Hướng dẫn triển khai FHIR cốt lõi Việt Nam — VN Core FHIR Implementation Guide - Draft for Community Review (v0.9.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

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Hồ sơ tài nguyên: Giải trình bảng kê chi phí KCB chi tiết — VN Core Itemized Healthcare Cost Explanation of Benefit

Profile ExplanationOfBenefit dẫn xuất biểu diễn cùng ledger bảng kê 13 cột sau giám định. Mỗi dòng liên kết với một giai đoạn hưởng; thành tiền BH đủ điều kiện dùng adjudication eligible, quỹ BHYT dùng benefit, người bệnh cùng trả dùng copay, còn nguồn khác và người bệnh tự trả dùng các mã VN Core hiện hữu other-fund và patient-self-pay. Căn cứ: [QĐ 697/QĐ-BYT] (ban hành 19/03/2026, hiệu lực 19/03/2026) — Mẫu bảng kê chi phí KCB; [NĐ 188/2025/NĐ-CP] (ban hành 01/07/2025, hiệu lực 15/08/2025) — Hướng dẫn thi hành Luật BHYT.

This derived ExplanationOfBenefit profile represents the same 13-column ledger after payer adjudication. Every item references a benefit stage. Eligible amount, BHYT fund payment, and patient co-payment use the existing HL7 adjudication codes eligible, benefit, and copay; other-source payment and patient self-pay use the existing VN Core codes other-fund and patient-self-pay.

Usages:

• Examples for this Profile: ExplanationOfBenefit/ExampleExplanationOfBenefitItemizedMultiStage

You can also check for usages in the FHIR IG Statistics

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• Tất cả

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ExplanationOfBenefit	C	0..*	VNCoreExplanationOfBenefit	Explanation of Benefit resource Constraints: vn-itemized-eob-stage-sequence-unique, vn-itemized-eob-coverage-reference-distinct, vn-itemized-eob-single-focal-insurance, vn-itemized-eob-item-stage-exists, vn-itemized-eob-money-vnd, vn-itemized-eob-total-submitted-sum, vn-itemized-eob-total-eligible-sum, vn-itemized-eob-total-benefit-sum, vn-itemized-eob-total-copay-sum, vn-itemized-eob-total-other-fund-sum, vn-itemized-eob-total-self-pay-sum, vn-itemized-eob-payment-equals-benefit-total
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:paymentPeriod		0..1	(Complex)	Kỳ thanh toán BHYT (năm/tháng) — NAM_QT, THANG_QT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
extension:paymentMethod		0..1	CodeableConcept	Phương thức thanh toán (FFS/Capitation/DRG) — MA_PTTT 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
status	?!SΣ	1..1	code	Trạng thái giải trình Binding: ExplanationOfBenefitStatus (required): A code specifying the state of the resource instance.
type	SΣ	1..1	CodeableConcept	Loại: institutional (nội trú), professional (ngoại trú) Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
use	SΣ	1..1	code	Mục đích: claim (thanh toán) Binding: Use (required): Complete, proposed, exploratory, other.
patient	SΣ	1..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile)	Bệnh nhân
created	SΣ	1..1	dateTime	Ngày tạo giải trình
insurer	SΣ	1..1	Reference(Organization)	Cơ quan BHXH thanh toán
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)	Cơ sở KCB thực hiện
outcome	SΣ	1..1	code	Kết quả giám định: complete | partial | error Binding: ClaimProcessingCodes (required): The result of the claim processing.
diagnosis		0..*	BackboneElement	Chẩn đoán — 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	Mã bệnh ICD-10 VN Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
type	S	0..*	CodeableConcept	Loại chẩn đoán (chính/phụ) Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
insurance	SΣ	1..*	BackboneElement	Các Coverage thực được giám định và các giai đoạn hưởng — Real adjudicated Coverages with their benefit stages
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:benefitStage	SC	1..*	(Complex)	Sequence, period và mức hưởng của giai đoạn — Stage sequence, period, and benefit level URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage Constraints: vn-coverage-benefit-stage-level-range
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)	Thẻ BHYT (Coverage)
item	SC	1..*	BackboneElement	Dòng bảng kê sau giám định — Adjudicated itemized-statement line Constraints: vn-itemized-eob-eligible-consistent, vn-itemized-eob-serviced-in-stage, vn-itemized-eob-line-allocation-sum, vn-itemized-eob-insured-fields-required, vn-itemized-eob-benefit-level-matches-stage, vn-itemized-eob-other-fund-breakdown-sum
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:otherFundBreakdown	C	0..1	(Complex)	Chi tiết nguồn khác chi trả theo dòng: NSNN/VTNN/VTTN/CL (T_NGUONKHAC_*) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown Constraints: vn-other-fund-breakdown-money-vnd-value
extension:paymentSource		0..1	CodeableConcept	Nguồn chi trả dòng chi phí (NGUON_CTRA) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-source Binding: Nguồn chi trả — Vietnam Payment Source ValueSet (extensible)
extension:recurrentWoundBenefit		0..1	boolean	Flag VET_THUONG_TP cho dòng thuốc/DVKT/VTYT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-recurrent-wound-benefit
extension:tenderInfo		0..1	string	Thông tin thầu dòng chi phí (TT_THAU) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-tender-info
extension:processingMethod		0..1	CodeableConcept	Phương pháp chế biến YHCT (MA_PP_CHEBIEN) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-traditional-processing-method Binding: Phương pháp chế biến vị thuốc cổ truyền — VN Traditional Medicine Processing Method ValueSet (extensible)
extension:benefitStageSequence	S	1..1	positiveInt	Sequence giai đoạn hưởng của dòng — Line benefit-stage sequence URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence
extension:insuranceCostInfo	S	1..1	(Complex)	Các cột đơn giá/tỷ lệ/thành tiền BHYT — BHYT price, ratio, and eligible-amount columns URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
Slices for extension				Content/Rules for all slices
extension:scope		0..1	Extension	Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"scope"
value[x]		1..1	CodeableConcept	Value of extension Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:paymentRatio		0..1	Extension	Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentRatio"
value[x]		1..1	decimal	Value of extension
extension:benefitLevel		0..1	Extension	Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"benefitLevel"
value[x]		1..1	decimal	Value of extension
extension:paymentCeiling		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentCeiling"
value[x]		1..1	Money	Trần thanh toán BHYT (VND)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:servicePaymentRatio		0..1	Extension	Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"servicePaymentRatio"
value[x]		1..1	decimal	Value of extension
extension:insuranceUnitPrice		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceUnitPrice"
value[x]		1..1	Money	Đơn giá BHYT thanh toán (VND)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceLineAmount"
value[x]		1..1	Money	Thành tiền BH đủ điều kiện (VND) — Eligible insurance line amount
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
url		1..1	uri	"http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	S	1..1	positiveInt	Item instance identifier
category	S	1..1	CodeableConcept	Nhóm chi phí QĐ 697/QĐ-BYT — QĐ 697/QĐ-BYT cost category Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (required)
productOrService	S	1..1	CodeableConcept	Mã dịch vụ/thuốc/TBYT Binding: USCLSCodes (example): Allowable service and product codes.
serviced[x]	S	1..1		Ngày/khoảng thực hiện trong giai đoạn hưởng — Service date/period within the benefit stage
servicedDate			date
servicedPeriod			Period
quantity	S	1..1	SimpleQuantity(4.0.1)	Số lượng của dòng — Line quantity
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unitPrice	S	1..1	Money	Đơn giá bệnh viện, VND — Hospital unit price in VND
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
net	S	1..1	Money	Thành tiền bệnh viện, VND — Hospital line amount in VND
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
Slices for adjudication		6..*	BackboneElement	Kết quả giám định từng dòng Slice: Unordered, Open by pattern:category
adjudication:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	S	1..1	CodeableConcept	Type of adjudication information Binding: AdjudicationValueCodes (extensible)
amount	S	0..1	Money	Monetary amount
adjudication:submitted	S	1..1	BackboneElement	Kết quả giám định từng dòng
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	S	1..1	CodeableConcept	Thành tiền bệnh viện đề nghị, cột 7 — Submitted hospital amount, column 7 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: submitted
display		1..1	string	Representation defined by the system Fixed Value: Submitted Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	S	1..1	Money	Monetary amount
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
adjudication:eligible	S	1..1	BackboneElement	Kết quả giám định từng dòng
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	S	1..1	CodeableConcept	Thành tiền BH đủ điều kiện, cột 9 — Eligible insurance amount, column 9 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: eligible
display		1..1	string	Representation defined by the system Fixed Value: Eligible Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	S	1..1	Money	Monetary amount
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
adjudication:insuranceFund	S	1..1	BackboneElement	Kết quả giám định từng dòng
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	S	1..1	CodeableConcept	Quỹ BHYT thanh toán, cột 10 — BHYT fund payment, column 10 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: benefit
display		1..1	string	Representation defined by the system Fixed Value: Benefit Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	S	1..1	Money	Monetary amount
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
adjudication:patientCopay	S	1..1	BackboneElement	Kết quả giám định từng dòng
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	S	1..1	CodeableConcept	Người bệnh cùng chi trả, cột 11 — Patient co-payment, column 11 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: copay
display		1..1	string	Representation defined by the system Fixed Value: CoPay
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	S	1..1	Money	Monetary amount
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
adjudication:otherSource	S	1..1	BackboneElement	Kết quả giám định từng dòng
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	S	1..1	CodeableConcept	Nguồn khác thanh toán, cột 12 — Other-source payment, column 12 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: other-fund
display		1..1	string	Representation defined by the system Fixed Value: Nguồn khác
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	S	1..1	Money	Monetary amount
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
adjudication:patientSelfPay	S	1..1	BackboneElement	Kết quả giám định từng dòng
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	S	1..1	CodeableConcept	Người bệnh tự trả, cột 13 — Patient self-pay, column 13 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: patient-self-pay
display		1..1	string	Representation defined by the system Fixed Value: Người bệnh tự trả
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	S	1..1	Money	Monetary amount
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
detail		0..*	BackboneElement	Chi tiết cấu thành gói TBYT, cột 5/6/8/9 — Device-package component columns 5/6/8/9
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:insuranceCostInfo	S	1..1	(Complex)	Cột 5/6/8/9 của component gói TBYT — Device-package component columns 5/6/8/9 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
Slices for extension				Content/Rules for all slices
extension:scope		0..1	Extension	Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"scope"
value[x]		1..1	CodeableConcept	Value of extension Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:paymentRatio		0..1	Extension	Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentRatio"
value[x]		1..1	decimal	Value of extension
extension:benefitLevel		0..1	Extension	Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"benefitLevel"
value[x]		1..1	decimal	Value of extension
extension:paymentCeiling		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentCeiling"
value[x]		1..1	Money	Trần thanh toán BHYT (VND)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:servicePaymentRatio		0..1	Extension	Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"servicePaymentRatio"
value[x]		1..1	decimal	Value of extension
extension:insuranceUnitPrice		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceUnitPrice"
value[x]		1..1	Money	Đơn giá BHYT thanh toán (VND)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceLineAmount"
value[x]		1..1	Money	Thành tiền BH đủ điều kiện (VND) — Eligible insurance line amount
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
url		1..1	uri	"http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Product or service provided
productOrService	S	1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
quantity	S	1..1	SimpleQuantity(4.0.1)	Count of products or services
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unitPrice	S	1..1	Money	Fee, charge or cost per item
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
net	S	1..1	Money	Total item cost
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
Slices for total	SΣ	6..*	BackboneElement	Tổng hợp theo nhóm giám định Slice: Unordered, Open by pattern:category
total:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	SΣ	1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible)
amount	SΣ	1..1	Money	Số tiền
total:submitted	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	SΣ	1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: submitted
display		1..1	string	Representation defined by the system Fixed Value: Submitted Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:eligible	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	SΣ	1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: eligible
display		1..1	string	Representation defined by the system Fixed Value: Eligible Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:insuranceFund	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	SΣ	1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: benefit
display		1..1	string	Representation defined by the system Fixed Value: Benefit Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:patientCopay	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	SΣ	1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: copay
display		1..1	string	Representation defined by the system Fixed Value: CoPay
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:otherSource	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	SΣ	1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: other-fund
display		1..1	string	Representation defined by the system Fixed Value: Nguồn khác
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:patientSelfPay	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	SΣ	1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: patient-self-pay
display		1..1	string	Representation defined by the system Fixed Value: Người bệnh tự trả
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
payment	S	0..1	BackboneElement	Thông tin thanh toán
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
amount	S	0..1	Money	Số tiền BHYT thanh toán
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	📦0.9.0	This IG
ExplanationOfBenefit.​diagnosis.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.extension:insuranceCostInfo.​extension:scope.value[x]	Base	extensible	Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​item.extension:insuranceCostInfo.​extension:paymentCeiling.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.extension:insuranceCostInfo.​extension:insuranceUnitPrice.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.extension:insuranceCostInfo.​extension:insuranceLineAmount.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.category	Base	required	Danh mục chi phí KCB — Vietnam Cost Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​item.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.unitPrice.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.net.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication.category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:submitted.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:submitted.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:eligible.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:eligible.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:insuranceFund.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:insuranceFund.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientCopay.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientCopay.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:otherSource.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:otherSource.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientSelfPay.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientSelfPay.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.extension:insuranceCostInfo.​extension:scope.value[x]	Base	extensible	Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​item.detail.extension:insuranceCostInfo.​extension:paymentCeiling.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.extension:insuranceCostInfo.​extension:insuranceUnitPrice.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.extension:insuranceCostInfo.​extension:insuranceLineAmount.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.unitPrice.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.net.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:submitted.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:submitted.amount.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:eligible.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:eligible.amount.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:insuranceFund.​category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:insuranceFund.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:patientCopay.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:patientCopay.amount.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:otherSource.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:otherSource.amount.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:patientSelfPay.​category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:patientSelfPay.​amount.currency	Base	required	CurrencyCode	📍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()
vn-coverage-benefit-stage-level-range	error	ExplanationOfBenefit.insurance.extension:benefitStage	Mức hưởng của giai đoạn phải nằm trong khoảng từ 0 đến 100 phần trăm. The benefit level for a coverage stage SHALL be between 0 and 100 percent.	extension('benefitLevel').value >= 0 and extension('benefitLevel').value <= 100
vn-itemized-eob-benefit-level-matches-stage	error	ExplanationOfBenefit.item	Mức hưởng trên dòng, nếu có, phải bằng mức hưởng của benefit stage được dòng tham chiếu. An item's benefit level, when present, SHALL equal the benefit level of its referenced stage.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value.exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value = %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('benefitLevel').value
vn-itemized-eob-coverage-reference-distinct	error	ExplanationOfBenefit	Mỗi Coverage chỉ được xuất hiện một lần trong EOB bảng kê. Every Coverage SHALL appear only once in the itemized EOB.	insurance.coverage.reference.isDistinct()
vn-itemized-eob-eligible-consistent	error	ExplanationOfBenefit.item	Nếu dòng đồng thời có insuranceCostInfo.insuranceLineAmount và adjudication eligible thì hai số tiền phải bằng nhau. When both insuranceCostInfo.insuranceLineAmount and eligible adjudication are present, their amounts SHALL be equal.	(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.exists() and adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.exists()) implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.value = adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value
vn-itemized-eob-insured-fields-required	error	ExplanationOfBenefit.item	Khi adjudication ghi quỹ BHYT thanh toán một dòng, tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện phải có. When adjudication records a BHYT fund payment, the BHYT payment ratio and eligible insurance line amount SHALL be present.	(adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value > 0) implies (extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-eob-item-stage-exists	error	ExplanationOfBenefit	Mỗi dòng chi phí phải tham chiếu một sequence giai đoạn hưởng tồn tại trên insurance. Every cost line SHALL reference a benefit-stage sequence declared on insurance.	item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value.all($this in %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value)
vn-itemized-eob-line-allocation-sum	error	ExplanationOfBenefit.item	Thành tiền bệnh viện của dòng (cột 7) phải bằng tổng benefit, copay, other-fund và patient-self-pay (cột 10+11+12+13). The EOB line net amount SHALL equal the sum of the four adjudicated payment sources.	net.value = adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value
vn-itemized-eob-money-vnd	error	ExplanationOfBenefit	Mọi giá trị tiền tệ của ledger EOB phải dùng VND. Every monetary value in the itemized EOB ledger SHALL use VND.	item.unitPrice.currency.all($this = 'VND') and item.net.currency.all($this = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and item.adjudication.amount.currency.all($this = 'VND') and item.detail.unitPrice.currency.all($this = 'VND') and item.detail.net.currency.all($this = 'VND') and item.detail.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and total.amount.currency.all($this = 'VND')
vn-itemized-eob-other-fund-breakdown-sum	error	ExplanationOfBenefit.item	Khi có chi tiết nguồn khác, tổng các thành phần phải bằng adjudication other-fund của dòng. When an other-fund breakdown is present, its components SHALL sum to the line's other-fund adjudication.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').extension.value.ofType(Money).value.aggregate($this + $total, 0) = adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value
vn-itemized-eob-payment-equals-benefit-total	error	ExplanationOfBenefit	Khi có payment mà không có adjustment, số tiền thanh toán phải bằng total benefit. When payment is present without an adjustment, its amount SHALL equal the benefit total.	(payment.exists() and payment.adjustment.empty()) implies payment.amount.value = total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value
vn-itemized-eob-serviced-in-stage	error	ExplanationOfBenefit.item	Ngày hoặc khoảng thời gian thực hiện dòng chi phí phải nằm trong period của giai đoạn hưởng được tham chiếu; Period phải có cả start và end. Gateway vẫn phải kiểm tra lại tương quan này trước khi gửi do khác biệt giữa các validator FHIRPath R4. The service date or period SHALL fall within the referenced benefit-stage period, and a serviced Period SHALL contain both start and end. The submission gateway SHALL still repeat this correlation check because R4 FHIRPath validators differ.	(serviced.ofType(date).exists() implies (serviced.ofType(date) >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(date) <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end)) and (serviced.ofType(Period).exists() implies (serviced.ofType(Period).start.exists() and serviced.ofType(Period).end.exists() and serviced.ofType(Period).start >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(Period).end <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end))
vn-itemized-eob-single-focal-insurance	error	ExplanationOfBenefit	EOB bảng kê phải có đúng một Coverage focal. An itemized EOB SHALL have exactly one focal Coverage.	insurance.where(focal = true).count() = 1
vn-itemized-eob-stage-sequence-unique	error	ExplanationOfBenefit	Mỗi sequence giai đoạn hưởng trên insurance phải duy nhất trong ExplanationOfBenefit. Every insurance benefit-stage sequence SHALL be unique within the ExplanationOfBenefit.	insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value.isDistinct()
vn-itemized-eob-total-benefit-sum	error	ExplanationOfBenefit	Total benefit phải bằng tổng adjudication benefit của các item. The benefit total SHALL equal the sum of item benefit adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-copay-sum	error	ExplanationOfBenefit	Total copay phải bằng tổng adjudication copay của các item. The copay total SHALL equal the sum of item copay adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-eligible-sum	error	ExplanationOfBenefit	Total eligible phải bằng tổng adjudication eligible của các item. The eligible total SHALL equal the sum of item eligible adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-other-fund-sum	error	ExplanationOfBenefit	Total other-fund phải bằng tổng adjudication other-fund của các item. The other-fund total SHALL equal the sum of item other-fund adjudications.	total.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-self-pay-sum	error	ExplanationOfBenefit	Total patient-self-pay phải bằng tổng adjudication patient-self-pay của các item. The patient-self-pay total SHALL equal the sum of item patient-self-pay adjudications.	total.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-submitted-sum	error	ExplanationOfBenefit	Total submitted phải bằng tổng item.net. The submitted total SHALL equal the sum of item net amounts.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'submitted').exists()).amount.value = item.net.value.aggregate($this + $total, 0)
vn-other-fund-breakdown-money-vnd-value	error	ExplanationOfBenefit.item.extension:otherFundBreakdown	Mọi Money con phải có value và dùng VND. Every child Money SHALL have a value and use VND.	extension.value.ofType(Money).all(value.exists() and currency = 'VND')

