Claim Submission - Request (Transaction) - TTL Representation

DHIN 2025Connectathon FHIR IG, published by DHIN. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/Nigeria-FHIR-Community/2025Connectathon/ and changes regularly. See the Directory of published versions
: Claim Submission - Request (Transaction) - 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:Bundle ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "ClaimSubmission-Request"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-claim-submission-bundle"^^xsd:anyURI ;
fhir:l <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-claim-submission-bundle>     ] )
  ] ; # 
  fhir:type [ fhir:v "transaction"] ; # 
  fhir:entry ( [
fhir:fullUrl [
fhir:v "urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef"^^xsd:anyURI ;
fhir:l <urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef>     ] ;
    ( fhir:resource <urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef> ) ;
fhir:request [
fhir:method [ fhir:v "POST" ] ;
fhir:url [
fhir:v "Patient"^^xsd:anyURI ;
fhir:l fhir:Patient       ]     ]
  ] [
fhir:fullUrl [
fhir:v "urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef"^^xsd:anyURI ;
fhir:l <urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef>     ] ;
    ( fhir:resource <urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef> ) ;
fhir:request [
fhir:method [ fhir:v "POST" ] ;
fhir:url [
fhir:v "Organization"^^xsd:anyURI ;
fhir:l fhir:Organization       ]     ]
  ] [
fhir:fullUrl [
fhir:v "urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef"^^xsd:anyURI ;
fhir:l <urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef>     ] ;
    ( fhir:resource <urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef> ) ;
fhir:request [
fhir:method [ fhir:v "POST" ] ;
fhir:url [
fhir:v "Organization"^^xsd:anyURI ;
fhir:l fhir:Organization       ]     ]
  ] [
fhir:fullUrl [
fhir:v "urn:uuid:eee55566-e5f6-4789-a123-456789abcdef"^^xsd:anyURI ;
fhir:l <urn:uuid:eee55566-e5f6-4789-a123-456789abcdef>     ] ;
    ( fhir:resource <urn:uuid:eee55566-e5f6-4789-a123-456789abcdef> ) ;
fhir:request [
fhir:method [ fhir:v "POST" ] ;
fhir:url [
fhir:v "Coverage"^^xsd:anyURI ;
fhir:l fhir:Coverage       ]     ]
  ] [
fhir:fullUrl [
fhir:v "urn:uuid:fff66677-e5f6-4789-a123-456789abcdef"^^xsd:anyURI ;
fhir:l <urn:uuid:fff66677-e5f6-4789-a123-456789abcdef>     ] ;
    ( fhir:resource <urn:uuid:fff66677-e5f6-4789-a123-456789abcdef> ) ;
fhir:request [
fhir:method [ fhir:v "POST" ] ;
fhir:url [
fhir:v "Claim"^^xsd:anyURI ;
fhir:l fhir:Claim       ]     ]
  ] ) . # 

<urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef> a fhir:Patient ;
  fhir:id [ fhir:v "NgPatient-Claim-001"] ; # 
  fhir:meta [
fhir:lastUpdated [ fhir:v "2025-10-25T14:30:00+01:00"^^xsd:dateTime ] ;
    ( fhir:profile [
fhir:v "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-patient"^^xsd:anyURI ;
fhir:l <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-patient>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_NgPatient-Claim-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient NgPatient-Claim-001</b></p><a name=\"NgPatient-Claim-001\"> </a><a name=\"hcNgPatient-Claim-001\"> </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\">Last updated: 2025-10-25 14:30:00+0100</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-ng-patient.html\">NG Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Amaka Nwosu  Female, DoB: 1992-07-15 ( mobile: 08045678901)</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=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\">22 River Road Port Harcourt RI </td></tr></table></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:identifier ( [
fhir:type [
      ( fhir:coding [
fhir:system [
fhir:v "https://sandbox.dhin-hie.org/ig/CodeSystem/patient-identifier-cs"^^xsd:anyURI ;
fhir:l <https://sandbox.dhin-hie.org/ig/CodeSystem/patient-identifier-cs>         ] ;
fhir:code [ fhir:v "MOBILE" ] ;
fhir:display [ fhir:v "mobile" ]       ] )     ] ;
fhir:system [
fhir:v "https://sandbox.dhin-hie.org/ig/CodeSystem/patient-identifier-cs"^^xsd:anyURI ;
fhir:l <https://sandbox.dhin-hie.org/ig/CodeSystem/patient-identifier-cs>     ] ;
fhir:value [ fhir:v "08045678901" ]
  ] ) ; # 
  fhir:active [ fhir:v true] ; # 
  fhir:name ( [
fhir:family [ fhir:v "Nwosu" ] ;
    ( fhir:given [ fhir:v "Amaka" ] )
  ] ) ; # 
  fhir:gender [ fhir:v "female"] ; # 
  fhir:birthDate [ fhir:v "1992-07-15"^^xsd:date] ; # 
  fhir:address ( [
