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

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Hồ sơ tài nguyên: Yêu cầu bảng kê chi phí KCB chi tiết — VN Core Itemized Healthcare Cost Claim

Profile Claim dẫn xuất cho bảng kê chi phí khám bệnh, chữa bệnh chi tiết gồm 13 cột và hỗ trợ nhiều giai đoạn hưởng trong cùng một đợt KCB, kể cả một thẻ BHYT đổi mức hưởng. Mỗi item liên kết tường minh với một benefit stage và phân bổ thành tiền bệnh viện vào bốn nguồn thanh toán. Dòng chi tiết bên trong gói thiết bị được biểu diễn bằng item.detail; theo ngoại lệ của văn bản, allocation chỉ bắt buộc ở item tổng gói, không bắt buộc ở detail. Căn cứ: [QĐ 697/QĐ-BYT] (ban hành 19/03/2026, hiệu lực 19/03/2026) — Mẫu bảng kê chi phí KCB; [NĐ 188/2025/NĐ-CP] (ban hành 01/07/2025, hiệu lực 15/08/2025) — Hướng dẫn thi hành Luật BHYT.

This derived Claim profile represents the 13-column itemized healthcare-cost statement and supports multiple benefit stages within one episode, including a benefit-level change on the same BHYT coverage. Every item explicitly identifies its benefit stage and allocates the hospital line amount across four payment sources. Detail rows inside a medical-device package are represented by item.detail; under the legal exception, allocation is required only at the package item level and not on detail rows.

Usages:

• Examples for this Profile: Claim/ExampleClaimItemizedMultiStage

You can also check for usages in the FHIR IG Statistics

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Mô tả profile, differential, snapshot và các biểu diễn liên quan.

• Bảng phần tử chính
• Bảng Differential
• Bảng Snapshot
• Thống kê/Tham chiếu
• Tất cả

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Claim	C	0..*	VNCoreClaim	Claim, Pre-determination or Pre-authorization Constraints: vn-claim-single-focal-insurance, vn-claim-coverage-not-expired, vn-itemized-claim-stage-sequence-unique, vn-itemized-claim-coverage-reference-distinct, vn-itemized-claim-single-focal-insurance, vn-itemized-claim-item-stage-exists, vn-itemized-claim-money-vnd, vn-itemized-claim-total-sum
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:costSummary	S	0..1	(Complex)	Tổng chi phí theo nhóm: thuốc, VTYT, BHYT, tự trả, cùng chi trả, nguồn khác URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary
extension:paymentPeriod		0..1	(Complex)	Kỳ thanh toán BHYT (năm/tháng) — NAM_QT, THANG_QT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
extension:paymentMethod		0..1	CodeableConcept	Phương thức thanh toán (FFS/Capitation/DRG) — MA_PTTT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method Binding: Phương thức thanh toán BHYT — VN Payment Method ValueSet (extensible)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	S	1..*	Identifier	Định danh hồ sơ thanh toán, bao gồm MA_LK Slice: Unordered, Open by value:system
identifier:MALK	S	1..1	Identifier	Mã liên kết hồ sơ (MA_LK)
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-identifier-type-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MA_LK
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://fhir.hl7.org.vn/core/sid/ma-lk
value	SΣ	1..1	string	Giá trị MA_LK Example General: 123456
status	?!SΣ	1..1	code	Trạng thái yêu cầu thanh toán Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	SΣ	1..1	CodeableConcept	Loại yêu cầu: institutional (nội trú), professional (ngoại trú) Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
subType	S	0..1	CodeableConcept	Mã đối tượng đến KCB (MA_DOITUONG_KCB theo QĐ 3276/QĐ-BYT) Binding: Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet (extensible)
use	SΣ	1..1	code	Mục đích: claim (thanh toán) | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
patient	SΣ	1..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile)	Bệnh nhân (XML 3176: MA_BN)
created	SΣ	1..1	dateTime	Ngày tạo yêu cầu
insurer	SΣ	0..1	Reference(Organization)	Cơ quan BHXH thanh toán
provider	SΣ	1..1	Reference(Cơ sở y tế VN Core — VN Core Organization Profile | Nhân viên y tế VN Core — VN Core Practitioner Profile | Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile)	Cơ sở KCB thực hiện (XML 3176: MA_CSKCB)
priority	Σ	1..1	CodeableConcept	Mức ưu tiên xử lý Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
diagnosis	S	1..*	BackboneElement	Chẩn đoán — ICD-10 VN (XML 3176: MA_BENH, MA_BENHKHAC)
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	S	1..1	positiveInt	Diagnosis instance identifier
Slices for diagnosis[x]		1..1		Nature of illness or problem Slice: Unordered, Open by type:$this Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.
diagnosisCodeableConcept			CodeableConcept
diagnosisReference			Reference(Condition)
diagnosis[x]:diagnosisCodeableConcept	S	0..1	CodeableConcept	Mã bệnh ICD-10 VN (QĐ 4469/QĐ-BYT) Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
type	S	0..*	CodeableConcept	Loại chẩn đoán (chính/phụ) Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
insurance	SΣ	1..*	BackboneElement	Các Coverage thực tham gia COB và các giai đoạn hưởng — Real Coverages in COB with their benefit stages
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:benefitStage	SC	1..*	(Complex)	Sequence, period và mức hưởng của giai đoạn — Stage sequence, period, and benefit level URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage Constraints: vn-coverage-benefit-stage-level-range
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	SΣ	1..1	positiveInt	Thứ tự phối hợp quyền lợi (COB), không phải sequence giai đoạn — Coordination-of-benefits order, not a stage sequence
focal	SΣ	1..1	boolean	Coverage to be used for adjudication
coverage	SΣ	1..1	Reference(Thẻ BHYT VN Core — VN Core Coverage Profile)	Thẻ BHYT (Coverage)
item	SC	1..*	BackboneElement	Dòng tổng hợp chịu phân bổ; chi tiết gói TBYT nằm ở detail — Allocated summary line; device-package components use detail Constraints: vn-itemized-claim-serviced-in-stage, vn-itemized-claim-line-allocation-sum, vn-itemized-claim-insured-fields-required, vn-itemized-claim-detail-insured-fields-required, vn-itemized-claim-benefit-level-matches-stage, vn-itemized-claim-other-fund-breakdown-sum
Slices for extension		3..*	Extension	Extension Slice: Unordered, Open by value:url
extension:department		0..1	CodeableConcept	Khoa thực hiện (MA_KHOA) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-item-department Binding: Danh mục mã khoa — Vietnam Department ValueSet (extensible)
extension:deviceGroup		0..1	CodeableConcept	Nhóm TBYT BHYT N01-N09 cho dòng chi phí thiết bị/vật tư URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-device-group Binding: Nhóm thiết bị y tế theo danh mục BHYT — VN Device Group VS (extensible)
extension:deviceInsuranceScope		0..1	CodeableConcept	Legacy PHAM_VI cho dòng TBYT; dữ liệu mới ưu tiên insuranceCostInfo.scope URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-device-insurance-scope Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:insuranceCostInfo	S	1..1	(Complex)	Các cột đơn giá/tỷ lệ/thành tiền BHYT — BHYT price, ratio, and eligible-amount columns URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
Slices for extension				Content/Rules for all slices
extension:scope		0..1	Extension	Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"scope"
value[x]		1..1	CodeableConcept	Value of extension Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:paymentRatio		0..1	Extension	Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentRatio"
value[x]		1..1	decimal	Value of extension
extension:benefitLevel		0..1	Extension	Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"benefitLevel"
value[x]		1..1	decimal	Value of extension
extension:paymentCeiling		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentCeiling"
value[x]		1..1	Money	Trần thanh toán BHYT (VND)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:servicePaymentRatio		0..1	Extension	Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"servicePaymentRatio"
value[x]		1..1	decimal	Value of extension
extension:insuranceUnitPrice		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceUnitPrice"
value[x]		1..1	Money	Đơn giá BHYT thanh toán (VND)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceLineAmount"
value[x]		1..1	Money	Thành tiền BH đủ điều kiện (VND) — Eligible insurance line amount
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
url		1..1	uri	"http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
extension:otherFundBreakdown	C	0..1	(Complex)	Chi tiết nguồn khác chi trả theo dòng: NSNN/VTNN/VTTN/CL (T_NGUONKHAC_*) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown Constraints: vn-other-fund-breakdown-money-vnd-value
extension:anesthesiaMethod		0..1	CodeableConcept	Phương pháp vô cảm dòng DVKT (PP_VO_CAM) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-anesthesia-method Binding: Phương pháp vô cảm — Vietnam Anesthesia Method ValueSet (required)
extension:paymentSource		0..1	CodeableConcept	Nguồn chi trả dòng chi phí (NGUON_CTRA) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-source Binding: Nguồn chi trả — Vietnam Payment Source ValueSet (extensible)
extension:recurrentWoundBenefit		0..1	boolean	Flag VET_THUONG_TP cho dòng thuốc/DVKT/VTYT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-recurrent-wound-benefit
extension:tenderInfo		0..1	string	Thông tin thầu dòng chi phí (TT_THAU) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-tender-info
extension:processingMethod		0..1	CodeableConcept	Phương pháp chế biến YHCT (MA_PP_CHEBIEN) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-traditional-processing-method Binding: Phương pháp chế biến vị thuốc cổ truyền — VN Traditional Medicine Processing Method ValueSet (extensible)
extension:benefitStageSequence	S	1..1	positiveInt	Sequence giai đoạn hưởng của dòng — Line benefit-stage sequence URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence
extension:linePaymentAllocation	S	1..1	(Complex)	Bốn nguồn thanh toán cột 10–13 — Four payment sources in columns 10–13 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	S	1..1	positiveInt	Item instance identifier
category	S	1..1	CodeableConcept	Nhóm chi phí QĐ 697/QĐ-BYT — QĐ 697/QĐ-BYT cost category Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (required)
productOrService	S	1..1	CodeableConcept	Mã dịch vụ/thuốc/TBYT Binding: USCLSCodes (example): Allowable service and product codes.
serviced[x]	S	1..1		Ngày/khoảng thực hiện trong giai đoạn hưởng — Service date/period within the benefit stage
servicedDate			date
servicedPeriod			Period
quantity	S	1..1	SimpleQuantity(4.0.1)	Số lượng của dòng — Line quantity
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unitPrice	S	1..1	Money	Đơn giá bệnh viện, VND — Hospital unit price in VND
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
net	S	1..1	Money	Thành tiền bệnh viện, bằng tổng bốn nguồn — Hospital line amount equal to four-source allocation
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
detail		0..*	BackboneElement	Chi tiết cấu thành gói TBYT; không bắt buộc allocation — Device-package components without required allocation
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:insuranceCostInfo	S	1..1	(Complex)	Cột 5/6/8/9 của component gói TBYT — Device-package component columns 5/6/8/9 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
Slices for extension				Content/Rules for all slices
extension:scope		0..1	Extension	Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"scope"
value[x]		1..1	CodeableConcept	Value of extension Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:paymentRatio		0..1	Extension	Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentRatio"
value[x]		1..1	decimal	Value of extension
extension:benefitLevel		0..1	Extension	Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"benefitLevel"
value[x]		1..1	decimal	Value of extension
extension:paymentCeiling		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentCeiling"
value[x]		1..1	Money	Trần thanh toán BHYT (VND)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:servicePaymentRatio		0..1	Extension	Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"servicePaymentRatio"
value[x]		1..1	decimal	Value of extension
extension:insuranceUnitPrice		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceUnitPrice"
value[x]		1..1	Money	Đơn giá BHYT thanh toán (VND)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceLineAmount"
value[x]		1..1	Money	Thành tiền BH đủ điều kiện (VND) — Eligible insurance line amount
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
url		1..1	uri	"http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
productOrService	S	1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
quantity	S	1..1	SimpleQuantity(4.0.1)	Count of products or services
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unitPrice	S	1..1	Money	Fee, charge or cost per item
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
net	S	1..1	Money	Total item cost
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total	S	1..1	Money	Tổng thành tiền của tất cả dòng — Sum of all item net amounts
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Claim.identifier:MALK.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Claim.identifier:MALK.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Claim.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Claim.type	Base	extensible	Claim Type Codes	📍4.0.1	FHIR Std.
Claim.subType	Base	extensible	Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet	📦0.9.0	This IG
Claim.use	Base	required	Use	📍4.0.1	FHIR Std.
Claim.priority	Base	example	Process Priority Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.diagnosis[x]	Base	example	ICD-10 Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.diagnosis[x]:diagnosisCodeableConcept	Base	extensible	Mã chẩn đoán — VN Core Condition Code ValueSet	📦0.9.0	This IG
Claim.diagnosis.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.item.extension:insuranceCostInfo.​extension:scope.value[x]	Base	extensible	Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet	📦0.9.0	This IG
Claim.item.extension:insuranceCostInfo.​extension:paymentCeiling.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.extension:insuranceCostInfo.​extension:insuranceUnitPrice.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.extension:insuranceCostInfo.​extension:insuranceLineAmount.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.category	Base	required	Danh mục chi phí KCB — Vietnam Cost Category ValueSet	📦0.9.0	This IG
Claim.item.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item.unitPrice.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.net.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.extension:insuranceCostInfo.​extension:scope.value[x]	Base	extensible	Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet	📦0.9.0	This IG
Claim.item.detail.extension:insuranceCostInfo.​extension:paymentCeiling.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.extension:insuranceCostInfo.​extension:insuranceUnitPrice.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.extension:insuranceCostInfo.​extension:insuranceLineAmount.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item.detail.unitPrice.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.net.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.total.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Claim	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Claim	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Claim	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Claim	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Claim	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
vn-claim-coverage-not-expired	warning	Claim	Cảnh báo: thẻ BHYT focal có thể đã hết hạn tại thời điểm tạo Claim — theo NĐ 188/2025/NĐ-CP ban hành 01/07/2025, hiệu lực 15/08/2025, Đ15	insurance.where(focal = true).coverage.resolve().period.end.all($this >= %resource.created)
vn-claim-single-focal-insurance	error	Claim	Phải có đúng 1 thẻ BHYT chính (focal=true). Các thẻ bổ trợ dùng focal=false — theo QĐ 697/QĐ-BYT ngày 19/03/2026 cột 13, NĐ 188/2025/NĐ-CP ban hành 01/07/2025, hiệu lực 15/08/2025, Đ22; sai hồ sơ/chứng từ BHYT có thể bị xử phạt theo NĐ 90/2026/NĐ-CP (ban hành 30/03/2026, hiệu lực 15/05/2026 — đang áp dụng)	insurance.where(focal = true).count() = 1
vn-coverage-benefit-stage-level-range	error	Claim.insurance.extension:benefitStage	Mức hưởng của giai đoạn phải nằm trong khoảng từ 0 đến 100 phần trăm. The benefit level for a coverage stage SHALL be between 0 and 100 percent.	extension('benefitLevel').value >= 0 and extension('benefitLevel').value <= 100
vn-itemized-claim-benefit-level-matches-stage	error	Claim.item	Mức hưởng trên dòng, nếu có, phải bằng mức hưởng của benefit stage được dòng tham chiếu. An item's benefit level, when present, SHALL equal the benefit level of its referenced stage.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value.exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value = %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('benefitLevel').value
vn-itemized-claim-coverage-reference-distinct	error	Claim	Mỗi Coverage chỉ được xuất hiện một lần trong Claim bảng kê. Every Coverage SHALL appear only once in the itemized Claim.	insurance.coverage.reference.isDistinct()
vn-itemized-claim-detail-insured-fields-required	error	Claim.item	Khi quỹ BHYT thanh toán item có detail, mọi detail phải có tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện. When the BHYT fund pays an item containing details, every detail SHALL carry its BHYT payment ratio and eligible insurance line amount.	(detail.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.ofType(Money).value > 0) implies detail.all(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-claim-insured-fields-required	error	Claim.item	Khi quỹ BHYT thanh toán một dòng, tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện phải có. When the BHYT fund pays a line, its BHYT payment ratio and eligible insurance line amount SHALL be present.	(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.ofType(Money).value > 0) implies (extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-claim-item-stage-exists	error	Claim	Mỗi dòng chi phí phải tham chiếu một sequence giai đoạn hưởng tồn tại trên insurance. Every cost line SHALL reference a benefit-stage sequence declared on insurance.	item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value.all($this in %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value)
vn-itemized-claim-line-allocation-sum	error	Claim.item	Thành tiền bệnh viện của dòng (cột 7) phải bằng tổng quỹ BHYT, người bệnh cùng trả, nguồn khác và người bệnh tự trả (cột 10+11+12+13). The line net amount (column 7) SHALL equal the sum of the four payment allocations (columns 10+11+12+13).	net.value = extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('patientCopay').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('otherSource').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('patientSelfPay').value.value
vn-itemized-claim-money-vnd	error	Claim	Mọi giá trị tiền tệ của ledger bảng kê phải dùng VND. Every monetary value in the itemized-claim ledger SHALL use VND.	item.unitPrice.currency.all($this = 'VND') and item.net.currency.all($this = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension.value.ofType(Money).all(currency = 'VND') and item.detail.unitPrice.currency.all($this = 'VND') and item.detail.net.currency.all($this = 'VND') and item.detail.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and total.currency.all($this = 'VND')
vn-itemized-claim-other-fund-breakdown-sum	error	Claim.item	Khi có chi tiết nguồn khác, tổng các thành phần phải bằng khoản otherSource trong phân bổ dòng. When an other-fund breakdown is present, its components SHALL sum to the line's otherSource allocation.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').extension.value.ofType(Money).value.aggregate($this + $total, 0) = extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('otherSource').value.ofType(Money).value
vn-itemized-claim-serviced-in-stage	error	Claim.item	Ngày hoặc khoảng thời gian thực hiện dòng chi phí phải nằm trong period của giai đoạn hưởng được tham chiếu; Period phải có cả start và end. Gateway vẫn phải kiểm tra lại tương quan này trước khi gửi do khác biệt giữa các validator FHIRPath R4. The service date or period SHALL fall within the referenced benefit-stage period, and a serviced Period SHALL contain both start and end. The submission gateway SHALL still repeat this correlation check because R4 FHIRPath validators differ.	(serviced.ofType(date).exists() implies (serviced.ofType(date) >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(date) <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end)) and (serviced.ofType(Period).exists() implies (serviced.ofType(Period).start.exists() and serviced.ofType(Period).end.exists() and serviced.ofType(Period).start >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(Period).end <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end))
vn-itemized-claim-single-focal-insurance	error	Claim	Claim bảng kê phải có đúng một Coverage focal. An itemized Claim SHALL have exactly one focal Coverage.	insurance.where(focal = true).count() = 1
vn-itemized-claim-stage-sequence-unique	error	Claim	Mỗi sequence giai đoạn hưởng trên insurance phải duy nhất trong Claim. Every insurance benefit-stage sequence SHALL be unique within the Claim.	insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value.isDistinct()
vn-itemized-claim-total-sum	error	Claim	Tổng Claim phải bằng tổng thành tiền của tất cả item. The Claim total SHALL equal the sum of all item net amounts.	total.value = item.net.value.aggregate($this + $total, 0)
vn-other-fund-breakdown-money-vnd-value	error	Claim.item.extension:otherFundBreakdown	Mọi Money con phải có value và dùng VND. Every child Money SHALL have a value and use VND.	extension.value.ofType(Money).all(value.exists() and currency = 'VND')