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ExplanationOfBenefit	C	0..*	VNCoreExplanationOfBenefit	Explanation of Benefit resource Constraints: vn-itemized-eob-stage-sequence-unique, vn-itemized-eob-coverage-reference-distinct, vn-itemized-eob-single-focal-insurance, vn-itemized-eob-item-stage-exists, vn-itemized-eob-money-vnd, vn-itemized-eob-total-submitted-sum, vn-itemized-eob-total-eligible-sum, vn-itemized-eob-total-benefit-sum, vn-itemized-eob-total-copay-sum, vn-itemized-eob-total-other-fund-sum, vn-itemized-eob-total-self-pay-sum, vn-itemized-eob-payment-equals-benefit-total
Slices for extension				Content/Rules for all slices
extension:costSummary		0..0		Tổng chi phí theo nhóm — Claim Cost Summary Extension
insurance		1..*	BackboneElement	Các Coverage thực được giám định và các giai đoạn hưởng — Real adjudicated Coverages with their benefit stages
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:benefitStage	S	1..*	(Complex)	Sequence, period và mức hưởng của giai đoạn — Stage sequence, period, and benefit level URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage
item	C	1..*	BackboneElement	Dòng bảng kê sau giám định — Adjudicated itemized-statement line Constraints: vn-itemized-eob-eligible-consistent, vn-itemized-eob-serviced-in-stage, vn-itemized-eob-line-allocation-sum, vn-itemized-eob-insured-fields-required, vn-itemized-eob-benefit-level-matches-stage, vn-itemized-eob-other-fund-breakdown-sum
extension		2..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:benefitStageSequence	S	1..1	positiveInt	Sequence giai đoạn hưởng của dòng — Line benefit-stage sequence URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence
extension:insuranceCostInfo	S	1..1	(Complex)	Các cột đơn giá/tỷ lệ/thành tiền BHYT — BHYT price, ratio, and eligible-amount columns URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
Slices for extension				Content/Rules for all slices
extension:paymentCeiling		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:insuranceUnitPrice		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
category		1..1	CodeableConcept	Nhóm chi phí QĐ 697/QĐ-BYT — QĐ 697/QĐ-BYT cost category Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (required)
serviced[x]	S	1..1	date, Period	Ngày/khoảng thực hiện trong giai đoạn hưởng — Service date/period within the benefit stage
quantity	S	1..1	SimpleQuantity(4.0.1)	Số lượng của dòng — Line quantity
value		1..1	decimal	Numerical value (with implicit precision)
unitPrice	S	1..1	Money	Đơn giá bệnh viện, VND — Hospital unit price in VND
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
net		1..1	Money	Thành tiền bệnh viện, VND — Hospital line amount in VND
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
Slices for adjudication		6..*	BackboneElement	Kết quả giám định từng dòng Slice: Unordered, Open by pattern:category
adjudication:submitted	S	1..1	BackboneElement	Kết quả giám định từng dòng
category		1..1	CodeableConcept	Thành tiền bệnh viện đề nghị, cột 7 — Submitted hospital amount, column 7 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
code		1..1	code	Symbol in syntax defined by the system Fixed Value: submitted
display		1..1	string	Representation defined by the system Fixed Value: Submitted Amount
amount		1..1	Money	Monetary amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
adjudication:eligible	S	1..1	BackboneElement	Kết quả giám định từng dòng
category		1..1	CodeableConcept	Thành tiền BH đủ điều kiện, cột 9 — Eligible insurance amount, column 9 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
code		1..1	code	Symbol in syntax defined by the system Fixed Value: eligible
display		1..1	string	Representation defined by the system Fixed Value: Eligible Amount
amount		1..1	Money	Monetary amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
adjudication:insuranceFund	S	1..1	BackboneElement	Kết quả giám định từng dòng
category		1..1	CodeableConcept	Quỹ BHYT thanh toán, cột 10 — BHYT fund payment, column 10 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
code		1..1	code	Symbol in syntax defined by the system Fixed Value: benefit
display		1..1	string	Representation defined by the system Fixed Value: Benefit Amount
amount		1..1	Money	Monetary amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
adjudication:patientCopay	S	1..1	BackboneElement	Kết quả giám định từng dòng
category		1..1	CodeableConcept	Người bệnh cùng chi trả, cột 11 — Patient co-payment, column 11 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
code		1..1	code	Symbol in syntax defined by the system Fixed Value: copay
display		1..1	string	Representation defined by the system Fixed Value: CoPay
amount		1..1	Money	Monetary amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
adjudication:otherSource	S	1..1	BackboneElement	Kết quả giám định từng dòng
category		1..1	CodeableConcept	Nguồn khác thanh toán, cột 12 — Other-source payment, column 12 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: other-fund
display		1..1	string	Representation defined by the system Fixed Value: Nguồn khác
amount		1..1	Money	Monetary amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
adjudication:patientSelfPay	S	1..1	BackboneElement	Kết quả giám định từng dòng
category		1..1	CodeableConcept	Người bệnh tự trả, cột 13 — Patient self-pay, column 13 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: patient-self-pay
display		1..1	string	Representation defined by the system Fixed Value: Người bệnh tự trả
amount		1..1	Money	Monetary amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
detail		0..*	BackboneElement	Chi tiết cấu thành gói TBYT, cột 5/6/8/9 — Device-package component columns 5/6/8/9
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:insuranceCostInfo	S	1..1	(Complex)	Cột 5/6/8/9 của component gói TBYT — Device-package component columns 5/6/8/9 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
Slices for extension				Content/Rules for all slices
extension:paymentCeiling		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:insuranceUnitPrice		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
productOrService	S	1..1	CodeableConcept	Billing, service, product, or drug code
quantity	S	1..1	SimpleQuantity(4.0.1)	Count of products or services
value		1..1	decimal	Numerical value (with implicit precision)
unitPrice	S	1..1	Money	Fee, charge or cost per item
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
net	S	1..1	Money	Total item cost
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
adjudication		0..0		Detail level adjudication details
Slices for total		6..*	BackboneElement	Tổng hợp theo nhóm giám định Slice: Unordered, Open by pattern:category
total:submitted	S	1..1	BackboneElement	Tổng hợp theo nhóm giám định
category		1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
code		1..1	code	Symbol in syntax defined by the system Fixed Value: submitted
display		1..1	string	Representation defined by the system Fixed Value: Submitted Amount
amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
total:eligible	S	1..1	BackboneElement	Tổng hợp theo nhóm giám định
category		1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
code		1..1	code	Symbol in syntax defined by the system Fixed Value: eligible
display		1..1	string	Representation defined by the system Fixed Value: Eligible Amount
amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
total:insuranceFund	S	1..1	BackboneElement	Tổng hợp theo nhóm giám định
category		1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
code		1..1	code	Symbol in syntax defined by the system Fixed Value: benefit
display		1..1	string	Representation defined by the system Fixed Value: Benefit Amount
amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
total:patientCopay	S	1..1	BackboneElement	Tổng hợp theo nhóm giám định
category		1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
code		1..1	code	Symbol in syntax defined by the system Fixed Value: copay
display		1..1	string	Representation defined by the system Fixed Value: CoPay
amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
total:otherSource	S	1..1	BackboneElement	Tổng hợp theo nhóm giám định
category		1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: other-fund
display		1..1	string	Representation defined by the system Fixed Value: Nguồn khác
amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
total:patientSelfPay	S	1..1	BackboneElement	Tổng hợp theo nhóm giám định
category		1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: patient-self-pay
display		1..1	string	Representation defined by the system Fixed Value: Người bệnh tự trả
amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
ExplanationOfBenefit.​item.category	Base	required	Danh mục chi phí KCB — Vietnam Cost Category ValueSet	📦0.9.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
vn-itemized-eob-benefit-level-matches-stage	error	ExplanationOfBenefit.item	Mức hưởng trên dòng, nếu có, phải bằng mức hưởng của benefit stage được dòng tham chiếu. An item's benefit level, when present, SHALL equal the benefit level of its referenced stage.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value.exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value = %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('benefitLevel').value
vn-itemized-eob-coverage-reference-distinct	error	ExplanationOfBenefit	Mỗi Coverage chỉ được xuất hiện một lần trong EOB bảng kê. Every Coverage SHALL appear only once in the itemized EOB.	insurance.coverage.reference.isDistinct()
vn-itemized-eob-eligible-consistent	error	ExplanationOfBenefit.item	Nếu dòng đồng thời có insuranceCostInfo.insuranceLineAmount và adjudication eligible thì hai số tiền phải bằng nhau. When both insuranceCostInfo.insuranceLineAmount and eligible adjudication are present, their amounts SHALL be equal.	(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.exists() and adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.exists()) implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.value = adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value
vn-itemized-eob-insured-fields-required	error	ExplanationOfBenefit.item	Khi adjudication ghi quỹ BHYT thanh toán một dòng, tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện phải có. When adjudication records a BHYT fund payment, the BHYT payment ratio and eligible insurance line amount SHALL be present.	(adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value > 0) implies (extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-eob-item-stage-exists	error	ExplanationOfBenefit	Mỗi dòng chi phí phải tham chiếu một sequence giai đoạn hưởng tồn tại trên insurance. Every cost line SHALL reference a benefit-stage sequence declared on insurance.	item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value.all($this in %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value)
vn-itemized-eob-line-allocation-sum	error	ExplanationOfBenefit.item	Thành tiền bệnh viện của dòng (cột 7) phải bằng tổng benefit, copay, other-fund và patient-self-pay (cột 10+11+12+13). The EOB line net amount SHALL equal the sum of the four adjudicated payment sources.	net.value = adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value
vn-itemized-eob-money-vnd	error	ExplanationOfBenefit	Mọi giá trị tiền tệ của ledger EOB phải dùng VND. Every monetary value in the itemized EOB ledger SHALL use VND.	item.unitPrice.currency.all($this = 'VND') and item.net.currency.all($this = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and item.adjudication.amount.currency.all($this = 'VND') and item.detail.unitPrice.currency.all($this = 'VND') and item.detail.net.currency.all($this = 'VND') and item.detail.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and total.amount.currency.all($this = 'VND')
vn-itemized-eob-other-fund-breakdown-sum	error	ExplanationOfBenefit.item	Khi có chi tiết nguồn khác, tổng các thành phần phải bằng adjudication other-fund của dòng. When an other-fund breakdown is present, its components SHALL sum to the line's other-fund adjudication.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').extension.value.ofType(Money).value.aggregate($this + $total, 0) = adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value
vn-itemized-eob-payment-equals-benefit-total	error	ExplanationOfBenefit	Khi có payment mà không có adjustment, số tiền thanh toán phải bằng total benefit. When payment is present without an adjustment, its amount SHALL equal the benefit total.	(payment.exists() and payment.adjustment.empty()) implies payment.amount.value = total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value
vn-itemized-eob-serviced-in-stage	error	ExplanationOfBenefit.item	Ngày hoặc khoảng thời gian thực hiện dòng chi phí phải nằm trong period của giai đoạn hưởng được tham chiếu; Period phải có cả start và end. Gateway vẫn phải kiểm tra lại tương quan này trước khi gửi do khác biệt giữa các validator FHIRPath R4. The service date or period SHALL fall within the referenced benefit-stage period, and a serviced Period SHALL contain both start and end. The submission gateway SHALL still repeat this correlation check because R4 FHIRPath validators differ.	(serviced.ofType(date).exists() implies (serviced.ofType(date) >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(date) <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end)) and (serviced.ofType(Period).exists() implies (serviced.ofType(Period).start.exists() and serviced.ofType(Period).end.exists() and serviced.ofType(Period).start >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(Period).end <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end))
vn-itemized-eob-single-focal-insurance	error	ExplanationOfBenefit	EOB bảng kê phải có đúng một Coverage focal. An itemized EOB SHALL have exactly one focal Coverage.	insurance.where(focal = true).count() = 1
vn-itemized-eob-stage-sequence-unique	error	ExplanationOfBenefit	Mỗi sequence giai đoạn hưởng trên insurance phải duy nhất trong ExplanationOfBenefit. Every insurance benefit-stage sequence SHALL be unique within the ExplanationOfBenefit.	insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value.isDistinct()
vn-itemized-eob-total-benefit-sum	error	ExplanationOfBenefit	Total benefit phải bằng tổng adjudication benefit của các item. The benefit total SHALL equal the sum of item benefit adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-copay-sum	error	ExplanationOfBenefit	Total copay phải bằng tổng adjudication copay của các item. The copay total SHALL equal the sum of item copay adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-eligible-sum	error	ExplanationOfBenefit	Total eligible phải bằng tổng adjudication eligible của các item. The eligible total SHALL equal the sum of item eligible adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-other-fund-sum	error	ExplanationOfBenefit	Total other-fund phải bằng tổng adjudication other-fund của các item. The other-fund total SHALL equal the sum of item other-fund adjudications.	total.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-self-pay-sum	error	ExplanationOfBenefit	Total patient-self-pay phải bằng tổng adjudication patient-self-pay của các item. The patient-self-pay total SHALL equal the sum of item patient-self-pay adjudications.	total.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-submitted-sum	error	ExplanationOfBenefit	Total submitted phải bằng tổng item.net. The submitted total SHALL equal the sum of item net amounts.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'submitted').exists()).amount.value = item.net.value.aggregate($this + $total, 0)

