VN Core FHIR Implementation Guide — Bộ Hướng dẫn Triển khai FHIR Cốt lõi cho Việt Nam
0.1.0 - STU1 Draft Viet Nam flag

VN Core FHIR Implementation Guide — Bộ Hướng dẫn Triển khai FHIR Cốt lõi cho Việt Nam - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

Resource Profile: Giai trinh quyen loi BHYT VN Core — VN Core ExplanationOfBenefit Profile

Official URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-explanation-of-benefit Version: 0.1.0
Draft as of 2026-03-21 Computable Name: VNCoreExplanationOfBenefit

Profile ExplanationOfBenefit cho Viet Nam. Giai trinh quyen loi BHYT — ket qua giam dinh va thanh toan. Mapping tu chuan du lieu dau ra phuc vu BHXH (XML 4210 -> QD 130 -> QD 3176). Bang ke chi phi theo QD 697/QD-BYT (19/3/2026) — 12 danh muc, 14 ma. Can cu:

  • QD 3176/QD-BYT (29/10/2024) — Chuan du lieu dau ra phuc vu BHXH
  • QD 697/QD-BYT (19/3/2026) — Mau bang ke chi phi KCB
  • ND 188/2025/ND-CP — Huong dan thi hanh Luat BHYT
  • Luat BHYT 2008 sua doi 2014

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Profile Content

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

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ExplanationOfBenefit 0..* ExplanationOfBenefit Explanation of Benefit resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costSummary S 0..1 (Complex) Tong chi phi theo nhom: thuoc, VTYT, BHYT, tu tra, cung chi tra, nguon khac
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary
.... extension:paymentPeriod 0..1 (Complex) Ky thanh toan BHYT (nam/thang) — NAM_QT, THANG_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
.... extension:paymentMethod 0..1 CodeableConcept Phuong thuc thanh toan (FFS/Capitation/DRG) — MA_PTTT_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method
Binding: Phương thức thanh toán BHYT — VN Payment Method ValueSet (extensible)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... type SΣ 1..1 CodeableConcept Loai: institutional (noi tru), professional (ngoai tru)
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
... use SΣ 1..1 code Muc dich: claim (thanh toan)
Binding: Use (required): Complete, proposed, exploratory, other.
... patient SΣ 1..1 Reference(Bệnh nhân VN Core — VN Core Patient Profile) Benh nhan
... created SΣ 1..1 dateTime Ngay tao giai trinh
... insurer SΣ 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Co quan BHXH thanh toan
... provider SΣ 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile | Nhân viên y tế VN Core — VN Core Practitioner Profile | Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile) Co so KCB thuc hien
... outcome SΣ 1..1 code Ket qua giam dinh: complete | partial | error
Binding: ClaimProcessingCodes (required): The result of the claim processing.
... diagnosis 0..* BackboneElement Chan doan — ICD-10 VN
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence S 1..1 positiveInt Diagnosis instance identifier
.... Slices for diagnosis[x] 1..1 Nature of illness or problem
Slice: Unordered, Open by type:$this
Binding: ICD-10Codes (example): ICD10 Diagnostic codes.
..... diagnosisCodeableConcept CodeableConcept
..... diagnosisReference Reference(Condition)
..... diagnosis[x]:diagnosisCodeableConcept S 0..1 CodeableConcept Ma benh ICD-10 VN
Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
.... type S 0..* CodeableConcept Loai chan doan (chinh/phu)
Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
... procedure 0..* BackboneElement Thu thuat/phau thuat — ICD-9-CM
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Procedure instance identifier
.... Slices for procedure[x] 1..1 Specific clinical procedure
Slice: Unordered, Open by type:$this
Binding: ICD-10ProcedureCodes (example): ICD10 Procedure codes.
..... procedureCodeableConcept CodeableConcept
..... procedureReference Reference(Procedure)
..... procedure[x]:procedureCodeableConcept 0..1 CodeableConcept Specific clinical procedure
Binding: Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet (extensible)
... insurance SΣ 1..* BackboneElement Thong tin BHYT
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... focal SΣ 1..1 boolean Coverage to be used for adjudication
.... coverage SΣ 1..1 Reference(Thẻ BHYT VN Core — VN Core Coverage Profile) The BHYT (Coverage)
... item S 0..* BackboneElement Chi tiet chi phi — 12 nhom per QD 697/QD-BYT
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence S 1..1 positiveInt Item instance identifier
.... category S 0..1 CodeableConcept Nhom chi phi (QD 697)
Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (extensible)
.... productOrService S 1..1 CodeableConcept Ma dich vu/thuoc/TBYT
Binding: USCLSCodes (example): Allowable service and product codes.
.... quantity 0..1 SimpleQuantity(4.0.1) So luong
.... unitPrice 0..1 Money Don gia
.... net S 0..1 Money Thanh tien
.... adjudication 0..* BackboneElement Ket qua giam dinh tung dong
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... category S 1..1 CodeableConcept Type of adjudication information
Binding: AdjudicationValueCodes (example): The adjudication codes.
..... amount S 0..1 Money Monetary amount
... total SΣ 0..* BackboneElement Tong hop theo nhom giam dinh
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... category SΣ 1..1 CodeableConcept Type of adjudication information
Binding: AdjudicationValueCodes (example): The adjudication codes.
.... amount SΣ 1..1 Money So tien
... payment S 0..1 BackboneElement Thong tin thanh toan
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 0..1 CodeableConcept Loai thanh toan
Binding: ExamplePaymentTypeCodes (example): The type (partial, complete) of the payment.
.... amount S 0..1 Money So tien BHYT thanh toan
... benefitPeriod 0..1 Period Ky quyen loi BHYT

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ExplanationOfBenefit.​status Base required ExplanationOfBenefitStatus 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​type Base extensible Claim Type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​use Base required Use 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​outcome Base required Claim Processing Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​diagnosis.diagnosis[x] Base example ICD-10 Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​diagnosis.diagnosis[x]:diagnosisCodeableConcept Base extensible Mã chẩn đoán — VN Core Condition Code ValueSet 📦0.1.0 This IG
ExplanationOfBenefit.​diagnosis.type Base example Example Diagnosis Type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​procedure.procedure[x] Base example ICD-10 Procedure Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​procedure.procedure[x]:procedureCodeableConcept Base extensible Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet 📦0.1.0 This IG
ExplanationOfBenefit.​item.category Base extensible Danh mục chi phí KCB — Vietnam Cost Category ValueSet 📦0.1.0 This IG
ExplanationOfBenefit.​item.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.adjudication.category Base example Adjudication Value Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​total.category Base example Adjudication Value Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​payment.type Base example Example Payment Type Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ExplanationOfBenefit If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ExplanationOfBenefit 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 ExplanationOfBenefit 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 ExplanationOfBenefit If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ExplanationOfBenefit 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 ExplanationOfBenefit