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Claim	C	0..*	VNCoreClaim	Claim, Pre-determination or Pre-authorization Constraints: vn-itemized-claim-stage-sequence-unique, vn-itemized-claim-coverage-reference-distinct, vn-itemized-claim-single-focal-insurance, vn-itemized-claim-item-stage-exists, vn-itemized-claim-money-vnd, vn-itemized-claim-total-sum
insurance		1..*	BackboneElement	Các Coverage thực tham gia COB và các giai đoạn hưởng — Real Coverages in COB with their benefit stages
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:benefitStage	S	1..*	(Complex)	Sequence, period và mức hưởng của giai đoạn — Stage sequence, period, and benefit level URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage
sequence	S	1..1	positiveInt	Thứ tự phối hợp quyền lợi (COB), không phải sequence giai đoạn — Coordination-of-benefits order, not a stage sequence
item	C	1..*	BackboneElement	Dòng tổng hợp chịu phân bổ; chi tiết gói TBYT nằm ở detail — Allocated summary line; device-package components use detail Constraints: vn-itemized-claim-serviced-in-stage, vn-itemized-claim-line-allocation-sum, vn-itemized-claim-insured-fields-required, vn-itemized-claim-detail-insured-fields-required, vn-itemized-claim-benefit-level-matches-stage, vn-itemized-claim-other-fund-breakdown-sum
extension		3..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:insuranceCostInfo	S	1..1	VNCoreExtInsuranceCostInfo	Các cột đơn giá/tỷ lệ/thành tiền BHYT — BHYT price, ratio, and eligible-amount columns
Slices for extension				Content/Rules for all slices
extension:paymentCeiling		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:insuranceUnitPrice		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:benefitStageSequence	S	1..1	positiveInt	Sequence giai đoạn hưởng của dòng — Line benefit-stage sequence URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence
extension:linePaymentAllocation	S	1..1	(Complex)	Bốn nguồn thanh toán cột 10–13 — Four payment sources in columns 10–13 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation
category		1..1	CodeableConcept	Nhóm chi phí QĐ 697/QĐ-BYT — QĐ 697/QĐ-BYT cost category Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (required)
serviced[x]	S	1..1	date, Period	Ngày/khoảng thực hiện trong giai đoạn hưởng — Service date/period within the benefit stage
quantity	S	1..1	SimpleQuantity(4.0.1)	Số lượng của dòng — Line quantity
value		1..1	decimal	Numerical value (with implicit precision)
unitPrice	S	1..1	Money	Đơn giá bệnh viện, VND — Hospital unit price in VND
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
net		1..1	Money	Thành tiền bệnh viện, bằng tổng bốn nguồn — Hospital line amount equal to four-source allocation
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
detail		0..*	BackboneElement	Chi tiết cấu thành gói TBYT; không bắt buộc allocation — Device-package components without required allocation
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:insuranceCostInfo	S	1..1	(Complex)	Cột 5/6/8/9 của component gói TBYT — Device-package component columns 5/6/8/9 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
Slices for extension				Content/Rules for all slices
extension:paymentCeiling		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:insuranceUnitPrice		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
productOrService	S	1..1	CodeableConcept	Billing, service, product, or drug code
quantity	S	1..1	SimpleQuantity(4.0.1)	Count of products or services
value		1..1	decimal	Numerical value (with implicit precision)
unitPrice	S	1..1	Money	Fee, charge or cost per item
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
net	S	1..1	Money	Total item cost
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
total		1..1	Money	Tổng thành tiền của tất cả dòng — Sum of all item net amounts
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
Documentation for this format

Terminology Bindings (Differential)

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

Constraints

Id	Grade	Path(s)	Description	Expression
vn-itemized-claim-benefit-level-matches-stage	error	Claim.item	Mức hưởng trên dòng, nếu có, phải bằng mức hưởng của benefit stage được dòng tham chiếu. An item's benefit level, when present, SHALL equal the benefit level of its referenced stage.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value.exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value = %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('benefitLevel').value
vn-itemized-claim-coverage-reference-distinct	error	Claim	Mỗi Coverage chỉ được xuất hiện một lần trong Claim bảng kê. Every Coverage SHALL appear only once in the itemized Claim.	insurance.coverage.reference.isDistinct()
vn-itemized-claim-detail-insured-fields-required	error	Claim.item	Khi quỹ BHYT thanh toán item có detail, mọi detail phải có tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện. When the BHYT fund pays an item containing details, every detail SHALL carry its BHYT payment ratio and eligible insurance line amount.	(detail.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.ofType(Money).value > 0) implies detail.all(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-claim-insured-fields-required	error	Claim.item	Khi quỹ BHYT thanh toán một dòng, tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện phải có. When the BHYT fund pays a line, its BHYT payment ratio and eligible insurance line amount SHALL be present.	(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.ofType(Money).value > 0) implies (extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-claim-item-stage-exists	error	Claim	Mỗi dòng chi phí phải tham chiếu một sequence giai đoạn hưởng tồn tại trên insurance. Every cost line SHALL reference a benefit-stage sequence declared on insurance.	item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value.all($this in %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value)
vn-itemized-claim-line-allocation-sum	error	Claim.item	Thành tiền bệnh viện của dòng (cột 7) phải bằng tổng quỹ BHYT, người bệnh cùng trả, nguồn khác và người bệnh tự trả (cột 10+11+12+13). The line net amount (column 7) SHALL equal the sum of the four payment allocations (columns 10+11+12+13).	net.value = extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('patientCopay').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('otherSource').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('patientSelfPay').value.value
vn-itemized-claim-money-vnd	error	Claim	Mọi giá trị tiền tệ của ledger bảng kê phải dùng VND. Every monetary value in the itemized-claim ledger SHALL use VND.	item.unitPrice.currency.all($this = 'VND') and item.net.currency.all($this = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension.value.ofType(Money).all(currency = 'VND') and item.detail.unitPrice.currency.all($this = 'VND') and item.detail.net.currency.all($this = 'VND') and item.detail.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and total.currency.all($this = 'VND')
vn-itemized-claim-other-fund-breakdown-sum	error	Claim.item	Khi có chi tiết nguồn khác, tổng các thành phần phải bằng khoản otherSource trong phân bổ dòng. When an other-fund breakdown is present, its components SHALL sum to the line's otherSource allocation.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').extension.value.ofType(Money).value.aggregate($this + $total, 0) = extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('otherSource').value.ofType(Money).value
vn-itemized-claim-serviced-in-stage	error	Claim.item	Ngày hoặc khoảng thời gian thực hiện dòng chi phí phải nằm trong period của giai đoạn hưởng được tham chiếu; Period phải có cả start và end. Gateway vẫn phải kiểm tra lại tương quan này trước khi gửi do khác biệt giữa các validator FHIRPath R4. The service date or period SHALL fall within the referenced benefit-stage period, and a serviced Period SHALL contain both start and end. The submission gateway SHALL still repeat this correlation check because R4 FHIRPath validators differ.	(serviced.ofType(date).exists() implies (serviced.ofType(date) >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(date) <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end)) and (serviced.ofType(Period).exists() implies (serviced.ofType(Period).start.exists() and serviced.ofType(Period).end.exists() and serviced.ofType(Period).start >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(Period).end <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end))
vn-itemized-claim-single-focal-insurance	error	Claim	Claim bảng kê phải có đúng một Coverage focal. An itemized Claim SHALL have exactly one focal Coverage.	insurance.where(focal = true).count() = 1
vn-itemized-claim-stage-sequence-unique	error	Claim	Mỗi sequence giai đoạn hưởng trên insurance phải duy nhất trong Claim. Every insurance benefit-stage sequence SHALL be unique within the Claim.	insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value.isDistinct()
vn-itemized-claim-total-sum	error	Claim	Tổng Claim phải bằng tổng thành tiền của tất cả item. The Claim total SHALL equal the sum of all item net amounts.	total.value = item.net.value.aggregate($this + $total, 0)

