalSignDiastolic	C	1..1	BackboneElement	Diastolic Constraints: P-Auth-SI-3, BV-00416, BV-00814, BV-00822
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-sign-diastolic
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: mm[Hg]
value	S	1..1	DP_decimal	Numerical value (with implicit precision)
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Blood Pressure Absence Reason (required)
supportingInfo:vitalSignHeight	C	1..1	BackboneElement	Patient height Constraints: P-Auth-SI-4, BV-00417, BV-00815, BV-00823
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-sign-height
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: cm
value	S	1..1	DP_decimal	Numerical value (with implicit precision)
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Height Absence Reason (required)
supportingInfo:vitalSignSystolic	C	1..1	BackboneElement	Systolic Constraints: P-Auth-SI-2, BV-00415, BV-00813, BV-00821
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-sign-systolic
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: mm[Hg]
value	S	1..1	DP_decimal	Numerical value (with implicit precision)
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Blood Pressure Absence Reason (required)
supportingInfo:vitalSignWeight	C	1..1	BackboneElement	Patient weight Constraints: P-Auth-SI-1, BV-00414, BV-00812, BV-00820
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-sign-weight
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: kg
value	S	1..1	DP_decimal	Numerical value (with implicit precision)
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Weight Absence Reason (required)
item
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:maternity		1..1	boolean	Maternity URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-maternity
careTeamSequence		1..*	DP_positiveInt	Applicable careTeam members
productOrService		1..1	DP_CodeableConcept_2	Billing, service, product, or drug code Binding: Professional Billing (required)
bodySite		0..1	DP_CodeableConcept	Anatomical location Binding: SNOMEDCTBodyStructures (required)
subSite		0..1	DP_CodeableConcept	Anatomical sub-location Binding: Sub Site (required)
detail
productOrService		1..1	DP_CodeableConcept_2	Billing, service, product, or drug code Binding: Professional Billing (required)
subDetail
productOrService		1..1	DP_CodeableConcept_2	Billing, service, product, or drug code Binding: Professional Billing (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Claim.supportingInfo:chiefComplaint.code.coding	required	SNOMEDCTClinicalFindings `http://hl7.org/fhir/ValueSet/clinical-findings` From the FHIR Standard
Claim.supportingInfo:investigation-result.code	required	InvestigationResult(a valid code from Investigation Result) `http://nphies.sa/terminology/ValueSet/investigation-result` From this IG
Claim.supportingInfo:labTest.code	required	LOINCCodes(a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` From the FHIR Standard
Claim.supportingInfo:onset.code	required	ICD_10_AM(a valid code from `http://hl7.org/fhir/sid/icd-10-am`) `http://nphies.sa/terminology/ValueSet/diagnosis-icd-10-am` From this IG
Claim.supportingInfo:oxygen-saturation.reason	required	OxygenSaturationAbsenceReason(a valid code from Oxygen Saturation Absence Reason) `http://nphies.sa/terminology/ValueSet/oxygen-saturation-absence-reason` From this IG
Claim.supportingInfo:pulse.reason	required	PulseAbsenceReason(a valid code from Pulse Absence Reason) `http://nphies.sa/terminology/ValueSet/pulse-absence-reason` From this IG
Claim.supportingInfo:reasonForVisit.code	required	VisitReason(a valid code from Visit Reason) `http://nphies.sa/terminology/ValueSet/visit-reason` From this IG
Claim.supportingInfo:respiratory-rate.reason	required	RespiratoryRateAbsenceReason(a valid code from Respiratory Rate Absence Reason) `http://nphies.sa/terminology/ValueSet/respiratory-rate-absence-reason` From this IG
Claim.supportingInfo:temperature.reason	required	TemperatureAbsenceReason(a valid code from Temperature Absence Reason) `http://nphies.sa/terminology/ValueSet/temperature-absence-reason` From this IG
Claim.supportingInfo:vitalSignDiastolic.reason	required	BloodPressureAbsenceReason(a valid code from Blood Pressure Absence Reason) `http://nphies.sa/terminology/ValueSet/blood-pressure-absence-reason` From this IG
Claim.supportingInfo:vitalSignHeight.reason	required	HeightAbsenceReason(a valid code from Height Absence Reason) `http://nphies.sa/terminology/ValueSet/height-absence-reason` From this IG
Claim.supportingInfo:vitalSignSystolic.reason	required	BloodPressureAbsenceReason(a valid code from Blood Pressure Absence Reason) `http://nphies.sa/terminology/ValueSet/blood-pressure-absence-reason` From this IG
Claim.supportingInfo:vitalSignWeight.reason	required	WeightAbsenceReason(a valid code from Weight Absence Reason) `http://nphies.sa/terminology/ValueSet/weight-absence-reason` From this IG
Claim.item.productOrService	required	ProfessionalBilling `http://nphies.sa/terminology/ValueSet/professional-billing` From this IG
Claim.item.bodySite	required	SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` From the FHIR Standard
Claim.item.subSite	required	SubSite(a valid code from Sub Site) `http://nphies.sa/terminology/ValueSet/subsite` From this IG
Claim.item.detail.productOrService	required	ProfessionalBilling `http://nphies.sa/terminology/ValueSet/professional-billing` From this IG
Claim.item.detail.subDetail.productOrService	required	ProfessionalBilling `http://nphies.sa/terminology/ValueSet/professional-billing` From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
BV-00365	error	Claim	Claim subtype is using an incorrect value when Claim type is 'Professional'. : subType.coding.first().code = 'op' or subType.coding.first().code = 'emr'
BV-00402	error	Claim.supportingInfo:info	Supporting information 'info' requires textual information in valueString. : value.ofType(string).exists()
BV-00404	error	Claim.supportingInfo:attachment	Supporting information 'attachment' requires the content to be provided. : value.ofType(Attachment).exists()
BV-00409	error	Claim.supportingInfo:employmentImpacted	Supporting information 'employmentImpacted' requires the period during which the employment was impacted. : timing.ofType(Period).exists()
BV-00410	error	Claim.supportingInfo:labTest	Supporting information 'lab-test' requires a valid LOINC code. : code.exists()
BV-00411	error	Claim.supportingInfo:labTest	If supporting information is 'lab-test' then valueQuantity SHALL exist and SHALL use a value specified in the UCUM code-system. : value.ofType(Quantity).exists()
BV-00412	error	Claim.supportingInfo:reasonForVisit	Supporting information 'reason-for-visit' requires a value from the specified NPHIES CodeSystem mentioning the reason for the visit. : code.exists()
BV-00413	error	Claim.supportingInfo:daysSupply	If Supporting information is 'days-supply' then valueQuantity SHALL exist and number of days SHALL use UCUM code 'd'. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'd'
BV-00414	error	Claim.supportingInfo:vitalSignWeight	If Supporting information is 'vital-sign-weight' and valueQuantity exist then it should use 'kg' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'kg'
BV-00415	error	Claim.supportingInfo:vitalSignSystolic	If Supporting information is 'vital-sign-systolic' and valueQuantity exist then it should use 'mm[Hg]'' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'mm[Hg]'
BV-00416	error	Claim.supportingInfo:vitalSignDiastolic	If Supporting information is 'vital-sign-diastolic' and valueQuantity exist then it should use 'mm[Hg]' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'mm[Hg]'
BV-00417	error	Claim.supportingInfo:vitalSignHeight	If Supporting information is 'vital-sign-height' and valueQuantity exist then it should use 'cm' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'cm'
BV-00428	error	Claim.supportingInfo:onset	Supporting information 'onset' requires the starting date and the ICD 10 code for the symptoms / illness. : code.exists() and timing.ofType(date).exists()
BV-00429	error	Claim.supportingInfo:chiefComplaint	Supporting information 'chief-complaint' requires the ICD 10 code for the symptoms / illness if a code is supplied. : code.exists()
BV-00486	error	Claim.supportingInfo:temperature	If Supporting information is 'temperature' and valueQuantity exist then it should use 'Cel' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'Cel'
BV-00487	error	Claim.supportingInfo:pulse	If Supporting information is 'pulse' and valueQuantity exist then it should use '/min' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '/min'
BV-00488	error	Claim.supportingInfo:oxygen-saturation	If Supporting information is 'oxygen-saturation' and valueQuantity exist then it should use '%' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '%'
BV-00489	error	Claim.supportingInfo:respiratory-rate	If Supporting information is 'respiratory-rate' and valueQuantity exist then it should use '/min' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '/min'
BV-00490	error	Claim.supportingInfo:last-menstrual-period	Supporting information 'last-menstrual-period' requires the date of start of last menstrual period. : timing.ofType(date).exists()
BV-00509	error	Claim.supportingInfo:birth-weight	If Supporting information is 'birth-weight' then valueQuantity shall exist and should use 'kg' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'kg'
BV-00752	error	Claim	Supporting information 'investigation-result' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'investigation-result').exists()
BV-00753	error	Claim.supportingInfo:investigation-result	Investigation Result ('Text' - value[x] valueString' Shall be Provided when Investigation Result Supporting info is selected with Code = 'other'. : ((code.coding.where(code='other').count() > 0) and value.exists()) implies value.ofType(string).exists()
BV-00771	error	Claim	Oxygen-saturation SHALL be provided in institutional claim or authorization. : supportingInfo.category.coding.where(code='oxygen-saturation').count() > 0
BV-00772	error	Claim	Diastolic SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-diastolic').count() > 0
BV-00773	error	Claim	Systolic SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-systolic').count() > 0
BV-00774	error	Claim	Pulse SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='pulse').count() > 0
BV-00775	error	Claim	Temperature SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='temperature').count() > 0
BV-00776	error	Claim	Height SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-height').count() > 0
BV-00777	error	Claim	Respiratory-rate SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='respiratory-rate').count() > 0
BV-00778	error	Claim	Weight SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-weight').count() > 0
BV-00779	error	Claim	Chief-complaint SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='chief-complaint').count() > 0
BV-00780	error	Claim	Oxygen-saturation SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='oxygen-saturation').count() > 0
BV-00803	error	Claim	Supporting information 'treatment-plan' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'treatment-plan').exists()
BV-00804	error	Claim	Supporting information 'patient-history' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'patient-history').exists()
BV-00805	error	Claim	Supporting information 'pphysical-examination' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'physical-examination').exists()
BV-00806	error	Claim	Supporting information 'history-of-present-illness' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'history-of-present-illness').exists()
BV-00812	error	Claim.supportingInfo:vitalSignWeight	If Claim supportingInfo category='vital-sign-weight' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00813	error	Claim.supportingInfo:vitalSignSystolic	If Claim supportingInfo category='vital-sign-systolic' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00814	error	Claim.supportingInfo:vitalSignDiastolic	If Claim supportingInfo category='vital-sign-diastolic' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00815	error	Claim.supportingInfo:vitalSignHeight	If Claim supportingInfo category='vital-sign-height' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00816	error	Claim.supportingInfo:temperature	If Claim supportingInfo category='temperature' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00817	error	Claim.supportingInfo:pulse	If Claim supportingInfo category='pulse' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00818	error	Claim.supportingInfo:oxygen-saturation	If Claim supportingInfo category='oxygen-saturation' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00819	error	Claim.supportingInfo:respiratory-rate	If Claim supportingInfo category='respiratory-rate' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00820	error	Claim.supportingInfo:vitalSignWeight	If Claim.supportingInfo.category.coding.code='vital-sign-weight' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/weight-absence-reason'
BV-00821	error	Claim.supportingInfo:vitalSignSystolic	If Claim.supportingInfo.category.coding.code='vital-sign-systolic' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/blood-pressure-absence-reason'
BV-00822	error	Claim.supportingInfo:vitalSignDiastolic	If Claim.supportingInfo.category.coding.code='vital-sign-diastolic' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/blood-pressure-absence-reason'
BV-00823	error	Claim.supportingInfo:vitalSignHeight	If Claim.supportingInfo.category.coding.code='vital-sign-height' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/height-absence-reason'
BV-00824	error	Claim.supportingInfo:temperature	If Claim.supportingInfo.category.coding.code='temperature' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/tempurature-absence-reason'
BV-00825	error	Claim.supportingInfo:pulse	If Claim.supportingInfo.category.coding.code='pulse' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/pulse-absence-reason'
BV-00826	error	Claim.supportingInfo:oxygen-saturation	If Claim.supportingInfo.category.coding.code='oxygen-saturation' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/oxygen-saturation-absence-reason'
BV-00827	error	Claim.supportingInfo:respiratory-rate	If Claim.supportingInfo.category.coding.code='respiratory-rate' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/respiratory-rate-absence-reason'
BV-00846	error	Claim.supportingInfo:investigation-result	Supporting information 'investigation-result' requires a attachment when attachment code is used with Code = 'IRA'. : (code.coding.where(code='IRA').count() > 0) implies value.ofType(Attachment).exists()
P-Auth-1	error	Claim.subType	SubType may only be OP or EMR : coding.first().code = 'op' or coding.first().code = 'emr'
P-Auth-SI-1	error	Claim.supportingInfo:vitalSignWeight	Patient weight must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-2	error	Claim.supportingInfo:vitalSignSystolic	Systolic blood pressure must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-3	error	Claim.supportingInfo:vitalSignDiastolic	Diastolic blood pressure must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-4	error	Claim.supportingInfo:vitalSignHeight	Patient height must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-5	error	Claim.supportingInfo:temperature	Patient temperature must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-6	error	Claim.supportingInfo:pulse	Patient pulse must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-7	error	Claim.supportingInfo:oxygen-saturation	Patient oxygen saturation must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-8	error	Claim.supportingInfo:respiratory-rate	Patient respiratory rate must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()

Description & Constraints Filter: Filters

Claim

0..*

NphiesAuthorizationBase

Claim, Pre-determination or Pre-authorization
Constraints: BV-00002, BV-00044, BV-00054, BV-00057, BV-00137, BV-00330, BV-00453, BV-00454, BV-00365, BV-00803, BV-00804, BV-00805, BV-00806, BV-00752, BV-00771, BV-00772, BV-00773, BV-00774, BV-00775, BV-00776, BV-00777, BV-00778, BV-00779, BV-00780

1..1

Logical id of this artifact
Max Length:64

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

timing[x]

0..1

When it occurred

timingDate

date

timingPeriod

Period

value[x]

0..1

Data to be provided

valueBoolean

valueString

valueQuantity

valueAttachment

valueReference

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:attachment

0..*

BackboneElement

Attachment
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00404

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: attachment

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

timing[x]

0..1

When it occurred

timingDate

timingPeriod

1..1

Data to be provided

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:birth-weight

0..1

BackboneElement

Birth Weight
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00509

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: birth-weight

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

1..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: kg

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:chiefComplaint

1..1

BackboneElement

Chief Complaint
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00429

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: chief-complaint

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

1..1

DP_CodeableConcept_1

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

coding

SΣ

0..*

DP_Coding

Code defined by a terminology system
Binding: SNOMEDCTClinicalFindings (required)

text

SΣ

0..1

string

Plain text representation of the concept
Max Length:250

timing[x]

0..1

When it occurred

timingDate

date

timingPeriod

Period

value[x]

0..1

Data to be provided

valueBoolean

valueString

valueQuantity

valueAttachment

valueReference

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:daysSupply

0..*

BackboneElement

Days Supply
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00413

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: days-supply

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

timing[x]

0..1

When it occurred

timingDate

date

timingPeriod

Period

Slices for value[x]

1..1

Data to be provided
Slice: Unordered, Open by type:$this

valueBoolean

valueString

valueQuantity

valueAttachment

valueReference

value[x]:valueQuantity

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: d

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:employmentImpacted

0..1

BackboneElement

Employment impacted
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00409

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: employmentImpacted

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_1

When it occurred

value[x]

0..1

Data to be provided

valueBoolean

valueString

valueQuantity

valueAttachment

valueReference

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:history-of-present-illness

1..1

BackboneElement

History of Present Illness
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: history-of-present-illness

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

timing[x]

0..1

When it occurred

timingDate

timingPeriod

1..1

Data to be provided

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:info

0..*

BackboneElement

Information
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00402

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: info

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

timing[x]

0..1

When it occurred

timingDate

timingPeriod

1..1

Data to be provided

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:investigation-result

0..*

BackboneElement

Investigation Result
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00753, BV-00846

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: investigation-result

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

1..1

DP_CodeableConcept

Type of information
Binding: Investigation Result (required)

timing[x]

0..1

When it occurred

timingDate

date

timingPeriod

Period

Slices for value[x]

0..1

Data to be provided
Slice: Unordered, Closed by type:$this

valueString

string(DP_string)

valueAttachment

Attachment(DP_Attachment)

value[x]:valueAttachment

0..1

DP_Attachment

Data to be provided

value[x]:valueString

0..1

DP_string

Data to be provided

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:labTest

0..*

BackboneElement

Lab Test
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00410, BV-00411

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: lab-test

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

1..1

DP_CodeableConcept

Type of information
Binding: LOINCCodes (required)

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

1..1

DP_Quantity_2

Data to be provided

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form
Required Pattern: http://unitsofmeasure.org

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:last-menstrual-period

0..1

BackboneElement

Last Menstrual Period
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00490

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: last-menstrual-period

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

date

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingDate

1..1

DP_date

When it occurred

value[x]

0..1

Data to be provided

valueBoolean

valueString

valueQuantity

valueAttachment

valueReference

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:onset

0..*

BackboneElement

Onset of symptoms
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00428

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: onset

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

1..1

DP_CodeableConcept

Type of information
Binding: ICD-10-AM (required)

Slices for timing[x]

1..1

date

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingDate

1..1

DP_date

When it occurred

value[x]

0..1

Data to be provided

valueBoolean

valueString

valueQuantity

valueAttachment

valueReference

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:oxygen-saturation

1..1

BackboneElement

Patient Oxygen Saturation
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-7, BV-00488, BV-00818, BV-00826

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: oxygen-saturation

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: %

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: Oxygen Saturation Absence Reason (required)

supportingInfo:patient-history

1..1

BackboneElement

Patient History
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: patient-history

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

timing[x]

0..1

When it occurred

timingDate

timingPeriod

1..1

Data to be provided

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:physical-examination

1..1

BackboneElement

Physical Examination
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: physical-examination

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

timing[x]

0..1

When it occurred

timingDate

timingPeriod

1..1

Data to be provided

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:pulse

1..1

BackboneElement

Patient pulse
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-6, BV-00487, BV-00817, BV-00825

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: pulse

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: /min

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: Pulse Absence Reason (required)

supportingInfo:reasonForVisit

0..1

BackboneElement

Reason for visit
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00412

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: reason-for-visit

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

1..1

DP_CodeableConcept

Type of information
Binding: Visit Reason (required)

timing[x]

0..1

When it occurred

timingDate

date

timingPeriod

Period

value[x]

0..1

Data to be provided

valueBoolean

valueString

valueQuantity

valueAttachment

valueReference

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:respiratory-rate

1..1

BackboneElement

Patient Respiratory Rate
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-8, BV-00489, BV-00819, BV-00827

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: respiratory-rate

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: /min

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: Respiratory Rate Absence Reason (required)

supportingInfo:temperature

1..1

BackboneElement

Temperature
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-5, BV-00486, BV-00816, BV-00824

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: temperature

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: Cel

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: Temperature Absence Reason (required)

supportingInfo:treatment-plan

1..1

BackboneElement

Treatment Plan
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: treatment-plan

