QI-Core Implementation Guide: STU 4 (v4.0.0 for FHIR 4.0.1)

QI-Core Implementation Guide - This is the current published version.. See the Directory of published versions

Claim/example

Formats: Narrative, XML, JSON, Turtle

Raw ttl 

@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 "example"];
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/qicore/StructureDefinition/qicore-claim>     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: example</p><p><b>meta</b>: </p><p><b>identifier</b>: 6612346</p><p><b>status</b>: active</p><p><b>type</b>: Vision <span style=\"background: LightGoldenRodYellow\">(Details : {http://terminology.hl7.org/CodeSystem/claim-type code 'vision' = 'Vision)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: <a href=\"Patient-example.html\">Generated Summary: id: example; Medical record number = 12345 (USUAL); active; Peter James Chalmers (OFFICIAL), Jim Chalmers , Peter James Windsor (MAIDEN); ph: (03) 5555 6473(WORK), ph: (03) 3410 5613(MOBILE), ph: (03) 5555 8834(OLD); gender: male; birthDate: 1974-12-25; </a></p><p><b>created</b>: Aug 16, 2014 12:00:00 AM</p><p><b>insurer</b>: <a href=\"Organization-example.html\">Generated Summary: id: example; ??; active; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type team}\">Organizational team</span>; name: Health Level Seven International; ph: (+1) 734-677-7777, fax: (+1) 734-677-6622, hq@HL7.org</a></p><p><b>provider</b>: <a href=\"Practitioner-example.html\">Generated Summary: id: example; 23; active; Adam Careful </a></p><p><b>priority</b>: normal <span style=\"background: LightGoldenRodYellow\">(Details : {[not stated] code 'normal' = 'normal)</span></p><p><b>prescription</b>: <a href=\"MedicationRequest-example.html\">Generated Summary: id: example; status: active; intent: order; ????; authoredOn: Mar 26, 2015 12:32:52 AM; </a></p><h3>Payees</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Party</b></td></tr><tr><td>*</td><td>provider <span style=\"background: LightGoldenRodYellow\">(Details : {[not stated] code 'provider' = 'provider)</span></td><td><a href=\"Practitioner-example.html\">Generated Summary: id: example; 23; active; Adam Careful </a></td></tr></table><h3>CareTeams</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td>*</td><td>1</td><td><a href=\"Practitioner-example.html\">Generated Summary: id: example; 23; active; Adam Careful </a></td></tr></table><h3>Diagnoses</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td>*</td><td>1</td><td>654321 <span style=\"background: LightGoldenRodYellow\">(Details : {[not stated] code '654321' = '654321)</span></td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td>-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td>*</td><td>1</td><td>true</td><td><a href=\"Coverage-example.html\">Generated Summary: id: example; 12345; status: active; <span title=\"Codes: {urn:oid:2.16.840.1.113883.3.221.5 59}\">Other Private Insurance</span>; dependent: 0; <span title=\"Codes: \">self</span>; period: May 23, 2011 12:00:00 AM --&gt; May 23, 2012 12:00:00 AM; 9</a></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>careTeamSequence</b>: 1</p><p><b>productOrService</b>: glasses <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/fhir/CodeSystem/ex-visionservice code 'glasses' = 'glasses)</span></p><p><b>serviced</b>: 2014-08-16</p><p><b>unitPrice</b>: </p><blockquote><p><b>detail</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: frame <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/fhir/CodeSystem/ex-visionservice code 'frame' = 'frame)</span></p><p><b>unitPrice</b>: </p><p><b>net</b>: </p></blockquote><blockquote><p><b>detail</b></p><p><b>sequence</b>: 2</p><p><b>productOrService</b>: lens <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/fhir/CodeSystem/ex-visionservice code 'lens' = 'lens)</span></p><p><b>quantity</b>: 2</p><p><b>unitPrice</b>: </p><p><b>net</b>: </p></blockquote><blockquote><p><b>detail</b></p><p><b>sequence</b>: 3</p><p><b>productOrService</b>: fst <span style=\"background: LightGoldenRodYellow\">(Details : {http://example.org/fhir/CodeSystem/ex-visionservice code 'fst' = 'fst)</span></p><p><b>unitPrice</b>: </p><p><b>factor</b>: 0.07</p><p><b>net</b>: </p></blockquote></blockquote></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://terminology.hl7.org/CodeSystem/claim-type" ];