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Claim	C	0..*	VNCoreClaim	Claim, Pre-determination or Pre-authorization Constraints: vn-claim-single-focal-insurance, vn-claim-coverage-not-expired, vn-itemized-claim-stage-sequence-unique, vn-itemized-claim-coverage-reference-distinct, vn-itemized-claim-single-focal-insurance, vn-itemized-claim-item-stage-exists, vn-itemized-claim-money-vnd, vn-itemized-claim-total-sum
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:costSummary	S	0..1	(Complex)	Tổng chi phí theo nhóm: thuốc, VTYT, BHYT, tự trả, cùng chi trả, nguồn khác URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary
extension:paymentPeriod		0..1	(Complex)	Kỳ thanh toán BHYT (năm/tháng) — NAM_QT, THANG_QT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
extension:paymentMethod		0..1	CodeableConcept	Phương thức thanh toán (FFS/Capitation/DRG) — MA_PTTT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method Binding: Phương thức thanh toán BHYT — VN Payment Method ValueSet (extensible)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	S	1..*	Identifier	Định danh hồ sơ thanh toán, bao gồm MA_LK Slice: Unordered, Open by value:system
identifier:MALK	S	1..1	Identifier	Mã liên kết hồ sơ (MA_LK)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-identifier-type-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MA_LK
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://fhir.hl7.org.vn/core/sid/ma-lk
value	SΣ	1..1	string	Giá trị MA_LK Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	Trạng thái yêu cầu thanh toán Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	SΣ	1..1	CodeableConcept	Loại yêu cầu: institutional (nội trú), professional (ngoại trú) Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
subType	S	0..1	CodeableConcept	Mã đối tượng đến KCB (MA_DOITUONG_KCB theo QĐ 3276/QĐ-BYT) Binding: Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet (extensible)
use	SΣ	1..1	code	Mục đích: claim (thanh toán) | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
patient	SΣ	1..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile)	Bệnh nhân (XML 3176: MA_BN)
billablePeriod	Σ	0..1	Period	Relevant time frame for the claim
created	SΣ	1..1	dateTime	Ngày tạo yêu cầu
enterer		0..1	Reference(Practitioner | PractitionerRole)	Author of the claim
insurer	SΣ	0..1	Reference(Organization)	Cơ quan BHXH thanh toán
provider	SΣ	1..1	Reference(Cơ sở y tế VN Core — VN Core Organization Profile | Nhân viên y tế VN Core — VN Core Practitioner Profile | Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile)	Cơ sở KCB thực hiện (XML 3176: MA_CSKCB)
priority	Σ	1..1	CodeableConcept	Mức ưu tiên xử lý Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
fundsReserve		0..1	CodeableConcept	For whom to reserve funds Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).
related		0..*	BackboneElement	Prior or corollary claims
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
claim		0..1	Reference(Claim)	Reference to the related claim
relationship		0..1	CodeableConcept	How the reference claim is related Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.
reference		0..1	Identifier	File or case reference
prescription		0..1	Reference(DeviceRequest | MedicationRequest | VisionPrescription)	Prescription authorizing services and products
originalPrescription		0..1	Reference(DeviceRequest | MedicationRequest | VisionPrescription)	Original prescription if superseded by fulfiller
payee		0..1	BackboneElement	Recipient of benefits payable
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	CodeableConcept	Category of recipient Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.
party		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson)	Recipient reference
referral		0..1	Reference(ServiceRequest)	Treatment referral
facility		0..1	Reference(Location)	Servicing facility
careTeam		0..*	BackboneElement	Members of the care team
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Order of care team
provider		1..1	Reference(Practitioner | PractitionerRole | Organization)	Practitioner or organization
responsible		0..1	boolean	Indicator of the lead practitioner
role		0..1	CodeableConcept	Function within the team Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members.
qualification		0..1	CodeableConcept	Practitioner credential or specialization Binding: ExampleProviderQualificationCodes (example): Provider professional qualifications.
supportingInfo		0..*	BackboneElement	Supporting information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Information instance identifier
category		1..1	CodeableConcept	Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
code		0..1	CodeableConcept	Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes.
timing[x]		0..1		When it occurred
timingDate			date
timingPeriod			Period
value[x]		0..1		Data to be provided
valueBoolean			boolean
valueString			string
valueQuantity			Quantity
valueAttachment			Attachment
valueReference			Reference(Resource)
reason		0..1	CodeableConcept	Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
diagnosis	S	1..*	BackboneElement	Chẩn đoán — ICD-10 VN (XML 3176: MA_BENH, MA_BENHKHAC)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	S	1..1	positiveInt	Diagnosis instance identifier
Slices for diagnosis[x]		1..1		Nature of illness or problem Slice: Unordered, Open by type:$this Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.
diagnosisCodeableConcept			CodeableConcept
diagnosisReference			Reference(Condition)
diagnosis[x]:diagnosisCodeableConcept	S	0..1	CodeableConcept	Mã bệnh ICD-10 VN (QĐ 4469/QĐ-BYT) Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
type	S	0..*	CodeableConcept	Loại chẩn đoán (chính/phụ) Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
onAdmission		0..1	CodeableConcept	Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
packageCode		0..1	CodeableConcept	Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
procedure		0..*	BackboneElement	Thủ thuật/phẫu thuật — ICD-9-CM (XML 3176: MA_PTTT_QT)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Procedure instance identifier
type		0..*	CodeableConcept	Category of Procedure Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.
date		0..1	dateTime	When the procedure was performed
Slices for procedure[x]		1..1		Specific clinical procedure Slice: Unordered, Open by type:$this Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.
procedureCodeableConcept			CodeableConcept
procedureReference			Reference(Procedure)
procedure[x]:procedureCodeableConcept		0..1	CodeableConcept	Specific clinical procedure Binding: Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet (extensible)
udi		0..*	Reference(Device)	Unique device identifier
insurance	SΣ	1..*	BackboneElement	Các Coverage thực tham gia COB và các giai đoạn hưởng — Real Coverages in COB with their benefit stages
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:benefitStage	SC	1..*	(Complex)	Sequence, period và mức hưởng của giai đoạn — Stage sequence, period, and benefit level URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage Constraints: vn-coverage-benefit-stage-level-range
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	SΣ	1..1	positiveInt	Thứ tự phối hợp quyền lợi (COB), không phải sequence giai đoạn — Coordination-of-benefits order, not a stage sequence
focal	SΣ	1..1	boolean	Coverage to be used for adjudication
identifier		0..1	Identifier	Pre-assigned Claim number
coverage	SΣ	1..1	Reference(Thẻ BHYT VN Core — VN Core Coverage Profile)	Thẻ BHYT (Coverage)
businessArrangement		0..1	string	Additional provider contract number
preAuthRef		0..*	string	Prior authorization reference number
claimResponse		0..1	Reference(ClaimResponse)	Adjudication results
accident		0..1	BackboneElement	Thông tin tai nạn thương tích
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
date		1..1	date	When the incident occurred
type		0..1	CodeableConcept	Loại tai nạn (MA_TAI_NAN theo QĐ 3176/QĐ-BYT, Bảng 8) Binding: Mã tai nạn thương tích — Vietnam Accident Type ValueSet (extensible)
location[x]		0..1		Where the event occurred
locationAddress			Address
locationReference			Reference(Location)
item	SC	1..*	BackboneElement	Dòng tổng hợp chịu phân bổ; chi tiết gói TBYT nằm ở detail — Allocated summary line; device-package components use detail Constraints: vn-itemized-claim-serviced-in-stage, vn-itemized-claim-line-allocation-sum, vn-itemized-claim-insured-fields-required, vn-itemized-claim-detail-insured-fields-required, vn-itemized-claim-benefit-level-matches-stage, vn-itemized-claim-other-fund-breakdown-sum
id		0..1	string	Unique id for inter-element referencing
Slices for extension		3..*	Extension	Extension Slice: Unordered, Open by value:url
extension:department		0..1	CodeableConcept	Khoa thực hiện (MA_KHOA) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-item-department Binding: Danh mục mã khoa — Vietnam Department ValueSet (extensible)
extension:deviceGroup		0..1	CodeableConcept	Nhóm TBYT BHYT N01-N09 cho dòng chi phí thiết bị/vật tư URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-device-group Binding: Nhóm thiết bị y tế theo danh mục BHYT — VN Device Group VS (extensible)
extension:deviceInsuranceScope		0..1	CodeableConcept	Legacy PHAM_VI cho dòng TBYT; dữ liệu mới ưu tiên insuranceCostInfo.scope URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-device-insurance-scope Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:insuranceCostInfo	S	1..1	(Complex)	Các cột đơn giá/tỷ lệ/thành tiền BHYT — BHYT price, ratio, and eligible-amount columns URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:scope		0..1	Extension	Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"scope"
value[x]		1..1	CodeableConcept	Value of extension Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:paymentRatio		0..1	Extension	Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentRatio"
value[x]		1..1	decimal	Value of extension
extension:benefitLevel		0..1	Extension	Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"benefitLevel"
value[x]		1..1	decimal	Value of extension
extension:paymentCeiling		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentCeiling"
value[x]		1..1	Money	Trần thanh toán BHYT (VND)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:servicePaymentRatio		0..1	Extension	Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"servicePaymentRatio"
value[x]		1..1	decimal	Value of extension
extension:insuranceUnitPrice		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceUnitPrice"
value[x]		1..1	Money	Đơn giá BHYT thanh toán (VND)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceLineAmount"
value[x]		1..1	Money	Thành tiền BH đủ điều kiện (VND) — Eligible insurance line amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
url		1..1	uri	"http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
extension:otherFundBreakdown	C	0..1	(Complex)	Chi tiết nguồn khác chi trả theo dòng: NSNN/VTNN/VTTN/CL (T_NGUONKHAC_*) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown Constraints: vn-other-fund-breakdown-money-vnd-value
extension:anesthesiaMethod		0..1	CodeableConcept	Phương pháp vô cảm dòng DVKT (PP_VO_CAM) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-anesthesia-method Binding: Phương pháp vô cảm — Vietnam Anesthesia Method ValueSet (required)
extension:paymentSource		0..1	CodeableConcept	Nguồn chi trả dòng chi phí (NGUON_CTRA) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-source Binding: Nguồn chi trả — Vietnam Payment Source ValueSet (extensible)
extension:recurrentWoundBenefit		0..1	boolean	Flag VET_THUONG_TP cho dòng thuốc/DVKT/VTYT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-recurrent-wound-benefit
extension:tenderInfo		0..1	string	Thông tin thầu dòng chi phí (TT_THAU) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-tender-info
extension:processingMethod		0..1	CodeableConcept	Phương pháp chế biến YHCT (MA_PP_CHEBIEN) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-traditional-processing-method Binding: Phương pháp chế biến vị thuốc cổ truyền — VN Traditional Medicine Processing Method ValueSet (extensible)
extension:benefitStageSequence	S	1..1	positiveInt	Sequence giai đoạn hưởng của dòng — Line benefit-stage sequence URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence
extension:linePaymentAllocation	S	1..1	(Complex)	Bốn nguồn thanh toán cột 10–13 — Four payment sources in columns 10–13 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	S	1..1	positiveInt	Item instance identifier
careTeamSequence		0..*	positiveInt	Applicable careTeam members
diagnosisSequence		0..*	positiveInt	Applicable diagnoses
procedureSequence		0..*	positiveInt	Applicable procedures
informationSequence		0..*	positiveInt	Applicable exception and supporting information
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category	S	1..1	CodeableConcept	Nhóm chi phí QĐ 697/QĐ-BYT — QĐ 697/QĐ-BYT cost category Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (required)
productOrService	S	1..1	CodeableConcept	Mã dịch vụ/thuốc/TBYT Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Product or service billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
serviced[x]	S	1..1		Ngày/khoảng thực hiện trong giai đoạn hưởng — Service date/period within the benefit stage
servicedDate			date
servicedPeriod			Period
location[x]		0..1		Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
locationCodeableConcept			CodeableConcept
locationAddress			Address
locationReference			Reference(Location)
quantity	S	1..1	SimpleQuantity(4.0.1)	Số lượng của dòng — Line quantity
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
unitPrice	S	1..1	Money	Đơn giá bệnh viện, VND — Hospital unit price in VND
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
