This page is part of the FHIR Specification (v5.0.0-ballot: R5 Ballot - see ballot notes). 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 | Standards Status: Informative | Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson |
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Glasses 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 "660151"]; 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 Vision Claim for Glasses</div>" ]; fhir:Claim.identifier [ fhir:index 0; fhir:Identifier.system [ fhir:value "http://happysight.com/claim" ]; fhir:Identifier.value [ fhir:value "6612346" ] ]; 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 "vision" ] ] ]; 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.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.prescription [ fhir:link <http://www.optdocs.com/prescription/12345>; fhir:Reference.reference [ fhir:value "http://www.optdocs.com/prescription/12345" ] ]; 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: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 "654321" ] ] ] ]; 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://example.org/fhir/CodeSystem/ex-visionservice" ]; fhir:Coding.code [ fhir:value "glasses" ] ] ]; fhir:Claim.item.servicedDate [ fhir:value "2014-08-16"^^xsd:date ]; fhir:Claim.item.unitPrice [ fhir:Money.value [ fhir:value "214.00"^^xsd:decimal ]; fhir:Money.currency [ fhir:value "USD" ] ]; fhir:Claim.item.net [ fhir:Money.value [ fhir:value "214.00"^^xsd:decimal ]; fhir:Money.currency [ fhir:value "USD" ] ]; fhir:Claim.item.detail [ fhir:index 0; fhir:Claim.item.detail.sequence [ fhir:value "1"^^xsd:positiveInteger ]; fhir:Claim.item.detail.productOrService [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "http://example.org/fhir/CodeSystem/ex-visionservice" ]; fhir:Coding.code [ fhir:value "frame" ] ] ]; fhir:Claim.item.detail.unitPrice [ fhir:Money.value [ fhir:value "100.00"^^xsd:decimal ]; fhir:Money.currency [ fhir:value "USD" ] ]; fhir:Claim.item.detail.net [ fhir:Money.value [ fhir:value "100.00"^^xsd:decimal ]; fhir:Money.currency [ fhir:value "USD" ] ] ], [ fhir:index 1; fhir:Claim.item.detail.sequence [ fhir:value "2"^^xsd:positiveInteger ]; fhir:Claim.item.detail.productOrService [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "http://example.org/fhir/CodeSystem/ex-visionservice" ]; fhir:Coding.code [ fhir:value "lens" ] ] ]; fhir:Claim.item.detail.quantity [ fhir:Quantity.value [ fhir:value "2"^^xsd:decimal ] ]; fhir:Claim.item.detail.unitPrice [ fhir:Money.value [ fhir:value "50.00"^^xsd:decimal ]; fhir:Money.currency [ fhir:value "USD" ] ]; fhir:Claim.item.detail.net [ fhir:Money.value [ fhir:value "100.00"^^xsd:decimal ]; fhir:Money.currency [ fhir:value "USD" ] ] ], [ fhir:index 2; fhir:Claim.item.detail.sequence [ fhir:value "3"^^xsd:positiveInteger ]; fhir:Claim.item.detail.productOrService [ fhir:CodeableConcept.coding [ fhir:index 0; fhir:Coding.system [ fhir:value "http://example.org/fhir/CodeSystem/ex-visionservice" ]; fhir:Coding.code [ fhir:value "fst" ] ] ]; fhir:Claim.item.detail.unitPrice [ fhir:Money.value [ fhir:value "200.00"^^xsd:decimal ]; fhir:Money.currency [ fhir:value "USD" ] ]; fhir:Claim.item.detail.factor [ fhir:value "0.07"^^xsd:decimal ]; fhir:Claim.item.detail.net [ fhir:Money.value [ fhir:value "14.00"^^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.
FHIR ®© HL7.org 2011+. FHIR R5 Ballot hl7.fhir.core#5.0.0-ballot generated on Sat, Sep 10, 2022 05:01+1000.
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