Claim-example-oral-contained.ttl

SOA Dental Claim

@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/100152> a fhir:Claim;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "100152"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ]
  ];
  fhir:DomainResource.contained [
     fhir:index 0;
     fhir:Organization [
       fhir:index 0;
       fhir:Resource.id [ fhir:value "organization-1" ];
       fhir:Organization.identifier [
         fhir:index 0;
         fhir:Identifier.system [ fhir:value "http://www.jurisdiction.com/oralhealthoffices" ];
         fhir:Identifier.value [ fhir:value "3456" ]       ]     ]
  ];
  fhir:DomainResource.contained [
     fhir:index 1;
     fhir:Organization [
       fhir:index 0;
       fhir:Resource.id [ fhir:value "organization-2" ];
       fhir:Organization.identifier [
         fhir:index 0;
         fhir:Identifier.system [ fhir:value "http://www.bindb.com/bin" ];
         fhir:Identifier.value [ fhir:value "123456" ]       ]     ]
  ];
  fhir:DomainResource.contained [
     fhir:index 2;
     fhir:Practitioner [
       fhir:index 0;
       fhir:Resource.id [ fhir:value "practitioner-1" ];
       fhir:Practitioner.identifier [
         fhir:index 0;
         fhir:Identifier.system [ fhir:value "http://www.jurisdiction.com/oralhealthproviders" ];
         fhir:Identifier.value [ fhir:value "123456789" ]       ]     ]
  ];
  fhir:DomainResource.contained [
     fhir:index 3;
     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:DomainResource.contained [
     fhir:index 4;
     fhir:Coverage [
       fhir:index 0;
       fhir:Resource.id [ fhir:value "coverage-1" ];
       fhir:Coverage.issuerReference [
         fhir:Reference.reference [ fhir:value "#organization-2" ]       ];
       fhir:Coverage.type [
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/v3/ActCode" ];
         fhir:Coding.code [ fhir:value "EHCPOL" ]       ];
       fhir:Coverage.planholderReference [
         fhir:Reference.reference [ fhir:value "#patient-1" ]       ];
       fhir:Coverage.beneficiaryReference [
         fhir:Reference.reference [ fhir:value "#patient-1" ]       ];
       fhir:Coverage.relationship [
         fhir:Coding.code [ fhir:value "self" ]       ];
       fhir:Coverage.identifier [
         fhir:index 0;
         fhir:Identifier.system [ fhir:value "http://benefitsinc.com/certificate" ];
         fhir:Identifier.value [ fhir:value "12345" ]       ];
       fhir:Coverage.plan [ fhir:value "CBI35" ];
       fhir:Coverage.subPlan [ fhir:value "123" ];
       fhir:Coverage.dependent [ fhir:value "1"^^xs:int ];
       fhir:Coverage.sequence [ fhir:value "1"^^xs:int ]     ]
  ];
  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.targetReference [
     fhir:Reference.reference [ fhir:value "#organization-2" ]
  ];
  fhir:Claim.organizationReference [
     fhir:Reference.reference [ fhir:value "#organization-1" ]
  ];
  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.coverageReference [
       fhir:Reference.reference [ fhir:value "#coverage-1" ]     ]
  ];
  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.providerReference [
       fhir:Reference.reference [ fhir:value "#practitioner-1" ]     ];
     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" ]     ]
  ].

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