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ExplanationOfBenefit	C	0..*	VNCoreExplanationOfBenefit	Explanation of Benefit resource Constraints: vn-itemized-eob-stage-sequence-unique, vn-itemized-eob-coverage-reference-distinct, vn-itemized-eob-single-focal-insurance, vn-itemized-eob-item-stage-exists, vn-itemized-eob-money-vnd, vn-itemized-eob-total-submitted-sum, vn-itemized-eob-total-eligible-sum, vn-itemized-eob-total-benefit-sum, vn-itemized-eob-total-copay-sum, vn-itemized-eob-total-other-fund-sum, vn-itemized-eob-total-self-pay-sum, vn-itemized-eob-payment-equals-benefit-total
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 Bindings Purpose 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:paymentPeriod		0..1	(Complex)	Kỳ thanh toán BHYT (năm/tháng) — NAM_QT, THANG_QT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
extension:paymentMethod		0..1	CodeableConcept	Phương thức thanh toán (FFS/Capitation/DRG) — MA_PTTT 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	Trạng thái giải trình Binding: ExplanationOfBenefitStatus (required): A code specifying the state of the resource instance.
type	SΣ	1..1	CodeableConcept	Loại: institutional (nội trú), professional (ngoại trú) 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	Mục đích: claim (thanh toán) Binding: Use (required): Complete, proposed, exploratory, other.
patient	SΣ	1..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile)	Bệnh nhân
billablePeriod	Σ	0..1	Period	Relevant time frame for the claim
created	SΣ	1..1	dateTime	Ngày tạo giải trình
enterer		0..1	Reference(Practitioner | PractitionerRole)	Author of the claim
insurer	SΣ	1..1	Reference(Organization)	Cơ quan BHXH thanh toán
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)	Cơ sở KCB thực hiện
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	Kết quả giám định: 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	Chẩn đoán — 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:$this Binding: ICD-10Codes (example): ICD10 Diagnostic codes.
diagnosisCodeableConcept			CodeableConcept
diagnosisReference			Reference(Condition)
diagnosis[x]:diagnosisCodeableConcept	S	0..1	CodeableConcept	Mã bệnh ICD-10 VN Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
type	S	0..*	CodeableConcept	Loại chẩn đoán (chính/phụ) Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
onAdmission		0..1	CodeableConcept	Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
packageCode		0..1	CodeableConcept	Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
procedure		0..*	BackboneElement	Thủ thuật/phẫu thuật — ICD-9-CM
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Procedure instance identifier
type		0..*	CodeableConcept	Category of Procedure Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.
date		0..1	dateTime	When the procedure was performed
Slices for procedure[x]		1..1		Specific clinical procedure Slice: Unordered, Open by type:$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	Các Coverage thực được giám định và các giai đoạn hưởng — Real adjudicated Coverages with their benefit stages
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:benefitStage	SC	1..*	(Complex)	Sequence, period và mức hưởng của giai đoạn — Stage sequence, period, and benefit level URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage Constraints: vn-coverage-benefit-stage-level-range
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)	Thẻ 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	SC	1..*	BackboneElement	Dòng bảng kê sau giám định — Adjudicated itemized-statement line Constraints: vn-itemized-eob-eligible-consistent, vn-itemized-eob-serviced-in-stage, vn-itemized-eob-line-allocation-sum, vn-itemized-eob-insured-fields-required, vn-itemized-eob-benefit-level-matches-stage, vn-itemized-eob-other-fund-breakdown-sum
id		0..1	string	Unique id for inter-element referencing
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:otherFundBreakdown	C	0..1	(Complex)	Chi tiết nguồn khác chi trả theo dòng: NSNN/VTNN/VTTN/CL (T_NGUONKHAC_*) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown Constraints: vn-other-fund-breakdown-money-vnd-value
extension:paymentSource		0..1	CodeableConcept	Nguồn chi trả dòng chi phí (NGUON_CTRA) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-source Binding: Nguồn chi trả — Vietnam Payment Source ValueSet (extensible)
extension:recurrentWoundBenefit		0..1	boolean	Flag VET_THUONG_TP cho dòng thuốc/DVKT/VTYT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-recurrent-wound-benefit
extension:tenderInfo		0..1	string	Thông tin thầu dòng chi phí (TT_THAU) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-tender-info
extension:processingMethod		0..1	CodeableConcept	Phương pháp chế biến YHCT (MA_PP_CHEBIEN) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-traditional-processing-method Binding: Phương pháp chế biến vị thuốc cổ truyền — VN Traditional Medicine Processing Method ValueSet (extensible)
extension:benefitStageSequence	S	1..1	positiveInt	Sequence giai đoạn hưởng của dòng — Line benefit-stage sequence URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence
extension:insuranceCostInfo	S	1..1	(Complex)	Các cột đơn giá/tỷ lệ/thành tiền BHYT — BHYT price, ratio, and eligible-amount columns URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:scope		0..1	Extension	Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"scope"
value[x]		1..1	CodeableConcept	Value of extension Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:paymentRatio		0..1	Extension	Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentRatio"
value[x]		1..1	decimal	Value of extension
extension:benefitLevel		0..1	Extension	Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"benefitLevel"
value[x]		1..1	decimal	Value of extension
extension:paymentCeiling		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentCeiling"
value[x]		1..1	Money	Trần thanh toán BHYT (VND)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:servicePaymentRatio		0..1	Extension	Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"servicePaymentRatio"
value[x]		1..1	decimal	Value of extension
extension:insuranceUnitPrice		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceUnitPrice"
value[x]		1..1	Money	Đơn giá BHYT thanh toán (VND)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceLineAmount"
value[x]		1..1	Money	Thành tiền BH đủ điều kiện (VND) — Eligible insurance line amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
url		1..1	uri	"http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
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	1..1	CodeableConcept	Nhóm chi phí QĐ 697/QĐ-BYT — QĐ 697/QĐ-BYT cost category Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (required)
productOrService	S	1..1	CodeableConcept	Mã dịch vụ/thuốc/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]	S	1..1		Ngày/khoảng thực hiện trong giai đoạn hưởng — Service date/period within the benefit stage
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	S	1..1	SimpleQuantity(4.0.1)	Số lượng của dòng — Line quantity
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
unitPrice	S	1..1	Money	Đơn giá bệnh viện, VND — Hospital unit price in VND
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
factor		0..1	decimal	Price scaling factor
net	S	1..1	Money	Thành tiền bệnh viện, VND — Hospital line amount in VND
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
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
Slices for adjudication		6..*	BackboneElement	Kết quả giám định từng dòng Slice: Unordered, Open by pattern:category
adjudication:All Slices				Content/Rules for all slices
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 (extensible)
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
adjudication:submitted	S	1..1	BackboneElement	Kết quả giám định từng dòng
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	Thành tiền bệnh viện đề nghị, cột 7 — Submitted hospital amount, column 7 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: submitted
display		1..1	string	Representation defined by the system Fixed Value: Submitted Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
reason		0..1	CodeableConcept	Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): Adjudication reason codes.
amount	S	1..1	Money	Monetary amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
value		0..1	decimal	Non-monitary value
adjudication:eligible	S	1..1	BackboneElement	Kết quả giám định từng dòng
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	Thành tiền BH đủ điều kiện, cột 9 — Eligible insurance amount, column 9 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: eligible
display		1..1	string	Representation defined by the system Fixed Value: Eligible Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
reason		0..1	CodeableConcept	Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): Adjudication reason codes.
amount	S	1..1	Money	Monetary amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
value		0..1	decimal	Non-monitary value
adjudication:insuranceFund	S	1..1	BackboneElement	Kết quả giám định từng dòng
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	Quỹ BHYT thanh toán, cột 10 — BHYT fund payment, column 10 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: benefit
display		1..1	string	Representation defined by the system Fixed Value: Benefit Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
reason		0..1	CodeableConcept	Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): Adjudication reason codes.
amount	S	1..1	Money	Monetary amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
value		0..1	decimal	Non-monitary value
adjudication:patientCopay	S	1..1	BackboneElement	Kết quả giám định từng dòng
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	Người bệnh cùng chi trả, cột 11 — Patient co-payment, column 11 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: copay
display		1..1	string	Representation defined by the system Fixed Value: CoPay
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
reason		0..1	CodeableConcept	Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): Adjudication reason codes.
amount	S	1..1	Money	Monetary amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
value		0..1	decimal	Non-monitary value
adjudication:otherSource	S	1..1	BackboneElement	Kết quả giám định từng dòng
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	Nguồn khác thanh toán, cột 12 — Other-source payment, column 12 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: other-fund
display		1..1	string	Representation defined by the system Fixed Value: Nguồn khác
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
reason		0..1	CodeableConcept	Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): Adjudication reason codes.
amount	S	1..1	Money	Monetary amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
value		0..1	decimal	Non-monitary value
adjudication:patientSelfPay	S	1..1	BackboneElement	Kết quả giám định từng dòng
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	Người bệnh tự trả, cột 13 — Patient self-pay, column 13 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: patient-self-pay
display		1..1	string	Representation defined by the system Fixed Value: Người bệnh tự trả
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
reason		0..1	CodeableConcept	Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): Adjudication reason codes.
amount	S	1..1	Money	Monetary amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
value		0..1	decimal	Non-monitary value
detail		0..*	BackboneElement	Chi tiết cấu thành gói TBYT, cột 5/6/8/9 — Device-package component columns 5/6/8/9
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:insuranceCostInfo	S	1..1	(Complex)	Cột 5/6/8/9 của component gói TBYT — Device-package component columns 5/6/8/9 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:scope		0..1	Extension	Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"scope"
value[x]		1..1	CodeableConcept	Value of extension Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:paymentRatio		0..1	Extension	Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentRatio"
value[x]		1..1	decimal	Value of extension
extension:benefitLevel		0..1	Extension	Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"benefitLevel"
value[x]		1..1	decimal	Value of extension
extension:paymentCeiling		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentCeiling"
value[x]		1..1	Money	Trần thanh toán BHYT (VND)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:servicePaymentRatio		0..1	Extension	Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"servicePaymentRatio"
value[x]		1..1	decimal	Value of extension
extension:insuranceUnitPrice		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceUnitPrice"
value[x]		1..1	Money	Đơn giá BHYT thanh toán (VND)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceLineAmount"
value[x]		1..1	Money	Thành tiền BH đủ điều kiện (VND) — Eligible insurance line amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
url		1..1	uri	"http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
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	S	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	S	1..1	SimpleQuantity(4.0.1)	Count of products or services
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
unitPrice	S	1..1	Money	Fee, charge or cost per item
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
factor		0..1	decimal	Price scaling factor
net	S	1..1	Money	Total item cost
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
udi		0..*	Reference(Device)	Unique device identifier
noteNumber		0..*	positiveInt	Applicable note numbers
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
Slices for total	SΣ	6..*	BackboneElement	Tổng hợp theo nhóm giám định Slice: Unordered, Open by pattern:category
total:All Slices				Content/Rules for all slices
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	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible)
amount	SΣ	1..1	Money	Số tiền
total:submitted	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
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	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: submitted
display		1..1	string	Representation defined by the system Fixed Value: Submitted Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:eligible	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
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	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: eligible
display		1..1	string	Representation defined by the system Fixed Value: Eligible Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:insuranceFund	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
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	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: benefit
display		1..1	string	Representation defined by the system Fixed Value: Benefit Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:patientCopay	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
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	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: copay
display		1..1	string	Representation defined by the system Fixed Value: CoPay
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:otherSource	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
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	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: other-fund
display		1..1	string	Representation defined by the system Fixed Value: Nguồn khác
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:patientSelfPay	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
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	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: patient-self-pay
display		1..1	string	Representation defined by the system Fixed Value: Người bệnh tự trả
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
payment	S	0..1	BackboneElement	Thông tin thanh toán
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	Loại thanh toán 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	Số tiền BHYT thanh toán
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 Bindings Purpose AllLanguages Max Binding
benefitPeriod		0..1	Period	Kỳ quyền lợi 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
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	📦0.9.0	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	📦0.9.0	This IG
ExplanationOfBenefit.​accident.type	Base	extensible	ActIncidentCode	📦3.0.0	THO v7.2
ExplanationOfBenefit.​item.extension:insuranceCostInfo.​extension:scope.value[x]	Base	extensible	Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​item.extension:insuranceCostInfo.​extension:paymentCeiling.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.extension:insuranceCostInfo.​extension:insuranceUnitPrice.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.extension:insuranceCostInfo.​extension:insuranceLineAmount.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.category	Base	required	Danh mục chi phí KCB — Vietnam Cost Category ValueSet	📦0.9.0	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.unitPrice.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.net.currency	Base	required	CurrencyCode	📍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	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication.reason	Base	example	Adjudication Reason Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:submitted.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:submitted.​reason	Base	example	Adjudication Reason Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:submitted.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:eligible.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:eligible.​reason	Base	example	Adjudication Reason Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:eligible.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:insuranceFund.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:insuranceFund.​reason	Base	example	Adjudication Reason Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:insuranceFund.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientCopay.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientCopay.​reason	Base	example	Adjudication Reason Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientCopay.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:otherSource.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:otherSource.​reason	Base	example	Adjudication Reason Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:otherSource.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientSelfPay.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientSelfPay.​reason	Base	example	Adjudication Reason Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientSelfPay.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.extension:insuranceCostInfo.​extension:scope.value[x]	Base	extensible	Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​item.detail.extension:insuranceCostInfo.​extension:paymentCeiling.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.extension:insuranceCostInfo.​extension:insuranceUnitPrice.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.extension:insuranceCostInfo.​extension:insuranceLineAmount.​value[x].currency	Base	required	CurrencyCode	📍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.unitPrice.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.net.currency	Base	required	CurrencyCode	📍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	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:submitted.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:submitted.amount.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:eligible.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:eligible.amount.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:insuranceFund.​category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:insuranceFund.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:patientCopay.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:patientCopay.amount.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:otherSource.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:otherSource.amount.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:patientSelfPay.​category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:patientSelfPay.​amount.currency	Base	required	CurrencyCode	📍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()
vn-coverage-benefit-stage-level-range	error	ExplanationOfBenefit.insurance.extension:benefitStage	Mức hưởng của giai đoạn phải nằm trong khoảng từ 0 đến 100 phần trăm. The benefit level for a coverage stage SHALL be between 0 and 100 percent.	extension('benefitLevel').value >= 0 and extension('benefitLevel').value <= 100
vn-itemized-eob-benefit-level-matches-stage	error	ExplanationOfBenefit.item	Mức hưởng trên dòng, nếu có, phải bằng mức hưởng của benefit stage được dòng tham chiếu. An item's benefit level, when present, SHALL equal the benefit level of its referenced stage.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value.exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value = %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('benefitLevel').value
vn-itemized-eob-coverage-reference-distinct	error	ExplanationOfBenefit	Mỗi Coverage chỉ được xuất hiện một lần trong EOB bảng kê. Every Coverage SHALL appear only once in the itemized EOB.	insurance.coverage.reference.isDistinct()
vn-itemized-eob-eligible-consistent	error	ExplanationOfBenefit.item	Nếu dòng đồng thời có insuranceCostInfo.insuranceLineAmount và adjudication eligible thì hai số tiền phải bằng nhau. When both insuranceCostInfo.insuranceLineAmount and eligible adjudication are present, their amounts SHALL be equal.	(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.exists() and adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.exists()) implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.value = adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value
vn-itemized-eob-insured-fields-required	error	ExplanationOfBenefit.item	Khi adjudication ghi quỹ BHYT thanh toán một dòng, tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện phải có. When adjudication records a BHYT fund payment, the BHYT payment ratio and eligible insurance line amount SHALL be present.	(adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value > 0) implies (extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-eob-item-stage-exists	error	ExplanationOfBenefit	Mỗi dòng chi phí phải tham chiếu một sequence giai đoạn hưởng tồn tại trên insurance. Every cost line SHALL reference a benefit-stage sequence declared on insurance.	item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value.all($this in %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value)
vn-itemized-eob-line-allocation-sum	error	ExplanationOfBenefit.item	Thành tiền bệnh viện của dòng (cột 7) phải bằng tổng benefit, copay, other-fund và patient-self-pay (cột 10+11+12+13). The EOB line net amount SHALL equal the sum of the four adjudicated payment sources.	net.value = adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value
vn-itemized-eob-money-vnd	error	ExplanationOfBenefit	Mọi giá trị tiền tệ của ledger EOB phải dùng VND. Every monetary value in the itemized EOB ledger SHALL use VND.	item.unitPrice.currency.all($this = 'VND') and item.net.currency.all($this = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and item.adjudication.amount.currency.all($this = 'VND') and item.detail.unitPrice.currency.all($this = 'VND') and item.detail.net.currency.all($this = 'VND') and item.detail.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and total.amount.currency.all($this = 'VND')
vn-itemized-eob-other-fund-breakdown-sum	error	ExplanationOfBenefit.item	Khi có chi tiết nguồn khác, tổng các thành phần phải bằng adjudication other-fund của dòng. When an other-fund breakdown is present, its components SHALL sum to the line's other-fund adjudication.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').extension.value.ofType(Money).value.aggregate($this + $total, 0) = adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value
vn-itemized-eob-payment-equals-benefit-total	error	ExplanationOfBenefit	Khi có payment mà không có adjustment, số tiền thanh toán phải bằng total benefit. When payment is present without an adjustment, its amount SHALL equal the benefit total.	(payment.exists() and payment.adjustment.empty()) implies payment.amount.value = total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value
vn-itemized-eob-serviced-in-stage	error	ExplanationOfBenefit.item	Ngày hoặc khoảng thời gian thực hiện dòng chi phí phải nằm trong period của giai đoạn hưởng được tham chiếu; Period phải có cả start và end. Gateway vẫn phải kiểm tra lại tương quan này trước khi gửi do khác biệt giữa các validator FHIRPath R4. The service date or period SHALL fall within the referenced benefit-stage period, and a serviced Period SHALL contain both start and end. The submission gateway SHALL still repeat this correlation check because R4 FHIRPath validators differ.	(serviced.ofType(date).exists() implies (serviced.ofType(date) >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(date) <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end)) and (serviced.ofType(Period).exists() implies (serviced.ofType(Period).start.exists() and serviced.ofType(Period).end.exists() and serviced.ofType(Period).start >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(Period).end <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end))
vn-itemized-eob-single-focal-insurance	error	ExplanationOfBenefit	EOB bảng kê phải có đúng một Coverage focal. An itemized EOB SHALL have exactly one focal Coverage.	insurance.where(focal = true).count() = 1
vn-itemized-eob-stage-sequence-unique	error	ExplanationOfBenefit	Mỗi sequence giai đoạn hưởng trên insurance phải duy nhất trong ExplanationOfBenefit. Every insurance benefit-stage sequence SHALL be unique within the ExplanationOfBenefit.	insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value.isDistinct()
vn-itemized-eob-total-benefit-sum	error	ExplanationOfBenefit	Total benefit phải bằng tổng adjudication benefit của các item. The benefit total SHALL equal the sum of item benefit adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-copay-sum	error	ExplanationOfBenefit	Total copay phải bằng tổng adjudication copay của các item. The copay total SHALL equal the sum of item copay adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-eligible-sum	error	ExplanationOfBenefit	Total eligible phải bằng tổng adjudication eligible của các item. The eligible total SHALL equal the sum of item eligible adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-other-fund-sum	error	ExplanationOfBenefit	Total other-fund phải bằng tổng adjudication other-fund của các item. The other-fund total SHALL equal the sum of item other-fund adjudications.	total.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-self-pay-sum	error	ExplanationOfBenefit	Total patient-self-pay phải bằng tổng adjudication patient-self-pay của các item. The patient-self-pay total SHALL equal the sum of item patient-self-pay adjudications.	total.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-submitted-sum	error	ExplanationOfBenefit	Total submitted phải bằng tổng item.net. The submitted total SHALL equal the sum of item net amounts.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'submitted').exists()).amount.value = item.net.value.aggregate($this + $total, 0)
vn-other-fund-breakdown-money-vnd-value	error	ExplanationOfBenefit.item.extension:otherFundBreakdown	Mọi Money con phải có value và dùng VND. Every child Money SHALL have a value and use VND.	extension.value.ofType(Money).all(value.exists() and currency = 'VND')