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

timing[x]

0..1

When it occurred

timingDate

timingPeriod

1..1

Data to be provided

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:vitalSignDiastolic

1..1

BackboneElement

Diastolic
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-3, BV-00416, BV-00814, BV-00822

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: vital-sign-diastolic

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: mm[Hg]

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: Blood Pressure Absence Reason (required)

supportingInfo:vitalSignHeight

1..1

BackboneElement

Patient height
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-4, BV-00417, BV-00815, BV-00823

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: vital-sign-height

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: cm

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: Height Absence Reason (required)

supportingInfo:vitalSignSystolic

1..1

BackboneElement

Systolic
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-2, BV-00415, BV-00813, BV-00821

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: vital-sign-systolic

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: mm[Hg]

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: Blood Pressure Absence Reason (required)

supportingInfo:vitalSignWeight

1..1

BackboneElement

Patient weight
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-1, BV-00414, BV-00812, BV-00820

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: vital-sign-weight

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: kg

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: Weight Absence Reason (required)

diagnosis

1..*

BackboneElement

Pertinent diagnosis information

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Diagnosis instance identifier

Slices for diagnosis[x]

1..1

CodeableConcept

Nature of illness or problem
Slice: Unordered, Closed by type:$this
Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.

diagnosis[x]:diagnosisCodeableConcept

1..1

DP_CodeableConcept

Nature of illness or problem
Binding: ICD-10-AM (required)

type

1..1

DP_CodeableConcept

Timing or nature of the diagnosis
Binding: Diagnosis Type (required)

onAdmission

0..1

CodeableConcept

Present on admission
Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.

packageCode

0..1

CodeableConcept

Package billing code
Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.

procedure

0..*

BackboneElement

Clinical procedures performed

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

positiveInt

Procedure instance identifier

type

0..*

CodeableConcept

Category of Procedure
Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.

date

0..1

dateTime

When the procedure was performed

procedure[x]

1..1

Specific clinical procedure
Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.

procedureCodeableConcept

CodeableConcept

procedureReference

Reference(Procedure)

udi

0..*

Reference(Device)

Unique device identifier

insurance

1..*

BackboneElement

Patient insurance information

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Insurance instance identifier

focal

1..1

boolean

Coverage to be used for adjudication

identifier

0..1

Identifier

Pre-assigned Claim number

coverage

1..1

DP_Reference_1(Nphies Coverage)

Insurance information

businessArrangement

0..1

string

Additional provider contract number

preAuthRef

0..*

string

Prior authorization reference number

claimResponse

0..1

DP_Reference_1or3a(Nphies Authorization Response)

Adjudication results

accident

0..1

BackboneElement

Details of the event

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

date

1..1

DP_date

When the incident occurred

type

1..1

DP_CodeableConcept

The nature of the accident
Binding: ActIncidentCode (required)

Slices for location[x]

0..1

Where the event occurred
Slice: Unordered, Open by type:$this

locationAddress

Address

locationReference

Reference(Location)

location[x]:locationAddress

0..1

DP_Address

Where the event occurred

item

1..*

BackboneElement

Product or service provided
Constraints: BV-00036, BV-00042, BV-00123, BV-00439, BV-00482, BV-00484, BV-00502

0..1

string

Unique id for inter-element referencing

Slices for extension

1..*

Extension

Extension
Slice: Unordered, Open by value:url

extension:package

0..1

boolean

Package Code
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-package

extension:tax

0..1

DP_Money_SAR

Tax
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-tax

extension:patientShare

0..1

DP_Money_SAR

Patient Share
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-share

extension:payerShare

0..1

DP_Money_SAR

Payer Share
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-payer-share

extension:maternity

1..1

boolean

Maternity
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-maternity

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Item instance identifier

careTeamSequence

1..*

DP_positiveInt

Applicable careTeam members

0..*

Applicable diagnoses

0..*

Applicable procedures

informationSequence

0..*

DP_positiveInt

Applicable exception and supporting information

revenue

0..1

CodeableConcept

Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

category

0..1

CodeableConcept

Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

productOrService

1..1

DP_CodeableConcept_2

Billing, service, product, or drug code
Binding: Professional Billing (required)

modifier

0..*

CodeableConcept

Product or service billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

programCode

0..*

CodeableConcept

Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.

Slices for serviced[x]

1..1

Date or dates of service or product delivery
Slice: Unordered, Closed by type:$this

servicedDate

date

servicedPeriod

Period

serviced[x]:servicedDate

0..1

DP_date

Date or dates of service or product delivery

serviced[x]:servicedPeriod

0..1

DP_Period_2

Date or dates of service or product delivery

location[x]

0..1

Place of service or where product was supplied
Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.

locationCodeableConcept

locationAddress

locationReference

1..1

Count of products or services

unitPrice

1..1

DP_Money_SAR

Fee, charge or cost per item
Constraints: BV-00092

factor

0..1

DP_decimal

Price scaling factor

net

1..1

DP_Money_SAR

Total item cost
Constraints: BV-00093

udi

0..*

DP_Reference_1or3a(Device)

Unique device identifier

bodySite

0..1

DP_CodeableConcept

Anatomical location
Binding: SNOMEDCTBodyStructures (required)

subSite

0..1

DP_CodeableConcept

Anatomical sub-location
Binding: Sub Site (required)

encounter

0..*

Reference(Encounter)

Encounters related to this billed item

detail

0..*

BackboneElement

Product or service provided
Constraints: BV-00043

0..1

string

Unique id for inter-element referencing

Slices for extension

0..*

Extension

Extension
Slice: Unordered, Open by value:url

extension:tax

0..1

DP_Money_SAR

Tax
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-tax

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Item instance identifier

revenue

0..1

CodeableConcept

Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

category

0..1

CodeableConcept

Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

productOrService

1..1

DP_CodeableConcept_2

Billing, service, product, or drug code
Binding: Professional Billing (required)

modifier

0..*

CodeableConcept

Service/Product billing modifiers
Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.

programCode

0..*

CodeableConcept

Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.

quantity

1..1

DP_SimpleQuantity_1

Count of products or services

unitPrice

1..1

DP_Money_SAR

Fee, charge or cost per item
Constraints: BV-00094

factor

0..1

DP_decimal

Price scaling factor

net

1..1

DP_Money_SAR

Total item cost
Constraints: BV-00095

udi

0..*

DP_Reference_1or3a(Device)

Unique device identifier

subDetail

0..*

BackboneElement

Product or service provided

0..1

string

Unique id for inter-element referencing

Slices for extension

0..*

Extension

Extension
Slice: Unordered, Open by value:url

extension:tax

0..1

DP_Money_SAR

Tax
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-tax

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Item instance identifier

revenue

0..1

CodeableConcept

Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

category

0..1

CodeableConcept

Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

productOrService

1..1

DP_CodeableConcept_2

Billing, service, product, or drug code
Binding: Professional Billing (required)

0..*

0..*

Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.

quantity

1..1

DP_SimpleQuantity_1

Count of products or services

unitPrice

1..1

DP_Money_SAR

Fee, charge or cost per item

factor

0..1

DP_decimal

Price scaling factor

net

1..1

DP_Money_SAR

Total item cost

udi

0..*

DP_Reference_1or3a(Device)

Unique device identifier

total

1..1

DP_Money_SAR

Total claim cost
Constraints: BV-00096

Documentation for this format

Terminology Bindings

Path Conformance ValueSet / Code URI

Claim.meta.security

extensible

All Security Labels

http://hl7.org/fhir/ValueSet/security-labels

From the FHIR Standard

Claim.meta.tag

example

CommonTags

http://hl7.org/fhir/ValueSet/common-tags

From the FHIR Standard

Claim.language

preferred

CommonLanguages

http://hl7.org/fhir/ValueSet/languages

From the FHIR Standard

Additional Bindings

Purpose

AllLanguages

Max Binding

Claim.status

required

Pattern Value: active

http://hl7.org/fhir/ValueSet/fm-status|4.0.1

From the FHIR Standard

Claim.type

required

Pattern Value: professional

http://nphies.sa/terminology/ValueSet/claim-type

From this IG

Claim.subType

required

ClaimSubType(a valid code from Claim SubType)

http://nphies.sa/terminology/ValueSet/claim-subtype

From this IG

Claim.use

required

Pattern Value: preauthorization

http://hl7.org/fhir/ValueSet/claim-use|4.0.1

From the FHIR Standard

Claim.patient.type

extensible

ResourceType

http://hl7.org/fhir/ValueSet/resource-types

From the FHIR Standard

Claim.patient.identifier.use

required

IdentifierUse

http://hl7.org/fhir/ValueSet/identifier-use|4.0.1

From the FHIR Standard

Claim.patient.identifier.type

required

PatientIdentifierType

http://nphies.sa/terminology/ValueSet/patient-identifier-type

From this IG

Claim.insurer.type

extensible

ResourceType

http://hl7.org/fhir/ValueSet/resource-types

From the FHIR Standard

Claim.insurer.identifier.use

required

IdentifierUse

http://hl7.org/fhir/ValueSet/identifier-use|4.0.1

From the FHIR Standard

Claim.insurer.identifier.type

extensible

Pattern Value: NII

http://hl7.org/fhir/ValueSet/identifier-type

From the FHIR Standard

Claim.provider.type

extensible

ResourceType

http://hl7.org/fhir/ValueSet/resource-types

From the FHIR Standard

Claim.provider.identifier.use

required

IdentifierUse

http://hl7.org/fhir/ValueSet/identifier-use|4.0.1

From the FHIR Standard

Claim.provider.identifier.type

extensible

Pattern Value: PRN

http://hl7.org/fhir/ValueSet/identifier-type

From the FHIR Standard

Claim.priority

required

ProcessPriorityCodes

http://hl7.org/fhir/ValueSet/process-priority

From the FHIR Standard

Claim.fundsReserve

required

Funds Reservation Codes

http://hl7.org/fhir/ValueSet/fundsreserve

From the FHIR Standard

Claim.related.relationship

required

http://nphies.sa/terminology/ValueSet/related-claim-relationship

From this IG

Claim.payee.type

required

Claim Payee Type Codes

http://hl7.org/fhir/ValueSet/payeetype

From the FHIR Standard

Claim.careTeam.provider.type

extensible

ResourceType

http://hl7.org/fhir/ValueSet/resource-types

From the FHIR Standard

Claim.careTeam.provider.identifier.use

required

IdentifierUse

http://hl7.org/fhir/ValueSet/identifier-use|4.0.1

From the FHIR Standard

Claim.careTeam.provider.identifier.type

required

PractitionerIdentifier

http://nphies.sa/terminology/ValueSet/practitioner-identifier-type

From this IG

Claim.careTeam.role

required

ClaimCareTeamRoleCodes

http://hl7.org/fhir/ValueSet/claim-careteamrole

From the FHIR Standard

Claim.careTeam.qualification

required

PracticeCodes

http://nphies.sa/terminology/ValueSet/practice-codes

From this IG

Claim.supportingInfo.category

required

ClaimInformationCategory(a valid code from Claim Information Category)

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:attachment.category

required

Pattern Value: attachment

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:attachment.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:attachment.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:birth-weight.category

required

Pattern Value: birth-weight

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:birth-weight.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:birth-weight.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:birth-weight.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:chiefComplaint.category

required

Pattern Value: chief-complaint

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:chiefComplaint.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:chiefComplaint.code.coding

required

SNOMEDCTClinicalFindings

http://hl7.org/fhir/ValueSet/clinical-findings

From the FHIR Standard

Claim.supportingInfo:chiefComplaint.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:daysSupply.category

required

Pattern Value: days-supply

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:daysSupply.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:daysSupply.value[x]:valueQuantity.comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:daysSupply.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:employmentImpacted.category

required

Pattern Value: employmentImpacted

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:employmentImpacted.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:employmentImpacted.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:history-of-present-illness.category

required

Pattern Value: history-of-present-illness

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:history-of-present-illness.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:history-of-present-illness.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:info.category

required

Pattern Value: info

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:info.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:info.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:investigation-result.category

required

Pattern Value: investigation-result

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:investigation-result.code

required

InvestigationResult(a valid code from Investigation Result)

http://nphies.sa/terminology/ValueSet/investigation-result

From this IG

Claim.supportingInfo:investigation-result.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:labTest.category

required

Pattern Value: lab-test

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:labTest.code

required

LOINCCodes(a valid code from LOINC)

http://hl7.org/fhir/ValueSet/observation-codes

From the FHIR Standard

Claim.supportingInfo:labTest.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:labTest.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:last-menstrual-period.category

required

Pattern Value: last-menstrual-period

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:last-menstrual-period.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:last-menstrual-period.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:onset.category

required

Pattern Value: onset

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:onset.code

required

ICD_10_AM(a valid code from http://hl7.org/fhir/sid/icd-10-am)

http://nphies.sa/terminology/ValueSet/diagnosis-icd-10-am

From this IG

Claim.supportingInfo:onset.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:oxygen-saturation.category

required

Pattern Value: oxygen-saturation

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:oxygen-saturation.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:oxygen-saturation.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:oxygen-saturation.reason

required

OxygenSaturationAbsenceReason(a valid code from Oxygen Saturation Absence Reason)

http://nphies.sa/terminology/ValueSet/oxygen-saturation-absence-reason

From this IG

Claim.supportingInfo:patient-history.category

required

Pattern Value: patient-history

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:patient-history.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:patient-history.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:physical-examination.category

required

Pattern Value: physical-examination

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:physical-examination.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:physical-examination.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:pulse.category

required

Pattern Value: pulse

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:pulse.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:pulse.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:pulse.reason

required

PulseAbsenceReason(a valid code from Pulse Absence Reason)

http://nphies.sa/terminology/ValueSet/pulse-absence-reason

From this IG

Claim.supportingInfo:reasonForVisit.category

required

Pattern Value: reason-for-visit

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:reasonForVisit.code

required

VisitReason(a valid code from Visit Reason)

http://nphies.sa/terminology/ValueSet/visit-reason

From this IG

Claim.supportingInfo:reasonForVisit.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:respiratory-rate.category

required

Pattern Value: respiratory-rate

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:respiratory-rate.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:respiratory-rate.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:respiratory-rate.reason

required

RespiratoryRateAbsenceReason(a valid code from Respiratory Rate Absence Reason)

http://nphies.sa/terminology/ValueSet/respiratory-rate-absence-reason

From this IG

Claim.supportingInfo:temperature.category

required

Pattern Value: temperature

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:temperature.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:temperature.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:temperature.reason

required

TemperatureAbsenceReason(a valid code from Temperature Absence Reason)

http://nphies.sa/terminology/ValueSet/temperature-absence-reason

From this IG

Claim.supportingInfo:treatment-plan.category

required

Pattern Value: treatment-plan

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:treatment-plan.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:treatment-plan.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:vitalSignDiastolic.category

required

Pattern Value: vital-sign-diastolic

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:vitalSignDiastolic.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:vitalSignDiastolic.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:vitalSignDiastolic.reason

required

BloodPressureAbsenceReason(a valid code from Blood Pressure Absence Reason)

http://nphies.sa/terminology/ValueSet/blood-pressure-absence-reason

From this IG

Claim.supportingInfo:vitalSignHeight.category

required

Pattern Value: vital-sign-height

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:vitalSignHeight.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:vitalSignHeight.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:vitalSignHeight.reason

required

HeightAbsenceReason(a valid code from Height Absence Reason)

http://nphies.sa/terminology/ValueSet/height-absence-reason

From this IG

Claim.supportingInfo:vitalSignSystolic.category

required

Pattern Value: vital-sign-systolic

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:vitalSignSystolic.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:vitalSignSystolic.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:vitalSignSystolic.reason

required

BloodPressureAbsenceReason(a valid code from Blood Pressure Absence Reason)

http://nphies.sa/terminology/ValueSet/blood-pressure-absence-reason

From this IG

Claim.supportingInfo:vitalSignWeight.category

required

Pattern Value: vital-sign-weight

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:vitalSignWeight.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:vitalSignWeight.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:vitalSignWeight.reason

required

WeightAbsenceReason(a valid code from Weight Absence Reason)

http://nphies.sa/terminology/ValueSet/weight-absence-reason

From this IG

Claim.diagnosis.diagnosis[x]

example

ICD-10Codes

http://hl7.org/fhir/ValueSet/icd-10

From the FHIR Standard

Claim.diagnosis.diagnosis[x]:diagnosisCodeableConcept

required

ICD_10_AM(a valid code from http://hl7.org/fhir/sid/icd-10-am)

http://nphies.sa/terminology/ValueSet/diagnosis-icd-10-am

From this IG

Claim.diagnosis.type

required

DiagnosisType(a valid code from Diagnosis Type)

http://nphies.sa/terminology/ValueSet/diagnosis-type

From this IG

Claim.diagnosis.onAdmission

example

ExampleDiagnosisOnAdmissionCodes

http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission

From the FHIR Standard

Claim.diagnosis.packageCode

example

ExampleDiagnosisRelatedGroupCodes

http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup

From the FHIR Standard

Claim.procedure.type

example

ExampleProcedureTypeCodes

http://hl7.org/fhir/ValueSet/ex-procedure-type

From the FHIR Standard

Claim.procedure.procedure[x]

example

ICD-10ProcedureCodes

http://hl7.org/fhir/ValueSet/icd-10-procedures

From the FHIR Standard

Claim.accident.type

required

ActIncidentCode

http://terminology.hl7.org/ValueSet/v3-ActIncidentCode

Claim.item.revenue

example

ExampleRevenueCenterCodes

http://hl7.org/fhir/ValueSet/ex-revenue-center

From the FHIR Standard

Claim.item.category

example

BenefitCategoryCodes

http://hl7.org/fhir/ValueSet/ex-benefitcategory

From the FHIR Standard

Claim.item.productOrService

required

ProfessionalBilling

http://nphies.sa/terminology/ValueSet/professional-billing

From this IG

Claim.item.modifier

example

ModifierTypeCodes

http://hl7.org/fhir/ValueSet/claim-modifiers

From the FHIR Standard

Claim.item.programCode

example

ExampleProgramReasonCodes

http://hl7.org/fhir/ValueSet/ex-program-code

From the FHIR Standard

Claim.item.location[x]

example

ExampleServicePlaceCodes

http://hl7.org/fhir/ValueSet/service-place

From the FHIR Standard

Claim.item.bodySite

required

SNOMEDCTBodyStructures

http://hl7.org/fhir/ValueSet/body-site

From the FHIR Standard

Claim.item.subSite

required

SubSite(a valid code from Sub Site)

