FHIR Implementation Guide for HCX
0.7.0 - CI Build
FHIR Implementation Guide for HCX
0.7.0 - CI Build
FHIR Implementation Guide for HCX - Local Development build (v0.7.0). See the Directory of published versions
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:ValueSet;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "claim-supporting-info-codes"];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "generated" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This value set contains 229 concepts</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>System</b></td><td><b>Display</b></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-1\"> </a> POI-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Aadhar Identity Card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-2\"> </a> POI-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Passport</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-3\"> </a> POI-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Driving License</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-4\"> </a> POI-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Election Commision's Voter ID card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-5\"> </a> POI-5</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Income Tax PAN Card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-6\"> </a> POI-6</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Photo Credit Card/ Debit card (with Photo)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-7\"> </a> POI-7</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>ECHS / CGHS Card having photo</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-8\"> </a> POI-8</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Domicile Certificate / Caste Certificate with photograph</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-9\"> </a> POI-9</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Current passbook of Post Office / Govt. /PSU Bank/private banks</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-10\"> </a> POI-10</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Student ID card of the Govt. recognized educational institutions with photograph on it.</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-11\"> </a> POI-11</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Ration Card with photograph & address. (Issued from Maharashtra state not valid )</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-12\"> </a> POI-12</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Smart Card issued by CSD, Defence / Paramilitary Forces</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-13\"> </a> POI-13</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Arms License</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-14\"> </a> POI-14</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Senior Citizen Card having photo issued by the Govt.</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-15\"> </a> POI-15</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Pensioners Card having photo issued by the Govt.</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-16\"> </a> POI-16</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>ID Card issued to Tibetan (Refugees) Citizens by State Govt. / Central Govt. of India having photo</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-17\"> </a> POI-17</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Defence Personnel - Armed Forces ;Certificate from Competent Unit Authority</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-18\"> </a> POI-18</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Certificate of Address having Photo, issued by MP/ MLA / Group A Gazetted Officer on letter head with seal</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-19\"> </a> POI-19</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Certificate of address with photo from Govt. recognized educational institution (for students only)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-20\"> </a> POI-20</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Certificate of Address having Photo, issued by Head of Village / Gram Panchayat or its equivalent Authority. (for Rural Areas)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-21\"> </a> POI-21</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Address Card with Photo issued by Dept. of Posts</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-23\"> </a> POI-23</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Freedom fighter card with photo</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POI-24\"> </a> POI-24</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Kissan Passbook with photo</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-1\"> </a> POA-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Aadhaar Identity Card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-2\"> </a> POA-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Attachment</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-3\"> </a> POA-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Passport</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-4\"> </a> POA-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Driving License (Issued from Maharashtra state not valid )</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-5\"> </a> POA-5</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Election Commission’s Voter ID Card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-6\"> </a> POA-6</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Vehicle Registration Certificate / Smart card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-7\"> </a> POA-7</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Water Bill with address</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-8\"> </a> POA-8</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Electricity Bill of Govt./private company (not older than 3 months)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-9\"> </a> POA-9</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Telephone Bill of a fixed line. (Any Service Provider)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-10\"> </a> POA-10</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Registered Sale/Lease (Rent) Agreement</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-11\"> </a> POA-11</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Credit card statement with address</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-12\"> </a> POA-12</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Ration Card with photograph. (Issued from Maharashtra state not valid )</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-13\"> </a> POA-13</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Certificate of address with photo from Govt. recognized educational institution (for students only)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-14\"> </a> POA-14</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Current passbook of Post Office / Govt./PSU/private banks with complete address</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-15\"> </a> POA-15</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>IT Assessment Order</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-16\"> </a> POA-16</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>ECHS / CGHS Card having photo & address</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-17\"> </a> POA-17</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Domicile Certificate / Caste Certificate with photograph & address</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-18\"> </a> POA-18</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Arms License</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-19\"> </a> POA-19</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Senior Citizen Card having photo & address issued by the Govt.</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-20\"> </a> POA-20</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Pensioners Card having photo & address issued by the Govt.</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-21\"> </a> POA-21</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>ID Card issued to Tibetan (Refugees) Citizens by State Govt. / Central Govt. of India having photo & address</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-22\"> </a> POA-22</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Defence Personnel – Armed Forces ;Certificate from Competent Unit Authority</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-23\"> </a> POA-23</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Certificate of Address having Photo, issued by MP/ MLA / Group A Gazetted Officer on letter head with seal</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-24\"> </a> POA-24</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Certificate of Address having Photo, issued by Head of Village / Gram Panchayat or its equivalent Authority. (for Rural Areas)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-25\"> </a> POA-25</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Address Card with Photo issued by Dept. of Posts</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-26\"> </a> POA-26</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Freedom fighter card with photo & address</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-27\"> </a> POA-27</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Kissan Passbook with photo & address</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POA-28\"> </a> POA-28</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Surrender ID Card (BLT etc.) issued by Govt. of India & signed by IGP of the state</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POR-1\"> </a> POR-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>PDS Card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POR-2\"> </a> POR-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>MNREGA Job Card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POR-3\"> </a> POR-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>CGHS/ State Government/ ECHS/ ESIC Medical card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POR-4\"> </a> POR-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Pension Card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POR-5\"> </a> POR-5</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Army Canteen Card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POR-6\"> </a> POR-6</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Passport</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POR-7\"> </a> POR-7</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Birth Certificate issued by Registrar of Birth, Municipal Corporation and other notified local government bodies like Taluk, Tehsil etc.