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ExplanationOfBenefit 0..* ExplanationOfBenefit Explanation of Benefit resource
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costSummary S 0..1 (Complex) Tong chi phi theo nhom: thuoc, VTYT, BHYT, tu tra, cung chi tra, nguon khac
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary
.... extension:paymentPeriod 0..1 (Complex) Ky thanh toan BHYT (nam/thang) — NAM_QT, THANG_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
.... extension:paymentMethod 0..1 CodeableConcept Phuong thuc thanh toan (FFS/Capitation/DRG) — MA_PTTT_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method
Binding: Phương thức thanh toán BHYT — VN Payment Method ValueSet (extensible)
... status S 1..1 code Trang thai giai trinh
... type S 1..1 CodeableConcept Loai: institutional (noi tru), professional (ngoai tru)
... patient S 1..1 Reference(Bệnh nhân VN Core — VN Core Patient Profile) Benh nhan
... created S 1..1 dateTime Ngay tao giai trinh
... insurer S 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Co quan BHXH thanh toan
... provider S 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile | Nhân viên y tế VN Core — VN Core Practitioner Profile | Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile) Co so KCB thuc hien
... outcome S 1..1 code Ket qua giam dinh: complete | partial | error
... diagnosis 0..* BackboneElement Chan doan — ICD-10 VN
.... sequence S 1..1 positiveInt Diagnosis instance identifier
.... Slices for diagnosis[x] 1..1 CodeableConcept, Reference(Condition) Nature of illness or problem
Slice: Unordered, Open by type:$this
..... diagnosis[x]:diagnosisCodeableConcept S 0..1 CodeableConcept Ma benh ICD-10 VN
Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
.... type S 0..* CodeableConcept Loai chan doan (chinh/phu)
... procedure 0..* BackboneElement Thu thuat/phau thuat — ICD-9-CM
.... Slices for procedure[x] 1..1 CodeableConcept, Reference(Procedure) Specific clinical procedure
Slice: Unordered, Open by type:$this
..... procedure[x]:procedureCodeableConcept 0..1 CodeableConcept Specific clinical procedure
Binding: Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet (extensible)
... insurance S 1..* BackboneElement Thong tin BHYT
.... focal S 1..1 boolean Coverage to be used for adjudication
.... coverage S 1..1 Reference(Thẻ BHYT VN Core — VN Core Coverage Profile) The BHYT (Coverage)
... item S 0..* BackboneElement Chi tiet chi phi — 12 nhom per QD 697/QD-BYT
.... sequence S 1..1 positiveInt Item instance identifier
.... category S 0..1 CodeableConcept Nhom chi phi (QD 697)
Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (extensible)
.... productOrService S 1..1 CodeableConcept Ma dich vu/thuoc/TBYT
.... quantity 0..1 SimpleQuantity(4.0.1) So luong
.... unitPrice 0..1 Money Don gia
.... net S 0..1 Money Thanh tien
.... adjudication 0..* BackboneElement Ket qua giam dinh tung dong
..... category S 1..1 CodeableConcept Type of adjudication information
..... amount S 0..1 Money Monetary amount
... total S 0..* BackboneElement Tong hop theo nhom giam dinh
.... category S 1..1 CodeableConcept Type of adjudication information
.... amount S 1..1 Money So tien
... payment S 0..1 BackboneElement Thong tin thanh toan
.... type 0..1 CodeableConcept Loai thanh toan
.... amount S 0..1 Money So tien BHYT thanh toan
... benefitPeriod 0..1 Period Ky quyen loi BHYT

