This page is part of the Quality Improvement Core Framework (v2.1.0: STU 3 Ballot 1) based on FHIR R3. The current version which supercedes this version is 4.1.1. For a full list of available versions, see the Directory of published versions

Example: Claim-qicore-claim-example

Formats: XML, JSON, Turtle

@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:Resource.id [ fhir:value "qicore-claim-example"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n      <p>\n        <strong>id</strong>: example            \n      </p>\n      <p>\n        <strong>identifier</strong>: 6612346            \n      </p>\n      <p>\n        <strong>type</strong>: vision      \n      </p>\n      <p>\n        <strong>use</strong>: complete      \n      </p>\n      <p>\n        <strong>patient</strong>:                 \n        <a href=\"Patient-qicore-patient-example.html\">Patient/example</a>\n      </p>\n      <p>\n        <strong>insurer</strong>:                 \n        <a href=\"Organization-qicore-organization-example.html\">Organization/example</a>\n      </p>\n      <p>\n        <strong>organization</strong>:                 \n        <a href=\"Organization-qicore-organization-example.html\">Organization/example</a>\n      </p>\n      <p>\n        <strong>priority</strong>: normal      \n      </p>\n      <p>\n        <strong>prescription</strong>:                 \n        <a href=\"MedicationRequest-qicore-medicationrequest-example\">MedicationRequest/example</a>\n      </p>\n      <p>\n        <strong>payee</strong>:\n        <a href=\"Practitioner-qicore-practitioner-example\">Practitioner/example</a>\n      </p>\n      <p>\n        <strong>careTeam</strong>:\n        <a href=\"Practitioner-qicore-practitioner-example\">Practitioner/example</a>\n      </p>\n      <p>\n        <strong>diagnosis</strong>: 654321      \n      </p>\n      <p>\n        <strong>insurance</strong>:                 \n        <a href=\"Coverage-qicore-converage-example\">Coverage/example</a>\n      </p>\n      <blockquote>\n        <p>\n          <strong>item</strong>\n        </p>\n        <p>\n          <strong>service</strong>: glasses        \n        </p>\n        <p>\n          <strong>unitPrice</strong>: 214.00        \n        </p>\n        <p>\n          <strong>net</strong>: 214.00        \n        </p>\n        <blockquote>\n          <p><strong>detail 1</strong></p>\n          <p>\n            <strong>service</strong>: frame          \n          </p>\n          <p>\n            <strong>unitPrice</strong>: 100.00          \n          </p>\n          <p>\n            <strong>net</strong>: 100.00          \n          </p>\n        </blockquote>\n        <blockquote>\n          <p><strong>detail 2</strong></p>\n          <p>\n            <strong>service</strong>: lens          \n          </p>\n          <p>\n            <strong>unitPrice</strong>: 50.00          \n          </p>\n          <p>\n            <strong>net</strong>: 100.00          \n          </p>\n        </blockquote>\n        <blockquote>\n          <p><strong>detail 3</strong></p>\n          <p>\n            <strong>service</strong>: fst          \n          </p>\n          <p>\n            <strong>unitPrice</strong>: 200.00          \n          </p>\n          <p>\n            <strong>factor</strong>: 0.07          \n          </p>\n          <p>\n            <strong>net</strong>: 14.00          \n          </p>\n        </blockquote>\n      </blockquote>\n    </div>"
  ];
  fhir:Claim.identifier [
     fhir:index 0;
     fhir:Identifier.system [ fhir:value "http://happysight.com/claim" ];
     fhir:Identifier.value [ fhir:value "6612346" ]
  ];
  fhir:Claim.status [ fhir:value "active"];
  fhir:Claim.type [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://hl7.org/fhir/ex-claimtype" ];
       fhir:Coding.code [ fhir:value "vision" ]     ]
  ];
  fhir:Claim.use [ fhir:value "complete"];
  fhir:Claim.patient [
     fhir:Reference.reference [ fhir:value "Patient/qicore-patient-example" ]
  ];
  fhir:Claim.created [ fhir:value "2014-08-16"^^xsd:date];
  fhir:Claim.insurer [
     fhir:Reference.reference [ fhir:value "Organization/qicore-organization-example" ]
  ];
  fhir:Claim.organization [
     fhir:Reference.reference [ fhir:value "Organization/qicore-organization-example" ]
  ];
  fhir:Claim.priority [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.code [ fhir:value "normal" ]     ]
  ];
  fhir:Claim.prescription [
     fhir:Reference.reference [ fhir:value "MedicationRequest/qicore-medicationrequest-example" ]
