External - UAPI Copay claim upsert - bundle of claim bundles - TTL Representation - Universal API Implementation Guide v1.1.20

Universal API Implementation Guide - Local Development build (v1.1.20) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
: External - UAPI Copay claim upsert - bundle of claim bundles - 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:Bundle ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "uapi-bundle-copay-claim-upsert"] ; # 
  fhir:identifier [
fhir:use [ fhir:v "usual" ] ;
fhir:system [ fhir:v "http://risrx.com/claimbundleid"^^xsd:anyURI ] ;
fhir:value [ fhir:v "2f057cf1-19d5-425e-bae7-0612026b69cd" ]
  ] ; # 
  fhir:type [ fhir:v "collection"] ; # 
  fhir:timestamp [ fhir:v "2024-06-07T08:10:17-05:00"^^xsd:dateTime] ; # 
  fhir:entry ( [
fhir:fullUrl [ fhir:v "urn:uuid:d1e49065-2e38-45b0-af50-92e225868140"^^xsd:anyURI ] ;
    ( fhir:resource <urn:uuid:d1e49065-2e38-45b0-af50-92e225868140> )
  ] [
fhir:fullUrl [ fhir:v "urn:uuid:45597178-f243-419e-8af3-462359f89e91"^^xsd:anyURI ] ;
    ( fhir:resource <urn:uuid:45597178-f243-419e-8af3-462359f89e91> )
  ] ) . # 

<urn:uuid:d1e49065-2e38-45b0-af50-92e225868140> a fhir:Bundle ;
  fhir:id [ fhir:v "uapi-bundle-copay-claim-1"] ; # 
  fhir:identifier [
fhir:use [ fhir:v "usual" ] ;
fhir:system [ fhir:v "http://risrx.com/claimid"^^xsd:anyURI ] ;
fhir:value [ fhir:v "123456" ]
  ] ; # 
  fhir:type [ fhir:v "collection"] ; # 
  fhir:timestamp [ fhir:v "2024-06-07T08:10:17-05:00"^^xsd:dateTime] ; # 
  fhir:entry ( [
fhir:fullUrl [ fhir:v "urn:uuid:61b950a7-e518-4f69-b8dd-a1729c8f4bd5"^^xsd:anyURI ] ;
    ( fhir:resource <urn:uuid:61b950a7-e518-4f69-b8dd-a1729c8f4bd5> )
  ] [
fhir:fullUrl [ fhir:v "urn:uuid:3fd08ef2-34a2-4191-ad04-44353c2f133a"^^xsd:anyURI ] ;
    ( fhir:resource <urn:uuid:3fd08ef2-34a2-4191-ad04-44353c2f133a> )
  ] [
fhir:fullUrl [ fhir:v "urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"^^xsd:anyURI ] ;
    ( fhir:resource <urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1> )
  ] [
fhir:fullUrl [ fhir:v "urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545"^^xsd:anyURI ] ;
    ( fhir:resource <urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545> )
  ] [
fhir:fullUrl [ fhir:v "urn:uuid:5c2e19ac-8227-4de5-a893-069dec07448e"^^xsd:anyURI ] ;
    ( fhir:resource <urn:uuid:5c2e19ac-8227-4de5-a893-069dec07448e> )
  ] ) . # 

<urn:uuid:61b950a7-e518-4f69-b8dd-a1729c8f4bd5> a fhir:ExplanationOfBenefit, fhir:ExplanationOfBenefit ;
  fhir:id [ fhir:v "uapi-eob-copay-claim-1"], [ fhir:v "uapi-eob-copay-claim-1"] ; # 
  fhir:identifier ( [
fhir:use [ fhir:v "usual" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType"^^xsd:anyURI ]       ] [
fhir:code [ fhir:v "uc" ]       ] )     ] ;
fhir:system [ fhir:v "http://risrx.com/claimid"^^xsd:anyURI ] ;
fhir:value [ fhir:v "123456" ]
  ] [
fhir:use [ fhir:v "usual" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType"^^xsd:anyURI ]       ] [
fhir:code [ fhir:v "uc" ]       ] )     ] ;
fhir:system [ fhir:v "http://risrx.com/claimid"^^xsd:anyURI ] ;
fhir:value [ fhir:v "123456" ]
  ] ) ; # 
  fhir:status [ fhir:v "active"], [ fhir:v "active"] ; # 
  fhir:type [
    ( fhir:coding [
fhir:code [ fhir:v "institutional" ]     ] )
  ], [
    ( fhir:coding [
fhir:code [ fhir:v "institutional" ]     ] )
  ] ; # 
  fhir:use [ fhir:v "claim"], [ fhir:v "claim"] ; # 