    ( fhir:line [ fhir:v "22 River Road" ] ) ;
fhir:city [ fhir:v "Port Harcourt" ] ;
fhir:district [ fhir:v "ri-oyigbo" ] ;
fhir:state [ fhir:v "RI" ]
  ] ) . # 

<urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef> a fhir:Organization ;
  fhir:id [ fhir:v "NgOrganization-Provider-Claim-001"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-provider-organization"^^xsd:anyURI ;
fhir:l <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-provider-organization>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_NgOrganization-Provider-Claim-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization NgOrganization-Provider-Claim-001</b></p><a name=\"NgOrganization-Provider-Claim-001\"> </a><a name=\"hcNgOrganization-Provider-Claim-001\"> </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-ng-provider-organization.html\">NG Provider Organization</a></p></div><p><b>NG Owner of Facility</b>: <span title=\"Codes:{https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-location-owner-cs public}\">Public Health Institution Location</span></p><p><b>identifier</b>: <code>https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry</code>/HCF-RS-5678</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: Rivers State Teaching Hospital</p><p><b>telecom</b>: ph: 084-234-5678</p><p><b>address</b>: 100 Hospital Boulevard Port Harcourt RI </p></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:extension ( [
fhir:url [
fhir:v "https://sandbox.dhin-hie.org/ig/StructureDefinition/organization-owner"^^xsd:anyURI ;
fhir:l <https://sandbox.dhin-hie.org/ig/StructureDefinition/organization-owner>     ] ;
fhir:value [
a fhir:CodeableConcept ;
      ( fhir:coding [
fhir:system [
fhir:v "https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-location-owner-cs"^^xsd:anyURI ;
fhir:l <https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-location-owner-cs>         ] ;
fhir:code [ fhir:v "public" ]       ] )     ]
  ] ) ; # 
  fhir:identifier ( [
fhir:system [
fhir:v "https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry"^^xsd:anyURI ;
fhir:l <https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry>     ] ;
fhir:value [ fhir:v "HCF-RS-5678" ]
  ] ) ; # 
  fhir:active [ fhir:v true] ; # 
  fhir:type ( [
    ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/organization-type"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/organization-type>       ] ;
fhir:code [ fhir:v "prov" ] ;
fhir:display [ fhir:v "Healthcare Provider" ]     ] )
  ] ) ; # 
  fhir:name [ fhir:v "Rivers State Teaching Hospital"] ; # 
  fhir:telecom ( [
fhir:system [ fhir:v "phone" ] ;
fhir:value [ fhir:v "084-234-5678" ]
  ] ) ; # 
  fhir:address ( [
    ( fhir:line [ fhir:v "100 Hospital Boulevard" ] ) ;
fhir:city [ fhir:v "Port Harcourt" ] ;
fhir:district [ fhir:v "ri-oyigbo" ] ;
fhir:state [ fhir:v "RI" ]
  ] ) . # 

<urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef> a fhir:Organization ;
  fhir:id [ fhir:v "NgOrganization-Insurer-Claim-001"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-insurer-organization"^^xsd:anyURI ;
fhir:l <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-insurer-organization>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_NgOrganization-Insurer-Claim-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization NgOrganization-Insurer-Claim-001</b></p><a name=\"NgOrganization-Insurer-Claim-001\"> </a><a name=\"hcNgOrganization-Insurer-Claim-001\"> </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-ng-insurer-organization.html\">NG Insurer Organization</a></p></div><p><b>identifier</b>: <code>https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry</code>/HMO-MC-9988</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type ins}\">Insurance Company</span></p><p><b>name</b>: MediCare Plus HMO</p><p><b>telecom</b>: ph: 0700-MEDICARE</p><p><b>address</b>: 15 Insurance Plaza Port Harcourt RI </p></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:identifier ( [
fhir:system [
fhir:v "https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry"^^xsd:anyURI ;
fhir:l <https://sandbox.dhin-hie.org/ig/CodeSystem/nigeria-facility-registry>     ] ;
fhir:value [ fhir:v "HMO-MC-9988" ]
  ] ) ; # 
  fhir:active [ fhir:v true] ; # 
  fhir:type ( [
    ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/organization-type"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/organization-type>       ] ;
fhir:code [ fhir:v "ins" ] ;
fhir:display [ fhir:v "Insurance Company" ]     ] )