</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POR-8\"> </a> POR-8</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Any other Central/ State government issued family entitlement document</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POR-9\"> </a> POR-9</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Marriage Certificate issued by the government</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POR-10\"> </a> POR-10</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Address card having name and photo issued by Department of Posts</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POR-11\"> </a> POR-11</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Bhamashah Card/Jan-Aadhaar card issued by Govt. of Rajasthan</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POR-12\"> </a> POR-12</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Discharge card/ slip issued by Government hospitals for birth of a child</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POR-13\"> </a> POR-13</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Certificate of Identity having photo issued by MP or MLA or MLC or Municipal Councillor or Gazetted Officer on UIDAI standard certificate format</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-POR-14\"> </a> POR-14</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Certificate of Identity having photo and relationship with HoF issued by Village Panchayat Head or Mukhiya or its equivalent authority (for rural areas)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DOB-1\"> </a> DOB-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Birth Certificate issued by Registrar of Birth, Municipal Corporation and other notified local government bodies like Taluk, Tehsil etc.</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DOB-2\"> </a> DOB-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>SSLC Book/ Certificate</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DOB-3\"> </a> DOB-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Passport</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DOB-4\"> </a> DOB-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Certificate of Date of Birth issued by Group A Gazetted Officer on UIDAI standard certificate format</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DOB-5\"> </a> DOB-5</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>A certificate (on UIDAI standard certificate format for enrolment/ update) or ID Card having photo and Date of Birth (DOB) duly signed and issued by a Government authority</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DOB-6\"> </a> DOB-6</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Photo ID card having Date of Birth, issued by Recognized Educational Institution</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DOB-7\"> </a> DOB-7</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>PAN Card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DOB-8\"> </a> DOB-8</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Marksheet issued by any Government Board or University</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DOB-9\"> </a> DOB-9</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Government Photo ID Card/ Photo Identity Card issued by PSU containing DOB</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DOB-10\"> </a> DOB-10</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Central/ State Pension Payment Order</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DOB-11\"> </a> DOB-11</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Central Government Health Service Scheme Photo Card or Ex-Servicemen Contributory Health Scheme Photo card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DOB-12\"> </a> DOB-12</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>School Leaving Certificate (SLC)/ School Transfer Certificate (TC), containing Name and Date of Birth</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DOB-13\"> </a> DOB-13</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Extract of School Records issued by Head of School containing Name, Date of Birth and Photograph</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DOB-14\"> </a> DOB-14</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Certificate of Identity containing Name, DOB and Photo issued by Recognized Educational Institution signed by Head of Institute on UIDAI standard certificate format</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DOB-15\"> </a> DOB-15</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Certificate of identity containing Name, DOB and Photograph issued by Employees’ Provident Fund Organisation (EPFO) on UIDAI standard certificate format</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-PHT-1\"> </a> PHT-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Photograph of self</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-PHT-2\"> </a> PHT-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Photograph of family</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-PHT-3\"> </a> PHT-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Photograph of dead person</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-PHT-4\"> </a> PHT-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Photograph (any other required for claims adjudication)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-BVC-1\"> </a> BVC-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>PMJAY Beneficiary Card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-BVC-2\"> </a> BVC-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Insurance Card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-BVC-3\"> </a> BVC-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Employment ID card (for corporate cases)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-BVC-4\"> </a> BVC-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>ESHS/ESI card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-BVC-5\"> </a> BVC-5</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Bhamashah Card or any other Insurance scheme card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DEF-1\"> </a> DEF-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Self signed declaration form</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DEF-2\"> </a> DEF-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Hospital stamped and signed hospital declaration form</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DEF-3\"> </a> DEF-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Any other consent form or miscellaneous declaration form</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-SIG-1\"> </a> SIG-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>self signature (wet signature) scanned copy</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-SIG-2\"> </a> SIG-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>hospital signature and stamp (scanned copy)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-FCF-1\"> </a> FCF-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>duly signed filled Preauthorization form (scan)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-FCF-2\"> </a> FCF-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>duly signed filled Claim form (scan)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CER\"> </a> CER</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Medical Certificate</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-MB-1\"> </a> MB-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Final Bill</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-MB-2\"> </a> MB-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Interim Bill</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-MB-3\"> </a> MB-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Estimate Bill</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DIA-1\"> </a> DIA-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Lab Investigation Report</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DIA-2\"> </a> DIA-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Radiology Report</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DIA-3\"> </a> DIA-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Imaging Report with studies</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DIA-4\"> </a> DIA-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Genetic Assessment Report</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-HDS-1\"> </a> HDS-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Discharge Summary Report</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-HDS-2\"> </a> HDS-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Death Summary Report</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-HDS-3\"> </a> HDS-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Discharge Summary with LAMA/DAMA</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-REF-1\"> </a> REF-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>CGHS Refferal Letter</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-REF-2\"> </a> REF-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>ECHS/ESI