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
ExplanationOfBenefit.​diagnosis.diagnosis[x]:diagnosisCodeableConcept Base extensible Mã chẩn đoán — VN Core Condition Code ValueSet 📦0.1.0 This IG
ExplanationOfBenefit.​procedure.procedure[x]:procedureCodeableConcept Base extensible Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet 📦0.1.0 This IG
ExplanationOfBenefit.​item.category Base extensible Danh mục chi phí KCB — Vietnam Cost Category ValueSet 📦0.1.0 This IG
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ExplanationOfBenefit 0..* ExplanationOfBenefit Explanation of Benefit resource
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costSummary S 0..1 (Complex) Tong chi phi theo nhom: thuoc, VTYT, BHYT, tu tra, cung chi tra, nguon khac
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary
.... extension:paymentPeriod 0..1 (Complex) Ky thanh toan BHYT (nam/thang) — NAM_QT, THANG_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
.... extension:paymentMethod 0..1 CodeableConcept Phuong thuc thanh toan (FFS/Capitation/DRG) — MA_PTTT_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method
Binding: Phương thức thanh toán BHYT — VN Payment Method ValueSet (extensible)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier Business Identifier for the resource
... status ?!SΣ 1..1 code Trang thai giai trinh
Binding: ExplanationOfBenefitStatus (required): A code specifying the state of the resource instance.
... type SΣ 1..1 CodeableConcept Loai: institutional (noi tru), professional (ngoai tru)
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
... subType 0..1 CodeableConcept More granular claim type
Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode.
... use SΣ 1..1 code Muc dich: claim (thanh toan)
Binding: Use (required): Complete, proposed, exploratory, other.
... patient SΣ 1..1 Reference(Bệnh nhân VN Core — VN Core Patient Profile) Benh nhan
... billablePeriod Σ 0..1 Period Relevant time frame for the claim
... created SΣ 1..1 dateTime Ngay tao giai trinh
... enterer 0..1 Reference(Practitioner | PractitionerRole) Author of the claim
... insurer SΣ 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Co quan BHXH thanh toan
... provider SΣ 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile | Nhân viên y tế VN Core — VN Core Practitioner Profile | Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile) Co so KCB thuc hien
... priority 0..1 CodeableConcept Desired processing urgency
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
... fundsReserveRequested 0..1 CodeableConcept For whom to reserve funds
Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).
... fundsReserve 0..1 CodeableConcept Funds reserved status
Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).
... related 0..* BackboneElement Prior or corollary claims
.... id 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
.... claim 0..1 Reference(Claim) Reference to the related claim
.... relationship 0..1 CodeableConcept How the reference claim is related
Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.
.... reference 0..1 Identifier File or case reference
... prescription 0..1 Reference(MedicationRequest | VisionPrescription) Prescription authorizing services or products
... originalPrescription 0..1 Reference(MedicationRequest) Original prescription if superceded by fulfiller
... payee 0..1 BackboneElement Recipient of benefits payable
.... id 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
.... type 0..1 CodeableConcept Category of recipient
Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.
.... party 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson) Recipient reference
... referral 0..1 Reference(ServiceRequest) Treatment Referral
... facility 0..1 Reference(Location) Servicing Facility
... claim 0..1 Reference(Claim) Claim reference
... claimResponse 0..1 Reference(ClaimResponse) Claim response reference
... outcome SΣ 1..1 code Ket qua giam dinh: complete | partial | error
Binding: ClaimProcessingCodes (required): The result of the claim processing.
... disposition 0..1 string Disposition Message
... preAuthRef 0..* string Preauthorization reference
... preAuthRefPeriod 0..* Period Preauthorization in-effect period
... careTeam 0..* BackboneElement Care Team members
.... id 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 Order of care team
.... provider 1..1 Reference(Practitioner | PractitionerRole | Organization) Practitioner or organization
.... responsible 0..1 boolean Indicator of the lead practitioner
.... role 0..1 CodeableConcept Function within the team
Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members.
.... qualification 0..1 CodeableConcept Practitioner credential or specialization
Binding: ExampleProviderQualificationCodes (example): Provider professional qualifications.
... supportingInfo 0..* BackboneElement Supporting information
.... id 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 Information instance identifier
.... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
.... 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 boolean
..... valueString string
..... valueQuantity Quantity
..... valueAttachment Attachment
..... valueReference Reference(Resource)
.... reason 0..1 Coding Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
... diagnosis 0..* BackboneElement Chan doan — ICD-10 VN
.... id 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 S 1..1 positiveInt Diagnosis instance identifier
.... Slices for diagnosis[x] 1..1 Nature of illness or problem
Slice: Unordered, Open by type:$this
Binding: ICD-10Codes (example): ICD10 Diagnostic codes.
..... diagnosisCodeableConcept CodeableConcept
..... diagnosisReference Reference(Condition)
..... diagnosis[x]:diagnosisCodeableConcept S 0..1 CodeableConcept Ma benh ICD-10 VN
Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
.... type S 0..* CodeableConcept Loai chan doan (chinh/phu)
Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
.... onAdmission 0..1 CodeableConcept Present on admission
Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
.... packageCode 0..1 CodeableConcept Package billing code
Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
... procedure 0..* BackboneElement Thu thuat/phau thuat — ICD-9-CM
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Procedure instance identifier
.... type 0..* CodeableConcept Category of Procedure
Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.
.... date 0..1 dateTime When the procedure was performed
.... Slices for procedure[x] 1..1 Specific clinical procedure
Slice: Unordered, Open by type:$this
Binding: ICD-10ProcedureCodes (example): ICD10 Procedure codes.
..... procedureCodeableConcept CodeableConcept
..... procedureReference Reference(Procedure)
..... procedure[x]:procedureCodeableConcept 0..1 CodeableConcept Specific clinical procedure
Binding: Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet (extensible)
.... udi 0..* Reference(Device) Unique device identifier
... precedence 0..1 positiveInt Precedence (primary, secondary, etc.)
... insurance SΣ 1..* BackboneElement Thong tin BHYT
.... id 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
.... focal SΣ 1..1 boolean Coverage to be used for adjudication
.... coverage SΣ 1..1 Reference(Thẻ BHYT VN Core — VN Core Coverage Profile) The BHYT (Coverage)
.... preAuthRef 0..* string Prior authorization reference number
... accident 0..1 BackboneElement Details of the event
.... id 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 0..1 date When the incident occurred
.... type 0..1 CodeableConcept The nature of the accident
Binding: ActIncidentCode (extensible): Type of accident: work place, auto, etc.
.... location[x] 0..1 Where the event occurred
..... locationAddress Address
..... locationReference Reference(Location)
... item S 0..* BackboneElement Chi tiet chi phi — 12 nhom per QD 697/QD-BYT
.... id 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 S 1..1 positiveInt Item instance identifier
.... careTeamSequence 0..* positiveInt Applicable care team members
.... diagnosisSequence 0..* positiveInt Applicable diagnoses
.... procedureSequence 0..* positiveInt Applicable procedures
.... informationSequence 0..* 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 S 0..1 CodeableConcept Nhom chi phi (QD 697)
Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (extensible)
.... productOrService S 1..1 CodeableConcept Ma dich vu/thuoc/TBYT
Binding: USCLSCodes (example): Allowable service and product codes.
.... 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.
.... serviced[x] 0..1 Date or dates of service or product delivery
..... servicedDate date
..... servicedPeriod Period
.... location[x] 0..1 Place of service or where product was supplied
Binding: ExampleServicePlaceCodes (example): Place where the service is rendered.
..... locationCodeableConcept CodeableConcept
..... locationAddress Address
..... locationReference Reference(Location)
.... quantity 0..1 SimpleQuantity(4.0.1) So luong
.... unitPrice 0..1 Money Don gia
.... factor 0..1 decimal Price scaling factor
.... net S 0..1 Money Thanh tien
.... udi 0..* Reference(Device) Unique device identifier
.... bodySite 0..1 CodeableConcept Anatomical location
Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.
.... subSite 0..* CodeableConcept Anatomical sub-location
Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.
.... encounter 0..* Reference(Encounter) Encounters related to this billed item
.... noteNumber 0..* positiveInt Applicable note numbers
.... adjudication 0..* BackboneElement Ket qua giam dinh tung dong
..... id 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
..... category S 1..1 CodeableConcept Type of adjudication information
Binding: AdjudicationValueCodes (example): The adjudication codes.
..... reason 0..1 CodeableConcept Explanation of adjudication outcome
Binding: AdjudicationReasonCodes (example): Adjudication reason codes.
..... amount S 0..1 Money Monetary amount
..... value 0..1 decimal Non-monitary value
.... detail 0..* BackboneElement Additional items
..... id 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 Product or service provided
..... 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, medical, vision, oral-basic etc.
..... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
..... 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 0..1 SimpleQuantity(4.0.1) Count of products or services
..... unitPrice 0..1 Money Fee, charge or cost per item
..... factor 0..1 decimal Price scaling factor
..... net 0..1 Money Total item cost
..... udi 0..* Reference(Device) Unique device identifier
..... noteNumber 0..* positiveInt Applicable note numbers
..... adjudication 0..* See adjudication (ExplanationOfBenefit) Detail level adjudication details
..... subDetail 0..* BackboneElement Additional items
...... id 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 Product or service provided
...... 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, medical, vision, oral-basic etc.
...... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
...... 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 0..1 SimpleQuantity(4.0.1) Count of products or services
...... unitPrice 0..1 Money Fee, charge or cost per item
...... factor 0..1 decimal Price scaling factor
...... net 0..1 Money Total item cost
...... udi 0..* Reference(Device) Unique device identifier
...... noteNumber 0..* positiveInt Applicable note numbers
...... adjudication 0..* See adjudication (ExplanationOfBenefit) Subdetail level adjudication details
... addItem 0..* BackboneElement Insurer added line items
.... id 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
.... itemSequence 0..* positiveInt Item sequence number
.... detailSequence 0..* positiveInt Detail sequence number
.... subDetailSequence 0..* positiveInt Subdetail sequence number
.... provider 0..* Reference(Practitioner | PractitionerRole | Organization) Authorized providers
.... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
.... 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.
.... serviced[x] 0..1 Date or dates of service or product delivery
..... servicedDate date
..... servicedPeriod Period
.... location[x] 0..1 Place of service or where product was supplied
Binding: ExampleServicePlaceCodes (example): Place where the service is rendered.
..... locationCodeableConcept CodeableConcept
..... locationAddress Address
..... locationReference Reference(Location)
.... quantity 0..1 SimpleQuantity(4.0.1) Count of products or services
.... unitPrice 0..1 Money Fee, charge or cost per item
.... factor 0..1 decimal Price scaling factor
.... net 0..1 Money Total item cost
.... bodySite 0..1 CodeableConcept Anatomical location
Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.
.... subSite 0..* CodeableConcept Anatomical sub-location
Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.
.... noteNumber 0..* positiveInt Applicable note numbers
.... adjudication 0..* See adjudication (ExplanationOfBenefit) Added items adjudication
.... detail 0..* BackboneElement Insurer added line items
..... id 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
..... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
..... 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.
..... quantity 0..1 SimpleQuantity(4.0.1) Count of products or services
..... unitPrice 0..1 Money Fee, charge or cost per item
..... factor 0..1 decimal Price scaling factor
..... net 0..1 Money Total item cost
..... noteNumber 0..* positiveInt Applicable note numbers
..... adjudication 0..* See adjudication (ExplanationOfBenefit) Added items adjudication
..... subDetail 0..* BackboneElement Insurer added line items
...... id 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
...... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
...... 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.
...... quantity 0..1 SimpleQuantity(4.0.1) Count of products or services
...... unitPrice 0..1 Money Fee, charge or cost per item
...... factor 0..1 decimal Price scaling factor
...... net 0..1 Money Total item cost
...... noteNumber 0..* positiveInt Applicable note numbers
...... adjudication 0..* See adjudication (ExplanationOfBenefit) Added items adjudication
... adjudication 0..* See adjudication (ExplanationOfBenefit) Header-level adjudication
... total SΣ 0..* BackboneElement Tong hop theo nhom giam dinh
.... id 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
.... category SΣ 1..1 CodeableConcept Type of adjudication information
Binding: AdjudicationValueCodes (example): The adjudication codes.
.... amount SΣ 1..1 Money So tien
... payment S 0..1 BackboneElement Thong tin thanh toan
.... id 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
.... type 0..1 CodeableConcept Loai thanh toan
Binding: ExamplePaymentTypeCodes (example): The type (partial, complete) of the payment.
.... adjustment 0..1 Money Payment adjustment for non-claim issues
.... adjustmentReason 0..1 CodeableConcept Explanation for the variance
Binding: PaymentAdjustmentReasonCodes (example): Payment Adjustment reason codes.
.... date 0..1 date Expected date of payment
.... amount S 0..1 Money So tien BHYT thanh toan
.... identifier 0..1 Identifier Business identifier for the payment
... formCode 0..1 CodeableConcept Printed form identifier
Binding: Form Codes (example): The forms codes.
... form 0..1 Attachment Printed reference or actual form
... processNote 0..* BackboneElement Note concerning adjudication
.... id 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
.... number 0..1 positiveInt Note instance identifier
.... type 0..1 code display | print | printoper
Binding: NoteType (required): The presentation types of notes.
.... text 0..1 string Note explanatory text
.... language 0..1 CodeableConcept Language of the text
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... benefitPeriod 0..1 Period Ky quyen loi BHYT
... benefitBalance 0..* BackboneElement Balance by Benefit Category
.... id 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
.... category 1..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision, oral-basic etc.
.... excluded 0..1 boolean Excluded from the plan
.... name 0..1 string Short name for the benefit
.... description 0..1 string Description of the benefit or services covered
.... network 0..1 CodeableConcept In or out of network
Binding: NetworkTypeCodes (example): Code to classify in or out of network services.
.... unit 0..1 CodeableConcept Individual or family
Binding: UnitTypeCodes (example): Unit covered/serviced - individual or family.
.... term 0..1 CodeableConcept Annual or lifetime
Binding: BenefitTermCodes (example): Coverage unit - annual, lifetime.
.... financial 0..* BackboneElement Benefit Summary
..... id 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
..... type 1..1 CodeableConcept Benefit classification
Binding: BenefitTypeCodes (example): Deductable, visits, co-pay, etc.
..... allowed[x] 0..1 Benefits allowed
...... allowedUnsignedInt unsignedInt
...... allowedString string
...... allowedMoney Money
..... used[x] 0..1 Benefits used
...... usedUnsignedInt unsignedInt
...... usedMoney Money

