Coverage: Medicare Part C - TTL Representation - haau3 FHIR Implementation Guide (HFIG) v0.1.0

haau3 FHIR Implementation Guide (HFIG), published by haau3. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/haau3/fhir-ig/ and changes regularly. See the Directory of published versions
: Coverage: Medicare Part C - 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:Coverage ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "ef9b8f50-083d-4b82-9b48-ab4f372d6c59"] ; # 
  fhir:meta [
fhir:source [
fhir:v "bluebutton"^^xsd:anyURI ;
fhir:l fhir:bluebutton     ] ;
    ( fhir:profile [
fhir:v "https://haau3.com/fhir/StructureDefinition/haau3-coverage"^^xsd:anyURI ;
fhir:l <https://haau3.com/fhir/StructureDefinition/haau3-coverage>     ] [
fhir:v "http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage|6.1.0"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/core/StructureDefinition/us-core-coverage?version=6.1.0>     ] [
fhir:v "http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-bb/StructureDefinition/C4BB-Coverage>     ] ) ;
    ( fhir:tag [
fhir:system [
fhir:v "https://haau3.com/fhir/CodeSystem/source-system"^^xsd:anyURI ;
fhir:l <https://haau3.com/fhir/CodeSystem/source-system>       ] ;
fhir:code [ fhir:v "bluebutton" ] ;
fhir:display [ fhir:v "Imported from CMS Blue Button API" ]     ] [
fhir:system [
fhir:v "https://haau3.com/fhir/CodeSystem/source-system"^^xsd:anyURI ;
fhir:l <https://haau3.com/fhir/CodeSystem/source-system>       ] ;
fhir:code [ fhir:v "bluebutton" ] ;
fhir:display [ fhir:v "CMS Blue Button" ]     ] [
fhir:system [
fhir:v "https://haau3.com/fhir/CodeSystem/enrichment"^^xsd:anyURI ;
fhir:l <https://haau3.com/fhir/CodeSystem/enrichment>       ] ;
fhir:version [ fhir:v "1.0.0" ] ;
fhir:code [ fhir:v "coverage.cms-payor-binding" ] ;
fhir:display [ fhir:v "Bind Blue Button Coverage.payor to canonical CMS Organization (Organization/cms)" ]     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Coverage ef9b8f50-083d-4b82-9b48-ab4f372d6c59</b></p><a name=\"ef9b8f50-083d-4b82-9b48-ab4f372d6c59\"> </a><a name=\"hcef9b8f50-083d-4b82-9b48-ab4f372d6c59\"> </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\">Information Source: <a href=\"https://simplifier.net/resolve?scope=hl7.fhir.us.carin-bb@2.1.0&amp;canonical=http://hl7.org/fhir/us/core/3.1.1/bluebutton\">bluebutton</a></p><p style=\"margin-bottom: 0px\">Profiles: <a href=\"StructureDefinition-haau3-coverage.html\">Coverage</a>, <a href=\"http://hl7.org/fhir/us/core/STU6.1/StructureDefinition-us-core-coverage.html\">US Core Coverage Profileversion: null6.1.0)</a>, <a href=\"http://hl7.org/fhir/us/carin-bb/STU2.1/StructureDefinition-C4BB-Coverage.html\">C4BB Coverage</a></p><p style=\"margin-bottom: 0px\">Tags: Imported from CMS Blue Button API (Details: haau3 Source System Codes code bluebutton = 'Imported from CMS Blue Button API'), CMS Blue Button (Details: haau3 Source System Codes code bluebutton = 'CMS Blue Button'), Bind Blue Button Coverage.payor to canonical CMS Organization (Organization/cms) (Details: haau3 Enrichment Tags code coverage.cms-payor-binding = 'Bind Blue Button Coverage.payor to canonical CMS Organization (Organization/cms)')</p></div><p><b>gov/resources/variables/ptc_cntrct_id_01</b>: ptc_cntrct_id_01: Y0008 (Y0008)</p><p><b>gov/resources/variables/ptc_cntrct_id_02</b>: ptc_cntrct_id_02: Y0008 (Y0008)</p><p><b>gov/resources/variables/ptc_cntrct_id_03</b>: ptc_cntrct_id_03: Y0008 (Y0008)</p><p><b>gov/resources/variables/ptc_pbp_id_01</b>: ptc_pbp_id_01: 803 (803)</p><p><b>gov/resources/variables/ptc_pbp_id_02</b>: ptc_pbp_id_02: 803 (803)</p><p><b>gov/resources/variables/ptc_pbp_id_03</b>: ptc_pbp_id_03: 803 (803)</p><p><b>gov/resources/variables/rfrnc_yr</b>: 2025</p><p><b>gov/resources/variables/dual_01</b>: dual_01: NA (Non-Medicaid)</p><p><b>gov/resources/variables/dual_02</b>: dual_02: NA (Non-Medicaid)</p><p><b>gov/resources/variables/dual_03</b>: dual_03: NA (Non-Medicaid)</p><p><b>identifier</b>: <a href=\"NamingSystem-haau3-coverage-id.html\" title=\"Stable coverage id namespace for normalized haau3 coverage entries\">Haau3CoverageId</a>/cms-medicare-part-c-1S00EU7JH19</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode SUBSIDIZ}\">subsidized health program</span></p><p><b>subscriberId</b>: 1S00EU7JH19</p><p><b>beneficiary</b>: <a href=\"Patient-grandma-fung.html\">Grandma Fung  Female, DoB: 1911-01-01 ( https://haau3.com/fhir/NamingSystem/haau3-patient-id#Haau3PatientId#pat-12345)</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>payor</b>: <a href=\"Organization-cms.html\">Centers for Medicare &amp; Medicaid Services (CMS)</a></p><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class group}\">Group</span></p><p><b>value</b>: Medicare</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class plan}\">Plan</span></p><p><b>value</b>: Part C</p></blockquote></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:extension ( [
fhir:url [
fhir:v "https://bluebutton.cms.gov/resources/variables/ptc_cntrct_id_01"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/ptc_cntrct_id_01>     ] ;
fhir:value [
a fhir:Coding ;
fhir:system [
fhir:v "https://bluebutton.cms.gov/resources/variables/ptc_cntrct_id_01"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/ptc_cntrct_id_01>       ] ;
fhir:code [ fhir:v "Y0008" ]     ]
  ] [
fhir:url [
fhir:v "https://bluebutton.cms.gov/resources/variables/ptc_cntrct_id_02"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/ptc_cntrct_id_02>     ] ;
fhir:value [
a fhir:Coding ;
fhir:system [
fhir:v "https://bluebutton.cms.gov/resources/variables/ptc_cntrct_id_02"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/ptc_cntrct_id_02>       ] ;
fhir:code [ fhir:v "Y0008" ]     ]
  ] [
fhir:url [
fhir:v "https://bluebutton.cms.gov/resources/variables/ptc_cntrct_id_03"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/ptc_cntrct_id_03>     ] ;
fhir:value [
a fhir:Coding ;
fhir:system [
fhir:v "https://bluebutton.cms.gov/resources/variables/ptc_cntrct_id_03"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/ptc_cntrct_id_03>       ] ;
fhir:code [ fhir:v "Y0008" ]     ]
  ] [
fhir:url [
fhir:v "https://bluebutton.cms.gov/resources/variables/ptc_pbp_id_01"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/ptc_pbp_id_01>     ] ;
fhir:value [
a fhir:Coding ;
fhir:system [
fhir:v "https://bluebutton.cms.gov/resources/variables/ptc_pbp_id_01"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/ptc_pbp_id_01>       ] ;
fhir:code [ fhir:v "803" ]     ]
  ] [
fhir:url [
fhir:v "https://bluebutton.cms.gov/resources/variables/ptc_pbp_id_02"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/ptc_pbp_id_02>     ] ;
fhir:value [
a fhir:Coding ;
fhir:system [