factor		0..1	decimal	Price scaling factor
net	S	1..1	Money	Thành tiền bệnh viện, bằng tổng bốn nguồn — Hospital line amount equal to four-source allocation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
udi		0..*	Reference(Device)	Unique device identifier
bodySite		0..1	CodeableConcept	Anatomical location Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.
subSite		0..*	CodeableConcept	Anatomical sub-location Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.
encounter		0..*	Reference(Encounter)	Encounters related to this billed item
detail		0..*	BackboneElement	Chi tiết cấu thành gói TBYT; không bắt buộc allocation — Device-package components without required allocation
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:insuranceCostInfo	S	1..1	(Complex)	Cột 5/6/8/9 của component gói TBYT — Device-package component columns 5/6/8/9 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:scope		0..1	Extension	Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"scope"
value[x]		1..1	CodeableConcept	Value of extension Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:paymentRatio		0..1	Extension	Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentRatio"
value[x]		1..1	decimal	Value of extension
extension:benefitLevel		0..1	Extension	Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"benefitLevel"
value[x]		1..1	decimal	Value of extension
extension:paymentCeiling		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentCeiling"
value[x]		1..1	Money	Trần thanh toán BHYT (VND)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:servicePaymentRatio		0..1	Extension	Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"servicePaymentRatio"
value[x]		1..1	decimal	Value of extension
extension:insuranceUnitPrice		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceUnitPrice"
value[x]		1..1	Money	Đơn giá BHYT thanh toán (VND)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceLineAmount"
value[x]		1..1	Money	Thành tiền BH đủ điều kiện (VND) — Eligible insurance line amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
url		1..1	uri	"http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService	S	1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
quantity	S	1..1	SimpleQuantity(4.0.1)	Count of products or services
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
unitPrice	S	1..1	Money	Fee, charge or cost per item
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
factor		0..1	decimal	Price scaling factor
net	S	1..1	Money	Total item cost
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
udi		0..*	Reference(Device)	Unique device identifier
subDetail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
total	S	1..1	Money	Tổng thành tiền của tất cả dòng — Sum of all item net amounts
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Claim.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Claim.identifier:MALK.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Claim.identifier:MALK.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Claim.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Claim.type	Base	extensible	Claim Type Codes	📍4.0.1	FHIR Std.
Claim.subType	Base	extensible	Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet	📦0.9.0	This IG
Claim.use	Base	required	Use	📍4.0.1	FHIR Std.
Claim.priority	Base	example	Process Priority Codes	📍4.0.1	FHIR Std.
Claim.fundsReserve	Base	example	FundsReserve	📍4.0.1	FHIR Std.
Claim.related.relationship	Base	example	Example Related Claim Relationship Codes	📍4.0.1	FHIR Std.
Claim.payee.type	Base	example	PayeeType	📍4.0.1	FHIR Std.
Claim.careTeam.role	Base	example	Claim Care Team Role Codes	📍4.0.1	FHIR Std.
Claim.careTeam.qualification	Base	example	Example Provider Qualification Codes	📍4.0.1	FHIR Std.
Claim.supportingInfo.​category	Base	example	Claim Information Category Codes	📍4.0.1	FHIR Std.
Claim.supportingInfo.​code	Base	example	Exception Codes	📍4.0.1	FHIR Std.
Claim.supportingInfo.​reason	Base	example	Missing Tooth Reason Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.diagnosis[x]	Base	example	ICD-10 Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.diagnosis[x]:diagnosisCodeableConcept	Base	extensible	Mã chẩn đoán — VN Core Condition Code ValueSet	📦0.9.0	This IG
Claim.diagnosis.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.onAdmission	Base	example	Example Diagnosis on Admission Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.packageCode	Base	example	Example Diagnosis Related Group Codes	📍4.0.1	FHIR Std.
Claim.procedure.type	Base	example	Example Procedure Type Codes	📍4.0.1	FHIR Std.
Claim.procedure.procedure[x]	Base	example	ICD-10 Procedure Codes	📍4.0.1	FHIR Std.
Claim.procedure.procedure[x]:procedureCodeableConcept	Base	extensible	Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet	📦0.9.0	This IG
Claim.accident.type	Base	extensible	Mã tai nạn thương tích — Vietnam Accident Type ValueSet	📦0.9.0	This IG
Claim.item.extension:insuranceCostInfo.​extension:scope.value[x]	Base	extensible	Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet	📦0.9.0	This IG
Claim.item.extension:insuranceCostInfo.​extension:paymentCeiling.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.extension:insuranceCostInfo.​extension:insuranceUnitPrice.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.extension:insuranceCostInfo.​extension:insuranceLineAmount.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item.category	Base	required	Danh mục chi phí KCB — Vietnam Cost Category ValueSet	📦0.9.0	This IG
Claim.item.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item.modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item.programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item.location[x]	Base	example	Example Service Place Codes	📍4.0.1	FHIR Std.
Claim.item.unitPrice.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.net.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.bodySite	Base	example	Oral Site Codes	📍4.0.1	FHIR Std.
Claim.item.subSite	Base	example	Surface Codes	📍4.0.1	FHIR Std.
Claim.item.detail.extension:insuranceCostInfo.​extension:scope.value[x]	Base	extensible	Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet	📦0.9.0	This IG
Claim.item.detail.extension:insuranceCostInfo.​extension:paymentCeiling.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.extension:insuranceCostInfo.​extension:insuranceUnitPrice.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.extension:insuranceCostInfo.​extension:insuranceLineAmount.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item.detail.category	Base	example	Benefit Category Codes	📍4.0.1	FHIR Std.
Claim.item.detail.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item.detail.modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item.detail.programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item.detail.unitPrice.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.net.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​category	Base	example	Benefit Category Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.total.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Claim	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Claim	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Claim	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Claim	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Claim	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
vn-claim-coverage-not-expired	warning	Claim	Cảnh báo: thẻ BHYT focal có thể đã hết hạn tại thời điểm tạo Claim — theo NĐ 188/2025/NĐ-CP ban hành 01/07/2025, hiệu lực 15/08/2025, Đ15	insurance.where(focal = true).coverage.resolve().period.end.all($this >= %resource.created)
vn-claim-single-focal-insurance	error	Claim	Phải có đúng 1 thẻ BHYT chính (focal=true). Các thẻ bổ trợ dùng focal=false — theo QĐ 697/QĐ-BYT ngày 19/03/2026 cột 13, NĐ 188/2025/NĐ-CP ban hành 01/07/2025, hiệu lực 15/08/2025, Đ22; sai hồ sơ/chứng từ BHYT có thể bị xử phạt theo NĐ 90/2026/NĐ-CP (ban hành 30/03/2026, hiệu lực 15/05/2026 — đang áp dụng)	insurance.where(focal = true).count() = 1
vn-coverage-benefit-stage-level-range	error	Claim.insurance.extension:benefitStage	Mức hưởng của giai đoạn phải nằm trong khoảng từ 0 đến 100 phần trăm. The benefit level for a coverage stage SHALL be between 0 and 100 percent.	extension('benefitLevel').value >= 0 and extension('benefitLevel').value <= 100
vn-itemized-claim-benefit-level-matches-stage	error	Claim.item	Mức hưởng trên dòng, nếu có, phải bằng mức hưởng của benefit stage được dòng tham chiếu. An item's benefit level, when present, SHALL equal the benefit level of its referenced stage.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value.exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value = %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('benefitLevel').value
vn-itemized-claim-coverage-reference-distinct	error	Claim	Mỗi Coverage chỉ được xuất hiện một lần trong Claim bảng kê. Every Coverage SHALL appear only once in the itemized Claim.	insurance.coverage.reference.isDistinct()
vn-itemized-claim-detail-insured-fields-required	error	Claim.item	Khi quỹ BHYT thanh toán item có detail, mọi detail phải có tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện. When the BHYT fund pays an item containing details, every detail SHALL carry its BHYT payment ratio and eligible insurance line amount.	(detail.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.ofType(Money).value > 0) implies detail.all(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-claim-insured-fields-required	error	Claim.item	Khi quỹ BHYT thanh toán một dòng, tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện phải có. When the BHYT fund pays a line, its BHYT payment ratio and eligible insurance line amount SHALL be present.	(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.ofType(Money).value > 0) implies (extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-claim-item-stage-exists	error	Claim	Mỗi dòng chi phí phải tham chiếu một sequence giai đoạn hưởng tồn tại trên insurance. Every cost line SHALL reference a benefit-stage sequence declared on insurance.	item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value.all($this in %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value)
vn-itemized-claim-line-allocation-sum	error	Claim.item	Thành tiền bệnh viện của dòng (cột 7) phải bằng tổng quỹ BHYT, người bệnh cùng trả, nguồn khác và người bệnh tự trả (cột 10+11+12+13). The line net amount (column 7) SHALL equal the sum of the four payment allocations (columns 10+11+12+13).	net.value = extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('patientCopay').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('otherSource').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('patientSelfPay').value.value
vn-itemized-claim-money-vnd	error	Claim	Mọi giá trị tiền tệ của ledger bảng kê phải dùng VND. Every monetary value in the itemized-claim ledger SHALL use VND.	item.unitPrice.currency.all($this = 'VND') and item.net.currency.all($this = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension.value.ofType(Money).all(currency = 'VND') and item.detail.unitPrice.currency.all($this = 'VND') and item.detail.net.currency.all($this = 'VND') and item.detail.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and total.currency.all($this = 'VND')
vn-itemized-claim-other-fund-breakdown-sum	error	Claim.item	Khi có chi tiết nguồn khác, tổng các thành phần phải bằng khoản otherSource trong phân bổ dòng. When an other-fund breakdown is present, its components SHALL sum to the line's otherSource allocation.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').extension.value.ofType(Money).value.aggregate($this + $total, 0) = extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('otherSource').value.ofType(Money).value
vn-itemized-claim-serviced-in-stage	error	Claim.item	Ngày hoặc khoảng thời gian thực hiện dòng chi phí phải nằm trong period của giai đoạn hưởng được tham chiếu; Period phải có cả start và end. Gateway vẫn phải kiểm tra lại tương quan này trước khi gửi do khác biệt giữa các validator FHIRPath R4. The service date or period SHALL fall within the referenced benefit-stage period, and a serviced Period SHALL contain both start and end. The submission gateway SHALL still repeat this correlation check because R4 FHIRPath validators differ.	(serviced.ofType(date).exists() implies (serviced.ofType(date) >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(date) <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end)) and (serviced.ofType(Period).exists() implies (serviced.ofType(Period).start.exists() and serviced.ofType(Period).end.exists() and serviced.ofType(Period).start >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(Period).end <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end))
vn-itemized-claim-single-focal-insurance	error	Claim	Claim bảng kê phải có đúng một Coverage focal. An itemized Claim SHALL have exactly one focal Coverage.	insurance.where(focal = true).count() = 1
vn-itemized-claim-stage-sequence-unique	error	Claim	Mỗi sequence giai đoạn hưởng trên insurance phải duy nhất trong Claim. Every insurance benefit-stage sequence SHALL be unique within the Claim.	insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value.isDistinct()
vn-itemized-claim-total-sum	error	Claim	Tổng Claim phải bằng tổng thành tiền của tất cả item. The Claim total SHALL equal the sum of all item net amounts.	total.value = item.net.value.aggregate($this + $total, 0)
vn-other-fund-breakdown-money-vnd-value	error	Claim.item.extension:otherFundBreakdown	Mọi Money con phải có value và dùng VND. Every child Money SHALL have a value and use VND.	extension.value.ofType(Money).all(value.exists() and currency = 'VND')