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ExplanationOfBenefit.​language Base preferred Common Languages 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​status Base required ExplanationOfBenefitStatus 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​type Base extensible Claim Type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​subType Base example Example Claim SubType Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​use Base required Use 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​priority Base example Process Priority Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​fundsReserveRequested Base example FundsReserve 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​fundsReserve Base example FundsReserve 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​related.relationship Base example Example Related Claim Relationship Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​payee.type Base example PayeeType 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​outcome Base required Claim Processing Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​careTeam.role Base example Claim Care Team Role Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​careTeam.qualification Base example Example Provider Qualification Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​supportingInfo.category Base example Claim Information Category Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​supportingInfo.code Base example Exception Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​supportingInfo.reason Base example Missing Tooth Reason Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​diagnosis.diagnosis[x] Base example ICD-10 Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​diagnosis.diagnosis[x]:diagnosisCodeableConcept Base extensible Mã chẩn đoán — VN Core Condition Code ValueSet 📦0.1.0 This IG
ExplanationOfBenefit.​diagnosis.type Base example Example Diagnosis Type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​diagnosis.onAdmission Base example Example Diagnosis on Admission Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​diagnosis.packageCode Base example Example Diagnosis Related Group Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​procedure.type Base example Example Procedure Type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​procedure.procedure[x] Base example ICD-10 Procedure Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​procedure.procedure[x]:procedureCodeableConcept Base extensible Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet 📦0.1.0 This IG
ExplanationOfBenefit.​accident.type Base extensible ActIncidentCode 📦3.0.0 THO v6.2
ExplanationOfBenefit.​item.revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.category Base extensible Danh mục chi phí KCB — Vietnam Cost Category ValueSet 📦0.1.0 This IG
ExplanationOfBenefit.​item.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.programCode Base example Example Program Reason Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.location[x] Base example Example Service Place Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.bodySite Base example Oral Site Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.subSite Base example Surface Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.adjudication.category Base example Adjudication Value Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.adjudication.reason Base example Adjudication Reason Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.category Base example Benefit Category Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.programCode Base example Example Program Reason Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.subDetail.​revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.subDetail.​category Base example Benefit Category Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.subDetail.​productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.subDetail.​modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.subDetail.​programCode Base example Example Program Reason Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.programCode Base example Example Program Reason Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.location[x] Base example Example Service Place Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.bodySite Base example Oral Site Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.subSite Base example Surface Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.detail.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.detail.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.detail.subDetail.​productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.detail.subDetail.​modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​total.category Base example Adjudication Value Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​payment.type Base example Example Payment Type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​payment.adjustmentReason Base example Payment Adjustment Reason Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​formCode Base example Forms 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​processNote.type Base required NoteType 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​processNote.language Base preferred Common Languages 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​benefitBalance.category Base example Benefit Category Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​benefitBalance.network Base example Network Type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​benefitBalance.unit Base example Unit Type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​benefitBalance.term Base example Benefit Term Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​benefitBalance.financial.​type Base example Benefit Type Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ExplanationOfBenefit If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ExplanationOfBenefit 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 ExplanationOfBenefit 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 ExplanationOfBenefit If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ExplanationOfBenefit 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()