http://nphies.sa/terminology/ValueSet/subsite

From this IG

Claim.item.detail.revenue

example

ExampleRevenueCenterCodes

http://hl7.org/fhir/ValueSet/ex-revenue-center

From the FHIR Standard

Claim.item.detail.category

example

BenefitCategoryCodes

http://hl7.org/fhir/ValueSet/ex-benefitcategory

From the FHIR Standard

Claim.item.detail.productOrService

required

ProfessionalBilling

http://nphies.sa/terminology/ValueSet/professional-billing

From this IG

Claim.item.detail.modifier

example

ModifierTypeCodes

http://hl7.org/fhir/ValueSet/claim-modifiers

From the FHIR Standard

Claim.item.detail.programCode

example

ExampleProgramReasonCodes

http://hl7.org/fhir/ValueSet/ex-program-code

From the FHIR Standard

Claim.item.detail.subDetail.revenue

example

ExampleRevenueCenterCodes

http://hl7.org/fhir/ValueSet/ex-revenue-center

From the FHIR Standard

Claim.item.detail.subDetail.category

example

BenefitCategoryCodes

http://hl7.org/fhir/ValueSet/ex-benefitcategory

From the FHIR Standard

Claim.item.detail.subDetail.productOrService

required

ProfessionalBilling

http://nphies.sa/terminology/ValueSet/professional-billing

From this IG

Claim.item.detail.subDetail.modifier

example

ModifierTypeCodes

http://hl7.org/fhir/ValueSet/claim-modifiers

From the FHIR Standard

Claim.item.detail.subDetail.programCode

example

ExampleProgramReasonCodes

http://hl7.org/fhir/ValueSet/ex-program-code

From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
BV-00002	error	Claim	Claim care team sequence is not unique within the submitted claim resource. : careTeam.exists() implies careTeam.sequence.isDistinct()
BV-00036	error	Claim.item	No Claim item detail provided when Claim item package = true. : extension('http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-package').exists() implies extension('http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-package').first().value = true implies detail.exists().not()
BV-00042	error	Claim.item	Claim item detail sequence in not unique within the Claim item. : detail.sequence.exists() implies detail.sequence.isDistinct()
BV-00043	error	Claim.item.detail	Claim item subDetail sequence in not unique within the Claim item detail. : subDetail.sequence.exists() implies subDetail.sequence.isDistinct()
BV-00044	error	Claim	Item sequence value is not unique within the Claim resource. : item.sequence.exists() implies item.sequence.isDistinct()
BV-00054	error	Claim	One and only one principal diagnosis is required. : diagnosis.type.coding.where(code='principal').count() = 1
BV-00056	error	Claim.payee	Payee party is not provided when payee type='other'. : type.coding.where(code='other').count() > 0 implies party.exists()
BV-00057	error	Claim	Diagnosis is not unique in the submitted request. : diagnosis.diagnosis.ofType(CodeableConcept).isDistinct()
BV-00092	error	Claim.item.unitPrice	Claim Item UnitPrice Currency is not SAR. : currency = 'SAR'
BV-00093	error	Claim.item.net	Claim Item Net Currency is not SAR. : currency = 'SAR'
BV-00094	error	Claim.item.detail.unitPrice	Claim Item Detail UnitPrice Currency is not SAR. : currency = 'SAR'
BV-00095	error	Claim.item.detail.net	Claim Item Detail Net Currency is not SAR. : currency = 'SAR'
BV-00096	error	Claim.total	Claim Total Net Currency is not SAR. : currency = 'SAR'
BV-00123	error	Claim.item	Claim servicedate is not using a correct data type. : serviced.ofType(date).exists() or serviced.ofType(Period).exists()
BV-00137	error	Claim	The claim identifier does not exist. : identifier.exists()
BV-00316	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Claim supportingInfo valueString value length is longer than the maximum specified length of 250 English characters and 125 Arabic characters. : value.ofType(string).exists() implies value.ofType(string).length() <= 250
BV-00330	error	Claim	Claim status is not using the specified value 'active'. : status.exists() implies status='active'
BV-00347	error	Claim.extension:eligibilityOffLineDate	Claim eligibility OfflineDate is greater than current date. : value.ofType(dateTime) <= now()
BV-00365	error	Claim	Claim subtype is using an incorrect value when Claim type is 'Professional'. : subType.coding.first().code = 'op' or subType.coding.first().code = 'emr'
BV-00402	error	Claim.supportingInfo:info	Supporting information 'info' requires textual information in valueString. : value.ofType(string).exists()
BV-00404	error	Claim.supportingInfo:attachment	Supporting information 'attachment' requires the content to be provided. : value.ofType(Attachment).exists()
BV-00409	error	Claim.supportingInfo:employmentImpacted	Supporting information 'employmentImpacted' requires the period during which the employment was impacted. : timing.ofType(Period).exists()
BV-00410	error	Claim.supportingInfo:labTest	Supporting information 'lab-test' requires a valid LOINC code. : code.exists()
BV-00411	error	Claim.supportingInfo:labTest	If supporting information is 'lab-test' then valueQuantity SHALL exist and SHALL use a value specified in the UCUM code-system. : value.ofType(Quantity).exists()
BV-00412	error	Claim.supportingInfo:reasonForVisit	Supporting information 'reason-for-visit' requires a value from the specified NPHIES CodeSystem mentioning the reason for the visit. : code.exists()
BV-00413	error	Claim.supportingInfo:daysSupply	If Supporting information is 'days-supply' then valueQuantity SHALL exist and number of days SHALL use UCUM code 'd'. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'd'
BV-00414	error	Claim.supportingInfo:vitalSignWeight	If Supporting information is 'vital-sign-weight' and valueQuantity exist then it should use 'kg' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'kg'
BV-00415	error	Claim.supportingInfo:vitalSignSystolic	If Supporting information is 'vital-sign-systolic' and valueQuantity exist then it should use 'mm[Hg]'' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'mm[Hg]'
BV-00416	error	Claim.supportingInfo:vitalSignDiastolic	If Supporting information is 'vital-sign-diastolic' and valueQuantity exist then it should use 'mm[Hg]' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'mm[Hg]'
BV-00417	error	Claim.supportingInfo:vitalSignHeight	If Supporting information is 'vital-sign-height' and valueQuantity exist then it should use 'cm' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'cm'
BV-00428	error	Claim.supportingInfo:onset	Supporting information 'onset' requires the starting date and the ICD 10 code for the symptoms / illness. : code.exists() and timing.ofType(date).exists()
BV-00429	error	Claim.supportingInfo:chiefComplaint	Supporting information 'chief-complaint' requires the ICD 10 code for the symptoms / illness if a code is supplied. : code.exists()
BV-00439	error	Claim.item	If period is provided then Claim.item.servicedDate must not be used. : serviced.exists() implies (serviced.ofType(date).exists() xor serviced.ofType(Period).exists())
BV-00453	error	Claim	Claim supportingInfo sequence value is not unique within the claim request. : supportingInfo.sequence.exists() implies supportingInfo.sequence.isDistinct()
BV-00454	error	Claim	Claim diagnosis sequence value is not unique within the claim request. : diagnosis.sequence.isDistinct()
BV-00482	error	Claim.item	Item factor must be a positive decimal value. : factor.exists() implies factor >= 0
BV-00484	error	Claim.item	The subSite shall not be allowed if the bodySite is not provided. : subSite.exists() implies bodySite.exists()
BV-00486	error	Claim.supportingInfo:temperature	If Supporting information is 'temperature' and valueQuantity exist then it should use 'Cel' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'Cel'
BV-00487	error	Claim.supportingInfo:pulse	If Supporting information is 'pulse' and valueQuantity exist then it should use '/min' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '/min'
BV-00488	error	Claim.supportingInfo:oxygen-saturation	If Supporting information is 'oxygen-saturation' and valueQuantity exist then it should use '%' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '%'
BV-00489	error	Claim.supportingInfo:respiratory-rate	If Supporting information is 'respiratory-rate' and valueQuantity exist then it should use '/min' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '/min'
BV-00490	error	Claim.supportingInfo:last-menstrual-period	Supporting information 'last-menstrual-period' requires the date of start of last menstrual period. : timing.ofType(date).exists()
BV-00494	error	Claim.payee	Claim payee party must not provided when Claim payee type value is not 'other'. : type.coding.where(code!='other').count() > 0 implies party.exists().not()
BV-00502	error	Claim.item	Claim item informationSequence is not unique within the Claim item. : informationSequence.isDistinct()
BV-00509	error	Claim.supportingInfo:birth-weight	If Supporting information is 'birth-weight' then valueQuantity shall exist and should use 'kg' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'kg'
BV-00530	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	If supportingInfo code element is provided and the category is not 'chief-complaint' then a code is required. : (code.exists() and category.coding.first().code != 'chief-complaint') implies code.coding.code.exists()
BV-00531	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	The supportingInfo code element is required if supportingInfo category is 'chief-complaint'. : category.exists() implies (category.coding.first().code = 'chief-complaint') implies code.exists()
BV-00752	error	Claim	Supporting information 'investigation-result' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'investigation-result').exists()
BV-00753	error	Claim.supportingInfo:investigation-result	Investigation Result ('Text' - value[x] valueString' Shall be Provided when Investigation Result Supporting info is selected with Code = 'other'. : ((code.coding.where(code='other').count() > 0) and value.exists()) implies value.ofType(string).exists()
BV-00771	error	Claim	Oxygen-saturation SHALL be provided in institutional claim or authorization. : supportingInfo.category.coding.where(code='oxygen-saturation').count() > 0
BV-00772	error	Claim	Diastolic SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-diastolic').count() > 0
BV-00773	error	Claim	Systolic SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-systolic').count() > 0
BV-00774	error	Claim	Pulse SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='pulse').count() > 0
BV-00775	error	Claim	Temperature SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='temperature').count() > 0
BV-00776	error	Claim	Height SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-height').count() > 0
BV-00777	error	Claim	Respiratory-rate SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='respiratory-rate').count() > 0
BV-00778	error	Claim	Weight SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-weight').count() > 0
BV-00779	error	Claim	Chief-complaint SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='chief-complaint').count() > 0
BV-00780	error	Claim	Oxygen-saturation SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='oxygen-saturation').count() > 0
BV-00782	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Supporting information 'treatment-plan' requires textual information. : category.coding.where(code='treatment-plan').count() > 0 implies value.ofType(string).exists()
BV-00783	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Supporting information 'patient-history' requires textual information. : category.coding.where(code='patient-history').count() > 0 implies value.ofType(string).exists()
BV-00784	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Supporting information 'physical-examination' requires textual information . : category.coding.where(code='physical-examination').count() > 0 implies value.ofType(string).exists()
BV-00785	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Supporting information 'history-of-present-illness' requires textual information . : category.coding.where(code='history-of-present-illness').count() > 0 implies value.ofType(string).exists()
BV-00803	error	Claim	Supporting information 'treatment-plan' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'treatment-plan').exists()
BV-00804	error	Claim	Supporting information 'patient-history' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'patient-history').exists()
BV-00805	error	Claim	Supporting information 'pphysical-examination' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'physical-examination').exists()
BV-00806	error	Claim	Supporting information 'history-of-present-illness' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'history-of-present-illness').exists()
BV-00812	error	Claim.supportingInfo:vitalSignWeight	If Claim supportingInfo category='vital-sign-weight' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00813	error	Claim.supportingInfo:vitalSignSystolic	If Claim supportingInfo category='vital-sign-systolic' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00814	error	Claim.supportingInfo:vitalSignDiastolic	If Claim supportingInfo category='vital-sign-diastolic' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00815	error	Claim.supportingInfo:vitalSignHeight	If Claim supportingInfo category='vital-sign-height' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00816	error	Claim.supportingInfo:temperature	If Claim supportingInfo category='temperature' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00817	error	Claim.supportingInfo:pulse	If Claim supportingInfo category='pulse' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00818	error	Claim.supportingInfo:oxygen-saturation	If Claim supportingInfo category='oxygen-saturation' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00819	error	Claim.supportingInfo:respiratory-rate	If Claim supportingInfo category='respiratory-rate' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00820	error	Claim.supportingInfo:vitalSignWeight	If Claim.supportingInfo.category.coding.code='vital-sign-weight' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/weight-absence-reason'
BV-00821	error	Claim.supportingInfo:vitalSignSystolic	If Claim.supportingInfo.category.coding.code='vital-sign-systolic' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/blood-pressure-absence-reason'
BV-00822	error	Claim.supportingInfo:vitalSignDiastolic	If Claim.supportingInfo.category.coding.code='vital-sign-diastolic' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/blood-pressure-absence-reason'
BV-00823	error	Claim.supportingInfo:vitalSignHeight	If Claim.supportingInfo.category.coding.code='vital-sign-height' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/height-absence-reason'
BV-00824	error	Claim.supportingInfo:temperature	If Claim.supportingInfo.category.coding.code='temperature' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/tempurature-absence-reason'
BV-00825	error	Claim.supportingInfo:pulse	If Claim.supportingInfo.category.coding.code='pulse' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/pulse-absence-reason'
BV-00826	error	Claim.supportingInfo:oxygen-saturation	If Claim.supportingInfo.category.coding.code='oxygen-saturation' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/oxygen-saturation-absence-reason'
BV-00827	error	Claim.supportingInfo:respiratory-rate	If Claim.supportingInfo.category.coding.code='respiratory-rate' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/respiratory-rate-absence-reason'
BV-00846	error	Claim.supportingInfo:investigation-result	Supporting information 'investigation-result' requires a attachment when attachment code is used with Code = 'IRA'. : (code.coding.where(code='IRA').count() > 0) implies value.ofType(Attachment).exists()
P-Auth-1	error	Claim.subType	SubType may only be OP or EMR : coding.first().code = 'op' or coding.first().code = 'emr'
P-Auth-SI-1	error	Claim.supportingInfo:vitalSignWeight	Patient weight must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-2	error	Claim.supportingInfo:vitalSignSystolic	Systolic blood pressure must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-3	error	Claim.supportingInfo:vitalSignDiastolic	Diastolic blood pressure must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-4	error	Claim.supportingInfo:vitalSignHeight	Patient height must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-5	error	Claim.supportingInfo:temperature	Patient temperature must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-6	error	Claim.supportingInfo:pulse	Patient pulse must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-7	error	Claim.supportingInfo:oxygen-saturation	Patient oxygen saturation must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-8	error	Claim.supportingInfo:respiratory-rate	Patient respiratory rate must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
dom-2	error	Claim	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Claim	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Claim	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Claim	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Claim	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from NphiesAuthorizationBase

Summary

Mandatory: 40 elements(21 nested mandatory elements)
Must-Support: 27 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

The element 1 is sliced based on the value of Claim.supportingInfo (Closed)
The element 1 is sliced based on the value of Claim.supportingInfo.timing[x]
The element 1 is sliced based on the value of Claim.supportingInfo.value[x]