Summary

Mandatory: 18 elements(16 nested mandatory elements)
Must-Support: 13 elements
Fixed: 11 elements

Extensions

This structure refers to these extensions:

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

Dạng xem phần tử chính

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Claim	C	0..*	VNCoreClaim	Claim, Pre-determination or Pre-authorization Constraints: vn-claim-single-focal-insurance, vn-claim-coverage-not-expired, vn-itemized-claim-stage-sequence-unique, vn-itemized-claim-coverage-reference-distinct, vn-itemized-claim-single-focal-insurance, vn-itemized-claim-item-stage-exists, vn-itemized-claim-money-vnd, vn-itemized-claim-total-sum
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension				Content/Rules for all slices
extension:costSummary	S	0..1	(Complex)	Tổng chi phí theo nhóm: thuốc, VTYT, BHYT, tự trả, cùng chi trả, nguồn khác URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary
extension:paymentPeriod		0..1	(Complex)	Kỳ thanh toán BHYT (năm/tháng) — NAM_QT, THANG_QT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
extension:paymentMethod		0..1	CodeableConcept	Phương thức thanh toán (FFS/Capitation/DRG) — MA_PTTT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method Binding: Phương thức thanh toán BHYT — VN Payment Method ValueSet (extensible)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	S	1..*	Identifier	Định danh hồ sơ thanh toán, bao gồm MA_LK Slice: Unordered, Open by value:system
identifier:MALK	S	1..1	Identifier	Mã liên kết hồ sơ (MA_LK)
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-identifier-type-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MA_LK
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://fhir.hl7.org.vn/core/sid/ma-lk
value	SΣ	1..1	string	Giá trị MA_LK Example General: 123456
status	?!SΣ	1..1	code	Trạng thái yêu cầu thanh toán Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	SΣ	1..1	CodeableConcept	Loại yêu cầu: institutional (nội trú), professional (ngoại trú) Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
subType	S	0..1	CodeableConcept	Mã đối tượng đến KCB (MA_DOITUONG_KCB theo QĐ 3276/QĐ-BYT) Binding: Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet (extensible)
use	SΣ	1..1	code	Mục đích: claim (thanh toán) | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
patient	SΣ	1..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile)	Bệnh nhân (XML 3176: MA_BN)
created	SΣ	1..1	dateTime	Ngày tạo yêu cầu
insurer	SΣ	0..1	Reference(Organization)	Cơ quan BHXH thanh toán
provider	SΣ	1..1	Reference(Cơ sở y tế VN Core — VN Core Organization Profile | Nhân viên y tế VN Core — VN Core Practitioner Profile | Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile)	Cơ sở KCB thực hiện (XML 3176: MA_CSKCB)
priority	Σ	1..1	CodeableConcept	Mức ưu tiên xử lý Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
diagnosis	S	1..*	BackboneElement	Chẩn đoán — ICD-10 VN (XML 3176: MA_BENH, MA_BENHKHAC)
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	S	1..1	positiveInt	Diagnosis instance identifier
Slices for diagnosis[x]		1..1		Nature of illness or problem Slice: Unordered, Open by type:$this Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.
diagnosisCodeableConcept			CodeableConcept
diagnosisReference			Reference(Condition)
diagnosis[x]:diagnosisCodeableConcept	S	0..1	CodeableConcept	Mã bệnh ICD-10 VN (QĐ 4469/QĐ-BYT) Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
type	S	0..*	CodeableConcept	Loại chẩn đoán (chính/phụ) Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
insurance	SΣ	1..*	BackboneElement	Các Coverage thực tham gia COB và các giai đoạn hưởng — Real Coverages in COB with their benefit stages
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:benefitStage	SC	1..*	(Complex)	Sequence, period và mức hưởng của giai đoạn — Stage sequence, period, and benefit level URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage Constraints: vn-coverage-benefit-stage-level-range
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	SΣ	1..1	positiveInt	Thứ tự phối hợp quyền lợi (COB), không phải sequence giai đoạn — Coordination-of-benefits order, not a stage sequence
focal	SΣ	1..1	boolean	Coverage to be used for adjudication
coverage	SΣ	1..1	Reference(Thẻ BHYT VN Core — VN Core Coverage Profile)	Thẻ BHYT (Coverage)
item	SC	1..*	BackboneElement	Dòng tổng hợp chịu phân bổ; chi tiết gói TBYT nằm ở detail — Allocated summary line; device-package components use detail Constraints: vn-itemized-claim-serviced-in-stage, vn-itemized-claim-line-allocation-sum, vn-itemized-claim-insured-fields-required, vn-itemized-claim-detail-insured-fields-required, vn-itemized-claim-benefit-level-matches-stage, vn-itemized-claim-other-fund-breakdown-sum
Slices for extension		3..*	Extension	Extension Slice: Unordered, Open by value:url
extension:department		0..1	CodeableConcept	Khoa thực hiện (MA_KHOA) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-item-department Binding: Danh mục mã khoa — Vietnam Department ValueSet (extensible)
extension:deviceGroup		0..1	CodeableConcept	Nhóm TBYT BHYT N01-N09 cho dòng chi phí thiết bị/vật tư URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-device-group Binding: Nhóm thiết bị y tế theo danh mục BHYT — VN Device Group VS (extensible)
extension:deviceInsuranceScope		0..1	CodeableConcept	Legacy PHAM_VI cho dòng TBYT; dữ liệu mới ưu tiên insuranceCostInfo.scope URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-device-insurance-scope Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:insuranceCostInfo	S	1..1	(Complex)	Các cột đơn giá/tỷ lệ/thành tiền BHYT — BHYT price, ratio, and eligible-amount columns URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
Slices for extension				Content/Rules for all slices
extension:scope		0..1	Extension	Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"scope"
value[x]		1..1	CodeableConcept	Value of extension Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:paymentRatio		0..1	Extension	Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentRatio"
value[x]		1..1	decimal	Value of extension
extension:benefitLevel		0..1	Extension	Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"benefitLevel"
value[x]		1..1	decimal	Value of extension
extension:paymentCeiling		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentCeiling"
value[x]		1..1	Money	Trần thanh toán BHYT (VND)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:servicePaymentRatio		0..1	Extension	Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"servicePaymentRatio"
value[x]		1..1	decimal	Value of extension
extension:insuranceUnitPrice		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceUnitPrice"
value[x]		1..1	Money	Đơn giá BHYT thanh toán (VND)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceLineAmount"
value[x]		1..1	Money	Thành tiền BH đủ điều kiện (VND) — Eligible insurance line amount
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
url		1..1	uri	"http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
extension:otherFundBreakdown	C	0..1	(Complex)	Chi tiết nguồn khác chi trả theo dòng: NSNN/VTNN/VTTN/CL (T_NGUONKHAC_*) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown Constraints: vn-other-fund-breakdown-money-vnd-value
extension:anesthesiaMethod		0..1	CodeableConcept	Phương pháp vô cảm dòng DVKT (PP_VO_CAM) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-anesthesia-method Binding: Phương pháp vô cảm — Vietnam Anesthesia Method ValueSet (required)
extension:paymentSource		0..1	CodeableConcept	Nguồn chi trả dòng chi phí (NGUON_CTRA) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-source Binding: Nguồn chi trả — Vietnam Payment Source ValueSet (extensible)
extension:recurrentWoundBenefit		0..1	boolean	Flag VET_THUONG_TP cho dòng thuốc/DVKT/VTYT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-recurrent-wound-benefit
extension:tenderInfo		0..1	string	Thông tin thầu dòng chi phí (TT_THAU) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-tender-info
extension:processingMethod		0..1	CodeableConcept	Phương pháp chế biến YHCT (MA_PP_CHEBIEN) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-traditional-processing-method Binding: Phương pháp chế biến vị thuốc cổ truyền — VN Traditional Medicine Processing Method ValueSet (extensible)
extension:benefitStageSequence	S	1..1	positiveInt	Sequence giai đoạn hưởng của dòng — Line benefit-stage sequence URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence
extension:linePaymentAllocation	S	1..1	(Complex)	Bốn nguồn thanh toán cột 10–13 — Four payment sources in columns 10–13 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	S	1..1	positiveInt	Item instance identifier
category	S	1..1	CodeableConcept	Nhóm chi phí QĐ 697/QĐ-BYT — QĐ 697/QĐ-BYT cost category Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (required)
productOrService	S	1..1	CodeableConcept	Mã dịch vụ/thuốc/TBYT Binding: USCLSCodes (example): Allowable service and product codes.
serviced[x]	S	1..1		Ngày/khoảng thực hiện trong giai đoạn hưởng — Service date/period within the benefit stage
servicedDate			date
servicedPeriod			Period
quantity	S	1..1	SimpleQuantity(4.0.1)	Số lượng của dòng — Line quantity
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unitPrice	S	1..1	Money	Đơn giá bệnh viện, VND — Hospital unit price in VND
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
net	S	1..1	Money	Thành tiền bệnh viện, bằng tổng bốn nguồn — Hospital line amount equal to four-source allocation
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
detail		0..*	BackboneElement	Chi tiết cấu thành gói TBYT; không bắt buộc allocation — Device-package components without required allocation
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:insuranceCostInfo	S	1..1	(Complex)	Cột 5/6/8/9 của component gói TBYT — Device-package component columns 5/6/8/9 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
Slices for extension				Content/Rules for all slices
extension:scope		0..1	Extension	Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"scope"
value[x]		1..1	CodeableConcept	Value of extension Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:paymentRatio		0..1	Extension	Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentRatio"
value[x]		1..1	decimal	Value of extension
extension:benefitLevel		0..1	Extension	Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"benefitLevel"
value[x]		1..1	decimal	Value of extension
extension:paymentCeiling		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentCeiling"
value[x]		1..1	Money	Trần thanh toán BHYT (VND)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:servicePaymentRatio		0..1	Extension	Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"servicePaymentRatio"
value[x]		1..1	decimal	Value of extension
extension:insuranceUnitPrice		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceUnitPrice"
value[x]		1..1	Money	Đơn giá BHYT thanh toán (VND)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceLineAmount"
value[x]		1..1	Money	Thành tiền BH đủ điều kiện (VND) — Eligible insurance line amount
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
url		1..1	uri	"http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
productOrService	S	1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
quantity	S	1..1	SimpleQuantity(4.0.1)	Count of products or services
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unitPrice	S	1..1	Money	Fee, charge or cost per item
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
net	S	1..1	Money	Total item cost
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
total	S	1..1	Money	Tổng thành tiền của tất cả dòng — Sum of all item net amounts
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Claim.identifier:MALK.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Claim.identifier:MALK.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Claim.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Claim.type	Base	extensible	Claim Type Codes	📍4.0.1	FHIR Std.
Claim.subType	Base	extensible	Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet	📦0.9.0	This IG
Claim.use	Base	required	Use	📍4.0.1	FHIR Std.
Claim.priority	Base	example	Process Priority Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.diagnosis[x]	Base	example	ICD-10 Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.diagnosis[x]:diagnosisCodeableConcept	Base	extensible	Mã chẩn đoán — VN Core Condition Code ValueSet	📦0.9.0	This IG
Claim.diagnosis.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.item.extension:insuranceCostInfo.​extension:scope.value[x]	Base	extensible	Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet	📦0.9.0	This IG
Claim.item.extension:insuranceCostInfo.​extension:paymentCeiling.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.extension:insuranceCostInfo.​extension:insuranceUnitPrice.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.extension:insuranceCostInfo.​extension:insuranceLineAmount.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.category	Base	required	Danh mục chi phí KCB — Vietnam Cost Category ValueSet	📦0.9.0	This IG
Claim.item.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item.unitPrice.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.net.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.extension:insuranceCostInfo.​extension:scope.value[x]	Base	extensible	Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet	📦0.9.0	This IG
Claim.item.detail.extension:insuranceCostInfo.​extension:paymentCeiling.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.extension:insuranceCostInfo.​extension:insuranceUnitPrice.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.extension:insuranceCostInfo.​extension:insuranceLineAmount.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item.detail.unitPrice.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.net.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.total.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Claim	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Claim	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Claim	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Claim	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Claim	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
vn-claim-coverage-not-expired	warning	Claim	Cảnh báo: thẻ BHYT focal có thể đã hết hạn tại thời điểm tạo Claim — theo NĐ 188/2025/NĐ-CP ban hành 01/07/2025, hiệu lực 15/08/2025, Đ15	insurance.where(focal = true).coverage.resolve().period.end.all($this >= %resource.created)
vn-claim-single-focal-insurance	error	Claim	Phải có đúng 1 thẻ BHYT chính (focal=true). Các thẻ bổ trợ dùng focal=false — theo QĐ 697/QĐ-BYT ngày 19/03/2026 cột 13, NĐ 188/2025/NĐ-CP ban hành 01/07/2025, hiệu lực 15/08/2025, Đ22; sai hồ sơ/chứng từ BHYT có thể bị xử phạt theo NĐ 90/2026/NĐ-CP (ban hành 30/03/2026, hiệu lực 15/05/2026 — đang áp dụng)	insurance.where(focal = true).count() = 1
vn-coverage-benefit-stage-level-range	error	Claim.insurance.extension:benefitStage	Mức hưởng của giai đoạn phải nằm trong khoảng từ 0 đến 100 phần trăm. The benefit level for a coverage stage SHALL be between 0 and 100 percent.	extension('benefitLevel').value >= 0 and extension('benefitLevel').value <= 100
vn-itemized-claim-benefit-level-matches-stage	error	Claim.item	Mức hưởng trên dòng, nếu có, phải bằng mức hưởng của benefit stage được dòng tham chiếu. An item's benefit level, when present, SHALL equal the benefit level of its referenced stage.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value.exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value = %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('benefitLevel').value
vn-itemized-claim-coverage-reference-distinct	error	Claim	Mỗi Coverage chỉ được xuất hiện một lần trong Claim bảng kê. Every Coverage SHALL appear only once in the itemized Claim.	insurance.coverage.reference.isDistinct()
vn-itemized-claim-detail-insured-fields-required	error	Claim.item	Khi quỹ BHYT thanh toán item có detail, mọi detail phải có tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện. When the BHYT fund pays an item containing details, every detail SHALL carry its BHYT payment ratio and eligible insurance line amount.	(detail.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.ofType(Money).value > 0) implies detail.all(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-claim-insured-fields-required	error	Claim.item	Khi quỹ BHYT thanh toán một dòng, tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện phải có. When the BHYT fund pays a line, its BHYT payment ratio and eligible insurance line amount SHALL be present.	(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.ofType(Money).value > 0) implies (extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-claim-item-stage-exists	error	Claim	Mỗi dòng chi phí phải tham chiếu một sequence giai đoạn hưởng tồn tại trên insurance. Every cost line SHALL reference a benefit-stage sequence declared on insurance.	item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value.all($this in %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value)
vn-itemized-claim-line-allocation-sum	error	Claim.item	Thành tiền bệnh viện của dòng (cột 7) phải bằng tổng quỹ BHYT, người bệnh cùng trả, nguồn khác và người bệnh tự trả (cột 10+11+12+13). The line net amount (column 7) SHALL equal the sum of the four payment allocations (columns 10+11+12+13).	net.value = extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('patientCopay').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('otherSource').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('patientSelfPay').value.value
vn-itemized-claim-money-vnd	error	Claim	Mọi giá trị tiền tệ của ledger bảng kê phải dùng VND. Every monetary value in the itemized-claim ledger SHALL use VND.	item.unitPrice.currency.all($this = 'VND') and item.net.currency.all($this = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension.value.ofType(Money).all(currency = 'VND') and item.detail.unitPrice.currency.all($this = 'VND') and item.detail.net.currency.all($this = 'VND') and item.detail.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and total.currency.all($this = 'VND')
vn-itemized-claim-other-fund-breakdown-sum	error	Claim.item	Khi có chi tiết nguồn khác, tổng các thành phần phải bằng khoản otherSource trong phân bổ dòng. When an other-fund breakdown is present, its components SHALL sum to the line's otherSource allocation.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').extension.value.ofType(Money).value.aggregate($this + $total, 0) = extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('otherSource').value.ofType(Money).value
vn-itemized-claim-serviced-in-stage	error	Claim.item	Ngày hoặc khoảng thời gian thực hiện dòng chi phí phải nằm trong period của giai đoạn hưởng được tham chiếu; Period phải có cả start và end. Gateway vẫn phải kiểm tra lại tương quan này trước khi gửi do khác biệt giữa các validator FHIRPath R4. The service date or period SHALL fall within the referenced benefit-stage period, and a serviced Period SHALL contain both start and end. The submission gateway SHALL still repeat this correlation check because R4 FHIRPath validators differ.	(serviced.ofType(date).exists() implies (serviced.ofType(date) >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(date) <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end)) and (serviced.ofType(Period).exists() implies (serviced.ofType(Period).start.exists() and serviced.ofType(Period).end.exists() and serviced.ofType(Period).start >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(Period).end <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end))
vn-itemized-claim-single-focal-insurance	error	Claim	Claim bảng kê phải có đúng một Coverage focal. An itemized Claim SHALL have exactly one focal Coverage.	insurance.where(focal = true).count() = 1
vn-itemized-claim-stage-sequence-unique	error	Claim	Mỗi sequence giai đoạn hưởng trên insurance phải duy nhất trong Claim. Every insurance benefit-stage sequence SHALL be unique within the Claim.	insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value.isDistinct()
vn-itemized-claim-total-sum	error	Claim	Tổng Claim phải bằng tổng thành tiền của tất cả item. The Claim total SHALL equal the sum of all item net amounts.	total.value = item.net.value.aggregate($this + $total, 0)
vn-other-fund-breakdown-money-vnd-value	error	Claim.item.extension:otherFundBreakdown	Mọi Money con phải có value và dùng VND. Every child Money SHALL have a value and use VND.	extension.value.ofType(Money).all(value.exists() and currency = 'VND')

