Da Vinci Prior Authorization Support (PAS) FHIR IG
2.1.0 - STU 2.1 United States of America flag

This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.1.0: STU 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: Submit Claim Beneficiary Example - TTL Representation

Page standards status: Informative

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@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:Patient ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "BeneficiaryExample"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-beneficiary>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Patient BeneficiaryExample</b></p><a name=\"BeneficiaryExample\"> </a><a name=\"hcBeneficiaryExample\"> </a><a name=\"BeneficiaryExample-en-US\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">JESSE SMITH  Female, DoB: 1947-01-18 ( Member Number)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Known multipleBirth status of Patient\">Multiple Birth:</td><td colspan=\"3\">1</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\">US </td></tr></table></div>"
  ] ; # 
  fhir:identifier ( [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "MB" ]       ] )     ] ;
fhir:system [ fhir:v "http://example.org/MIN"^^xsd:anyURI ] ;
fhir:value [ fhir:v "12345678902" ]
  ] ) ; # 
  fhir:name ( [
fhir:family [ fhir:v "SMITH" ] ;
    ( fhir:given [ fhir:v "JESSE" ] )
  ] ) ; # 
  fhir:gender [ fhir:v "female"] ; # 
  fhir:birthDate [ fhir:v "1947-01-18"^^xsd:date] ; # 
  fhir:address ( [
fhir:country [ fhir:v "US" ]
  ] ) ; # 
  fhir:multipleBirth [ fhir:v "1"^^xsd:integer] . #