Patient Cost Transparency Implementation Guide
2.0.2 - STU 2 United States of America flag

Patient Cost Transparency Implementation Guide, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.0.2 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pct/ and changes regularly. See the Directory of published versions

: PCT-GFE-Missing-Bundle-1

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@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/Bundle/PCT-GFE-Missing-Bundle-1> a fhir:Bundle ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "PCT-GFE-Missing-Bundle-1"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-missing-bundle" ;
       fhir:index -1 ;
       fhir:link <http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-gfe-missing-bundle>
     ]
  ] ;
  fhir:Resource.language [ fhir:value "en"] ;
  fhir:Bundle.identifier [
     fhir:Identifier.system [ fhir:value "http://example.com/identifiers/bundle" ] ;
     fhir:Identifier.value [ fhir:value "59688475-2324-3242-2347384376" ]
  ] ;
  fhir:Bundle.type [ fhir:value "collection"] ;
  fhir:Bundle.timestamp [ fhir:value "2024-03-27T11:01:00+05:00"^^xsd:dateTime] ;
  fhir:Bundle.entry [
     fhir:index -1 ;
     fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Organization/org1002" ] ;
     fhir:Bundle.entry.resource <http://example.org/fhir/Organization/org1002>
  ], [
     fhir:index -1 ;
     fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Patient/patient1001" ] ;
     fhir:Bundle.entry.resource <http://example.org/fhir/Patient/patient1001>
  ], [
     fhir:index -1 ;
     fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Coverage/coverage1001" ] ;
     fhir:Bundle.entry.resource <http://example.org/fhir/Coverage/coverage1001>
  ], [
     fhir:index -1 ;
     fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/Organization/org1001" ] ;
     fhir:Bundle.entry.resource <http://example.org/fhir/Organization/org1001>
  ], [
     fhir:index -1 ;
     fhir:Element.id [ fhir:value "PCT-DeviceRequest-1" ] ;
     fhir:Bundle.entry.fullUrl [ fhir:value "http://example.org/fhir/DeviceRequest/PCT-DeviceRequest-1" ] ;
     fhir:Bundle.entry.resource <http://example.org/fhir/DeviceRequest/PCT-DeviceRequest-1>
  ] .

<http://example.org/fhir/Organization/org1002> a fhir:Organization ;
  fhir:Resource.id [ fhir:value "org1002"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization" ;
       fhir:index -1 ;
       fhir:link <http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization>
     ]
  ] ;
  fhir:Resource.language [ fhir:value "en"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_org1002\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization org1002</b></p><a name=\"org1002\"> </a><a name=\"hcorg1002\"> </a><div style=\"display: inline-block; background-color: #fbffeb; 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-davinci-pct-organization.html\">PCT Organization</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Boston Radiology Center (Healthcare Provider) (http://hl7.org/fhir/sid/us-npi#United States National Provider Identifier#9941339100)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td colspan=\"3\">true</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"The kind(s) of organization that this is\">Type:</td><td colspan=\"3\"><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Other Id (see the one above)\">Other Id:</td><td colspan=\"3\">Tax ID number/TAX-3211001</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the organization\">Contact Detail</td><td colspan=\"3\"><ul><li>ph: 781-232-3200(Work)</li><li>32 Fruit Street Boston MA 02114 US </li></ul></td></tr></table></div>"
  ] ;
  fhir:Organization.identifier [
     fhir:index -1 ;
     fhir:Identifier.system [ fhir:value "http://hl7.org/fhir/sid/us-npi" ] ;
     fhir:Identifier.value [ fhir:value "9941339100" ]
  ], [
     fhir:index -1 ;
     fhir:Identifier.type [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0203" ] ;
         fhir:Coding.code [ fhir:value "TAX" ]
       ]
     ] ;
     fhir:Identifier.system [ fhir:value "urn:oid:2.16.840.1.113883.4.4" ] ;
     fhir:Identifier.value [ fhir:value "TAX-3211001" ]
  ] ;
  fhir:Organization.active [ fhir:value "true"^^xsd:boolean] ;
  fhir:Organization.type [
     fhir:index -1 ;
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/organization-type" ] ;
       fhir:Coding.code [ fhir:value "prov" ] ;
       fhir:Coding.display [ fhir:value "Healthcare Provider" ]
     ]
  ] ;
  fhir:Organization.name [ fhir:value "Boston Radiology Center"] ;
  fhir:Organization.telecom [
     fhir:index -1 ;
     fhir:ContactPoint.system [ fhir:value "phone" ] ;
     fhir:ContactPoint.value [ fhir:value "781-232-3200" ] ;
     fhir:ContactPoint.use [ fhir:value "work" ]
  ] ;
  fhir:Organization.address [
     fhir:index -1 ;
     fhir:Address.line [
       fhir:value "32 Fruit Street" ;
       fhir:index -1
     ] ;
     fhir:Address.city [ fhir:value "Boston" ] ;
     fhir:Address.state [ fhir:value "MA" ] ;
     fhir:Address.postalCode [ fhir:value "02114" ] ;
     fhir:Address.country [ fhir:value "US" ]
  ] .