fhir:v "https://bluebutton.cms.gov/resources/variables/ptc_pbp_id_02"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/ptc_pbp_id_02>       ] ;
fhir:code [ fhir:v "803" ]     ]
  ] [
fhir:url [
fhir:v "https://bluebutton.cms.gov/resources/variables/ptc_pbp_id_03"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/ptc_pbp_id_03>     ] ;
fhir:value [
a fhir:Coding ;
fhir:system [
fhir:v "https://bluebutton.cms.gov/resources/variables/ptc_pbp_id_03"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/ptc_pbp_id_03>       ] ;
fhir:code [ fhir:v "803" ]     ]
  ] [
fhir:url [
fhir:v "https://bluebutton.cms.gov/resources/variables/rfrnc_yr"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/rfrnc_yr>     ] ;
fhir:value [
a fhir:Date ;
fhir:v "2025"^^xsd:gYear     ]
  ] [
fhir:url [
fhir:v "https://bluebutton.cms.gov/resources/variables/dual_01"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/dual_01>     ] ;
fhir:value [
a fhir:Coding ;
fhir:system [
fhir:v "https://bluebutton.cms.gov/resources/variables/dual_01"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/dual_01>       ] ;
fhir:code [ fhir:v "NA" ] ;
fhir:display [ fhir:v "Non-Medicaid" ]     ]
  ] [
fhir:url [
fhir:v "https://bluebutton.cms.gov/resources/variables/dual_02"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/dual_02>     ] ;
fhir:value [
a fhir:Coding ;
fhir:system [
fhir:v "https://bluebutton.cms.gov/resources/variables/dual_02"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/dual_02>       ] ;
fhir:code [ fhir:v "NA" ] ;
fhir:display [ fhir:v "Non-Medicaid" ]     ]
  ] [
fhir:url [
fhir:v "https://bluebutton.cms.gov/resources/variables/dual_03"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/dual_03>     ] ;
fhir:value [
a fhir:Coding ;
fhir:system [
fhir:v "https://bluebutton.cms.gov/resources/variables/dual_03"^^xsd:anyURI ;
fhir:l <https://bluebutton.cms.gov/resources/variables/dual_03>       ] ;
fhir:code [ fhir:v "NA" ] ;
fhir:display [ fhir:v "Non-Medicaid" ]     ]
  ] ) ; # 
  fhir:identifier ( [
fhir:system [
fhir:v "https://haau3.com/fhir/NamingSystem/haau3-coverage-id"^^xsd:anyURI ;
fhir:l <https://haau3.com/fhir/NamingSystem/haau3-coverage-id>     ] ;
fhir:value [ fhir:v "cms-medicare-part-c-1S00EU7JH19" ]
  ] ) ; # 
  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 "SUBSIDIZ" ]     ] )
  ] ; # 
  fhir:subscriberId [ fhir:v "1S00EU7JH19"] ; # 
  fhir:beneficiary [
fhir:l fhir:Patient/grandma-fung ;
fhir:reference [ fhir:v "Patient/grandma-fung" ]
  ] ; # 
  fhir:relationship [
    ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/subscriber-relationship"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/subscriber-relationship>       ] ;
fhir:code [ fhir:v "self" ] ;
fhir:display [ fhir:v "Self" ]     ] )
  ] ; # 
  fhir:payor ( [
fhir:l fhir:Organization/cms ;
fhir:reference [ fhir:v "Organization/cms" ] ;
fhir:type [
fhir:v "Organization"^^xsd:anyURI ;
fhir:l fhir:Organization     ] ;
fhir:display [ fhir:v "Centers for Medicare & Medicaid Services (CMS)" ]
  ] ) ; # 
  fhir:class ( [
fhir:type [
      ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/coverage-class>         ] ;
fhir:code [ fhir:v "group" ] ;
fhir:display [ fhir:v "Group" ]       ] )     ] ;
fhir:value [ fhir:v "Medicare" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/coverage-class>         ] ;
fhir:code [ fhir:v "plan" ] ;
fhir:display [ fhir:v "Plan" ]       ] )     ] ;
fhir:value [ fhir:v "Part C" ]
  ] ) . #