Key Elements View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ExplanationOfBenefit 0..* ExplanationOfBenefit Explanation of Benefit resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costSummary S 0..1 (Complex) Tong chi phi theo nhom: thuoc, VTYT, BHYT, tu tra, cung chi tra, nguon khac
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary
.... extension:paymentPeriod 0..1 (Complex) Ky thanh toan BHYT (nam/thang) — NAM_QT, THANG_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
.... extension:paymentMethod 0..1 CodeableConcept Phuong thuc thanh toan (FFS/Capitation/DRG) — MA_PTTT_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method
Binding: Phương thức thanh toán BHYT — VN Payment Method ValueSet (extensible)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... type SΣ 1..1 CodeableConcept Loai: institutional (noi tru), professional (ngoai tru)
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
... use SΣ 1..1 code Muc dich: claim (thanh toan)
Binding: Use (required): Complete, proposed, exploratory, other.
... patient SΣ 1..1 Reference(Bệnh nhân VN Core — VN Core Patient Profile) Benh nhan
... created SΣ 1..1 dateTime Ngay tao giai trinh
... insurer SΣ 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Co quan BHXH thanh toan
... provider SΣ 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile | Nhân viên y tế VN Core — VN Core Practitioner Profile | Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile) Co so KCB thuc hien
... outcome SΣ 1..1 code Ket qua giam dinh: complete | partial | error
Binding: ClaimProcessingCodes (required): The result of the claim processing.
... diagnosis 0..* BackboneElement Chan doan — ICD-10 VN
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence S 1..1 positiveInt Diagnosis instance identifier
.... Slices for diagnosis[x] 1..1 Nature of illness or problem
Slice: Unordered, Open by type:$this
Binding: ICD-10Codes (example): ICD10 Diagnostic codes.
..... diagnosisCodeableConcept CodeableConcept
..... diagnosisReference Reference(Condition)
..... diagnosis[x]:diagnosisCodeableConcept S 0..1 CodeableConcept Ma benh ICD-10 VN
Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
.... type S 0..* CodeableConcept Loai chan doan (chinh/phu)
Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
... procedure 0..* BackboneElement Thu thuat/phau thuat — ICD-9-CM
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Procedure instance identifier
.... Slices for procedure[x] 1..1 Specific clinical procedure
Slice: Unordered, Open by type:$this
Binding: ICD-10ProcedureCodes (example): ICD10 Procedure codes.
..... procedureCodeableConcept CodeableConcept
..... procedureReference Reference(Procedure)
..... procedure[x]:procedureCodeableConcept 0..1 CodeableConcept Specific clinical procedure
Binding: Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet (extensible)
... insurance SΣ 1..* BackboneElement Thong tin BHYT
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... focal SΣ 1..1 boolean Coverage to be used for adjudication
.... coverage SΣ 1..1 Reference(Thẻ BHYT VN Core — VN Core Coverage Profile) The BHYT (Coverage)
... item S 0..* BackboneElement Chi tiet chi phi — 12 nhom per QD 697/QD-BYT
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence S 1..1 positiveInt Item instance identifier
.... category S 0..1 CodeableConcept Nhom chi phi (QD 697)
Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (extensible)
.... productOrService S 1..1 CodeableConcept Ma dich vu/thuoc/TBYT
Binding: USCLSCodes (example): Allowable service and product codes.
.... quantity 0..1 SimpleQuantity(4.0.1) So luong
.... unitPrice 0..1 Money Don gia
.... net S 0..1 Money Thanh tien
.... adjudication 0..* BackboneElement Ket qua giam dinh tung dong
..... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
..... category S 1..1 CodeableConcept Type of adjudication information
Binding: AdjudicationValueCodes (example): The adjudication codes.
..... amount S 0..1 Money Monetary amount
... total SΣ 0..* BackboneElement Tong hop theo nhom giam dinh
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... category SΣ 1..1 CodeableConcept Type of adjudication information
Binding: AdjudicationValueCodes (example): The adjudication codes.
.... amount SΣ 1..1 Money So tien
... payment S 0..1 BackboneElement Thong tin thanh toan
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... type 0..1 CodeableConcept Loai thanh toan
Binding: ExamplePaymentTypeCodes (example): The type (partial, complete) of the payment.
.... amount S 0..1 Money So tien BHYT thanh toan
... benefitPeriod 0..1 Period Ky quyen loi BHYT

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ExplanationOfBenefit.​status Base required ExplanationOfBenefitStatus 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​type Base extensible Claim Type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​use Base required Use 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​outcome Base required Claim Processing Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​diagnosis.diagnosis[x] Base example ICD-10 Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​diagnosis.diagnosis[x]:diagnosisCodeableConcept Base extensible Mã chẩn đoán — VN Core Condition Code ValueSet 📦0.1.0 This IG
ExplanationOfBenefit.​diagnosis.type Base example Example Diagnosis Type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​procedure.procedure[x] Base example ICD-10 Procedure Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​procedure.procedure[x]:procedureCodeableConcept Base extensible Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet 📦0.1.0 This IG
ExplanationOfBenefit.​item.category Base extensible Danh mục chi phí KCB — Vietnam Cost Category ValueSet 📦0.1.0 This IG
ExplanationOfBenefit.​item.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.adjudication.category Base example Adjudication Value Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​total.category Base example Adjudication Value Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​payment.type Base example Example Payment Type Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ExplanationOfBenefit If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ExplanationOfBenefit 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 ExplanationOfBenefit 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 ExplanationOfBenefit If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ExplanationOfBenefit 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 ExplanationOfBenefit

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ExplanationOfBenefit 0..* ExplanationOfBenefit Explanation of Benefit resource
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costSummary S 0..1 (Complex) Tong chi phi theo nhom: thuoc, VTYT, BHYT, tu tra, cung chi tra, nguon khac
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary
.... extension:paymentPeriod 0..1 (Complex) Ky thanh toan BHYT (nam/thang) — NAM_QT, THANG_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
.... extension:paymentMethod 0..1 CodeableConcept Phuong thuc thanh toan (FFS/Capitation/DRG) — MA_PTTT_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method
Binding: Phương thức thanh toán BHYT — VN Payment Method ValueSet (extensible)
... status S 1..1 code Trang thai giai trinh
... type S 1..1 CodeableConcept Loai: institutional (noi tru), professional (ngoai tru)
... patient S 1..1 Reference(Bệnh nhân VN Core — VN Core Patient Profile) Benh nhan
... created S 1..1 dateTime Ngay tao giai trinh
... insurer S 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Co quan BHXH thanh toan
... provider S 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile | Nhân viên y tế VN Core — VN Core Practitioner Profile | Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile) Co so KCB thuc hien
... outcome S 1..1 code Ket qua giam dinh: complete | partial | error
... diagnosis 0..* BackboneElement Chan doan — ICD-10 VN
.... sequence S 1..1 positiveInt Diagnosis instance identifier
.... Slices for diagnosis[x] 1..1 CodeableConcept, Reference(Condition) Nature of illness or problem
Slice: Unordered, Open by type:$this
..... diagnosis[x]:diagnosisCodeableConcept S 0..1 CodeableConcept Ma benh ICD-10 VN
Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
.... type S 0..* CodeableConcept Loai chan doan (chinh/phu)
... procedure 0..* BackboneElement Thu thuat/phau thuat — ICD-9-CM
.... Slices for procedure[x] 1..1 CodeableConcept, Reference(Procedure) Specific clinical procedure
Slice: Unordered, Open by type:$this
..... procedure[x]:procedureCodeableConcept 0..1 CodeableConcept Specific clinical procedure
Binding: Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet (extensible)
... insurance S 1..* BackboneElement Thong tin BHYT
.... focal S 1..1 boolean Coverage to be used for adjudication
.... coverage S 1..1 Reference(Thẻ BHYT VN Core — VN Core Coverage Profile) The BHYT (Coverage)
... item S 0..* BackboneElement Chi tiet chi phi — 12 nhom per QD 697/QD-BYT
.... sequence S 1..1 positiveInt Item instance identifier
.... category S 0..1 CodeableConcept Nhom chi phi (QD 697)
Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (extensible)
.... productOrService S 1..1 CodeableConcept Ma dich vu/thuoc/TBYT
.... quantity 0..1 SimpleQuantity(4.0.1) So luong
.... unitPrice 0..1 Money Don gia
.... net S 0..1 Money Thanh tien
.... adjudication 0..* BackboneElement Ket qua giam dinh tung dong
..... category S 1..1 CodeableConcept Type of adjudication information
..... amount S 0..1 Money Monetary amount
... total S 0..* BackboneElement Tong hop theo nhom giam dinh
.... category S 1..1 CodeableConcept Type of adjudication information
.... amount S 1..1 Money So tien
... payment S 0..1 BackboneElement Thong tin thanh toan
.... type 0..1 CodeableConcept Loai thanh toan
.... amount S 0..1 Money So tien BHYT thanh toan
... benefitPeriod 0..1 Period Ky quyen loi BHYT

