R6 Ballot (1st Draft)

This page is part of the FHIR Specification v6.0.0-ballot1: Release 6 Ballot (1st Draft) (see Ballot Notes). The current version is 5.0.0. For a full list of available versions, see the Directory of published versions

Example Claim/960150 (Turtle)

Financial Management Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Device, Encounter, Patient, Practitioner, RelatedPerson

Raw Turtle (+ also see Turtle/RDF Format Specification)

Simple Institutional Service 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 "960150"] ; # 
  fhir:text [
     fhir:status [ fhir:v "generated" ] ;
     fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the Claim</div>"
  ] ; # 
  fhir:identifier ( [
     fhir:system [ fhir:v "http://happyhospital.com/claim"^^xsd:anyURI ] ;
     fhir:value [ fhir:v "9612345" ]
  ] ) ; # 
  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 "institutional" ]
     ] )
  ] ; # 
  fhir:subType [
     fhir:coding ( [
       fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-claimsubtype"^^xsd:anyURI ] ;
       fhir:code [ fhir:v "emergency" ]
     ] )
  ] ; # 
  fhir:use [ fhir:v "claim"] ; # 
  fhir:patient [
     fhir:reference [ fhir:v "Patient/1" ]
  ] ; # 
  fhir:created [ fhir:v "2014-08-16"^^xsd:date] ; # 
  fhir:enterer [
     fhir:identifier [
       fhir:system [ fhir:v "http://jurisdiction.org/facilities/HOSP1234/users"^^xsd:anyURI ] ;
       fhir:value [ fhir:v "UC1234" ]
     ]
  ] ; # 
  fhir:insurer [
     fhir:reference [ fhir:v "Organization/2" ]
  ] ; # 
  fhir:provider [
     fhir:reference [ fhir:v "Organization/1" ]
  ] ; # 
  fhir:priority [
     fhir:coding ( [
       fhir:code [ fhir:v "normal" ]
     ] )
  ] ; # 
  fhir:payee [
     fhir:type [
       fhir:coding ( [
         fhir:code [ fhir:v "provider" ]
       ] )
     ]
  ] ; # 
  fhir:facility [
     fhir:identifier [
       fhir:system [ fhir:v "http://jurisdiction.org/facilities"^^xsd:anyURI ] ;
       fhir:value [ fhir:v "HOSP1234" ]
     ]
  ] ; # 
  fhir:careTeam ( [
     fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
     fhir:provider [
       fhir:reference [ fhir:v "Practitioner/example" ]
     ]
  ] ) ; # 
  fhir:diagnosis ( [
     fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
     fhir:diagnosis [
       a fhir:CodeableConcept ;
       fhir:coding ( [
         fhir:code [ fhir:v "654456" ]
       ] )
     ]
  ] ) ; # 
  fhir:procedure ( [
     fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
     fhir:type ( [
       fhir:coding ( [
         fhir:code [ fhir:v "primary" ]
       ] )
     ] ) ;
     fhir:date [ fhir:v "2014-08-16"^^xsd:date ] ;
     fhir:procedure [
       a fhir:CodeableConcept ;
       fhir:coding ( [
         fhir:code [ fhir:v "SDI9901" ]
       ] ) ;
       fhir:text [ fhir:v "Subcutaneous diagnostic implant" ]
     ] ;
     fhir:udi ( [
       fhir:reference [ fhir:v "Device/example" ]
     ] )
  ] ) ; # 
  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:productOrService [
       fhir:coding ( [
         fhir:system [ fhir:v "http://hl7.org/fhir/ex-serviceproduct"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "exam" ]
       ] )
     ] ;
     fhir:serviced [ fhir:v "2014-08-16"^^xsd:date ] ;
     fhir:unitPrice [
       fhir:value [ fhir:v "125.00"^^xsd:decimal ] ;
       fhir:currency [ fhir:v "USD" ]
     ] ;
     fhir:net [
       fhir:value [ fhir:v "125.00"^^xsd:decimal ] ;
       fhir:currency [ fhir:v "USD" ]
     ] ;
     fhir:encounter ( [
       fhir:reference [ fhir:v "Encounter/example" ]
     ] )
  ] ) ; # 
  fhir:total [
     fhir:value [ fhir:v "125.00"^^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.