Release 4 Snapshot 3: Connectathon 32 Base

This page is part of the Snapshot #3 for FHIR Specification (v4.0.1: R4 - Mixed Normative and STU ) in it's permanent home (it will always be available at this URL). The current version which supercedes this version is 5.0.0 R5 , released to support Connectathon 32 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

Capabilitystatement-knowledge-repository.json

Example ClaimResponse/R3502 (JSON)

FHIR Infrastructure Financial Management Work Group Maturity Level : N/A Standards Status : Informative Compartments : Not linked to any defined compartments Patient , Practitioner

Raw JSON ( canonical form + also see JSON Format Specification )

Knowledge Repository Base Capability Statement Primary insurance response to a 3Tier Vision Claim

{
  "resourceType": "CapabilityStatement",
  "id": "knowledge-repository",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n      <h2>Knowledge Repository Service Conformance Statement</h2>\n      <div>\n        <p>Basic conformance statement for a Knowledge Repository Service. A server can support more functionality\n           than defined here, but this is the minimum amount</p>\n\n      </div>\n      <table>\n        <tr>\n          <td>Mode</td>\n          <td>SERVER</td>\n        </tr>\n        <tr>\n          <td>Description</td>\n          <td>RESTful Knowledge Repository Server</td>\n        </tr>\n        <tr>\n          <td>Transaction</td>\n          <td/>\n        </tr>\n        <tr>\n          <td>System History</td>\n          <td/>\n        </tr>\n        <tr>\n          <td>System Search</td>\n          <td/>\n        </tr>\n      </table>\n      <table>\n        <tr>\n          <th>\n            <b>Resource Type</b>\n          </th>\n          <th>\n            <b>Profile</b>\n          </th>\n          <th>\n            <b>Read</b>\n          </th>\n          <th>\n            <b>V-Read</b>\n          </th>\n          <th>\n            <b>Search</b>\n          </th>\n          <th>\n            <b>Update</b>\n          </th>\n          <th>\n            <b>Updates</b>\n          </th>\n          <th>\n            <b>Create</b>\n          </th>\n          <th>\n            <b>Delete</b>\n          </th>\n          <th>\n            <b>History</b>\n          </th>\n        </tr>\n      </table>\n    </div>"

  "resourceType" : "ClaimResponse",
  "id" : "R3502",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the ClaimResponse</div>"

  },
  "url": "http://hl7.org/fhir/knowledge-repository",
  "name": "Knowledge Repository Service Conformance Statement",
  "status": "draft",
  "date": "2017-02-25",
  "publisher": "HL7, Inc",
  "contact": [
    {
      "name": "FHIR Project",
      "telecom": [
        {
          "system": "other",
          "value": "http://hl7.org/fhir"
        }
      ]

  "identifier" : [{
    "system" : "http://thebenefitcompany.com/claimresponse",
    "value" : "CR6532875367"
  }],
  "status" : "active",
  "type" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
      "code" : "vision"
    }]
  },
  "use" : "claim",
  "patient" : {
    "reference" : "Patient/1"
  },
  "created" : "2014-08-16",
  "insurer" : {
    "reference" : "Organization/2"
  },
  "requestor" : {
    "reference" : "Organization/1"
  },
  "request" : {
    "identifier" : {
      "system" : "http://happysight.com/claim",
      "value" : "6612346"

    }
  ],
  "description": "Basic conformance statement for a Knowledge Repository Service. A server can support more functionality    than defined here, but this is the minimum amount",
  "kind": "capability",
  "software": {
    "name": "ACME Knowledge Repository Service"

  },
  "fhirVersion": "4.0.1",
  "format": [
    "json",
    "xml"
  ],
  "rest": [

  "outcome" : "complete",
  "disposition" : "Claim settled as per contract.",
  "payeeType" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/payeetype",
      "code" : "provider"
    }]
  },
  "item" : [{
    "itemSequence" : 1,
    "adjudication" : [{
      "category" : {
        "coding" : [{
          "code" : "eligible"
        }]
      },
      "amount" : {
        "value" : 235.40,
        "currency" : "USD"
      }
    },

