LinuxForHealth FHIR Implementation Guide
8.0.0 - draft
LinuxForHealth FHIR Implementation Guide - Local Development build (v8.0.0). See the Directory of published versions
@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 -------------------------------------------------------------------
a fhir:Claim;
fhir:nodeRole fhir:treeRoot;
fhir:Resource.id [ fhir:value "CDMClaimDrugInstance"];
fhir:Resource.meta [
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/tenant-id" ];
fhir:Extension.valueString [ fhir:value "tenant7209" ] ], [
fhir:index 1;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/ingestion-batch-id" ];
fhir:Extension.valueString [ fhir:value "rgVCJnQBxvghkKTI8Hzz" ] ], [
fhir:index 2;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/process-name" ];
fhir:Extension.valueString [ fhir:value "TREX" ] ], [
fhir:index 3;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/process-client-id" ];
fhir:Extension.valueString [ fhir:value "7209" ] ], [
fhir:index 4;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/process-record-id" ];
fhir:Extension.valueIdentifier [
fhir:Identifier.system [ fhir:value "http://acme-health.com/WellnessCenterPharmacy" ];
fhir:Identifier.value [ fhir:value "7209_07869_e00080779_3938586_2516181" ] ] ], [
fhir:index 5;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/source-file-id" ];
fhir:Extension.valueString [ fhir:value "e00080779" ] ];
fhir:Meta.source [ fhir:value "http://acme-health.com/WellnessCenterPharmacy" ];
fhir:Meta.profile [
fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/cdm-claim-drug";
fhir:index 0;
fhir:link <http://linuxforhealth.org/fhir/cdm/StructureDefinition/cdm-claim-drug> ]
];
fhir:DomainResource.text [
fhir:Narrative.status [ fhir:value "extensions" ];
fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Claim</b><a name=\"CDMClaimDrugInstance\"> </a></p><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\">Resource Claim \"CDMClaimDrugInstance\" </p><p style=\"margin-bottom: 0px\">Information Source: http://acme-health.com/WellnessCenterPharmacy!</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-cdm-claim-drug.html\">CDM Claim Drug</a></p></div><p><b>Snapshot Age In Years</b>: 20</p><p><b>Aggregate Claim Indicator</b>: N</p><p><b>Claim Snapshot Provider Name</b>: Dr Smith</p><p><b>Claim Snapshot Provider Zip Code</b>: 79912</p><p><b>Company Code</b>: LocCompanyCd <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-company-code#LocCompanyCd)</span></p><p><b>Employee Business Unit</b>: EmpBusUnit1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-employee-business-unit#EmpBusUnit1)</span></p><p><b>Employer</b>: EmployerCode1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-employer-code#EmployerCode1)</span></p><p><b>Financial System</b>: FinanceSys1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-financial-system#FinanceSys1)</span></p><p><b>Claim Category</b>: F1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (claim-status-category-codes#F1)</span></p><p><b>Claim Status</b>: F1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (claim-status-codes#F1)</span></p><p><b>Last Claim Indicator</b>: Y</p><p><b>RX Count</b>: 1</p><p><b>Submission Type</b>: SubmitType1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-submission-type#SubmitType1)</span></p><p><b>Payer PCP Responsibility Indicator</b>: N</p><p><b>identifier</b>: Prescription Number: 00000000000000000001921078(use: OFFICIAL)</p><p><b>status</b>: active</p><p><b>type</b>: Pharmacy; Pharmacy claims for goods and services <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-payer-claim-type.html\">Payer Claim Type Codes</a>#pharmacy; local-claim-type#Pharmacy)</span></p><p><b>use</b>: claim</p><p><b>patient</b>: <a href=\"Patient-CDMPatientInstance.html\">Patient/CDMPatientInstance</a> \" MCLASTNAME\"</p><p><b>created</b>: 2017-07-25 05:31:00-0500</p><p><b>provider</b>: <a href=\"Organization-Provider1.html\">Organization/Provider1</a> \"Dr Smith\"</p><p><b>priority</b>: Normal <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-processpriority.html\">Process Priority Codes</a>#normal)</span></p><p><b>prescription</b>: <a href=\"MedicationRequest-MedicationRequestDrugExample.html\">MedicationRequest/MedicationRequestDrugExample</a></p><blockquote><p><b>careTeam</b></p><p><b>sequence</b>: 1</p><p><b>provider</b>: <a href=\"Practitioner-DrKelly.html\">Practitioner/DrKelly</a> \" KELLY\"</p><p><b>role</b>: Ordering provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-claim-care-team-role.html\">Claim Care Team Role Codes</a>#ordering)</span></p></blockquote><blockquote><p><b>careTeam</b></p><p><b>sequence</b>: 2</p><p><b>provider</b>: <a href=\"Organization-Payer1.html\">Organization/Payer1</a> \"Payer 1\"</p><p><b>role</b>: Servicing provider <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-claim-care-team-role.html\">Claim Care Team Role Codes</a>#servicing)</span></p><p><b>qualification</b>: 01 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-specialty#01)</span></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 1</p><p><b>category</b>: Day Supply <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-claim-supporting-info-category.html\">Claim Supporting Info Category Codes</a>#dayssupply)</span></p><p><b>value</b>: 30</p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 2</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>code</b>: Network provider indicator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-claim-supporting-info-type.html\">Claim Supporting Info Type Codes</a>#network-provider-indicator)</span></p><p><b>value</b>: Y</p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 3</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>code</b>: 8 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-ncpdp-dispense-as-written.html\">NCPDP Dispense As Written Codes</a>#8)</span></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 4</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>code</b>: Refill number <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-claim-supporting-info-type.html\">Claim Supporting Info Type Codes</a>#refill-number)</span></p><p><b>value</b>: 4</p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 5</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>code</b>: Retail <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-rx-mail-or-retail.html\">Rx Mail Or Retail Codes</a>#r)</span></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 6</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>code</b>: Drug compound indicator <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-claim-supporting-info-type.html\">Claim Supporting Info Type Codes</a>#compound-indicator)</span></p><p><b>value</b>: N</p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 7</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>code</b>: Local dispensing status <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-dispensing-status#LocalDispenseStatus)</span></p><p><b>value</b>: N</p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 8</p><p><b>category</b>: Information <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-claiminformationcategory.html\">Claim Information Category Codes</a>#info)</span></p><p><b>code</b>: Local RX rebate <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-rx-rebate#LocalRxRebate)</span></p><p><b>value</b>: Generic</p></blockquote><h3>Insurances</h3><table class=\"grid\"><tr><td>-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Identifier</b></td><td><b>Coverage</b></td></tr><tr><td>*</td><td>, </td><td>1</td><td>true</td><td>id: PPOB</td><td><a href=\"Coverage-CoverageDrugExample.html\">Coverage/CoverageDrugExample</a></td></tr></table><blockquote><p><b>item</b></p><p><b>Compound Code</b>: CompoundCd1 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (local-compound-code#CompoundCd1)</span></p><p><b>Capitated Service Indicator</b>: N</p><p><b>Fully Insured Indicator</b>: Y</p><p><b>Nursing Home Indicator</b>: N</p><p><b>sequence</b>: 1</p><p><b>careTeamSequence</b>: 1</p><p><b>productOrService</b>: 69452-0151-20 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-ndc-no-hyphens.html\">NDC No Hyphens Codes</a>#69452015120; local-service-type#LocServiceType)</span></p><p><b>serviced</b>: 2017-06-18</p><p><b>location</b>: Pharmacy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-CMSPlaceofServiceCodes.html\">CMS Place of Service Codes (POS)</a>#01; local-place-of-service#LocalPlcOfService)</span></p><p><b>quantity</b>: 30</p><h3>Nets</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td></tr><tr><td>*</td><td>18.86</td></tr></table><blockquote><p><b>detail</b></p><p><b>Claim Item Detail Classification</b>: Dispensing Fee <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-claim-item-detail-classification.html\">Claim Item Detail Classification Codes</a>#dispensing-fee)</span></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: 69452-0151-20 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-ndc-no-hyphens.html\">NDC No Hyphens Codes</a>#69452015120)</span></p><h3>UnitPrices</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td></tr><tr><td>*</td><td>2</td></tr></table></blockquote><blockquote><p><b>detail</b></p><p><b>Claim Item Detail Classification</b>: Ingredient Cost <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-claim-item-detail-classification.html\">Claim Item Detail Classification Codes</a>#ingredient-cost)</span></p><p><b>sequence</b>: 2</p><p><b>productOrService</b>: 69452-0151-20 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-ndc-no-hyphens.html\">NDC No Hyphens Codes</a>#69452015120)</span></p><h3>UnitPrices</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td></tr><tr><td>*</td><td>3</td></tr></table></blockquote><blockquote><p><b>detail</b></p><p><b>Claim Item Detail Classification</b>: Sales Tax <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-claim-item-detail-classification.html\">Claim Item Detail Classification Codes</a>#sales-tax)</span></p><p><b>sequence</b>: 3</p><p><b>productOrService</b>: 69452-0151-20 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-ndc-no-hyphens.html\">NDC No Hyphens Codes</a>#69452015120)</span></p><h3>UnitPrices</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td></tr><tr><td>*</td><td>1</td></tr></table></blockquote></blockquote></div>"
];
fhir:DomainResource.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/snapshot-age-in-years" ];
fhir:Extension.valueUnsignedInt [ fhir:value "20"^^xsd:nonNegativeInteger ]
], [
fhir:index 1;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/aggregate-claim-indicator" ];
fhir:Extension.valueString [ fhir:value "N" ]
], [
fhir:index 2;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/claim-snapshot-provider-name" ];
fhir:Extension.valueString [ fhir:value "Dr Smith" ]
], [
fhir:index 3;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/claim-snapshot-provider-zip-code" ];
fhir:Extension.valueString [ fhir:value "79912" ]
], [
fhir:index 4;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/company-code" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://acme-health.com/CodeSystem/local-company-code" ];
fhir:Coding.code [ fhir:value "LocCompanyCd" ] ] ]
], [
fhir:index 5;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/employee-business-unit" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://acme-health.com/CodeSystem/local-employee-business-unit" ];
fhir:Coding.code [ fhir:value "EmpBusUnit1" ] ] ]
], [
fhir:index 6;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/employer" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://acme-health.com/CodeSystem/local-employer-code" ];
fhir:Coding.code [ fhir:value "EmployerCode1" ] ] ]
], [
fhir:index 7;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/financial-system" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://acme-health.com/CodeSystem/local-financial-system" ];
fhir:Coding.code [ fhir:value "FinanceSys1" ] ] ]
], [
