Release 4B R5 Final QA

This page is part of the FHIR Specification (v4.3.0: R4B (v5.0.0-draft-final: Final QA Preview for R5 - STU see ballot notes ). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

Claim-example-oral-contained.ttl

Example Claim/100152 (Turtle)

Financial Management Work Group Maturity Level : N/A Standards Status : Informative Compartments : Device , Encounter , Patient , Practitioner , RelatedPerson

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

SOA Dental Claim (Contained) 

@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 -------------------------------------------------------------------

<http://hl7.org/fhir/Claim/100152> a fhir:Claim;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "100152"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the Oral Health Claim</div>"
  ];
  fhir:DomainResource.contained [
     a fhir:Organization;
     fhir:index 0;
     fhir:Resource.id [ fhir:value "org-insurer" ];
     fhir:Organization.identifier [
       fhir:index 0;
       fhir:Identifier.system [ fhir:value "http://www.bindb.com/bin" ];
       fhir:Identifier.value [ fhir:value "123456" ]
     ]
  ], [
     a fhir:Organization;
     fhir:index 1;
     fhir:Resource.id [ fhir:value "org-org" ];
     fhir:Organization.identifier [
       fhir:index 0;
       fhir:Identifier.system [ fhir:value "http://www.jurisdiction.com/oralhealthoffices" ];
       fhir:Identifier.value [ fhir:value "3456" ]
     ]
  ], [
     a fhir:Practitioner;
     fhir:index 2;
     fhir:Resource.id [ fhir:value "provider-1" ];
     fhir:Practitioner.identifier [
       fhir:index 0;
       fhir:Identifier.system [ fhir:value "http://www.jurisdiction.com/oralhealthproviders" ];
       fhir:Identifier.value [ fhir:value "123456789" ]
     ]
  ], [
     a fhir:Patient;
     fhir:index 3;
     fhir:Resource.id [ fhir:value "patient-1" ];
     fhir:Patient.name [
       fhir:index 0;
       fhir:HumanName.use [ fhir:value "official" ];
       fhir:HumanName.family [ fhir:value "Donald" ];
       fhir:HumanName.given [
         fhir:value "Duck";
         fhir:index 0
       ]
     ];
     fhir:Patient.gender [ fhir:value "male" ];
     fhir:Patient.birthDate [ fhir:value "1986-05-17"^^xsd:date ];
     fhir:Patient.address [
       fhir:index 0;
       fhir:Address.use [ fhir:value "home" ];
       fhir:Address.line [
         fhir:value "1234 Main Street";
         fhir:index 0
       ];
       fhir:Address.city [ fhir:value "Vancouver" ];
       fhir:Address.postalCode [ fhir:value "V2H1Y3" ];
       fhir:Address.country [ fhir:value "CAD" ]
     ]
  ], [
     a fhir:Coverage;
     fhir:index 4;
     fhir:Resource.id [ fhir:value "coverage-1" ];
     fhir:Coverage.identifier [
       fhir:index 0;
       fhir:Identifier.system [ fhir:value "http://benefitsinc.com/certificate" ];
       fhir:Identifier.value [ fhir:value "12345" ]
     ];
     fhir:Coverage.status [ fhir:value "active" ];
     fhir:Coverage.type [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-ActCode" ];
         fhir:Coding.code [ fhir:value "EHCPOL" ]
       ]
     ];
     fhir:Coverage.subscriber [
       fhir:Reference.reference [ fhir:value "#patient-1" ]
     ];
     fhir:Coverage.beneficiary [
       fhir:Reference.reference [ fhir:value "#patient-1" ]
     ];
     fhir:Coverage.dependent [ fhir:value "1" ];
     fhir:Coverage.relationship [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.code [ fhir:value "self" ]
       ]
     ];
     fhir:Coverage.payor [
       fhir:index 0;
       fhir:Reference.identifier [
         fhir:Identifier.system [ fhir:value "http://www.bindb.com/bin" ];
         fhir:Identifier.value [ fhir:value "123456" ]

