bundle-chargeback-submitted - TTL Representation - 340B FHIR Exchange Implementation Guide v0.1.0-ballot

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: bundle-chargeback-submitted - 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 "bundle-chargeback-submitted"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-message-bundle"^^xsd:anyURI ;
fhir:l <https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-message-bundle>     ] )
  ] ; # 
  fhir:identifier [
fhir:system [
fhir:v "https://exchange.example.org/bundle-ids"^^xsd:anyURI ;
fhir:l <https://exchange.example.org/bundle-ids>     ] ;
fhir:value [ fhir:v "bundle-sub-1001" ]
  ] ; # 
  fhir:type [ fhir:v "message"] ; # 
  fhir:timestamp [ fhir:v "2026-04-24T15:00:00Z"^^xsd:dateTime] ; # 
  fhir:entry ( [
fhir:fullUrl [
fhir:v "urn:uuid:11111111-1111-4111-8111-111111111111"^^xsd:anyURI ;
fhir:l <urn:uuid:11111111-1111-4111-8111-111111111111>     ] ;
    ( fhir:resource <urn:uuid:11111111-1111-4111-8111-111111111111> )
  ] [
fhir:fullUrl [
fhir:v "urn:uuid:22222222-2222-4222-8222-222222222222"^^xsd:anyURI ;
fhir:l <urn:uuid:22222222-2222-4222-8222-222222222222>     ] ;
    ( fhir:resource <urn:uuid:22222222-2222-4222-8222-222222222222> )
  ] [
fhir:fullUrl [
fhir:v "urn:uuid:33333333-3333-4333-8333-333333333333"^^xsd:anyURI ;
fhir:l <urn:uuid:33333333-3333-4333-8333-333333333333>     ] ;
    ( fhir:resource <urn:uuid:33333333-3333-4333-8333-333333333333> )
  ] [
fhir:fullUrl [
fhir:v "urn:uuid:44444444-4444-4444-8444-444444444444"^^xsd:anyURI ;
fhir:l <urn:uuid:44444444-4444-4444-8444-444444444444>     ] ;
    ( fhir:resource <urn:uuid:44444444-4444-4444-8444-444444444444> )
  ] [
fhir:fullUrl [
fhir:v "urn:uuid:55555555-5555-4555-8555-555555555555"^^xsd:anyURI ;
fhir:l <urn:uuid:55555555-5555-4555-8555-555555555555>     ] ;
    ( fhir:resource <urn:uuid:55555555-5555-4555-8555-555555555555> )
  ] [
fhir:fullUrl [
fhir:v "urn:uuid:66666666-6666-4666-8666-666666666666"^^xsd:anyURI ;
fhir:l <urn:uuid:66666666-6666-4666-8666-666666666666>     ] ;
    ( fhir:resource <urn:uuid:66666666-6666-4666-8666-666666666666> )
  ] ) . # 

<urn:uuid:11111111-1111-4111-8111-111111111111> a fhir:MessageHeader ;
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader </b></p><p><b>event</b>: events: 340b.chargeback.submitted (340b.chargeback.submitted)</p><h3>Sources</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Endpoint</b></td></tr><tr><td style=\"display: none\">*</td><td>urn:system:tpa-01</td></tr></table><p><b>focus</b>: <a href=\"Bundle-bundle-chargeback-submitted.html#urn-uuid-22222222-2222-4222-8222-222222222222\">Claim: extension = tx-1001,corr-9001,1.2.0,https://exchange.example.org/chargeback#cb-1001; status = active; type = Pharmacy; use = claim; created = 2026-04-24; priority = Normal</a></p></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:event [
a fhir:Coding ;
fhir:system [
fhir:v "https://exchange.example.org/events"^^xsd:anyURI ;
fhir:l <https://exchange.example.org/events>     ] ;
fhir:code [ fhir:v "340b.chargeback.submitted" ]
  ] ; # 
  fhir:source [
fhir:endpoint [
fhir:v "urn:system:tpa-01"^^xsd:anyURI ;
fhir:l <urn:system:tpa-01>     ]
  ] ; # 
  fhir:focus ( [
fhir:l <urn:uuid:22222222-2222-4222-8222-222222222222> ;
fhir:reference [ fhir:v "urn:uuid:22222222-2222-4222-8222-222222222222" ]
  ] ) . # 