doco Documentation for this format

Terminology Bindings (Differential)

Path Status Usage ValueSet Version Source
ExplanationOfBenefit.​diagnosis.diagnosis[x]:diagnosisCodeableConcept Base extensible Mã chẩn đoán — VN Core Condition Code ValueSet 📦0.1.0 This IG
ExplanationOfBenefit.​procedure.procedure[x]:procedureCodeableConcept Base extensible Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet 📦0.1.0 This IG
ExplanationOfBenefit.​item.category Base extensible Danh mục chi phí KCB — Vietnam Cost Category ValueSet 📦0.1.0 This IG

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. ExplanationOfBenefit 0..* ExplanationOfBenefit Explanation of Benefit resource
... id Σ 0..1 id Logical id of this artifact
... meta Σ 0..1 Meta Metadata about the resource
... implicitRules ?!Σ 0..1 uri A set of rules under which this content was created
... language 0..1 code Language of the resource content
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... text 0..1 Narrative Text summary of the resource, for human interpretation
This profile does not constrain the narrative in regard to content, language, or traceability to data elements
... contained 0..* Resource Contained, inline Resources
... Slices for extension 0..* Extension Extension
Slice: Unordered, Open by value:url
.... extension:costSummary S 0..1 (Complex) Tong chi phi theo nhom: thuoc, VTYT, BHYT, tu tra, cung chi tra, nguon khac
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary
.... extension:paymentPeriod 0..1 (Complex) Ky thanh toan BHYT (nam/thang) — NAM_QT, THANG_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
.... extension:paymentMethod 0..1 CodeableConcept Phuong thuc thanh toan (FFS/Capitation/DRG) — MA_PTTT_QT
URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method
Binding: Phương thức thanh toán BHYT — VN Payment Method ValueSet (extensible)
... modifierExtension ?! 0..* Extension Extensions that cannot be ignored
... identifier 0..* Identifier Business Identifier for the resource
... status ?!SΣ 1..1 code Trang thai giai trinh
Binding: ExplanationOfBenefitStatus (required): A code specifying the state of the resource instance.
... type SΣ 1..1 CodeableConcept Loai: institutional (noi tru), professional (ngoai tru)
Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
... subType 0..1 CodeableConcept More granular claim type
Binding: ExampleClaimSubTypeCodes (example): A more granular claim typecode.
... use SΣ 1..1 code Muc dich: claim (thanh toan)
Binding: Use (required): Complete, proposed, exploratory, other.
... patient SΣ 1..1 Reference(Bệnh nhân VN Core — VN Core Patient Profile) Benh nhan
... billablePeriod Σ 0..1 Period Relevant time frame for the claim
... created SΣ 1..1 dateTime Ngay tao giai trinh
... enterer 0..1 Reference(Practitioner | PractitionerRole) Author of the claim
... insurer SΣ 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile) Co quan BHXH thanh toan
... provider SΣ 1..1 Reference(Cơ sở y tế VN Core — VN Core Organization Profile | Nhân viên y tế VN Core — VN Core Practitioner Profile | Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile) Co so KCB thuc hien
... priority 0..1 CodeableConcept Desired processing urgency
Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
... fundsReserveRequested 0..1 CodeableConcept For whom to reserve funds
Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).
... fundsReserve 0..1 CodeableConcept Funds reserved status
Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).
... related 0..* BackboneElement Prior or corollary claims
.... id 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
.... claim 0..1 Reference(Claim) Reference to the related claim
.... relationship 0..1 CodeableConcept How the reference claim is related
Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.
.... reference 0..1 Identifier File or case reference
... prescription 0..1 Reference(MedicationRequest | VisionPrescription) Prescription authorizing services or products
... originalPrescription 0..1 Reference(MedicationRequest) Original prescription if superceded by fulfiller
... payee 0..1 BackboneElement Recipient of benefits payable
.... id 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
.... type 0..1 CodeableConcept Category of recipient
Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.
.... party 0..1 Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson) Recipient reference
... referral 0..1 Reference(ServiceRequest) Treatment Referral
... facility 0..1 Reference(Location) Servicing Facility
... claim 0..1 Reference(Claim) Claim reference
... claimResponse 0..1 Reference(ClaimResponse) Claim response reference
... outcome SΣ 1..1 code Ket qua giam dinh: complete | partial | error
Binding: ClaimProcessingCodes (required): The result of the claim processing.
... disposition 0..1 string Disposition Message
... preAuthRef 0..* string Preauthorization reference
... preAuthRefPeriod 0..* Period Preauthorization in-effect period
... careTeam 0..* BackboneElement Care Team members
.... id 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 Order of care team
.... provider 1..1 Reference(Practitioner | PractitionerRole | Organization) Practitioner or organization
.... responsible 0..1 boolean Indicator of the lead practitioner
.... role 0..1 CodeableConcept Function within the team
Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members.
.... qualification 0..1 CodeableConcept Practitioner credential or specialization
Binding: ExampleProviderQualificationCodes (example): Provider professional qualifications.
... supportingInfo 0..* BackboneElement Supporting information
.... id 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 Information instance identifier
.... category 1..1 CodeableConcept Classification of the supplied information
Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
.... 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 boolean
..... valueString string
..... valueQuantity Quantity
..... valueAttachment Attachment
..... valueReference Reference(Resource)
.... reason 0..1 Coding Explanation for the information
Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
... diagnosis 0..* BackboneElement Chan doan — ICD-10 VN
.... id 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 S 1..1 positiveInt Diagnosis instance identifier
.... Slices for diagnosis[x] 1..1 Nature of illness or problem
Slice: Unordered, Open by type:$this
Binding: ICD-10Codes (example): ICD10 Diagnostic codes.
..... diagnosisCodeableConcept CodeableConcept
..... diagnosisReference Reference(Condition)
..... diagnosis[x]:diagnosisCodeableConcept S 0..1 CodeableConcept Ma benh ICD-10 VN
Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
.... type S 0..* CodeableConcept Loai chan doan (chinh/phu)
Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
.... onAdmission 0..1 CodeableConcept Present on admission
Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
.... packageCode 0..1 CodeableConcept Package billing code
Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
... procedure 0..* BackboneElement Thu thuat/phau thuat — ICD-9-CM
.... id 0..1 string Unique id for inter-element referencing
.... extension 0..* Extension Additional content defined by implementations
.... modifierExtension ?!Σ 0..* Extension Extensions that cannot be ignored even if unrecognized
.... sequence 1..1 positiveInt Procedure instance identifier
.... type 0..* CodeableConcept Category of Procedure
Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.
.... date 0..1 dateTime When the procedure was performed
.... Slices for procedure[x] 1..1 Specific clinical procedure
Slice: Unordered, Open by type:$this
Binding: ICD-10ProcedureCodes (example): ICD10 Procedure codes.
..... procedureCodeableConcept CodeableConcept
..... procedureReference Reference(Procedure)
..... procedure[x]:procedureCodeableConcept 0..1 CodeableConcept Specific clinical procedure
Binding: Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet (extensible)
.... udi 0..* Reference(Device) Unique device identifier
... precedence 0..1 positiveInt Precedence (primary, secondary, etc.)
... insurance SΣ 1..* BackboneElement Thong tin BHYT
.... id 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
.... focal SΣ 1..1 boolean Coverage to be used for adjudication
.... coverage SΣ 1..1 Reference(Thẻ BHYT VN Core — VN Core Coverage Profile) The BHYT (Coverage)
.... preAuthRef 0..* string Prior authorization reference number
... accident 0..1 BackboneElement Details of the event
.... id 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 0..1 date When the incident occurred
.... type 0..1 CodeableConcept The nature of the accident
Binding: ActIncidentCode (extensible): Type of accident: work place, auto, etc.
.... location[x] 0..1 Where the event occurred
..... locationAddress Address
..... locationReference Reference(Location)
... item S 0..* BackboneElement Chi tiet chi phi — 12 nhom per QD 697/QD-BYT
.... id 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 S 1..1 positiveInt Item instance identifier
.... careTeamSequence 0..* positiveInt Applicable care team members
.... diagnosisSequence 0..* positiveInt Applicable diagnoses
.... procedureSequence 0..* positiveInt Applicable procedures