  fhir:patient [
fhir:reference [ fhir:v "urn:uuid:3fd08ef2-34a2-4191-ad04-44353c2f133a" ]
  ], [
fhir:reference [ fhir:v "urn:uuid:3fd08ef2-34a2-4191-ad04-44353c2f133a" ]
  ] ; # 
  fhir:created [ fhir:v "2024-06-06T21:01:11.230Z"^^xsd:dateTime], [ fhir:v "2024-06-06T21:01:11.230Z"^^xsd:dateTime] ; # 
  fhir:insurer [
fhir:reference [ fhir:v "urn:uuid:d02db104-a75c-433f-8764-9778c2e20626" ]
  ], [
fhir:reference [ fhir:v "urn:uuid:d02db104-a75c-433f-8764-9778c2e20626" ]
  ] ; # 
  fhir:provider [
fhir:reference [ fhir:v "urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1" ]
  ], [
fhir:reference [ fhir:v "urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1" ]
  ] ; # 
  fhir:payee [
fhir:party [
fhir:reference [ fhir:v "urn:uuid:081d9568-2f85-4211-a84e-224d675b18ef" ]     ]
  ], [
fhir:party [
fhir:reference [ fhir:v "urn:uuid:081d9568-2f85-4211-a84e-224d675b18ef" ]     ]
  ] ; # 
  fhir:outcome [ fhir:v "complete"], [ fhir:v "complete"] ; # 
  fhir:supportingInfo ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-copay-claim-supporting-info-category"^^xsd:anyURI ] ;
fhir:code [ fhir:v "eobdate" ]       ] )     ] ;
fhir:value [
a fhir:string ;
fhir:v "2024-06-07"     ]
  ] [
fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ;
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-copay-claim-supporting-info-category"^^xsd:anyURI ] ;
fhir:code [ fhir:v "ndc" ]       ] )     ] ;
fhir:value [
a fhir:string ;
fhir:v "50242021501"     ]
  ] [
fhir:sequence [ fhir:v "3"^^xsd:positiveInteger ] ;
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-copay-claim-supporting-info-category"^^xsd:anyURI ] ;
fhir:code [ fhir:v "claimrequesteddate" ]       ] )     ] ;
fhir:value [
a fhir:string ;
fhir:v "2024-06-01"     ]
  ] [
fhir:sequence [ fhir:v "4"^^xsd:positiveInteger ] ;
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-copay-claim-supporting-info-category"^^xsd:anyURI ] ;
fhir:code [ fhir:v "claimapproveddate" ]       ] )     ] ;
fhir:value [
a fhir:string ;
fhir:v "2024-06-03"     ]
  ] [
fhir:sequence [ fhir:v "5"^^xsd:positiveInteger ] ;
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-copay-claim-supporting-info-category"^^xsd:anyURI ] ;
fhir:code [ fhir:v "jcode" ]       ] )     ] ;
fhir:value [
a fhir:string ;
fhir:v "J2357"     ]
  ] [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-copay-claim-supporting-info-category"^^xsd:anyURI ] ;
fhir:code [ fhir:v "eobdate" ]       ] )     ] ;
fhir:value [
a fhir:string ;
fhir:v "2024-06-07"     ]
  ] [
fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ;
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-copay-claim-supporting-info-category"^^xsd:anyURI ] ;
fhir:code [ fhir:v "ndc" ]       ] )     ] ;
fhir:value [
a fhir:string ;
fhir:v "50242021501"     ]
  ] [
fhir:sequence [ fhir:v "3"^^xsd:positiveInteger ] ;
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-copay-claim-supporting-info-category"^^xsd:anyURI ] ;
fhir:code [ fhir:v "claimrequesteddate" ]       ] )     ] ;
fhir:value [
a fhir:string ;
fhir:v "2024-06-01"     ]
  ] [
fhir:sequence [ fhir:v "4"^^xsd:positiveInteger ] ;
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-copay-claim-supporting-info-category"^^xsd:anyURI ] ;
fhir:code [ fhir:v "claimapproveddate" ]       ] )     ] ;
fhir:value [
a fhir:string ;
fhir:v "2024-06-03"     ]
