Invoice Profile

Canonical	../StructureDefinition/nexus-emr-core-invoice
Status	draft · 1.26.0
Base	Invoice (constraint)
CQL primary code path	type — what this means
Source	FSH · JSON

Nexus EMR profile for Invoice representing Canadian provider-side billing records. Aligned with Oscar Pro's billing model: one invoice per claim header, with its line items inline. Phase 1 scope: Ontario OHIP billing via Oscar Pro.

Examples

Example

Example OHIP billing invoice with 2 line items (A007 general assessment + K030 chronic care premium) demonstrating oscarBillingStatus, shadowBill, and payProgram extensions

Invoice/nexus-emr-invoice-example — claims conformance to Invoice Profile

{
  "resourceType": "Invoice",
  "id": "nexus-emr-invoice-example",
  "meta": {
    "profile": [
      "../StructureDefinition/nexus-emr-core-invoice"
    ]
  },
  "identifier": [
    {
      "use": "secondary",
      "system": "../NamingSystem/cedarbrook-clinic-invoice-header-id",
      "value": "78234"
    }
  ],
  "text": {
    "status": "generated",
    "div": "<div xmlns="http://www.w3.org/1999/xhtml">OHIP bill for Avery Linwood, April 8, 2026 visit &#8212; intermediate assessment A007 ($44.55) with diabetic management assessment K030 ($45.75). Total $90.30.</div>"
  },
  "status": "issued",
  "extension": [
    {
      "url": "../StructureDefinition/oscar-billing-status-extension",
      "valueCode": "O"
    },
    {
      "url": "../StructureDefinition/oscar-billing-shadow-bill-extension",
      "valueBoolean": false
    },
    {
      "url": "../StructureDefinition/oscar-service-location-extension",
      "valueReference": {
        "reference": "Location/cedarbrook-site-a"
      }
    }
  ],
  "type": {
    "coding": [
      {
        "system": "../CodeSystem/oscar-pay-program-cs",
        "code": "HCP",
        "display": "OHIP HCP"
      }
    ]
  },
  "subject": {
    "reference": "Patient/avery-linwood"
  },
  "issuer": {
    "reference": "Organization/cedarbrook-clinic"
  },
  "date": "2026-04-08T10:15:00-04:00",
  "participant": [
    {
      "role": {
        "text": "billing"
      },
      "actor": {
        "reference": "Practitioner/dr-emil-navarro",
        "display": "Dr. Emil A. Navarro, MD"
      }
    }
  ],
  "lineItem": [
    {
      "sequence": 1,
      "chargeItemCodeableConcept": {
        "coding": [
          {
            "system": "../CodeSystem/on-ohip-schedule-of-benefits",
            "code": "A007",
            "display": "GP/FP-Intermediate assessment/well baby care"
          }
        ],
        "text": "GP/FP-Intermediate assessment/well baby care"
      },
      "priceComponent": [
        {
          "type": "base",
          "amount": {
            "value": 44.55,
            "currency": "CAD"
          },
          "factor": 1
        }
      ]
    },
    {
      "sequence": 2,
      "chargeItemCodeableConcept": {
        "coding": [
          {
            "system": "../CodeSystem/on-ohip-schedule-of-benefits",
            "code": "K030",
            "display": "GP/FP-Diabetic Management Assessment"
          }
        ],
        "text": "GP/FP-Diabetic Management Assessment"
      },
      "priceComponent": [
        {
          "type": "base",
          "amount": {
            "value": 45.75,
            "currency": "CAD"
          },
          "factor": 1
        }
      ]
    }
  ],
  "totalGross": {
    "value": 90.3,
    "currency": "CAD"
  },
  "note": [
    {
      "text": "15-minute visit, diabetes management discussion"
    }
  ]
}