.... informationSequence 0..* 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 S 0..1 CodeableConcept Nhom chi phi (QD 697)
Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (extensible)
.... productOrService S 1..1 CodeableConcept Ma dich vu/thuoc/TBYT
Binding: USCLSCodes (example): Allowable service and product codes.
.... 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.
.... serviced[x] 0..1 Date or dates of service or product delivery
..... servicedDate date
..... servicedPeriod Period
.... location[x] 0..1 Place of service or where product was supplied
Binding: ExampleServicePlaceCodes (example): Place where the service is rendered.
..... locationCodeableConcept CodeableConcept
..... locationAddress Address
..... locationReference Reference(Location)
.... quantity 0..1 SimpleQuantity(4.0.1) So luong
.... unitPrice 0..1 Money Don gia
.... factor 0..1 decimal Price scaling factor
.... net S 0..1 Money Thanh tien
.... udi 0..* Reference(Device) Unique device identifier
.... bodySite 0..1 CodeableConcept Anatomical location
Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.
.... subSite 0..* CodeableConcept Anatomical sub-location
Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.
.... encounter 0..* Reference(Encounter) Encounters related to this billed item
.... noteNumber 0..* positiveInt Applicable note numbers
.... adjudication 0..* BackboneElement Ket qua giam dinh tung dong
..... id 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
..... category S 1..1 CodeableConcept Type of adjudication information
Binding: AdjudicationValueCodes (example): The adjudication codes.
..... reason 0..1 CodeableConcept Explanation of adjudication outcome
Binding: AdjudicationReasonCodes (example): Adjudication reason codes.
..... amount S 0..1 Money Monetary amount
..... value 0..1 decimal Non-monitary value
.... detail 0..* BackboneElement Additional items
..... id 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 Product or service provided
..... 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, medical, vision, oral-basic etc.
..... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
..... 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 0..1 SimpleQuantity(4.0.1) Count of products or services
..... unitPrice 0..1 Money Fee, charge or cost per item
..... factor 0..1 decimal Price scaling factor
..... net 0..1 Money Total item cost
..... udi 0..* Reference(Device) Unique device identifier
..... noteNumber 0..* positiveInt Applicable note numbers
..... adjudication 0..* See adjudication (ExplanationOfBenefit) Detail level adjudication details
..... subDetail 0..* BackboneElement Additional items
...... id 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 Product or service provided
...... 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, medical, vision, oral-basic etc.
...... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
...... 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 0..1 SimpleQuantity(4.0.1) Count of products or services
...... unitPrice 0..1 Money Fee, charge or cost per item
...... factor 0..1 decimal Price scaling factor
...... net 0..1 Money Total item cost
...... udi 0..* Reference(Device) Unique device identifier
...... noteNumber 0..* positiveInt Applicable note numbers
...... adjudication 0..* See adjudication (ExplanationOfBenefit) Subdetail level adjudication details
... addItem 0..* BackboneElement Insurer added line items
.... id 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
.... itemSequence 0..* positiveInt Item sequence number
.... detailSequence 0..* positiveInt Detail sequence number
.... subDetailSequence 0..* positiveInt Subdetail sequence number
.... provider 0..* Reference(Practitioner | PractitionerRole | Organization) Authorized providers
.... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
.... 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.
.... serviced[x] 0..1 Date or dates of service or product delivery
..... servicedDate date
..... servicedPeriod Period
.... location[x] 0..1 Place of service or where product was supplied
Binding: ExampleServicePlaceCodes (example): Place where the service is rendered.
..... locationCodeableConcept CodeableConcept
..... locationAddress Address
..... locationReference Reference(Location)
.... quantity 0..1 SimpleQuantity(4.0.1) Count of products or services
.... unitPrice 0..1 Money Fee, charge or cost per item
.... factor 0..1 decimal Price scaling factor
.... net 0..1 Money Total item cost
.... bodySite 0..1 CodeableConcept Anatomical location
Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.
.... subSite 0..* CodeableConcept Anatomical sub-location
Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.
.... noteNumber 0..* positiveInt Applicable note numbers
.... adjudication 0..* See adjudication (ExplanationOfBenefit) Added items adjudication
.... detail 0..* BackboneElement Insurer added line items
..... id 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
..... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
..... 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.
..... quantity 0..1 SimpleQuantity(4.0.1) Count of products or services
..... unitPrice 0..1 Money Fee, charge or cost per item
..... factor 0..1 decimal Price scaling factor
..... net 0..1 Money Total item cost
..... noteNumber 0..* positiveInt Applicable note numbers
..... adjudication 0..* See adjudication (ExplanationOfBenefit) Added items adjudication
..... subDetail 0..* BackboneElement Insurer added line items
...... id 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
...... productOrService 1..1 CodeableConcept Billing, service, product, or drug code
Binding: USCLSCodes (example): Allowable service and product codes.
...... 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.
...... quantity 0..1 SimpleQuantity(4.0.1) Count of products or services
...... unitPrice 0..1 Money Fee, charge or cost per item
...... factor 0..1 decimal Price scaling factor
...... net 0..1 Money Total item cost
...... noteNumber 0..* positiveInt Applicable note numbers
...... adjudication 0..* See adjudication (ExplanationOfBenefit) Added items adjudication
... adjudication 0..* See adjudication (ExplanationOfBenefit) Header-level adjudication
... total SΣ 0..* BackboneElement Tong hop theo nhom giam dinh
.... id 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
.... category SΣ 1..1 CodeableConcept Type of adjudication information
Binding: AdjudicationValueCodes (example): The adjudication codes.
.... amount SΣ 1..1 Money So tien
... payment S 0..1 BackboneElement Thong tin thanh toan
.... id 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
.... type 0..1 CodeableConcept Loai thanh toan
Binding: ExamplePaymentTypeCodes (example): The type (partial, complete) of the payment.
.... adjustment 0..1 Money Payment adjustment for non-claim issues
.... adjustmentReason 0..1 CodeableConcept Explanation for the variance
Binding: PaymentAdjustmentReasonCodes (example): Payment Adjustment reason codes.
.... date 0..1 date Expected date of payment
.... amount S 0..1 Money So tien BHYT thanh toan
.... identifier 0..1 Identifier Business identifier for the payment
... formCode 0..1 CodeableConcept Printed form identifier
Binding: Form Codes (example): The forms codes.
... form 0..1 Attachment Printed reference or actual form
... processNote 0..* BackboneElement Note concerning adjudication
.... id 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
.... number 0..1 positiveInt Note instance identifier
.... type 0..1 code display | print | printoper
Binding: NoteType (required): The presentation types of notes.
.... text 0..1 string Note explanatory text
.... language 0..1 CodeableConcept Language of the text
Binding: CommonLanguages (preferred): A human language.
Additional BindingsPurpose
AllLanguages Max Binding
... benefitPeriod 0..1 Period Ky quyen loi BHYT
... benefitBalance 0..* BackboneElement Balance by Benefit Category
.... id 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
.... category 1..1 CodeableConcept Benefit classification
Binding: BenefitCategoryCodes (example): Benefit categories such as: oral, medical, vision, oral-basic etc.
.... excluded 0..1 boolean Excluded from the plan
.... name 0..1 string Short name for the benefit
.... description 0..1 string Description of the benefit or services covered
.... network 0..1 CodeableConcept In or out of network
Binding: NetworkTypeCodes (example): Code to classify in or out of network services.
.... unit 0..1 CodeableConcept Individual or family
Binding: UnitTypeCodes (example): Unit covered/serviced - individual or family.
.... term 0..1 CodeableConcept Annual or lifetime
Binding: BenefitTermCodes (example): Coverage unit - annual, lifetime.
.... financial 0..* BackboneElement Benefit Summary
..... id 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
..... type 1..1 CodeableConcept Benefit classification
Binding: BenefitTypeCodes (example): Deductable, visits, co-pay, etc.
..... allowed[x] 0..1 Benefits allowed
...... allowedUnsignedInt unsignedInt
...... allowedString string
...... allowedMoney Money
..... used[x] 0..1 Benefits used
...... usedUnsignedInt unsignedInt
...... usedMoney Money