Dạng xem Differential

Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Claim	C	0..*	VNCoreClaim	Claim, Pre-determination or Pre-authorization Constraints: vn-itemized-claim-stage-sequence-unique, vn-itemized-claim-coverage-reference-distinct, vn-itemized-claim-single-focal-insurance, vn-itemized-claim-item-stage-exists, vn-itemized-claim-money-vnd, vn-itemized-claim-total-sum
insurance		1..*	BackboneElement	Các Coverage thực tham gia COB và các giai đoạn hưởng — Real Coverages in COB with their benefit stages
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:benefitStage	S	1..*	(Complex)	Sequence, period và mức hưởng của giai đoạn — Stage sequence, period, and benefit level URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage
sequence	S	1..1	positiveInt	Thứ tự phối hợp quyền lợi (COB), không phải sequence giai đoạn — Coordination-of-benefits order, not a stage sequence
item	C	1..*	BackboneElement	Dòng tổng hợp chịu phân bổ; chi tiết gói TBYT nằm ở detail — Allocated summary line; device-package components use detail Constraints: vn-itemized-claim-serviced-in-stage, vn-itemized-claim-line-allocation-sum, vn-itemized-claim-insured-fields-required, vn-itemized-claim-detail-insured-fields-required, vn-itemized-claim-benefit-level-matches-stage, vn-itemized-claim-other-fund-breakdown-sum
extension		3..*	Extension	Extension
Slices for extension				Content/Rules for all slices
extension:insuranceCostInfo	S	1..1	VNCoreExtInsuranceCostInfo	Các cột đơn giá/tỷ lệ/thành tiền BHYT — BHYT price, ratio, and eligible-amount columns
Slices for extension				Content/Rules for all slices
extension:paymentCeiling		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:insuranceUnitPrice		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:benefitStageSequence	S	1..1	positiveInt	Sequence giai đoạn hưởng của dòng — Line benefit-stage sequence URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence
extension:linePaymentAllocation	S	1..1	(Complex)	Bốn nguồn thanh toán cột 10–13 — Four payment sources in columns 10–13 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation
category		1..1	CodeableConcept	Nhóm chi phí QĐ 697/QĐ-BYT — QĐ 697/QĐ-BYT cost category Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (required)
serviced[x]	S	1..1	date, Period	Ngày/khoảng thực hiện trong giai đoạn hưởng — Service date/period within the benefit stage
quantity	S	1..1	SimpleQuantity(4.0.1)	Số lượng của dòng — Line quantity
value		1..1	decimal	Numerical value (with implicit precision)
unitPrice	S	1..1	Money	Đơn giá bệnh viện, VND — Hospital unit price in VND
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
net		1..1	Money	Thành tiền bệnh viện, bằng tổng bốn nguồn — Hospital line amount equal to four-source allocation
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
detail		0..*	BackboneElement	Chi tiết cấu thành gói TBYT; không bắt buộc allocation — Device-package components without required allocation
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:insuranceCostInfo	S	1..1	(Complex)	Cột 5/6/8/9 của component gói TBYT — Device-package component columns 5/6/8/9 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
Slices for extension				Content/Rules for all slices
extension:paymentCeiling		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:insuranceUnitPrice		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
value[x]
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
productOrService	S	1..1	CodeableConcept	Billing, service, product, or drug code
quantity	S	1..1	SimpleQuantity(4.0.1)	Count of products or services
value		1..1	decimal	Numerical value (with implicit precision)
unitPrice	S	1..1	Money	Fee, charge or cost per item
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
net	S	1..1	Money	Total item cost
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
total		1..1	Money	Tổng thành tiền của tất cả dòng — Sum of all item net amounts
value		1..1	decimal	Numerical value (with implicit precision)
currency		1..1	code	ISO 4217 Currency Code Fixed Value: VND
Documentation for this format

Terminology Bindings (Differential)

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

Constraints

Id	Grade	Path(s)	Description	Expression
vn-itemized-claim-benefit-level-matches-stage	error	Claim.item	Mức hưởng trên dòng, nếu có, phải bằng mức hưởng của benefit stage được dòng tham chiếu. An item's benefit level, when present, SHALL equal the benefit level of its referenced stage.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value.exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value = %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('benefitLevel').value
vn-itemized-claim-coverage-reference-distinct	error	Claim	Mỗi Coverage chỉ được xuất hiện một lần trong Claim bảng kê. Every Coverage SHALL appear only once in the itemized Claim.	insurance.coverage.reference.isDistinct()
vn-itemized-claim-detail-insured-fields-required	error	Claim.item	Khi quỹ BHYT thanh toán item có detail, mọi detail phải có tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện. When the BHYT fund pays an item containing details, every detail SHALL carry its BHYT payment ratio and eligible insurance line amount.	(detail.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.ofType(Money).value > 0) implies detail.all(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-claim-insured-fields-required	error	Claim.item	Khi quỹ BHYT thanh toán một dòng, tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện phải có. When the BHYT fund pays a line, its BHYT payment ratio and eligible insurance line amount SHALL be present.	(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.ofType(Money).value > 0) implies (extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-claim-item-stage-exists	error	Claim	Mỗi dòng chi phí phải tham chiếu một sequence giai đoạn hưởng tồn tại trên insurance. Every cost line SHALL reference a benefit-stage sequence declared on insurance.	item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value.all($this in %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value)
vn-itemized-claim-line-allocation-sum	error	Claim.item	Thành tiền bệnh viện của dòng (cột 7) phải bằng tổng quỹ BHYT, người bệnh cùng trả, nguồn khác và người bệnh tự trả (cột 10+11+12+13). The line net amount (column 7) SHALL equal the sum of the four payment allocations (columns 10+11+12+13).	net.value = extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('patientCopay').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('otherSource').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('patientSelfPay').value.value
vn-itemized-claim-money-vnd	error	Claim	Mọi giá trị tiền tệ của ledger bảng kê phải dùng VND. Every monetary value in the itemized-claim ledger SHALL use VND.	item.unitPrice.currency.all($this = 'VND') and item.net.currency.all($this = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension.value.ofType(Money).all(currency = 'VND') and item.detail.unitPrice.currency.all($this = 'VND') and item.detail.net.currency.all($this = 'VND') and item.detail.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and total.currency.all($this = 'VND')
vn-itemized-claim-other-fund-breakdown-sum	error	Claim.item	Khi có chi tiết nguồn khác, tổng các thành phần phải bằng khoản otherSource trong phân bổ dòng. When an other-fund breakdown is present, its components SHALL sum to the line's otherSource allocation.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').extension.value.ofType(Money).value.aggregate($this + $total, 0) = extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('otherSource').value.ofType(Money).value
vn-itemized-claim-serviced-in-stage	error	Claim.item	Ngày hoặc khoảng thời gian thực hiện dòng chi phí phải nằm trong period của giai đoạn hưởng được tham chiếu; Period phải có cả start và end. Gateway vẫn phải kiểm tra lại tương quan này trước khi gửi do khác biệt giữa các validator FHIRPath R4. The service date or period SHALL fall within the referenced benefit-stage period, and a serviced Period SHALL contain both start and end. The submission gateway SHALL still repeat this correlation check because R4 FHIRPath validators differ.	(serviced.ofType(date).exists() implies (serviced.ofType(date) >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(date) <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end)) and (serviced.ofType(Period).exists() implies (serviced.ofType(Period).start.exists() and serviced.ofType(Period).end.exists() and serviced.ofType(Period).start >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(Period).end <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end))
vn-itemized-claim-single-focal-insurance	error	Claim	Claim bảng kê phải có đúng một Coverage focal. An itemized Claim SHALL have exactly one focal Coverage.	insurance.where(focal = true).count() = 1
vn-itemized-claim-stage-sequence-unique	error	Claim	Mỗi sequence giai đoạn hưởng trên insurance phải duy nhất trong Claim. Every insurance benefit-stage sequence SHALL be unique within the Claim.	insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value.isDistinct()
vn-itemized-claim-total-sum	error	Claim	Tổng Claim phải bằng tổng thành tiền của tất cả item. The Claim total SHALL equal the sum of all item net amounts.	total.value = item.net.value.aggregate($this + $total, 0)