  ] ) ; # 
  fhir:name [ fhir:v "MediCare Plus HMO"] ; # 
  fhir:telecom ( [
fhir:system [ fhir:v "phone" ] ;
fhir:value [ fhir:v "0700-MEDICARE" ]
  ] ) ; # 
  fhir:address ( [
    ( fhir:line [ fhir:v "15 Insurance Plaza" ] ) ;
fhir:city [ fhir:v "Port Harcourt" ] ;
fhir:district [ fhir:v "ri-oyigbo" ] ;
fhir:state [ fhir:v "RI" ]
  ] ) . # 

<urn:uuid:eee55566-e5f6-4789-a123-456789abcdef> a fhir:Coverage ;
  fhir:id [ fhir:v "NgCoverage-Claim-001"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-coverage"^^xsd:anyURI ;
fhir:l <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-coverage>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_NgCoverage-Claim-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage NgCoverage-Claim-001</b></p><a name=\"NgCoverage-Claim-001\"> </a><a name=\"hcNgCoverage-Claim-001\"> </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-ng-coverage.html\">NG Claim Coverage</a></p></div><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode EHCPOL}\">extended healthcare</span></p><p><b>beneficiary</b>: <a href=\"Bundle-ClaimSubmission-Request.html#urn-uuid-aaabbbc2-e5f6-4789-a123-456789abcdef\">Amaka Nwosu  Female, DoB: 1992-07-15 ( mobile: 08045678901)</a></p><p><b>period</b>: 2025-01-01 --&gt; 2025-12-31</p><p><b>payor</b>: <a href=\"Bundle-ClaimSubmission-Request.html#urn-uuid-ddd44455-e5f6-4789-a123-456789abcdef\">Organization MediCare Plus HMO</a></p></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:type [
    ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActCode>       ] ;
fhir:code [ fhir:v "EHCPOL" ] ;
fhir:display [ fhir:v "extended healthcare" ]     ] )
  ] ; # 
  fhir:beneficiary [
fhir:l <urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef> ;
fhir:reference [ fhir:v "urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef" ]
  ] ; # 
  fhir:period [
fhir:start [ fhir:v "2025-01-01"^^xsd:date ] ;
fhir:end [ fhir:v "2025-12-31"^^xsd:date ]
  ] ; # 
  fhir:payor ( [
fhir:l <urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef> ;
fhir:reference [ fhir:v "urn:uuid:ddd44455-e5f6-4789-a123-456789abcdef" ]
  ] ) . # 

<urn:uuid:fff66677-e5f6-4789-a123-456789abcdef> a fhir:Claim ;
  fhir:id [ fhir:v "NgClaim-Claim-001"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-claim"^^xsd:anyURI ;
fhir:l <https://sandbox.dhin-hie.org/ig/StructureDefinition/ng-claim>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_NgClaim-Claim-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim NgClaim-Claim-001</b></p><a name=\"NgClaim-Claim-001\"> </a><a name=\"hcNgClaim-Claim-001\"> </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-ng-claim.html\">NG Claim</a></p></div><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type institutional}\">Institutional</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: <a href=\"Bundle-ClaimSubmission-Request.html#urn-uuid-aaabbbc2-e5f6-4789-a123-456789abcdef\">Amaka Nwosu  Female, DoB: 1992-07-15 ( mobile: 08045678901)</a></p><p><b>created</b>: 2025-10-25 14:35:00+0100</p><p><b>provider</b>: <a href=\"Bundle-ClaimSubmission-Request.html#urn-uuid-ccc33344-e5f6-4789-a123-456789abcdef\">Organization Rivers State Teaching Hospital</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><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=\"Bundle-ClaimSubmission-Request.html#urn-uuid-eee55566-e5f6-4789-a123-456789abcdef\">Coverage: status = active; type = extended healthcare; period = 2025-01-01 --&gt; 2025-12-31</a></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-USCLS 1205}\">Appendectomy</span></p><p><b>serviced</b>: 2025-10-22</p><p><b>quantity</b>: 1</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>150000</td><td>Nigerian naira</td></tr></table><h3>Nets</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>150000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>productOrService</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-USCLS 1201}\">Exam, recall</span></p><p><b>serviced</b>: 2025-10-22 --&gt; 2025-10-25</p><p><b>quantity</b>: 3</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>20000</td><td>Nigerian naira</td></tr></table><h3>Nets</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>60000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 3</p><p><b>productOrService</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-USCLS 1101}\">Laboratory Tests</span></p><p><b>serviced</b>: 2025-10-22</p><p><b>quantity</b>: 