  ];
  fhir:Claim.payee [
     fhir:Claim.payee.type [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.code [ fhir:value "provider" ]       ]     ];
     fhir:Claim.payee.party [
       fhir:Reference.reference [ fhir:value "Practitioner/qicore-practitioner-example" ]     ]
  ];
  fhir:Claim.careTeam [
     fhir:index 0;
     fhir:Claim.careTeam.sequence [ fhir:value "1"^^xsd:positiveInteger ];
     fhir:Claim.careTeam.provider [
       fhir:Reference.reference [ fhir:value "Practitioner/qicore-practitioner-example" ]     ]
  ];
  fhir:Claim.diagnosis [
     fhir:index 0;
     fhir:Claim.diagnosis.sequence [ fhir:value "1"^^xsd:positiveInteger ];
     fhir:Claim.diagnosis.diagnosisCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.code [ fhir:value "654321" ]       ]     ]
  ];
  fhir:Claim.insurance [
     fhir:index 0;
     fhir:Claim.insurance.sequence [ fhir:value "1"^^xsd:positiveInteger ];
     fhir:Claim.insurance.focal [ fhir:value "true"^^xsd:boolean ];
     fhir:Claim.insurance.coverage [
       fhir:Reference.reference [ fhir:value "Coverage/qicore-coverage-example" ]     ]
  ];
  fhir:Claim.item [
     fhir:index 0;
     fhir:Claim.item.sequence [ fhir:value "1"^^xsd:positiveInteger ];
     fhir:Claim.item.careTeamLinkId [
       fhir:value "1"^^xsd:positiveInteger;
       fhir:index 0     ];
     fhir:Claim.item.service [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/ex-visionservice" ];
         fhir:Coding.code [ fhir:value "glasses" ]       ]     ];
     fhir:Claim.item.servicedDate [ fhir:value "2014-08-16"^^xsd:date ];
     fhir:Claim.item.unitPrice [
       fhir:Quantity.value [ fhir:value "214.00"^^xsd:decimal ];
       fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ];
       fhir:Quantity.code [ fhir:value "USD" ]     ];
     fhir:Claim.item.net [
       fhir:Quantity.value [ fhir:value "214.00"^^xsd:decimal ];
       fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ];
       fhir:Quantity.code [ fhir:value "USD" ]     ];
     fhir:Claim.item.detail [
       fhir:index 0;
       fhir:Claim.item.detail.sequence [ fhir:value "1"^^xsd:positiveInteger ];
       fhir:Claim.item.detail.service [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/ex-visionservice" ];
           fhir:Coding.code [ fhir:value "frame" ]         ]       ];
       fhir:Claim.item.detail.unitPrice [
         fhir:Quantity.value [ fhir:value "100.00"^^xsd:decimal ];
         fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ];
         fhir:Quantity.code [ fhir:value "USD" ]       ];
       fhir:Claim.item.detail.net [
         fhir:Quantity.value [ fhir:value "100.00"^^xsd:decimal ];
         fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ];
         fhir:Quantity.code [ fhir:value "USD" ]       ]     ], [
       fhir:index 1;
       fhir:Claim.item.detail.sequence [ fhir:value "2"^^xsd:positiveInteger ];
       fhir:Claim.item.detail.service [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/ex-visionservice" ];
           fhir:Coding.code [ fhir:value "lens" ]         ]       ];
       fhir:Claim.item.detail.quantity [
         fhir:Quantity.value [ fhir:value "2"^^xsd:decimal ]       ];
       fhir:Claim.item.detail.unitPrice [
         fhir:Quantity.value [ fhir:value "50.00"^^xsd:decimal ];
         fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ];
         fhir:Quantity.code [ fhir:value "USD" ]       ];
       fhir:Claim.item.detail.net [
         fhir:Quantity.value [ fhir:value "100.00"^^xsd:decimal ];
         fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ];
         fhir:Quantity.code [ fhir:value "USD" ]       ]     ], [
       fhir:index 2;
       fhir:Claim.item.detail.sequence [ fhir:value "3"^^xsd:positiveInteger ];
       fhir:Claim.item.detail.service [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/ex-visionservice" ];
           fhir:Coding.code [ fhir:value "fst" ]         ]       ];
       fhir:Claim.item.detail.unitPrice [
         fhir:Quantity.value [ fhir:value "200.00"^^xsd:decimal ];
         fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ];
         fhir:Quantity.code [ fhir:value "USD" ]       ];
       fhir:Claim.item.detail.factor [ fhir:value "0.07"^^xsd:decimal ];
       fhir:Claim.item.detail.net [
         fhir:Quantity.value [ fhir:value "14.00"^^xsd:decimal ];
         fhir:Quantity.system [ fhir:value "urn:iso:std:iso:4217" ];
         fhir:Quantity.code [ fhir:value "USD" ]       ]     ]
  ].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.