  ] [
fhir:sequence [ fhir:v "5"^^xsd:positiveInteger ] ;
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-copay-claim-supporting-info-category"^^xsd:anyURI ] ;
fhir:code [ fhir:v "jcode" ]       ] )     ] ;
fhir:value [
a fhir:string ;
fhir:v "J2357"     ]
  ] ) ; # 
  fhir:insurance ( [
fhir:focal [ fhir:v true ] ;
fhir:coverage [
fhir:reference [ fhir:v "urn:uuid:b0574bf9-d016-4af7-a895-269abd739db3" ]     ]
  ] [
fhir:focal [ fhir:v true ] ;
fhir:coverage [
fhir:reference [ fhir:v "urn:uuid:b0574bf9-d016-4af7-a895-269abd739db3" ]     ]
  ] ) ; # 
  fhir:item ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:productOrService [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSProcedureCodes"^^xsd:anyURI ] ;
fhir:code [ fhir:v "96401" ]       ] )     ] ;
fhir:serviced [
a fhir:date ;
fhir:v "2024-06-01"^^xsd:date     ] ;
    ( fhir:adjudication [
fhir:category [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationCategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "submitted" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "250"^^xsd:decimal ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationCategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "eligible" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v 104.16 ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationCategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "paidtoprovider" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v 78.12 ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationCategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "copay" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "0"^^xsd:decimal ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationCategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "deductible" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "25"^^xsd:decimal ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationCategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "coinsurance" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v 26.04 ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationCategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "patienttotalresponsibility" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v 51.04 ]       ]     ] )
  ] [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:productOrService [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/ValueSet/AMACPTCMSHCPCSProcedureCodes"^^xsd:anyURI ] ;
fhir:code [ fhir:v "96401" ]       ] )     ] ;
fhir:serviced [
a fhir:date ;
fhir:v "2024-06-01"^^xsd:date     ] ;
    ( fhir:adjudication [
fhir:category [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationCategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "submitted" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "250"^^xsd:decimal ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationCategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "eligible" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v 104.16 ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationCategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "paidtoprovider" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v 78.12 ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationCategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "copay" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "0"^^xsd:decimal ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationCategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "deductible" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "25"^^xsd:decimal ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationCategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "coinsurance" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v 26.04 ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBAdjudicationCategory"^^xsd:anyURI ] ;
fhir:code [ fhir:v "patienttotalresponsibility" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v 51.04 ]       ]     ] )
  ] ) ; # 
  fhir:adjudication ( [
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.gene.com/fhir/usix/uapi/ValueSet/uapi-copay-adjudication-category-discriminator"^^xsd:anyURI ] ;
fhir:code [ fhir:v "claimstatus" ]       ] )     ] ;
fhir:reason [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-copay-claim-status"^^xsd:anyURI ] ;
fhir:code [ fhir:v "approved" ]       ] )     ]
  ] [
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.gene.com/fhir/usix/uapi/ValueSet/uapi-copay-adjudication-category-discriminator"^^xsd:anyURI ] ;
fhir:code [ fhir:v "claimstatus" ]       ] )     ] ;
fhir:reason [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-copay-claim-status"^^xsd:anyURI ] ;
fhir:code [ fhir:v "approved" ]       ] )     ]
  ] ) ; # 
  fhir:total ( [
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-copay-payment-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "check" ]       ] )     ] ;
fhir:amount [
fhir:value [ fhir:v 5.01 ]     ]
  ] [
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"^^xsd:anyURI ] ;
fhir:code [ fhir:v "paidbypatient" ]       ] )     ] ;
fhir:amount [
fhir:value [ fhir:v "5"^^xsd:decimal ]     ]
  ] [
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"^^xsd:anyURI ] ;
fhir:code [ fhir:v "submitted" ]       ] )     ] ;
fhir:amount [
fhir:value [ fhir:v 13.11 ]     ]
  ] [
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-copay-payment-type"^^xsd:anyURI ] ;
fhir:code [ fhir:v "check" ]       ] )     ] ;
fhir:amount [
fhir:value [ fhir:v 5.01 ]     ]
  ] [
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"^^xsd:anyURI ] ;
fhir:code [ fhir:v "paidbypatient" ]       ] )     ] ;
fhir:amount [
fhir:value [ fhir:v "5"^^xsd:decimal ]     ]
  ] [
fhir:category [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBAdjudication"^^xsd:anyURI ] ;
fhir:code [ fhir:v "submitted" ]       ] )     ] ;
fhir:amount [
fhir:value [ fhir:v 13.11 ]     ]
  ] ) ; # 
  fhir:payment [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerClaimPaymentStatusCode"^^xsd:anyURI ] ;
fhir:code [ fhir:v "paid" ]       ] )     ] ;
fhir:date [ fhir:v "2024-06-06"^^xsd:date ] ;
fhir:identifier [
fhir:system [ fhir:v "http://risrx.com/checknum"^^xsd:anyURI ] ;
fhir:value [ fhir:v "123456" ]     ]
  ], [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://hl7.org/fhir/us/carin-bb/ValueSet/C4BBPayerClaimPaymentStatusCode"^^xsd:anyURI ] ;
fhir:code [ fhir:v "paid" ]       ] )     ] ;
fhir:date [ fhir:v "2024-06-06"^^xsd:date ] ;
fhir:identifier [
fhir:system [ fhir:v "http://risrx.com/checknum"^^xsd:anyURI ] ;
fhir:value [ fhir:v "123456" ]     ]
  ] . # 

<urn:uuid:3fd08ef2-34a2-4191-ad04-44353c2f133a> a fhir:Patient, fhir:Patient ;
