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
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.