    {
      "mode": "server",
      "documentation": "RESTful Knowledge Repository Service",
      "security": {
        "cors": true,
        "service": [
          {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/restful-security-service",
                "code": "Certificates"
              }
            ]
          }
        ]

      "category" : {
        "coding" : [{
          "code" : "copay"
        }]

      },
      "resource": [

      "amount" : {
        "value" : 20.00,
        "currency" : "USD"
      }
    },
    {
      "category" : {
        "coding" : [{
          "code" : "eligpercent"
        }]
      },
      "value" : 80.00
    },
    {
      "category" : {
        "coding" : [{
          "code" : "benefit"
        }]
      },
      "amount" : {
        "value" : 172.32,
        "currency" : "USD"
      }
    }],
    "detail" : [{
      "detailSequence" : 1,
      "noteNumber" : [1],
      "adjudication" : [{
        "category" : {
          "coding" : [{
            "code" : "eligible"
          }]
        },
        "amount" : {
          "value" : 100.00,
          "currency" : "USD"
        }
      },
      {
        "category" : {
          "coding" : [{
            "code" : "copay"
          }]
        },
        "amount" : {
          "value" : 20.00,
          "currency" : "USD"
        }
      },
      {
        "category" : {
          "coding" : [{
            "code" : "eligpercent"
          }]
        },
        "value" : 80.00
      },
      {
        "category" : {
          "coding" : [{
            "code" : "benefit"
          }]
        },
        "amount" : {
          "value" : 80.00,
          "currency" : "USD"
        }
      }]
    },
    {
      "detailSequence" : 2,
      "noteNumber" : [1],
      "adjudication" : [{
        "category" : {
          "coding" : [{
            "code" : "eligible"
          }]
        },
        "amount" : {
          "value" : 110.00,
          "currency" : "USD"
        }
      },
      {
        "category" : {
          "coding" : [{
            "code" : "eligpercent"
          }]
        },
        "value" : 80.00
      },
      {
        "category" : {
          "coding" : [{
            "code" : "benefit"
          }]
        },
        "amount" : {
          "value" : 88.00,
          "currency" : "USD"
        }
      }],
      "subDetail" : [{
        "subDetailSequence" : 1,
        "noteNumber" : [1],
        "adjudication" : [{
          "category" : {
            "coding" : [{
              "code" : "eligible"
            }]
          },
          "amount" : {
            "value" : 60.00,
            "currency" : "USD"
          }
        },

        {
          "type": "Library",
          "profile": "StructureDefinition/Library",
          "interaction": [
            {
              "code": "read",
              "documentation": "Read allows clients to get the logical definitions of the libraries"
            },
            {
              "code": "search-type",
              "documentation": "Search allows clients to filter libraries based on a provided search parameter"
            }
          ],
          "searchParam": [
            {
              "name": "description",
              "definition": "http://hl7.org/fhir/SearchParameter/Library-description",
              "type": "string"
            },
            {
              "name": "identifier",
              "definition": "http://hl7.org/fhir/SearchParameter/Library-identifier",
              "type": "token"
            },
            {
              "name": "status",
              "definition": "http://hl7.org/fhir/SearchParameter/Library-status",
              "type": "token"
            },
            {
              "name": "title",
              "definition": "http://hl7.org/fhir/SearchParameter/Library-title",
              "type": "string"
            },
            {
              "name": "topic",
              "definition": "http://hl7.org/fhir/SearchParameter/Library-topic",
              "type": "token"
            },
            {
              "name": "version",
              "definition": "http://hl7.org/fhir/SearchParameter/Library-version",
              "type": "string"
            },
            {
              "name": "composed-of",
              "definition": "http://hl7.org/fhir/SearchParameter/Library-composed-of",
              "type": "reference"
            },
            {
              "name": "depends-on",
              "definition": "http://hl7.org/fhir/SearchParameter/Library-depends-on",
              "type": "reference"
            },
            {
              "name": "derived-from",
              "definition": "http://hl7.org/fhir/SearchParameter/Library-derived-from",
              "type": "reference"
            },
            {
              "name": "predecessor",
              "definition": "http://hl7.org/fhir/SearchParameter/Library-predecessor",
              "type": "reference"
            },
            {
              "name": "successor",
              "definition": "http://hl7.org/fhir/SearchParameter/Library-successor",
              "type": "reference"
            }
          ]

