This page is part of the FHIR Specification (v1.6.0: STU 3 Ballot 4). 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
@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/100154> a fhir:Claim; fhir:nodeRole fhir:treeRoot; fhir:Resource.id [ fhir:value "100154"]; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "generated" ]; fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\">This example assumes a national health care scheme where patients, providers and organizations have known business identifiers.</div>" ]; 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.insurerIdentifier [ 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"^^xsd:positiveInteger ]; fhir:Claim.diagnosis.diagnosis [ fhir:Coding.code [ fhir:value "123456" ] ] ]; fhir:Claim.patientIdentifier [ fhir:Identifier.system [ fhir:value "http://www.jurisdiction.com/nationalId" ]; fhir:Identifier.value [ fhir:value "123AB345" ] ]; 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.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"^^xsd:positiveInteger ]; fhir:Claim.item.careTeam [ fhir:index 0; fhir:Claim.item.careTeam.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"^^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" ] ] ] . # -------------------------------------------------------------------------------------
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.