       fhir:Coding.code [ fhir:value "vision" ]     ]
  ];
  fhir:Claim.use [ fhir:value "claim"];
  fhir:Claim.patient [
     fhir:Reference.reference [ fhir:value "Patient/example" ]
  ];
  fhir:Claim.created [ fhir:value "2014-08-16"^^xsd:date];
  fhir:Claim.insurer [
     fhir:Reference.reference [ fhir:value "Organization/example" ]
  ];
  fhir:Claim.provider [
     fhir:Reference.reference [ fhir:value "Practitioner/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/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/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/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/example" ]     ]
  ];
  fhir:Claim.item [
     fhir:index 0;
     fhir:Claim.item.sequence [ fhir:value "1"^^xsd:positiveInteger ];
     fhir:Claim.item.careTeamSequence [
       fhir:value "1"^^xsd:positiveInteger;
       fhir:index 0     ];
     fhir:Claim.item.productOrService [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://example.org/fhir/CodeSystem/ex-visionservice" ];
         fhir:Coding.code [ fhir:value "glasses" ]       ]     ];
     fhir:Claim.item.servicedDate [ fhir:value "2014-08-16"^^xsd:date ];
     fhir:Claim.item.unitPrice [
       fhir:Money.value [ fhir:value "214.00"^^xsd:decimal ];
       fhir:Money.currency [ fhir:value "USD" ]     ];
     fhir:Claim.item.detail [
       fhir:index 0;
       fhir:Claim.item.detail.sequence [ fhir:value "1"^^xsd:positiveInteger ];
       fhir:Claim.item.detail.productOrService [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://example.org/fhir/CodeSystem/ex-visionservice" ];
           fhir:Coding.code [ fhir:value "frame" ]         ]       ];
       fhir:Claim.item.detail.unitPrice [
         fhir:Money.value [ fhir:value "100.00"^^xsd:decimal ];
         fhir:Money.currency [ fhir:value "USD" ]       ];
       fhir:Claim.item.detail.net [
         fhir:Money.value [ fhir:value "100.00"^^xsd:decimal ];
         fhir:Money.currency [ fhir:value "USD" ]       ]     ], [
       fhir:index 1;
       fhir:Claim.item.detail.sequence [ fhir:value "2"^^xsd:positiveInteger ];
       fhir:Claim.item.detail.productOrService [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://example.org/fhir/CodeSystem/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:Money.value [ fhir:value "50.00"^^xsd:decimal ];
         fhir:Money.currency [ fhir:value "USD" ]       ];
       fhir:Claim.item.detail.net [
         fhir:Money.value [ fhir:value "100.00"^^xsd:decimal ];
         fhir:Money.currency [ fhir:value "USD" ]       ]     ], [
       fhir:index 2;
       fhir:Claim.item.detail.sequence [ fhir:value "3"^^xsd:positiveInteger ];
       fhir:Claim.item.detail.productOrService [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://example.org/fhir/CodeSystem/ex-visionservice" ];
           fhir:Coding.code [ fhir:value "fst" ]         ]       ];
       fhir:Claim.item.detail.unitPrice [
         fhir:Money.value [ fhir:value "200.00"^^xsd:decimal ];
         fhir:Money.currency [ fhir:value "USD" ]       ];
       fhir:Claim.item.detail.factor [ fhir:value "0.07"^^xsd:decimal ];
       fhir:Claim.item.detail.net [
         fhir:Money.value [ fhir:value "14.00"^^xsd:decimal ];
         fhir:Money.currency [ fhir:value "USD" ]       ]     ]
  ].

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

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