[a fhir:Claim ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "100152"] ; # 
  fhir:text [
     fhir:status [ fhir:v "generated" ] ;
     fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the Oral Health Claim</div>"
  ] ; # 
  fhir:contained ( [
     a fhir:Organization ;
     fhir:id [ fhir:v "org-insurer" ] ;
     fhir:identifier ( [
       fhir:system [ fhir:v "http://www.bindb.com/bin"^^xsd:anyURI ] ;
       fhir:value [ fhir:v "123456" ]
     ] )
  ] [
     a fhir:Organization ;
     fhir:id [ fhir:v "org-org" ] ;
     fhir:identifier ( [
       fhir:system [ fhir:v "http://www.jurisdiction.com/oralhealthoffices"^^xsd:anyURI ] ;
       fhir:value [ fhir:v "3456" ]
     ] )
  ] [
     a fhir:Practitioner ;
     fhir:id [ fhir:v "provider-1" ] ;
     fhir:identifier ( [
       fhir:system [ fhir:v "http://www.jurisdiction.com/oralhealthproviders"^^xsd:anyURI ] ;
       fhir:value [ fhir:v "123456789" ]
     ] )
  ] [
     a fhir:Patient ;
     fhir:id [ fhir:v "patient-1" ] ;
     fhir:name ( [
       fhir:use [ fhir:v "official" ] ;
       fhir:family [ fhir:v "Donald" ] ;
       fhir:given ( [ fhir:v "Duck" ] )
     ] ) ;
     fhir:gender [ fhir:v "male" ] ;
     fhir:birthDate [ fhir:v "1986-05-17"^^xsd:date ] ;
     fhir:address ( [
       fhir:use [ fhir:v "home" ] ;
       fhir:line ( [ fhir:v "1234 Main Street" ] ) ;
       fhir:city [ fhir:v "Vancouver" ] ;
       fhir:postalCode [ fhir:v "V2H1Y3" ] ;
       fhir:country [ fhir:v "CAD" ]
     ] )
  ] [
     a fhir:Coverage ;
     fhir:id [ fhir:v "coverage-1" ] ;
     fhir:identifier ( [
       fhir:system [ fhir:v "http://benefitsinc.com/certificate"^^xsd:anyURI ] ;
       fhir:value [ fhir:v "12345" ]
     ] ) ;
     fhir:status [ fhir:v "active" ] ;
     fhir:kind [ fhir:v "insurance" ] ;
     fhir:type [
       fhir:coding ( [
         fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
         fhir:code [ fhir:v "EHCPOL" ]
       ] )
     ] ;
     fhir:subscriber [
       fhir:reference [ fhir:v "#patient-1" ]
     ] ;
     fhir:beneficiary [
       fhir:reference [ fhir:v "#patient-1" ]
     ] ;
     fhir:dependent [ fhir:v "1" ] ;
     fhir:relationship [
       fhir:coding ( [
         fhir:code [ fhir:v "self" ]
       ] )
     ] ;
     fhir:insurer [
       fhir:identifier [
         fhir:system [ fhir:v "http://www.bindb.com/bin"^^xsd:anyURI ] ;
         fhir:value [ fhir:v "123456" ]

       ]
     ];
     fhir:Coverage.class [
       fhir:index 0;
       fhir:Coverage.class.type [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/coverage-class" ];
           fhir:Coding.code [ fhir:value "plan" ]
         ]
       ];
       fhir:Coverage.class.value [ fhir:value "CBI35" ];
       fhir:Coverage.class.name [ fhir:value "Corporate Baker's Inc. Plan#35" ]
     ], [
       fhir:index 1;
       fhir:Coverage.class.type [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/coverage-class" ];
           fhir:Coding.code [ fhir:value "subplan" ]
         ]
       ];
       fhir:Coverage.class.value [ fhir:value "123" ];
       fhir:Coverage.class.name [ fhir:value "Trainee Part-time Benefits" ]
     ], [
       fhir:index 2;
       fhir:Coverage.class.type [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/coverage-class" ];
           fhir:Coding.code [ fhir:value "sequence" ]
         ]
       ];
       fhir:Coverage.class.value [ fhir:value "1" ]
     ]
  ];
  fhir:Claim.identifier [
     fhir:index 0;
     fhir:Identifier.system [ fhir:value "http://happyvalley.com/claim" ];
     fhir:Identifier.value [ fhir:value "12347" ]
  ];
  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 "oral" ]
     ]
  ];
  fhir:Claim.use [ fhir:value "claim"];
  fhir:Claim.patient [
     fhir:Reference.reference [ fhir:value "#patient-1" ]
  ];
  fhir:Claim.created [ fhir:value "2014-08-16"^^xsd:date];
  fhir:Claim.insurer [
     fhir:Reference.reference [ fhir:value "#org-insurer" ]
  ];
  fhir:Claim.provider [
     fhir:Reference.reference [ fhir:value "#org-org" ]
  ];
  fhir:Claim.priority [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.code [ fhir:value "normal" ]
     ]
  ];
  fhir:Claim.payee [
     fhir:Claim.payee.type [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.code [ fhir:value "provider" ]