Doctor Referral Letter</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-REF-3\"> </a> REF-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Doctor Referral letter (to specialist)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-REF-4\"> </a> REF-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Upward Referral Letter (referral from HWC, SC, PHC,CHC to District Hospital)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-REF-5\"> </a> REF-5</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Downward Referral Letter (referral from higher facility to the original referee facility)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-REF-6\"> </a> REF-6</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Inter Hospital Referral Letter</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-REF-7\"> </a> REF-7</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Doctor Referral letter (to hospital)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DEL-1\"> </a> DEL-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Doctor signed treatment extension letter</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DEL-2\"> </a> DEL-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Doctor signed discharge extension letter</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DEL-3\"> </a> DEL-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>post discharge readmission request letter</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CD-1\"> </a> CD-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Doctor Prescription</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CD-2\"> </a> CD-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Consultation Summary Note</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CD-3\"> </a> CD-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Daily progress note</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CD-4\"> </a> CD-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Nursing notes</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CD-5\"> </a> CD-5</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>OT Surgery Notes</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CD-6\"> </a> CD-6</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Flowsheet</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CD-7\"> </a> CD-7</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>ICU monitoring reports with notes</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CD-8\"> </a> CD-8</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Medication Diapensation Notes</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CD-9\"> </a> CD-9</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>CarePlan</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CD-10\"> </a> CD-10</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Emergency Treatment Notes</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CD-11\"> </a> CD-11</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Bedside monitoring report</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CD-12\"> </a> CD-12</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Point of care testing report</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-EID-1\"> </a> EID-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Employment ID card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-EID-2\"> </a> EID-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>CGHS card or Pension document</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-EID-3\"> </a> EID-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>ECHS service card</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-FIR-1\"> </a> FIR-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>FIR report</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CIL-1\"> </a> CIL-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Preauthorization approval letter</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CIL-2\"> </a> CIL-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Claim approval letter</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CIL--3\"> </a> CIL- 3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Treatment Authorization latter from employer(for public and private sector employees,CGHS, ECHS employees)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DIS-1\"> </a> DIS-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>LAMA</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DIS-2\"> </a> DIS-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>DAMA</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DIS-3\"> </a> DIS-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Normal Discharge</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DIS-4\"> </a> DIS-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Death</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DIS-5\"> </a> DIS-5</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>DischargeToHome (Discharge disposition status)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DIS-6\"> </a> DIS-6</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>DischargetoMortuary(death disposition)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DIS-7\"> </a> DIS-7</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>DischargeToUnknownLocation</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DIS-8\"> </a> DIS-8</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>DischargeToDifferentState</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-DIS-9\"> </a> DIS-9</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>DischargeToDifferentCountry</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-ONS-1\"> </a> ONS-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Admission date -Discharge date</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-ONS-2\"> </a> ONS-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Discharge start-discharge end time</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-ONS-3\"> </a> ONS-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>PatientNormalRoom (start datetime- enddatetime)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-ONS-4\"> </a> ONS-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>PatientEmergencyRoom(start datetime-enddatetime)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-ONS-5\"> </a> ONS-5</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>PatientSurgeryPerformed(startdatetime-enddatetime)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-ONS-6\"> </a> ONS-6</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>PatientICUStay (startdatetime-enddatetime)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-REL-1\"> </a> REL-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>ProcedurePerformedDetail</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-REL-2\"> </a> REL-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>ProcedurePerformedDateTime</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-REL-3\"> </a> REL-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>ServiceRenderedDetail</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-REL-4\"> </a> REL-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>ServiceRenderedDateTime</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-REL-5\"> </a> REL-5</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>InvestigationPerformedDetail</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-REL-6\"> </a> REL-6</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>InvestigationPerformedDetailDateTime</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-EXC-1\"> </a> EXC-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>InsurancePolicyExclusions</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-EXC-2\"> </a> EXC-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>CostlyProcedureNotCoveredInPolicy</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-EXC-3\"> </a> EXC-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>ExpensiveMedicinesNotCoveredinPackage</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-EXC-4\"> </a> EXC-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>ConsummablesAndDisposiblesNotcoveredinPolicy</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-EMP-1\"> </a> EMP-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>EmploymentDetail</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-COI-1\"> </a> COI-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Cause of Injury or Accident</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-COI-2\"> </a> COI-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Patient Condition at time of admission after injury</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-COI-3\"> </a> COI-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Vehicle Acident detail</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-COI-4\"> </a> COI-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Fire Burns detail</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-COI-5\"> </a> COI-5</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Snake Bite detail</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-COI-6\"> </a> COI-6</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Electric Shock detail</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-COI--7\"> </a> COI -7</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Consumption of Poisonous substance detail(FIR Registered or not)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-COI-8\"> </a> COI-8</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Attack on human body detail (FIR Registered or not)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-COI-9\"> </a> COI-9</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>ImmediateTreatmentProvidedToPatientAfterAccident</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-COI-10\"> </a> COI-10</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>AnyPreviousClaimsDueToAccident (previous claim details)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-COI-11\"> </a> COI-11</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Date of Accident or Injury</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-COI-12\"> </a> COI-12</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Date-Time of Hospitalization Due to Accident</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-VRE-1\"> </a> VRE-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>EncounterDateTime</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-VRE-2\"> </a> VRE-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>EncounterType</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-VRE-3\"> </a> VRE-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>ReasonCodes (encounter reason)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-VRE-4\"> </a> VRE-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>EncounterOutcome</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CRD-1\"> </a> CRD-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Claim received date time</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CRD-2\"> </a> CRD-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>document details (submitted with claims)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-CRD-3\"> </a> CRD-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>courier number of claim reciept</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-IND-1\"> </a> IND-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>MLC Case (Boolean Y/N)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-IND-2\"> </a> IND-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>MultiPayorClaim (Boolean Y/N)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-IND-3\"> </a> IND-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Primary and Secondary Payor Details (in case of Multi Payor claims)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-IND-4\"> </a> IND-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>PrimaryorSecondaryClaim</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-IND-5\"> </a> IND-5</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Details of claim settled by primary payor (in case of secondary claims - attachment)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-IND-6\"> </a> IND-6</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>PMJAYInsurancePortabilityCase (Y/N) (treatment received in a different state)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-IND-7\"> </a> IND-7</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>PrimarySHADetails (SHA/TPA detail of state where PMJAY benefeciary belongs to)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-IND-8\"> </a> IND-8</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>SecondarySHADetails (SHA/TPA detail of state where benefeciary received treatment)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-IND-9\"> </a> IND-9</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>EmploymentImpacted (Y/N) for long disabilities)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-IND-10\"> </a> IND-10</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Employment impacted period (start date - end date)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-IND-11\"> </a> IND-11</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>HospitalizedIndicator (if patient was hospitalized or not - Y/N)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-MAT-1\"> </a> MAT-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Materials Forwarded</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-NMI-1\"> </a> NMI-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Claim query detail</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-TRD-1\"> </a> TRD-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Treatment detail</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-1\"> </a> INF-1</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>additional info related to claim ( conveying additional situation and condition information.)</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-2\"> </a> INF-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Family Physician Name</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-3\"> </a> INF-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Family Physician Contact</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-4\"> </a> INF-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Family Physician Number</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-5\"> </a> INF-5</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Insurance Number</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-6\"> </a> INF-6</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Insurance Company</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-7\"> </a> INF-7</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Employee ID</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-8\"> </a> INF-8</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Employer Name</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-9\"> </a> INF-9</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Hospital Name</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-10\"> </a> INF-10</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Rohini ID</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-11\"> </a> INF-11</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Email</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-11\"> </a> INF-11</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Name of Insurance Company</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-12\"> </a> INF-12</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Name of TPA</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-13\"> </a> INF-13</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Proposer Name</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-14\"> </a> INF-14</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Patient's Member ID</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-15\"> </a> INF-15</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Relation with Proposer</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-16\"> </a> INF-16</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Expected Date of Admission</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-17\"> </a> INF-17</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Policy Number</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-18\"> </a> INF-18</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Expected Date of Discharge</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-19\"> </a> INF-19</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Room category</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-20\"> </a> INF-20</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Eligible Room Category as per T&C of Policy Contract</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-21\"> </a> INF-21</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Provisional Diagnosis</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-22\"> </a> INF-22</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Proposed line of treatment</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-23\"> </a> INF-23</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Estimated Length of stay</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-TRD-2\"> </a> TRD-2</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Medical Management</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-TRD-3\"> </a> TRD-3</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Surgical Management</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-TRD-4\"> </a> TRD-4</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Intensive Care</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-TRD-5\"> </a> TRD-5</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Investigation</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-TRD-6\"> </a> TRD-6</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Non allopathic treatment</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-24\"> </a> INF-24</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Name of treating Doctor</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-25\"> </a> INF-25</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Qualitifcation</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-INF-26\"> </a> INF-26</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Registation Number</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-PoPr.locationPhoto\"> </a> PoPr.locationPhoto</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Photo of the location with subject</td></tr><tr><td style=\"white-space:nowrap\"><a name=\"http---hcxprotocol.io-codes-claim-supporting-info-codes-PoPr.deviceLocation\"> </a> PoPr.deviceLocation</td><td>http://hcxprotocol.io/codes/claim-supporting-info-codes</td><td>Real time geolocation from certified devices</td></tr></table></div>"
];
fhir:ValueSet.url [ fhir:value "https://ig.hcxprotocol.io/v0.7/ValueSet-claim-supporting-info-codes.html"];
fhir:ValueSet.version [ fhir:value "0.7.0"];
fhir:ValueSet.name [ fhir:value "ClaimSupportingInfoCodes"];
fhir:ValueSet.status [ fhir:value "active"];
fhir:ValueSet.date [ fhir:value "2022-08-01"^^xsd:date];
fhir:ValueSet.publisher [ fhir:value "HCX Open Community"];
fhir:ValueSet.contact [
fhir:index 0;
fhir:ContactDetail.name [ fhir:value "HCX Open Community" ];
fhir:ContactDetail.telecom [
fhir:index 0;
fhir:ContactPoint.system [ fhir:value "url" ];
fhir:ContactPoint.value [ fhir:value "http://hcxprotocol.io/" ] ]
];
fhir:ValueSet.description [ fhir:value "This is the value set for the codes of different supporting information that can be shared along with the submission of a claim"];
fhir:ValueSet.expansion [
