@prefix fhir: . @prefix owl: . @prefix rdf: . @prefix rdfs: . @prefix sct: . @prefix xsd: . # - resource ------------------------------------------------------------------- a fhir:Bundle ; fhir:nodeRole fhir:treeRoot ; fhir:id [ fhir:v "ClaimBundle-predetermination-example-01"] ; # fhir:meta [ fhir:profile ( [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/ClaimBundle"^^xsd:anyURI ; fhir:link ] ) ; fhir:security ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-Confidentiality"^^xsd:anyURI ] ; fhir:code [ fhir:v "V" ] ; fhir:display [ fhir:v "very restricted" ] ] ) ] ; # fhir:identifier [ fhir:value [ fhir:v "ac3c6c57-2053-4d0e-ac40-139ccccff876" ] ] ; # fhir:type [ fhir:v "collection"] ; # fhir:timestamp [ fhir:v "2025-03-07T11:32:26.605+05:30"^^xsd:dateTime] ; # fhir:entry ( [ fhir:fullUrl [ fhir:v "urn:uuid:253934fe-510d-49eb-98a5-6040665e9d47"^^xsd:anyURI ] ; fhir:resource ( ) ] [ fhir:fullUrl [ fhir:v "urn:uuid:56656117-b031-4d82-97f4-d30d699fb40a"^^xsd:anyURI ] ; fhir:resource ( ) ] [ fhir:fullUrl [ fhir:v "urn:uuid:1fe25aff-9fa9-4b44-acfb-f114187fd9c7"^^xsd:anyURI ] ; fhir:resource ( ) ] [ fhir:fullUrl [ fhir:v "urn:uuid:97f8790a-89bc-45af-b7e0-2e103cb571f4"^^xsd:anyURI ] ; fhir:resource ( ) ] [ fhir:fullUrl [ fhir:v "urn:uuid:1837911c-9b5f-4564-872e-fc696b49986d"^^xsd:anyURI ] ; fhir:resource ( ) ] [ fhir:fullUrl [ fhir:v "urn:uuid:4ed8a29b-0a08-45d3-8f70-f3769c3e1c03"^^xsd:anyURI ] ; fhir:resource ( ) ] ) . # a fhir:Claim ; fhir:id [ fhir:v "253934fe-510d-49eb-98a5-6040665e9d47"] ; # fhir:meta [ fhir:profile ( [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Claim"^^xsd:anyURI ; fhir:link ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "

Generated Narrative: Claim 253934fe-510d-49eb-98a5-6040665e9d47

identifier: 7612345

status: Active

type: Inpatient care management (procedure)

use: Predetermination

patient: Patient

billablePeriod: 2025-03-07 11:01:00+0500 --> 2025-04-07 11:01:00+0500

created: 2025-03-07 11:01:00+0500

insurer: Organization

provider: Organization

priority: Normal

CareTeams

-	Sequence	Provider	Role	Qualification
*	1	Practitioner	Healthcare professional (occupation)	Clinical specialty (qualifier value)

Diagnoses

-	Sequence	Diagnosis[x]	Type
*	1	Cardiac arrest, unspecified	Final diagnosis (discharge) (contextual qualifier) (qualifier value)

procedure
sequence: 1
procedure: Angiography

procedure
sequence: 2
procedure: Angioplasty of blood vessel

Insurances

-	Sequence	Focal	Coverage
*	1	true	Coverage

item
sequence: 1
careTeamSequence: 1
productOrService: Angiography
UnitPrices
- Value Currency
* 10000 Indian rupee
Nets
- Value Currency
* 10000 Indian rupee

item
sequence: 2
careTeamSequence: 1
productOrService: Angioplasty of blood vessel
UnitPrices
- Value Currency
* 40000 Indian rupee
Nets
- Value Currency
* 40000 Indian rupee

item
sequence: 3
careTeamSequence: 1
productOrService: Intensive care unit
UnitPrices
- Value Currency
* 2000 Indian rupee
Nets
- Value Currency
* 20000 Indian rupee