Key Elements View

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Claim	C	0..*	NphiesAuthorizationBase	Claim, Pre-determination or Pre-authorization Constraints: BV-00002, BV-00044, BV-00054, BV-00057, BV-00137, BV-00330, BV-00453, BV-00454, BV-00365, BV-00803, BV-00804, BV-00805, BV-00806, BV-00752, BV-00771, BV-00772, BV-00773, BV-00774, BV-00775, BV-00776, BV-00777, BV-00778, BV-00779, BV-00780
id	Σ	1..1	id	Logical id of this artifact Max Length:64
meta	Σ	1..1	Meta	Metadata about the resource
profile	Σ	1..*	DP_canonical(StructureDefinition)	Profiles this resource claims to conform to
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:eligibilityResponse	S	0..1	DP_Reference_3a(Nphies CoverageEligibilityResponse)	Eligibility Response URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-eligibility-response
extension:eligibilityOffLine	S	0..1	DP_string	Eligibility Offline Reference URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-eligibility-offline-reference
extension:eligibilityOffLineDate	SC	0..1	DP_dateTime	Eligibility Offline Date URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-eligibility-offline-date Constraints: BV-00347
extension:newborn	S	0..1	boolean	Newborn URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-newborn
extension:transfer	S	0..1	boolean	Transfer URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-transfer
extension:transferAuthorizationProvider	S	0..1	DP_Reference_1or4(Nphies Provider Organization \| Nphies Practitioner)	Transfer Authorization Provider URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-transferAuthorizationProvider
extension:transferAuthorizationPeriod	S	0..1	DP_Period_2	Transfer Authorization Period URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-transferAuthorizationPeriod
extension:transferAuthorizationNumber	S	0..1	DP_string	Transfer Authorization Number URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-transferAuthorizationNumber
extension:encounter		1..1	(Complex)	Encounter URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-encounter
extension		0..0
url		1..1	uri	"http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-encounter"
value[x]		1..1	DP_Reference_1(Nphies Encounter AMB (Auth) \| Nphies Encounter EMER (Auth) \| Nphies Encounter HH (Auth) \| Nphies Encounter VR (Auth))	Value of extension
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		1..1	DP_Identifier_A	Business Identifier for claim
status	?!Σ	1..1	DP_code	active \| cancelled \| draft \| entered-in-error Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance. Required Pattern: active
type	Σ	1..1	DP_CodeableConcept	Category or discipline Binding: Claim Type Codes (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: professional
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
subType	C	1..1	DP_CodeableConcept	More granular claim type Binding: Claim SubType (required) Constraints: P-Auth-1
use	Σ	1..1	DP_code	claim \| preauthorization \| predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim. Required Pattern: preauthorization
patient	Σ	1..1	DP_Reference_1or2a(Nphies Patient)	The recipient of the products and services
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL Max Length:250
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual \| official \| temp \| secondary \| old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	DP_CodeableConcept	Description of identifier Binding: Patient Identifier Type (required)
system	Σ	1..1	DP_uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456 Max Length:50
display	Σ	0..1	string	Text alternative for the resource Max Length:200
created	Σ	1..1	DP_dateTime	Resource creation date
insurer	Σ	1..1	DP_Reference_1or2a(Nphies Insurer Organization)	Target
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL Max Length:250
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual \| official \| temp \| secondary \| old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	DP_CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: NII
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	DP_uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456 Max Length:50
display	Σ	0..1	string	Text alternative for the resource Max Length:200
provider	Σ	1..1	DP_Reference_1or2a(Nphies Provider Organization)	Party responsible for the claim
reference	SΣC	0..1	string	Literal reference, Relative, internal or absolute URL Max Length:250
identifier	SΣ	0..1	Identifier	Logical reference, when literal reference is not known
use	?!Σ	0..1	code	usual \| official \| temp \| secondary \| old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	1..1	DP_CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/v2-0203
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: PRN
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	DP_uri	The namespace for the identifier value Example General: http://www.acme.com/identifiers/patient
value	Σ	1..1	string	The value that is unique Example General: 123456 Max Length:50
display	Σ	0..1	string	Text alternative for the resource Max Length:200
priority	Σ	1..1	DP_CodeableConcept	Desired processing ugency Binding: ProcessPriorityCodes (required)
fundsReserve	S	0..1	DP_CodeableConcept	For whom to reserve funds Binding: Funds Reservation Codes (required)
related	S	0..*	BackboneElement	Prior or corollary claims
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
claim		1..1	DP_Reference_1or3a(Nphies Authorization Professional)	Reference to the related claim
relationship		1..1	DP_CodeableConcept	How the reference claim is related Binding: Related Claim Relationship (required)
payee	C	1..1	BackboneElement	Recipient of benefits payable Constraints: BV-00056, BV-00494
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	DP_CodeableConcept	Category of recipient Binding: Claim Payee Type Codes (required)
party	S	0..1	DP_Reference_1or2b(Nphies Organization \| Nphies Patient)	Recipient reference
referral	S	0..1	DP_Reference_3a(ServiceRequest)	Treatment referral
facility	S	0..1	DP_Reference_1(Nphies Location)	Servicing facility
careTeam		1..*	BackboneElement	Members of the care team
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Order of care team
provider		1..1	DP_Reference_1or2a(Nphies Practitioner)	Practitioner or organization
role		1..1	DP_CodeableConcept	Function within the team Binding: ClaimCareTeamRoleCodes (required)
qualification		1..1	DP_CodeableConcept	Practitioner credential or specialization Binding: Practice Codes (required)
Slices for supportingInfo	SC	13..*	BackboneElement	Supporting information Slice: Unordered, Closed by value:category Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531
supportingInfo:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required)
supportingInfo:attachment	SC	0..*	BackboneElement	Attachment Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00404
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: attachment
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]		1..1	DP_Attachment	Data to be provided
supportingInfo:birth-weight	SC	0..1	BackboneElement	Birth Weight Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00509
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: birth-weight
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]		1..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: kg
value	Σ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
supportingInfo:chiefComplaint	SC	1..1	BackboneElement	Chief Complaint Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00429
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: chief-complaint
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code		1..1	DP_CodeableConcept_1	Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes.
coding	SΣ	0..*	DP_Coding	Code defined by a terminology system Binding: SNOMEDCTClinicalFindings (required)
text	SΣ	0..1	string	Plain text representation of the concept Max Length:250
supportingInfo:daysSupply	SC	0..*	BackboneElement	Days Supply Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00413
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: days-supply
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for value[x]		1..1		Data to be provided Slice: Unordered, Open by type:$this
valueBoolean			boolean
valueString			string
valueQuantity			Quantity
valueAttachment			Attachment
valueReference			Reference(Resource)
value[x]:valueQuantity		0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: d
value	Σ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
supportingInfo:employmentImpacted	SC	0..1	BackboneElement	Employment impacted Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00409
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: employmentImpacted
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_1	When it occurred
supportingInfo:history-of-present-illness	SC	1..1	BackboneElement	History of Present Illness Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: history-of-present-illness
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]		1..1	DP_string	Data to be provided
supportingInfo:info	SC	0..*	BackboneElement	Information Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00402
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: info
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]		1..1	DP_string	Data to be provided
supportingInfo:investigation-result	SC	0..*	BackboneElement	Investigation Result Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00753, BV-00846
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: investigation-result
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code		1..1	DP_CodeableConcept	Type of information Binding: Investigation Result (required)
Slices for value[x]	S	0..1		Data to be provided Slice: Unordered, Closed by type:$this
valueString			string(DP_string)
valueAttachment			Attachment(DP_Attachment)
value[x]:valueAttachment	S	0..1	DP_Attachment	Data to be provided
value[x]:valueString	S	0..1	DP_string	Data to be provided
supportingInfo:labTest	SC	0..*	BackboneElement	Lab Test Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00410, BV-00411
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: lab-test
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code		1..1	DP_CodeableConcept	Type of information Binding: LOINCCodes (required)
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]		1..1	DP_Quantity_2	Data to be provided
value	Σ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
code	Σ	1..1	DP_code	Coded form of the unit
supportingInfo:last-menstrual-period	SC	0..1	BackboneElement	Last Menstrual Period Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00490
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: last-menstrual-period
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	date	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingDate		1..1	DP_date	When it occurred
supportingInfo:onset	SC	0..*	BackboneElement	Onset of symptoms Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00428
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: onset
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code		1..1	DP_CodeableConcept	Type of information Binding: ICD-10-AM (required)
Slices for timing[x]		1..1	date	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingDate		1..1	DP_date	When it occurred
supportingInfo:oxygen-saturation	SC	1..1	BackboneElement	Patient Oxygen Saturation Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-7, BV-00488, BV-00818, BV-00826
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: oxygen-saturation
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: %
value	SΣ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Oxygen Saturation Absence Reason (required)
supportingInfo:patient-history	SC	1..1	BackboneElement	Patient History Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: patient-history
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]		1..1	DP_string	Data to be provided
supportingInfo:physical-examination	SC	1..1	BackboneElement	Physical Examination Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: physical-examination
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]		1..1	DP_string	Data to be provided
supportingInfo:pulse	SC	1..1	BackboneElement	Patient pulse Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-6, BV-00487, BV-00817, BV-00825
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: pulse
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: /min
value	SΣ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Pulse Absence Reason (required)
supportingInfo:reasonForVisit	SC	0..1	BackboneElement	Reason for visit Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00412
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: reason-for-visit
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
code		1..1	DP_CodeableConcept	Type of information Binding: Visit Reason (required)
supportingInfo:respiratory-rate	SC	1..1	BackboneElement	Patient Respiratory Rate Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-8, BV-00489, BV-00819, BV-00827
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: respiratory-rate
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: /min
value	SΣ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Respiratory Rate Absence Reason (required)
supportingInfo:temperature	SC	1..1	BackboneElement	Temperature Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-5, BV-00486, BV-00816, BV-00824
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: temperature
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: Cel
value	SΣ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Temperature Absence Reason (required)
supportingInfo:treatment-plan	SC	1..1	BackboneElement	Treatment Plan Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: treatment-plan
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
value[x]		1..1	DP_string	Data to be provided
supportingInfo:vitalSignDiastolic	SC	1..1	BackboneElement	Diastolic Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-3, BV-00416, BV-00814, BV-00822
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-sign-diastolic
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: mm[Hg]
value	SΣ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Blood Pressure Absence Reason (required)
supportingInfo:vitalSignHeight	SC	1..1	BackboneElement	Patient height Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-4, BV-00417, BV-00815, BV-00823
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-sign-height
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: cm
value	SΣ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Height Absence Reason (required)
supportingInfo:vitalSignSystolic	SC	1..1	BackboneElement	Systolic Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-2, BV-00415, BV-00813, BV-00821
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-sign-systolic
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: mm[Hg]
value	SΣ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Blood Pressure Absence Reason (required)
supportingInfo:vitalSignWeight	SC	1..1	BackboneElement	Patient weight Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-1, BV-00414, BV-00812, BV-00820
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Information instance identifier
category		1..1	DP_CodeableConcept	Classification of the supplied information Binding: Claim Information Category (required) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-sign-weight
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Closed by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
value		0..1	decimal	Numerical value (with implicit precision)
comparator		0..1	code	< \| <= \| >= \| > - how to understand the value
unit		0..1	string	Unit representation
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: kg
value	SΣ	1..1	DP_decimal	Numerical value (with implicit precision)
comparator	?!Σ	0..1	code	< \| <= \| >= \| > - how to understand the value Binding: QuantityComparator (required): How the Quantity should be understood and represented.
unit	Σ	0..1	string	Unit representation Max Length:40
system	ΣC	1..1	DP_uri	System that defines coded unit form
code	Σ	1..1	DP_code	Coded form of the unit
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Weight Absence Reason (required)
diagnosis		1..*	BackboneElement	Pertinent diagnosis information
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Diagnosis instance identifier
Slices for diagnosis[x]		1..1	CodeableConcept	Nature of illness or problem Slice: Unordered, Closed by type:$this Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.
diagnosis[x]:diagnosisCodeableConcept		1..1	DP_CodeableConcept	Nature of illness or problem Binding: ICD-10-AM (required)
type		1..1	DP_CodeableConcept	Timing or nature of the diagnosis Binding: Diagnosis Type (required)
insurance	Σ	1..*	BackboneElement	Patient insurance information
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	1..1	DP_positiveInt	Insurance instance identifier
focal	Σ	1..1	boolean	Coverage to be used for adjudication
coverage	Σ	1..1	DP_Reference_1(Nphies Coverage)	Insurance information
preAuthRef	S	0..*	string	Prior authorization reference number
claimResponse	S	0..1	DP_Reference_1or3a(Nphies Authorization Response)	Adjudication results
accident	S	0..1	BackboneElement	Details of the event
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
date		1..1	DP_date	When the incident occurred
type		1..1	DP_CodeableConcept	The nature of the accident Binding: ActIncidentCode (required)
Slices for location[x]		0..1		Where the event occurred Slice: Unordered, Open by type:$this
locationAddress			Address
locationReference			Reference(Location)
location[x]:locationAddress	S	0..1	DP_Address	Where the event occurred
item	C	1..*	BackboneElement	Product or service provided Constraints: BV-00036, BV-00042, BV-00123, BV-00439, BV-00482, BV-00484, BV-00502
Slices for extension	S	1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:package	S	0..1	boolean	Package Code URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-package
extension:tax	S	0..1	DP_Money_SAR	Tax URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-tax
extension:patientShare	S	0..1	DP_Money_SAR	Patient Share URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-share
extension:payerShare	S	0..1	DP_Money_SAR	Payer Share URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-payer-share
extension:maternity	S	1..1	boolean	Maternity URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-maternity
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Item instance identifier
careTeamSequence		1..*	DP_positiveInt	Applicable careTeam members
diagnosisSequence	S	0..*	DP_positiveInt	Applicable diagnoses
informationSequence	S	0..*	DP_positiveInt	Applicable exception and supporting information
productOrService		1..1	DP_CodeableConcept_2	Billing, service, product, or drug code Binding: Professional Billing (required)
Slices for serviced[x]		1..1		Date or dates of service or product delivery Slice: Unordered, Closed by type:$this
servicedDate			date
servicedPeriod			Period
serviced[x]:servicedDate	S	0..1	DP_date	Date or dates of service or product delivery
serviced[x]:servicedPeriod	S	0..1	DP_Period_2	Date or dates of service or product delivery
quantity		1..1	DP_SimpleQuantity_1	Count of products or services
unitPrice	C	1..1	DP_Money_SAR	Fee, charge or cost per item Constraints: BV-00092
factor	S	0..1	DP_decimal	Price scaling factor
net	C	1..1	DP_Money_SAR	Total item cost Constraints: BV-00093
udi	S	0..*	DP_Reference_1or3a(Device)	Unique device identifier
bodySite	S	0..1	DP_CodeableConcept	Anatomical location Binding: SNOMEDCTBodyStructures (required)
subSite	S	0..1	DP_CodeableConcept	Anatomical sub-location Binding: Sub Site (required)
detail	SC	0..*	BackboneElement	Product or service provided Constraints: BV-00043
Slices for extension				Content/Rules for all slices
extension:tax	S	0..1	DP_Money_SAR	Tax URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-tax
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Item instance identifier
productOrService		1..1	DP_CodeableConcept_2	Billing, service, product, or drug code Binding: Professional Billing (required)
quantity		1..1	DP_SimpleQuantity_1	Count of products or services
unitPrice	C	1..1	DP_Money_SAR	Fee, charge or cost per item Constraints: BV-00094
factor	S	0..1	DP_decimal	Price scaling factor
net	C	1..1	DP_Money_SAR	Total item cost Constraints: BV-00095
udi	S	0..*	DP_Reference_1or3a(Device)	Unique device identifier
subDetail	S	0..*	BackboneElement	Product or service provided
Slices for extension				Content/Rules for all slices
extension:tax	S	0..1	DP_Money_SAR	Tax URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-tax
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	DP_positiveInt	Item instance identifier
productOrService		1..1	DP_CodeableConcept_2	Billing, service, product, or drug code Binding: Professional Billing (required)
quantity		1..1	DP_SimpleQuantity_1	Count of products or services
unitPrice		1..1	DP_Money_SAR	Fee, charge or cost per item
factor	S	0..1	DP_decimal	Price scaling factor
net		1..1	DP_Money_SAR	Total item cost
udi	S	0..*	DP_Reference_1or3a(Device)	Unique device identifier
total	C	1..1	DP_Money_SAR	Total claim cost Constraints: BV-00096
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet / Code	URI
Claim.status	required	Pattern Value: active `http://hl7.org/fhir/ValueSet/fm-status\|4.0.1` From the FHIR Standard
Claim.type	required	Pattern Value: professional `http://nphies.sa/terminology/ValueSet/claim-type` From this IG
Claim.subType	required	ClaimSubType(a valid code from Claim SubType) `http://nphies.sa/terminology/ValueSet/claim-subtype` From this IG
Claim.use	required	Pattern Value: preauthorization `http://hl7.org/fhir/ValueSet/claim-use\|4.0.1` From the FHIR Standard
Claim.patient.identifier.use	required	IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use\|4.0.1` From the FHIR Standard
Claim.patient.identifier.type	required	PatientIdentifierType `http://nphies.sa/terminology/ValueSet/patient-identifier-type` From this IG
Claim.insurer.identifier.use	required	IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use\|4.0.1` From the FHIR Standard
Claim.insurer.identifier.type	extensible	Pattern Value: NII `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
Claim.provider.identifier.use	required	IdentifierUse `http://hl7.org/fhir/ValueSet/identifier-use\|4.0.1` From the FHIR Standard
Claim.provider.identifier.type	extensible	Pattern Value: PRN `http://hl7.org/fhir/ValueSet/identifier-type` From the FHIR Standard
Claim.priority	required	ProcessPriorityCodes `http://hl7.org/fhir/ValueSet/process-priority` From the FHIR Standard
Claim.fundsReserve	required	Funds Reservation Codes `http://hl7.org/fhir/ValueSet/fundsreserve` From the FHIR Standard
Claim.related.relationship	required	RelatedClaimRelationship(a valid code from Related Claim Relationship) `http://nphies.sa/terminology/ValueSet/related-claim-relationship` From this IG
Claim.payee.type	required	Claim Payee Type Codes `http://hl7.org/fhir/ValueSet/payeetype` From the FHIR Standard
Claim.careTeam.role	required	ClaimCareTeamRoleCodes `http://hl7.org/fhir/ValueSet/claim-careteamrole` From the FHIR Standard
Claim.careTeam.qualification	required	PracticeCodes `http://nphies.sa/terminology/ValueSet/practice-codes` From this IG
Claim.supportingInfo.category	required	ClaimInformationCategory(a valid code from Claim Information Category) `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:attachment.category	required	Pattern Value: attachment `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:birth-weight.category	required	Pattern Value: birth-weight `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:birth-weight.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:chiefComplaint.category	required	Pattern Value: chief-complaint `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:chiefComplaint.code	example	ExceptionCodes `http://hl7.org/fhir/ValueSet/claim-exception` From the FHIR Standard
Claim.supportingInfo:chiefComplaint.code.coding	required	SNOMEDCTClinicalFindings `http://hl7.org/fhir/ValueSet/clinical-findings` From the FHIR Standard
Claim.supportingInfo:daysSupply.category	required	Pattern Value: days-supply `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:daysSupply.value[x]:valueQuantity.comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:employmentImpacted.category	required	Pattern Value: employmentImpacted `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:history-of-present-illness.category	required	Pattern Value: history-of-present-illness `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:info.category	required	Pattern Value: info `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:investigation-result.category	required	Pattern Value: investigation-result `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:investigation-result.code	required	InvestigationResult(a valid code from Investigation Result) `http://nphies.sa/terminology/ValueSet/investigation-result` From this IG
Claim.supportingInfo:labTest.category	required	Pattern Value: lab-test `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:labTest.code	required	LOINCCodes(a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` From the FHIR Standard
Claim.supportingInfo:labTest.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:last-menstrual-period.category	required	Pattern Value: last-menstrual-period `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:onset.category	required	Pattern Value: onset `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:onset.code	required	ICD_10_AM(a valid code from `http://hl7.org/fhir/sid/icd-10-am`) `http://nphies.sa/terminology/ValueSet/diagnosis-icd-10-am` From this IG
Claim.supportingInfo:oxygen-saturation.category	required	Pattern Value: oxygen-saturation `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:oxygen-saturation.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:oxygen-saturation.reason	required	OxygenSaturationAbsenceReason(a valid code from Oxygen Saturation Absence Reason) `http://nphies.sa/terminology/ValueSet/oxygen-saturation-absence-reason` From this IG
Claim.supportingInfo:patient-history.category	required	Pattern Value: patient-history `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:physical-examination.category	required	Pattern Value: physical-examination `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:pulse.category	required	Pattern Value: pulse `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:pulse.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:pulse.reason	required	PulseAbsenceReason(a valid code from Pulse Absence Reason) `http://nphies.sa/terminology/ValueSet/pulse-absence-reason` From this IG
Claim.supportingInfo:reasonForVisit.category	required	Pattern Value: reason-for-visit `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:reasonForVisit.code	required	VisitReason(a valid code from Visit Reason) `http://nphies.sa/terminology/ValueSet/visit-reason` From this IG
Claim.supportingInfo:respiratory-rate.category	required	Pattern Value: respiratory-rate `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:respiratory-rate.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:respiratory-rate.reason	required	RespiratoryRateAbsenceReason(a valid code from Respiratory Rate Absence Reason) `http://nphies.sa/terminology/ValueSet/respiratory-rate-absence-reason` From this IG
Claim.supportingInfo:temperature.category	required	Pattern Value: temperature `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:temperature.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:temperature.reason	required	TemperatureAbsenceReason(a valid code from Temperature Absence Reason) `http://nphies.sa/terminology/ValueSet/temperature-absence-reason` From this IG
Claim.supportingInfo:treatment-plan.category	required	Pattern Value: treatment-plan `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:vitalSignDiastolic.category	required	Pattern Value: vital-sign-diastolic `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:vitalSignDiastolic.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:vitalSignDiastolic.reason	required	BloodPressureAbsenceReason(a valid code from Blood Pressure Absence Reason) `http://nphies.sa/terminology/ValueSet/blood-pressure-absence-reason` From this IG
Claim.supportingInfo:vitalSignHeight.category	required	Pattern Value: vital-sign-height `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:vitalSignHeight.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:vitalSignHeight.reason	required	HeightAbsenceReason(a valid code from Height Absence Reason) `http://nphies.sa/terminology/ValueSet/height-absence-reason` From this IG
Claim.supportingInfo:vitalSignSystolic.category	required	Pattern Value: vital-sign-systolic `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:vitalSignSystolic.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:vitalSignSystolic.reason	required	BloodPressureAbsenceReason(a valid code from Blood Pressure Absence Reason) `http://nphies.sa/terminology/ValueSet/blood-pressure-absence-reason` From this IG
Claim.supportingInfo:vitalSignWeight.category	required	Pattern Value: vital-sign-weight `http://nphies.sa/terminology/ValueSet/claim-information-category` From this IG
Claim.supportingInfo:vitalSignWeight.value[x].comparator	required	QuantityComparator `http://hl7.org/fhir/ValueSet/quantity-comparator\|4.0.1` From the FHIR Standard
Claim.supportingInfo:vitalSignWeight.reason	required	WeightAbsenceReason(a valid code from Weight Absence Reason) `http://nphies.sa/terminology/ValueSet/weight-absence-reason` From this IG
Claim.diagnosis.diagnosis[x]	example	ICD-10Codes `http://hl7.org/fhir/ValueSet/icd-10` From the FHIR Standard
Claim.diagnosis.diagnosis[x]:diagnosisCodeableConcept	required	ICD_10_AM(a valid code from `http://hl7.org/fhir/sid/icd-10-am`) `http://nphies.sa/terminology/ValueSet/diagnosis-icd-10-am` From this IG
Claim.diagnosis.type	required	DiagnosisType(a valid code from Diagnosis Type) `http://nphies.sa/terminology/ValueSet/diagnosis-type` From this IG
Claim.accident.type	required	ActIncidentCode `http://terminology.hl7.org/ValueSet/v3-ActIncidentCode`
Claim.item.productOrService	required	ProfessionalBilling `http://nphies.sa/terminology/ValueSet/professional-billing` From this IG
Claim.item.bodySite	required	SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` From the FHIR Standard
Claim.item.subSite	required	SubSite(a valid code from Sub Site) `http://nphies.sa/terminology/ValueSet/subsite` From this IG
Claim.item.detail.productOrService	required	ProfessionalBilling `http://nphies.sa/terminology/ValueSet/professional-billing` From this IG
Claim.item.detail.subDetail.productOrService	required	ProfessionalBilling `http://nphies.sa/terminology/ValueSet/professional-billing` From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
BV-00002	error	Claim	Claim care team sequence is not unique within the submitted claim resource. : careTeam.exists() implies careTeam.sequence.isDistinct()
BV-00036	error	Claim.item	No Claim item detail provided when Claim item package = true. : extension('http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-package').exists() implies extension('http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-package').first().value = true implies detail.exists().not()
BV-00042	error	Claim.item	Claim item detail sequence in not unique within the Claim item. : detail.sequence.exists() implies detail.sequence.isDistinct()
BV-00043	error	Claim.item.detail	Claim item subDetail sequence in not unique within the Claim item detail. : subDetail.sequence.exists() implies subDetail.sequence.isDistinct()
BV-00044	error	Claim	Item sequence value is not unique within the Claim resource. : item.sequence.exists() implies item.sequence.isDistinct()
BV-00054	error	Claim	One and only one principal diagnosis is required. : diagnosis.type.coding.where(code='principal').count() = 1
BV-00056	error	Claim.payee	Payee party is not provided when payee type='other'. : type.coding.where(code='other').count() > 0 implies party.exists()
BV-00057	error	Claim	Diagnosis is not unique in the submitted request. : diagnosis.diagnosis.ofType(CodeableConcept).isDistinct()
BV-00092	error	Claim.item.unitPrice	Claim Item UnitPrice Currency is not SAR. : currency = 'SAR'
BV-00093	error	Claim.item.net	Claim Item Net Currency is not SAR. : currency = 'SAR'
BV-00094	error	Claim.item.detail.unitPrice	Claim Item Detail UnitPrice Currency is not SAR. : currency = 'SAR'
BV-00095	error	Claim.item.detail.net	Claim Item Detail Net Currency is not SAR. : currency = 'SAR'
BV-00096	error	Claim.total	Claim Total Net Currency is not SAR. : currency = 'SAR'
BV-00123	error	Claim.item	Claim servicedate is not using a correct data type. : serviced.ofType(date).exists() or serviced.ofType(Period).exists()
BV-00137	error	Claim	The claim identifier does not exist. : identifier.exists()
BV-00316	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Claim supportingInfo valueString value length is longer than the maximum specified length of 250 English characters and 125 Arabic characters. : value.ofType(string).exists() implies value.ofType(string).length() <= 250
BV-00330	error	Claim	Claim status is not using the specified value 'active'. : status.exists() implies status='active'
BV-00347	error	Claim.extension:eligibilityOffLineDate	Claim eligibility OfflineDate is greater than current date. : value.ofType(dateTime) <= now()
BV-00365	error	Claim	Claim subtype is using an incorrect value when Claim type is 'Professional'. : subType.coding.first().code = 'op' or subType.coding.first().code = 'emr'
BV-00402	error	Claim.supportingInfo:info	Supporting information 'info' requires textual information in valueString. : value.ofType(string).exists()
BV-00404	error	Claim.supportingInfo:attachment	Supporting information 'attachment' requires the content to be provided. : value.ofType(Attachment).exists()
BV-00409	error	Claim.supportingInfo:employmentImpacted	Supporting information 'employmentImpacted' requires the period during which the employment was impacted. : timing.ofType(Period).exists()
BV-00410	error	Claim.supportingInfo:labTest	Supporting information 'lab-test' requires a valid LOINC code. : code.exists()
BV-00411	error	Claim.supportingInfo:labTest	If supporting information is 'lab-test' then valueQuantity SHALL exist and SHALL use a value specified in the UCUM code-system. : value.ofType(Quantity).exists()
BV-00412	error	Claim.supportingInfo:reasonForVisit	Supporting information 'reason-for-visit' requires a value from the specified NPHIES CodeSystem mentioning the reason for the visit. : code.exists()
BV-00413	error	Claim.supportingInfo:daysSupply	If Supporting information is 'days-supply' then valueQuantity SHALL exist and number of days SHALL use UCUM code 'd'. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'd'
BV-00414	error	Claim.supportingInfo:vitalSignWeight	If Supporting information is 'vital-sign-weight' and valueQuantity exist then it should use 'kg' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'kg'
BV-00415	error	Claim.supportingInfo:vitalSignSystolic	If Supporting information is 'vital-sign-systolic' and valueQuantity exist then it should use 'mm[Hg]'' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'mm[Hg]'
BV-00416	error	Claim.supportingInfo:vitalSignDiastolic	If Supporting information is 'vital-sign-diastolic' and valueQuantity exist then it should use 'mm[Hg]' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'mm[Hg]'
BV-00417	error	Claim.supportingInfo:vitalSignHeight	If Supporting information is 'vital-sign-height' and valueQuantity exist then it should use 'cm' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'cm'
BV-00428	error	Claim.supportingInfo:onset	Supporting information 'onset' requires the starting date and the ICD 10 code for the symptoms / illness. : code.exists() and timing.ofType(date).exists()
BV-00429	error	Claim.supportingInfo:chiefComplaint	Supporting information 'chief-complaint' requires the ICD 10 code for the symptoms / illness if a code is supplied. : code.exists()
BV-00439	error	Claim.item	If period is provided then Claim.item.servicedDate must not be used. : serviced.exists() implies (serviced.ofType(date).exists() xor serviced.ofType(Period).exists())
BV-00453	error	Claim	Claim supportingInfo sequence value is not unique within the claim request. : supportingInfo.sequence.exists() implies supportingInfo.sequence.isDistinct()
BV-00454	error	Claim	Claim diagnosis sequence value is not unique within the claim request. : diagnosis.sequence.isDistinct()
BV-00482	error	Claim.item	Item factor must be a positive decimal value. : factor.exists() implies factor >= 0
BV-00484	error	Claim.item	The subSite shall not be allowed if the bodySite is not provided. : subSite.exists() implies bodySite.exists()
BV-00486	error	Claim.supportingInfo:temperature	If Supporting information is 'temperature' and valueQuantity exist then it should use 'Cel' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'Cel'
BV-00487	error	Claim.supportingInfo:pulse	If Supporting information is 'pulse' and valueQuantity exist then it should use '/min' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '/min'
BV-00488	error	Claim.supportingInfo:oxygen-saturation	If Supporting information is 'oxygen-saturation' and valueQuantity exist then it should use '%' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '%'
BV-00489	error	Claim.supportingInfo:respiratory-rate	If Supporting information is 'respiratory-rate' and valueQuantity exist then it should use '/min' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '/min'
BV-00490	error	Claim.supportingInfo:last-menstrual-period	Supporting information 'last-menstrual-period' requires the date of start of last menstrual period. : timing.ofType(date).exists()
BV-00494	error	Claim.payee	Claim payee party must not provided when Claim payee type value is not 'other'. : type.coding.where(code!='other').count() > 0 implies party.exists().not()
BV-00502	error	Claim.item	Claim item informationSequence is not unique within the Claim item. : informationSequence.isDistinct()
BV-00509	error	Claim.supportingInfo:birth-weight	If Supporting information is 'birth-weight' then valueQuantity shall exist and should use 'kg' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'kg'
BV-00530	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	If supportingInfo code element is provided and the category is not 'chief-complaint' then a code is required. : (code.exists() and category.coding.first().code != 'chief-complaint') implies code.coding.code.exists()
BV-00531	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	The supportingInfo code element is required if supportingInfo category is 'chief-complaint'. : category.exists() implies (category.coding.first().code = 'chief-complaint') implies code.exists()
BV-00752	error	Claim	Supporting information 'investigation-result' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'investigation-result').exists()
BV-00753	error	Claim.supportingInfo:investigation-result	Investigation Result ('Text' - value[x] valueString' Shall be Provided when Investigation Result Supporting info is selected with Code = 'other'. : ((code.coding.where(code='other').count() > 0) and value.exists()) implies value.ofType(string).exists()
BV-00771	error	Claim	Oxygen-saturation SHALL be provided in institutional claim or authorization. : supportingInfo.category.coding.where(code='oxygen-saturation').count() > 0
BV-00772	error	Claim	Diastolic SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-diastolic').count() > 0
BV-00773	error	Claim	Systolic SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-systolic').count() > 0
BV-00774	error	Claim	Pulse SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='pulse').count() > 0
BV-00775	error	Claim	Temperature SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='temperature').count() > 0
BV-00776	error	Claim	Height SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-height').count() > 0
BV-00777	error	Claim	Respiratory-rate SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='respiratory-rate').count() > 0
BV-00778	error	Claim	Weight SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-weight').count() > 0
BV-00779	error	Claim	Chief-complaint SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='chief-complaint').count() > 0
BV-00780	error	Claim	Oxygen-saturation SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='oxygen-saturation').count() > 0
BV-00782	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Supporting information 'treatment-plan' requires textual information. : category.coding.where(code='treatment-plan').count() > 0 implies value.ofType(string).exists()
BV-00783	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Supporting information 'patient-history' requires textual information. : category.coding.where(code='patient-history').count() > 0 implies value.ofType(string).exists()
BV-00784	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Supporting information 'physical-examination' requires textual information . : category.coding.where(code='physical-examination').count() > 0 implies value.ofType(string).exists()
BV-00785	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Supporting information 'history-of-present-illness' requires textual information . : category.coding.where(code='history-of-present-illness').count() > 0 implies value.ofType(string).exists()
BV-00803	error	Claim	Supporting information 'treatment-plan' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'treatment-plan').exists()
BV-00804	error	Claim	Supporting information 'patient-history' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'patient-history').exists()
BV-00805	error	Claim	Supporting information 'pphysical-examination' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'physical-examination').exists()
BV-00806	error	Claim	Supporting information 'history-of-present-illness' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'history-of-present-illness').exists()
BV-00812	error	Claim.supportingInfo:vitalSignWeight	If Claim supportingInfo category='vital-sign-weight' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00813	error	Claim.supportingInfo:vitalSignSystolic	If Claim supportingInfo category='vital-sign-systolic' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00814	error	Claim.supportingInfo:vitalSignDiastolic	If Claim supportingInfo category='vital-sign-diastolic' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00815	error	Claim.supportingInfo:vitalSignHeight	If Claim supportingInfo category='vital-sign-height' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00816	error	Claim.supportingInfo:temperature	If Claim supportingInfo category='temperature' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00817	error	Claim.supportingInfo:pulse	If Claim supportingInfo category='pulse' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00818	error	Claim.supportingInfo:oxygen-saturation	If Claim supportingInfo category='oxygen-saturation' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00819	error	Claim.supportingInfo:respiratory-rate	If Claim supportingInfo category='respiratory-rate' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00820	error	Claim.supportingInfo:vitalSignWeight	If Claim.supportingInfo.category.coding.code='vital-sign-weight' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/weight-absence-reason'
BV-00821	error	Claim.supportingInfo:vitalSignSystolic	If Claim.supportingInfo.category.coding.code='vital-sign-systolic' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/blood-pressure-absence-reason'
BV-00822	error	Claim.supportingInfo:vitalSignDiastolic	If Claim.supportingInfo.category.coding.code='vital-sign-diastolic' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/blood-pressure-absence-reason'
BV-00823	error	Claim.supportingInfo:vitalSignHeight	If Claim.supportingInfo.category.coding.code='vital-sign-height' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/height-absence-reason'
BV-00824	error	Claim.supportingInfo:temperature	If Claim.supportingInfo.category.coding.code='temperature' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/tempurature-absence-reason'
BV-00825	error	Claim.supportingInfo:pulse	If Claim.supportingInfo.category.coding.code='pulse' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/pulse-absence-reason'
BV-00826	error	Claim.supportingInfo:oxygen-saturation	If Claim.supportingInfo.category.coding.code='oxygen-saturation' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/oxygen-saturation-absence-reason'
BV-00827	error	Claim.supportingInfo:respiratory-rate	If Claim.supportingInfo.category.coding.code='respiratory-rate' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/respiratory-rate-absence-reason'
BV-00846	error	Claim.supportingInfo:investigation-result	Supporting information 'investigation-result' requires a attachment when attachment code is used with Code = 'IRA'. : (code.coding.where(code='IRA').count() > 0) implies value.ofType(Attachment).exists()
P-Auth-1	error	Claim.subType	SubType may only be OP or EMR : coding.first().code = 'op' or coding.first().code = 'emr'
P-Auth-SI-1	error	Claim.supportingInfo:vitalSignWeight	Patient weight must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-2	error	Claim.supportingInfo:vitalSignSystolic	Systolic blood pressure must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-3	error	Claim.supportingInfo:vitalSignDiastolic	Diastolic blood pressure must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-4	error	Claim.supportingInfo:vitalSignHeight	Patient height must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-5	error	Claim.supportingInfo:temperature	Patient temperature must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-6	error	Claim.supportingInfo:pulse	Patient pulse must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-7	error	Claim.supportingInfo:oxygen-saturation	Patient oxygen saturation must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-8	error	Claim.supportingInfo:respiratory-rate	Patient respiratory rate must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
dom-2	error	Claim	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Claim	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Claim	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Claim	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Claim	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