fhir:ValueSet.expansion.timestamp [ fhir:value "2022-08-01T08:15:30+05:30"^^xsd:dateTime ];
fhir:ValueSet.expansion.contains [
fhir:index 0;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Aadhar Identity Card" ] ], [
fhir:index 1;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Passport" ] ], [
fhir:index 2;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Driving License" ] ], [
fhir:index 3;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Election Commision's Voter ID card" ] ], [
fhir:index 4;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-5" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Income Tax PAN Card" ] ], [
fhir:index 5;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-6" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Photo Credit Card/ Debit card (with Photo)" ] ], [
fhir:index 6;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-7" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "ECHS / CGHS Card having photo" ] ], [
fhir:index 7;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-8" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Domicile Certificate / Caste Certificate with photograph" ] ], [
fhir:index 8;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-9" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Current passbook of Post Office / Govt. /PSU Bank/private banks" ] ], [
fhir:index 9;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-10" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Student ID card of the Govt. recognized educational institutions with photograph on it." ] ], [
fhir:index 10;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-11" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Ration Card with photograph & address. (Issued from Maharashtra state not valid )" ] ], [
fhir:index 11;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-12" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Smart Card issued by CSD, Defence / Paramilitary Forces" ] ], [
fhir:index 12;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-13" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Arms License" ] ], [
fhir:index 13;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-14" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Senior Citizen Card having photo issued by the Govt." ] ], [
fhir:index 14;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-15" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Pensioners Card having photo issued by the Govt." ] ], [
fhir:index 15;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-16" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "ID Card issued to Tibetan (Refugees) Citizens by State Govt. / Central Govt. of India having photo" ] ], [
fhir:index 16;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-17" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Defence Personnel - Armed Forces ;Certificate from Competent Unit Authority" ] ], [
fhir:index 17;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-18" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Certificate of Address having Photo, issued by MP/ MLA / Group A Gazetted Officer on letter head with seal" ] ], [
fhir:index 18;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-19" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Certificate of address with photo from Govt. recognized educational institution (for students only)" ] ], [
fhir:index 19;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-20" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Certificate of Address having Photo, issued by Head of Village / Gram Panchayat or its equivalent Authority. (for Rural Areas)" ] ], [
fhir:index 20;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-21" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Address Card with Photo issued by Dept. of Posts" ] ], [
fhir:index 21;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-23" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Freedom fighter card with photo" ] ], [
fhir:index 22;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POI-24" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Kissan Passbook with photo" ] ], [
fhir:index 23;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Aadhaar Identity Card" ] ], [
fhir:index 24;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Attachment" ] ], [
fhir:index 25;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Passport" ] ], [
fhir:index 26;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Driving License (Issued from Maharashtra state not valid )" ] ], [
fhir:index 27;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-5" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Election Commission’s Voter ID Card" ] ], [
fhir:index 28;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-6" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Vehicle Registration Certificate / Smart card" ] ], [
fhir:index 29;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-7" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Water Bill with address" ] ], [
fhir:index 30;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-8" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Electricity Bill of Govt./private company (not older than 3 months)" ] ], [
fhir:index 31;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-9" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Telephone Bill of a fixed line. (Any Service Provider)" ] ], [
fhir:index 32;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-10" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Registered Sale/Lease (Rent) Agreement" ] ], [
fhir:index 33;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-11" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Credit card statement with address" ] ], [
fhir:index 34;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-12" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Ration Card with photograph. (Issued from Maharashtra state not valid )" ] ], [
fhir:index 35;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-13" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Certificate of address with photo from Govt. recognized educational institution (for students only)" ] ], [
fhir:index 36;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-14" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Current passbook of Post Office / Govt./PSU/private banks with complete address" ] ], [
fhir:index 37;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-15" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "IT Assessment Order" ] ], [
fhir:index 38;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-16" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "ECHS / CGHS Card having photo & address" ] ], [
fhir:index 39;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-17" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Domicile Certificate / Caste Certificate with photograph & address" ] ], [
fhir:index 40;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-18" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Arms License" ] ], [
fhir:index 41;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-19" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Senior Citizen Card having photo & address issued by the Govt." ] ], [
fhir:index 42;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-20" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Pensioners Card having photo & address issued by the Govt." ] ], [
fhir:index 43;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-21" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "ID Card issued to Tibetan (Refugees) Citizens by State Govt. / Central Govt. of India having photo & address" ] ], [
fhir:index 44;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-22" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Defence Personnel – Armed Forces ;Certificate from Competent Unit Authority" ] ], [
fhir:index 45;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-23" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Certificate of Address having Photo, issued by MP/ MLA / Group A Gazetted Officer on letter head with seal" ] ], [
fhir:index 46;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-24" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Certificate of Address having Photo, issued by Head of Village / Gram Panchayat or its equivalent Authority. (for Rural Areas)" ] ], [
fhir:index 47;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-25" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Address Card with Photo issued by Dept. of Posts" ] ], [
fhir:index 48;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-26" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Freedom fighter card with photo & address" ] ], [
fhir:index 49;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-27" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Kissan Passbook with photo & address" ] ], [
fhir:index 50;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POA-28" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Surrender ID Card (BLT etc.) issued by Govt. of India & signed by IGP of the state" ] ], [
fhir:index 51;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POR-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "PDS Card" ] ], [
fhir:index 52;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POR-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "MNREGA Job Card" ] ], [
fhir:index 53;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POR-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "CGHS/ State Government/ ECHS/ ESIC Medical card" ] ], [
fhir:index 54;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POR-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Pension Card" ] ], [
fhir:index 55;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POR-5" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Army Canteen Card" ] ], [
fhir:index 56;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POR-6" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Passport" ] ], [