  fhir:id [ fhir:v "3fd08ef2-34a2-4191-ad04-44353c2f133a"], [ fhir:v "3fd08ef2-34a2-4191-ad04-44353c2f133a"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://fhir.developer.gene.com/StructureDefinition/uapi-patient"^^xsd:anyURI ;
fhir:link <https://fhir.developer.gene.com/StructureDefinition/uapi-patient>     ] )
  ], [
    ( fhir:profile [
fhir:v "https://fhir.developer.gene.com/StructureDefinition/uapi-patient"^^xsd:anyURI ;
fhir:link <https://fhir.developer.gene.com/StructureDefinition/uapi-patient>     ] )
  ] ; # 
  fhir:identifier ( [
fhir:use [ fhir:v "usual" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "PI" ] ;
fhir:display [ fhir:v "Patient internal identifier" ]       ] )     ] ;
fhir:system [ fhir:v "http://risrx.com/masterpatientcardid"^^xsd:anyURI ] ;
fhir:value [ fhir:v "12220c4c-b03b-4ebc-9bb7-1c5ddafbb30c" ] ;
fhir:assigner [
fhir:display [ fhir:v "RisRx" ]     ]
  ] [
fhir:use [ fhir:v "usual" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "PI" ] ;
fhir:display [ fhir:v "Patient internal identifier" ]       ] )     ] ;
fhir:system [ fhir:v "http://risrx.com/masterpatientcardid"^^xsd:anyURI ] ;
fhir:value [ fhir:v "12220c4c-b03b-4ebc-9bb7-1c5ddafbb30c" ] ;
fhir:assigner [
fhir:display [ fhir:v "RisRx" ]     ]
  ] ) ; # 
  fhir:name ( [
fhir:use [ fhir:v "official" ] ;
fhir:family [ fhir:v "Michaelson" ] ;
    ( fhir:given [ fhir:v "Ryan" ] [ fhir:v "Tom" ] )
  ] [
fhir:use [ fhir:v "official" ] ;
fhir:family [ fhir:v "Michaelson" ] ;
    ( fhir:given [ fhir:v "Ryan" ] [ fhir:v "Tom" ] )
  ] ) ; # 
  fhir:telecom ( [
fhir:system [ fhir:v "phone" ] ;
fhir:value [ fhir:v "1231231234" ] ;
fhir:use [ fhir:v "home" ] ;
fhir:rank [ fhir:v "1"^^xsd:positiveInteger ]
  ] [
fhir:system [ fhir:v "phone" ] ;
fhir:value [ fhir:v "1234561234" ] ;
fhir:use [ fhir:v "mobile" ] ;
fhir:rank [ fhir:v "2"^^xsd:positiveInteger ]
  ] [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "bobster83@example.com" ] ;
fhir:use [ fhir:v "home" ] ;
fhir:rank [ fhir:v "3"^^xsd:positiveInteger ]
  ] [
fhir:system [ fhir:v "phone" ] ;
fhir:value [ fhir:v "1231231234" ] ;
fhir:use [ fhir:v "home" ] ;
fhir:rank [ fhir:v "1"^^xsd:positiveInteger ]
  ] [
fhir:system [ fhir:v "phone" ] ;
fhir:value [ fhir:v "1234561234" ] ;
fhir:use [ fhir:v "mobile" ] ;
fhir:rank [ fhir:v "2"^^xsd:positiveInteger ]
  ] [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "bobster83@example.com" ] ;
fhir:use [ fhir:v "home" ] ;
fhir:rank [ fhir:v "3"^^xsd:positiveInteger ]
  ] ) ; # 
  fhir:gender [ fhir:v "male"], [ fhir:v "male"] ; # 
  fhir:birthDate [ fhir:v "1972-10-29"^^xsd:date], [ fhir:v "1972-10-29"^^xsd:date] ; # 
  fhir:address ( [
    ( fhir:line [ fhir:v "1234 Main St" ] ) ;
fhir:city [ fhir:v "San Francisco" ] ;
fhir:state [ fhir:v "CA" ] ;
fhir:postalCode [ fhir:v "94105" ] ;
fhir:country [ fhir:v "US" ]
  ] [
    ( fhir:line [ fhir:v "1234 Main St" ] ) ;
fhir:city [ fhir:v "San Francisco" ] ;
fhir:state [ fhir:v "CA" ] ;
fhir:postalCode [ fhir:v "94105" ] ;
fhir:country [ fhir:v "US" ]
  ] ) ; # 
  fhir:communication ( [
fhir:language [
      ( fhir:coding [
fhir:system [ fhir:v "urn:ietf:bcp:47"^^xsd:anyURI ] ;
fhir:code [ fhir:v "en" ] ;
fhir:display [ fhir:v "English" ]       ] )     ] ;
fhir:preferred [ fhir:v true ]
  ] [
fhir:language [
      ( fhir:coding [
fhir:system [ fhir:v "urn:ietf:bcp:47"^^xsd:anyURI ] ;
