Kenya eClaims FHIR IG
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Kenya eClaims FHIR IG - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

: Claim - Example - 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:Claim ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "f6dc7f9e-1558-4b92-adbd-447771c7b2f9"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://example.com/fhir/StructureDefinition/eclaims-claim"^^xsd:anyURI ;
fhir:l <https://example.com/fhir/StructureDefinition/eclaims-claim>     ] )
  ] ; # 
  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: Claim f6dc7f9e-1558-4b92-adbd-447771c7b2f9</b></p><a name=\"f6dc7f9e-1558-4b92-adbd-447771c7b2f9\"> </a><a name=\"hcf6dc7f9e-1558-4b92-adbd-447771c7b2f9\"> </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-eclaims-claim.html\">Claim Profile</a></p></div><p><b>identifier</b>: <code>https://uat-mis.apeiro-digital.com/fhir/claim</code>/f6dc7f9e-1558-4b92-adbd-447771c7b2f9</p><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>subType</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-claimsubtype op}\">op</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href=\"https://uat-mis.apeiro-digital.com/fhir/Patient/BZ38380568-6\">https://uat-mis.apeiro-digital.com/fhir/Patient/BZ38380568-6</a></p><p><b>billablePeriod</b>: 2025-01-04 --&gt; 2025-01-05</p><p><b>created</b>: 2025-01-03</p><p><b>provider</b>: <a href=\"Organization/FID-22-101101-0\">Organization/FID-22-101101-0</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{https://uat-mis.apeiro-digital.com/fhir/terminology/CodeSystem/icd-11 XT77}\">XT77</span></td></tr></table><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=\"https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage\">https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage</a></td></tr></table><blockquote><p><b>item</b></p><p><b>com/fhir/sha-coverage/StructureDefinition/Coverage</b>: <a href=\"https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage\">https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage</a></p><p><b>sequence</b>: 1</p><p><b>category</b>: <span title=\"Codes:{https://uat-mis.apeiro-digital.com/fhir/CodeSystem/category-codes procedure}\">Procedure</span></p><p><b>productOrService</b>: <span title=\"Codes:{https://uat-mis.apeiro-digital.com/fhir/CodeSystem/intervention-codes SHA-12-001}\">SHA-12-001</span></p><p><b>serviced</b>: 2025-01-04</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>50</td><td>Kenyan shilling</td></tr></table><p><b>factor</b>: 1</p><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>50</td><td>Kenyan shilling</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>50</td><td>Kenyan shilling</td></tr></table></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:identifier ( [
fhir:system [
fhir:v "https://uat-mis.apeiro-digital.com/fhir/claim"^^xsd:anyURI ;
fhir:l <https://uat-mis.apeiro-digital.com/fhir/claim>     ] ;
fhir:value [ fhir:v "f6dc7f9e-1558-4b92-adbd-447771c7b2f9" ]
  ] ) ; # 
  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:subType [
    ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/ex-claimsubtype"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/ex-claimsubtype>       ] ;
fhir:code [ fhir:v "op" ]     ] )
  ] ; # 
  fhir:use [ fhir:v "preauthorization"] ; # 
  fhir:patient [
fhir:l <https://uat-mis.apeiro-digital.com/fhir/Patient/BZ38380568-6> ;
fhir:reference [ fhir:v "https://uat-mis.apeiro-digital.com/fhir/Patient/BZ38380568-6" ] ;
fhir:type [
fhir:v "Patient"^^xsd:anyURI ;
fhir:l fhir:Patient     ] ;
