@prefix fhir: . @prefix owl: . @prefix rdfs: . @prefix xsd: . # - resource ------------------------------------------------------------------- a fhir:Claim ; fhir:nodeRole fhir:treeRoot ; fhir:id [ fhir:v "HomecareAuthorizationDifferentialExample"] ; # fhir:meta [ fhir:profile ( [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claim-update"^^xsd:anyURI ; fhir:link ] ) ; fhir:security ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ObservationValue"^^xsd:anyURI ] ; fhir:code [ fhir:v "SUBSETTED" ] ] ) ] ; # fhir:text [ fhir:status [ fhir:v "extensions" ] ; fhir:div "

Generated Narrative: Claim

Resource Claim "HomecareAuthorizationDifferentialExample"

Profile: PAS Claim Update

Security Labels: http://terminology.hl7.org/CodeSystem/v3-ObservationValue

identifier: id: 111099

status: active

type: Professional (Claim Type Codes#professional)

use: preauthorization

patient: Patient/SubscriberExample " SMITH"

created: 2019-07-20 11:01:00+0500

insurer: Organization/InsurerExample "MARYLAND CAPITAL INSURANCE COMPANY"

provider: Organization/UMOExample "DR. JOE SMITH CORPORATION"

priority: Normal (Process Priority Codes#normal)

Insurances

-SequenceFocalCoverage
*1trueCoverage/InsuranceExample

item

ServiceItemRequestType: Health Services Review (1525#HS)

CertificationType: Initial (1322#I)

modifierExtension[http://hl7.org/fhir/us/davinci-pas/StructureDefinition/modifierextension-infoCancelled]

sequence: 2

category: Home Health Care (1365#42)

productOrService: B4184 (HCPCSReleaseCodeSets#B4184)

item

InfoChanged: added

ServiceItemRequestType: Health Services Review (1525#HS)

CertificationType: Initial (1322#I)

sequence: 3

category: Home Health Care (1365#42)

productOrService: B4185 (HCPCSReleaseCodeSets#B4185)

" ] ; # fhir:identifier ( [ fhir:system [ fhir:v "http://example.org/PATIENT_EVENT_TRACE_NUMBER"^^xsd:anyURI ] ; fhir:value [ fhir:v "111099" ] ; fhir:assigner [ fhir:identifier [ fhir:system [ fhir:v "http://example.org/USER_ASSIGNED"^^xsd:anyURI ] ; fhir:value [ fhir:v "9012345678" ] ] ] ] ) ; # 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:use [ fhir:v "preauthorization"] ; # fhir:patient [ fhir:link ; fhir:reference [ fhir:v "Patient/SubscriberExample" ] ] ; # fhir:created [ fhir:v "2019-07-20T11:01:00+05:00"^^xsd:dateTime] ; # fhir:insurer [ fhir:link ; fhir:reference [ fhir:v "Organization/InsurerExample" ] ] ; # fhir:provider [ fhir:link ; fhir:reference [ fhir:v "Organization/UMOExample" ] ] ; # fhir:priority [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/processpriority"^^xsd:anyURI ] ; fhir:code [ fhir:v "normal" ] ] ) ] ; # fhir:insurance ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:focal [ fhir:v "true"^^xsd:boolean ] ; fhir:coverage [ fhir:link ; fhir:reference [ fhir:v "Coverage/InsuranceExample" ] ] ] ) ; # fhir:_item ( [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; fhir:coding ( [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/1525"^^xsd:anyURI ] ; fhir:code [ fhir:v "HS" ] ; fhir:display [ fhir:v "Health Services Review" ] ] ) ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; fhir:coding ( [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/1322"^^xsd:anyURI ] ; fhir:code [ fhir:v "I" ] ; fhir:display [ fhir:v "Initial" ] ] ) ] ] ) ; fhir:modifierExtension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/modifierextension-infoCancelled"^^xsd:anyURI ] ; fhir:value [ fhir:v "true"^^xsd:boolean ] ] ) ; fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ; fhir:category [ fhir:coding ( [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/1365"^^xsd:anyURI ] ; fhir:code [ fhir:v "42" ] ; fhir:display [ fhir:v "Home Health Care" ] ] ) ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"^^xsd:anyURI ] ; fhir:code [ fhir:v "B4184" ] ] ) ] ] ) ; # fhir:item ( [ fhir:extension ( [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-infoChanged"^^xsd:anyURI ] ; fhir:value [ fhir:v "added" ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; fhir:coding ( [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/1525"^^xsd:anyURI ] ; fhir:code [ fhir:v "HS" ] ; fhir:display [ fhir:v "Health Services Review" ] ] ) ] ] [ fhir:url [ fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType"^^xsd:anyURI ] ; fhir:value [ a fhir:CodeableConcept ; fhir:coding ( [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/1322"^^xsd:anyURI ] ; fhir:code [ fhir:v "I" ] ; fhir:display [ fhir:v "Initial" ] ] ) ] ] ) ; fhir:sequence [ fhir:v "3"^^xsd:positiveInteger ] ; fhir:category [ fhir:coding ( [ fhir:system [ fhir:v "https://codesystem.x12.org/005010/1365"^^xsd:anyURI ] ; fhir:code [ fhir:v "42" ] ; fhir:display [ fhir:v "Home Health Care" ] ] ) ] ; fhir:productOrService [ fhir:coding ( [ fhir:system [ fhir:v "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets"^^xsd:anyURI ] ; fhir:code [ fhir:v "B4185" ] ] ) ] ] ) . # a fhir:us . a fhir:us . a fhir:us . a fhir:us . # -------------------------------------------------------------------------------------