Example Claim/960151 (Turtle)
Raw Turtle (+ also see Turtle/RDF Format Specification)
Rich 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 "960151"]; #
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 "96123451" ]
]; #
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.use [ fhir:value "claim"]; #
fhir:Claim.patient [
fhir:Reference.reference [ fhir:value "Patient/1" ]
]; #
fhir:Claim.billablePeriod [
fhir:Period.start [ fhir:value "2014-08-15"^^xsd:date ];
fhir:Period.end [ fhir:value "2014-08-16"^^xsd:date ]
]; #
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.identifier [
fhir:Identifier.system [ fhir:value "http://npid.org/providerid" ];
fhir:Identifier.value [ fhir:value "NJ12345" ]
]
]; #
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.diagnosisRelatedGroup [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/ex-diagnosisrelatedgroup" ];
fhir:Coding.code [ fhir:value "400" ];
fhir:Coding.display [ fhir:value "Head trauma - concussion" ]
]
]; #
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.careTeam.responsible [ fhir:value "true"^^xsd:boolean ];
fhir:Claim.careTeam.role [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://example.org/fhir/CodeSystem/claim-careteamrole" ];
fhir:Coding.code [ fhir:value "primary" ]
]
];
fhir:Claim.careTeam.specialty [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://example.org/fhir/CodeSystem/provider-qualification" ];
fhir:Coding.code [ fhir:value "physician" ]
]
]
]; #
fhir:Claim.supportingInfo [
fhir:index 0;
fhir:Claim.supportingInfo.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.supportingInfo.category [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claiminformationcategory" ];
fhir:Coding.code [ fhir:value "employmentimpacted" ]
]
];
fhir:Claim.supportingInfo.timingPeriod [
fhir:Period.start [ fhir:value "2014-08-16"^^xsd:date ];
fhir:Period.end [ fhir:value "2014-08-16"^^xsd:date ]
]
], [
fhir:index 1;
fhir:Claim.supportingInfo.sequence [ fhir:value "2"^^xsd:positiveInteger ];
fhir:Claim.supportingInfo.category [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claiminformationcategory" ];
fhir:Coding.code [ fhir:value "hospitalized" ]
]
];
fhir:Claim.supportingInfo.timingPeriod [
fhir:Period.start [ fhir:value "2014-08-15"^^xsd:date ];
fhir:Period.end [ fhir:value "2014-08-16"^^xsd:date ]
]
]; #
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.diagnosis.type [
fhir:index 0;
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/ex-diagnosistype" ];
fhir:Coding.code [ fhir:value "admitting" ]
]
]
]; #
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.insurance.businessArrangement [ fhir:value "BA987123" ];
fhir:Claim.insurance.preAuthRef [
fhir:value "PA2014G56473";
fhir:index 0
]
]; #
fhir:Claim.accident [
fhir:Claim.accident.date [ fhir:value "2014-07-09"^^xsd:date ];
fhir:Claim.accident.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-ActIncidentCode" ];
fhir:Coding.code [ fhir:value "SPT" ];
fhir:Coding.display [ fhir:value "Sporting Accident" ]
]
];
fhir:Claim.accident.locationAddress [
fhir:Address.text [ fhir:value "Grouse Mountain Ski Hill" ]
]
]; #
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.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.
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