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 Referral Request Example - TTL Representation

Page standards status: Informative

Raw ttl | Download


@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:ServiceRequest ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "ReferralRequestExample"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-servicerequest"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-servicerequest>     ] )
  ] ; # 
  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: ServiceRequest ReferralRequestExample</b></p><a name=\"ReferralRequestExample\"> </a><a name=\"hcReferralRequestExample\"> </a><a name=\"ReferralRequestExample-en-US\"> </a><p><b>status</b>: Active</p><p><b>intent</b>: Order</p><p><b>code</b>: <span title=\"Codes:{https://codesystem.x12.org/005010/1365 3}\">Consultation</span></p><p><b>quantity</b>: 1 visit<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  code1 = '1')</span></p><p><b>subject</b>: <a href=\"Patient-SubscriberExample.html\">JOE SMITH  Male, DoB Unknown ( Member Number)</a></p></div>"
  ] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:intent [ fhir:v "order"] ; # 
  fhir:code [
    ( fhir:coding [
fhir:system [ fhir:v "https://codesystem.x12.org/005010/1365"^^xsd:anyURI ] ;
fhir:code [ fhir:v "3" ] ;
fhir:display [ fhir:v "Consultation" ]     ] )
  ] ; # 
  fhir:quantity [
a fhir:Quantity ;
fhir:value [ fhir:v "1"^^xsd:decimal ] ;
fhir:unit [ fhir:v "visit" ] ;
fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ;
fhir:code [ fhir:v "1" ]
  ] ; # 
  fhir:subject [
fhir:reference [ fhir:v "Patient/SubscriberExample" ]
  ] . #