<http://example.org/fhir/Patient/patient1001> a fhir:Patient ;
  fhir:Resource.id [ fhir:value "patient1001"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0" ;
       fhir:index -1 ;
       fhir:link <http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient|7.0.0>
     ]
  ] ;
  fhir:Resource.language [ fhir:value "en"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "additional" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_patient1001\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\"><b>Eve Betterhalf</b> female, DoB: 1955-07-23 ( <code>http://example.com/identifiers/patient</code>/1001)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Known Marital status of Patient\">Marital Status:</td><td colspan=\"3\"><span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-MaritalStatus U}\">unmarried</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Details:</td><td colspan=\"3\"><ul><li>ph: 781-949-4949(MOBILE)</li><li>222 Burlington Road, Bedford MA 01730</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Languages spoken\">Language:</td><td colspan=\"3\"><span title=\"Codes: {urn:ietf:bcp:47 en-US}\">English (United States)</span> (preferred)</td></tr></table></div>"
  ] ;
  fhir:Patient.identifier [
     fhir:index -1 ;
     fhir:Identifier.system [ fhir:value "http://example.com/identifiers/patient" ] ;
     fhir:Identifier.value [ fhir:value "1001" ]
  ] ;
  fhir:Patient.name [
     fhir:index -1 ;
     fhir:HumanName.text [ fhir:value "Eve Betterhalf" ] ;
     fhir:HumanName.family [ fhir:value "Betterhalf" ] ;
     fhir:HumanName.given [
       fhir:value "Eve" ;
       fhir:index -1
     ]
  ] ;
  fhir:Patient.telecom [
     fhir:index -1 ;
     fhir:ContactPoint.system [ fhir:value "phone" ] ;
     fhir:ContactPoint.value [ fhir:value "781-949-4949" ] ;
     fhir:ContactPoint.use [ fhir:value "mobile" ]
  ] ;
  fhir:Patient.gender [ fhir:value "female"] ;
  fhir:Patient.birthDate [ fhir:value "1955-07-23"^^xsd:date] ;
  fhir:Patient.address [
     fhir:index -1 ;
     fhir:Address.text [ fhir:value "222 Burlington Road, Bedford MA 01730" ]
  ] ;
  fhir:Patient.maritalStatus [
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus" ] ;
       fhir:Coding.code [ fhir:value "U" ] ;
       fhir:Coding.display [ fhir:value "unmarried" ]
     ]
  ] ;
  fhir:Patient.communication [
     fhir:index -1 ;
     fhir:Patient.communication.language [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "urn:ietf:bcp:47" ] ;
         fhir:Coding.code [ fhir:value "en-US" ] ;
         fhir:Coding.display [ fhir:value "English (United States)" ]
       ]
     ] ;
     fhir:Patient.communication.preferred [ fhir:value "true"^^xsd:boolean ]
  ] .