Summary

Mandatory: 57 elements(16 nested mandatory elements)
Must-Support: 23 elements
Fixed: 22 elements
Prohibited: 2 elements

Extensions

This structure refers to these extensions:

• http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage
• http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence
• http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the values of ExplanationOfBenefit.item.adjudication
• The element 1 is sliced based on the values of ExplanationOfBenefit.total

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Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ExplanationOfBenefit	C	0..*	VNCoreExplanationOfBenefit	Explanation of Benefit resource Constraints: vn-itemized-eob-stage-sequence-unique, vn-itemized-eob-coverage-reference-distinct, vn-itemized-eob-single-focal-insurance, vn-itemized-eob-item-stage-exists, vn-itemized-eob-money-vnd, vn-itemized-eob-total-submitted-sum, vn-itemized-eob-total-eligible-sum, vn-itemized-eob-total-benefit-sum, vn-itemized-eob-total-copay-sum, vn-itemized-eob-total-other-fund-sum, vn-itemized-eob-total-self-pay-sum, vn-itemized-eob-payment-equals-benefit-total
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:paymentPeriod		0..1	(Complex)	Kỳ thanh toán BHYT (năm/tháng) — NAM_QT, THANG_QT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
extension:paymentMethod		0..1	CodeableConcept	Phương thức thanh toán (FFS/Capitation/DRG) — MA_PTTT 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
status	?!SΣ	1..1	code	Trạng thái giải trình Binding: ExplanationOfBenefitStatus (required): A code specifying the state of the resource instance.
type	SΣ	1..1	CodeableConcept	Loại: institutional (nội trú), professional (ngoại trú) Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
use	SΣ	1..1	code	Mục đích: claim (thanh toán) Binding: Use (required): Complete, proposed, exploratory, other.
patient	SΣ	1..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile)	Bệnh nhân
created	SΣ	1..1	dateTime	Ngày tạo giải trình
insurer	SΣ	1..1	Reference(Organization)	Cơ quan BHXH thanh toán
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)	Cơ sở KCB thực hiện
outcome	SΣ	1..1	code	Kết quả giám định: complete | partial | error Binding: ClaimProcessingCodes (required): The result of the claim processing.
diagnosis		0..*	BackboneElement	Chẩn đoán — 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	Mã bệnh ICD-10 VN Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
type	S	0..*	CodeableConcept	Loại chẩn đoán (chính/phụ) Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
insurance	SΣ	1..*	BackboneElement	Các Coverage thực được giám định và các giai đoạn hưởng — Real adjudicated Coverages with their benefit stages
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:benefitStage	SC	1..*	(Complex)	Sequence, period và mức hưởng của giai đoạn — Stage sequence, period, and benefit level URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage Constraints: vn-coverage-benefit-stage-level-range
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)	Thẻ BHYT (Coverage)
item	SC	1..*	BackboneElement	Dòng bảng kê sau giám định — Adjudicated itemized-statement line Constraints: vn-itemized-eob-eligible-consistent, vn-itemized-eob-serviced-in-stage, vn-itemized-eob-line-allocation-sum, vn-itemized-eob-insured-fields-required, vn-itemized-eob-benefit-level-matches-stage, vn-itemized-eob-other-fund-breakdown-sum
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:otherFundBreakdown	C	0..1	(Complex)	Chi tiết nguồn khác chi trả theo dòng: NSNN/VTNN/VTTN/CL (T_NGUONKHAC_*) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown Constraints: vn-other-fund-breakdown-money-vnd-value
extension:paymentSource		0..1	CodeableConcept	Nguồn chi trả dòng chi phí (NGUON_CTRA) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-source Binding: Nguồn chi trả — Vietnam Payment Source ValueSet (extensible)
extension:recurrentWoundBenefit		0..1	boolean	Flag VET_THUONG_TP cho dòng thuốc/DVKT/VTYT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-recurrent-wound-benefit
extension:tenderInfo		0..1	string	Thông tin thầu dòng chi phí (TT_THAU) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-tender-info
extension:processingMethod		0..1	CodeableConcept	Phương pháp chế biến YHCT (MA_PP_CHEBIEN) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-traditional-processing-method Binding: Phương pháp chế biến vị thuốc cổ truyền — VN Traditional Medicine Processing Method ValueSet (extensible)
extension:benefitStageSequence	S	1..1	positiveInt	Sequence giai đoạn hưởng của dòng — Line benefit-stage sequence URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence
extension:insuranceCostInfo	S	1..1	(Complex)	Các cột đơn giá/tỷ lệ/thành tiền BHYT — BHYT price, ratio, and eligible-amount columns URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
Slices for extension				Content/Rules for all slices
extension:scope		0..1	Extension	Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"scope"
value[x]		1..1	CodeableConcept	Value of extension Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:paymentRatio		0..1	Extension	Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentRatio"
value[x]		1..1	decimal	Value of extension
extension:benefitLevel		0..1	Extension	Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"benefitLevel"
value[x]		1..1	decimal	Value of extension
extension:paymentCeiling		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentCeiling"
value[x]		1..1	Money	Trần thanh toán BHYT (VND)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:servicePaymentRatio		0..1	Extension	Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"servicePaymentRatio"
value[x]		1..1	decimal	Value of extension
extension:insuranceUnitPrice		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceUnitPrice"
value[x]		1..1	Money	Đơn giá BHYT thanh toán (VND)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceLineAmount"
value[x]		1..1	Money	Thành tiền BH đủ điều kiện (VND) — Eligible insurance line amount
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
url		1..1	uri	"http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	S	1..1	positiveInt	Item instance identifier
category	S	1..1	CodeableConcept	Nhóm chi phí QĐ 697/QĐ-BYT — QĐ 697/QĐ-BYT cost category Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (required)
productOrService	S	1..1	CodeableConcept	Mã dịch vụ/thuốc/TBYT Binding: USCLSCodes (example): Allowable service and product codes.
serviced[x]	S	1..1		Ngày/khoảng thực hiện trong giai đoạn hưởng — Service date/period within the benefit stage
servicedDate			date
servicedPeriod			Period
quantity	S	1..1	SimpleQuantity(4.0.1)	Số lượng của dòng — Line quantity
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unitPrice	S	1..1	Money	Đơn giá bệnh viện, VND — Hospital unit price in VND
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
net	S	1..1	Money	Thành tiền bệnh viện, VND — Hospital line amount in VND
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
Slices for adjudication		6..*	BackboneElement	Kết quả giám định từng dòng Slice: Unordered, Open by pattern:category
adjudication:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	S	1..1	CodeableConcept	Type of adjudication information Binding: AdjudicationValueCodes (extensible)
amount	S	0..1	Money	Monetary amount
adjudication:submitted	S	1..1	BackboneElement	Kết quả giám định từng dòng
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	S	1..1	CodeableConcept	Thành tiền bệnh viện đề nghị, cột 7 — Submitted hospital amount, column 7 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: submitted
display		1..1	string	Representation defined by the system Fixed Value: Submitted Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	S	1..1	Money	Monetary amount
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
adjudication:eligible	S	1..1	BackboneElement	Kết quả giám định từng dòng
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	S	1..1	CodeableConcept	Thành tiền BH đủ điều kiện, cột 9 — Eligible insurance amount, column 9 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: eligible
display		1..1	string	Representation defined by the system Fixed Value: Eligible Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	S	1..1	Money	Monetary amount
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
adjudication:insuranceFund	S	1..1	BackboneElement	Kết quả giám định từng dòng
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	S	1..1	CodeableConcept	Quỹ BHYT thanh toán, cột 10 — BHYT fund payment, column 10 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: benefit
display		1..1	string	Representation defined by the system Fixed Value: Benefit Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	S	1..1	Money	Monetary amount
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
adjudication:patientCopay	S	1..1	BackboneElement	Kết quả giám định từng dòng
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	S	1..1	CodeableConcept	Người bệnh cùng chi trả, cột 11 — Patient co-payment, column 11 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: copay
display		1..1	string	Representation defined by the system Fixed Value: CoPay
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	S	1..1	Money	Monetary amount
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
adjudication:otherSource	S	1..1	BackboneElement	Kết quả giám định từng dòng
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	S	1..1	CodeableConcept	Nguồn khác thanh toán, cột 12 — Other-source payment, column 12 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: other-fund
display		1..1	string	Representation defined by the system Fixed Value: Nguồn khác
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	S	1..1	Money	Monetary amount
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
adjudication:patientSelfPay	S	1..1	BackboneElement	Kết quả giám định từng dòng
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	S	1..1	CodeableConcept	Người bệnh tự trả, cột 13 — Patient self-pay, column 13 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: patient-self-pay
display		1..1	string	Representation defined by the system Fixed Value: Người bệnh tự trả
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	S	1..1	Money	Monetary amount
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
detail		0..*	BackboneElement	Chi tiết cấu thành gói TBYT, cột 5/6/8/9 — Device-package component columns 5/6/8/9
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:insuranceCostInfo	S	1..1	(Complex)	Cột 5/6/8/9 của component gói TBYT — Device-package component columns 5/6/8/9 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
Slices for extension				Content/Rules for all slices
extension:scope		0..1	Extension	Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"scope"
value[x]		1..1	CodeableConcept	Value of extension Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:paymentRatio		0..1	Extension	Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentRatio"
value[x]		1..1	decimal	Value of extension
extension:benefitLevel		0..1	Extension	Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"benefitLevel"
value[x]		1..1	decimal	Value of extension
extension:paymentCeiling		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentCeiling"
value[x]		1..1	Money	Trần thanh toán BHYT (VND)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:servicePaymentRatio		0..1	Extension	Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"servicePaymentRatio"
value[x]		1..1	decimal	Value of extension
extension:insuranceUnitPrice		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceUnitPrice"
value[x]		1..1	Money	Đơn giá BHYT thanh toán (VND)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceLineAmount"
value[x]		1..1	Money	Thành tiền BH đủ điều kiện (VND) — Eligible insurance line amount
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
url		1..1	uri	"http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Product or service provided
productOrService	S	1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
quantity	S	1..1	SimpleQuantity(4.0.1)	Count of products or services
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unitPrice	S	1..1	Money	Fee, charge or cost per item
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
net	S	1..1	Money	Total item cost
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
Slices for total	SΣ	6..*	BackboneElement	Tổng hợp theo nhóm giám định Slice: Unordered, Open by pattern:category
total:All Slices				Content/Rules for all slices
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	SΣ	1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible)
amount	SΣ	1..1	Money	Số tiền
total:submitted	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	SΣ	1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: submitted
display		1..1	string	Representation defined by the system Fixed Value: Submitted Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:eligible	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	SΣ	1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: eligible
display		1..1	string	Representation defined by the system Fixed Value: Eligible Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:insuranceFund	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	SΣ	1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: benefit
display		1..1	string	Representation defined by the system Fixed Value: Benefit Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:patientCopay	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	SΣ	1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: copay
display		1..1	string	Representation defined by the system Fixed Value: CoPay
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:otherSource	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	SΣ	1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: other-fund
display		1..1	string	Representation defined by the system Fixed Value: Nguồn khác
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:patientSelfPay	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
category	SΣ	1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: patient-self-pay
display		1..1	string	Representation defined by the system Fixed Value: Người bệnh tự trả
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
payment	S	0..1	BackboneElement	Thông tin thanh toán
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
amount	S	0..1	Money	Số tiền BHYT thanh toán
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	📦0.9.0	This IG
ExplanationOfBenefit.​diagnosis.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.extension:insuranceCostInfo.​extension:scope.value[x]	Base	extensible	Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​item.extension:insuranceCostInfo.​extension:paymentCeiling.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.extension:insuranceCostInfo.​extension:insuranceUnitPrice.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.extension:insuranceCostInfo.​extension:insuranceLineAmount.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.category	Base	required	Danh mục chi phí KCB — Vietnam Cost Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​item.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.unitPrice.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.net.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication.category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:submitted.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:submitted.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:eligible.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:eligible.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:insuranceFund.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:insuranceFund.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientCopay.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientCopay.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:otherSource.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:otherSource.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientSelfPay.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientSelfPay.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.extension:insuranceCostInfo.​extension:scope.value[x]	Base	extensible	Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​item.detail.extension:insuranceCostInfo.​extension:paymentCeiling.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.extension:insuranceCostInfo.​extension:insuranceUnitPrice.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.extension:insuranceCostInfo.​extension:insuranceLineAmount.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.unitPrice.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.net.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:submitted.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:submitted.amount.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:eligible.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:eligible.amount.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:insuranceFund.​category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:insuranceFund.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:patientCopay.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:patientCopay.amount.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:otherSource.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:otherSource.amount.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:patientSelfPay.​category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:patientSelfPay.​amount.currency	Base	required	CurrencyCode	📍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()
vn-coverage-benefit-stage-level-range	error	ExplanationOfBenefit.insurance.extension:benefitStage	Mức hưởng của giai đoạn phải nằm trong khoảng từ 0 đến 100 phần trăm. The benefit level for a coverage stage SHALL be between 0 and 100 percent.	extension('benefitLevel').value >= 0 and extension('benefitLevel').value <= 100
vn-itemized-eob-benefit-level-matches-stage	error	ExplanationOfBenefit.item	Mức hưởng trên dòng, nếu có, phải bằng mức hưởng của benefit stage được dòng tham chiếu. An item's benefit level, when present, SHALL equal the benefit level of its referenced stage.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value.exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value = %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('benefitLevel').value
vn-itemized-eob-coverage-reference-distinct	error	ExplanationOfBenefit	Mỗi Coverage chỉ được xuất hiện một lần trong EOB bảng kê. Every Coverage SHALL appear only once in the itemized EOB.	insurance.coverage.reference.isDistinct()
vn-itemized-eob-eligible-consistent	error	ExplanationOfBenefit.item	Nếu dòng đồng thời có insuranceCostInfo.insuranceLineAmount và adjudication eligible thì hai số tiền phải bằng nhau. When both insuranceCostInfo.insuranceLineAmount and eligible adjudication are present, their amounts SHALL be equal.	(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.exists() and adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.exists()) implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.value = adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value
vn-itemized-eob-insured-fields-required	error	ExplanationOfBenefit.item	Khi adjudication ghi quỹ BHYT thanh toán một dòng, tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện phải có. When adjudication records a BHYT fund payment, the BHYT payment ratio and eligible insurance line amount SHALL be present.	(adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value > 0) implies (extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-eob-item-stage-exists	error	ExplanationOfBenefit	Mỗi dòng chi phí phải tham chiếu một sequence giai đoạn hưởng tồn tại trên insurance. Every cost line SHALL reference a benefit-stage sequence declared on insurance.	item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value.all($this in %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value)
vn-itemized-eob-line-allocation-sum	error	ExplanationOfBenefit.item	Thành tiền bệnh viện của dòng (cột 7) phải bằng tổng benefit, copay, other-fund và patient-self-pay (cột 10+11+12+13). The EOB line net amount SHALL equal the sum of the four adjudicated payment sources.	net.value = adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value
vn-itemized-eob-money-vnd	error	ExplanationOfBenefit	Mọi giá trị tiền tệ của ledger EOB phải dùng VND. Every monetary value in the itemized EOB ledger SHALL use VND.	item.unitPrice.currency.all($this = 'VND') and item.net.currency.all($this = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and item.adjudication.amount.currency.all($this = 'VND') and item.detail.unitPrice.currency.all($this = 'VND') and item.detail.net.currency.all($this = 'VND') and item.detail.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and total.amount.currency.all($this = 'VND')
vn-itemized-eob-other-fund-breakdown-sum	error	ExplanationOfBenefit.item	Khi có chi tiết nguồn khác, tổng các thành phần phải bằng adjudication other-fund của dòng. When an other-fund breakdown is present, its components SHALL sum to the line's other-fund adjudication.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').extension.value.ofType(Money).value.aggregate($this + $total, 0) = adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value
vn-itemized-eob-payment-equals-benefit-total	error	ExplanationOfBenefit	Khi có payment mà không có adjustment, số tiền thanh toán phải bằng total benefit. When payment is present without an adjustment, its amount SHALL equal the benefit total.	(payment.exists() and payment.adjustment.empty()) implies payment.amount.value = total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value
vn-itemized-eob-serviced-in-stage	error	ExplanationOfBenefit.item	Ngày hoặc khoảng thời gian thực hiện dòng chi phí phải nằm trong period của giai đoạn hưởng được tham chiếu; Period phải có cả start và end. Gateway vẫn phải kiểm tra lại tương quan này trước khi gửi do khác biệt giữa các validator FHIRPath R4. The service date or period SHALL fall within the referenced benefit-stage period, and a serviced Period SHALL contain both start and end. The submission gateway SHALL still repeat this correlation check because R4 FHIRPath validators differ.	(serviced.ofType(date).exists() implies (serviced.ofType(date) >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(date) <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end)) and (serviced.ofType(Period).exists() implies (serviced.ofType(Period).start.exists() and serviced.ofType(Period).end.exists() and serviced.ofType(Period).start >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(Period).end <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end))
vn-itemized-eob-single-focal-insurance	error	ExplanationOfBenefit	EOB bảng kê phải có đúng một Coverage focal. An itemized EOB SHALL have exactly one focal Coverage.	insurance.where(focal = true).count() = 1
vn-itemized-eob-stage-sequence-unique	error	ExplanationOfBenefit	Mỗi sequence giai đoạn hưởng trên insurance phải duy nhất trong ExplanationOfBenefit. Every insurance benefit-stage sequence SHALL be unique within the ExplanationOfBenefit.	insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value.isDistinct()
vn-itemized-eob-total-benefit-sum	error	ExplanationOfBenefit	Total benefit phải bằng tổng adjudication benefit của các item. The benefit total SHALL equal the sum of item benefit adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-copay-sum	error	ExplanationOfBenefit	Total copay phải bằng tổng adjudication copay của các item. The copay total SHALL equal the sum of item copay adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-eligible-sum	error	ExplanationOfBenefit	Total eligible phải bằng tổng adjudication eligible của các item. The eligible total SHALL equal the sum of item eligible adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-other-fund-sum	error	ExplanationOfBenefit	Total other-fund phải bằng tổng adjudication other-fund của các item. The other-fund total SHALL equal the sum of item other-fund adjudications.	total.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-self-pay-sum	error	ExplanationOfBenefit	Total patient-self-pay phải bằng tổng adjudication patient-self-pay của các item. The patient-self-pay total SHALL equal the sum of item patient-self-pay adjudications.	total.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-submitted-sum	error	ExplanationOfBenefit	Total submitted phải bằng tổng item.net. The submitted total SHALL equal the sum of item net amounts.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'submitted').exists()).amount.value = item.net.value.aggregate($this + $total, 0)
vn-other-fund-breakdown-money-vnd-value	error	ExplanationOfBenefit.item.extension:otherFundBreakdown	Mọi Money con phải có value và dùng VND. Every child Money SHALL have a value and use VND.	extension.value.ofType(Money).all(value.exists() and currency = 'VND')