fhir:index 8;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/claim-category" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://x12.org/codes/claim-status-category-codes" ];
fhir:Coding.code [ fhir:value "F1" ] ] ]
], [
fhir:index 9;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/claim-status" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://x12.org/codes/claim-status-codes" ];
fhir:Coding.code [ fhir:value "F1" ] ] ]
], [
fhir:index 10;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/last-claim-indicator" ];
fhir:Extension.valueString [ fhir:value "Y" ]
], [
fhir:index 11;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/rx-count" ];
fhir:Extension.valueUnsignedInt [ fhir:value "1"^^xsd:nonNegativeInteger ]
], [
fhir:index 12;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/submission-type" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://acme-health.com/CodeSystem/local-submission-type" ];
fhir:Coding.code [ fhir:value "SubmitType1" ] ] ]
], [
fhir:index 13;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/payer-pcp-responsibility-indicator" ];
fhir:Extension.valueString [ fhir:value "N" ]
];
fhir:Claim.identifier [
fhir:index 0;
fhir:Identifier.use [ fhir:value "official" ];
fhir:Identifier.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/identifier-type" ];
fhir:Coding.code [ fhir:value "RXN" ] ] ];
fhir:Identifier.system [ fhir:value "http://acme-health.com/CodeSystem/local-claim-identifier" ];
fhir:Identifier.value [ fhir:value "00000000000000000001921078" ];
fhir:Identifier.assigner [
fhir:Reference.display [ fhir:value "Acme Health - Wellness Center Pharmacy" ] ]
];
fhir:Claim.status [ fhir:value "active"];
fhir:Claim.type [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/payer-claim-type" ];
fhir:Coding.code [ fhir:value "pharmacy" ] ], [
fhir:index 1;
fhir:Coding.system [ fhir:value "http://acme-health.com/CodeSystem/local-claim-type" ];
fhir:Coding.code [ fhir:value "Pharmacy" ] ]
];
fhir:Claim.use [ fhir:value "claim"];
fhir:Claim.patient [
fhir:Reference.reference [ fhir:value "Patient/CDMPatientInstance" ]
];
fhir:Claim.created [ fhir:value "2017-07-25T17:31:00-05:00"^^xsd:dateTime];
fhir:Claim.provider [
fhir:Reference.reference [ fhir:value "Organization/Provider1" ]
];
fhir:Claim.priority [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/processpriority" ];
fhir:Coding.code [ fhir:value "normal" ] ]
];
fhir:Claim.prescription [
fhir:Reference.reference [ fhir:value "MedicationRequest/MedicationRequestDrugExample" ]
];
fhir:Claim.careTeam [
fhir:index 0;
fhir:Claim.careTeam.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.careTeam.provider [
fhir:Reference.reference [ fhir:value "Practitioner/DrKelly" ] ];
fhir:Claim.careTeam.role [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/claim-care-team-role" ];
fhir:Coding.code [ fhir:value "ordering" ] ] ]
], [
fhir:index 1;
fhir:Claim.careTeam.sequence [ fhir:value "2"^^xsd:positiveInteger ];
fhir:Claim.careTeam.provider [
fhir:Reference.reference [ fhir:value "Organization/Payer1" ] ];
fhir:Claim.careTeam.role [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/claim-care-team-role" ];
fhir:Coding.code [ fhir:value "servicing" ] ] ];
fhir:Claim.careTeam.qualification [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://acme-health.com/CodeSystem/local-specialty" ];
fhir:Coding.code [ fhir:value "01" ] ] ]
];
fhir:Claim.supportingInfo [
fhir:index 0;
fhir:Claim.supportingInfo.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.supportingInfo.category [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/claim-supporting-info-category" ];
fhir:Coding.code [ fhir:value "dayssupply" ] ] ];
fhir:Claim.supportingInfo.valueQuantity [
fhir:Quantity.value [ fhir:value "30"^^xsd:decimal ] ]
], [
fhir:index 1;
fhir:Claim.supportingInfo.sequence [ fhir:value "2"^^xsd:positiveInteger ];
fhir:Claim.supportingInfo.category [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claiminformationcategory" ];