<http://example.org/fhir/Coverage/coverage1001> a fhir:Coverage ;
  fhir:Resource.id [ fhir:value "coverage1001"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage" ;
       fhir:index -1 ;
       fhir:link <http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-coverage>
     ]
  ] ;
  fhir:Resource.language [ fhir:value "en"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "extensions" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_coverage1001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage coverage1001</b></p><a name=\"coverage1001\"> </a><a name=\"hccoverage1001\"> </a><div style=\"display: inline-block; background-color: #fbffeb; 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-davinci-pct-coverage.html\">PCT Coverage</a></p></div><p><b>R5: insurance | self-pay | other (new)</b>: insurance</p><p><b>status</b>: Active</p><p><b>subscriberId</b>: PFP123450000</p><p><b>beneficiary</b>: <a href=\"Patient-patient1001.html\">Eve Betterhalf Female, DoB: 1955-07-23 ( http://example.com/identifiers/patient#1001)</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>period</b>: 2021-01-01 --&gt; 2022-01-01</p><p><b>payor</b>: <a href=\"Organization-org1001.html\">Umbrella Insurance Company (Payer) (Electronic Transmitter Identification Number: ETIN-3200002)</a></p><h3>Classes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Value</b></td><td><b>Name</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class plan}\">Plan</span></td><td>Premim Family Plus</td><td>Premim Family Plus Plan</td></tr></table><h3>CostToBeneficiaries</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-copay-type copaypct}\">Copay Percentage</span></td><td>20</td></tr></table></div>"
  ] ;
  fhir:DomainResource.extension [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/5.0/StructureDefinition/extension-Coverage.kind" ] ;
     fhir:Extension.valueCode [ fhir:value "insurance" ]
  ] ;
  fhir:Coverage.status [ fhir:value "active"] ;
  fhir:Coverage.subscriberId [ fhir:value "PFP123450000"] ;
  fhir:Coverage.beneficiary [
     fhir:link <http://hl7.org/fhir/Patient/patient1001> ;
     fhir:Reference.reference [ fhir:value "Patient/patient1001" ]
  ] ;
  fhir:Coverage.relationship [
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/subscriber-relationship" ] ;
       fhir:Coding.code [ fhir:value "self" ] ;
       fhir:Coding.display [ fhir:value "Self" ]
     ]
  ] ;
  fhir:Coverage.period [
     fhir:Period.start [ fhir:value "2021-01-01"^^xsd:date ] ;
     fhir:Period.end [ fhir:value "2022-01-01"^^xsd:date ]
  ] ;
  fhir:Coverage.payor [
     fhir:index -1 ;
     fhir:link <http://hl7.org/fhir/Organization/org1001> ;
     fhir:Reference.reference [ fhir:value "Organization/org1001" ]
  ] ;
  fhir:Coverage.class [
     fhir:index -1 ;
     fhir:Coverage.class.type [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/coverage-class" ] ;
         fhir:Coding.code [ fhir:value "plan" ] ;
         fhir:Coding.display [ fhir:value "Plan" ]
       ]
     ] ;
     fhir:Coverage.class.value [ fhir:value "Premim Family Plus" ] ;
     fhir:Coverage.class.name [ fhir:value "Premim Family Plus Plan" ]
  ] ;
  fhir:Coverage.costToBeneficiary [
     fhir:index -1 ;
     fhir:Coverage.costToBeneficiary.type [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/coverage-copay-type" ] ;
         fhir:Coding.code [ fhir:value "copaypct" ] ;
         fhir:Coding.display [ fhir:value "Copay Percentage" ]
       ]
     ] ;
     fhir:Coverage.costToBeneficiary.valueQuantity [
       fhir:Quantity.value [ fhir:value "20"^^xsd:decimal ]
     ]
  ] .

<http://hl7.org/fhir/Patient/patient1001> a fhir:Patient .

<http://hl7.org/fhir/Organization/org1001> a fhir:Organization .