Dạng xem Differential

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ExplanationOfBenefit	C	0..*	VNCoreExplanationOfBenefit	Explanation of Benefit resource Constraints: vn-itemized-eob-stage-sequence-unique, vn-itemized-eob-coverage-reference-distinct, vn-itemized-eob-single-focal-insurance, vn-itemized-eob-item-stage-exists, vn-itemized-eob-money-vnd, vn-itemized-eob-total-submitted-sum, vn-itemized-eob-total-eligible-sum, vn-itemized-eob-total-benefit-sum, vn-itemized-eob-total-copay-sum, vn-itemized-eob-total-other-fund-sum, vn-itemized-eob-total-self-pay-sum, vn-itemized-eob-payment-equals-benefit-total
Slices for extension				Content/Rules for all slices
extension:costSummary		0..0		Tổng chi phí theo nhóm — Claim Cost Summary Extension
insurance		1..*	BackboneElement	Các Coverage thực được giám định và các giai đoạn hưởng — Real adjudicated Coverages with their benefit stages
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:benefitStage	S	1..*	(Complex)	Sequence, period và mức hưởng của giai đoạn — Stage sequence, period, and benefit level URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage
item	C	1..*	BackboneElement	Dòng bảng kê sau giám định — Adjudicated itemized-statement line Constraints: vn-itemized-eob-eligible-consistent, vn-itemized-eob-serviced-in-stage, vn-itemized-eob-line-allocation-sum, vn-itemized-eob-insured-fields-required, vn-itemized-eob-benefit-level-matches-stage, vn-itemized-eob-other-fund-breakdown-sum
extension		2..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:benefitStageSequence	S	1..1	positiveInt	Sequence giai đoạn hưởng của dòng — Line benefit-stage sequence URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence
extension:insuranceCostInfo	S	1..1	(Complex)	Các cột đơn giá/tỷ lệ/thành tiền BHYT — BHYT price, ratio, and eligible-amount columns URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
Slices for extension				Content/Rules for all slices
extension:paymentCeiling		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:insuranceUnitPrice		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
category		1..1	CodeableConcept	Nhóm chi phí QĐ 697/QĐ-BYT — QĐ 697/QĐ-BYT cost category Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (required)
serviced[x]	S	1..1	date, Period	Ngày/khoảng thực hiện trong giai đoạn hưởng — Service date/period within the benefit stage
quantity	S	1..1	SimpleQuantity(4.0.1)	Số lượng của dòng — Line quantity
value		1..1	decimal	Numerical value (with implicit precision)
unitPrice	S	1..1	Money	Đơn giá bệnh viện, VND — Hospital unit price in VND
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
net		1..1	Money	Thành tiền bệnh viện, VND — Hospital line amount in VND
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
Slices for adjudication		6..*	BackboneElement	Kết quả giám định từng dòng Slice: Unordered, Open by pattern:category
adjudication:submitted	S	1..1	BackboneElement	Kết quả giám định từng dòng
category		1..1	CodeableConcept	Thành tiền bệnh viện đề nghị, cột 7 — Submitted hospital amount, column 7 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
code		1..1	code	Symbol in syntax defined by the system Fixed Value: submitted
display		1..1	string	Representation defined by the system Fixed Value: Submitted Amount
amount		1..1	Money	Monetary amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
adjudication:eligible	S	1..1	BackboneElement	Kết quả giám định từng dòng
category		1..1	CodeableConcept	Thành tiền BH đủ điều kiện, cột 9 — Eligible insurance amount, column 9 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
code		1..1	code	Symbol in syntax defined by the system Fixed Value: eligible
display		1..1	string	Representation defined by the system Fixed Value: Eligible Amount
amount		1..1	Money	Monetary amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
adjudication:insuranceFund	S	1..1	BackboneElement	Kết quả giám định từng dòng
category		1..1	CodeableConcept	Quỹ BHYT thanh toán, cột 10 — BHYT fund payment, column 10 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
code		1..1	code	Symbol in syntax defined by the system Fixed Value: benefit
display		1..1	string	Representation defined by the system Fixed Value: Benefit Amount
amount		1..1	Money	Monetary amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
adjudication:patientCopay	S	1..1	BackboneElement	Kết quả giám định từng dòng
category		1..1	CodeableConcept	Người bệnh cùng chi trả, cột 11 — Patient co-payment, column 11 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
code		1..1	code	Symbol in syntax defined by the system Fixed Value: copay
display		1..1	string	Representation defined by the system Fixed Value: CoPay
amount		1..1	Money	Monetary amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
adjudication:otherSource	S	1..1	BackboneElement	Kết quả giám định từng dòng
category		1..1	CodeableConcept	Nguồn khác thanh toán, cột 12 — Other-source payment, column 12 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: other-fund
display		1..1	string	Representation defined by the system Fixed Value: Nguồn khác
amount		1..1	Money	Monetary amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
adjudication:patientSelfPay	S	1..1	BackboneElement	Kết quả giám định từng dòng
category		1..1	CodeableConcept	Người bệnh tự trả, cột 13 — Patient self-pay, column 13 Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: patient-self-pay
display		1..1	string	Representation defined by the system Fixed Value: Người bệnh tự trả
amount		1..1	Money	Monetary amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
detail		0..*	BackboneElement	Chi tiết cấu thành gói TBYT, cột 5/6/8/9 — Device-package component columns 5/6/8/9
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:insuranceCostInfo	S	1..1	(Complex)	Cột 5/6/8/9 của component gói TBYT — Device-package component columns 5/6/8/9 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
Slices for extension				Content/Rules for all slices
extension:paymentCeiling		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:insuranceUnitPrice		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
productOrService	S	1..1	CodeableConcept	Billing, service, product, or drug code
quantity	S	1..1	SimpleQuantity(4.0.1)	Count of products or services
value		1..1	decimal	Numerical value (with implicit precision)
unitPrice	S	1..1	Money	Fee, charge or cost per item
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
net	S	1..1	Money	Total item cost
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
adjudication		0..0		Detail level adjudication details
Slices for total		6..*	BackboneElement	Tổng hợp theo nhóm giám định Slice: Unordered, Open by pattern:category
total:submitted	S	1..1	BackboneElement	Tổng hợp theo nhóm giám định
category		1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
code		1..1	code	Symbol in syntax defined by the system Fixed Value: submitted
display		1..1	string	Representation defined by the system Fixed Value: Submitted Amount
amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
total:eligible	S	1..1	BackboneElement	Tổng hợp theo nhóm giám định
category		1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
code		1..1	code	Symbol in syntax defined by the system Fixed Value: eligible
display		1..1	string	Representation defined by the system Fixed Value: Eligible Amount
amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
total:insuranceFund	S	1..1	BackboneElement	Tổng hợp theo nhóm giám định
category		1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
code		1..1	code	Symbol in syntax defined by the system Fixed Value: benefit
display		1..1	string	Representation defined by the system Fixed Value: Benefit Amount
amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
total:patientCopay	S	1..1	BackboneElement	Tổng hợp theo nhóm giám định
category		1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
code		1..1	code	Symbol in syntax defined by the system Fixed Value: copay
display		1..1	string	Representation defined by the system Fixed Value: CoPay
amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
total:otherSource	S	1..1	BackboneElement	Tổng hợp theo nhóm giám định
category		1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: other-fund
display		1..1	string	Representation defined by the system Fixed Value: Nguồn khác
amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
total:patientSelfPay	S	1..1	BackboneElement	Tổng hợp theo nhóm giám định
category		1..1	CodeableConcept	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Required Pattern: At least the following
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
code		1..1	code	Symbol in syntax defined by the system Fixed Value: patient-self-pay
display		1..1	string	Representation defined by the system Fixed Value: Người bệnh tự trả
amount
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
Documentation for this format

Terminology Bindings (Differential)

Path	Status	Usage	ValueSet	Version	Source
ExplanationOfBenefit.​item.category	Base	required	Danh mục chi phí KCB — Vietnam Cost Category ValueSet	📦0.9.0	This IG