Differential View

This structure is derived from NphiesAuthorizationBase

Name	Flags	Card.	Type	Description & Constraints Filter: Bindings Constraints Obligations
Claim	C	0..*	NphiesAuthorizationBase	Claim, Pre-determination or Pre-authorization Constraints: BV-00365, BV-00803, BV-00804, BV-00805, BV-00806, BV-00752, BV-00771, BV-00772, BV-00773, BV-00774, BV-00775, BV-00776, BV-00777, BV-00778, BV-00779, BV-00780
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:encounter		1..1	(Complex)	Encounter URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-encounter
value[x]		1..1	DP_Reference_1(Nphies Encounter AMB (Auth) \| Nphies Encounter EMER (Auth) \| Nphies Encounter HH (Auth) \| Nphies Encounter VR (Auth))	Value of extension
type		1..1	DP_CodeableConcept	Category or discipline Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type
code		1..1	code	Symbol in syntax defined by the system Fixed Value: professional
subType	C	1..1	DP_CodeableConcept	More granular claim type Constraints: P-Auth-1
related
claim		1..1	DP_Reference_1or3a(Nphies Authorization Professional)	Reference to the related claim
careTeam		1..*	BackboneElement	Members of the care team
provider		1..1	DP_Reference_1or2a(Nphies Practitioner)	Practitioner or organization
Slices for supportingInfo		13..*	BackboneElement	Supporting information Slice: Unordered, Closed by value:category
supportingInfo:attachment	C	0..*	BackboneElement	Attachment Constraints: BV-00404
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: attachment
value[x]		1..1	DP_Attachment	Data to be provided
supportingInfo:birth-weight	C	0..1	BackboneElement	Birth Weight Constraints: BV-00509
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: birth-weight
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]		1..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: kg
value		1..1	DP_decimal	Numerical value (with implicit precision)
supportingInfo:chiefComplaint	C	1..1	BackboneElement	Chief Complaint Constraints: BV-00429
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: chief-complaint
code		1..1	DP_CodeableConcept_1	Type of information
coding		0..*	DP_Coding	Code defined by a terminology system Binding: SNOMEDCTClinicalFindings (required)
supportingInfo:daysSupply	C	0..*	BackboneElement	Days Supply Constraints: BV-00413
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: days-supply
Slices for value[x]		1..1	boolean, string, Quantity, Attachment, Reference(Resource)	Data to be provided Slice: Unordered, Open by type:$this
value[x]:valueQuantity		0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: d
value		1..1	DP_decimal	Numerical value (with implicit precision)
supportingInfo:employmentImpacted	C	0..1	BackboneElement	Employment impacted Constraints: BV-00409
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: employmentImpacted
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_1	When it occurred
supportingInfo:history-of-present-illness		1..1	BackboneElement	History of Present Illness
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: history-of-present-illness
value[x]		1..1	DP_string	Data to be provided
supportingInfo:info	C	0..*	BackboneElement	Information Constraints: BV-00402
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: info
value[x]		1..1	DP_string	Data to be provided
supportingInfo:investigation-result	C	0..*	BackboneElement	Investigation Result Constraints: BV-00753, BV-00846
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: investigation-result
code		1..1	DP_CodeableConcept	Type of information Binding: Investigation Result (required)
Slices for value[x]	S	0..1		Data to be provided Slice: Unordered, Open by type:$this
valueString			string(DP_string)
valueAttachment			Attachment(DP_Attachment)
value[x]:valueAttachment	S	0..1	DP_Attachment	Data to be provided
value[x]:valueString	S	0..1	DP_string	Data to be provided
supportingInfo:labTest	C	0..*	BackboneElement	Lab Test Constraints: BV-00410, BV-00411
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: lab-test
code		1..1	DP_CodeableConcept	Type of information Binding: LOINCCodes (required)
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]		1..1	DP_Quantity_2	Data to be provided
system		1..1	DP_uri	System that defines coded unit form Required Pattern: http://unitsofmeasure.org
supportingInfo:last-menstrual-period	C	0..1	BackboneElement	Last Menstrual Period Constraints: BV-00490
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: last-menstrual-period
Slices for timing[x]		1..1	date	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingDate		1..1	DP_date	When it occurred
supportingInfo:onset	C	0..*	BackboneElement	Onset of symptoms Constraints: BV-00428
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: onset
code		1..1	DP_CodeableConcept	Type of information Binding: ICD-10-AM (required)
Slices for timing[x]		1..1	date	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingDate		1..1	DP_date	When it occurred
supportingInfo:oxygen-saturation	C	1..1	BackboneElement	Patient Oxygen Saturation Constraints: P-Auth-SI-7, BV-00488, BV-00818, BV-00826
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: oxygen-saturation
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: %
value	S	1..1	DP_decimal	Numerical value (with implicit precision)
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Oxygen Saturation Absence Reason (required)
supportingInfo:patient-history		1..1	BackboneElement	Patient History
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: patient-history
value[x]		1..1	DP_string	Data to be provided
supportingInfo:physical-examination		1..1	BackboneElement	Physical Examination
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: physical-examination
value[x]		1..1	DP_string	Data to be provided
supportingInfo:pulse	C	1..1	BackboneElement	Patient pulse Constraints: P-Auth-SI-6, BV-00487, BV-00817, BV-00825
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: pulse
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: /min
value	S	1..1	DP_decimal	Numerical value (with implicit precision)
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Pulse Absence Reason (required)
supportingInfo:reasonForVisit	C	0..1	BackboneElement	Reason for visit Constraints: BV-00412
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: reason-for-visit
code		1..1	DP_CodeableConcept	Type of information Binding: Visit Reason (required)
supportingInfo:respiratory-rate	C	1..1	BackboneElement	Patient Respiratory Rate Constraints: P-Auth-SI-8, BV-00489, BV-00819, BV-00827
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: respiratory-rate
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: /min
value	S	1..1	DP_decimal	Numerical value (with implicit precision)
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Respiratory Rate Absence Reason (required)
supportingInfo:temperature	C	1..1	BackboneElement	Temperature Constraints: P-Auth-SI-5, BV-00486, BV-00816, BV-00824
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: temperature
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: Cel
value	S	1..1	DP_decimal	Numerical value (with implicit precision)
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Temperature Absence Reason (required)
supportingInfo:treatment-plan		1..1	BackboneElement	Treatment Plan
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: treatment-plan
value[x]		1..1	DP_string	Data to be provided
supportingInfo:vitalSignDiastolic	C	1..1	BackboneElement	Diastolic Constraints: P-Auth-SI-3, BV-00416, BV-00814, BV-00822
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-sign-diastolic
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: mm[Hg]
value	S	1..1	DP_decimal	Numerical value (with implicit precision)
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Blood Pressure Absence Reason (required)
supportingInfo:vitalSignHeight	C	1..1	BackboneElement	Patient height Constraints: P-Auth-SI-4, BV-00417, BV-00815, BV-00823
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-sign-height
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: cm
value	S	1..1	DP_decimal	Numerical value (with implicit precision)
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Height Absence Reason (required)
supportingInfo:vitalSignSystolic	C	1..1	BackboneElement	Systolic Constraints: P-Auth-SI-2, BV-00415, BV-00813, BV-00821
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-sign-systolic
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: mm[Hg]
value	S	1..1	DP_decimal	Numerical value (with implicit precision)
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Blood Pressure Absence Reason (required)
supportingInfo:vitalSignWeight	C	1..1	BackboneElement	Patient weight Constraints: P-Auth-SI-1, BV-00414, BV-00812, BV-00820
category		1..1	DP_CodeableConcept	Classification of the supplied information Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category
code		1..1	code	Symbol in syntax defined by the system Fixed Value: vital-sign-weight
Slices for timing[x]		1..1	Period	When it occurred Slice: Unordered, Open by type:$this
timing[x]:timingPeriod		1..1	DP_Period_3	When it occurred
value[x]	S	0..1	DP_Quantity_2	Data to be provided Required Pattern: At least the following
system		1..1	uri	System that defines coded unit form Fixed Value: http://unitsofmeasure.org
code		1..1	code	Coded form of the unit Fixed Value: kg
value	S	1..1	DP_decimal	Numerical value (with implicit precision)
reason	S	0..1	CodeableConcept	Explanation for the information Binding: Weight Absence Reason (required)
item
extension		1..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:maternity		1..1	boolean	Maternity URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-maternity
careTeamSequence		1..*	DP_positiveInt	Applicable careTeam members
productOrService		1..1	DP_CodeableConcept_2	Billing, service, product, or drug code Binding: Professional Billing (required)
bodySite		0..1	DP_CodeableConcept	Anatomical location Binding: SNOMEDCTBodyStructures (required)
subSite		0..1	DP_CodeableConcept	Anatomical sub-location Binding: Sub Site (required)
detail
productOrService		1..1	DP_CodeableConcept_2	Billing, service, product, or drug code Binding: Professional Billing (required)
subDetail
productOrService		1..1	DP_CodeableConcept_2	Billing, service, product, or drug code Binding: Professional Billing (required)
Documentation for this format