     ] ;
     fhir:class ( [
       fhir:type [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
           fhir:code [ fhir:v "plan" ]
         ] )
       ] ;
       fhir:value [
         fhir:value [ fhir:v "CBI35" ]
       ] ;
       fhir:name [ fhir:v "Corporate Baker's Inc. Plan#35" ]
     ] [
       fhir:type [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
           fhir:code [ fhir:v "subplan" ]
         ] )
       ] ;
       fhir:value [
         fhir:value [ fhir:v "123" ]
       ] ;
       fhir:name [ fhir:v "Trainee Part-time Benefits" ]
     ] [
       fhir:type [
         fhir:coding ( [
           fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
           fhir:code [ fhir:v "sequence" ]
         ] )
       ] ;
       fhir:value [
         fhir:value [ fhir:v "1" ]

       ]
     ] )
  ] ) ; # 
  fhir:identifier ( [
     fhir:system [ fhir:v "http://happyvalley.com/claim"^^xsd:anyURI ] ;
     fhir:value [ fhir:v "12347" ]
  ] ) ; # 
  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 "oral" ]
     ] )
  ] ; # 
  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 "#org-insurer" ]
  ] ; # 
  fhir:provider [
     fhir:reference [ fhir:v "#org-org" ]
  ] ; # 
  fhir:priority [
     fhir:coding ( [
       fhir:code [ fhir:v "normal" ]
     ] )
  ] ; # 
  fhir:payee [
     fhir:type [
       fhir:coding ( [
         fhir:code [ fhir:v "provider" ]
       ] )

     ]
  ];
  fhir:Claim.careTeam [
     fhir:index 0;
     fhir:Claim.careTeam.sequence [ fhir:value "1"^^xsd:positiveInteger ];
     fhir:Claim.careTeam.provider [
       fhir:Reference.reference [ fhir:value "#provider-1" ]

  ] ; # 
  fhir:careTeam ( [
     fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
     fhir:provider [
       fhir:reference [ fhir:v "#provider-1" ]

     ]
  ];
  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 "123456" ]
       ]

  ] ) ; # 
  fhir:diagnosis ( [
     fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
     fhir:diagnosis [
       a fhir:CodeableConcept ;
       fhir:coding ( [
         fhir:code [ fhir:v "123456" ]
       ] )

     ]
  ];
  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-1" ]

  ] ) ; # 
  fhir:insurance ( [
     fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
     fhir:focal [ fhir:v "true"^^xsd:boolean ] ;
     fhir:coverage [
       fhir:reference [ fhir:v "#coverage-1" ]

     ]
  ];
  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.code [ fhir:value "1200" ]
       ]
     ];
     fhir:Claim.item.servicedDate [ fhir:value "2014-08-16"^^xsd:date ];
     fhir:Claim.item.unitPrice [
       fhir:Money.value [ fhir:value "135.57"^^xsd:decimal ];
       fhir:Money.currency [ fhir:value "USD" ]
     ];
     fhir:Claim.item.net [
       fhir:Money.value [ fhir:value "135.57"^^xsd:decimal ];
       fhir:Money.currency [ fhir:value "USD" ]

  ] ) ; # 
  fhir:item ( [
     fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
     fhir:careTeamSequence ( [ fhir:v "1"^^xsd:positiveInteger ] ) ;
     fhir:productOrService [
       fhir:coding ( [
         fhir:code [ fhir:v "1200" ]
       ] )
     ] ;
     fhir:serviced [ fhir:v "2014-08-16"^^xsd:date ] ;
     fhir:unitPrice [
       fhir:value [ fhir:v "135.57"^^xsd:decimal ] ;
       fhir:currency [ fhir:v "USD" ]
     ] ;
     fhir:net [
       fhir:value [ fhir:v "135.57"^^xsd:decimal ] ;
       fhir:currency [ fhir:v "USD" ]

     ]
  ] .

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

<http://hl7.org/fhir/Claim/100152.ttl> a owl:Ontology;
  owl:imports fhir:fhir.ttl;
  owl:versionIRI <http://build.fhir.org/Claim/100152.ttl> .

  ] )] . # 


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

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.