Constraints

Id	Grade	Path(s)	Description	Expression
vn-itemized-eob-benefit-level-matches-stage	error	ExplanationOfBenefit.item	Mức hưởng trên dòng, nếu có, phải bằng mức hưởng của benefit stage được dòng tham chiếu. An item's benefit level, when present, SHALL equal the benefit level of its referenced stage.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value.exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value = %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('benefitLevel').value
vn-itemized-eob-coverage-reference-distinct	error	ExplanationOfBenefit	Mỗi Coverage chỉ được xuất hiện một lần trong EOB bảng kê. Every Coverage SHALL appear only once in the itemized EOB.	insurance.coverage.reference.isDistinct()
vn-itemized-eob-eligible-consistent	error	ExplanationOfBenefit.item	Nếu dòng đồng thời có insuranceCostInfo.insuranceLineAmount và adjudication eligible thì hai số tiền phải bằng nhau. When both insuranceCostInfo.insuranceLineAmount and eligible adjudication are present, their amounts SHALL be equal.	(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.exists() and adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.exists()) implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.value = adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value
vn-itemized-eob-insured-fields-required	error	ExplanationOfBenefit.item	Khi adjudication ghi quỹ BHYT thanh toán một dòng, tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện phải có. When adjudication records a BHYT fund payment, the BHYT payment ratio and eligible insurance line amount SHALL be present.	(adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value > 0) implies (extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-eob-item-stage-exists	error	ExplanationOfBenefit	Mỗi dòng chi phí phải tham chiếu một sequence giai đoạn hưởng tồn tại trên insurance. Every cost line SHALL reference a benefit-stage sequence declared on insurance.	item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value.all($this in %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value)
vn-itemized-eob-line-allocation-sum	error	ExplanationOfBenefit.item	Thành tiền bệnh viện của dòng (cột 7) phải bằng tổng benefit, copay, other-fund và patient-self-pay (cột 10+11+12+13). The EOB line net amount SHALL equal the sum of the four adjudicated payment sources.	net.value = adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value
vn-itemized-eob-money-vnd	error	ExplanationOfBenefit	Mọi giá trị tiền tệ của ledger EOB phải dùng VND. Every monetary value in the itemized EOB ledger SHALL use VND.	item.unitPrice.currency.all($this = 'VND') and item.net.currency.all($this = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and item.adjudication.amount.currency.all($this = 'VND') and item.detail.unitPrice.currency.all($this = 'VND') and item.detail.net.currency.all($this = 'VND') and item.detail.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and total.amount.currency.all($this = 'VND')
vn-itemized-eob-other-fund-breakdown-sum	error	ExplanationOfBenefit.item	Khi có chi tiết nguồn khác, tổng các thành phần phải bằng adjudication other-fund của dòng. When an other-fund breakdown is present, its components SHALL sum to the line's other-fund adjudication.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').extension.value.ofType(Money).value.aggregate($this + $total, 0) = adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value
vn-itemized-eob-payment-equals-benefit-total	error	ExplanationOfBenefit	Khi có payment mà không có adjustment, số tiền thanh toán phải bằng total benefit. When payment is present without an adjustment, its amount SHALL equal the benefit total.	(payment.exists() and payment.adjustment.empty()) implies payment.amount.value = total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value
vn-itemized-eob-serviced-in-stage	error	ExplanationOfBenefit.item	Ngày hoặc khoảng thời gian thực hiện dòng chi phí phải nằm trong period của giai đoạn hưởng được tham chiếu; Period phải có cả start và end. Gateway vẫn phải kiểm tra lại tương quan này trước khi gửi do khác biệt giữa các validator FHIRPath R4. The service date or period SHALL fall within the referenced benefit-stage period, and a serviced Period SHALL contain both start and end. The submission gateway SHALL still repeat this correlation check because R4 FHIRPath validators differ.	(serviced.ofType(date).exists() implies (serviced.ofType(date) >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(date) <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end)) and (serviced.ofType(Period).exists() implies (serviced.ofType(Period).start.exists() and serviced.ofType(Period).end.exists() and serviced.ofType(Period).start >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(Period).end <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end))
vn-itemized-eob-single-focal-insurance	error	ExplanationOfBenefit	EOB bảng kê phải có đúng một Coverage focal. An itemized EOB SHALL have exactly one focal Coverage.	insurance.where(focal = true).count() = 1
vn-itemized-eob-stage-sequence-unique	error	ExplanationOfBenefit	Mỗi sequence giai đoạn hưởng trên insurance phải duy nhất trong ExplanationOfBenefit. Every insurance benefit-stage sequence SHALL be unique within the ExplanationOfBenefit.	insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value.isDistinct()
vn-itemized-eob-total-benefit-sum	error	ExplanationOfBenefit	Total benefit phải bằng tổng adjudication benefit của các item. The benefit total SHALL equal the sum of item benefit adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-copay-sum	error	ExplanationOfBenefit	Total copay phải bằng tổng adjudication copay của các item. The copay total SHALL equal the sum of item copay adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-eligible-sum	error	ExplanationOfBenefit	Total eligible phải bằng tổng adjudication eligible của các item. The eligible total SHALL equal the sum of item eligible adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-other-fund-sum	error	ExplanationOfBenefit	Total other-fund phải bằng tổng adjudication other-fund của các item. The other-fund total SHALL equal the sum of item other-fund adjudications.	total.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-self-pay-sum	error	ExplanationOfBenefit	Total patient-self-pay phải bằng tổng adjudication patient-self-pay của các item. The patient-self-pay total SHALL equal the sum of item patient-self-pay adjudications.	total.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-submitted-sum	error	ExplanationOfBenefit	Total submitted phải bằng tổng item.net. The submitted total SHALL equal the sum of item net amounts.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'submitted').exists()).amount.value = item.net.value.aggregate($this + $total, 0)