fhir:Coding.code [ fhir:value "info" ] ] ];
fhir:Claim.supportingInfo.code [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/claim-supporting-info-type" ];
fhir:Coding.code [ fhir:value "network-provider-indicator" ] ] ];
fhir:Claim.supportingInfo.valueString [ fhir:value "Y" ]
], [
fhir:index 2;
fhir:Claim.supportingInfo.sequence [ fhir:value "3"^^xsd:positiveInteger ];
fhir:Claim.supportingInfo.category [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claiminformationcategory" ];
fhir:Coding.code [ fhir:value "info" ] ] ];
fhir:Claim.supportingInfo.code [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/ncpdp-dispense-as-written" ];
fhir:Coding.code [ fhir:value "8" ];
fhir:Coding.display [ fhir:value "8" ] ] ]
], [
fhir:index 3;
fhir:Claim.supportingInfo.sequence [ fhir:value "4"^^xsd:positiveInteger ];
fhir:Claim.supportingInfo.category [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claiminformationcategory" ];
fhir:Coding.code [ fhir:value "info" ] ] ];
fhir:Claim.supportingInfo.code [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/claim-supporting-info-type" ];
fhir:Coding.code [ fhir:value "refill-number" ] ] ];
fhir:Claim.supportingInfo.valueQuantity [
fhir:Quantity.value [ fhir:value "4"^^xsd:decimal ] ]
], [
fhir:index 4;
fhir:Claim.supportingInfo.sequence [ fhir:value "5"^^xsd:positiveInteger ];
fhir:Claim.supportingInfo.category [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claiminformationcategory" ];
fhir:Coding.code [ fhir:value "info" ] ] ];
fhir:Claim.supportingInfo.code [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/rx-mail-or-retail" ];
fhir:Coding.code [ fhir:value "r" ] ] ]
], [
fhir:index 5;
fhir:Claim.supportingInfo.sequence [ fhir:value "6"^^xsd:positiveInteger ];
fhir:Claim.supportingInfo.category [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claiminformationcategory" ];
fhir:Coding.code [ fhir:value "info" ] ] ];
fhir:Claim.supportingInfo.code [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/claim-supporting-info-type" ];
fhir:Coding.code [ fhir:value "compound-indicator" ] ] ];
fhir:Claim.supportingInfo.valueString [ fhir:value "N" ]
], [
fhir:index 6;
fhir:Claim.supportingInfo.sequence [ fhir:value "7"^^xsd:positiveInteger ];
fhir:Claim.supportingInfo.category [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claiminformationcategory" ];
fhir:Coding.code [ fhir:value "info" ] ] ];
fhir:Claim.supportingInfo.code [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://acme-health.com/CodeSystem/local-dispensing-status" ];
fhir:Coding.code [ fhir:value "LocalDispenseStatus" ];
fhir:Coding.display [ fhir:value "Local dispensing status" ] ] ];
fhir:Claim.supportingInfo.valueString [ fhir:value "N" ]
], [
fhir:index 7;
fhir:Claim.supportingInfo.sequence [ fhir:value "8"^^xsd:positiveInteger ];
fhir:Claim.supportingInfo.category [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claiminformationcategory" ];
fhir:Coding.code [ fhir:value "info" ] ] ];
fhir:Claim.supportingInfo.code [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://acme-health.com/CodeSystem/local-rx-rebate" ];
fhir:Coding.code [ fhir:value "LocalRxRebate" ];
fhir:Coding.display [ fhir:value "Local RX rebate" ] ] ];
fhir:Claim.supportingInfo.valueString [ fhir:value "Generic" ]
];
fhir:Claim.insurance [
fhir:index 0;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/crossover-indicator" ];
fhir:Extension.valueString [ fhir:value "N" ] ], [
fhir:index 1;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/line-of-business" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://acme-health.com/CodeSystem/local-line-of-business" ];
fhir:Coding.code [ fhir:value "LocalLineOfBusiness" ] ] ] ];
fhir:Claim.insurance.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.insurance.focal [ fhir:value "true"^^xsd:boolean ];
fhir:Claim.insurance.identifier [
fhir:Identifier.system [ fhir:value "http://acme-health.com/insurer" ];
fhir:Identifier.value [ fhir:value "PPOB" ] ];
fhir:Claim.insurance.coverage [
