Claim Oral Request #1 - TTL Representation - Healthcare Financial Services IG Edition 1 v0.3.0

Healthcare Financial Services IG Edition 1 - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
: Claim Oral Request #1 - 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 "293094"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/oral-claim"^^xsd:anyURI ;
fhir:link <http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/oral-claim>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Claim 293094</b></p><a name=\"293094\"> </a><a name=\"hc293094\"> </a><a name=\"293094-en-US\"> </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-oral-claim.html\">Nphies Claim Oral</a></p></div><p><b>Encounter</b>: <a href=\"Encounter-10132.html\">Encounter: extension = Initial client service event; identifier = http://saudidentalclinic.com.sa/identifiers/encounter#AB0032; status = finished; class = ambulatory (ActCode#AMB); serviceType = Dental Care; priority = elective; period = 2023-12-04 --&gt; (ongoing)</a></p><p><b>Episode</b>: <code>http://saudidentalclinic.com.sa/identifiers/episode</code>/SDC_EpisodeID_48903211</p><p><b>identifier</b>: <code>http://saudidentalclinic.com.sa/identifiers/claim</code>/req_293094</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type oral}\">Oral</span></p><p><b>subType</b>: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/claim-subtype op}\">OutPatient</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: <a href=\"Patient-453.html\">Sara Abbas Female, DoB: 1989-03-13 ( Permanent Resident Card Number: 2000000003)</a></p><p><b>created</b>: 2023-12-04 08:38:00+0300</p><p><b>insurer</b>: <a href=\"Organization-bff3aa1fbd3648619ac082357bf135db.html\">Organization Saudi National Insurance</a></p><p><b>provider</b>: <a href=\"Organization-215.html\">Organization Saudi Dental Clinic</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><h3>Payees</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/payeetype provider}\">Provider</span></td></tr></table><h3>CareTeams</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Provider</b></td><td><b>Role</b></td><td><b>Qualification</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><a href=\"Practitioner-4.html\">Practitioner Dr. Ashraf Naeem</a></td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claimcareteamrole primary}\">Primary provider</span></td><td><span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/practice-codes 22.00}\">Dental</span></td></tr></table><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://hl7.org/fhir/sid/icd-10-am K01.1}\">K01.1</span></td><td><span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/diagnosis-type principal}\">Principal Diagnosis</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=\"Coverage-1985.html\">Coverage: identifier = http://sni.com.sa/identifiers/memberid#0000000003; status = active; type = extended healthcare; relationship = Spouse; network = Golden C</a></td></tr></table><blockquote><p><b>item</b></p><p><b>Package Code</b>: false</p><p><b>Tax</b>: <span title=\"Saudi Riyal\">SAR30.00</span> (SAR)</p><p><b>Patient Share</b>: <span title=\"Saudi Riyal\">SAR40.00</span> (SAR)</p><p><b>Patient Invoice</b>: <code>http://saudigeneralhospital.com.sa/identifiers/patientInvoice</code>/Invc-20220120/IP-1110987</p><p><b>sequence</b>: 1</p><p><b>careTeamSequence</b>: 1</p><p><b>diagnosisSequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/oral-health-op 012}\">Periodic oral examination</span></p><p><b>serviced</b>: 2021-10-07</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>200</td><td>Saudi riyal</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>230</td><td>Saudi riyal</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>Package Code</b>: false</p><p><b>Tax</b>: <span title=\"Saudi Riyal\">SAR45.00</span> (SAR)</p><p><b>Patient Share</b>: <span title=\"Saudi Riyal\">SAR60.00</span> (SAR)</p><p><b>Patient Invoice</b>: <code>http://saudigeneralhospital.com.sa/identifiers/patientInvoice</code>/Invc-20220120/IP-1110987</p><p><b>sequence</b>: 2</p><p><b>careTeamSequence</b>: 1</p><p><b>diagnosisSequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/oral-health-op 97511-01-00}\">Metallic restoration of tooth, one surface, direct</span></p><p><b>serviced</b>: 2021-10-07</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>300</td><td>Saudi riyal</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>345</td><td>Saudi riyal</td></tr></table><p><b>bodySite</b>: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/fdi-oral-region 