          "category" : {
            "coding" : [{
              "code" : "eligpercent"
            }]
          },
          "value" : 80.00

        },
        {
          "type": "PlanDefinition",
          "profile": "StructureDefinition/PlanDefinition",
          "interaction": [
            {
              "code": "read",
              "documentation": "Read allows clients to get the logical definitions of the plan definitions"
            },
            {
              "code": "search-type",
              "documentation": "Search allows clients to filter plan definitions based on a provided search parameter"
            }
          ],
          "searchParam": [
            {
              "name": "description",
              "definition": "http://hl7.org/fhir/SearchParameter/PlanDefinition-description",
              "type": "string"
            },
            {
              "name": "identifier",
              "definition": "http://hl7.org/fhir/SearchParameter/PlanDefinition-identifier",
              "type": "token"
            },
            {
              "name": "status",
              "definition": "http://hl7.org/fhir/SearchParameter/PlanDefinition-status",
              "type": "token"
            },
            {
              "name": "title",
              "definition": "http://hl7.org/fhir/SearchParameter/PlanDefinition-title",
              "type": "string"
            },
            {
              "name": "topic",
              "definition": "http://hl7.org/fhir/SearchParameter/PlanDefinition-topic",
              "type": "token"
            },
            {
              "name": "version",
              "definition": "http://hl7.org/fhir/SearchParameter/PlanDefinition-version",
              "type": "string"
            },
            {
              "name": "composed-of",
              "definition": "http://hl7.org/fhir/SearchParameter/PlanDefinition-composed-of",
              "type": "reference"
            },
            {
              "name": "depends-on",
              "definition": "http://hl7.org/fhir/SearchParameter/PlanDefinition-depends-on",
              "type": "reference"
            },
            {
              "name": "derived-from",
              "definition": "http://hl7.org/fhir/SearchParameter/PlanDefinition-derived-from",
              "type": "reference"
            },
            {
              "name": "predecessor",
              "definition": "http://hl7.org/fhir/SearchParameter/PlanDefinition-predecessor",
              "type": "reference"
            },
            {
              "name": "successor",
              "definition": "http://hl7.org/fhir/SearchParameter/PlanDefinition-successor",
              "type": "reference"
            }
          ]

          "category" : {
            "coding" : [{
              "code" : "benefit"
            }]
          },
          "amount" : {
            "value" : 48.00,
            "currency" : "USD"
          }
        }]
      },
      {
        "subDetailSequence" : 2,
        "adjudication" : [{
          "category" : {
            "coding" : [{
              "code" : "eligible"
            }]
          },
          "amount" : {
            "value" : 30.00,
            "currency" : "USD"
          }