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Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
ExplanationOfBenefit	C	0..*	VNCoreExplanationOfBenefit	Explanation of Benefit resource Constraints: vn-itemized-eob-stage-sequence-unique, vn-itemized-eob-coverage-reference-distinct, vn-itemized-eob-single-focal-insurance, vn-itemized-eob-item-stage-exists, vn-itemized-eob-money-vnd, vn-itemized-eob-total-submitted-sum, vn-itemized-eob-total-eligible-sum, vn-itemized-eob-total-benefit-sum, vn-itemized-eob-total-copay-sum, vn-itemized-eob-total-other-fund-sum, vn-itemized-eob-total-self-pay-sum, vn-itemized-eob-payment-equals-benefit-total
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 Bindings Purpose 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:paymentPeriod		0..1	(Complex)	Kỳ thanh toán BHYT (năm/tháng) — NAM_QT, THANG_QT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
extension:paymentMethod		0..1	CodeableConcept	Phương thức thanh toán (FFS/Capitation/DRG) — MA_PTTT 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	Trạng thái giải trình Binding: ExplanationOfBenefitStatus (required): A code specifying the state of the resource instance.
type	SΣ	1..1	CodeableConcept	Loại: institutional (nội trú), professional (ngoại trú) 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	Mục đích: claim (thanh toán) Binding: Use (required): Complete, proposed, exploratory, other.
patient	SΣ	1..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile)	Bệnh nhân
billablePeriod	Σ	0..1	Period	Relevant time frame for the claim
created	SΣ	1..1	dateTime	Ngày tạo giải trình
enterer		0..1	Reference(Practitioner | PractitionerRole)	Author of the claim
insurer	SΣ	1..1	Reference(Organization)	Cơ quan BHXH thanh toán
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)	Cơ sở KCB thực hiện
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	Kết quả giám định: 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	Chẩn đoán — 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:$this Binding: ICD-10Codes (example): ICD10 Diagnostic codes.
diagnosisCodeableConcept			CodeableConcept
diagnosisReference			Reference(Condition)
diagnosis[x]:diagnosisCodeableConcept	S	0..1	CodeableConcept	Mã bệnh ICD-10 VN Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
type	S	0..*	CodeableConcept	Loại chẩn đoán (chính/phụ) Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
onAdmission		0..1	CodeableConcept	Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
packageCode		0..1	CodeableConcept	Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
procedure		0..*	BackboneElement	Thủ thuật/phẫu thuật — ICD-9-CM
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Procedure instance identifier
type		0..*	CodeableConcept	Category of Procedure Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.
date		0..1	dateTime	When the procedure was performed
Slices for procedure[x]		1..1		Specific clinical procedure Slice: Unordered, Open by type:$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	Các Coverage thực được giám định và các giai đoạn hưởng — Real adjudicated Coverages with their benefit stages
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:benefitStage	SC	1..*	(Complex)	Sequence, period và mức hưởng của giai đoạn — Stage sequence, period, and benefit level URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage Constraints: vn-coverage-benefit-stage-level-range
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)	Thẻ 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	SC	1..*	BackboneElement	Dòng bảng kê sau giám định — Adjudicated itemized-statement line Constraints: vn-itemized-eob-eligible-consistent, vn-itemized-eob-serviced-in-stage, vn-itemized-eob-line-allocation-sum, vn-itemized-eob-insured-fields-required, vn-itemized-eob-benefit-level-matches-stage, vn-itemized-eob-other-fund-breakdown-sum
id		0..1	string	Unique id for inter-element referencing
Slices for extension		2..*	Extension	Extension Slice: Unordered, Open by value:url
extension:otherFundBreakdown	C	0..1	(Complex)	Chi tiết nguồn khác chi trả theo dòng: NSNN/VTNN/VTTN/CL (T_NGUONKHAC_*) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown Constraints: vn-other-fund-breakdown-money-vnd-value
extension:paymentSource		0..1	CodeableConcept	Nguồn chi trả dòng chi phí (NGUON_CTRA) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-source Binding: Nguồn chi trả — Vietnam Payment Source ValueSet (extensible)
extension:recurrentWoundBenefit		0..1	boolean	Flag VET_THUONG_TP cho dòng thuốc/DVKT/VTYT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-recurrent-wound-benefit
extension:tenderInfo		0..1	string	Thông tin thầu dòng chi phí (TT_THAU) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-tender-info
extension:processingMethod		0..1	CodeableConcept	Phương pháp chế biến YHCT (MA_PP_CHEBIEN) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-traditional-processing-method Binding: Phương pháp chế biến vị thuốc cổ truyền — VN Traditional Medicine Processing Method ValueSet (extensible)
extension:benefitStageSequence	S	1..1	positiveInt	Sequence giai đoạn hưởng của dòng — Line benefit-stage sequence URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence
extension:insuranceCostInfo	S	1..1	(Complex)	Các cột đơn giá/tỷ lệ/thành tiền BHYT — BHYT price, ratio, and eligible-amount columns URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:scope		0..1	Extension	Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"scope"
value[x]		1..1	CodeableConcept	Value of extension Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:paymentRatio		0..1	Extension	Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentRatio"
value[x]		1..1	decimal	Value of extension
extension:benefitLevel		0..1	Extension	Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"benefitLevel"
value[x]		1..1	decimal	Value of extension
extension:paymentCeiling		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentCeiling"
value[x]		1..1	Money	Trần thanh toán BHYT (VND)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:servicePaymentRatio		0..1	Extension	Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"servicePaymentRatio"
value[x]		1..1	decimal	Value of extension
extension:insuranceUnitPrice		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceUnitPrice"
value[x]		1..1	Money	Đơn giá BHYT thanh toán (VND)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceLineAmount"
value[x]		1..1	Money	Thành tiền BH đủ điều kiện (VND) — Eligible insurance line amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
url		1..1	uri	"http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
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	1..1	CodeableConcept	Nhóm chi phí QĐ 697/QĐ-BYT — QĐ 697/QĐ-BYT cost category Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (required)
productOrService	S	1..1	CodeableConcept	Mã dịch vụ/thuốc/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]	S	1..1		Ngày/khoảng thực hiện trong giai đoạn hưởng — Service date/period within the benefit stage
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	S	1..1	SimpleQuantity(4.0.1)	Số lượng của dòng — Line quantity
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
unitPrice	S	1..1	Money	Đơn giá bệnh viện, VND — Hospital unit price in VND
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
factor		0..1	decimal	Price scaling factor
net	S	1..1	Money	Thành tiền bệnh viện, VND — Hospital line amount in VND
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
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
Slices for adjudication		6..*	BackboneElement	Kết quả giám định từng dòng Slice: Unordered, Open by pattern:category
adjudication:All Slices				Content/Rules for all slices
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 (extensible)
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
adjudication:submitted	S	1..1	BackboneElement	Kết quả giám định từng dòng
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	Thành tiền bệnh viện đề nghị, cột 7 — Submitted hospital amount, column 7 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: submitted
display		1..1	string	Representation defined by the system Fixed Value: Submitted Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
reason		0..1	CodeableConcept	Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): Adjudication reason codes.
amount	S	1..1	Money	Monetary amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
value		0..1	decimal	Non-monitary value
adjudication:eligible	S	1..1	BackboneElement	Kết quả giám định từng dòng
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	Thành tiền BH đủ điều kiện, cột 9 — Eligible insurance amount, column 9 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: eligible
display		1..1	string	Representation defined by the system Fixed Value: Eligible Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
reason		0..1	CodeableConcept	Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): Adjudication reason codes.
amount	S	1..1	Money	Monetary amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
value		0..1	decimal	Non-monitary value
adjudication:insuranceFund	S	1..1	BackboneElement	Kết quả giám định từng dòng
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	Quỹ BHYT thanh toán, cột 10 — BHYT fund payment, column 10 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: benefit
display		1..1	string	Representation defined by the system Fixed Value: Benefit Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
reason		0..1	CodeableConcept	Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): Adjudication reason codes.
amount	S	1..1	Money	Monetary amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
value		0..1	decimal	Non-monitary value
adjudication:patientCopay	S	1..1	BackboneElement	Kết quả giám định từng dòng
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	Người bệnh cùng chi trả, cột 11 — Patient co-payment, column 11 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: copay
display		1..1	string	Representation defined by the system Fixed Value: CoPay
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
reason		0..1	CodeableConcept	Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): Adjudication reason codes.
amount	S	1..1	Money	Monetary amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
value		0..1	decimal	Non-monitary value
adjudication:otherSource	S	1..1	BackboneElement	Kết quả giám định từng dòng
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	Nguồn khác thanh toán, cột 12 — Other-source payment, column 12 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: other-fund
display		1..1	string	Representation defined by the system Fixed Value: Nguồn khác
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
reason		0..1	CodeableConcept	Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): Adjudication reason codes.
amount	S	1..1	Money	Monetary amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
value		0..1	decimal	Non-monitary value
adjudication:patientSelfPay	S	1..1	BackboneElement	Kết quả giám định từng dòng
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	Người bệnh tự trả, cột 13 — Patient self-pay, column 13 Binding: AdjudicationValueCodes (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: patient-self-pay
display		1..1	string	Representation defined by the system Fixed Value: Người bệnh tự trả
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
reason		0..1	CodeableConcept	Explanation of adjudication outcome Binding: AdjudicationReasonCodes (example): Adjudication reason codes.
amount	S	1..1	Money	Monetary amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
value		0..1	decimal	Non-monitary value
detail		0..*	BackboneElement	Chi tiết cấu thành gói TBYT, cột 5/6/8/9 — Device-package component columns 5/6/8/9
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:insuranceCostInfo	S	1..1	(Complex)	Cột 5/6/8/9 của component gói TBYT — Device-package component columns 5/6/8/9 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:scope		0..1	Extension	Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"scope"
value[x]		1..1	CodeableConcept	Value of extension Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:paymentRatio		0..1	Extension	Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentRatio"
value[x]		1..1	decimal	Value of extension
extension:benefitLevel		0..1	Extension	Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"benefitLevel"
value[x]		1..1	decimal	Value of extension
extension:paymentCeiling		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentCeiling"
value[x]		1..1	Money	Trần thanh toán BHYT (VND)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:servicePaymentRatio		0..1	Extension	Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"servicePaymentRatio"
value[x]		1..1	decimal	Value of extension
extension:insuranceUnitPrice		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceUnitPrice"
value[x]		1..1	Money	Đơn giá BHYT thanh toán (VND)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceLineAmount"
value[x]		1..1	Money	Thành tiền BH đủ điều kiện (VND) — Eligible insurance line amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
url		1..1	uri	"http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
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	S	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	S	1..1	SimpleQuantity(4.0.1)	Count of products or services
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
unitPrice	S	1..1	Money	Fee, charge or cost per item
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
factor		0..1	decimal	Price scaling factor
net	S	1..1	Money	Total item cost
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
udi		0..*	Reference(Device)	Unique device identifier
noteNumber		0..*	positiveInt	Applicable note numbers
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
Slices for total	SΣ	6..*	BackboneElement	Tổng hợp theo nhóm giám định Slice: Unordered, Open by pattern:category
total:All Slices				Content/Rules for all slices
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	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible)
amount	SΣ	1..1	Money	Số tiền
total:submitted	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
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	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: submitted
display		1..1	string	Representation defined by the system Fixed Value: Submitted Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:eligible	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
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	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: eligible
display		1..1	string	Representation defined by the system Fixed Value: Eligible Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:insuranceFund	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
