This page is part of the electronic Long-Term Services and Supports Implementation Guide (v2.0.0: STU2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

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: claim2 - TTL Representation

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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:Claim ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "claim2"] ; # 
  fhir:meta [
fhir:versionId [ fhir:v "1" ] ;
fhir:lastUpdated [ fhir:v "2020-09-03T10:16:03.512-04:00"^^xsd:dateTime ] ;
fhir:source [ fhir:v "#KZ0jzPjXDrhCiMif"^^xsd:anyURI ] ;
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/eltss/StructureDefinition/Claim-eltss"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/eltss/StructureDefinition/Claim-eltss>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Claim </b><a name=\"claim2\"> </a><a name=\"hcclaim2\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">ResourceClaim &quot;claim2&quot; Version&quot;1&quot; Updated&quot;2020-09-03 10:16:03-0400&quot; </p><p style=\"margin-bottom: 0px\">Information Source: #KZ0jzPjXDrhCiMif!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-Claim-eltss.html\">Claim_eltss</a></p></div><p><b>status</b>: active</p><p><b>type</b>: Professional <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-claim-type.html\">Claim Type Codes</a>#professional)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: <a href=\"Patient-patientBSJ1.html\">Patient/patientBSJ1</a> &quot; SMITH-JOHNSON&quot;</p><p><b>created</b>: 2020-05-01</p><p><b>provider</b>: <a href=\"Organization-funding1.html\">Organization/funding1</a> &quot;Texas Department of Community Health&quot;</p><p><b>priority</b>: Normal <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#normal)</span></p><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"Coverage-coverage1.html\">Coverage/coverage1</a></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: G0108 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-hcpcs-Level-II.html\">Healthcare Common Procedure Coding System (HCPCS) level II alphanumeric codes</a>#G0108)</span></p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>55</td><td>USD</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>660</td><td>USD</td></tr></table></blockquote></div>"
  ] ; # 
  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 "professional" ]     ] )
  ] ; # 
  fhir:use [ fhir:v "claim"] ; # 
  fhir:patient [
fhir:reference [ fhir:v "Patient/patientBSJ1" ]
  ] ; # 
  fhir:created [ fhir:v "2020-05-01"^^xsd:date] ; # 
  fhir:provider [
fhir:reference [ fhir:v "Organization/funding1" ]
  ] ; # 
  fhir:priority [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/processpriority"^^xsd:anyURI ] ;
fhir:code [ fhir:v "normal" ]     ] )
  ] ; # 
  fhir:insurance ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:focal [ fhir:v "true"^^xsd:boolean ] ;
fhir:coverage [
fhir:reference [ fhir:v "Coverage/coverage1" ]     ]
  ] ) ; # 
  fhir:item ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:productOrService [
      ( fhir:coding [
fhir:system [ fhir:v "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"^^xsd:anyURI ] ;
fhir:code [ fhir:v "G0108" ]       ] )     ] ;
fhir:unitPrice [
fhir:value [ fhir:v "55"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]     ] ;
fhir:net [
fhir:value [ fhir:v "660"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]     ]
  ] ) . #