Terminology Bindings (Differential)

Path	Conformance	ValueSet	URI
Claim.supportingInfo:chiefComplaint.code.coding	required	SNOMEDCTClinicalFindings `http://hl7.org/fhir/ValueSet/clinical-findings` From the FHIR Standard
Claim.supportingInfo:investigation-result.code	required	InvestigationResult(a valid code from Investigation Result) `http://nphies.sa/terminology/ValueSet/investigation-result` From this IG
Claim.supportingInfo:labTest.code	required	LOINCCodes(a valid code from LOINC) `http://hl7.org/fhir/ValueSet/observation-codes` From the FHIR Standard
Claim.supportingInfo:onset.code	required	ICD_10_AM(a valid code from `http://hl7.org/fhir/sid/icd-10-am`) `http://nphies.sa/terminology/ValueSet/diagnosis-icd-10-am` From this IG
Claim.supportingInfo:oxygen-saturation.reason	required	OxygenSaturationAbsenceReason(a valid code from Oxygen Saturation Absence Reason) `http://nphies.sa/terminology/ValueSet/oxygen-saturation-absence-reason` From this IG
Claim.supportingInfo:pulse.reason	required	PulseAbsenceReason(a valid code from Pulse Absence Reason) `http://nphies.sa/terminology/ValueSet/pulse-absence-reason` From this IG
Claim.supportingInfo:reasonForVisit.code	required	VisitReason(a valid code from Visit Reason) `http://nphies.sa/terminology/ValueSet/visit-reason` From this IG
Claim.supportingInfo:respiratory-rate.reason	required	RespiratoryRateAbsenceReason(a valid code from Respiratory Rate Absence Reason) `http://nphies.sa/terminology/ValueSet/respiratory-rate-absence-reason` From this IG
Claim.supportingInfo:temperature.reason	required	TemperatureAbsenceReason(a valid code from Temperature Absence Reason) `http://nphies.sa/terminology/ValueSet/temperature-absence-reason` From this IG
Claim.supportingInfo:vitalSignDiastolic.reason	required	BloodPressureAbsenceReason(a valid code from Blood Pressure Absence Reason) `http://nphies.sa/terminology/ValueSet/blood-pressure-absence-reason` From this IG
Claim.supportingInfo:vitalSignHeight.reason	required	HeightAbsenceReason(a valid code from Height Absence Reason) `http://nphies.sa/terminology/ValueSet/height-absence-reason` From this IG
Claim.supportingInfo:vitalSignSystolic.reason	required	BloodPressureAbsenceReason(a valid code from Blood Pressure Absence Reason) `http://nphies.sa/terminology/ValueSet/blood-pressure-absence-reason` From this IG
Claim.supportingInfo:vitalSignWeight.reason	required	WeightAbsenceReason(a valid code from Weight Absence Reason) `http://nphies.sa/terminology/ValueSet/weight-absence-reason` From this IG
Claim.item.productOrService	required	ProfessionalBilling `http://nphies.sa/terminology/ValueSet/professional-billing` From this IG
Claim.item.bodySite	required	SNOMEDCTBodyStructures `http://hl7.org/fhir/ValueSet/body-site` From the FHIR Standard
Claim.item.subSite	required	SubSite(a valid code from Sub Site) `http://nphies.sa/terminology/ValueSet/subsite` From this IG
Claim.item.detail.productOrService	required	ProfessionalBilling `http://nphies.sa/terminology/ValueSet/professional-billing` From this IG
Claim.item.detail.subDetail.productOrService	required	ProfessionalBilling `http://nphies.sa/terminology/ValueSet/professional-billing` From this IG

Constraints

Id	Grade	Path(s)	Details	Requirements
BV-00365	error	Claim	Claim subtype is using an incorrect value when Claim type is 'Professional'. : subType.coding.first().code = 'op' or subType.coding.first().code = 'emr'
BV-00402	error	Claim.supportingInfo:info	Supporting information 'info' requires textual information in valueString. : value.ofType(string).exists()
BV-00404	error	Claim.supportingInfo:attachment	Supporting information 'attachment' requires the content to be provided. : value.ofType(Attachment).exists()
BV-00409	error	Claim.supportingInfo:employmentImpacted	Supporting information 'employmentImpacted' requires the period during which the employment was impacted. : timing.ofType(Period).exists()
BV-00410	error	Claim.supportingInfo:labTest	Supporting information 'lab-test' requires a valid LOINC code. : code.exists()
BV-00411	error	Claim.supportingInfo:labTest	If supporting information is 'lab-test' then valueQuantity SHALL exist and SHALL use a value specified in the UCUM code-system. : value.ofType(Quantity).exists()
BV-00412	error	Claim.supportingInfo:reasonForVisit	Supporting information 'reason-for-visit' requires a value from the specified NPHIES CodeSystem mentioning the reason for the visit. : code.exists()
BV-00413	error	Claim.supportingInfo:daysSupply	If Supporting information is 'days-supply' then valueQuantity SHALL exist and number of days SHALL use UCUM code 'd'. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'd'
BV-00414	error	Claim.supportingInfo:vitalSignWeight	If Supporting information is 'vital-sign-weight' and valueQuantity exist then it should use 'kg' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'kg'
BV-00415	error	Claim.supportingInfo:vitalSignSystolic	If Supporting information is 'vital-sign-systolic' and valueQuantity exist then it should use 'mm[Hg]'' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'mm[Hg]'
BV-00416	error	Claim.supportingInfo:vitalSignDiastolic	If Supporting information is 'vital-sign-diastolic' and valueQuantity exist then it should use 'mm[Hg]' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'mm[Hg]'
BV-00417	error	Claim.supportingInfo:vitalSignHeight	If Supporting information is 'vital-sign-height' and valueQuantity exist then it should use 'cm' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'cm'
BV-00428	error	Claim.supportingInfo:onset	Supporting information 'onset' requires the starting date and the ICD 10 code for the symptoms / illness. : code.exists() and timing.ofType(date).exists()
BV-00429	error	Claim.supportingInfo:chiefComplaint	Supporting information 'chief-complaint' requires the ICD 10 code for the symptoms / illness if a code is supplied. : code.exists()
BV-00486	error	Claim.supportingInfo:temperature	If Supporting information is 'temperature' and valueQuantity exist then it should use 'Cel' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'Cel'
BV-00487	error	Claim.supportingInfo:pulse	If Supporting information is 'pulse' and valueQuantity exist then it should use '/min' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '/min'
BV-00488	error	Claim.supportingInfo:oxygen-saturation	If Supporting information is 'oxygen-saturation' and valueQuantity exist then it should use '%' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '%'
BV-00489	error	Claim.supportingInfo:respiratory-rate	If Supporting information is 'respiratory-rate' and valueQuantity exist then it should use '/min' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '/min'
BV-00490	error	Claim.supportingInfo:last-menstrual-period	Supporting information 'last-menstrual-period' requires the date of start of last menstrual period. : timing.ofType(date).exists()
BV-00509	error	Claim.supportingInfo:birth-weight	If Supporting information is 'birth-weight' then valueQuantity shall exist and should use 'kg' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'kg'
BV-00752	error	Claim	Supporting information 'investigation-result' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'investigation-result').exists()
BV-00753	error	Claim.supportingInfo:investigation-result	Investigation Result ('Text' - value[x] valueString' Shall be Provided when Investigation Result Supporting info is selected with Code = 'other'. : ((code.coding.where(code='other').count() > 0) and value.exists()) implies value.ofType(string).exists()
BV-00771	error	Claim	Oxygen-saturation SHALL be provided in institutional claim or authorization. : supportingInfo.category.coding.where(code='oxygen-saturation').count() > 0
BV-00772	error	Claim	Diastolic SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-diastolic').count() > 0
BV-00773	error	Claim	Systolic SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-systolic').count() > 0
BV-00774	error	Claim	Pulse SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='pulse').count() > 0
BV-00775	error	Claim	Temperature SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='temperature').count() > 0
BV-00776	error	Claim	Height SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-height').count() > 0
BV-00777	error	Claim	Respiratory-rate SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='respiratory-rate').count() > 0
BV-00778	error	Claim	Weight SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-weight').count() > 0
BV-00779	error	Claim	Chief-complaint SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='chief-complaint').count() > 0
BV-00780	error	Claim	Oxygen-saturation SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='oxygen-saturation').count() > 0
BV-00803	error	Claim	Supporting information 'treatment-plan' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'treatment-plan').exists()
BV-00804	error	Claim	Supporting information 'patient-history' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'patient-history').exists()
BV-00805	error	Claim	Supporting information 'pphysical-examination' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'physical-examination').exists()
BV-00806	error	Claim	Supporting information 'history-of-present-illness' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'history-of-present-illness').exists()
BV-00812	error	Claim.supportingInfo:vitalSignWeight	If Claim supportingInfo category='vital-sign-weight' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00813	error	Claim.supportingInfo:vitalSignSystolic	If Claim supportingInfo category='vital-sign-systolic' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00814	error	Claim.supportingInfo:vitalSignDiastolic	If Claim supportingInfo category='vital-sign-diastolic' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00815	error	Claim.supportingInfo:vitalSignHeight	If Claim supportingInfo category='vital-sign-height' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00816	error	Claim.supportingInfo:temperature	If Claim supportingInfo category='temperature' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00817	error	Claim.supportingInfo:pulse	If Claim supportingInfo category='pulse' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00818	error	Claim.supportingInfo:oxygen-saturation	If Claim supportingInfo category='oxygen-saturation' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00819	error	Claim.supportingInfo:respiratory-rate	If Claim supportingInfo category='respiratory-rate' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00820	error	Claim.supportingInfo:vitalSignWeight	If Claim.supportingInfo.category.coding.code='vital-sign-weight' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/weight-absence-reason'
BV-00821	error	Claim.supportingInfo:vitalSignSystolic	If Claim.supportingInfo.category.coding.code='vital-sign-systolic' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/blood-pressure-absence-reason'
BV-00822	error	Claim.supportingInfo:vitalSignDiastolic	If Claim.supportingInfo.category.coding.code='vital-sign-diastolic' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/blood-pressure-absence-reason'
BV-00823	error	Claim.supportingInfo:vitalSignHeight	If Claim.supportingInfo.category.coding.code='vital-sign-height' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/height-absence-reason'
BV-00824	error	Claim.supportingInfo:temperature	If Claim.supportingInfo.category.coding.code='temperature' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/tempurature-absence-reason'
BV-00825	error	Claim.supportingInfo:pulse	If Claim.supportingInfo.category.coding.code='pulse' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/pulse-absence-reason'
BV-00826	error	Claim.supportingInfo:oxygen-saturation	If Claim.supportingInfo.category.coding.code='oxygen-saturation' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/oxygen-saturation-absence-reason'
BV-00827	error	Claim.supportingInfo:respiratory-rate	If Claim.supportingInfo.category.coding.code='respiratory-rate' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/respiratory-rate-absence-reason'
BV-00846	error	Claim.supportingInfo:investigation-result	Supporting information 'investigation-result' requires a attachment when attachment code is used with Code = 'IRA'. : (code.coding.where(code='IRA').count() > 0) implies value.ofType(Attachment).exists()
P-Auth-1	error	Claim.subType	SubType may only be OP or EMR : coding.first().code = 'op' or coding.first().code = 'emr'
P-Auth-SI-1	error	Claim.supportingInfo:vitalSignWeight	Patient weight must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-2	error	Claim.supportingInfo:vitalSignSystolic	Systolic blood pressure must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-3	error	Claim.supportingInfo:vitalSignDiastolic	Diastolic blood pressure must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-4	error	Claim.supportingInfo:vitalSignHeight	Patient height must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-5	error	Claim.supportingInfo:temperature	Patient temperature must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-6	error	Claim.supportingInfo:pulse	Patient pulse must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-7	error	Claim.supportingInfo:oxygen-saturation	Patient oxygen saturation must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-8	error	Claim.supportingInfo:respiratory-rate	Patient respiratory rate must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()

Snapshot View

Description & Constraints Filter: Filters

Claim

0..*

NphiesAuthorizationBase

1..1

Logical id of this artifact
Max Length:64

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

timing[x]

0..1

When it occurred

timingDate

date

timingPeriod

Period

value[x]

0..1

Data to be provided

valueBoolean

valueString

valueQuantity

valueAttachment

valueReference

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:attachment

0..*

BackboneElement

Attachment
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00404

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: attachment

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

timing[x]

0..1

When it occurred

timingDate

timingPeriod

1..1

Data to be provided

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:birth-weight

0..1

BackboneElement

Birth Weight
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00509

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: birth-weight

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

1..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: kg

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:chiefComplaint

1..1

BackboneElement

Chief Complaint
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00429

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: chief-complaint

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

1..1

DP_CodeableConcept_1

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

coding

SΣ

0..*

DP_Coding

Code defined by a terminology system
Binding: SNOMEDCTClinicalFindings (required)

text

SΣ

0..1

string

Plain text representation of the concept
Max Length:250

timing[x]

0..1

When it occurred

timingDate

date

timingPeriod

Period

value[x]

0..1

Data to be provided

valueBoolean

valueString

valueQuantity

valueAttachment

valueReference

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:daysSupply

0..*

BackboneElement

Days Supply
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00413

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: days-supply

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

timing[x]

0..1

When it occurred

timingDate

date

timingPeriod

Period

Slices for value[x]

1..1

Data to be provided
Slice: Unordered, Open by type:$this

valueBoolean

valueString

valueQuantity

valueAttachment

valueReference

value[x]:valueQuantity

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: d

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:employmentImpacted

0..1

BackboneElement

Employment impacted
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00409

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: employmentImpacted

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_1

When it occurred

value[x]

0..1

Data to be provided

valueBoolean

valueString

valueQuantity

valueAttachment

valueReference

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:history-of-present-illness

1..1

BackboneElement

History of Present Illness
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: history-of-present-illness

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

timing[x]

0..1

When it occurred

timingDate

timingPeriod

1..1

Data to be provided

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:info

0..*

BackboneElement

Information
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00402

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: info

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

timing[x]

0..1

When it occurred

timingDate

timingPeriod

1..1

Data to be provided

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:investigation-result

0..*

BackboneElement

Investigation Result
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00753, BV-00846

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: investigation-result

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

1..1

DP_CodeableConcept

Type of information
Binding: Investigation Result (required)

timing[x]

0..1

When it occurred

timingDate

date

timingPeriod

Period

Slices for value[x]

0..1

Data to be provided
Slice: Unordered, Closed by type:$this

valueString

string(DP_string)

valueAttachment

Attachment(DP_Attachment)

value[x]:valueAttachment

0..1

DP_Attachment

Data to be provided

value[x]:valueString

0..1

DP_string

Data to be provided

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:labTest

0..*

BackboneElement

Lab Test
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00410, BV-00411

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: lab-test

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

1..1

DP_CodeableConcept

Type of information
Binding: LOINCCodes (required)

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

1..1

DP_Quantity_2

Data to be provided

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form
Required Pattern: http://unitsofmeasure.org

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:last-menstrual-period

0..1

BackboneElement

Last Menstrual Period
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00490

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: last-menstrual-period

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

date

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingDate

1..1

DP_date

When it occurred

value[x]

0..1

Data to be provided

valueBoolean

valueString

valueQuantity

valueAttachment

valueReference

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:onset

0..*

BackboneElement

Onset of symptoms
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00428

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: onset

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

1..1

DP_CodeableConcept

Type of information
Binding: ICD-10-AM (required)

Slices for timing[x]

1..1

date

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingDate

1..1

DP_date

When it occurred

value[x]

0..1

Data to be provided

valueBoolean

valueString

valueQuantity

valueAttachment

valueReference

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:oxygen-saturation

1..1

BackboneElement

Patient Oxygen Saturation
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-7, BV-00488, BV-00818, BV-00826

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: oxygen-saturation

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: %

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: Oxygen Saturation Absence Reason (required)

supportingInfo:patient-history

1..1

BackboneElement

Patient History
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: patient-history

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

timing[x]

0..1

When it occurred

timingDate

timingPeriod

1..1

Data to be provided

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:physical-examination

1..1

BackboneElement

Physical Examination
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: physical-examination

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

timing[x]

0..1

When it occurred

timingDate

timingPeriod

1..1

Data to be provided

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:pulse

1..1

BackboneElement

Patient pulse
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-6, BV-00487, BV-00817, BV-00825

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: pulse

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: /min

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: Pulse Absence Reason (required)

supportingInfo:reasonForVisit

0..1

BackboneElement

Reason for visit
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, BV-00412

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: reason-for-visit

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

1..1

DP_CodeableConcept

Type of information
Binding: Visit Reason (required)

timing[x]

0..1

When it occurred

timingDate

date

timingPeriod

Period

value[x]

0..1

Data to be provided

valueBoolean

valueString

valueQuantity

valueAttachment

valueReference

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:respiratory-rate

1..1

BackboneElement

Patient Respiratory Rate
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-8, BV-00489, BV-00819, BV-00827

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: respiratory-rate

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: /min

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: Respiratory Rate Absence Reason (required)

supportingInfo:temperature

1..1

BackboneElement

Temperature
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-5, BV-00486, BV-00816, BV-00824

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: temperature

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: Cel

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: Temperature Absence Reason (required)

supportingInfo:treatment-plan

1..1

BackboneElement

Treatment Plan
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: treatment-plan

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

timing[x]

0..1

When it occurred

timingDate

timingPeriod

1..1

Data to be provided

reason

0..1

CodeableConcept

Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.

supportingInfo:vitalSignDiastolic

1..1

BackboneElement

Diastolic
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-3, BV-00416, BV-00814, BV-00822

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: vital-sign-diastolic

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: mm[Hg]

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: Blood Pressure Absence Reason (required)

supportingInfo:vitalSignHeight

1..1

BackboneElement

Patient height
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-4, BV-00417, BV-00815, BV-00823

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: vital-sign-height

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: cm

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: Height Absence Reason (required)

supportingInfo:vitalSignSystolic

1..1

BackboneElement

Systolic
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-2, BV-00415, BV-00813, BV-00821

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: vital-sign-systolic

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: mm[Hg]

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: Blood Pressure Absence Reason (required)

supportingInfo:vitalSignWeight

1..1

BackboneElement

Patient weight
Constraints: BV-00316, BV-00530, BV-00782, BV-00783, BV-00784, BV-00785, BV-00531, P-Auth-SI-1, BV-00414, BV-00812, BV-00820

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Information instance identifier

category

1..1

DP_CodeableConcept

Classification of the supplied information
Binding: Claim Information Category (required)
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

coding

1..*

Coding

Code defined by a terminology system
Fixed Value: (complex)

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

system

1..1

uri

Identity of the terminology system
Fixed Value: http://nphies.sa/terminology/CodeSystem/claim-information-category

version

0..1

string

Version of the system - if relevant

code

1..1

code

Symbol in syntax defined by the system
Fixed Value: vital-sign-weight

display

0..1

string

Representation defined by the system

userSelected

0..1

boolean

If this coding was chosen directly by the user

text

0..1

string

Plain text representation of the concept

code

0..1

CodeableConcept

Type of information
Binding: ExceptionCodes (example): The valuset used for additional information codes.

