STU 3 Candidate

This page is part of the FHIR Specification (v1.4.0: STU 3 Ballot 3). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

Claim-example-oral-contained-identifier.ttl

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SOA Dental Claim using identifiers and Contained

@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xs: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir//Claim/100155> a fhir:Claim;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "100155"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ]
  ];
  fhir:DomainResource.contained [
     fhir:index 0;
     fhir:Patient [
       fhir:index 0;
       fhir:Resource.id [ fhir:value "patient-1" ];
       fhir:Patient.name [
         fhir:index 0;
         fhir:HumanName.use [ fhir:value "official" ];
         fhir:HumanName.family [
           fhir:value "Donald";
           fhir:index 0         ];
         fhir:HumanName.given [
           fhir:value "Duck";
           fhir:index 0         ]       ];
       fhir:Patient.gender [ fhir:value "male" ];
       fhir:Patient.birthDate [ fhir:value "1986-05-17"^^xs:date ];
       fhir:Patient.address [
         fhir:index 0;
         fhir:Address.use [ fhir:value "home" ];
         fhir:Address.line [
           fhir:value "1234 Main Street";
           fhir:index 0         ];
         fhir:Address.city [ fhir:value "Vancouver" ];
         fhir:Address.postalCode [ fhir:value "V2H1Y3" ];
         fhir:Address.country [ fhir:value "CAD" ]       ]     ]
  ];
  fhir:Claim.type [ fhir:value "oral"];
  fhir:Claim.identifier [
     fhir:index 0;
     fhir:Identifier.system [ fhir:value "http://happyvalley.com/claim" ];
     fhir:Identifier.value [ fhir:value "12347" ]
  ];
  fhir:Claim.created [ fhir:value "2014-08-16"^^xs:date];
  fhir:Claim.targetIdentifier [
     fhir:Identifier.system [ fhir:value "http://www.jurisdiction.com/insurers" ];
     fhir:Identifier.value [ fhir:value "123456" ]
  ];
  fhir:Claim.organizationIdentifier [
     fhir:Identifier.system [ fhir:value "http://www.jurisdiction.com/careorganizations" ];
     fhir:Identifier.value [ fhir:value "HOSP12345" ]
  ];
  fhir:Claim.use [ fhir:value "complete"];
  fhir:Claim.priority [
     fhir:Coding.code [ fhir:value "normal" ]
  ];
  fhir:Claim.payee [
     fhir:Claim.payee.type [
       fhir:Coding.code [ fhir:value "provider" ]     ]
  ];
  fhir:Claim.diagnosis [
     fhir:index 0;
     fhir:Claim.diagnosis.sequence [ fhir:value "1"^^xs:int ];
     fhir:Claim.diagnosis.diagnosis [
       fhir:Coding.code [ fhir:value "123456" ]     ]
  ];
  fhir:Claim.patientReference [
     fhir:Reference.reference [ fhir:value "#patient-1" ]
  ];
  fhir:Claim.coverage [
     fhir:index 0;
     fhir:Claim.coverage.sequence [ fhir:value "1"^^xs:int ];
     fhir:Claim.coverage.focal [ fhir:value "true"^^xs:boolean ];
     fhir:Claim.coverage.coverageIdentifier [
       fhir:Identifier.system [ fhir:value "http://www.jurisdiction.com/nationalplan" ];
       fhir:Identifier.value [ fhir:value "123AB345" ]     ]
  ];
  fhir:Claim.item [
     fhir:index 0;
     fhir:Claim.item.sequence [ fhir:value "1"^^xs:int ];
     fhir:Claim.item.type [
       fhir:Coding.code [ fhir:value "service" ]     ];
     fhir:Claim.item.providerIdentifier [
       fhir:Identifier.system [ fhir:value "http://www.jurisdiction.com/providerId" ];
       fhir:Identifier.value [ fhir:value "MD98765" ]     ];
     fhir:Claim.item.service [
       fhir:Coding.code [ fhir:value "1200" ]     ];
     fhir:Claim.item.servicedDate [ fhir:value "2014-08-16"^^xs:date ];
     fhir:Claim.item.unitPrice [
       fhir:Quantity.value [ fhir:value "135.57"^^xs:decimal ];
       fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ];
       fhir:Quantity.code [ fhir:value "USD" ]     ];
     fhir:Claim.item.net [
       fhir:Quantity.value [ fhir:value "135.57"^^xs:decimal ];
       fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ];
       fhir:Quantity.code [ fhir:value "USD" ]     ]
  ].

# -------------------------------------------------------------------------------------


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