        },
        {
          "type": "ActivityDefinition",
          "profile": "StructureDefinition/ActivityDefinition",
          "interaction": [
            {
              "code": "read",
              "documentation": "Read allows clients to get the logical definitions of the activity definitions"
            },
            {
              "code": "search-type",
              "documentation": "Search allows clients to filter activity definitions based on a provided search parameter"
            }
          ],
          "searchParam": [
            {
              "name": "description",
              "definition": "http://hl7.org/fhir/SearchParameter/ActivityDefinition-description",
              "type": "string"
            },
            {
              "name": "identifier",
              "definition": "http://hl7.org/fhir/SearchParameter/ActivityDefinition-identifier",
              "type": "token"
            },
            {
              "name": "status",
              "definition": "http://hl7.org/fhir/SearchParameter/ActivityDefinition-status",
              "type": "token"
            },
            {
              "name": "title",
              "definition": "http://hl7.org/fhir/SearchParameter/ActivityDefinition-title",
              "type": "string"
            },
            {
              "name": "topic",
              "definition": "http://hl7.org/fhir/SearchParameter/ActivityDefinition-topic",
              "type": "token"
            },
            {
              "name": "version",
              "definition": "http://hl7.org/fhir/SearchParameter/ActivityDefinition-version",
              "type": "string"
            },
            {
              "name": "composed-of",
              "definition": "http://hl7.org/fhir/SearchParameter/ActivityDefinition-composed-of",
              "type": "reference"
            },
            {
              "name": "depends-on",
              "definition": "http://hl7.org/fhir/SearchParameter/ActivityDefinition-depends-on",
              "type": "reference"
            },
            {
              "name": "derived-from",
              "definition": "http://hl7.org/fhir/SearchParameter/ActivityDefinition-derived-from",
              "type": "reference"
            },
            {
              "name": "predecessor",
              "definition": "http://hl7.org/fhir/SearchParameter/ActivityDefinition-predecessor",
              "type": "reference"
            },
            {
              "name": "successor",
              "definition": "http://hl7.org/fhir/SearchParameter/ActivityDefinition-successor",
              "type": "reference"
            }
          ]

          "category" : {
            "coding" : [{
              "code" : "eligpercent"
            }]
          },
          "value" : 80.00

        },
        {
          "type": "Measure",
          "profile": "StructureDefinition/Measure",
          "interaction": [
            {
              "code": "read",
              "documentation": "Read allows clients to get the logical definitions of the measures"
            },
            {
              "code": "search-type",
              "documentation": "Search allows clients to filter measures based on a provided search parameter"
            }
          ],
          "searchParam": [
            {
              "name": "description",
              "definition": "http://hl7.org/fhir/SearchParameter/Measure-description",
              "type": "string"
            },
            {
              "name": "identifier",
              "definition": "http://hl7.org/fhir/SearchParameter/Measure-identifier",
              "type": "token"
            },
            {
              "name": "status",
              "definition": "http://hl7.org/fhir/SearchParameter/Measure-status",
              "type": "token"
            },
            {
              "name": "title",
              "definition": "http://hl7.org/fhir/SearchParameter/Measure-title",
              "type": "string"
            },
            {
              "name": "topic",
              "definition": "http://hl7.org/fhir/SearchParameter/Measure-topic",
              "type": "token"
            },
            {
              "name": "version",
              "definition": "http://hl7.org/fhir/SearchParameter/Measure-version",
              "type": "string"
            },
            {
              "name": "composed-of",
              "definition": "http://hl7.org/fhir/SearchParameter/Measure-composed-of",
              "type": "reference"
            },
            {
              "name": "depends-on",
              "definition": "http://hl7.org/fhir/SearchParameter/Measure-depends-on",
              "type": "reference"
            },
            {
              "name": "derived-from",
              "definition": "http://hl7.org/fhir/SearchParameter/Measure-derived-from",
              "type": "reference"
            },
            {
              "name": "predecessor",
              "definition": "http://hl7.org/fhir/SearchParameter/Measure-predecessor",
              "type": "reference"
            },
            {
              "name": "successor",
              "definition": "http://hl7.org/fhir/SearchParameter/Measure-successor",
              "type": "reference"
            }
          ]

          "category" : {
            "coding" : [{
              "code" : "benefit"
            }]
          },
          "amount" : {
            "value" : 24.00,
            "currency" : "USD"
          }
        }]
      },
      {
        "subDetailSequence" : 3,
        "noteNumber" : [1],
        "adjudication" : [{
          "category" : {
            "coding" : [{
              "code" : "eligible"
            }]
          },
          "amount" : {
            "value" : 10.00,
            "currency" : "USD"
          }