13}\">UPPER RIGHT; PERMANENT TEETH # 3</span></p></blockquote><blockquote><p><b>item</b></p><p><b>Package Code</b>: false</p><p><b>Tax</b>: <span title=\"Saudi Riyal\">SAR195.00</span> (SAR)</p><p><b>Patient Share</b>: <span title=\"Saudi Riyal\">SAR100.00</span> (SAR)</p><p><b>Patient Invoice</b>: <code>http://saudigeneralhospital.com.sa/identifiers/patientInvoice</code>/Invc-20220120/IP-1110987</p><p><b>sequence</b>: 3</p><p><b>careTeamSequence</b>: 1</p><p><b>diagnosisSequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/oral-health-op 618}\">Full crown metallic indirect</span></p><p><b>serviced</b>: 2021-10-07</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>1300</td><td>Saudi riyal</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>1495</td><td>Saudi riyal</td></tr></table><p><b>bodySite</b>: <span title=\"Codes:{http://nphies.sa/terminology/CodeSystem/fdi-oral-region 37}\">LOWER LEFT; PERMANENT TEETH # 7</span></p></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>2070</td><td>Saudi riyal</td></tr></table></div>"^^rdf:XMLLiteral
  ] ; # 
  fhir:extension ( [
fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-encounter"^^xsd:anyURI ] ;
fhir:value [
a fhir:Reference ;
fhir:reference [ fhir:v "Encounter/10132" ]     ]
  ] [
fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-episode"^^xsd:anyURI ] ;
fhir:value [
a fhir:Identifier ;
fhir:system [ fhir:v "http://saudidentalclinic.com.sa/identifiers/episode"^^xsd:anyURI ] ;
fhir:value [ fhir:v "SDC_EpisodeID_48903211" ]     ]
  ] ) ; # 
  fhir:identifier ( [
fhir:system [ fhir:v "http://saudidentalclinic.com.sa/identifiers/claim"^^xsd:anyURI ] ;
fhir:value [ fhir:v "req_293094" ]
  ] ) ; # 
  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 "oral" ]     ] )
  ] ; # 
  fhir:subType [
    ( fhir:coding [
fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-subtype"^^xsd:anyURI ] ;
fhir:code [ fhir:v "op" ]     ] )
  ] ; # 
  fhir:use [ fhir:v "claim"] ; # 
  fhir:patient [
fhir:reference [ fhir:v "Patient/453" ]
  ] ; # 
  fhir:created [ fhir:v "2023-12-04T08:38:00+03:00"^^xsd:dateTime] ; # 
  fhir:insurer [
fhir:reference [ fhir:v "Organization/bff3aa1fbd3648619ac082357bf135db" ]
  ] ; # 
  fhir:provider [
fhir:reference [ fhir:v "Organization/215" ]
  ] ; # 
  fhir:priority [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/processpriority"^^xsd:anyURI ] ;
fhir:code [ fhir:v "normal" ]     ] )
  ] ; # 
  fhir:payee [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/payeetype"^^xsd:anyURI ] ;
fhir:code [ fhir:v "provider" ]       ] )     ]
  ] ; # 
  fhir:careTeam ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:provider [
fhir:reference [ fhir:v "Practitioner/4" ]     ] ;
fhir:role [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/claimcareteamrole"^^xsd:anyURI ] ;
fhir:code [ fhir:v "primary" ]       ] )     ] ;
fhir:qualification [
      ( fhir:coding [
fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/practice-codes"^^xsd:anyURI ] ;
fhir:code [ fhir:v "22.00" ]       ] )     ]
  ] ) ; # 
  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-am"^^xsd:anyURI ] ;
fhir:code [ fhir:v "K01.1" ]       ] )     ] ;
    ( fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/diagnosis-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "principal" ]       ] )     ] )
  ] ) ; # 
  fhir:insurance ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:focal [ fhir:v true ] ;
fhir:coverage [
fhir:reference [ fhir:v "Coverage/1985" ]     ]
  ] ) ; # 
  fhir:item ( [
    ( fhir:extension [
fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-package"^^xsd:anyURI ] ;
fhir:value [
a fhir:boolean ;
fhir:v false       ]     ] [
fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-tax"^^xsd:anyURI ] ;
fhir:value [
a fhir:Money ;
fhir:value [ fhir:v "30"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]       ]     ] [
fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-share"^^xsd:anyURI ] ;
fhir:value [
a fhir:Money ;
fhir:value [ fhir:v "40"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]       ]     ] [
fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice"^^xsd:anyURI ] ;
fhir:value [
a fhir:Identifier ;
fhir:system [ fhir:v "http://saudigeneralhospital.com.sa/identifiers/patientInvoice"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Invc-20220120/IP-1110987" ]       ]     ] ) ;
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
    ( fhir:careTeamSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ;