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Name	Flags	Card.	Type	Description & Constraints    Filter: Bindings Constraints Obligations
Claim	C	0..*	VNCoreClaim	Claim, Pre-determination or Pre-authorization Constraints: vn-claim-single-focal-insurance, vn-claim-coverage-not-expired, vn-itemized-claim-stage-sequence-unique, vn-itemized-claim-coverage-reference-distinct, vn-itemized-claim-single-focal-insurance, vn-itemized-claim-item-stage-exists, vn-itemized-claim-money-vnd, vn-itemized-claim-total-sum
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
extension:costSummary	S	0..1	(Complex)	Tổng chi phí theo nhóm: thuốc, VTYT, BHYT, tự trả, cùng chi trả, nguồn khác URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary
extension:paymentPeriod		0..1	(Complex)	Kỳ thanh toán BHYT (năm/tháng) — NAM_QT, THANG_QT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period
extension:paymentMethod		0..1	CodeableConcept	Phương thức thanh toán (FFS/Capitation/DRG) — MA_PTTT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method Binding: Phương thức thanh toán BHYT — VN Payment Method ValueSet (extensible)
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
Slices for identifier	S	1..*	Identifier	Định danh hồ sơ thanh toán, bao gồm MA_LK Slice: Unordered, Open by value:system
identifier:MALK	S	1..1	Identifier	Mã liên kết hồ sơ (MA_LK)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
use	?!Σ	0..1	code	usual | official | temp | secondary | old (If known) Binding: IdentifierUse (required): Identifies the purpose for this identifier, if known .
type	Σ	0..1	CodeableConcept	Description of identifier Binding: Identifier Type Codes (extensible): A coded type for an identifier that can be used to determine which identifier to use for a specific purpose. Required Pattern: At least the following
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
coding		1..*	Coding	Code defined by a terminology system Fixed Value: (Complex)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
system		1..1	uri	Identity of the terminology system Fixed Value: http://fhir.hl7.org.vn/core/CodeSystem/vn-identifier-type-cs
version		0..1	string	Version of the system - if relevant
code		1..1	code	Symbol in syntax defined by the system Fixed Value: MA_LK
display		0..1	string	Representation defined by the system
userSelected		0..1	boolean	If this coding was chosen directly by the user
text		0..1	string	Plain text representation of the concept
system	Σ	1..1	uri	The namespace for the identifier value Fixed Value: http://fhir.hl7.org.vn/core/sid/ma-lk
value	SΣ	1..1	string	Giá trị MA_LK Example General: 123456
period	Σ	0..1	Period	Time period when id is/was valid for use
assigner	Σ	0..1	Reference(Organization)	Organization that issued id (may be just text)
status	?!SΣ	1..1	code	Trạng thái yêu cầu thanh toán Binding: FinancialResourceStatusCodes (required): A code specifying the state of the resource instance.
type	SΣ	1..1	CodeableConcept	Loại yêu cầu: institutional (nội trú), professional (ngoại trú) Binding: ClaimTypeCodes (extensible): The type or discipline-style of the claim.
subType	S	0..1	CodeableConcept	Mã đối tượng đến KCB (MA_DOITUONG_KCB theo QĐ 3276/QĐ-BYT) Binding: Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet (extensible)
use	SΣ	1..1	code	Mục đích: claim (thanh toán) | preauthorization | predetermination Binding: Use (required): The purpose of the Claim: predetermination, preauthorization, claim.
patient	SΣ	1..1	Reference(Bệnh nhân VN Core — VN Core Patient Profile)	Bệnh nhân (XML 3176: MA_BN)
billablePeriod	Σ	0..1	Period	Relevant time frame for the claim
created	SΣ	1..1	dateTime	Ngày tạo yêu cầu
enterer		0..1	Reference(Practitioner | PractitionerRole)	Author of the claim
insurer	SΣ	0..1	Reference(Organization)	Cơ quan BHXH thanh toán
provider	SΣ	1..1	Reference(Cơ sở y tế VN Core — VN Core Organization Profile | Nhân viên y tế VN Core — VN Core Practitioner Profile | Vai trò nhân viên y tế VN Core — VN Core PractitionerRole Profile)	Cơ sở KCB thực hiện (XML 3176: MA_CSKCB)
priority	Σ	1..1	CodeableConcept	Mức ưu tiên xử lý Binding: ProcessPriorityCodes (example): The timeliness with which processing is required: stat, normal, deferred.
fundsReserve		0..1	CodeableConcept	For whom to reserve funds Binding: Funds Reservation Codes (example): For whom funds are to be reserved: (Patient, Provider, None).
related		0..*	BackboneElement	Prior or corollary claims
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
claim		0..1	Reference(Claim)	Reference to the related claim
relationship		0..1	CodeableConcept	How the reference claim is related Binding: ExampleRelatedClaimRelationshipCodes (example): Relationship of this claim to a related Claim.
reference		0..1	Identifier	File or case reference
prescription		0..1	Reference(DeviceRequest | MedicationRequest | VisionPrescription)	Prescription authorizing services and products
originalPrescription		0..1	Reference(DeviceRequest | MedicationRequest | VisionPrescription)	Original prescription if superseded by fulfiller
payee		0..1	BackboneElement	Recipient of benefits payable
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
type		1..1	CodeableConcept	Category of recipient Binding: Claim Payee Type Codes (example): A code for the party to be reimbursed.
party		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson)	Recipient reference
referral		0..1	Reference(ServiceRequest)	Treatment referral
facility		0..1	Reference(Location)	Servicing facility
careTeam		0..*	BackboneElement	Members of the care team
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Order of care team
provider		1..1	Reference(Practitioner | PractitionerRole | Organization)	Practitioner or organization
responsible		0..1	boolean	Indicator of the lead practitioner
role		0..1	CodeableConcept	Function within the team Binding: ClaimCareTeamRoleCodes (example): The role codes for the care team members.
qualification		0..1	CodeableConcept	Practitioner credential or specialization Binding: ExampleProviderQualificationCodes (example): Provider professional qualifications.
supportingInfo		0..*	BackboneElement	Supporting information
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Information instance identifier
category		1..1	CodeableConcept	Classification of the supplied information Binding: ClaimInformationCategoryCodes (example): The valuset used for additional information category codes.
code		0..1	CodeableConcept	Type of information Binding: ExceptionCodes (example): The valuset used for additional information codes.
timing[x]		0..1		When it occurred
timingDate			date
timingPeriod			Period
value[x]		0..1		Data to be provided
valueBoolean			boolean
valueString			string
valueQuantity			Quantity
valueAttachment			Attachment
valueReference			Reference(Resource)
reason		0..1	CodeableConcept	Explanation for the information Binding: MissingToothReasonCodes (example): Reason codes for the missing teeth.
diagnosis	S	1..*	BackboneElement	Chẩn đoán — ICD-10 VN (XML 3176: MA_BENH, MA_BENHKHAC)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	S	1..1	positiveInt	Diagnosis instance identifier
Slices for diagnosis[x]		1..1		Nature of illness or problem Slice: Unordered, Open by type:$this Binding: ICD-10Codes (example): Example ICD10 Diagnostic codes.
diagnosisCodeableConcept			CodeableConcept
diagnosisReference			Reference(Condition)
diagnosis[x]:diagnosisCodeableConcept	S	0..1	CodeableConcept	Mã bệnh ICD-10 VN (QĐ 4469/QĐ-BYT) Binding: Mã chẩn đoán — VN Core Condition Code ValueSet (extensible)
type	S	0..*	CodeableConcept	Loại chẩn đoán (chính/phụ) Binding: ExampleDiagnosisTypeCodes (example): The type of the diagnosis: admitting, principal, discharge.
onAdmission		0..1	CodeableConcept	Present on admission Binding: ExampleDiagnosisOnAdmissionCodes (example): Present on admission.
packageCode		0..1	CodeableConcept	Package billing code Binding: ExampleDiagnosisRelatedGroupCodes (example): The DRG codes associated with the diagnosis.
procedure		0..*	BackboneElement	Thủ thuật/phẫu thuật — ICD-9-CM (XML 3176: MA_PTTT_QT)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Procedure instance identifier
type		0..*	CodeableConcept	Category of Procedure Binding: ExampleProcedureTypeCodes (example): Example procedure type codes.
date		0..1	dateTime	When the procedure was performed
Slices for procedure[x]		1..1		Specific clinical procedure Slice: Unordered, Open by type:$this Binding: ICD-10ProcedureCodes (example): Example ICD10 Procedure codes.
procedureCodeableConcept			CodeableConcept
procedureReference			Reference(Procedure)
procedure[x]:procedureCodeableConcept		0..1	CodeableConcept	Specific clinical procedure Binding: Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet (extensible)
udi		0..*	Reference(Device)	Unique device identifier
insurance	SΣ	1..*	BackboneElement	Các Coverage thực tham gia COB và các giai đoạn hưởng — Real Coverages in COB with their benefit stages
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:benefitStage	SC	1..*	(Complex)	Sequence, period và mức hưởng của giai đoạn — Stage sequence, period, and benefit level URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage Constraints: vn-coverage-benefit-stage-level-range
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	SΣ	1..1	positiveInt	Thứ tự phối hợp quyền lợi (COB), không phải sequence giai đoạn — Coordination-of-benefits order, not a stage sequence
focal	SΣ	1..1	boolean	Coverage to be used for adjudication
identifier		0..1	Identifier	Pre-assigned Claim number
coverage	SΣ	1..1	Reference(Thẻ BHYT VN Core — VN Core Coverage Profile)	Thẻ BHYT (Coverage)
businessArrangement		0..1	string	Additional provider contract number
preAuthRef		0..*	string	Prior authorization reference number
claimResponse		0..1	Reference(ClaimResponse)	Adjudication results
accident		0..1	BackboneElement	Thông tin tai nạn thương tích
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
date		1..1	date	When the incident occurred
type		0..1	CodeableConcept	Loại tai nạn (MA_TAI_NAN theo QĐ 3176/QĐ-BYT, Bảng 8) Binding: Mã tai nạn thương tích — Vietnam Accident Type ValueSet (extensible)
location[x]		0..1		Where the event occurred
locationAddress			Address
locationReference			Reference(Location)
item	SC	1..*	BackboneElement	Dòng tổng hợp chịu phân bổ; chi tiết gói TBYT nằm ở detail — Allocated summary line; device-package components use detail Constraints: vn-itemized-claim-serviced-in-stage, vn-itemized-claim-line-allocation-sum, vn-itemized-claim-insured-fields-required, vn-itemized-claim-detail-insured-fields-required, vn-itemized-claim-benefit-level-matches-stage, vn-itemized-claim-other-fund-breakdown-sum
id		0..1	string	Unique id for inter-element referencing
Slices for extension		3..*	Extension	Extension Slice: Unordered, Open by value:url
extension:department		0..1	CodeableConcept	Khoa thực hiện (MA_KHOA) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-item-department Binding: Danh mục mã khoa — Vietnam Department ValueSet (extensible)
extension:deviceGroup		0..1	CodeableConcept	Nhóm TBYT BHYT N01-N09 cho dòng chi phí thiết bị/vật tư URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-device-group Binding: Nhóm thiết bị y tế theo danh mục BHYT — VN Device Group VS (extensible)
extension:deviceInsuranceScope		0..1	CodeableConcept	Legacy PHAM_VI cho dòng TBYT; dữ liệu mới ưu tiên insuranceCostInfo.scope URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-device-insurance-scope Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:insuranceCostInfo	S	1..1	(Complex)	Các cột đơn giá/tỷ lệ/thành tiền BHYT — BHYT price, ratio, and eligible-amount columns URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:scope		0..1	Extension	Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"scope"
value[x]		1..1	CodeableConcept	Value of extension Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:paymentRatio		0..1	Extension	Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentRatio"
value[x]		1..1	decimal	Value of extension
extension:benefitLevel		0..1	Extension	Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"benefitLevel"
value[x]		1..1	decimal	Value of extension
extension:paymentCeiling		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentCeiling"
value[x]		1..1	Money	Trần thanh toán BHYT (VND)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:servicePaymentRatio		0..1	Extension	Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"servicePaymentRatio"
value[x]		1..1	decimal	Value of extension
extension:insuranceUnitPrice		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceUnitPrice"
value[x]		1..1	Money	Đơn giá BHYT thanh toán (VND)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceLineAmount"
value[x]		1..1	Money	Thành tiền BH đủ điều kiện (VND) — Eligible insurance line amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
url		1..1	uri	"http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
extension:otherFundBreakdown	C	0..1	(Complex)	Chi tiết nguồn khác chi trả theo dòng: NSNN/VTNN/VTTN/CL (T_NGUONKHAC_*) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown Constraints: vn-other-fund-breakdown-money-vnd-value
extension:anesthesiaMethod		0..1	CodeableConcept	Phương pháp vô cảm dòng DVKT (PP_VO_CAM) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-anesthesia-method Binding: Phương pháp vô cảm — Vietnam Anesthesia Method ValueSet (required)
extension:paymentSource		0..1	CodeableConcept	Nguồn chi trả dòng chi phí (NGUON_CTRA) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-source Binding: Nguồn chi trả — Vietnam Payment Source ValueSet (extensible)
extension:recurrentWoundBenefit		0..1	boolean	Flag VET_THUONG_TP cho dòng thuốc/DVKT/VTYT URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-recurrent-wound-benefit
extension:tenderInfo		0..1	string	Thông tin thầu dòng chi phí (TT_THAU) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-tender-info
extension:processingMethod		0..1	CodeableConcept	Phương pháp chế biến YHCT (MA_PP_CHEBIEN) URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-traditional-processing-method Binding: Phương pháp chế biến vị thuốc cổ truyền — VN Traditional Medicine Processing Method ValueSet (extensible)
extension:benefitStageSequence	S	1..1	positiveInt	Sequence giai đoạn hưởng của dòng — Line benefit-stage sequence URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence
extension:linePaymentAllocation	S	1..1	(Complex)	Bốn nguồn thanh toán cột 10–13 — Four payment sources in columns 10–13 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	S	1..1	positiveInt	Item instance identifier
careTeamSequence		0..*	positiveInt	Applicable careTeam members
diagnosisSequence		0..*	positiveInt	Applicable diagnoses
procedureSequence		0..*	positiveInt	Applicable procedures
informationSequence		0..*	positiveInt	Applicable exception and supporting information
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category	S	1..1	CodeableConcept	Nhóm chi phí QĐ 697/QĐ-BYT — QĐ 697/QĐ-BYT cost category Binding: Danh mục chi phí KCB — Vietnam Cost Category ValueSet (required)
productOrService	S	1..1	CodeableConcept	Mã dịch vụ/thuốc/TBYT Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Product or service billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
serviced[x]	S	1..1		Ngày/khoảng thực hiện trong giai đoạn hưởng — Service date/period within the benefit stage
servicedDate			date
servicedPeriod			Period
location[x]		0..1		Place of service or where product was supplied Binding: ExampleServicePlaceCodes (example): Place of service: pharmacy, school, prison, etc.
locationCodeableConcept			CodeableConcept
locationAddress			Address
locationReference			Reference(Location)
quantity	S	1..1	SimpleQuantity(4.0.1)	Số lượng của dòng — Line quantity
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
unitPrice	S	1..1	Money	Đơn giá bệnh viện, VND — Hospital unit price in VND
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
factor		0..1	decimal	Price scaling factor
net	S	1..1	Money	Thành tiền bệnh viện, bằng tổng bốn nguồn — Hospital line amount equal to four-source allocation
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
udi		0..*	Reference(Device)	Unique device identifier
bodySite		0..1	CodeableConcept	Anatomical location Binding: OralSiteCodes (example): The code for the teeth, quadrant, sextant and arch.
subSite		0..*	CodeableConcept	Anatomical sub-location Binding: SurfaceCodes (example): The code for the tooth surface and surface combinations.
encounter		0..*	Reference(Encounter)	Encounters related to this billed item
detail		0..*	BackboneElement	Chi tiết cấu thành gói TBYT; không bắt buộc allocation — Device-package components without required allocation
id		0..1	string	Unique id for inter-element referencing
Slices for extension		1..*	Extension	Extension Slice: Unordered, Open by value:url
extension:insuranceCostInfo	S	1..1	(Complex)	Cột 5/6/8/9 của component gói TBYT — Device-package component columns 5/6/8/9 URL: http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info
id		0..1	string	Unique id for inter-element referencing
Slices for extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
Slices for extension				Content/Rules for all slices
extension:scope		0..1	Extension	Phạm vi BHYT (PHAM_VI): 1=trong DM, 2=ngoài DM, 3=NĐ 70/2015/NĐ-CP
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"scope"
value[x]		1..1	CodeableConcept	Value of extension Binding: Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet (extensible)
extension:paymentRatio		0..1	Extension	Tỷ lệ thanh toán BHYT (TYLE_TT) — VD: 100, 80, 50
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentRatio"
value[x]		1..1	decimal	Value of extension
extension:benefitLevel		0..1	Extension	Mức hưởng BHYT (MUC_HUONG) — VD: 100, 80, 40
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"benefitLevel"
value[x]		1..1	decimal	Value of extension
extension:paymentCeiling		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"paymentCeiling"
value[x]		1..1	Money	Trần thanh toán BHYT (VND)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:servicePaymentRatio		0..1	Extension	Tỷ lệ thanh toán DVKT/giường/công khám (TYLE_TT_DV) — VD: 100, 50, 33
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"servicePaymentRatio"
value[x]		1..1	decimal	Value of extension
extension:insuranceUnitPrice		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceUnitPrice"
value[x]		1..1	Money	Đơn giá BHYT thanh toán (VND)
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
extension:insuranceLineAmount		0..1	Extension	Extension
id		0..1	string	Unique id for inter-element referencing
extension		0..0		Extension Slice: Unordered, Open by value:url
url		1..1	uri	"insuranceLineAmount"
value[x]		1..1	Money	Thành tiền BH đủ điều kiện (VND) — Eligible insurance line amount
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	0..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
url		1..1	uri	"http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info"
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService	S	1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
quantity	S	1..1	SimpleQuantity(4.0.1)	Count of products or services
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
unit	Σ	0..1	string	Unit representation
system	ΣC	0..1	uri	System that defines coded unit form
code	Σ	0..1	code	Coded form of the unit
unitPrice	S	1..1	Money	Fee, charge or cost per item
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
factor		0..1	decimal	Price scaling factor
net	S	1..1	Money	Total item cost
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
udi		0..*	Reference(Device)	Unique device identifier
subDetail		0..*	BackboneElement	Product or service provided
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence		1..1	positiveInt	Item instance identifier
revenue		0..1	CodeableConcept	Revenue or cost center code Binding: ExampleRevenueCenterCodes (example): Codes for the revenue or cost centers supplying the service and/or products.
category		0..1	CodeableConcept	Benefit classification Binding: BenefitCategoryCodes (example): Benefit categories such as: oral-basic, major, glasses.
productOrService		1..1	CodeableConcept	Billing, service, product, or drug code Binding: USCLSCodes (example): Allowable service and product codes.
modifier		0..*	CodeableConcept	Service/Product billing modifiers Binding: ModifierTypeCodes (example): Item type or modifiers codes, eg for Oral whether the treatment is cosmetic or associated with TMJ, or an appliance was lost or stolen.
programCode		0..*	CodeableConcept	Program the product or service is provided under Binding: ExampleProgramReasonCodes (example): Program specific reason codes.
quantity		0..1	SimpleQuantity(4.0.1)	Count of products or services
unitPrice		0..1	Money	Fee, charge or cost per item
factor		0..1	decimal	Price scaling factor
net		0..1	Money	Total item cost
udi		0..*	Reference(Device)	Unique device identifier
total	S	1..1	Money	Tổng thành tiền của tất cả dòng — Sum of all item net amounts
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
value	Σ	1..1	decimal	Numerical value (with implicit precision)
currency	Σ	1..1	code	ISO 4217 Currency Code Binding: Currencies (required): A code indicating the currency, taken from ISO 4217. Fixed Value: VND
Documentation for this format