fhir:code [ fhir:v "en" ] ;
fhir:display [ fhir:v "English" ]       ] )     ] ;
fhir:preferred [ fhir:v true ]
  ] ) ; # 
  fhir:managingOrganization [
fhir:reference [ fhir:v "urn:uuid:cf3f3cea-f679-4e30-891b-457e4dd46468" ]
  ], [
fhir:reference [ fhir:v "urn:uuid:cf3f3cea-f679-4e30-891b-457e4dd46468" ]
  ] . # 

<urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1> a fhir:Practitioner, fhir:Practitioner ;
  fhir:id [ fhir:v "695d0991-5e03-46df-934a-85a28acd95c1"], [ fhir:v "695d0991-5e03-46df-934a-85a28acd95c1"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://fhir.developer.gene.com/StructureDefinition/uapi-practitioner"^^xsd:anyURI ;
fhir:link <https://fhir.developer.gene.com/StructureDefinition/uapi-practitioner>     ] )
  ], [
    ( fhir:profile [
fhir:v "https://fhir.developer.gene.com/StructureDefinition/uapi-practitioner"^^xsd:anyURI ;
fhir:link <https://fhir.developer.gene.com/StructureDefinition/uapi-practitioner>     ] )
  ] ; # 
  fhir:identifier ( [
fhir:use [ fhir:v "official" ] ;
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 "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1922071448" ] ;
fhir:assigner [
fhir:display [ fhir:v "Centers for Medicare & Medicaid Services" ]     ]
  ] [
fhir:use [ fhir:v "official" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "TAX" ] ;
fhir:display [ fhir:v "Tax ID number" ]       ] )     ] ;
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "00000000" ]
  ] [
fhir:use [ fhir:v "official" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "NPI" ] ;
fhir:display [ fhir:v "National provider identifier" ]       ] )     ] ;
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1639285034" ]
  ] [
fhir:use [ fhir:v "official" ] ;
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 "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1922071448" ] ;
fhir:assigner [
fhir:display [ fhir:v "Centers for Medicare & Medicaid Services" ]     ]
  ] [
fhir:use [ fhir:v "official" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "TAX" ] ;
fhir:display [ fhir:v "Tax ID number" ]       ] )     ] ;
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "00000000" ]
  ] [
fhir:use [ fhir:v "official" ] ;
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v2-0203"^^xsd:anyURI ] ;
fhir:code [ fhir:v "NPI" ] ;
fhir:display [ fhir:v "National provider identifier" ]       ] )     ] ;
fhir:system [ fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ] ;
fhir:value [ fhir:v "1639285034" ]
  ] ) ; # 
  fhir:name ( [
fhir:use [ fhir:v "official" ] ;
fhir:family [ fhir:v "CRUZ" ] ;
    ( fhir:given [ fhir:v "MARISSA" ] )
  ] [
fhir:use [ fhir:v "official" ] ;
fhir:family [ fhir:v "CRUZ" ] ;
    ( fhir:given [ fhir:v "MARISSA" ] )
  ] ) . # 

<urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545> a fhir:RelatedPerson, fhir:RelatedPerson ;
  fhir:id [ fhir:v "4db51d32-65c3-4f8c-959e-0155c6d14545"], [ fhir:v "4db51d32-65c3-4f8c-959e-0155c6d14545"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://fhir.developer.gene.com/StructureDefinition/uapi-relatedPerson"^^xsd:anyURI ;
fhir:link <https://fhir.developer.gene.com/StructureDefinition/uapi-relatedPerson>     ] )
  ], [
    ( fhir:profile [
fhir:v "https://fhir.developer.gene.com/StructureDefinition/uapi-relatedPerson"^^xsd:anyURI ;
