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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)
Glasses Claim, 3 Tier, Secondary Coverage
@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 "660152"] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the Vision Claim for Glasses</div>" ] ; # fhir:contained ( [ a fhir:Device ; fhir:id [ fhir:v "device-frame" ] ] [ a fhir:Device ; fhir:id [ fhir:v "device-lens" ] ] ) ; # fhir:identifier ( [ fhir:system [ fhir:v "http://happysight.com/claim"^^xsd:anyURI ] ; fhir:value [ fhir:v "6612347" ] ] ) ; # 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 "vision" ] ] ) ] ; # 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 "normal" ] ] ) ] ; # fhir:prescription [ fhir:link <http://www.optdocs.com/prescription/12345> ; fhir:reference [ fhir:v "http://www.optdocs.com/prescription/12345" ] ] ; # 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:diagnosis ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:diagnosis [ a fhir:CodeableConcept ; fhir:coding ( [ fhir:code [ fhir:v "654321" ] ] ) ] ] ) ; # fhir:insurance ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; # Patient's own coverage - primary fhir:focal [ fhir:v "false"^^xsd:boolean ] ; fhir:coverage [ fhir:reference [ fhir:v "Coverage/9876B1" ] ] ; fhir:preAuthRef ( [ fhir:v "PR7652387237" ] ) ; fhir:claimResponse [ fhir:reference [ fhir:v "ClaimResponse/R3500" ] ] ] [ fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ; # Spouses's own coverage - secondary fhir:focal [ fhir:v "true"^^xsd:boolean ] ; fhir:coverage [ fhir:reference [ fhir:v "Coverage/9876B1" ] ] ; fhir:preAuthRef ( [ fhir:v "AB543GTD7567" ] ) ] ) ; # fhir:item ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:careTeamSequence ( [ fhir:v "1"^^xsd:positiveInteger ] ) ; fhir:revenue [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-revenue-center"^^xsd:anyURI ] ; fhir:code [ fhir:v "0010" ] ; fhir:display [ fhir:v "Vision Clinic" ] ] ) ] ; fhir:category [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/benefit-subcategory"^^xsd:anyURI ] ; fhir:code [ fhir:v "F6" ] ; fhir:display [ fhir:v "Vision Coverage" ] ] ) ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/ex-visionservice"^^xsd:anyURI ] ; fhir:code [ fhir:v "glasses" ] ] ) ] ; fhir:modifier ( [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/modifiers"^^xsd:anyURI ] ; fhir:code [ fhir:v "rooh" ] ] ) ] ) ; fhir:programCode ( [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-programcode"^^xsd:anyURI ] ; fhir:code [ fhir:v "none" ] ] ) ] ) ; fhir:serviced [ fhir:v "2014-08-16"^^xsd:date ] ; fhir:unitPrice [ fhir:value [ fhir:v "235.40"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ; fhir:net [ fhir:value [ fhir:v "235.40"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ; fhir:detail ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:revenue [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-revenue-center"^^xsd:anyURI ] ; fhir:code [ fhir:v "0010" ] ; fhir:display [ fhir:v "Vision Clinic" ] ] ) ] ; fhir:category [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/benefit-subcategory"^^xsd:anyURI ] ; fhir:code [ fhir:v "F6" ] ; fhir:display [ fhir:v "Vision Coverage" ] ] ) ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/ex-visionservice"^^xsd:anyURI ] ; fhir:code [ fhir:v "frame" ] ] ) ] ; fhir:modifier ( [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/modifiers"^^xsd:anyURI ] ; fhir:code [ fhir:v "rooh" ] ] ) ] ) ; fhir:unitPrice [ fhir:value [ fhir:v "100.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ; fhir:factor [ fhir:v "1.1"^^xsd:decimal ] ; fhir:net [ fhir:value [ fhir:v "110.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ; # 10% surcharge for out of hours work fhir:udi ( [ fhir:reference [ fhir:v "#device-frame" ] ] ) ] [ fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ; fhir:revenue [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-revenue-center"^^xsd:anyURI ] ; fhir:code [ fhir:v "0010" ] ; fhir:display [ fhir:v "Vision Clinic" ] ] ) ] ; fhir:category [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/benefit-subcategory"^^xsd:anyURI ] ; fhir:code [ fhir:v "F6" ] ; fhir:display [ fhir:v "Vision Coverage" ] ] ) ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/ex-visionservice"^^xsd:anyURI ] ; fhir:code [ fhir:v "lens" ] ] ) ] ; fhir:programCode ( [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-programcode"^^xsd:anyURI ] ; fhir:code [ fhir:v "none" ] ] ) ] ) ; fhir:quantity [ fhir:value [ fhir:v "2"^^xsd:decimal ] ] ; fhir:unitPrice [ fhir:value [ fhir:v "55.