Totals

-	Value	Currency
*	70000	Indian rupee

"^^rdf:XMLLiteral ] ; # fhir:identifier ( [ fhir:value [ fhir:v "7612345" ] ] ) ; # fhir:status [ fhir:v "active"] ; # fhir:type [ fhir:coding ( [ a sct:737481003 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "737481003" ] ; fhir:display [ fhir:v "Inpatient care management (procedure)" ] ] ) ] ; # fhir:use [ fhir:v "predetermination"] ; # fhir:patient [ fhir:reference [ fhir:v "urn:uuid:56656117-b031-4d82-97f4-d30d699fb40a" ] ; fhir:display [ fhir:v "Patient" ] ] ; # fhir:billablePeriod [ fhir:start [ fhir:v "2025-03-07T11:01:00+05:00"^^xsd:dateTime ] ; fhir:end [ fhir:v "2025-04-07T11:01:00+05:00"^^xsd:dateTime ] ] ; # fhir:created [ fhir:v "2025-03-07T11:01:00+05:00"^^xsd:dateTime] ; # fhir:insurer [ fhir:reference [ fhir:v "urn:uuid:1fe25aff-9fa9-4b44-acfb-f114187fd9c7" ] ; fhir:display [ fhir:v "Organization" ] ] ; # fhir:provider [ fhir:reference [ fhir:v "urn:uuid:97f8790a-89bc-45af-b7e0-2e103cb571f4" ] ; fhir:display [ fhir:v "Organization" ] ] ; # fhir:priority [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/processpriority"^^xsd:anyURI ] ; fhir:code [ fhir:v "normal" ] ] ) ] ; # fhir:careTeam ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:provider [ fhir:reference [ fhir:v "urn:uuid:1837911c-9b5f-4564-872e-fc696b49986d" ] ; fhir:display [ fhir:v "Practitioner" ] ] ; fhir:role [ fhir:coding ( [ a sct:223366009 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "223366009" ] ; fhir:display [ fhir:v "Healthcare professional (occupation)" ] ] ) ] ; fhir:qualification [ fhir:coding ( [ a sct:394658006 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "394658006" ] ; fhir:display [ fhir:v "Clinical specialty (qualifier value)" ] ] ) ] ] ) ; # 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"^^xsd:anyURI ] ; fhir:code [ fhir:v "I46.9" ] ; fhir:display [ fhir:v "Cardiac arrest, unspecified" ] ] ) ] ; fhir:type ( [ fhir:coding ( [ a sct:89100005 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "89100005" ] ; fhir:display [ fhir:v "Final diagnosis (discharge) (contextual qualifier) (qualifier value)" ] ] ) ] ) ] ) ; # fhir:procedure ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:procedure [ a fhir:CodeableConcept ; fhir:coding ( [ a sct:77343006 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "77343006" ] ; fhir:display [ fhir:v "Angiography" ] ] ) ] ] [ fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ; fhir:procedure [ a fhir:CodeableConcept ; fhir:coding ( [ a sct:418285008 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "418285008" ] ; fhir:display [ fhir:v "Angioplasty of blood vessel" ] ] ) ] ] ) ; # fhir:insurance ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:focal [ fhir:v "true"^^xsd:boolean ] ; fhir:coverage [ fhir:reference [ fhir:v "urn:uuid:4ed8a29b-0a08-45d3-8f70-f3769c3e1c03" ] ; fhir:display [ fhir:v "Coverage" ] ] ] ) ; # fhir:item ( [ fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ; fhir:careTeamSequence ( [ fhir:v "1"^^xsd:positiveInteger ] ) ; fhir:productOrService [ fhir:coding ( [ a sct:77343006 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "77343006" ] ; fhir:display [ fhir:v "Angiography" ] ] ) ] ; fhir:unitPrice [ fhir:value [ fhir:v "10000"^^xsd:decimal ] ; fhir:currency [ fhir:v "INR" ] ] ; fhir:net [ fhir:value [ fhir:v "10000"^^xsd:decimal ] ; fhir:currency [ fhir:v "INR" ] ] ] [ fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ; fhir:careTeamSequence ( [ fhir:v "1"^^xsd:positiveInteger ] ) ; fhir:productOrService [ fhir:coding ( [ a sct:418285008 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "418285008" ] ; fhir:display [ fhir:v "Angioplasty of blood vessel" ] ] ) ] ; fhir:unitPrice [ fhir:value [ fhir:v "40000"^^xsd:decimal ] ; fhir:currency [ fhir:v "INR" ] ] ; fhir:net [ fhir:value [ fhir:v "40000"^^xsd:decimal ] ; fhir:currency [ fhir:v "INR" ] ] ] [ fhir:sequence [ fhir:v "3"^^xsd:positiveInteger ] ; fhir:careTeamSequence ( [ fhir:v "1"^^xsd:positiveInteger ] ) ; fhir:productOrService [ fhir:coding ( [ a sct:309904001 ; fhir:system [ fhir:v "http://snomed.info/sct"^^xsd:anyURI ] ; fhir:code [ fhir:v "309904001" ] ; fhir:display [ fhir:v "Intensive care unit" ] ] ) ] ; fhir:unitPrice [ fhir:value [ fhir:v "2000"^^xsd:decimal ] ; fhir:currency [ fhir:v "INR" ] ] ; fhir:net [ fhir:value [ fhir:v "20000"^^xsd:decimal ] ; fhir:currency [ fhir:v "INR" ] ] ] ) ; # fhir:total [ fhir:value [ fhir:v "70000"^^xsd:decimal ] ; fhir:currency [ fhir:v "INR" ] ] . # a fhir:Patient ; fhir:id [ fhir:v "56656117-b031-4d82-97f4-d30d699fb40a"] ; # fhir:meta [ fhir:profile ( [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient"^^xsd:anyURI ; fhir:link ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "

Generated Narrative: Patient 56656117-b031-4d82-97f4-d30d699fb40a

Adarsh Agrawal Male, DoB: 1981-01-12 ( Adhaar number: 7225-4829-5255)

Contact Detail

"^^rdf:XMLLiteral ] ; # fhir:identifier ( [ fhir:type [ fhir:coding ( [ fhir:system [ fhir:v "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code"^^xsd:anyURI ] ; fhir:code [ fhir:v "ADN" ] ; fhir:display [ fhir:v "Adhaar number" ] ] ) ] ; fhir:system [ fhir:v "https://uidai.gov.in/"^^xsd:anyURI ] ; fhir:value [ fhir:v "7225-4829-5255" ] ] ) ; # fhir:name ( [ fhir:text [ fhir:v "Adarsh Agrawal" ] ] ) ; # fhir:telecom ( [ fhir:system [ fhir:v "phone" ] ; fhir:value [ fhir:v "+919818512600" ] ; fhir:use [ fhir:v "home" ] ] ) ; # fhir:gender [ fhir:v "male"] ; # fhir:birthDate [ fhir:v "1981-01-12"^^xsd:date] . # a fhir:Organization ; fhir:id [ fhir:v "1fe25aff-9fa9-4b44-acfb-f114187fd9c7"] ; # fhir:meta [ fhir:profile ( [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"^^xsd:anyURI ; fhir:link ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "

Generated Narrative: Organization 1fe25aff-9fa9-4b44-acfb-f114187fd9c7

identifier: Registry of Hospitals in Network of Insurance (ROHINI) ID/4567878

type: Insurance Company

name: XYZ Insurance Co. Ltd.

telecom: +91 243 2634 1234, contact@xyz.org

"^^rdf:XMLLiteral ] ; # fhir:identifier ( [ fhir:type [ fhir:coding ( [ fhir:system [ fhir:v "https://nrces.in/ndhm/fhir/r4/CodeSystem/ndhm-identifier-type-code"^^xsd:anyURI ] ; fhir:code [ fhir:v "ROHINI" ] ; fhir:display [ fhir:v "Registry of Hospitals in Network of Insurance (ROHINI) ID" ] ] ) ] ; fhir:system [ fhir:v "https://rohini.iib.gov.in/"^^xsd:anyURI ] ; fhir:value [ fhir:v "4567878" ] ] ) ; # fhir:type ( [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/organization-type"^^xsd:anyURI ] ; fhir:code [ fhir:v "ins" ] ; fhir:display [ fhir:v "Insurance Company" ] ] ) ] ) ; # fhir:name [ fhir:v "XYZ Insurance Co. Ltd."] ; # fhir:telecom ( [ fhir:system [ fhir:v "phone" ] ; fhir:value [ fhir:v "+91 243 2634 1234" ] ; fhir:use [ fhir:v "work" ] ] [ fhir:system [ fhir:v "email" ] ; fhir:value [ fhir:v "contact@xyz.org" ] ; fhir:use [ fhir:v "work" ] ] ) . # a fhir:Organization ; fhir:id [ fhir:v "97f8790a-89bc-45af-b7e0-2e103cb571f4"] ; # fhir:meta [ fhir:profile ( [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization"^^xsd:anyURI ; fhir:link ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "

Generated Narrative: Organization 97f8790a-89bc-45af-b7e0-2e103cb571f4

identifier: Provider number/45675454

type: Healthcare Provider

name: XYZ Hospital Co. Ltd.