fhir:link <https://fhir.developer.gene.com/StructureDefinition/uapi-relatedPerson>     ] )
  ] ; # 
  fhir:patient [
fhir:reference [ fhir:v "urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c" ] ;
fhir:type [ fhir:v "Patient"^^xsd:anyURI ]
  ], [
fhir:reference [ fhir:v "urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c" ] ;
fhir:type [ fhir:v "Patient"^^xsd:anyURI ]
  ] ; # 
  fhir:relationship ( [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-RoleCode"^^xsd:anyURI ] ;
fhir:code [ fhir:v "SIGOTHR" ] ;
fhir:display [ fhir:v "significant other" ]     ] )
  ] [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-RoleCode"^^xsd:anyURI ] ;
fhir:code [ fhir:v "SIGOTHR" ] ;
fhir:display [ fhir:v "significant other" ]     ] )
  ] ) ; # 
  fhir:name ( [
fhir:use [ fhir:v "official" ] ;
fhir:family [ fhir:v "Smith" ] ;
    ( fhir:given [ fhir:v "Bob Paul" ] )
  ] [
fhir:use [ fhir:v "official" ] ;
fhir:family [ fhir:v "Smith" ] ;
    ( fhir:given [ fhir:v "Bob Paul" ] )
  ] ) ; # 
  fhir:telecom ( [
fhir:system [ fhir:v "phone" ] ;
fhir:value [ fhir:v "1234567890" ] ;
fhir:use [ fhir:v "mobile" ]
  ] [
fhir:system [ fhir:v "phone" ] ;
fhir:value [ fhir:v "1234567890" ] ;
fhir:use [ fhir:v "mobile" ]
  ] ) ; # 
  fhir:birthDate [ fhir:v "1972-10-29"^^xsd:date], [ fhir:v "1972-10-29"^^xsd:date] . # 

<urn:uuid:5c2e19ac-8227-4de5-a893-069dec07448e> a fhir:Coverage, fhir:Coverage ;
  fhir:id [ fhir:v "b0574bf9-d016-4af7-a895-269abd739db3"], [ fhir:v "b0574bf9-d016-4af7-a895-269abd739db3"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://fhir.developer.gene.com/StructureDefinition/uapi-coverage"^^xsd:anyURI ;
fhir:link <https://fhir.developer.gene.com/StructureDefinition/uapi-coverage>     ] )
  ], [
    ( fhir:profile [
fhir:v "https://fhir.developer.gene.com/StructureDefinition/uapi-coverage"^^xsd:anyURI ;
fhir:link <https://fhir.developer.gene.com/StructureDefinition/uapi-coverage>     ] )
  ] ; # 
  fhir:extension ( [
fhir:url [ fhir:v "https://fhir.developer.gene.com/StructureDefinition/IssuedDate"^^xsd:anyURI ] ;
fhir:value [
a fhir:date ;
fhir:v "2023-02-26"^^xsd:date     ]
  ] [
fhir:url [ fhir:v "https://fhir.developer.gene.com/StructureDefinition/IssuedDate"^^xsd:anyURI ] ;
fhir:value [
a fhir:date ;
fhir:v "2023-02-26"^^xsd:date     ]
  ] ) ; # 
  fhir:status [ fhir:v "active"], [ fhir:v "active"] ; # 
  fhir:type [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:code [ fhir:v "pay" ] ;
fhir:display [ fhir:v "Pay" ]     ] )
  ], [
    ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ] ;
fhir:code [ fhir:v "pay" ] ;
fhir:display [ fhir:v "Pay" ]     ] )
  ] ; # 
  fhir:subscriber [
fhir:reference [ fhir:v "urn:uuid:3fd08ef2-34a2-4191-ad04-44353c2f133a" ] ;
fhir:type [ fhir:v "Patient"^^xsd:anyURI ]
  ], [
fhir:reference [ fhir:v "urn:uuid:3fd08ef2-34a2-4191-ad04-44353c2f133a" ] ;
fhir:type [ fhir:v "Patient"^^xsd:anyURI ]
  ] ; # 
  fhir:subscriberId [ fhir:v "EYE00044137"], [ fhir:v "EYE00044137"] ; # 
  fhir:beneficiary [
fhir:reference [ fhir:v "urn:uuid:3fd08ef2-34a2-4191-ad04-44353c2f133a" ] ;
fhir:type [ fhir:v "Patient"^^xsd:anyURI ]
  ], [
fhir:reference [ fhir:v "urn:uuid:3fd08ef2-34a2-4191-ad04-44353c2f133a" ] ;
fhir:type [ fhir:v "Patient"^^xsd:anyURI ]
  ] ; # 
  fhir:period [
fhir:start [ fhir:v "2023-02-08"^^xsd:date ] ;
fhir:end [ fhir:v "2199-12-31"^^xsd:date ]
  ], [
