SIL HIE Implementation Guide
0.1.0 - sil-hie-active
SIL HIE Implementation Guide, published by Kathurima Kimathi. 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/savannahghi/hie-fhir-ig-profile/ and changes regularly. See the Directory of published versions
@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 -------------------------------------------------------------------
<http://hl7.org/fhir/Claim/HIEClaim-example> a fhir:Claim ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "HIEClaim-example"] ; #
fhir:meta [
fhir:profile ( [
fhir:v "https://nshr.dha.go.ke/fhir/StructureDefinition/claim"^^xsd:anyURI ;
fhir:link <https://nshr.dha.go.ke/fhir/StructureDefinition/claim>
] )
] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>HIE Claim</b></p><p>Outpatient professional claim for Jane Patient, created 2025-11-12. Billed by Acme Health Center to PayerOne Insurance.</p><table><thead><tr><th align=\"left\">Section</th><th align=\"left\">Details</th></tr></thead><tbody><tr><td>Identifiers</td><td>Claim Number: CLM-2025-0001</td></tr><tr><td>Claim</td><td>Status: active, Use: claim, Type: professional, Priority: routine</td></tr><tr><td>Patient</td><td>Jane Patient (Patient/p-001)</td></tr><tr><td>Billable period</td><td>2025-11-10 to 2025-11-10</td></tr><tr><td>Provider</td><td>Acme Health Center (Organization/org-001)</td></tr><tr><td>Insurer</td><td>PayerOne Insurance (Organization/org-payer-001), Coverage cov-001, Focal: true</td></tr><tr><td>Diagnosis</td><td>Primary: Headache (R51.9 ICD-10-CM)</td></tr><tr><td>Items</td><td>1 x 99213, Office/outpatient visit est, UnitPrice 75.00 USD, Net 75.00 USD</td></tr><tr><td>Total</td><td>Category: submitted, Amount: 75.00 USD</td></tr></tbody></table></div>"^^rdf:XMLLiteral ]
] ; #
fhir:identifier ( [
fhir:use [ fhir:v "official" ] ;
fhir:type [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "ACSN" ] ;
fhir:display [ fhir:v "Accession ID" ]
] )
] ;
fhir:system [ fhir:v "http://example.org/claims"^^xsd:anyURI ] ;
fhir:value [ fhir:v "CLM-2025-0001" ]
] ) ; #
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 "professional" ] ;
fhir:display [ fhir:v "Professional" ]
] )
] ; #
fhir:use [ fhir:v "claim"] ; #
fhir:patient [
fhir:link <http://hl7.org/fhir/Patient/p-001> ;
fhir:reference [ fhir:v "Patient/p-001" ] ;
fhir:display [ fhir:v "Jane Patient" ]
] ; #
fhir:billablePeriod [
fhir:start [ fhir:v "2025-11-10"^^xsd:date ] ;
fhir:end [ fhir:v "2025-11-10"^^xsd:date ]
] ; #
fhir:created [ fhir:v "2025-11-12T10:15:00+03:00"^^xsd:dateTime] ; #
fhir:insurer [
fhir:link <http://hl7.org/fhir/Organization/org-payer-001> ;
fhir:reference [ fhir:v "Organization/org-payer-001" ] ;
fhir:display [ fhir:v "PayerOne Insurance" ]
] ; #
fhir:provider [
fhir:link <http://hl7.org/fhir/Organization/org-001> ;
fhir:reference [ fhir:v "Organization/org-001" ] ;
fhir:display [ fhir:v "Acme Health Center" ]
] ; #
fhir:priority [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/processpriority"^^xsd:anyURI ] ;
fhir:code [ fhir:v "routine" ] ;
fhir:display [ fhir:v "Routine" ]
] )
] ; #
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:code [ fhir:v "R51.9" ] ;
fhir:display [ fhir:v "Headache, unspecified" ]
] )
] ;
fhir:type ( [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/claim-diagnosis-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "principal" ] ;
fhir:display [ fhir:v "Principal Diagnosis" ]
] )
] )
] ) ; #
fhir:insurance ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:focal [ fhir:v true ] ;
fhir:coverage [
fhir:link <http://hl7.org/fhir/Coverage/cov-001> ;
fhir:reference [ fhir:v "Coverage/cov-001" ] ;
fhir:display [ fhir:v "Primary PPO Plan" ]
]
] ) ; #
fhir:item ( [
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 "100" ] ;
fhir:display [ fhir:v "General Medical" ]
] )
] ;
fhir:category [
fhir:coding ( [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/ex-benefitcategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "professional-visit" ] ;
fhir:display [ fhir:v "Professional Visit" ]
] )
] ;
fhir:productOrService [
fhir:coding ( [
fhir:system [ fhir:v "http://www.ama-assn.org/go/cpt"^^xsd:anyURI ] ;
fhir:code [ fhir:v "99213" ] ;
fhir:display [ fhir:v "Office or other outpatient visit, established patient" ]
] )
] ;
fhir:quantity [
fhir:value [ fhir:v "1"^^xsd:decimal ]
] ;
fhir:unitPrice [
fhir:value [ fhir:v "75"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]
] ;
fhir:net [
fhir:value [ fhir:v "75"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]
] ;
fhir:encounter ( [
fhir:link <http://hl7.org/fhir/Encounter/enc-001> ;
fhir:reference [ fhir:v "Encounter/enc-001" ] ;
fhir:display [ fhir:v "Ambulatory visit 2025-11-10" ]
] ) ;
fhir:detail ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:productOrService [
fhir:coding ( [
fhir:system [ fhir:v "http://www.ama-assn.org/go/cpt"^^xsd:anyURI ] ;
fhir:code [ fhir:v "99213" ] ;
fhir:display [ fhir:v "Office or other outpatient visit, established patient" ]
] )
] ;
fhir:quantity [
fhir:value [ fhir:v "1"^^xsd:decimal ]
] ;
fhir:unitPrice [
fhir:value [ fhir:v "75"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]
] ;
fhir:net [
fhir:value [ fhir:v "75"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]
] ;
fhir:subDetail ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:productOrService [
fhir:coding ( [
fhir:system [ fhir:v "http://www.ama-assn.org/go/cpt"^^xsd:anyURI ] ;
fhir:code [ fhir:v "99070" ] ;
fhir:display [ fhir:v "Supplies and materials" ]
] )
] ;
fhir:quantity [
fhir:value [ fhir:v "1"^^xsd:decimal ]
] ;
fhir:unitPrice [
fhir:value [ fhir:v "5"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]
] ;
fhir:net [
fhir:value [ fhir:v "5"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]
]
] )
] )
] ) ; #
fhir:total [
fhir:value [ fhir:v "75"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]
] . #
<http://hl7.org/fhir/Patient/p-001> a fhir:Patient .
<http://hl7.org/fhir/Organization/org-payer-001> a fhir:Organization .
<http://hl7.org/fhir/Organization/org-001> a fhir:Organization .
<http://hl7.org/fhir/Coverage/cov-001> a fhir:Coverage .
<http://hl7.org/fhir/Encounter/enc-001> a fhir:Encounter .
IG © 2025+ Kathurima Kimathi. Package hie-fhir-ig-profile#0.1.0 based on FHIR 4.3.0. Generated 2026-09-05
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