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 xsd: <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:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the Oral Health Claim</div>"
  ];
  fhir:DomainResource.contained [
     a 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" ]
     ]
  ], [
     a fhir:Organization;
     fhir:index 1;
     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" ]
     ]
  ], [
     a fhir:Practitioner;
     fhir:index 2;
     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" ]
     ]
  ], [
     a fhir:Patient;
     fhir:index 3;
     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"^^xsd: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" ]
     ]
  ], [
     a fhir:Coverage;
     fhir:index 4;
     fhir:Resource.id [ fhir:value "coverage-1" ];
     fhir:Coverage.status [ fhir:value "active" ];
     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"^^xsd:positiveInteger ];
     fhir:Coverage.sequence [ fhir:value "1"^^xsd:positiveInteger ]
  ];
  fhir:Claim.identifier [
     fhir:index 0;
     fhir:Identifier.system [ fhir:value "http://happyvalley.com/claim" ];
     fhir:Identifier.value [ fhir:value "12347" ]
  ];
  fhir:Claim.status [ fhir:value "active"];
  fhir:Claim.type [
     fhir:Coding.system [ fhir:value "http://hl7.org/fhir/ex-claimtype" ];
     fhir:Coding.code [ fhir:value "oral" ]
  ];
  fhir:Claim.created [ fhir:value "2014-08-16"^^xsd:date];
  fhir:Claim.insurerReference [
     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"^^xsd:positiveInteger ];
     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"^^xsd:positiveInteger ];
     fhir:Claim.coverage.focal [ fhir:value "true"^^xsd: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"^^xsd:positiveInteger ];
     fhir:Claim.item.careTeam [
       fhir:index 0;
       fhir:Claim.item.careTeam.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"^^xsd:date ];
     fhir:Claim.item.unitPrice [
       fhir:Quantity.value [ fhir:value "135.57"^^xsd: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"^^xsd:decimal ];
       fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ];
       fhir:Quantity.code [ fhir:value "USD" ]
     ]
  ] .

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