2026 US Quality Core Implementation Guide
0.5.0 - cibuild US

2026 US Quality Core Implementation Guide, published by Office of the National Coordinator for Health Information Technology (ONC). This guide is not an authorized publication; it is the continuous build for version 0.5.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/FHIR/us-quality-core/ and changes regularly. See the Directory of published versions

## : Claim example - TTL Representation

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

     a fhir:Claim ;
      fhir:nodeRole fhir:treeRoot ;
      fhir:id [ fhir:v "example"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-claim"^^xsd:anyURI ;
    fhir:l <http://fhir.org/guides/onc/us-quality-core/StructureDefinition/us-quality-core-claim>     ] )
      ] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Claim example</b></p><a name=\"example\"> </a><a name=\"hcexample\"> </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\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-us-quality-core-claim.html\">US Quality Core Claim</a></p></div><p><b>identifier</b>: <code>http://example.org/claims</code>/6612346</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>: Claim</p><p><b>patient</b>: <a href=\"Patient-example.html\">Jim Chalmers  Male, DoB: 1974-12-25 ( Social Security number (use: usual, period: 2001-05-06 --&gt; (ongoing)))</a></p><p><b>created</b>: 2014-08-16</p><p><b>insurer</b>: <a href=\"Organization-example.html\">Organization Health Level Seven International</a></p><p><b>provider</b>: <a href=\"Practitioner-example.html\">Practitioner Adam Careful </a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><h3>Payees</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Party</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/payeetype provider}\">Provider</span></td><td><a href=\"Practitioner-example.html\">Practitioner Adam Careful </a></td></tr></table><h3>CareTeams</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><a href=\"Practitioner-example.html\">Practitioner Adam Careful </a></td></tr></table><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td><td><b>OnAdmission</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://hl7.org/fhir/sid/icd-10-cm K35.80}\">Unspecified acute appendicitis</span></td><td><span title=\"Codes:{https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalAcqCond/Coding Y}\">Y</span></td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"Coverage-example.html\">Coverage: identifier = Member Number; status = active; type = Other Private Insurance; subscriberId = 12191; dependent = 0; relationship = Self; period = 2011-05-23 --&gt; 2012-05-23; order = 9</a></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>careTeamSequence</b>: 1</p><p><b>diagnosisSequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://www.ama-assn.org/go/cpt 44950}\">Appendectomy</span></p><p><b>serviced</b>: 2013-04-05</p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>4000.00</td><td>United States dollar</td></tr></table></blockquote></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:identifier ( [
    fhir:system [
    fhir:v "http://example.org/claims"^^xsd:anyURI ;
    fhir:l <http://example.org/claims>     ] ;
    fhir:value [ fhir:v "6612346" ]
      ] ) ; #
      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:display [ fhir:v "Professional" ]     ] )
      ] ; #
      fhir:use [ fhir:v "claim"] ; #
      fhir:patient [
    fhir:l fhir:Patient/example ;
    fhir:reference [ fhir:v "Patient/example" ]
      ] ; #
      fhir:created [ fhir:v "2014-08-16"^^xsd:date] ; #
      fhir:insurer [
    fhir:l fhir:Organization/example ;
    fhir:reference [ fhir:v "Organization/example" ]
      ] ; #
      fhir:provider [
    fhir:l fhir:Practitioner/example ;
    fhir:reference [ fhir:v "Practitioner/example" ]
      ] ; #
      fhir:priority [
        ( fhir:coding [
    fhir:system [
    fhir:v "http://terminology.hl7.org/CodeSystem/processpriority"^^xsd:anyURI ;
    fhir:l <http://terminology.hl7.org/CodeSystem/processpriority>       ] ;
    fhir:code [ fhir:v "normal" ]     ] )
      ] ; #
      fhir:payee [
    fhir:type [
          ( fhir:coding [
    fhir:system [
    fhir:v "http://terminology.hl7.org/CodeSystem/payeetype"^^xsd:anyURI ;
    fhir:l <http://terminology.hl7.org/CodeSystem/payeetype>         ] ;
    fhir:code [ fhir:v "provider" ]       ] )     ] ;
    fhir:party [
    fhir:l fhir:Practitioner/example ;
    fhir:reference [ fhir:v "Practitioner/example" ]     ]
      ] ; #
      fhir:careTeam ( [
    fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
    fhir:provider [
    fhir:l fhir:Practitioner/example ;
    fhir:reference [ fhir:v "Practitioner/example" ]     ]
      ] ) ; #
      fhir:diagnosis ( [
    fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
    fhir:diagnosis [
    a fhir:CodeableConcept ;
          ( fhir:coding [
    fhir:system [
    fhir:v "http://hl7.org/fhir/sid/icd-10-cm"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/sid/icd-10-cm>         ] ;
    fhir:code [ fhir:v "K35.80" ] ;
    fhir:display [ fhir:v "Unspecified acute appendicitis" ]       ] )     ] ;
    fhir:onAdmission [
          ( fhir:coding [
    fhir:system [
    fhir:v "https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalAcqCond/Coding"^^xsd:anyURI ;
    fhir:l <https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalAcqCond/Coding>         ] ;
    fhir:code [ fhir:v "Y" ]       ] )     ]
      ] ) ; #
      fhir:insurance ( [
    fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
    fhir:focal [ fhir:v true ] ;
    fhir:coverage [
    fhir:l fhir:Coverage/example ;
    fhir:reference [ fhir:v "Coverage/example" ]     ]
      ] ) ; #
      fhir:item ( [
    fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
        ( fhir:careTeamSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ;
        ( fhir:diagnosisSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ;
    fhir:productOrService [
          ( fhir:coding [
    fhir:system [
    fhir:v "http://www.ama-assn.org/go/cpt"^^xsd:anyURI ;
    fhir:l <http://www.ama-assn.org/go/cpt>         ] ;
    fhir:code [ fhir:v "44950" ] ;
    fhir:display [ fhir:v "Appendectomy" ]       ] )     ] ;
    fhir:serviced [
    a fhir:Date ;
    fhir:v "2013-04-05"^^xsd:date     ] ;
    fhir:unitPrice [
    fhir:value [ fhir:v 4000.00 ] ;
    fhir:currency [ fhir:v "USD" ]     ]
      ] ) . #