doco Documentation for this format

Terminology Bindings

Path Status Usage ValueSet Version Source
ExplanationOfBenefit.​language Base preferred Common Languages 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​status Base required ExplanationOfBenefitStatus 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​type Base extensible Claim Type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​subType Base example Example Claim SubType Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​use Base required Use 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​priority Base example Process Priority Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​fundsReserveRequested Base example FundsReserve 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​fundsReserve Base example FundsReserve 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​related.relationship Base example Example Related Claim Relationship Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​payee.type Base example PayeeType 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​outcome Base required Claim Processing Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​careTeam.role Base example Claim Care Team Role Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​careTeam.qualification Base example Example Provider Qualification Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​supportingInfo.category Base example Claim Information Category Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​supportingInfo.code Base example Exception Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​supportingInfo.reason Base example Missing Tooth Reason Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​diagnosis.diagnosis[x] Base example ICD-10 Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​diagnosis.diagnosis[x]:diagnosisCodeableConcept Base extensible Mã chẩn đoán — VN Core Condition Code ValueSet 📦0.1.0 This IG
ExplanationOfBenefit.​diagnosis.type Base example Example Diagnosis Type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​diagnosis.onAdmission Base example Example Diagnosis on Admission Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​diagnosis.packageCode Base example Example Diagnosis Related Group Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​procedure.type Base example Example Procedure Type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​procedure.procedure[x] Base example ICD-10 Procedure Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​procedure.procedure[x]:procedureCodeableConcept Base extensible Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet 📦0.1.0 This IG
ExplanationOfBenefit.​accident.type Base extensible ActIncidentCode 📦3.0.0 THO v6.2
ExplanationOfBenefit.​item.revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.category Base extensible Danh mục chi phí KCB — Vietnam Cost Category ValueSet 📦0.1.0 This IG
ExplanationOfBenefit.​item.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.programCode Base example Example Program Reason Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.location[x] Base example Example Service Place Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.bodySite Base example Oral Site Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.subSite Base example Surface Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.adjudication.category Base example Adjudication Value Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.adjudication.reason Base example Adjudication Reason Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.category Base example Benefit Category Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.programCode Base example Example Program Reason Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.subDetail.​revenue Base example Example Revenue Center Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.subDetail.​category Base example Benefit Category Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.subDetail.​productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.subDetail.​modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​item.detail.subDetail.​programCode Base example Example Program Reason Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.programCode Base example Example Program Reason Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.location[x] Base example Example Service Place Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.bodySite Base example Oral Site Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.subSite Base example Surface Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.detail.productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.detail.modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.detail.subDetail.​productOrService Base example USCLS Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​addItem.detail.subDetail.​modifier Base example Modifier type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​total.category Base example Adjudication Value Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​payment.type Base example Example Payment Type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​payment.adjustmentReason Base example Payment Adjustment Reason Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​formCode Base example Forms 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​processNote.type Base required NoteType 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​processNote.language Base preferred Common Languages 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​benefitBalance.category Base example Benefit Category Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​benefitBalance.network Base example Network Type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​benefitBalance.unit Base example Unit Type Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​benefitBalance.term Base example Benefit Term Codes 📍4.0.1 FHIR Std.
ExplanationOfBenefit.​benefitBalance.financial.​type Base example Benefit Type Codes 📍4.0.1 FHIR Std.

Constraints

Id Grade Path(s) Description Expression
dom-2 error ExplanationOfBenefit If the resource is contained in another resource, it SHALL NOT contain nested Resources contained.contained.empty()
dom-3 error ExplanationOfBenefit 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 ExplanationOfBenefit 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 ExplanationOfBenefit If a resource is contained in another resource, it SHALL NOT have a security label contained.meta.security.empty()
dom-6 best practice ExplanationOfBenefit 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()

 

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