This page is part of the FHIR Specification (v3.3.0: R4 Ballot 2). 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
Financial Management Work Group | Maturity Level: N/A | Ballot Status: Informative | Compartments: Encounter, Patient, Practitioner, RelatedPerson |
Simple 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/100150> a fhir:Claim; fhir:nodeRole fhir:treeRoot; fhir:Resource.id [ fhir:value "100150"]; 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:Claim.identifier [ fhir:index 0; fhir:Identifier.system [ fhir:value "http://happyvalley.com/claim" ]; fhir:Identifier.value [ fhir:value "12345" ] ]; fhir:Claim.status [ fhir:value "active"]; fhir:Claim.type [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "http://hl7.org/fhir/claim-type" ]; fhir:Coding.code [ fhir:value "oral" ] ] ]; fhir:Claim.use [ fhir:value "complete"]; fhir:Claim.patient [ fhir:link <http://hl7.org/fhir/Patient/1>; fhir:Reference.reference [ fhir:value "Patient/1" ] ]; fhir:Claim.created [ fhir:value "2014-08-16"^^xsd:date]; fhir:Claim.insurer [ fhir:link <http://hl7.org/fhir/Organization/2>; fhir:Reference.reference [ fhir:value "Organization/2" ] ]; fhir:Claim.provider [ fhir:link <http://hl7.org/fhir/Organization/1>; fhir:Reference.reference [ fhir:value "Organization/1" ] ]; fhir:Claim.priority [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.code [ fhir:value "normal" ] ] ]; fhir:Claim.payee [ fhir:Claim.payee.type [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.code [ fhir:value "provider" ] ] ] ]; fhir:Claim.careTeam [ fhir:index 0; fhir:Claim.careTeam.sequence [ fhir:value "1"^^xsd:positiveInteger ]; fhir:Claim.careTeam.provider [ fhir:link <http://hl7.org/fhir/Practitioner/example>; fhir:Reference.reference [ fhir:value "Practitioner/example" ] ] ]; fhir:Claim.diagnosis [ fhir:index 0; fhir:Claim.diagnosis.sequence [ fhir:value "1"^^xsd:positiveInteger ]; fhir:Claim.diagnosis.diagnosisCodeableConcept [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.code [ fhir:value "123456" ] ] ] ]; fhir:Claim.insurance [ fhir:index 0; fhir:Claim.insurance.sequence [ fhir:value "1"^^xsd:positiveInteger ]; fhir:Claim.insurance.focal [ fhir:value "true"^^xsd:boolean ]; fhir:Claim.insurance.identifier [ fhir:Identifier.system [ fhir:value "http://happyvalley.com/claim" ]; fhir:Identifier.value [ fhir:value "12345" ] ]; fhir:Claim.insurance.coverage [ fhir:link <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"^^xsd:positiveInteger ]; fhir:Claim.item.careTeamSequence [ fhir:value "1"^^xsd:positiveInteger; fhir:index 0 ]; fhir:Claim.item.service [ fhir:CodeableConcept.coding [ fhir:index 0; 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" ] ] ] . <http://hl7.org/fhir/Patient/1> a fhir:Patient . <http://hl7.org/fhir/Organization/2> a fhir:Organization . <http://hl7.org/fhir/Organization/1> a fhir:Organization . <http://hl7.org/fhir/Practitioner/example> a fhir:Practitioner . <http://hl7.org/fhir/Coverage/9876B1> a fhir:Coverage . # - ontology header ------------------------------------------------------------ <http://hl7.org/fhir/Claim/100150.ttl> a owl:Ontology; owl:imports fhir:fhir.ttl; owl:versionIRI <http://build.fhir.org/Claim/100150.ttl> . # -------------------------------------------------------------------------------------
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.