This page is part of the FHIR Specification (v5.0.0: R5 - STU). This is the current published version. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3
Financial Management Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Device, Encounter, Patient, Practitioner, RelatedPerson |
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Simple Pharmacy Compound Claim
@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 "760152"] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the Pharmacy Claim</div>" ] ; # fhir:identifier ( [ fhir:system [ fhir:v "http://happypharma.com/claim"^^xsd:anyURI ] ; fhir:value [ fhir:v "7612345" ] ] ) ; # 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 "pharmacy" ] ] ) ] ; # fhir:use [ fhir:v "claim"] ; # fhir:patient [ fhir:reference [ fhir:v "Patient/1" ] ] ; # fhir:created [ fhir:v "2014-08-16"^^xsd:date] ; # fhir:insurer [ fhir:reference [ fhir:v "Organization/2" ] ] ; # fhir:provider [ fhir:reference [ fhir:v "Organization/1" ] ] ; # fhir:priority [ fhir:coding ( [ fhir:code [ fhir:v "stat" ] ] ) ] ; # fhir:payee [ fhir:type [ fhir:coding ( [ fhir:code [ fhir:v "provider" ] ] ) ] ] ; # fhir:careTeam ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:provider [ fhir:reference [ fhir:v "Practitioner/example" ] ] ] ) ; # fhir:supportingInfo ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:category [ fhir:coding ( [ fhir:code [ fhir:v "pharmacyrefill" ] ] ) ] ; fhir:code [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/pharmacy-refill"^^xsd:anyURI ] ; fhir:code [ fhir:v "new" ] ] ) ] ] [ fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ; fhir:category [ fhir:coding ( [ fhir:code [ fhir:v "pharmacyinformation" ] ] ) ] ; fhir:code [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/pharmacy-information"^^xsd:anyURI ] ; fhir:code [ fhir:v "refillsremaining" ] ] ) ] ; fhir:value [ a fhir:Quantity ; fhir:value [ fhir:v "0"^^xsd:decimal ] ] ] [ fhir:sequence [ fhir:v "3"^^xsd:positiveInteger ] ; fhir:category [ fhir:coding ( [ fhir:code [ fhir:v "pharmacyinformation" ] ] ) ] ; fhir:code [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/pharmacy-information"^^xsd:anyURI ] ; fhir:code [ fhir:v "dayssupply" ] ] ) ] ; fhir:value [ a fhir:Quantity ; fhir:value [ fhir:v "10"^^xsd:decimal ] ] ] [ fhir:sequence [ fhir:v "4"^^xsd:positiveInteger ] ; fhir:category [ fhir:coding ( [ fhir:code [ fhir:v "pharmacy" ] ] ) ] ; fhir:code [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/pharmacy-form"^^xsd:anyURI ] ; fhir:code [ fhir:v "capsule" ] ] ) ] ] ) ; # fhir:diagnosis ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:diagnosis [ a fhir:CodeableConcept ; fhir:coding ( [ fhir:code [ fhir:v "654456" ] ] ) ] ] ) ; # fhir:insurance ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:focal [ fhir:v "true"^^xsd:boolean ] ; fhir:coverage [ fhir:reference [ fhir:v "Coverage/9876B1" ] ] ] ) ; # fhir:item ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:careTeamSequence ( [ fhir:v "1"^^xsd:positiveInteger ] ) ; fhir:informationSequence ( [ fhir:v "1"^^xsd:positiveInteger ] [ fhir:v "2"^^xsd:positiveInteger ] [ fhir:v "3"^^xsd:positiveInteger ] [ fhir:v "4"^^xsd:positiveInteger ] ) ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://localdruglist.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "compound" ] ; fhir:display [ fhir:v "Custom compound" ] ] ) ] ; # type=compoundmedication fhir:serviced [ fhir:v "2014-08-16"^^xsd:date ] ; fhir:quantity [ fhir:value [ fhir:v "30"^^xsd:decimal ] ; fhir:unit [ fhir:v "TAB" ] ; fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm"^^xsd:anyURI ] ; fhir:code [ fhir:v "TAB" ] ] ; fhir:net [ fhir:value [ fhir:v "155.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ; fhir:detail ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://localdruglist.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "44001" ] ; fhir:display [ fhir:v "Acetaminophen 250mg" ] ] ) ] ; # type=packagemedication fhir:quantity [ fhir:value [ fhir:v "250"^^xsd:decimal ] ; fhir:unit [ fhir:v "mg" ] ] ; fhir:net [ fhir:value [ fhir:v "20.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ; fhir:subDetail ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://hl7.org/fhir/ex-pharmaservice"^^xsd:anyURI ] ; fhir:code [ fhir:v "drugcost" ] ] ) ] ; # type=costitem fhir:net [ fhir:value [ fhir:v "20.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ] ) ] [ fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://localdruglist.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "44035" ] ; fhir:display [ fhir:v "Phenacetin 50mg" ] ] ) ] ; # type=packagemedication fhir:quantity [ fhir:value [ fhir:v "50"^^xsd:decimal ] ; fhir:unit [ fhir:v "mg" ] ] ; fhir:net [ fhir:value [ fhir:v "25.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ; fhir:subDetail ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://hl7.org/fhir/ex-pharmaservice"^^xsd:anyURI ] ; fhir:code [ fhir:v "drugcost" ] ] ) ] ; # type=costitem fhir:net [ fhir:value [ fhir:v "25.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ] ) ] [ fhir:sequence [ fhir:v "3"^^xsd:positiveInteger ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://localdruglist.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "44057" ] ; fhir:display [ fhir:v "Codeine 25mg" ] ] ) ] ; # type=packagemedication fhir:quantity [ fhir:value [ fhir:v "25"^^xsd:decimal ] ; fhir:unit [ fhir:v "mg" ] ] ; fhir:net [ fhir:value [ fhir:v "28.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ; fhir:subDetail ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://hl7.org/fhir/ex-pharmaservice"^^xsd:anyURI ] ; fhir:code [ fhir:v "drugcost" ] ] ) ] ; # type=costitem fhir:net [ fhir:value [ fhir:v "28.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ] ) ] [ fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://hl7.org/fhir/ex-pharmaservice"^^xsd:anyURI ] ; fhir:code [ fhir:v "markup" ] ] ) ] ; # type=costitem fhir:net [ fhir:value [ fhir:v "22.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ] [ fhir:sequence [ fhir:v "3"^^xsd:positiveInteger ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://hl7.org/fhir/ex-pharmaservice"^^xsd:anyURI ] ; fhir:code [ fhir:v "compoundfee" ] ] ) ] ; # type=costitem fhir:net [ fhir:value [ fhir:v "60.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ] ) ] ) ; # fhir:total [ fhir:value [ fhir:v "155.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ]] . # # -------------------------------------------------------------------------------------
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.
FHIR ®© HL7.org 2011+. FHIR R5 hl7.fhir.core#5.0.0 generated on Sun, Mar 26, 2023 15:24+1100.
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