@prefix fhir: . @prefix owl: . @prefix rdf: . @prefix rdfs: . @prefix xsd: . # - resource ------------------------------------------------------------------- a fhir:Claim ; fhir:nodeRole fhir:treeRoot ; fhir:id [ fhir:v "483078"] ; # fhir:meta [ fhir:profile ( [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/pharmacy-claim"^^xsd:anyURI ; fhir:link ] ) ] ; # fhir:text [ fhir:status [ fhir:v "extensions" ] ; fhir:div "

Generated Narrative: Claim 483078

Claim Batch Identifier: http://saudicentralpharmacy.sa.com/identifiers/batch/123456787879zxc2345678ujh

Claim Batch Number: 1

Claim Batch Period: 2023-12-06 --> 2023-12-06

Authorization Offline Date: 2023-12-05 11:05:48+0300

Episode: http://saudicentralpharmacy.sa.com/identifiers/episode/EpisodeID-209-0120

identifier: http://saudicentralpharmacy.sa.com/identifiers/claim/req_1902483080

status: Active

type: Pharmacy

subType: OutPatient

use: Claim

patient: Ahmad Khaled Abbas(official) Male, DoB: 1984-12-25 ( Passport Number: G12345678)

created: 2023-12-05 09:20:15+0300

insurer: Organization Saudi National Insurance

provider: Organization Saudi Pharmacy

priority: Normal

Payees

-Type
*Provider

SupportingInfos

-SequenceCategoryValue[x]
*1Days Supply30 d (Details: UCUM coded = 'd')

Diagnoses

-SequenceDiagnosis[x]Type
*1Viral infection, unspecifiedPrincipal Diagnosis

Insurances

-SequenceFocalCoveragePreAuthRef
*1trueCoverage: identifier = http://sni.com.sa/identifiers/memberid#0000000001; status = active; type = extended healthcare; dependent = 01; relationship = Self; network = Golden CPseudo-payer-Portal-Auth-02

item

Patient Share: SAR0.00 (SAR)

Package Code: false

Tax: SAR9.00 (SAR)

Patient Invoice: http://saudicentralpharmacy.sa.com/identifiers/patientInvoice/Invc-20220120-90408

Prescribed Medication: 06285096001627

Pharmacist Selection Reason: patient request

Maternity: false

sequence: 1

diagnosisSequence: 1

informationSequence: 1

productOrService: RELENZA 5MG POWDER FOR INHALATION

serviced: 2023-12-04

quantity: 1

UnitPrices

-ValueCurrency
*60Saudi riyal

Nets

-ValueCurrency
*69Saudi riyal

Totals

-ValueCurrency
*69Saudi riyal
"^^rdf:XMLLiteral ] ; # fhir:extension ( [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-batch-identifier"^^xsd:anyURI ] ; fhir:value [ a fhir:Identifier ; fhir:system [ fhir:v "http://saudicentralpharmacy.sa.com/identifiers/batch"^^xsd:anyURI ] ; fhir:value [ fhir:v "123456787879zxc2345678ujh" ] ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-batch-number"^^xsd:anyURI ] ; fhir:value [ a fhir:positiveInt ; fhir:v "1"^^xsd:positiveInteger ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-batch-period"^^xsd:anyURI ] ; fhir:value [ a fhir:Period ; fhir:start [ fhir:v "2023-12-06"^^xsd:date ] ; fhir:end [ fhir:v "2023-12-06"^^xsd:date ] ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-authorization-offline-date"^^xsd:anyURI ] ; fhir:value [ a fhir:dateTime ; fhir:v "2023-12-05T11:05:48+03:00"^^xsd:dateTime ] ] [ 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://saudicentralpharmacy.sa.com/identifiers/episode"^^xsd:anyURI ] ; fhir:value [ fhir:v "EpisodeID-209-0120" ] ] ] ) ; # fhir:identifier ( [ fhir:system [ fhir:v "http://saudicentralpharmacy.sa.com/identifiers/claim"^^xsd:anyURI ] ; fhir:value [ fhir:v "req_1902483080" ] ] ) ; # 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 "pharmacy" ] ] ) ] ; # 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:link ; fhir:reference [ fhir:v "Patient/123454186" ] ] ; # fhir:created [ fhir:v "2023-12-05T09:20:15.23+03:00"^^xsd:dateTime] ; # fhir:insurer [ fhir:link ; fhir:reference [ fhir:v "Organization/bff3aa1fbd3648619ac082357bf135db" ] ] ; # fhir:provider [ fhir:link ; fhir:reference [ fhir:v "Organization/6025" ] ] ; # 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:supportingInfo ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:category [ fhir:coding ( [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/claim-information-category"^^xsd:anyURI ] ; fhir:code [ fhir:v "days-supply" ] ] ) ] ; fhir:value [ a fhir:Quantity ; fhir:value [ fhir:v "30"^^xsd:decimal ] ; fhir:system [ fhir:v "http://unitsofmeasure.org"^^xsd:anyURI ] ; fhir:code [ fhir:v "d" ] ] ] ) ; # 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 "B34.9" ] ; fhir:display [ fhir:v "Viral infection, unspecified" ] ] ) ] ; 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:link ; fhir:reference [ fhir:v "Coverage/1333" ] ] ; fhir:preAuthRef ( [ fhir:v "Pseudo-payer-Portal-Auth-02" ] ) ] ) ; # fhir:item ( [ fhir:extension ( [ 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 "0"^^xsd:decimal ] ; fhir:currency [ fhir:v "SAR" ] ] ] [ 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 "9"^^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://saudicentralpharmacy.sa.com/identifiers/patientInvoice"^^xsd:anyURI ] ; fhir:value [ fhir:v "Invc-20220120-90408" ] ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-prescribed-Medication"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; fhir:coding ( [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/medication-codes"^^xsd:anyURI ] ; fhir:code [ fhir:v "06285096001627" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-pharmacist-Selection-Reason"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; fhir:coding ( [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/pharmacist-selection-reason"^^xsd:anyURI ] ; fhir:code [ fhir:v "patient-request" ] ] ) ] ] [ fhir:url [ fhir:v "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-maternity"^^xsd:anyURI ] ; fhir:value [ a fhir:boolean ; fhir:v false ] ] ) ; fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:diagnosisSequence ( [ fhir:v "1"^^xsd:positiveInteger ] ) ; fhir:informationSequence ( [ fhir:v "1"^^xsd:positiveInteger ] ) ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://nphies.sa/terminology/CodeSystem/medication-codes"^^xsd:anyURI ] ; fhir:code [ fhir:v "06285096001627" ] ; fhir:display [ fhir:v "RELENZA 5MG POWDER FOR INHALATION" ] ] ) ] ; fhir:serviced [ a fhir:date ; fhir:v "2023-12-04"^^xsd:date ] ; fhir:quantity [ fhir:value [ fhir:v "1"^^xsd:decimal ] ] ; fhir:unitPrice [ fhir:value [ fhir:v "60"^^xsd:decimal ] ; fhir:currency [ fhir:v "SAR" ] ] ; fhir:net [ fhir:value [ fhir:v "69"^^xsd:decimal ] ; fhir:currency [ fhir:v "SAR" ] ] ] ) ; # fhir:total [ fhir:value [ fhir:v "69"^^xsd:decimal ] ; fhir:currency [ fhir:v "SAR" ] ] . # # -------------------------------------------------------------------------------------