fhir:index 57;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POR-7" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Birth Certificate issued by Registrar of Birth, Municipal Corporation and other notified local government bodies like Taluk, Tehsil etc." ] ], [
fhir:index 58;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POR-8" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Any other Central/ State government issued family entitlement document" ] ], [
fhir:index 59;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POR-9" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Marriage Certificate issued by the government" ] ], [
fhir:index 60;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POR-10" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Address card having name and photo issued by Department of Posts" ] ], [
fhir:index 61;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POR-11" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Bhamashah Card/Jan-Aadhaar card issued by Govt. of Rajasthan" ] ], [
fhir:index 62;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POR-12" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Discharge card/ slip issued by Government hospitals for birth of a child" ] ], [
fhir:index 63;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POR-13" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Certificate of Identity having photo issued by MP or MLA or MLC or Municipal Councillor or Gazetted Officer on UIDAI standard certificate format" ] ], [
fhir:index 64;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "POR-14" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Certificate of Identity having photo and relationship with HoF issued by Village Panchayat Head or Mukhiya or its equivalent authority (for rural areas)" ] ], [
fhir:index 65;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DOB-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Birth Certificate issued by Registrar of Birth, Municipal Corporation and other notified local government bodies like Taluk, Tehsil etc." ] ], [
fhir:index 66;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DOB-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "SSLC Book/ Certificate" ] ], [
fhir:index 67;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DOB-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Passport" ] ], [
fhir:index 68;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DOB-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Certificate of Date of Birth issued by Group A Gazetted Officer on UIDAI standard certificate format" ] ], [
fhir:index 69;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DOB-5" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "A certificate (on UIDAI standard certificate format for enrolment/ update) or ID Card having photo and Date of Birth (DOB) duly signed and issued by a Government authority" ] ], [
fhir:index 70;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DOB-6" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Photo ID card having Date of Birth, issued by Recognized Educational Institution" ] ], [
fhir:index 71;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DOB-7" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "PAN Card" ] ], [
fhir:index 72;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DOB-8" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Marksheet issued by any Government Board or University" ] ], [
fhir:index 73;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DOB-9" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Government Photo ID Card/ Photo Identity Card issued by PSU containing DOB" ] ], [
fhir:index 74;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DOB-10" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Central/ State Pension Payment Order" ] ], [
fhir:index 75;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DOB-11" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Central Government Health Service Scheme Photo Card or Ex-Servicemen Contributory Health Scheme Photo card" ] ], [
fhir:index 76;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DOB-12" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "School Leaving Certificate (SLC)/ School Transfer Certificate (TC), containing Name and Date of Birth" ] ], [
fhir:index 77;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DOB-13" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Extract of School Records issued by Head of School containing Name, Date of Birth and Photograph" ] ], [
fhir:index 78;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DOB-14" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Certificate of Identity containing Name, DOB and Photo issued by Recognized Educational Institution signed by Head of Institute on UIDAI standard certificate format" ] ], [
fhir:index 79;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DOB-15" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Certificate of identity containing Name, DOB and Photograph issued by Employees’ Provident Fund Organisation (EPFO) on UIDAI standard certificate format" ] ], [
fhir:index 80;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "PHT-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Photograph of self" ] ], [
fhir:index 81;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "PHT-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Photograph of family" ] ], [
fhir:index 82;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "PHT-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Photograph of dead person" ] ], [
fhir:index 83;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "PHT-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Photograph (any other required for claims adjudication)" ] ], [
fhir:index 84;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "BVC-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "PMJAY Beneficiary Card" ] ], [
fhir:index 85;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "BVC-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Insurance Card" ] ], [
fhir:index 86;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "BVC-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Employment ID card (for corporate cases)" ] ], [
fhir:index 87;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "BVC-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "ESHS/ESI card" ] ], [
fhir:index 88;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "BVC-5" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Bhamashah Card or any other Insurance scheme card" ] ], [
fhir:index 89;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DEF-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Self signed declaration form" ] ], [
fhir:index 90;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DEF-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Hospital stamped and signed hospital declaration form" ] ], [
fhir:index 91;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DEF-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Any other consent form or miscellaneous declaration form" ] ], [
fhir:index 92;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "SIG-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "self signature (wet signature) scanned copy" ] ], [
fhir:index 93;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "SIG-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "hospital signature and stamp (scanned copy)" ] ], [
fhir:index 94;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "FCF-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "duly signed filled Preauthorization form (scan)" ] ], [
fhir:index 95;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "FCF-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "duly signed filled Claim form (scan)" ] ], [
fhir:index 96;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CER" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Medical Certificate" ] ], [
fhir:index 97;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "MB-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Final Bill" ] ], [
fhir:index 98;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "MB-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Interim Bill" ] ], [
fhir:index 99;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "MB-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Estimate Bill" ] ], [
fhir:index 100;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DIA-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Lab Investigation Report" ] ], [
fhir:index 101;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DIA-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Radiology Report" ] ], [
fhir:index 102;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DIA-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Imaging Report with studies" ] ], [
fhir:index 103;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DIA-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Genetic Assessment Report" ] ], [
fhir:index 104;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "HDS-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Discharge Summary Report" ] ], [
fhir:index 105;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "HDS-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Death Summary Report" ] ], [
fhir:index 106;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "HDS-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Discharge Summary with LAMA/DAMA" ] ], [
fhir:index 107;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "REF-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "CGHS Refferal Letter" ] ], [
fhir:index 108;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "REF-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "ECHS/ESI Doctor Referral Letter" ] ], [
fhir:index 109;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "REF-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Doctor Referral letter (to specialist)" ] ], [