Terminology Bindings

Path	Status	Usage	ValueSet	Version	Source
Claim.language	Base	preferred	Common Languages	📍4.0.1	FHIR Std.
Claim.identifier:MALK.​use	Base	required	IdentifierUse	📍4.0.1	FHIR Std.
Claim.identifier:MALK.​type	Base	extensible	IdentifierType	📍4.0.1	FHIR Std.
Claim.status	Base	required	Financial Resource Status Codes	📍4.0.1	FHIR Std.
Claim.type	Base	extensible	Claim Type Codes	📍4.0.1	FHIR Std.
Claim.subType	Base	extensible	Mã đối tượng đến KCB — Vietnam Patient Visit Type ValueSet	📦0.9.0	This IG
Claim.use	Base	required	Use	📍4.0.1	FHIR Std.
Claim.priority	Base	example	Process Priority Codes	📍4.0.1	FHIR Std.
Claim.fundsReserve	Base	example	FundsReserve	📍4.0.1	FHIR Std.
Claim.related.relationship	Base	example	Example Related Claim Relationship Codes	📍4.0.1	FHIR Std.
Claim.payee.type	Base	example	PayeeType	📍4.0.1	FHIR Std.
Claim.careTeam.role	Base	example	Claim Care Team Role Codes	📍4.0.1	FHIR Std.
Claim.careTeam.qualification	Base	example	Example Provider Qualification Codes	📍4.0.1	FHIR Std.
Claim.supportingInfo.​category	Base	example	Claim Information Category Codes	📍4.0.1	FHIR Std.
Claim.supportingInfo.​code	Base	example	Exception Codes	📍4.0.1	FHIR Std.
Claim.supportingInfo.​reason	Base	example	Missing Tooth Reason Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.diagnosis[x]	Base	example	ICD-10 Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.diagnosis[x]:diagnosisCodeableConcept	Base	extensible	Mã chẩn đoán — VN Core Condition Code ValueSet	📦0.9.0	This IG
Claim.diagnosis.type	Base	example	Example Diagnosis Type Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.onAdmission	Base	example	Example Diagnosis on Admission Codes	📍4.0.1	FHIR Std.
Claim.diagnosis.packageCode	Base	example	Example Diagnosis Related Group Codes	📍4.0.1	FHIR Std.
Claim.procedure.type	Base	example	Example Procedure Type Codes	📍4.0.1	FHIR Std.
Claim.procedure.procedure[x]	Base	example	ICD-10 Procedure Codes	📍4.0.1	FHIR Std.
Claim.procedure.procedure[x]:procedureCodeableConcept	Base	extensible	Mã thủ thuật/dịch vụ kỹ thuật — VN Core Procedure Code ValueSet	📦0.9.0	This IG
Claim.accident.type	Base	extensible	Mã tai nạn thương tích — Vietnam Accident Type ValueSet	📦0.9.0	This IG
Claim.item.extension:insuranceCostInfo.​extension:scope.value[x]	Base	extensible	Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet	📦0.9.0	This IG
Claim.item.extension:insuranceCostInfo.​extension:paymentCeiling.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.extension:insuranceCostInfo.​extension:insuranceUnitPrice.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.extension:insuranceCostInfo.​extension:insuranceLineAmount.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item.category	Base	required	Danh mục chi phí KCB — Vietnam Cost Category ValueSet	📦0.9.0	This IG
Claim.item.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item.modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item.programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item.location[x]	Base	example	Example Service Place Codes	📍4.0.1	FHIR Std.
Claim.item.unitPrice.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.net.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.bodySite	Base	example	Oral Site Codes	📍4.0.1	FHIR Std.
Claim.item.subSite	Base	example	Surface Codes	📍4.0.1	FHIR Std.
Claim.item.detail.extension:insuranceCostInfo.​extension:scope.value[x]	Base	extensible	Phạm vi hưởng BHYT — Vietnam Insurance Scope ValueSet	📦0.9.0	This IG
Claim.item.detail.extension:insuranceCostInfo.​extension:paymentCeiling.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.extension:insuranceCostInfo.​extension:insuranceUnitPrice.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.extension:insuranceCostInfo.​extension:insuranceLineAmount.​value[x].currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item.detail.category	Base	example	Benefit Category Codes	📍4.0.1	FHIR Std.
Claim.item.detail.productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item.detail.modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item.detail.programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.item.detail.unitPrice.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.net.​currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​revenue	Base	example	Example Revenue Center Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​category	Base	example	Benefit Category Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​productOrService	Base	example	USCLS Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​modifier	Base	example	Modifier type Codes	📍4.0.1	FHIR Std.
Claim.item.detail.subDetail.​programCode	Base	example	Example Program Reason Codes	📍4.0.1	FHIR Std.
Claim.total.currency	Base	required	CurrencyCode	📍4.0.1	FHIR Std.

Constraints

Id	Grade	Path(s)	Description	Expression
dom-2	error	Claim	If the resource is contained in another resource, it SHALL NOT contain nested Resources	contained.contained.empty()
dom-3	error	Claim	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource	contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	Claim	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated	contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	Claim	If a resource is contained in another resource, it SHALL NOT have a security label	contained.meta.security.empty()
dom-6	best practice	Claim	A resource should have narrative for robust management	text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children	hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both	extension.exists() != value.exists()
vn-claim-coverage-not-expired	warning	Claim	Cảnh báo: thẻ BHYT focal có thể đã hết hạn tại thời điểm tạo Claim — theo NĐ 188/2025/NĐ-CP ban hành 01/07/2025, hiệu lực 15/08/2025, Đ15	insurance.where(focal = true).coverage.resolve().period.end.all($this >= %resource.created)
vn-claim-single-focal-insurance	error	Claim	Phải có đúng 1 thẻ BHYT chính (focal=true). Các thẻ bổ trợ dùng focal=false — theo QĐ 697/QĐ-BYT ngày 19/03/2026 cột 13, NĐ 188/2025/NĐ-CP ban hành 01/07/2025, hiệu lực 15/08/2025, Đ22; sai hồ sơ/chứng từ BHYT có thể bị xử phạt theo NĐ 90/2026/NĐ-CP (ban hành 30/03/2026, hiệu lực 15/05/2026 — đang áp dụng)	insurance.where(focal = true).count() = 1
vn-coverage-benefit-stage-level-range	error	Claim.insurance.extension:benefitStage	Mức hưởng của giai đoạn phải nằm trong khoảng từ 0 đến 100 phần trăm. The benefit level for a coverage stage SHALL be between 0 and 100 percent.	extension('benefitLevel').value >= 0 and extension('benefitLevel').value <= 100
vn-itemized-claim-benefit-level-matches-stage	error	Claim.item	Mức hưởng trên dòng, nếu có, phải bằng mức hưởng của benefit stage được dòng tham chiếu. An item's benefit level, when present, SHALL equal the benefit level of its referenced stage.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value.exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('benefitLevel').value = %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('benefitLevel').value
vn-itemized-claim-coverage-reference-distinct	error	Claim	Mỗi Coverage chỉ được xuất hiện một lần trong Claim bảng kê. Every Coverage SHALL appear only once in the itemized Claim.	insurance.coverage.reference.isDistinct()
vn-itemized-claim-detail-insured-fields-required	error	Claim.item	Khi quỹ BHYT thanh toán item có detail, mọi detail phải có tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện. When the BHYT fund pays an item containing details, every detail SHALL carry its BHYT payment ratio and eligible insurance line amount.	(detail.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.ofType(Money).value > 0) implies detail.all(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-claim-insured-fields-required	error	Claim.item	Khi quỹ BHYT thanh toán một dòng, tỷ lệ thanh toán BHYT và thành tiền BH đủ điều kiện phải có. When the BHYT fund pays a line, its BHYT payment ratio and eligible insurance line amount SHALL be present.	(extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.ofType(Money).value > 0) implies (extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('paymentRatio').value.exists() and extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension('insuranceLineAmount').value.ofType(Money).value.exists())
vn-itemized-claim-item-stage-exists	error	Claim	Mỗi dòng chi phí phải tham chiếu một sequence giai đoạn hưởng tồn tại trên insurance. Every cost line SHALL reference a benefit-stage sequence declared on insurance.	item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value.all($this in %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value)
vn-itemized-claim-line-allocation-sum	error	Claim.item	Thành tiền bệnh viện của dòng (cột 7) phải bằng tổng quỹ BHYT, người bệnh cùng trả, nguồn khác và người bệnh tự trả (cột 10+11+12+13). The line net amount (column 7) SHALL equal the sum of the four payment allocations (columns 10+11+12+13).	net.value = extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('insuranceFund').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('patientCopay').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('otherSource').value.value + extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('patientSelfPay').value.value
vn-itemized-claim-money-vnd	error	Claim	Mọi giá trị tiền tệ của ledger bảng kê phải dùng VND. Every monetary value in the itemized-claim ledger SHALL use VND.	item.unitPrice.currency.all($this = 'VND') and item.net.currency.all($this = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and item.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension.value.ofType(Money).all(currency = 'VND') and item.detail.unitPrice.currency.all($this = 'VND') and item.detail.net.currency.all($this = 'VND') and item.detail.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info').extension.value.ofType(Money).all(currency = 'VND') and total.currency.all($this = 'VND')
vn-itemized-claim-other-fund-breakdown-sum	error	Claim.item	Khi có chi tiết nguồn khác, tổng các thành phần phải bằng khoản otherSource trong phân bổ dòng. When an other-fund breakdown is present, its components SHALL sum to the line's otherSource allocation.	extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').exists() implies extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown').extension.value.ofType(Money).value.aggregate($this + $total, 0) = extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation').extension('otherSource').value.ofType(Money).value
vn-itemized-claim-serviced-in-stage	error	Claim.item	Ngày hoặc khoảng thời gian thực hiện dòng chi phí phải nằm trong period của giai đoạn hưởng được tham chiếu; Period phải có cả start và end. Gateway vẫn phải kiểm tra lại tương quan này trước khi gửi do khác biệt giữa các validator FHIRPath R4. The service date or period SHALL fall within the referenced benefit-stage period, and a serviced Period SHALL contain both start and end. The submission gateway SHALL still repeat this correlation check because R4 FHIRPath validators differ.	(serviced.ofType(date).exists() implies (serviced.ofType(date) >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(date) <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end)) and (serviced.ofType(Period).exists() implies (serviced.ofType(Period).start.exists() and serviced.ofType(Period).end.exists() and serviced.ofType(Period).start >= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).start and serviced.ofType(Period).end <= %resource.insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').where(extension('sequence').value = %context.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence').value).extension('period').value.ofType(Period).end))
vn-itemized-claim-single-focal-insurance	error	Claim	Claim bảng kê phải có đúng một Coverage focal. An itemized Claim SHALL have exactly one focal Coverage.	insurance.where(focal = true).count() = 1
vn-itemized-claim-stage-sequence-unique	error	Claim	Mỗi sequence giai đoạn hưởng trên insurance phải duy nhất trong Claim. Every insurance benefit-stage sequence SHALL be unique within the Claim.	insurance.extension('http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage').extension('sequence').value.isDistinct()
vn-itemized-claim-total-sum	error	Claim	Tổng Claim phải bằng tổng thành tiền của tất cả item. The Claim total SHALL equal the sum of all item net amounts.	total.value = item.net.value.aggregate($this + $total, 0)
vn-other-fund-breakdown-money-vnd-value	error	Claim.item.extension:otherFundBreakdown	Mọi Money con phải có value và dùng VND. Every child Money SHALL have a value and use VND.	extension.value.ofType(Money).all(value.exists() and currency = 'VND')

Summary

Mandatory: 18 elements(16 nested mandatory elements)
Must-Support: 13 elements
Fixed: 11 elements

Extensions

This structure refers to these extensions:

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