fhir:start [ fhir:v "2023-02-08"^^xsd:date ] ;
fhir:end [ fhir:v "2199-12-31"^^xsd:date ]
  ] ; # 
  fhir:payor ( [
fhir:reference [ fhir:v "urn:uuid:d02db104-a75c-433f-8764-9778c2e20626" ] ;
fhir:type [ fhir:v "Organization"^^xsd:anyURI ]
  ] [
fhir:reference [ fhir:v "urn:uuid:d02db104-a75c-433f-8764-9778c2e20626" ] ;
fhir:type [ fhir:v "Organization"^^xsd:anyURI ]
  ] ) ; # 
  fhir:class ( [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "rxbin" ] ;
fhir:display [ fhir:v "RX BIN" ]       ] )     ] ;
fhir:value [ fhir:v "600426" ] ;
fhir:name [ fhir:v "BIN" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "rxpcn" ] ;
fhir:display [ fhir:v "RX PCN" ]       ] )     ] ;
fhir:value [ fhir:v "54" ] ;
fhir:name [ fhir:v "PCN" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "group" ] ;
fhir:display [ fhir:v "Group" ]       ] )     ] ;
fhir:value [ fhir:v "EC38532005" ] ;
fhir:name [ fhir:v "Group Number" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "plan" ] ;
fhir:display [ fhir:v "Plan" ]       ] )     ] ;
fhir:value [ fhir:v "Xolair-Admin" ] ;
fhir:name [ fhir:v "Xolair Co Pay program" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "rxbin" ] ;
fhir:display [ fhir:v "RX BIN" ]       ] )     ] ;
fhir:value [ fhir:v "600426" ] ;
fhir:name [ fhir:v "BIN" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "rxpcn" ] ;
fhir:display [ fhir:v "RX PCN" ]       ] )     ] ;
fhir:value [ fhir:v "54" ] ;
fhir:name [ fhir:v "PCN" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "group" ] ;
fhir:display [ fhir:v "Group" ]       ] )     ] ;
fhir:value [ fhir:v "EC38532005" ] ;
fhir:name [ fhir:v "Group Number" ]
  ] [
fhir:type [
      ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/coverage-class"^^xsd:anyURI ] ;
fhir:code [ fhir:v "plan" ] ;
fhir:display [ fhir:v "Plan" ]       ] )     ] ;
fhir:value [ fhir:v "Xolair-Admin" ] ;
fhir:name [ fhir:v "Xolair Co Pay program" ]
  ] ) ; # 
  fhir:order [ fhir:v "1"^^xsd:positiveInteger], [ fhir:v "1"^^xsd:positiveInteger] ; # 
  fhir:network [ fhir:v "Genentech"], [ fhir:v "Genentech"] . # 

<urn:uuid:45597178-f243-419e-8af3-462359f89e91> a fhir:Bundle ;
  fhir:id [ fhir:v "uapi-bundle-copay-claim-2"] ; # 
  fhir:identifier [
fhir:use [ fhir:v "usual" ] ;
fhir:system [ fhir:v "http://risrx.com/claimid"^^xsd:anyURI ] ;
fhir:value [ fhir:v "953f66c2-383c-4d8b-a306-2938b1b92f6b" ]
  ] ; # 
  fhir:type [ fhir:v "collection"] ; # 
  fhir:timestamp [ fhir:v "2024-06-07T08:10:17-05:00"^^xsd:dateTime] ; # 
  fhir:entry ( [
fhir:fullUrl [ fhir:v "urn:uuid:61b950a7-e518-4f69-b8dd-a1729c8f4bd5"^^xsd:anyURI ] ;
    ( fhir:resource <urn:uuid:61b950a7-e518-4f69-b8dd-a1729c8f4bd5> )
  ] [
fhir:fullUrl [ fhir:v "urn:uuid:3fd08ef2-34a2-4191-ad04-44353c2f133a"^^xsd:anyURI ] ;
    ( fhir:resource <urn:uuid:3fd08ef2-34a2-4191-ad04-44353c2f133a> )
  ] [
fhir:fullUrl [ fhir:v "urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"^^xsd:anyURI ] ;
    ( fhir:resource <urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1> )
  ] [
fhir:fullUrl [ fhir:v "urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545"^^xsd:anyURI ] ;
    ( fhir:resource <urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545> )
  ] [
fhir:fullUrl [ fhir:v "urn:uuid:5c2e19ac-8227-4de5-a893-069dec07448e"^^xsd:anyURI ] ;
    ( fhir:resource <urn:uuid:5c2e19ac-8227-4de5-a893-069dec07448e> )
  ] ) . #