Slices for timing[x]

1..1

Period

When it occurred
Slice: Unordered, Closed by type:$this

timing[x]:timingPeriod

1..1

DP_Period_3

When it occurred

value[x]

0..1

DP_Quantity_2

Data to be provided
Required Pattern: At least the following

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

value

0..1

decimal

Numerical value (with implicit precision)

comparator

0..1

code

< | <= | >= | > - how to understand the value

0..1

Unit representation

1..1

System that defines coded unit form
Fixed Value: http://unitsofmeasure.org

code

1..1

code

Coded form of the unit
Fixed Value: kg

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations
Slice: Unordered, Open by value:url

value

SΣ

1..1

DP_decimal

Numerical value (with implicit precision)

comparator

?!Σ

0..1

code

< | <= | >= | > - how to understand the value
Binding: QuantityComparator (required): How the Quantity should be understood and represented.

unit

0..1

string

Unit representation
Max Length:40

system

ΣC

1..1

DP_uri

System that defines coded unit form

code

1..1

DP_code

Coded form of the unit

reason

0..1

CodeableConcept

Explanation for the information
Binding: Weight Absence Reason (required)

diagnosis

1..*

BackboneElement

Pertinent diagnosis information

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Diagnosis instance identifier

Slices for diagnosis[x]

1..1

CodeableConcept

Nature of illness or problem
Slice: Unordered, Closed by type:$this
Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.

diagnosis[x]:diagnosisCodeableConcept

1..1

DP_CodeableConcept

Nature of illness or problem
Binding: ICD-10-AM (required)

type

1..1

DP_CodeableConcept

Timing or nature of the diagnosis
Binding: Diagnosis Type (required)

onAdmission

0..1

CodeableConcept

Present on admission
Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.

packageCode

0..1

CodeableConcept

Package billing code
Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.

procedure

0..*

BackboneElement

Clinical procedures performed

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

positiveInt

Procedure instance identifier

type

0..*

CodeableConcept

Category of Procedure
Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.

date

0..1

dateTime

When the procedure was performed

procedure[x]

1..1

Specific clinical procedure
Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.

procedureCodeableConcept

CodeableConcept

procedureReference

Reference(Procedure)

udi

0..*

Reference(Device)

Unique device identifier

insurance

1..*

BackboneElement

Patient insurance information

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Insurance instance identifier

focal

1..1

boolean

Coverage to be used for adjudication

identifier

0..1

Identifier

Pre-assigned Claim number

coverage

1..1

DP_Reference_1(Nphies Coverage)

Insurance information

businessArrangement

0..1

string

Additional provider contract number

preAuthRef

0..*

string

Prior authorization reference number

claimResponse

0..1

DP_Reference_1or3a(Nphies Authorization Response)

Adjudication results

accident

0..1

BackboneElement

Details of the event

0..1

string

Unique id for inter-element referencing

extension

0..*

Extension

Additional content defined by implementations

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

date

1..1

DP_date

When the incident occurred

type

1..1

DP_CodeableConcept

The nature of the accident
Binding: ActIncidentCode (required)

Slices for location[x]

0..1

Where the event occurred
Slice: Unordered, Open by type:$this

locationAddress

Address

locationReference

Reference(Location)

location[x]:locationAddress

0..1

DP_Address

Where the event occurred

item

1..*

BackboneElement

Product or service provided
Constraints: BV-00036, BV-00042, BV-00123, BV-00439, BV-00482, BV-00484, BV-00502

0..1

string

Unique id for inter-element referencing

Slices for extension

1..*

Extension

Extension
Slice: Unordered, Open by value:url

extension:package

0..1

boolean

Package Code
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-package

extension:tax

0..1

DP_Money_SAR

Tax
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-tax

extension:patientShare

0..1

DP_Money_SAR

Patient Share
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-share

extension:payerShare

0..1

DP_Money_SAR

Payer Share
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-payer-share

extension:maternity

1..1

boolean

Maternity
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-maternity

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Item instance identifier

careTeamSequence

1..*

DP_positiveInt

Applicable careTeam members

0..*

Applicable diagnoses

0..*

Applicable procedures

informationSequence

0..*

DP_positiveInt

Applicable exception and supporting information

revenue

0..1

CodeableConcept

Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

category

0..1

CodeableConcept

Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

productOrService

1..1

DP_CodeableConcept_2

Billing, service, product, or drug code
Binding: Professional Billing (required)

0..*

0..*

Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.

Slices for serviced[x]

1..1

Date or dates of service or product delivery
Slice: Unordered, Closed by type:$this

servicedDate

date

servicedPeriod

Period

serviced[x]:servicedDate

0..1

DP_date

Date or dates of service or product delivery

serviced[x]:servicedPeriod

0..1

DP_Period_2

Date or dates of service or product delivery

location[x]

0..1

Place of service or where product was supplied
Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.

locationCodeableConcept

locationAddress

locationReference

1..1

Count of products or services

unitPrice

1..1

DP_Money_SAR

Fee, charge or cost per item
Constraints: BV-00092

factor

0..1

DP_decimal

Price scaling factor

net

1..1

DP_Money_SAR

Total item cost
Constraints: BV-00093

udi

0..*

DP_Reference_1or3a(Device)

Unique device identifier

bodySite

0..1

DP_CodeableConcept

Anatomical location
Binding: SNOMEDCTBodyStructures (required)

subSite

0..1

DP_CodeableConcept

Anatomical sub-location
Binding: Sub Site (required)

encounter

0..*

Reference(Encounter)

Encounters related to this billed item

detail

0..*

BackboneElement

Product or service provided
Constraints: BV-00043

0..1

string

Unique id for inter-element referencing

Slices for extension

0..*

Extension

Extension
Slice: Unordered, Open by value:url

extension:tax

0..1

DP_Money_SAR

Tax
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-tax

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Item instance identifier

revenue

0..1

CodeableConcept

Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

category

0..1

CodeableConcept

Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

productOrService

1..1

DP_CodeableConcept_2

Billing, service, product, or drug code
Binding: Professional Billing (required)

0..*

0..*

Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.

quantity

1..1

DP_SimpleQuantity_1

Count of products or services

unitPrice

1..1

DP_Money_SAR

Fee, charge or cost per item
Constraints: BV-00094

factor

0..1

DP_decimal

Price scaling factor

net

1..1

DP_Money_SAR

Total item cost
Constraints: BV-00095

udi

0..*

DP_Reference_1or3a(Device)

Unique device identifier

subDetail

0..*

BackboneElement

Product or service provided

0..1

string

Unique id for inter-element referencing

Slices for extension

0..*

Extension

Extension
Slice: Unordered, Open by value:url

extension:tax

0..1

DP_Money_SAR

Tax
URL: http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-tax

modifierExtension

?!Σ

0..*

Extension

Extensions that cannot be ignored even if unrecognized

sequence

1..1

DP_positiveInt

Item instance identifier

revenue

0..1

CodeableConcept

Revenue or cost center code
Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.

category

0..1

CodeableConcept

Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.

productOrService

1..1

DP_CodeableConcept_2

Billing, service, product, or drug code
Binding: Professional Billing (required)

0..*

0..*

Program the product or service is provided under
Binding: ExampleProgramReasonCodes (example): Program specific reason codes.

quantity

1..1

DP_SimpleQuantity_1

Count of products or services

unitPrice

1..1

DP_Money_SAR

Fee, charge or cost per item

factor

0..1

DP_decimal

Price scaling factor

net

1..1

DP_Money_SAR

Total item cost

udi

0..*

DP_Reference_1or3a(Device)

Unique device identifier

total

1..1

DP_Money_SAR

Total claim cost
Constraints: BV-00096

Documentation for this format

Terminology Bindings

Path Conformance ValueSet / Code URI

Claim.meta.security

extensible

All Security Labels

http://hl7.org/fhir/ValueSet/security-labels

From the FHIR Standard

Claim.meta.tag

example

CommonTags

http://hl7.org/fhir/ValueSet/common-tags

From the FHIR Standard

Claim.language

preferred

CommonLanguages

http://hl7.org/fhir/ValueSet/languages

From the FHIR Standard

Additional Bindings

Purpose

AllLanguages

Max Binding

Claim.status

required

Pattern Value: active

http://hl7.org/fhir/ValueSet/fm-status|4.0.1

From the FHIR Standard

Claim.type

required

Pattern Value: professional

http://nphies.sa/terminology/ValueSet/claim-type

From this IG

Claim.subType

required

ClaimSubType(a valid code from Claim SubType)

http://nphies.sa/terminology/ValueSet/claim-subtype

From this IG

Claim.use

required

Pattern Value: preauthorization

http://hl7.org/fhir/ValueSet/claim-use|4.0.1

From the FHIR Standard

Claim.patient.type

extensible

ResourceType

http://hl7.org/fhir/ValueSet/resource-types

From the FHIR Standard

Claim.patient.identifier.use

required

IdentifierUse

http://hl7.org/fhir/ValueSet/identifier-use|4.0.1

From the FHIR Standard

Claim.patient.identifier.type

required

PatientIdentifierType

http://nphies.sa/terminology/ValueSet/patient-identifier-type

From this IG

Claim.insurer.type

extensible

ResourceType

http://hl7.org/fhir/ValueSet/resource-types

From the FHIR Standard

Claim.insurer.identifier.use

required

IdentifierUse

http://hl7.org/fhir/ValueSet/identifier-use|4.0.1

From the FHIR Standard

Claim.insurer.identifier.type

extensible

Pattern Value: NII

http://hl7.org/fhir/ValueSet/identifier-type

From the FHIR Standard

Claim.provider.type

extensible

ResourceType

http://hl7.org/fhir/ValueSet/resource-types

From the FHIR Standard

Claim.provider.identifier.use

required

IdentifierUse

http://hl7.org/fhir/ValueSet/identifier-use|4.0.1

From the FHIR Standard

Claim.provider.identifier.type

extensible

Pattern Value: PRN

http://hl7.org/fhir/ValueSet/identifier-type

From the FHIR Standard

Claim.priority

required

ProcessPriorityCodes

http://hl7.org/fhir/ValueSet/process-priority

From the FHIR Standard

Claim.fundsReserve

required

Funds Reservation Codes

http://hl7.org/fhir/ValueSet/fundsreserve

From the FHIR Standard

Claim.related.relationship

required

http://nphies.sa/terminology/ValueSet/related-claim-relationship

From this IG

Claim.payee.type

required

Claim Payee Type Codes

http://hl7.org/fhir/ValueSet/payeetype

From the FHIR Standard

Claim.careTeam.provider.type

extensible

ResourceType

http://hl7.org/fhir/ValueSet/resource-types

From the FHIR Standard

Claim.careTeam.provider.identifier.use

required

IdentifierUse

http://hl7.org/fhir/ValueSet/identifier-use|4.0.1

From the FHIR Standard

Claim.careTeam.provider.identifier.type

required

PractitionerIdentifier

http://nphies.sa/terminology/ValueSet/practitioner-identifier-type

From this IG

Claim.careTeam.role

required

ClaimCareTeamRoleCodes

http://hl7.org/fhir/ValueSet/claim-careteamrole

From the FHIR Standard

Claim.careTeam.qualification

required

PracticeCodes

http://nphies.sa/terminology/ValueSet/practice-codes

From this IG

Claim.supportingInfo.category

required

ClaimInformationCategory(a valid code from Claim Information Category)

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:attachment.category

required

Pattern Value: attachment

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:attachment.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:attachment.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:birth-weight.category

required

Pattern Value: birth-weight

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:birth-weight.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:birth-weight.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:birth-weight.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:chiefComplaint.category

required

Pattern Value: chief-complaint

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:chiefComplaint.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:chiefComplaint.code.coding

required

SNOMEDCTClinicalFindings

http://hl7.org/fhir/ValueSet/clinical-findings

From the FHIR Standard

Claim.supportingInfo:chiefComplaint.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:daysSupply.category

required

Pattern Value: days-supply

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:daysSupply.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:daysSupply.value[x]:valueQuantity.comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:daysSupply.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:employmentImpacted.category

required

Pattern Value: employmentImpacted

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:employmentImpacted.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:employmentImpacted.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:history-of-present-illness.category

required

Pattern Value: history-of-present-illness

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:history-of-present-illness.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:history-of-present-illness.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:info.category

required

Pattern Value: info

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:info.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:info.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:investigation-result.category

required

Pattern Value: investigation-result

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:investigation-result.code

required

InvestigationResult(a valid code from Investigation Result)

http://nphies.sa/terminology/ValueSet/investigation-result

From this IG

Claim.supportingInfo:investigation-result.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:labTest.category

required

Pattern Value: lab-test

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:labTest.code

required

LOINCCodes(a valid code from LOINC)

http://hl7.org/fhir/ValueSet/observation-codes

From the FHIR Standard

Claim.supportingInfo:labTest.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:labTest.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:last-menstrual-period.category

required

Pattern Value: last-menstrual-period

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:last-menstrual-period.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:last-menstrual-period.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:onset.category

required

Pattern Value: onset

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:onset.code

required

ICD_10_AM(a valid code from http://hl7.org/fhir/sid/icd-10-am)

http://nphies.sa/terminology/ValueSet/diagnosis-icd-10-am

From this IG

Claim.supportingInfo:onset.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:oxygen-saturation.category

required

Pattern Value: oxygen-saturation

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:oxygen-saturation.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:oxygen-saturation.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:oxygen-saturation.reason

required

OxygenSaturationAbsenceReason(a valid code from Oxygen Saturation Absence Reason)

http://nphies.sa/terminology/ValueSet/oxygen-saturation-absence-reason

From this IG

Claim.supportingInfo:patient-history.category

required

Pattern Value: patient-history

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:patient-history.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:patient-history.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:physical-examination.category

required

Pattern Value: physical-examination

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:physical-examination.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:physical-examination.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:pulse.category

required

Pattern Value: pulse

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:pulse.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:pulse.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:pulse.reason

required

PulseAbsenceReason(a valid code from Pulse Absence Reason)

http://nphies.sa/terminology/ValueSet/pulse-absence-reason

From this IG

Claim.supportingInfo:reasonForVisit.category

required

Pattern Value: reason-for-visit

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:reasonForVisit.code

required

VisitReason(a valid code from Visit Reason)

http://nphies.sa/terminology/ValueSet/visit-reason

From this IG

Claim.supportingInfo:reasonForVisit.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:respiratory-rate.category

required

Pattern Value: respiratory-rate

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:respiratory-rate.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:respiratory-rate.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:respiratory-rate.reason

required

RespiratoryRateAbsenceReason(a valid code from Respiratory Rate Absence Reason)

http://nphies.sa/terminology/ValueSet/respiratory-rate-absence-reason

From this IG

Claim.supportingInfo:temperature.category

required

Pattern Value: temperature

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:temperature.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:temperature.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:temperature.reason

required

TemperatureAbsenceReason(a valid code from Temperature Absence Reason)

http://nphies.sa/terminology/ValueSet/temperature-absence-reason

From this IG

Claim.supportingInfo:treatment-plan.category

required

Pattern Value: treatment-plan

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:treatment-plan.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:treatment-plan.reason

example

MissingToothReasonCodes

http://hl7.org/fhir/ValueSet/missing-tooth-reason

From the FHIR Standard

Claim.supportingInfo:vitalSignDiastolic.category

required

Pattern Value: vital-sign-diastolic

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:vitalSignDiastolic.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:vitalSignDiastolic.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:vitalSignDiastolic.reason

required

BloodPressureAbsenceReason(a valid code from Blood Pressure Absence Reason)

http://nphies.sa/terminology/ValueSet/blood-pressure-absence-reason

From this IG

Claim.supportingInfo:vitalSignHeight.category

required

Pattern Value: vital-sign-height

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:vitalSignHeight.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:vitalSignHeight.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:vitalSignHeight.reason

required

HeightAbsenceReason(a valid code from Height Absence Reason)

http://nphies.sa/terminology/ValueSet/height-absence-reason

From this IG

Claim.supportingInfo:vitalSignSystolic.category

required

Pattern Value: vital-sign-systolic

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:vitalSignSystolic.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:vitalSignSystolic.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:vitalSignSystolic.reason

required

BloodPressureAbsenceReason(a valid code from Blood Pressure Absence Reason)

http://nphies.sa/terminology/ValueSet/blood-pressure-absence-reason

From this IG

Claim.supportingInfo:vitalSignWeight.category

required

Pattern Value: vital-sign-weight

http://nphies.sa/terminology/ValueSet/claim-information-category

From this IG

Claim.supportingInfo:vitalSignWeight.code

example

ExceptionCodes

http://hl7.org/fhir/ValueSet/claim-exception

From the FHIR Standard

Claim.supportingInfo:vitalSignWeight.value[x].comparator

required

QuantityComparator

http://hl7.org/fhir/ValueSet/quantity-comparator|4.0.1

From the FHIR Standard

Claim.supportingInfo:vitalSignWeight.reason

required

WeightAbsenceReason(a valid code from Weight Absence Reason)

http://nphies.sa/terminology/ValueSet/weight-absence-reason

From this IG

Claim.diagnosis.diagnosis[x]

