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
Simple Pharmacy Service 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/860150> a fhir:Claim; fhir:nodeRole fhir:treeRoot; fhir:Resource.id [ fhir:value "860150"]; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "generated" ] ]; fhir:Claim.type [ fhir:value "professional"]; fhir:Claim.identifier [ fhir:index 0; fhir:Identifier.system [ fhir:value "http://happypdocs.com/claim" ]; fhir:Identifier.value [ fhir:value "8612345" ] ]; fhir:Claim.created [ fhir:value "2014-08-16"^^xs:date]; fhir:Claim.targetReference [ fhir:reference <http://hl7.org/fhir/Organization/2>; fhir:Reference.reference [ fhir:value "Organization/2" ] ]; fhir:Claim.organizationReference [ fhir:reference <http://hl7.org/fhir/Organization/1>; 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 "654456" ] ] ]; fhir:Claim.patientReference [ fhir:reference <http://hl7.org/fhir/Patient/1>; 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 <http://hl7.org/fhir/Coverage/9876B1>; fhir:Reference.reference [ fhir:value "Coverage/9876B1" ] ] ]; 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 <http://hl7.org/fhir/Practitioner/example>; fhir:Reference.reference [ fhir:value "Practitioner/example" ] ]; fhir:Claim.item.service [ fhir:Coding.system [ fhir:value "http://hl7.org/fhir/ex-serviceproduct" ]; fhir:Coding.code [ fhir:value "exam" ] ]; fhir:Claim.item.servicedDate [ fhir:value "2014-08-16"^^xs:date ]; fhir:Claim.item.unitPrice [ fhir:Quantity.value [ fhir:value "75.00"^^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 "75.00"^^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.