fhir:index 110;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "REF-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Upward Referral Letter (referral from HWC, SC, PHC,CHC to District Hospital)" ] ], [
fhir:index 111;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "REF-5" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Downward Referral Letter (referral from higher facility to the original referee facility)" ] ], [
fhir:index 112;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "REF-6" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Inter Hospital Referral Letter" ] ], [
fhir:index 113;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "REF-7" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Doctor Referral letter (to hospital)" ] ], [
fhir:index 114;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DEL-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Doctor signed treatment extension letter" ] ], [
fhir:index 115;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DEL-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Doctor signed discharge extension letter" ] ], [
fhir:index 116;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DEL-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "post discharge readmission request letter" ] ], [
fhir:index 117;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CD-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Doctor Prescription" ] ], [
fhir:index 118;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CD-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Consultation Summary Note" ] ], [
fhir:index 119;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CD-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Daily progress note" ] ], [
fhir:index 120;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CD-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Nursing notes" ] ], [
fhir:index 121;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CD-5" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "OT Surgery Notes" ] ], [
fhir:index 122;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CD-6" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Flowsheet" ] ], [
fhir:index 123;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CD-7" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "ICU monitoring reports with notes" ] ], [
fhir:index 124;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CD-8" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Medication Diapensation Notes" ] ], [
fhir:index 125;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CD-9" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "CarePlan" ] ], [
fhir:index 126;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CD-10" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Emergency Treatment Notes" ] ], [
fhir:index 127;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CD-11" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Bedside monitoring report" ] ], [
fhir:index 128;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CD-12" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Point of care testing report" ] ], [
fhir:index 129;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "EID-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Employment ID card" ] ], [
fhir:index 130;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "EID-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "CGHS card or Pension document" ] ], [
fhir:index 131;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "EID-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "ECHS service card" ] ], [
fhir:index 132;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "FIR-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "FIR report" ] ], [
fhir:index 133;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CIL-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Preauthorization approval letter" ] ], [
fhir:index 134;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CIL-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Claim approval letter" ] ], [
fhir:index 135;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CIL- 3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Treatment Authorization latter from employer(for public and private sector employees,CGHS, ECHS employees)" ] ], [
fhir:index 136;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DIS-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "LAMA" ] ], [
fhir:index 137;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DIS-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "DAMA" ] ], [
fhir:index 138;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DIS-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Normal Discharge" ] ], [
fhir:index 139;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DIS-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Death" ] ], [
fhir:index 140;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DIS-5" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "DischargeToHome (Discharge disposition status)" ] ], [
fhir:index 141;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DIS-6" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "DischargetoMortuary(death disposition)" ] ], [
fhir:index 142;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DIS-7" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "DischargeToUnknownLocation" ] ], [
fhir:index 143;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DIS-8" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "DischargeToDifferentState" ] ], [
fhir:index 144;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "DIS-9" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "DischargeToDifferentCountry" ] ], [
fhir:index 145;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "ONS-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Admission date -Discharge date" ] ], [
fhir:index 146;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "ONS-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Discharge start-discharge end time" ] ], [
fhir:index 147;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "ONS-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "PatientNormalRoom (start datetime- enddatetime)" ] ], [
fhir:index 148;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "ONS-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "PatientEmergencyRoom(start datetime-enddatetime)" ] ], [
fhir:index 149;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "ONS-5" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "PatientSurgeryPerformed(startdatetime-enddatetime)" ] ], [
fhir:index 150;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "ONS-6" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "PatientICUStay (startdatetime-enddatetime)" ] ], [
fhir:index 151;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "REL-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "ProcedurePerformedDetail" ] ], [
fhir:index 152;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "REL-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "ProcedurePerformedDateTime" ] ], [
fhir:index 153;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "REL-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "ServiceRenderedDetail" ] ], [
fhir:index 154;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "REL-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "ServiceRenderedDateTime" ] ], [
fhir:index 155;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "REL-5" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "InvestigationPerformedDetail" ] ], [
fhir:index 156;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "REL-6" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "InvestigationPerformedDetailDateTime" ] ], [
fhir:index 157;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "EXC-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "InsurancePolicyExclusions" ] ], [
fhir:index 158;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "EXC-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "CostlyProcedureNotCoveredInPolicy" ] ], [
fhir:index 159;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "EXC-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "ExpensiveMedicinesNotCoveredinPackage" ] ], [
fhir:index 160;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "EXC-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "ConsummablesAndDisposiblesNotcoveredinPolicy" ] ], [
fhir:index 161;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "EMP-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "EmploymentDetail" ] ], [
fhir:index 162;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "COI-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Cause of Injury or Accident" ] ], [
fhir:index 163;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "COI-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Patient Condition at time of admission after injury" ] ], [
fhir:index 164;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "COI-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Vehicle Acident detail" ] ], [
fhir:index 165;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "COI-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Fire Burns detail" ] ], [
fhir:index 166;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "COI-5" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Snake Bite detail" ] ], [
fhir:index 167;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "COI-6" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Electric Shock detail" ] ], [
fhir:index 168;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "COI -7" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Consumption of Poisonous substance detail(FIR Registered or not)" ] ], [
fhir:index 169;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "COI-8" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Attack on human body detail (FIR Registered or not)" ] ], [