example

ICD-10Codes

http://hl7.org/fhir/ValueSet/icd-10

From the FHIR Standard

Claim.diagnosis.diagnosis[x]:diagnosisCodeableConcept

required

ICD_10_AM(a valid code from http://hl7.org/fhir/sid/icd-10-am)

http://nphies.sa/terminology/ValueSet/diagnosis-icd-10-am

From this IG

Claim.diagnosis.type

required

DiagnosisType(a valid code from Diagnosis Type)

http://nphies.sa/terminology/ValueSet/diagnosis-type

From this IG

Claim.diagnosis.onAdmission

example

ExampleDiagnosisOnAdmissionCodes

http://hl7.org/fhir/ValueSet/ex-diagnosis-on-admission

From the FHIR Standard

Claim.diagnosis.packageCode

example

ExampleDiagnosisRelatedGroupCodes

http://hl7.org/fhir/ValueSet/ex-diagnosisrelatedgroup

From the FHIR Standard

Claim.procedure.type

example

ExampleProcedureTypeCodes

http://hl7.org/fhir/ValueSet/ex-procedure-type

From the FHIR Standard

Claim.procedure.procedure[x]

example

ICD-10ProcedureCodes

http://hl7.org/fhir/ValueSet/icd-10-procedures

From the FHIR Standard

Claim.accident.type

required

ActIncidentCode

http://terminology.hl7.org/ValueSet/v3-ActIncidentCode

Claim.item.revenue

example

ExampleRevenueCenterCodes

http://hl7.org/fhir/ValueSet/ex-revenue-center

From the FHIR Standard

Claim.item.category

example

BenefitCategoryCodes

http://hl7.org/fhir/ValueSet/ex-benefitcategory

From the FHIR Standard

Claim.item.productOrService

required

ProfessionalBilling

http://nphies.sa/terminology/ValueSet/professional-billing

From this IG

Claim.item.modifier

example

ModifierTypeCodes

http://hl7.org/fhir/ValueSet/claim-modifiers

From the FHIR Standard

Claim.item.programCode

example

ExampleProgramReasonCodes

http://hl7.org/fhir/ValueSet/ex-program-code

From the FHIR Standard

Claim.item.location[x]

example

ExampleServicePlaceCodes

http://hl7.org/fhir/ValueSet/service-place

From the FHIR Standard

Claim.item.bodySite

required

SNOMEDCTBodyStructures

http://hl7.org/fhir/ValueSet/body-site

From the FHIR Standard

Claim.item.subSite

required

SubSite(a valid code from Sub Site)

http://nphies.sa/terminology/ValueSet/subsite

From this IG

Claim.item.detail.revenue

example

ExampleRevenueCenterCodes

http://hl7.org/fhir/ValueSet/ex-revenue-center

From the FHIR Standard

Claim.item.detail.category

example

BenefitCategoryCodes

http://hl7.org/fhir/ValueSet/ex-benefitcategory

From the FHIR Standard

Claim.item.detail.productOrService

required

ProfessionalBilling

http://nphies.sa/terminology/ValueSet/professional-billing

From this IG

Claim.item.detail.modifier

example

ModifierTypeCodes

http://hl7.org/fhir/ValueSet/claim-modifiers

From the FHIR Standard

Claim.item.detail.programCode

example

ExampleProgramReasonCodes

http://hl7.org/fhir/ValueSet/ex-program-code

From the FHIR Standard

Claim.item.detail.subDetail.revenue

example

ExampleRevenueCenterCodes

http://hl7.org/fhir/ValueSet/ex-revenue-center

From the FHIR Standard

Claim.item.detail.subDetail.category

example

BenefitCategoryCodes

http://hl7.org/fhir/ValueSet/ex-benefitcategory

From the FHIR Standard

Claim.item.detail.subDetail.productOrService

required

ProfessionalBilling

http://nphies.sa/terminology/ValueSet/professional-billing

From this IG

Claim.item.detail.subDetail.modifier

example

ModifierTypeCodes

http://hl7.org/fhir/ValueSet/claim-modifiers

From the FHIR Standard

Claim.item.detail.subDetail.programCode

example

ExampleProgramReasonCodes

http://hl7.org/fhir/ValueSet/ex-program-code

From the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
BV-00002	error	Claim	Claim care team sequence is not unique within the submitted claim resource. : careTeam.exists() implies careTeam.sequence.isDistinct()
BV-00036	error	Claim.item	No Claim item detail provided when Claim item package = true. : extension('http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-package').exists() implies extension('http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-package').first().value = true implies detail.exists().not()
BV-00042	error	Claim.item	Claim item detail sequence in not unique within the Claim item. : detail.sequence.exists() implies detail.sequence.isDistinct()
BV-00043	error	Claim.item.detail	Claim item subDetail sequence in not unique within the Claim item detail. : subDetail.sequence.exists() implies subDetail.sequence.isDistinct()
BV-00044	error	Claim	Item sequence value is not unique within the Claim resource. : item.sequence.exists() implies item.sequence.isDistinct()
BV-00054	error	Claim	One and only one principal diagnosis is required. : diagnosis.type.coding.where(code='principal').count() = 1
BV-00056	error	Claim.payee	Payee party is not provided when payee type='other'. : type.coding.where(code='other').count() > 0 implies party.exists()
BV-00057	error	Claim	Diagnosis is not unique in the submitted request. : diagnosis.diagnosis.ofType(CodeableConcept).isDistinct()
BV-00092	error	Claim.item.unitPrice	Claim Item UnitPrice Currency is not SAR. : currency = 'SAR'
BV-00093	error	Claim.item.net	Claim Item Net Currency is not SAR. : currency = 'SAR'
BV-00094	error	Claim.item.detail.unitPrice	Claim Item Detail UnitPrice Currency is not SAR. : currency = 'SAR'
BV-00095	error	Claim.item.detail.net	Claim Item Detail Net Currency is not SAR. : currency = 'SAR'
BV-00096	error	Claim.total	Claim Total Net Currency is not SAR. : currency = 'SAR'
BV-00123	error	Claim.item	Claim servicedate is not using a correct data type. : serviced.ofType(date).exists() or serviced.ofType(Period).exists()
BV-00137	error	Claim	The claim identifier does not exist. : identifier.exists()
BV-00316	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Claim supportingInfo valueString value length is longer than the maximum specified length of 250 English characters and 125 Arabic characters. : value.ofType(string).exists() implies value.ofType(string).length() <= 250
BV-00330	error	Claim	Claim status is not using the specified value 'active'. : status.exists() implies status='active'
BV-00347	error	Claim.extension:eligibilityOffLineDate	Claim eligibility OfflineDate is greater than current date. : value.ofType(dateTime) <= now()
BV-00365	error	Claim	Claim subtype is using an incorrect value when Claim type is 'Professional'. : subType.coding.first().code = 'op' or subType.coding.first().code = 'emr'
BV-00402	error	Claim.supportingInfo:info	Supporting information 'info' requires textual information in valueString. : value.ofType(string).exists()
BV-00404	error	Claim.supportingInfo:attachment	Supporting information 'attachment' requires the content to be provided. : value.ofType(Attachment).exists()
BV-00409	error	Claim.supportingInfo:employmentImpacted	Supporting information 'employmentImpacted' requires the period during which the employment was impacted. : timing.ofType(Period).exists()
BV-00410	error	Claim.supportingInfo:labTest	Supporting information 'lab-test' requires a valid LOINC code. : code.exists()
BV-00411	error	Claim.supportingInfo:labTest	If supporting information is 'lab-test' then valueQuantity SHALL exist and SHALL use a value specified in the UCUM code-system. : value.ofType(Quantity).exists()
BV-00412	error	Claim.supportingInfo:reasonForVisit	Supporting information 'reason-for-visit' requires a value from the specified NPHIES CodeSystem mentioning the reason for the visit. : code.exists()
BV-00413	error	Claim.supportingInfo:daysSupply	If Supporting information is 'days-supply' then valueQuantity SHALL exist and number of days SHALL use UCUM code 'd'. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'd'
BV-00414	error	Claim.supportingInfo:vitalSignWeight	If Supporting information is 'vital-sign-weight' and valueQuantity exist then it should use 'kg' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'kg'
BV-00415	error	Claim.supportingInfo:vitalSignSystolic	If Supporting information is 'vital-sign-systolic' and valueQuantity exist then it should use 'mm[Hg]'' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'mm[Hg]'
BV-00416	error	Claim.supportingInfo:vitalSignDiastolic	If Supporting information is 'vital-sign-diastolic' and valueQuantity exist then it should use 'mm[Hg]' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'mm[Hg]'
BV-00417	error	Claim.supportingInfo:vitalSignHeight	If Supporting information is 'vital-sign-height' and valueQuantity exist then it should use 'cm' code from UCUM system. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'cm'
BV-00428	error	Claim.supportingInfo:onset	Supporting information 'onset' requires the starting date and the ICD 10 code for the symptoms / illness. : code.exists() and timing.ofType(date).exists()
BV-00429	error	Claim.supportingInfo:chiefComplaint	Supporting information 'chief-complaint' requires the ICD 10 code for the symptoms / illness if a code is supplied. : code.exists()
BV-00439	error	Claim.item	If period is provided then Claim.item.servicedDate must not be used. : serviced.exists() implies (serviced.ofType(date).exists() xor serviced.ofType(Period).exists())
BV-00453	error	Claim	Claim supportingInfo sequence value is not unique within the claim request. : supportingInfo.sequence.exists() implies supportingInfo.sequence.isDistinct()
BV-00454	error	Claim	Claim diagnosis sequence value is not unique within the claim request. : diagnosis.sequence.isDistinct()
BV-00482	error	Claim.item	Item factor must be a positive decimal value. : factor.exists() implies factor >= 0
BV-00484	error	Claim.item	The subSite shall not be allowed if the bodySite is not provided. : subSite.exists() implies bodySite.exists()
BV-00486	error	Claim.supportingInfo:temperature	If Supporting information is 'temperature' and valueQuantity exist then it should use 'Cel' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'Cel'
BV-00487	error	Claim.supportingInfo:pulse	If Supporting information is 'pulse' and valueQuantity exist then it should use '/min' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '/min'
BV-00488	error	Claim.supportingInfo:oxygen-saturation	If Supporting information is 'oxygen-saturation' and valueQuantity exist then it should use '%' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '%'
BV-00489	error	Claim.supportingInfo:respiratory-rate	If Supporting information is 'respiratory-rate' and valueQuantity exist then it should use '/min' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = '/min'
BV-00490	error	Claim.supportingInfo:last-menstrual-period	Supporting information 'last-menstrual-period' requires the date of start of last menstrual period. : timing.ofType(date).exists()
BV-00494	error	Claim.payee	Claim payee party must not provided when Claim payee type value is not 'other'. : type.coding.where(code!='other').count() > 0 implies party.exists().not()
BV-00502	error	Claim.item	Claim item informationSequence is not unique within the Claim item. : informationSequence.isDistinct()
BV-00509	error	Claim.supportingInfo:birth-weight	If Supporting information is 'birth-weight' then valueQuantity shall exist and should use 'kg' code from UCUM. : value.ofType(Quantity).exists() implies value.ofType(Quantity).code = 'kg'
BV-00530	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	If supportingInfo code element is provided and the category is not 'chief-complaint' then a code is required. : (code.exists() and category.coding.first().code != 'chief-complaint') implies code.coding.code.exists()
BV-00531	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	The supportingInfo code element is required if supportingInfo category is 'chief-complaint'. : category.exists() implies (category.coding.first().code = 'chief-complaint') implies code.exists()
BV-00752	error	Claim	Supporting information 'investigation-result' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'investigation-result').exists()
BV-00753	error	Claim.supportingInfo:investigation-result	Investigation Result ('Text' - value[x] valueString' Shall be Provided when Investigation Result Supporting info is selected with Code = 'other'. : ((code.coding.where(code='other').count() > 0) and value.exists()) implies value.ofType(string).exists()
BV-00771	error	Claim	Oxygen-saturation SHALL be provided in institutional claim or authorization. : supportingInfo.category.coding.where(code='oxygen-saturation').count() > 0
BV-00772	error	Claim	Diastolic SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-diastolic').count() > 0
BV-00773	error	Claim	Systolic SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-systolic').count() > 0
BV-00774	error	Claim	Pulse SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='pulse').count() > 0
BV-00775	error	Claim	Temperature SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='temperature').count() > 0
BV-00776	error	Claim	Height SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-height').count() > 0
BV-00777	error	Claim	Respiratory-rate SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='respiratory-rate').count() > 0
BV-00778	error	Claim	Weight SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='vital-sign-weight').count() > 0
BV-00779	error	Claim	Chief-complaint SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='chief-complaint').count() > 0
BV-00780	error	Claim	Oxygen-saturation SHALL be provided in professional claim or authorization. : supportingInfo.category.coding.where(code='oxygen-saturation').count() > 0
BV-00782	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Supporting information 'treatment-plan' requires textual information. : category.coding.where(code='treatment-plan').count() > 0 implies value.ofType(string).exists()
BV-00783	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Supporting information 'patient-history' requires textual information. : category.coding.where(code='patient-history').count() > 0 implies value.ofType(string).exists()
BV-00784	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Supporting information 'physical-examination' requires textual information . : category.coding.where(code='physical-examination').count() > 0 implies value.ofType(string).exists()
BV-00785	error	Claim.supportingInfo, Claim.supportingInfo:attachment, Claim.supportingInfo:birth-weight, Claim.supportingInfo:chiefComplaint, Claim.supportingInfo:daysSupply, Claim.supportingInfo:employmentImpacted, Claim.supportingInfo:history-of-present-illness, Claim.supportingInfo:info, Claim.supportingInfo:investigation-result, Claim.supportingInfo:labTest, Claim.supportingInfo:last-menstrual-period, Claim.supportingInfo:onset, Claim.supportingInfo:oxygen-saturation, Claim.supportingInfo:patient-history, Claim.supportingInfo:physical-examination, Claim.supportingInfo:pulse, Claim.supportingInfo:reasonForVisit, Claim.supportingInfo:respiratory-rate, Claim.supportingInfo:temperature, Claim.supportingInfo:treatment-plan, Claim.supportingInfo:vitalSignDiastolic, Claim.supportingInfo:vitalSignHeight, Claim.supportingInfo:vitalSignSystolic, Claim.supportingInfo:vitalSignWeight	Supporting information 'history-of-present-illness' requires textual information . : category.coding.where(code='history-of-present-illness').count() > 0 implies value.ofType(string).exists()
BV-00803	error	Claim	Supporting information 'treatment-plan' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'treatment-plan').exists()
BV-00804	error	Claim	Supporting information 'patient-history' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'patient-history').exists()
BV-00805	error	Claim	Supporting information 'pphysical-examination' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'physical-examination').exists()
BV-00806	error	Claim	Supporting information 'history-of-present-illness' is required in claim and authorization. : supportingInfo.category.coding.where(code = 'history-of-present-illness').exists()
BV-00812	error	Claim.supportingInfo:vitalSignWeight	If Claim supportingInfo category='vital-sign-weight' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00813	error	Claim.supportingInfo:vitalSignSystolic	If Claim supportingInfo category='vital-sign-systolic' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00814	error	Claim.supportingInfo:vitalSignDiastolic	If Claim supportingInfo category='vital-sign-diastolic' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00815	error	Claim.supportingInfo:vitalSignHeight	If Claim supportingInfo category='vital-sign-height' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00816	error	Claim.supportingInfo:temperature	If Claim supportingInfo category='temperature' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00817	error	Claim.supportingInfo:pulse	If Claim supportingInfo category='pulse' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00818	error	Claim.supportingInfo:oxygen-saturation	If Claim supportingInfo category='oxygen-saturation' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00819	error	Claim.supportingInfo:respiratory-rate	If Claim supportingInfo category='respiratory-rate' then either valueQuantity or reason SHALL exist. : value.ofType(Quantity).exists() or reason.exists()
BV-00820	error	Claim.supportingInfo:vitalSignWeight	If Claim.supportingInfo.category.coding.code='vital-sign-weight' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/weight-absence-reason'
BV-00821	error	Claim.supportingInfo:vitalSignSystolic	If Claim.supportingInfo.category.coding.code='vital-sign-systolic' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/blood-pressure-absence-reason'
BV-00822	error	Claim.supportingInfo:vitalSignDiastolic	If Claim.supportingInfo.category.coding.code='vital-sign-diastolic' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/blood-pressure-absence-reason'
BV-00823	error	Claim.supportingInfo:vitalSignHeight	If Claim.supportingInfo.category.coding.code='vital-sign-height' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/height-absence-reason'
BV-00824	error	Claim.supportingInfo:temperature	If Claim.supportingInfo.category.coding.code='temperature' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/tempurature-absence-reason'
BV-00825	error	Claim.supportingInfo:pulse	If Claim.supportingInfo.category.coding.code='pulse' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/pulse-absence-reason'
BV-00826	error	Claim.supportingInfo:oxygen-saturation	If Claim.supportingInfo.category.coding.code='oxygen-saturation' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/oxygen-saturation-absence-reason'
BV-00827	error	Claim.supportingInfo:respiratory-rate	If Claim.supportingInfo.category.coding.code='respiratory-rate' and Claim.supportingInfo.reason exist then the reason SHALL use a code from the specified valueSet. : reason.exists() implies reason.coding.first().system='http://nphies.sa/terminology/CodeSystem/respiratory-rate-absence-reason'
BV-00846	error	Claim.supportingInfo:investigation-result	Supporting information 'investigation-result' requires a attachment when attachment code is used with Code = 'IRA'. : (code.coding.where(code='IRA').count() > 0) implies value.ofType(Attachment).exists()
P-Auth-1	error	Claim.subType	SubType may only be OP or EMR : coding.first().code = 'op' or coding.first().code = 'emr'
P-Auth-SI-1	error	Claim.supportingInfo:vitalSignWeight	Patient weight must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-2	error	Claim.supportingInfo:vitalSignSystolic	Systolic blood pressure must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-3	error	Claim.supportingInfo:vitalSignDiastolic	Diastolic blood pressure must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-4	error	Claim.supportingInfo:vitalSignHeight	Patient height must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-5	error	Claim.supportingInfo:temperature	Patient temperature must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-6	error	Claim.supportingInfo:pulse	Patient pulse must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-7	error	Claim.supportingInfo:oxygen-saturation	Patient oxygen saturation must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
P-Auth-SI-8	error	Claim.supportingInfo:respiratory-rate	Patient respiratory rate must contain either the measure or a data absence code. : value.ofType(Quantity).exists() xor reason.exists()
dom-2	error	Claim	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	Claim	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference \| %resource.descendants().as(canonical) \| %resource.descendants().as(uri) \| %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Claim	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Claim	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	Claim	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	ALL elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	ALL extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()

This structure is derived from NphiesAuthorizationBase

Summary

Mandatory: 40 elements(21 nested mandatory elements)
Must-Support: 27 elements

Structures

This structure refers to these other structures:

Extensions

This structure refers to these extensions:

Slices

This structure defines the following Slices:

The element 1 is sliced based on the value of Claim.supportingInfo (Closed)
The element 1 is sliced based on the value of Claim.supportingInfo.timing[x]
The element 1 is sliced based on the value of Claim.supportingInfo.value[x]

Other representations of profile: CSV, Excel, Schematron