fhir:identifier [
fhir:use [ fhir:v "official" ] ;
fhir:system [
fhir:v "https://uat-mis.apeiro-digital.com/fhir/identifier/shanumber"^^xsd:anyURI ;
fhir:l <https://uat-mis.apeiro-digital.com/fhir/identifier/shanumber>       ] ;
fhir:value [ fhir:v "BZ38380568-6" ]     ]
  ] ; # 
  fhir:billablePeriod [
fhir:start [ fhir:v "2025-01-04"^^xsd:date ] ;
fhir:end [ fhir:v "2025-01-05"^^xsd:date ]
  ] ; # 
  fhir:created [ fhir:v "2025-01-03"^^xsd:date] ; # 
  fhir:provider [
fhir:l fhir:Organization/FID-22-101101-0 ;
fhir:reference [ fhir:v "Organization/FID-22-101101-0" ] ;
fhir:type [
fhir:v "Organization"^^xsd:anyURI ;
fhir:l fhir:Organization     ] ;
fhir:identifier [
fhir:use [ fhir:v "official" ] ;
fhir:type [
        ( fhir:coding [
fhir:system [
fhir:v "http://ts-kenyahie.health/facility-identifier-type"^^xsd:anyURI ;
fhir:l <http://ts-kenyahie.health/facility-identifier-type>           ] ;
fhir:code [ fhir:v "fr-code" ]         ] )       ] ;
fhir:system [
fhir:v "https://fr.kenya-hie.health/api/v4/Organization"^^xsd:anyURI ;
fhir:l <https://fr.kenya-hie.health/api/v4/Organization>       ] ;
fhir:value [ fhir:v "FID-22-101101-0" ]     ]
  ] ; # 
  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:diagnosis ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:diagnosis [
a fhir:CodeableConcept ;
      ( fhir:coding [
fhir:system [
fhir:v "https://uat-mis.apeiro-digital.com/fhir/terminology/CodeSystem/icd-11"^^xsd:anyURI ;
fhir:l <https://uat-mis.apeiro-digital.com/fhir/terminology/CodeSystem/icd-11>         ] ;
fhir:code [ fhir:v "XT77" ] ;
fhir:display [ fhir:v "XT77" ]       ] )     ]
  ] ) ; # 
  fhir:insurance ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:focal [ fhir:v true ] ;
fhir:coverage [
fhir:l <https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage> ;
fhir:reference [ fhir:v "https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage" ]     ]
  ] ) ; # 
  fhir:item ( [
    ( fhir:extension [
fhir:url [
fhir:v "https://uat-mis.apeiro-digital.com/fhir/sha-coverage/StructureDefinition/Coverage"^^xsd:anyURI ;
fhir:l <https://uat-mis.apeiro-digital.com/fhir/sha-coverage/StructureDefinition/Coverage>       ] ;
fhir:value [
a fhir:Reference ;
fhir:l <https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage> ;
fhir:reference [ fhir:v "https://uat-mis.apeiro-digital.com/fhir/Coverage/CR6164711105276-6-sha-coverage" ]       ]     ] ) ;
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:category [
      ( fhir:coding [
fhir:system [
fhir:v "https://uat-mis.apeiro-digital.com/fhir/CodeSystem/category-codes"^^xsd:anyURI ;
fhir:l <https://uat-mis.apeiro-digital.com/fhir/CodeSystem/category-codes>         ] ;
fhir:code [ fhir:v "procedure" ] ;
fhir:display [ fhir:v "Procedure" ]       ] )     ] ;
fhir:productOrService [
      ( fhir:coding [
fhir:system [
fhir:v "https://uat-mis.apeiro-digital.com/fhir/CodeSystem/intervention-codes"^^xsd:anyURI ;
fhir:l <https://uat-mis.apeiro-digital.com/fhir/CodeSystem/intervention-codes>         ] ;
fhir:code [ fhir:v "SHA-12-001" ] ;
fhir:display [ fhir:v "SHA-12-001" ]       ] )     ] ;
fhir:serviced [
a fhir:Date ;
fhir:v "2025-01-04"^^xsd:date     ] ;
fhir:quantity [
fhir:value [ fhir:v "1"^^xsd:decimal ]     ] ;
fhir:unitPrice [
fhir:value [ fhir:v "50"^^xsd:decimal ] ;
fhir:currency [ fhir:v "KES" ]     ] ;
fhir:factor [ fhir:v "1"^^xsd:decimal ] ;
fhir:net [
fhir:value [ fhir:v "50"^^xsd:decimal ] ;
fhir:currency [ fhir:v "KES" ]     ]
  ] ) ; # 
  fhir:total [
fhir:value [ fhir:v "50"^^xsd:decimal ] ;
fhir:currency [ fhir:v "KES" ]
  ] . #