telecom: +91 243 2634 1278, contact@xyz.org

"^^rdf:XMLLiteral ] ; # fhir:identifier ( [ fhir:type [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ; fhir:code [ fhir:v "PRN" ] ; fhir:display [ fhir:v "Provider number" ] ] ) ] ; fhir:system [ fhir:v "https://facility.ndhm.gov.in"^^xsd:anyURI ] ; fhir:value [ fhir:v "45675454" ] ] ) ; # fhir:type ( [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/organization-type"^^xsd:anyURI ] ; fhir:code [ fhir:v "prov" ] ; fhir:display [ fhir:v "Healthcare Provider" ] ] ) ] ) ; # fhir:name [ fhir:v "XYZ Hospital Co. Ltd."] ; # fhir:telecom ( [ fhir:system [ fhir:v "phone" ] ; fhir:value [ fhir:v "+91 243 2634 1278" ] ; fhir:use [ fhir:v "work" ] ] [ fhir:system [ fhir:v "email" ] ; fhir:value [ fhir:v "contact@xyz.org" ] ; fhir:use [ fhir:v "work" ] ] ) . # a fhir:Practitioner ; fhir:id [ fhir:v "1837911c-9b5f-4564-872e-fc696b49986d"] ; # fhir:meta [ fhir:profile ( [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner"^^xsd:anyURI ; fhir:link ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "

Generated Narrative: Practitioner 1837911c-9b5f-4564-872e-fc696b49986d

identifier: Medical License number/21-1521-3828-3227

name: Dr. Aayush Agrawal

"^^rdf:XMLLiteral ] ; # fhir:identifier ( [ fhir:type [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ; fhir:code [ fhir:v "MD" ] ; fhir:display [ fhir:v "Medical License number" ] ] ) ] ; fhir:system [ fhir:v "https://doctor.ndhm.gov.in"^^xsd:anyURI ] ; fhir:value [ fhir:v "21-1521-3828-3227" ] ] ) ; # fhir:name ( [ fhir:text [ fhir:v "Dr. Aayush Agrawal" ] ] ) . # a fhir:Coverage ; fhir:id [ fhir:v "4ed8a29b-0a08-45d3-8f70-f3769c3e1c03"] ; # fhir:meta [ fhir:profile ( [ fhir:v "https://nrces.in/ndhm/fhir/r4/StructureDefinition/Coverage"^^xsd:anyURI ; fhir:link ] ) ] ; # fhir:text [ fhir:status [ fhir:v "generated" ] ; fhir:div "

Generated Narrative: Coverage 4ed8a29b-0a08-45d3-8f70-f3769c3e1c03

identifier: https://xyzinsurance.in/policynumber//235037120

status: Active

type: health insurance plan policy

subscriber: Patient

subscriberId: ABC123456BI007

beneficiary: Patient

relationship: Self

period: ?? --> 2026-03-17

payor: Organization

"^^rdf:XMLLiteral ] ; # fhir:identifier ( [ fhir:system [ fhir:v "https://xyzinsurance.in/policynumber/"^^xsd:anyURI ] ; fhir:value [ fhir:v "235037120" ] ] ) ; # fhir:status [ fhir:v "active"] ; # fhir:type [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ; fhir:code [ fhir:v "HIP" ] ; fhir:display [ fhir:v "health insurance plan policy" ] ] ) ] ; # fhir:subscriber [ fhir:reference [ fhir:v "urn:uuid:56656117-b031-4d82-97f4-d30d699fb40a" ] ; fhir:display [ fhir:v "Patient" ] ] ; # fhir:subscriberId [ fhir:v "ABC123456BI007"] ; # fhir:beneficiary [ fhir:reference [ fhir:v "urn:uuid:56656117-b031-4d82-97f4-d30d699fb40a" ] ; fhir:display [ fhir:v "Patient" ] ] ; # fhir:relationship [ fhir:coding ( [ fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/subscriber-relationship"^^xsd:anyURI ] ; fhir:code [ fhir:v "self" ] ] ) ] ; # fhir:period [ fhir:end [ fhir:v "2026-03-17"^^xsd:date ] ] ; # fhir:payor ( [ fhir:reference [ fhir:v "urn:uuid:1fe25aff-9fa9-4b44-acfb-f114187fd9c7" ] ; fhir:display [ fhir:v "Organization" ] ] ) . # # -------------------------------------------------------------------------------------