Example Claim/960150 (Turtle)
Raw Turtle (+ also see Turtle/RDF Format Specification)
Simple Institutional 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 xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
[a fhir:Claim;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "960150"];
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 Claim</div>"
];
fhir:Claim.identifier [
fhir:index 0;
fhir:Identifier.system [ fhir:value "http://happyhospital.com/claim" ];
fhir:Identifier.value [ fhir:value "9612345" ]
];
fhir:Claim.status [ fhir:value "active"];
fhir:Claim.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ];
fhir:Coding.code [ fhir:value "institutional" ]
]
];
fhir:Claim.subType [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/ex-claimsubtype" ];
fhir:Coding.code [ fhir:value "emergency" ]
]
];
fhir:Claim.use [ fhir:value "claim"];
fhir:Claim.patient [
fhir:Reference.reference [ fhir:value "Patient/1" ]
];
fhir:Claim.created [ fhir:value "2014-08-16"^^xsd:date];
fhir:Claim.enterer [
fhir:Reference.identifier [
fhir:Identifier.system [ fhir:value "http://jurisdiction.org/facilities/HOSP1234/users" ];
fhir:Identifier.value [ fhir:value "UC1234" ]
]
];
fhir:Claim.insurer [
fhir:Reference.reference [ fhir:value "Organization/2" ]
];
fhir:Claim.provider [
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.facility [
fhir:Reference.identifier [
fhir:Identifier.system [ fhir:value "http://jurisdiction.org/facilities" ];
fhir:Identifier.value [ fhir:value "HOSP1234" ]
]
];
fhir:Claim.careTeam [
fhir:index 0;
fhir:Claim.careTeam.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.careTeam.provider [
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 "654456" ]
]
]
];
fhir:Claim.procedure [
fhir:index 0;
fhir:Claim.procedure.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.procedure.type [
fhir:index 0;
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.code [ fhir:value "primary" ]
]
];
fhir:Claim.procedure.date [ fhir:value "2014-08-16"^^xsd:date ];
fhir:Claim.procedure.procedureCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.code [ fhir:value "SDI9901" ]
];
fhir:CodeableConcept.text [ fhir:value "Subcutaneous diagnostic implant" ]
];
fhir:Claim.procedure.udi [
fhir:index 0;
fhir:Reference.reference [ fhir:value "Device/example" ]
]
];
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.coverage [
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.productOrService [
fhir:CodeableConcept.coding [
fhir:index 0;
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"^^xsd:date ];
fhir:Claim.item.unitPrice [
fhir:Money.value [ fhir:value "125.00"^^xsd:decimal ];
fhir:Money.currency [ fhir:value "USD" ]
];
fhir:Claim.item.net [
fhir:Money.value [ fhir:value "125.00"^^xsd:decimal ];
fhir:Money.currency [ fhir:value "USD" ]
];
fhir:Claim.item.encounter [
fhir:index 0;
fhir:Reference.reference [ fhir:value "Encounter/example" ]
]
];
fhir:Claim.total [
fhir:Money.value [ fhir:value "125.00"^^xsd:decimal ];
fhir:Money.currency [ fhir:value "USD" ]
]] .
# - ontology header ------------------------------------------------------------
[a owl:Ontology;
owl:imports fhir:fhir.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.