    ( fhir:diagnosisSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ;
fhir:productOrService [
      ( fhir:coding [
fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/oral-health-op"^^xsd:anyURI ] ;
fhir:code [ fhir:v "012" ] ;
fhir:display [ fhir:v "Periodic oral examination" ]       ] )     ] ;
fhir:serviced [
a fhir:date ;
fhir:v "2021-10-07"^^xsd:date     ] ;
fhir:quantity [
fhir:value [ fhir:v "1"^^xsd:decimal ]     ] ;
fhir:unitPrice [
fhir:value [ fhir:v "200"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]     ] ;
fhir:net [
fhir:value [ fhir:v "230"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]     ]
  ] [
    ( fhir:extension [
fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-package"^^xsd:anyURI ] ;
fhir:value [
a fhir:boolean ;
fhir:v false       ]     ] [
fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-tax"^^xsd:anyURI ] ;
fhir:value [
a fhir:Money ;
fhir:value [ fhir:v "45"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]       ]     ] [
fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-share"^^xsd:anyURI ] ;
fhir:value [
a fhir:Money ;
fhir:value [ fhir:v "60"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]       ]     ] [
fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice"^^xsd:anyURI ] ;
fhir:value [
a fhir:Identifier ;
fhir:system [ fhir:v "http://saudigeneralhospital.com.sa/identifiers/patientInvoice"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Invc-20220120/IP-1110987" ]       ]     ] ) ;
fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ;
    ( fhir:careTeamSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ;
    ( fhir:diagnosisSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ;
fhir:productOrService [
      ( fhir:coding [
fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/oral-health-op"^^xsd:anyURI ] ;
fhir:code [ fhir:v "97511-01-00" ] ;
fhir:display [ fhir:v "Metallic restoration of tooth, one surface, direct" ]       ] )     ] ;
fhir:serviced [
a fhir:date ;
fhir:v "2021-10-07"^^xsd:date     ] ;
fhir:quantity [
fhir:value [ fhir:v "1"^^xsd:decimal ]     ] ;
fhir:unitPrice [
fhir:value [ fhir:v "300"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]     ] ;
fhir:net [
fhir:value [ fhir:v "345"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]     ] ;
fhir:bodySite [
      ( fhir:coding [
fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/fdi-oral-region"^^xsd:anyURI ] ;
fhir:code [ fhir:v "13" ] ;
fhir:display [ fhir:v "UPPER RIGHT; PERMANENT TEETH # 3" ]       ] )     ]
  ] [
    ( fhir:extension [
fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-package"^^xsd:anyURI ] ;
fhir:value [
a fhir:boolean ;
fhir:v false       ]     ] [
fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-tax"^^xsd:anyURI ] ;
fhir:value [
a fhir:Money ;
fhir:value [ fhir:v "195"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]       ]     ] [
fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-share"^^xsd:anyURI ] ;
fhir:value [
a fhir:Money ;
fhir:value [ fhir:v "100"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]       ]     ] [
fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice"^^xsd:anyURI ] ;
fhir:value [
a fhir:Identifier ;
fhir:system [ fhir:v "http://saudigeneralhospital.com.sa/identifiers/patientInvoice"^^xsd:anyURI ] ;
fhir:value [ fhir:v "Invc-20220120/IP-1110987" ]       ]     ] ) ;
fhir:sequence [ fhir:v "3"^^xsd:positiveInteger ] ;
    ( fhir:careTeamSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ;
    ( fhir:diagnosisSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ;
fhir:productOrService [
      ( fhir:coding [
fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/oral-health-op"^^xsd:anyURI ] ;
fhir:code [ fhir:v "618" ] ;
fhir:display [ fhir:v "Full crown metallic indirect" ]       ] )     ] ;
fhir:serviced [
a fhir:date ;
fhir:v "2021-10-07"^^xsd:date     ] ;
fhir:quantity [
fhir:value [ fhir:v "1"^^xsd:decimal ]     ] ;
fhir:unitPrice [
fhir:value [ fhir:v "1300"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]     ] ;
fhir:net [
fhir:value [ fhir:v "1495"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]     ] ;
fhir:bodySite [
      ( fhir:coding [
fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/fdi-oral-region"^^xsd:anyURI ] ;
fhir:code [ fhir:v "37" ] ;
fhir:display [ fhir:v "LOWER LEFT; PERMANENT TEETH # 7" ]       ] )     ]
  ] ) ; # 
  fhir:total [
fhir:value [ fhir:v "2070"^^xsd:decimal ] ;
fhir:currency [ fhir:v "SAR" ]
  ] . #