<http://example.org/fhir/Organization/org1001> a fhir:Organization ;
  fhir:Resource.id [ fhir:value "org1001"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization" ;
       fhir:index -1 ;
       fhir:link <http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-organization>
     ]
  ] ;
  fhir:Resource.language [ fhir:value "en"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_org1001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization org1001</b></p><a name=\"org1001\"> </a><a name=\"hcorg1001\"> </a><div style=\"display: inline-block; background-color: #fbffeb; 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-davinci-pct-organization.html\">PCT Organization</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Umbrella Insurance Company (Payer) (Electronic Transmitter Identification Number: ETIN-3200002)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td colspan=\"3\">true</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"The kind(s) of organization that this is\">Type:</td><td colspan=\"3\"><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type pay}\">Payer</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the organization\">Contact Detail</td><td colspan=\"3\"><ul><li>ph: 860-547-5001(Work)</li><li>680 Asylum Street Hartford CT 06155 US </li></ul></td></tr></table></div>"
  ] ;
  fhir:Organization.identifier [
     fhir:index -1 ;
     fhir:Identifier.type [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0203" ] ;
         fhir:Coding.code [ fhir:value "ETIN" ]
       ]
     ] ;
     fhir:Identifier.value [ fhir:value "ETIN-3200002" ]
  ] ;
  fhir:Organization.active [ fhir:value "true"^^xsd:boolean] ;
  fhir:Organization.type [
     fhir:index -1 ;
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/organization-type" ] ;
       fhir:Coding.code [ fhir:value "pay" ] ;
       fhir:Coding.display [ fhir:value "Payer" ]
     ]
  ] ;
  fhir:Organization.name [ fhir:value "Umbrella Insurance Company"] ;
  fhir:Organization.telecom [
     fhir:index -1 ;
     fhir:ContactPoint.system [ fhir:value "phone" ] ;
     fhir:ContactPoint.value [ fhir:value "860-547-5001" ] ;
     fhir:ContactPoint.use [ fhir:value "work" ]
  ] ;
  fhir:Organization.address [
     fhir:index -1 ;
     fhir:Address.line [
       fhir:value "680 Asylum Street" ;
       fhir:index -1
     ] ;
     fhir:Address.city [ fhir:value "Hartford" ] ;
     fhir:Address.state [ fhir:value "CT" ] ;
     fhir:Address.postalCode [ fhir:value "06155" ] ;
     fhir:Address.country [ fhir:value "US" ]
  ] .

<http://example.org/fhir/DeviceRequest/PCT-DeviceRequest-1> a fhir:DeviceRequest ;
  fhir:Resource.id [ fhir:value "PCT-DeviceRequest-1"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-devicerequest" ;
       fhir:index -1 ;
       fhir:link <http://hl7.org/fhir/us/davinci-pct/StructureDefinition/davinci-pct-devicerequest>
     ]
  ] ;
  fhir:Resource.language [ fhir:value "en"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"DeviceRequest_PCT-DeviceRequest-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: DeviceRequest PCT-DeviceRequest-1</b></p><a name=\"PCT-DeviceRequest-1\"> </a><a name=\"hcPCT-DeviceRequest-1\"> </a><div style=\"display: inline-block; background-color: #fbffeb; 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-davinci-pct-devicerequest.html\">PCT GFE DeviceRequest</a></p></div><p><b>status</b>: Active</p><p><b>intent</b>: Proposal</p><p><b>code</b>: <span title=\"Codes:{http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets L1820}\">Ko elas w/ condyle pads &amp; jo</span></p><p><b>subject</b>: <a href=\"Patient-patient1001.html\">Eve Betterhalf Female, DoB: 1955-07-23 ( http://example.com/identifiers/patient#1001)</a></p></div>"
  ] ;
  fhir:DeviceRequest.status [ fhir:value "active"] ;
  fhir:DeviceRequest.intent [ fhir:value "proposal"] ;
  fhir:DeviceRequest.codeCodeableConcept [
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets" ] ;
       fhir:Coding.code [ fhir:value "L1820" ]
     ]
  ] ;
  fhir:DeviceRequest.subject [
     fhir:link <http://hl7.org/fhir/Patient/patient1001> ;
     fhir:Reference.reference [ fhir:value "Patient/patient1001" ]
  ] .

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

<http://hl7.org/fhir/Bundle/PCT-GFE-Missing-Bundle-1.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/Bundle/PCT-GFE-Missing-Bundle-1.ttl> .