fhir:index 170;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "COI-9" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "ImmediateTreatmentProvidedToPatientAfterAccident" ] ], [
fhir:index 171;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "COI-10" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "AnyPreviousClaimsDueToAccident (previous claim details)" ] ], [
fhir:index 172;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "COI-11" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Date of Accident or Injury" ] ], [
fhir:index 173;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "COI-12" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Date-Time of Hospitalization Due to Accident" ] ], [
fhir:index 174;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "VRE-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "EncounterDateTime" ] ], [
fhir:index 175;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "VRE-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "EncounterType" ] ], [
fhir:index 176;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "VRE-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "ReasonCodes (encounter reason)" ] ], [
fhir:index 177;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "VRE-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "EncounterOutcome" ] ], [
fhir:index 178;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CRD-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Claim received date time" ] ], [
fhir:index 179;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CRD-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "document details (submitted with claims)" ] ], [
fhir:index 180;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "CRD-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "courier number of claim reciept" ] ], [
fhir:index 181;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "IND-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "MLC Case (Boolean Y/N)" ] ], [
fhir:index 182;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "IND-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "MultiPayorClaim (Boolean Y/N)" ] ], [
fhir:index 183;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "IND-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Primary and Secondary Payor Details (in case of Multi Payor claims)" ] ], [
fhir:index 184;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "IND-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "PrimaryorSecondaryClaim" ] ], [
fhir:index 185;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "IND-5" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Details of claim settled by primary payor (in case of secondary claims - attachment)" ] ], [
fhir:index 186;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "IND-6" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "PMJAYInsurancePortabilityCase (Y/N) (treatment received in a different state)" ] ], [
fhir:index 187;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "IND-7" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "PrimarySHADetails (SHA/TPA detail of state where PMJAY benefeciary belongs to)" ] ], [
fhir:index 188;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "IND-8" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "SecondarySHADetails (SHA/TPA detail of state where benefeciary received treatment)" ] ], [
fhir:index 189;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "IND-9" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "EmploymentImpacted (Y/N) for long disabilities)" ] ], [
fhir:index 190;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "IND-10" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Employment impacted period (start date - end date)" ] ], [
fhir:index 191;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "IND-11" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "HospitalizedIndicator (if patient was hospitalized or not - Y/N)" ] ], [
fhir:index 192;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "MAT-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Materials Forwarded" ] ], [
fhir:index 193;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "NMI-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Claim query detail" ] ], [
fhir:index 194;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "TRD-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Treatment detail" ] ], [
fhir:index 195;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-1" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "additional info related to claim ( conveying additional situation and condition information.)" ] ], [
fhir:index 196;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Family Physician Name" ] ], [
fhir:index 197;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Family Physician Contact" ] ], [
fhir:index 198;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Family Physician Number" ] ], [
fhir:index 199;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-5" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Insurance Number" ] ], [
fhir:index 200;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-6" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Insurance Company" ] ], [
fhir:index 201;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-7" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Employee ID" ] ], [
fhir:index 202;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-8" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Employer Name" ] ], [
fhir:index 203;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-9" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Hospital Name" ] ], [
fhir:index 204;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-10" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Rohini ID" ] ], [
fhir:index 205;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-11" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Email" ] ], [
fhir:index 206;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-11" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Name of Insurance Company" ] ], [
fhir:index 207;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-12" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Name of TPA" ] ], [
fhir:index 208;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-13" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Proposer Name" ] ], [
fhir:index 209;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-14" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Patient's Member ID" ] ], [
fhir:index 210;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-15" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Relation with Proposer" ] ], [
fhir:index 211;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-16" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Expected Date of Admission" ] ], [
fhir:index 212;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-17" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Policy Number" ] ], [
fhir:index 213;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-18" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Expected Date of Discharge" ] ], [
fhir:index 214;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-19" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Room category" ] ], [
fhir:index 215;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-20" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Eligible Room Category as per T&C of Policy Contract" ] ], [
fhir:index 216;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-21" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Provisional Diagnosis" ] ], [
fhir:index 217;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-22" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Proposed line of treatment" ] ], [
fhir:index 218;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-23" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Estimated Length of stay" ] ], [
fhir:index 219;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "TRD-2" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Medical Management" ] ], [
fhir:index 220;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "TRD-3" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Surgical Management" ] ], [
fhir:index 221;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "TRD-4" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Intensive Care" ] ], [
fhir:index 222;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "TRD-5" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Investigation" ] ], [
fhir:index 223;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "TRD-6" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Non allopathic treatment" ] ], [
fhir:index 224;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-24" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Name of treating Doctor" ] ], [
fhir:index 225;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-25" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Qualitifcation" ] ], [
fhir:index 226;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "INF-26" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Registation Number" ] ], [
fhir:index 227;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "PoPr.locationPhoto" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Photo of the location with subject" ] ], [
fhir:index 228;
fhir:ValueSet.expansion.contains.system [ fhir:value "http://hcxprotocol.io/codes/claim-supporting-info-codes" ];
fhir:ValueSet.expansion.contains.code [ fhir:value "PoPr.deviceLocation" ];
fhir:ValueSet.expansion.contains.display [ fhir:value "Real time geolocation from certified devices" ] ]
].
# - ontology header ------------------------------------------------------------
a owl:Ontology;
owl:imports fhir:fhir.ttl.
IG © 2021+ HCX Open Community. Package hcxprotocol.io#0.7.0 based on FHIR 4.0.1. Generated 2022-11-04
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