        },
        {
          "type": "Questionnaire",
          "profile": "StructureDefinition/Questionnaire",
          "interaction": [
            {
              "code": "read",
              "documentation": "Read allows clients to get the logical definitions of the measures"
            },
            {
              "code": "search-type",
              "documentation": "Search allows clients to filter measures based on a provided search parameter"
            }
          ],
          "searchParam": [
            {
              "name": "code",
              "definition": "http://hl7.org/fhir/SearchParameter/Questionnaire-code",
              "type": "token"
            },
            {
              "name": "context",
              "definition": "http://hl7.org/fhir/SearchParameter/Questionnaire-context",
              "type": "token"
            },
            {
              "name": "date",
              "definition": "http://hl7.org/fhir/SearchParameter/Questionnaire-date",
              "type": "date"
            },
            {
              "name": "identifier",
              "definition": "http://hl7.org/fhir/SearchParameter/Questionnaire-identifier",
              "type": "token"
            },
            {
              "name": "publisher",
              "definition": "http://hl7.org/fhir/SearchParameter/Questionnaire-publisher",
              "type": "string"
            },
            {
              "name": "status",
              "definition": "http://hl7.org/fhir/SearchParameter/Questionnaire-status",
              "type": "token"
            },
            {
              "name": "title",
              "definition": "http://hl7.org/fhir/SearchParameter/Questionnaire-title",
              "type": "string"
            },
            {
              "name": "version",
              "definition": "http://hl7.org/fhir/SearchParameter/Questionnaire-version",
              "type": "string"
            }
          ]
        }
      ],
      "operation": [

          "category" : {
            "coding" : [{
              "code" : "eligpercent"
            }]
          },
          "value" : 80.00
        },

        {
          "name": "data-requirements",
          "definition": "OperationDefinition/Library-data-requirements"

          "category" : {
            "coding" : [{
              "code" : "benefit"
            }]
          },
          "amount" : {
            "value" : 8.00,
            "currency" : "USD"
          }
        }]
      }]
    },
    {
      "detailSequence" : 3,
      "noteNumber" : [1],
      "adjudication" : [{
        "category" : {
          "coding" : [{
            "code" : "eligible"
          }]
        },
        "amount" : {
          "value" : 200.00,
          "currency" : "USD"

        }
      ]

      },
      {
        "category" : {
          "coding" : [{
            "code" : "eligpercent"
          }]
        },
        "value" : 80.00
      },
      {
        "category" : {
          "coding" : [{
            "code" : "benefit"
          }]
        },
        "amount" : {
          "value" : 14.00,
          "currency" : "USD"
        }
      }]
    }]
  }],
  "total" : [{
    "category" : {
      "coding" : [{
        "code" : "submitted"
      }]
    },
    "amount" : {
      "value" : 235.40,
      "currency" : "USD"

    }
  ]

  },
  {
    "category" : {
      "coding" : [{
        "code" : "benefit"
      }]
    },
    "amount" : {
      "value" : 182.00,
      "currency" : "USD"
    }
  }],
  "payment" : {
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/ex-paymenttype",
        "code" : "complete"
      }]
    },
    "adjustment" : {
      "value" : 75.00,
      "currency" : "USD"
    },
    "adjustmentReason" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/payment-adjustment-reason",
        "code" : "a002",
        "display" : "Prior Overpayment"
      }]
    },
    "date" : "2014-08-16",
    "amount" : {
      "value" : 107.00,
      "currency" : "USD"
    },
    "identifier" : {
      "system" : "http://thebenefitcompany.com/paymentidentifier",
      "value" : "201416-123456"
    }
  },
  "processNote" : [{
    "number" : 1,
    "type" : "display",
    "text" : "After hours surcharge declined",
    "language" : {
      "coding" : [{
        "system" : "urn:ietf:bcp:47",
        "code" : "en-CA"
      }]
    }
  }]

}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.