This page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions 
. Page versions: R5 R4B R4 R3
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:id [ fhir:v "960151"] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the Claim</div>"
] ; #
fhir:identifier ( [
fhir:system [ fhir:v "http://happyhospital.com/claim"^^xsd:anyURI ] ;
fhir:value [ fhir:v "96123451" ]
] ) ; #
fhir:status [ fhir:v "active"] ; #
fhir:type [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "institutional" ]
] )
] ; #
fhir:use [ fhir:v "claim"] ; #
fhir:patient [
fhir:reference [ fhir:v "Patient/1" ]
] ; #
fhir:billablePeriod [
fhir:start [ fhir:v "2014-08-15"^^xsd:date ] ;
fhir:end [ fhir:v "2014-08-16"^^xsd:date ]
] ; #
fhir:created [ fhir:v "2014-08-16"^^xsd:date] ; #
fhir:enterer [
fhir:identifier [
fhir:system [ fhir:v "http://jurisdiction.org/facilities/HOSP1234/users"^^xsd:anyURI ] ;
fhir:value [ fhir:v "UC1234" ]
]
] ; #
fhir:insurer [
fhir:reference [ fhir:v "Organization/2" ]
] ; #
fhir:provider [
fhir:identifier [
fhir:system [ fhir:v "http://npid.org/providerid"^^xsd:anyURI ] ;
fhir:value [ fhir:v "NJ12345" ]
]
] ; #
fhir:priority [
fhir:coding ( [
fhir:code [ fhir:v "normal" ]
] )
] ; #
fhir:payee [
fhir:type [
fhir:coding ( [
fhir:code [ fhir:v "provider" ]
] )
]
] ; #
fhir:facility [
fhir:identifier [
fhir:system [ fhir:v "http://jurisdiction.org/facilities"^^xsd:anyURI ] ;
fhir:value [ fhir:v "HOSP1234" ]
]
] ; #
fhir:diagnosisRelatedGroup [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-diagnosisrelatedgroup"^^xsd:anyURI ] ;
fhir:code [ fhir:v "400" ] ;
fhir:display [ fhir:v "Head trauma - concussion" ]
] )
] ; #
fhir:careTeam ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:provider [
fhir:reference [ fhir:v "Practitioner/example" ]
] ;
fhir:responsible [ fhir:v "true"^^xsd:boolean ] ;
fhir:role [
fhir:coding ( [
fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/claim-careteamrole"^^xsd:anyURI ] ;
fhir:code [ fhir:v "primary" ]
] )
] ;
fhir:specialty [
fhir:coding ( [
fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/provider-qualification"^^xsd:anyURI ] ;
fhir:code [ fhir:v "physician" ]
] )
]
] ) ; #
fhir:supportingInfo ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:category [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/claiminformationcategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "employmentimpacted" ]
] )
] ;
fhir:timing [
a fhir:Period ;
fhir:start [ fhir:v "2014-08-16"^^xsd:date ] ;
fhir:end [ fhir:v "2014-08-16"^^xsd:date ]
]
] [
fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ;
fhir:category [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/claiminformationcategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "hospitalized" ]
] )
] ;
fhir:timing [
a fhir:Period ;
fhir:start [ fhir:v "2014-08-15"^^xsd:date ] ;
fhir:end [ fhir:v "2014-08-16"^^xsd:date ]
]
] ) ; #
fhir:diagnosis ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:diagnosis [
a fhir:CodeableConcept ;
fhir:coding ( [
fhir:code [ fhir:v "654456" ]
] )
] ;
fhir:type ( [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-diagnosistype"^^xsd:anyURI ] ;
fhir:code [ fhir:v "admitting" ]
] )
] )
] ) ; #
fhir:insurance ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:focal [ fhir:v "true"^^xsd:boolean ] ;
fhir:coverage [
fhir:reference [ fhir:v "Coverage/9876B1" ]
] ;
fhir:businessArrangement [ fhir:v "BA987123" ] ;
fhir:preAuthRef ( [ fhir:v "PA2014G56473" ] )
] ) ; #
fhir:accident [
fhir:date [ fhir:v "2014-07-09"^^xsd:date ] ;
fhir:type [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActIncidentCode"^^xsd:anyURI ] ;
fhir:code [ fhir:v "SPT" ] ;
fhir:display [ fhir:v "Sporting Accident" ]
] )
] ;
fhir:location [
a fhir:Address ;
fhir:text [ fhir:v "Grouse Mountain Ski Hill" ]
]
] ; #
fhir:item ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:careTeamSequence ( [ fhir:v "1"^^xsd:positiveInteger ] ) ;
fhir:productOrService [
fhir:coding ( [
fhir:system [ fhir:v "http://hl7.org/fhir/ex-serviceproduct"^^xsd:anyURI ] ;
fhir:code [ fhir:v "exam" ]
] )
] ;
fhir:serviced [ fhir:v "2014-08-16"^^xsd:date ] ;
fhir:unitPrice [
fhir:value [ fhir:v "125.00"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]
] ;
fhir:net [
fhir:value [ fhir:v "125.00"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]
]
] ) ; #
fhir:total [
fhir:value [ fhir:v "125.00"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]
]] . #
# -------------------------------------------------------------------------------------
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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