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ; fhir:net [ fhir:value [ fhir:v "110.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ; fhir:subDetail ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:revenue [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-revenue-center"^^xsd:anyURI ] ; fhir:code [ fhir:v "0010" ] ; fhir:display [ fhir:v "Vision Clinic" ] ] ) ] ; fhir:category [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/benefit-subcategory"^^xsd:anyURI ] ; fhir:code [ fhir:v "F6" ] ; fhir:display [ fhir:v "Vision Coverage" ] ] ) ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/ex-visionservice"^^xsd:anyURI ] ; fhir:code [ fhir:v "lens" ] ] ) ] ; fhir:modifier ( [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/modifiers"^^xsd:anyURI ] ; fhir:code [ fhir:v "rooh" ] ] ) ] ) ; fhir:programCode ( [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-programcode"^^xsd:anyURI ] ; fhir:code [ fhir:v "none" ] ] ) ] ) ; fhir:quantity [ fhir:value [ fhir:v "2"^^xsd:decimal ] ] ; fhir:unitPrice [ fhir:value [ fhir:v "30.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ; fhir:factor [ fhir:v "1.1"^^xsd:decimal ] ; fhir:net [ fhir:value [ fhir:v "66.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ; # 10% surchage for out of hours work fhir:udi ( [ fhir:reference [ fhir:v "#device-lens" ] ] ) ] [ fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ; fhir:revenue [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-revenue-center"^^xsd:anyURI ] ; fhir:code [ fhir:v "0010" ] ; fhir:display [ fhir:v "Vision Clinic" ] ] ) ] ; fhir:category [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/benefit-subcategory"^^xsd:anyURI ] ; fhir:code [ fhir:v "F6" ] ; fhir:display [ fhir:v "Vision Coverage" ] ] ) ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/ex-visionservice"^^xsd:anyURI ] ; fhir:code [ fhir:v "hardening" ] ] ) ] ; fhir:modifier ( [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/modifiers"^^xsd:anyURI ] ; fhir:code [ fhir:v "rooh" ] ] ) ] ) ; fhir:quantity [ fhir:value [ fhir:v "2"^^xsd:decimal ] ] ; fhir:unitPrice [ fhir:value [ fhir:v "15.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ; fhir:factor [ fhir:v "1.1"^^xsd:decimal ] ; fhir:net [ fhir:value [ fhir:v "33.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] # 10% surchage for out of hours work ] [ fhir:sequence [ fhir:v "3"^^xsd:positiveInteger ] ; fhir:revenue [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-revenue-center"^^xsd:anyURI ] ; fhir:code [ fhir:v "0010" ] ; fhir:display [ fhir:v "Vision Clinic" ] ] ) ] ; fhir:category [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/benefit-subcategory"^^xsd:anyURI ] ; fhir:code [ fhir:v "F6" ] ; fhir:display [ fhir:v "Vision Coverage" ] ] ) ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/ex-visionservice"^^xsd:anyURI ] ; fhir:code [ fhir:v "UV coating" ] ] ) ] ; fhir:modifier ( [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/modifiers"^^xsd:anyURI ] ; fhir:code [ fhir:v "rooh" ] ] ) ] ) ; fhir:quantity [ fhir:value [ fhir:v "2"^^xsd:decimal ] ] ; fhir:unitPrice [ fhir:value [ fhir:v "5.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ; fhir:factor [ fhir:v "1.1"^^xsd:decimal ] ; fhir:net [ fhir:value [ fhir:v "11.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] # 10% surchage for out of hours work ] ) ] [ fhir:sequence [ fhir:v "3"^^xsd:positiveInteger ] ; fhir:revenue [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-revenue-center"^^xsd:anyURI ] ; fhir:code [ fhir:v "0010" ] ; fhir:display [ fhir:v "Vision Clinic" ] ] ) ] ; fhir:category [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/benefit-subcategory"^^xsd:anyURI ] ; fhir:code [ fhir:v "F6" ] ; fhir:display [ fhir:v "Vision Coverage" ] ] ) ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://example.org/fhir/CodeSystem/ex-visionservice"^^xsd:anyURI ] ; fhir:code [ fhir:v "fst" ] ] ) ] ; fhir:unitPrice [ fhir:value [ fhir:v "220.00"^^xsd:decimal ] ; fhir:currency [ fhir:v "USD" ] ] ; fhir:factor [ fhir:v "0.07"^^xsd:decimal ] ; fhir:net [ fhir:value [ fhir:v "15.40"^^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 R6 hl7.fhir.core#6.0.0-ballot2 generated on Thu, Nov 21, 2024 12:34+0000.
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