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	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: benefit
display		1..1	string	Representation defined by the system Fixed Value: Benefit Amount
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:patientCopay	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
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	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://terminology.hl7.org/CodeSystem/adjudication
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: copay
display		1..1	string	Representation defined by the system Fixed Value: CoPay
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:otherSource	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
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	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: other-fund
display		1..1	string	Representation defined by the system Fixed Value: Nguồn khác
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total:patientSelfPay	SΣ	1..1	BackboneElement	Tổng hợp theo nhóm giám định
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	Loại tổng: submitted | eligible | copay | benefit hoặc category BHYT cục bộ Binding: Loại adjudication BHYT — BHYT Adjudication Category ValueSet (extensible) Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: patient-self-pay
display		1..1	string	Representation defined by the system Fixed Value: Người bệnh tự trả
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
amount	SΣ	1..1	Money	Số tiền
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
payment	S	0..1	BackboneElement	Thông tin thanh toán
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	Loại thanh toán 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	Số tiền BHYT thanh toán
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 Bindings Purpose AllLanguages Max Binding
benefitPeriod		0..1	Period	Kỳ quyền lợi 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
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	📦0.9.0	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	📦0.9.0	This IG
ExplanationOfBenefit.​accident.type	Base	extensible	ActIncidentCode	📦3.0.0	THO v7.2
ExplanationOfBenefit.​item.extension:insuranceCostInfo.​extension:scope.value[x]	Base	extensible	Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​item.extension:insuranceCostInfo.​extension:paymentCeiling.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.extension:insuranceCostInfo.​extension:insuranceUnitPrice.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.extension:insuranceCostInfo.​extension:insuranceLineAmount.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.category	Base	required	Danh mục chi phí KCB — Vietnam Cost Category ValueSet	📦0.9.0	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.unitPrice.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.net.currency	Base	required	CurrencyCode	📍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	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication.reason	Base	example	Adjudication Reason Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:submitted.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:submitted.​reason	Base	example	Adjudication Reason Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:submitted.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:eligible.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:eligible.​reason	Base	example	Adjudication Reason Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:eligible.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:insuranceFund.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:insuranceFund.​reason	Base	example	Adjudication Reason Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:insuranceFund.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientCopay.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientCopay.​reason	Base	example	Adjudication Reason Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientCopay.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:otherSource.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:otherSource.​reason	Base	example	Adjudication Reason Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:otherSource.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientSelfPay.​category	Base	extensible	Adjudication Value Codes	📦4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientSelfPay.​reason	Base	example	Adjudication Reason Codes	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.adjudication:patientSelfPay.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.extension:insuranceCostInfo.​extension:scope.value[x]	Base	extensible	Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​item.detail.extension:insuranceCostInfo.​extension:paymentCeiling.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.extension:insuranceCostInfo.​extension:insuranceUnitPrice.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.extension:insuranceCostInfo.​extension:insuranceLineAmount.​value[x].currency	Base	required	CurrencyCode	📍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.unitPrice.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​item.detail.net.currency	Base	required	CurrencyCode	📍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	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:submitted.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:submitted.amount.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:eligible.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:eligible.amount.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:insuranceFund.​category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:insuranceFund.​amount.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:patientCopay.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:patientCopay.amount.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:otherSource.category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:otherSource.amount.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
ExplanationOfBenefit.​total:patientSelfPay.​category	Base	extensible	Loại adjudication BHYT — BHYT Adjudication Category ValueSet	📦0.9.0	This IG
ExplanationOfBenefit.​total:patientSelfPay.​amount.currency	Base	required	CurrencyCode	📍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()
vn-coverage-benefit-stage-level-range	error	ExplanationOfBenefit.insurance.extension:benefitStage	Mức hưởng của giai đoạn phải nằm trong khoảng từ 0 đến 100 phần trăm. The benefit level for a coverage stage SHALL be between 0 and 100 percent.	extension('benefitLevel').value >= 0 and extension('benefitLevel').value <= 100
vn-itemized-eob-benefit-level-matches-stage	error	ExplanationOfBenefit.item	Mức hưởng trên dòng, nếu có, phải bằng mức hưởng của benefit stage được dòng tham chiếu. An item's benefit level, when present, SHALL equal the benefit level of its referenced stage.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value.exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value = %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('benefitLevel').value
vn-itemized-eob-coverage-reference-distinct	error	ExplanationOfBenefit	Mỗi Coverage chỉ được xuất hiện một lần trong EOB bảng kê. Every Coverage SHALL appear only once in the itemized EOB.	insurance.coverage.reference.isDistinct()
vn-itemized-eob-eligible-consistent	error	ExplanationOfBenefit.item	Nếu dòng đồng thời có insuranceCostInfo.insuranceLineAmount và adjudication eligible thì hai số tiền phải bằng nhau. When both insuranceCostInfo.insuranceLineAmount and eligible adjudication are present, their amounts SHALL be equal.	(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.exists() and adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.exists()) implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.value = adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value
vn-itemized-eob-insured-fields-required	error	ExplanationOfBenefit.item	Khi adjudication ghi quỹ BHYT thanh toán một dòng, tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện phải có. When adjudication records a BHYT fund payment, the BHYT payment ratio and eligible insurance line amount SHALL be present.	(adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value > 0) implies (extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-eob-item-stage-exists	error	ExplanationOfBenefit	Mỗi dòng chi phí phải tham chiếu một sequence giai đoạn hưởng tồn tại trên insurance. Every cost line SHALL reference a benefit-stage sequence declared on insurance.	item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value.all($this in %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value)
vn-itemized-eob-line-allocation-sum	error	ExplanationOfBenefit.item	Thành tiền bệnh viện của dòng (cột 7) phải bằng tổng benefit, copay, other-fund và patient-self-pay (cột 10+11+12+13). The EOB line net amount SHALL equal the sum of the four adjudicated payment sources.	net.value = adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value + adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value
vn-itemized-eob-money-vnd	error	ExplanationOfBenefit	Mọi giá trị tiền tệ của ledger EOB phải dùng VND. Every monetary value in the itemized EOB ledger SHALL use VND.	item.unitPrice.currency.all($this = 'VND') and item.net.currency.all($this = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and item.adjudication.amount.currency.all($this = 'VND') and item.detail.unitPrice.currency.all($this = 'VND') and item.detail.net.currency.all($this = 'VND') and item.detail.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and total.amount.currency.all($this = 'VND')
vn-itemized-eob-other-fund-breakdown-sum	error	ExplanationOfBenefit.item	Khi có chi tiết nguồn khác, tổng các thành phần phải bằng adjudication other-fund của dòng. When an other-fund breakdown is present, its components SHALL sum to the line's other-fund adjudication.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').extension.value.ofType(Money).value.aggregate($this + $total, 0) = adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value
vn-itemized-eob-payment-equals-benefit-total	error	ExplanationOfBenefit	Khi có payment mà không có adjustment, số tiền thanh toán phải bằng total benefit. When payment is present without an adjustment, its amount SHALL equal the benefit total.	(payment.exists() and payment.adjustment.empty()) implies payment.amount.value = total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value
vn-itemized-eob-serviced-in-stage	error	ExplanationOfBenefit.item	Ngày hoặc khoảng thời gian thực hiện dòng chi phí phải nằm trong period của giai đoạn hưởng được tham chiếu; Period phải có cả start và end. Gateway vẫn phải kiểm tra lại tương quan này trước khi gửi do khác biệt giữa các validator FHIRPath R4. The service date or period SHALL fall within the referenced benefit-stage period, and a serviced Period SHALL contain both start and end. The submission gateway SHALL still repeat this correlation check because R4 FHIRPath validators differ.	(serviced.ofType(date).exists() implies (serviced.ofType(date) >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(date) <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end)) and (serviced.ofType(Period).exists() implies (serviced.ofType(Period).start.exists() and serviced.ofType(Period).end.exists() and serviced.ofType(Period).start >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(Period).end <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end))
vn-itemized-eob-single-focal-insurance	error	ExplanationOfBenefit	EOB bảng kê phải có đúng một Coverage focal. An itemized EOB SHALL have exactly one focal Coverage.	insurance.where(focal = true).count() = 1
vn-itemized-eob-stage-sequence-unique	error	ExplanationOfBenefit	Mỗi sequence giai đoạn hưởng trên insurance phải duy nhất trong ExplanationOfBenefit. Every insurance benefit-stage sequence SHALL be unique within the ExplanationOfBenefit.	insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value.isDistinct()
vn-itemized-eob-total-benefit-sum	error	ExplanationOfBenefit	Total benefit phải bằng tổng adjudication benefit của các item. The benefit total SHALL equal the sum of item benefit adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'benefit').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-copay-sum	error	ExplanationOfBenefit	Total copay phải bằng tổng adjudication copay của các item. The copay total SHALL equal the sum of item copay adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'copay').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-eligible-sum	error	ExplanationOfBenefit	Total eligible phải bằng tổng adjudication eligible của các item. The eligible total SHALL equal the sum of item eligible adjudications.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'eligible').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-other-fund-sum	error	ExplanationOfBenefit	Total other-fund phải bằng tổng adjudication other-fund của các item. The other-fund total SHALL equal the sum of item other-fund adjudications.	total.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'other-fund').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-self-pay-sum	error	ExplanationOfBenefit	Total patient-self-pay phải bằng tổng adjudication patient-self-pay của các item. The patient-self-pay total SHALL equal the sum of item patient-self-pay adjudications.	total.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value = item.adjudication.where(category.coding.where(system = 'http://fhir.hl7.org.vn/core/CodeSystem/vn-bhyt-adjudication-category-cs' and code = 'patient-self-pay').exists()).amount.value.aggregate($this + $total, 0)
vn-itemized-eob-total-submitted-sum	error	ExplanationOfBenefit	Total submitted phải bằng tổng item.net. The submitted total SHALL equal the sum of item net amounts.	total.where(category.coding.where(system = 'http://terminology.hl7.org/CodeSystem/adjudication' and code = 'submitted').exists()).amount.value = item.net.value.aggregate($this + $total, 0)
vn-other-fund-breakdown-money-vnd-value	error	ExplanationOfBenefit.item.extension:otherFundBreakdown	Mọi Money con phải có value và dùng VND. Every child Money SHALL have a value and use VND.	extension.value.ofType(Money).all(value.exists() and currency = 'VND')

Summary

Mandatory: 57 elements(16 nested mandatory elements)
Must-Support: 23 elements
Fixed: 22 elements
Prohibited: 2 elements

Extensions

This structure refers to these extensions:

• http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage
• http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence
• http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info

Slices

This structure defines the following Slices:

• The element 1 is sliced based on the values of ExplanationOfBenefit.item.adjudication
• The element 1 is sliced based on the values of ExplanationOfBenefit.total