This page is part of the Quality Improvement Core Framework (v7.0.0-ballot: STU7 (v7.0.0) Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 6.0.0. For a full list of available versions, see the Directory of published versions
: ClaimResponse example - TTL Representation
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:ClaimResponse ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "example"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claimresponse"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claimresponse> ] )
] ; #
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: ClaimResponse example</b></p><a name=\"example\"> </a><a name=\"hcexample\"> </a><a name=\"example-en-US\"> </a><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type vision}\">Vision</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href=\"Patient-example.html\">Jim Chalmers Male, DoB: 1974-12-25 ( Medical record number (use: usual, period: 2001-05-06 --> (ongoing)))</a></p><p><b>created</b>: 2018-02-24</p><p><b>insurer</b>: <a href=\"Organization-example.html\">Organization Health Level Seven International</a></p><p><b>requestor</b>: <a href=\"Practitioner-example.html\">Practitioner Adam Careful </a></p><p><b>request</b>: <a href=\"Claim-example.html\">Claim: identifier = http://happysight.com/claim#6612346; status = active; type = Vision; use = claim; created = 2014-08-16; priority = Normal</a></p><p><b>outcome</b>: Queued</p><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 1</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted Amount</span></p><h3>Amounts</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>235.40</td><td>United States dollar</td></tr></table></blockquote></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 "vision" ] ] )
] ; #
fhir:use [ fhir:v "preauthorization"] ; #
fhir:patient [
fhir:reference [ fhir:v "Patient/example" ]
] ; #
fhir:created [ fhir:v "2018-02-24"^^xsd:date] ; #
fhir:insurer [
fhir:reference [ fhir:v "Organization/example" ]
] ; #
fhir:requestor [
fhir:reference [ fhir:v "Practitioner/example" ]
] ; #
fhir:request [
fhir:reference [ fhir:v "Claim/example" ]
] ; #
fhir:outcome [ fhir:v "queued"] ; #
fhir:item ( [
fhir:itemSequence [ fhir:v "1"^^xsd:positiveInteger ] ;
( fhir:adjudication [
fhir:category [
( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ] ;
fhir:code [ fhir:v "submitted" ] ] ) ] ;
fhir:amount [
fhir:value [ fhir:v "235.40"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ] ] ] )
] ) . #