Release 5

This page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

Example Claim/960151 (Turtle)

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

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.