fhir:Reference.reference [ fhir:value "Coverage/CoverageDrugExample" ] ]
];
fhir:Claim.item [
fhir:index 0;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/compound-code" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://acme-health.com/CodeSystem/local-compound-code" ];
fhir:Coding.code [ fhir:value "CompoundCd1" ] ] ] ], [
fhir:index 1;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/capitated-service-indicator" ];
fhir:Extension.valueString [ fhir:value "N" ] ], [
fhir:index 2;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/fully-insured-indicator" ];
fhir:Extension.valueString [ fhir:value "Y" ] ], [
fhir:index 3;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/nursing-home-indicator" ];
fhir:Extension.valueString [ fhir:value "N" ] ];
fhir:Claim.item.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.item.careTeamSequence [
fhir:value "1"^^xsd:positiveInteger;
fhir:index 0 ];
fhir:Claim.item.productOrService [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/ndc-no-hyphens" ];
fhir:Coding.code [ fhir:value "69452015120" ] ], [
fhir:index 1;
fhir:Coding.system [ fhir:value "http://acme-health.com/CodeSystem/local-service-type" ];
fhir:Coding.code [ fhir:value "LocServiceType" ] ] ];
fhir:Claim.item.servicedDate [ fhir:value "2017-06-18"^^xsd:date ];
fhir:Claim.item.locationCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set" ];
fhir:Coding.code [ fhir:value "01" ];
fhir:Coding.display [ fhir:value "Pharmacy" ] ], [
fhir:index 1;
fhir:Coding.system [ fhir:value "http://acme-health.com/CodeSystem/local-place-of-service" ];
fhir:Coding.code [ fhir:value "LocalPlcOfService" ] ] ];
fhir:Claim.item.quantity [
fhir:Quantity.value [ fhir:value "30"^^xsd:decimal ] ];
fhir:Claim.item.net [
fhir:Money.value [ fhir:value "18.86"^^xsd:decimal ] ];
fhir:Claim.item.detail [
fhir:index 0;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/claim-item-detail-classification" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/claim-item-detail-classification" ];
fhir:Coding.code [ fhir:value "dispensing-fee" ] ] ] ];
fhir:Claim.item.detail.sequence [ fhir:value "1"^^xsd:positiveInteger ];
fhir:Claim.item.detail.productOrService [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/ndc-no-hyphens" ];
fhir:Coding.code [ fhir:value "69452015120" ] ] ];
fhir:Claim.item.detail.unitPrice [
fhir:Money.value [ fhir:value "2"^^xsd:decimal ] ] ], [
fhir:index 1;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/claim-item-detail-classification" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/claim-item-detail-classification" ];
fhir:Coding.code [ fhir:value "ingredient-cost" ] ] ] ];
fhir:Claim.item.detail.sequence [ fhir:value "2"^^xsd:positiveInteger ];
fhir:Claim.item.detail.productOrService [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/ndc-no-hyphens" ];
fhir:Coding.code [ fhir:value "69452015120" ] ] ];
fhir:Claim.item.detail.unitPrice [
fhir:Money.value [ fhir:value "3"^^xsd:decimal ] ] ], [
fhir:index 2;
fhir:Element.extension [
fhir:index 0;
fhir:Extension.url [ fhir:value "http://linuxforhealth.org/fhir/cdm/StructureDefinition/claim-item-detail-classification" ];
fhir:Extension.valueCodeableConcept [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/claim-item-detail-classification" ];
fhir:Coding.code [ fhir:value "sales-tax" ] ] ] ];
fhir:Claim.item.detail.sequence [ fhir:value "3"^^xsd:positiveInteger ];
fhir:Claim.item.detail.productOrService [
fhir:CodeableConcept.coding [
fhir:index 0;
fhir:Coding.system [ fhir:value "http://linuxforhealth.org/fhir/cdm/CodeSystem/ndc-no-hyphens" ];
fhir:Coding.code [ fhir:value "69452015120" ] ] ];
fhir:Claim.item.detail.unitPrice [
fhir:Money.value [ fhir:value "1"^^xsd:decimal ] ] ]
].
# - ontology header ------------------------------------------------------------
a owl:Ontology;
owl:imports fhir:fhir.ttl.
IG © 2021+ LinuxForHealth Team. Package linuxforhealth.fhir.ig#8.0.0 based on FHIR 4.0.1. Generated 2022-11-10
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