R6 Ballot (2nd Draft)

Publish-box (todo)

Example Coverage/9876B1 (Turtle)

Financial Management Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Patient, RelatedPerson

Raw Turtle (+ also see Turtle/RDF Format Specification)

General Person Primary Coverage Example

@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:Coverage ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "9876B1"] ; # 
  fhir:text [
     fhir:status [ fhir:v "generated" ] ;
     fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the coverage</div>"
  ] ; # 
  fhir:identifier ( [
     fhir:system [ fhir:v "http://benefitsinc.com/certificate"^^xsd:anyURI ] ;
     fhir:value [ fhir:v "12345" ]
  ] ) ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:kind [ fhir:v "insurance"] ; # 
  fhir:type [
     fhir:coding ( [
       fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
       fhir:code [ fhir:v "EHCPOL" ] ;
       fhir:display [ fhir:v "extended healthcare" ]
     ] )
  ] ; # 
  fhir:policyHolder [
     fhir:link <http://benefits.example.org/FHIR/Organization/CBI35> ;
     fhir:reference [ fhir:v "http://benefits.example.org/FHIR/Organization/CBI35" ]
  ] ; # 
  fhir:subscriber [
     fhir:reference [ fhir:v "Patient/4" ]
  ] ; # 
  fhir:beneficiary [
     fhir:reference [ fhir:v "Patient/4" ]
  ] ; # 
  fhir:dependent [ fhir:v "0"] ; # 
  fhir:relationship [
     fhir:coding ( [
       fhir:code [ fhir:v "self" ]
     ] )
  ] ; # 
  fhir:period [
     fhir:start [ fhir:v "2011-05-23"^^xsd:date ] ;
     fhir:end [ fhir:v "2012-05-23"^^xsd:date ]
  ] ; # 
  fhir:insurer [
     fhir:reference [ fhir:v "Organization/2" ]
  ] ; # 
  fhir:class ( [
     fhir:type [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "group" ]
       ] )
     ] ;
     fhir:value [
       fhir:value [ fhir:v "CB135" ]
     ] ;
     fhir:name [ fhir:v "Corporate Baker's Inc. Local #35" ]
  ] [
     fhir:type [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "subgroup" ]
       ] )
     ] ;
     fhir:value [
       fhir:value [ fhir:v "123" ]
     ] ;
     fhir:name [ fhir:v "Trainee Part-time Benefits" ]
  ] [
     fhir:type [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "plan" ]
       ] )
     ] ;
     fhir:value [
       fhir:value [ fhir:v "B37FC" ]
     ] ;
     fhir:name [ fhir:v "Full Coverage: Medical, Dental, Pharmacy, Vision, EHC" ]
  ] [
     fhir:type [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "subplan" ]
       ] )
     ] ;
     fhir:value [
       fhir:value [ fhir:v "P7" ]
     ] ;
     fhir:name [ fhir:v "Includes afterlife benefits" ]
  ] [
     fhir:type [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "class" ]
       ] )
     ] ;
     fhir:value [
       fhir:value [ fhir:v "SILVER" ]
     ] ;
     fhir:name [ fhir:v "Silver: Family Plan spouse only" ]
  ] [
     fhir:type [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "subclass" ]
       ] )
     ] ;
     fhir:value [
       fhir:value [ fhir:v "Tier2" ]
     ] ;
     fhir:name [ fhir:v "Low deductable, max $20 copay" ]
  ] [
     fhir:type [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "sequence" ]
       ] )
     ] ;
     fhir:value [
       fhir:value [ fhir:v "9" ]
     ]
  ] [
     fhir:type [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "rxid" ]
       ] )
     ] ;
     fhir:value [
       fhir:value [ fhir:v "MDF12345" ]
     ] #   member id used when submitting pharmacy claims  
  ] [
     fhir:type [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "rxbin" ]
       ] )
     ] ;
     fhir:value [
       fhir:value [ fhir:v "987654" ]
     ] #   the pharmacy processor BIN number used when submitting pharmacy claims  
  ] [
     fhir:type [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "rxgroup" ]
       ] )
     ] ;
     fhir:value [
       fhir:value [ fhir:v "M35PT" ]
     ] #   group used when submitting pharmacy claims  
  ] [
     fhir:type [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "rxpcn" ]
       ] )
     ] ;
     fhir:value [
       fhir:value [ fhir:v "234516" ]
     ] #   the PCN number used when submitting pharmacy claims  
  ] [
     fhir:type [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "sequence" ]
       ] )
     ] ;
     fhir:value [
       fhir:value [ fhir:v "9" ]
     ] #   the sequence number for a short-term continuance of the coverage  
  ] )] . #   The repeating 'class' element is proposed to replace the 'grouping' element  

# -------------------------------------------------------------------------------------


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.