@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/us/davinci-pas/ClaimResponse/RejectionResponseExample> a fhir:ClaimResponse ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "RejectionResponseExample"] ; # 
  fhir:meta [
     fhir:profile ( [
       fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse"^^xsd:anyURI ;
       fhir:l <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse>
     ] )
  ] ; # 
  fhir:language [ fhir:v "en"] ; # 
  fhir:text [
     fhir:status [ fhir:v "extensions" ] ;
     fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse RejectionResponseExample</b></p><a name=\"RejectionResponseExample\"> </a><a name=\"hcRejectionResponseExample\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Language: en</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-profile-claimresponse.html\">PAS Claim Response</a></p></div><blockquote><p><b>Claim Response Reviewer</b></p><ul><li>wasHumanReviewedFlag: true</li></ul></blockquote><p><b>identifier</b>: <code>http://example.org/PATIENT_EVENT_TRACE_NUMBER</code>/111099</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type professional}\">Professional</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href=\"Patient-SubscriberExample.html\">JOE SMITH  Male, DoB Unknown ( http://example.org/MIN#12345678901)</a></p><p><b>created</b>: 2005-05-02 11:02:00+0500</p><p><b>insurer</b>: <a href=\"Organization-InsurerExample.html\">Organization MARYLAND CAPITAL INSURANCE COMPANY</a></p><p><b>requestor</b>: <a href=\"Organization-UMOExample.html\">Organization DR. JOE SMITH CORPORATION</a></p><p><b>request</b>: <a href=\"Claim-ReferralAuthorizationExample.html\">Claim: extension = Urgent,; identifier = urn:trnorg:9012345678#111099; status = active; type = Professional; use = preauthorization; created = 2005-05-02 11:01:00+0500; priority = Normal</a></p><p><b>outcome</b>: Complete</p><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 1</p><h3>Adjudications</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Extension</b></td><td><b>Category</b></td></tr><tr><td style=\"display: none\">*</td><td/><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted Amount</span></td></tr></table></blockquote></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:extension ( [
     fhir:extension ( [
       fhir:url [
         fhir:v "wasHumanReviewedFlag"^^xsd:anyURI ;
         fhir:l fhir:wasHumanReviewedFlag
       ] ;
       fhir:value [
         a fhir:Boolean ;
         fhir:v true
       ]
     ] ) ;
     fhir:url [
       fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-claimResponseReviewer"^^xsd:anyURI ;
       fhir:l <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-claimResponseReviewer>
     ]
  ] ) ; # 
  fhir:identifier ( [
     fhir:system [
       fhir:v "http://example.org/PATIENT_EVENT_TRACE_NUMBER"^^xsd:anyURI ;
       fhir:l <http://example.org/PATIENT_EVENT_TRACE_NUMBER>
     ] ;
     fhir:value [ fhir:v "111099" ] ;
     fhir:assigner [
       fhir:identifier [
         fhir:system [
           fhir:v "http://example.org/USER_ASSIGNED"^^xsd:anyURI ;
           fhir:l <http://example.org/USER_ASSIGNED>
         ] ;
         fhir:value [ fhir:v "9012345678" ]
       ]
     ]
  ] ) ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:type [
     fhir:coding ( [
       fhir:system [
         fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ;
         fhir:l <http://terminology.hl7.org/CodeSystem/claim-type>
       ] ;
       fhir:code [ fhir:v "professional" ]
     ] )
  ] ; # 
  fhir:use [ fhir:v "preauthorization"] ; # 
  fhir:patient [
     fhir:l <http://hl7.org/fhir/us/davinci-pas/Patient/SubscriberExample> ;
     fhir:reference [ fhir:v "Patient/SubscriberExample" ]
  ] ; # 
  fhir:created [ fhir:v "2005-05-02T11:02:00+05:00"^^xsd:dateTime] ; # 
  fhir:insurer [
     fhir:l <http://hl7.org/fhir/us/davinci-pas/Organization/InsurerExample> ;
     fhir:reference [ fhir:v "Organization/InsurerExample" ]
  ] ; # 
  fhir:requestor [
     fhir:l <http://hl7.org/fhir/us/davinci-pas/Organization/UMOExample> ;
     fhir:reference [ fhir:v "Organization/UMOExample" ]
  ] ; # 
  fhir:request [
     fhir:l <http://hl7.org/fhir/us/davinci-pas/Claim/ReferralAuthorizationExample> ;
     fhir:reference [ fhir:v "Claim/ReferralAuthorizationExample" ]
  ] ; # 
  fhir:outcome [ fhir:v "complete"] ; # 
  fhir:item ( [
     fhir:itemSequence [ fhir:v "1"^^xsd:positiveInteger ] ;
     fhir:adjudication ( [
       fhir:extension ( [
         fhir:extension ( [
           fhir:url [
             fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode"^^xsd:anyURI ;
             fhir:l <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode>
           ] ;
           fhir:value [
             a fhir:CodeableConcept ;
             fhir:coding ( [
               fhir:system [
                 fhir:v "https://codesystem.x12.org/005010/306"^^xsd:anyURI ;
                 fhir:l <https://codesystem.x12.org/005010/306>
               ] ;
               fhir:code [ fhir:v "A3" ] ;
               fhir:display [ fhir:v "Not Certified" ]
             ] )
           ]
         ] ) ;
         fhir:url [
           fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction"^^xsd:anyURI ;
           fhir:l <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewAction>
         ]
       ] ) ;
       fhir:category [
         fhir:coding ( [
           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/adjudication>
           ] ;
           fhir:code [ fhir:v "submitted" ]
         ] )
       ]
     ] )
  ] ) . # 

<http://hl7.org/fhir/us/davinci-pas/Patient/SubscriberExample> a fhir:Us .

<http://hl7.org/fhir/us/davinci-pas/Organization/InsurerExample> a fhir:Us .

<http://hl7.org/fhir/us/davinci-pas/Organization/UMOExample> a fhir:Us .

<http://hl7.org/fhir/us/davinci-pas/Claim/ReferralAuthorizationExample> a fhir:Us .

# -------------------------------------------------------------------------------------