1</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>15000</td><td>Nigerian naira</td></tr></table><h3>Nets</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>15000</td><td>Nigerian naira</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 4</p><p><b>productOrService</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-USCLS 1102}\">Medications</span></p><p><b>serviced</b>: 2025-10-22</p><p><b>quantity</b>: 1</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>25000</td><td>Nigerian naira</td></tr></table><h3>Nets</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>25000</td><td>Nigerian naira</td></tr></table></blockquote><h3>Totals</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>250000</td><td>Nigerian naira</td></tr></table></div>"^^rdf:XMLLiteral ]
  ] ; # 
  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 "institutional" ] ;
fhir:display [ fhir:v "Institutional" ]     ] )
  ] ; # 
  fhir:use [ fhir:v "claim"] ; # 
  fhir:patient [
fhir:l <urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef> ;
fhir:reference [ fhir:v "urn:uuid:aaabbbc2-e5f6-4789-a123-456789abcdef" ]
  ] ; # 
  fhir:created [ fhir:v "2025-10-25T14:35:00+01:00"^^xsd:dateTime] ; # 
  fhir:provider [
fhir:l <urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef> ;
fhir:reference [ fhir:v "urn:uuid:ccc33344-e5f6-4789-a123-456789abcdef" ]
  ] ; # 
  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:insurance ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:focal [ fhir:v true ] ;
fhir:coverage [
fhir:l <urn:uuid:eee55566-e5f6-4789-a123-456789abcdef> ;
fhir:reference [ fhir:v "urn:uuid:eee55566-e5f6-4789-a123-456789abcdef" ]     ]
  ] ) ; # 
  fhir:item ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:productOrService [
      ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/ex-USCLS"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/ex-USCLS>         ] ;
fhir:code [ fhir:v "1205" ]       ] ) ;
fhir:text [ fhir:v "Appendectomy" ]     ] ;
fhir:serviced [
a fhir:Date ;
fhir:v "2025-10-22"^^xsd:date     ] ;
fhir:quantity [
fhir:value [ fhir:v "1"^^xsd:decimal ]     ] ;
fhir:unitPrice [
fhir:value [ fhir:v "150000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "NGN" ]     ] ;
fhir:net [
fhir:value [ fhir:v "150000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "NGN" ]     ]
  ] [
fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ;
fhir:productOrService [
      ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/ex-USCLS"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/ex-USCLS>         ] ;
fhir:code [ fhir:v "1201" ]       ] ) ;
fhir:text [ fhir:v "Exam, recall" ]     ] ;
fhir:serviced [
a fhir:Period ;
fhir:start [ fhir:v "2025-10-22"^^xsd:date ] ;
fhir:end [ fhir:v "2025-10-25"^^xsd:date ]     ] ;
fhir:quantity [
fhir:value [ fhir:v "3"^^xsd:decimal ]     ] ;
fhir:unitPrice [
fhir:value [ fhir:v "20000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "NGN" ]     ] ;
fhir:net [
fhir:value [ fhir:v "60000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "NGN" ]     ]
  ] [
fhir:sequence [ fhir:v "3"^^xsd:positiveInteger ] ;
fhir:productOrService [
      ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/ex-USCLS"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/ex-USCLS>         ] ;
fhir:code [ fhir:v "1101" ]       ] ) ;
fhir:text [ fhir:v "Laboratory Tests" ]     ] ;
fhir:serviced [
a fhir:Date ;
fhir:v "2025-10-22"^^xsd:date     ] ;
fhir:quantity [
fhir:value [ fhir:v "1"^^xsd:decimal ]     ] ;
fhir:unitPrice [
fhir:value [ fhir:v "15000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "NGN" ]     ] ;
fhir:net [
fhir:value [ fhir:v "15000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "NGN" ]     ]
  ] [
fhir:sequence [ fhir:v "4"^^xsd:positiveInteger ] ;
fhir:productOrService [
      ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/ex-USCLS"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/ex-USCLS>         ] ;
fhir:code [ fhir:v "1102" ]       ] ) ;
fhir:text [ fhir:v "Medications" ]     ] ;
fhir:serviced [
a fhir:Date ;
fhir:v "2025-10-22"^^xsd:date     ] ;
fhir:quantity [
fhir:value [ fhir:v "1"^^xsd:decimal ]     ] ;
fhir:unitPrice [
fhir:value [ fhir:v "25000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "NGN" ]     ] ;
fhir:net [
fhir:value [ fhir:v "25000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "NGN" ]     ]
  ] ) ; # 
  fhir:total [
fhir:value [ fhir:v "250000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "NGN" ]
  ] . #