<urn:uuid:22222222-2222-4222-8222-222222222222> a fhir:Claim ;
  fhir:id [ fhir:v "claim-340b-1001"] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_claim-340b-1001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim claim-340b-1001</b></p><a name=\"claim-340b-1001\"> </a><a name=\"hcclaim-340b-1001\"> </a><p><b>340B Exchange Transaction ID Extension</b>: tx-1001</p><p><b>340B Correlation ID Extension</b>: corr-9001</p><p><b>340B Rule Set Version Extension</b>: 1.2.0</p><p><b>340B Chargeback Reference Extension</b>: <code>https://exchange.example.org/chargeback</code>/cb-1001</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type pharmacy}\">Pharmacy</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: <a href=\"Bundle-bundle-chargeback-adjudicated.html#urn-uuid-33333333-3333-4333-8333-333333333333\">Pat Example  (no stated gender), DoB Unknown</a></p><p><b>created</b>: 2026-04-24</p><p><b>insurer</b>: <a href=\"Bundle-bundle-chargeback-adjudicated.html#urn-uuid-55555555-5555-4555-8555-555555555555\">Organization Example Manufacturer 77</a></p><p><b>provider</b>: <a href=\"Bundle-bundle-chargeback-submitted.html#urn-uuid-44444444-4444-4444-8444-444444444444\">Organization Example Pharmacy 22</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><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=\"Bundle-bundle-chargeback-submitted.html#urn-uuid-66666666-6666-4666-8666-666666666666\">Coverage: status = active</a></td></tr></table><h3>Items</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>ProductOrService</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://example.org/drug-codes 00000-1111-22}\">00000-1111-22</span></td></tr></table></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:extension ( [
fhir:url [
fhir:v "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-exchange-transaction-id"^^xsd:anyURI ;
fhir:l <https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-exchange-transaction-id>     ] ;
fhir:value [
a fhir:String ;
fhir:v "tx-1001"     ]
  ] [
fhir:url [
fhir:v "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-correlation-id"^^xsd:anyURI ;
fhir:l <https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-correlation-id>     ] ;
fhir:value [
a fhir:String ;
fhir:v "corr-9001"     ]
  ] [
fhir:url [
fhir:v "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-rule-set-version"^^xsd:anyURI ;
fhir:l <https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-rule-set-version>     ] ;
fhir:value [
a fhir:String ;
fhir:v "1.2.0"     ]
  ] [
fhir:url [
fhir:v "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-chargeback-reference"^^xsd:anyURI ;
fhir:l <https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-chargeback-reference>     ] ;
fhir:value [
a fhir:Identifier ;
fhir:system [
fhir:v "https://exchange.example.org/chargeback"^^xsd:anyURI ;
fhir:l <https://exchange.example.org/chargeback>       ] ;
fhir:value [ fhir:v "cb-1001" ]     ]
  ] ) ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:type [
    ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/claim-type>       ] ;
fhir:code [ fhir:v "pharmacy" ]     ] )
  ] ; # 
  fhir:use [ fhir:v "claim"] ; # 
  fhir:patient [
fhir:l <urn:uuid:33333333-3333-4333-8333-333333333333> ;
fhir:reference [ fhir:v "urn:uuid:33333333-3333-4333-8333-333333333333" ]
  ] ; # 
  fhir:created [ fhir:v "2026-04-24"^^xsd:date] ; # 
  fhir:insurer [
fhir:l <urn:uuid:55555555-5555-4555-8555-555555555555> ;
fhir:reference [ fhir:v "urn:uuid:55555555-5555-4555-8555-555555555555" ]
  ] ; # 
  fhir:provider [
fhir:l <urn:uuid:44444444-4444-4444-8444-444444444444> ;
fhir:reference [ fhir:v "urn:uuid:44444444-4444-4444-8444-444444444444" ]
  ] ; # 
  fhir:priority [
    ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/processpriority"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/processpriority>       ] ;
fhir:code [ fhir:v "normal" ]     ] )
  ] ; # 
  fhir:insurance ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:focal [ fhir:v true ] ;
fhir:coverage [
fhir:l <urn:uuid:66666666-6666-4666-8666-666666666666> ;
fhir:reference [ fhir:v "urn:uuid:66666666-6666-4666-8666-666666666666" ]     ]
  ] ) ; # 
  fhir:item ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:productOrService [
      ( fhir:coding [
fhir:system [
fhir:v "http://example.org/drug-codes"^^xsd:anyURI ;
fhir:l <http://example.org/drug-codes>         ] ;
fhir:code [ fhir:v "00000-1111-22" ]       ] )     ]
  ] ) . # 

<urn:uuid:33333333-3333-4333-8333-333333333333> a fhir:Patient ;
  fhir:id [ fhir:v "p-001"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_p-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient p-001</b></p><a name=\"p-001\"> </a><a name=\"hcp-001\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Pat Example  (no stated gender), DoB Unknown</p><hr/></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:name ( [
fhir:family [ fhir:v "Example" ] ;
    ( fhir:given [ fhir:v "Pat" ] )
  ] ) . # 

<urn:uuid:44444444-4444-4444-8444-444444444444> a fhir:Organization ;
  fhir:id [ fhir:v "pharmacy-22"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_pharmacy-22\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization pharmacy-22</b></p><a name=\"pharmacy-22\"> </a><a name=\"hcpharmacy-22\"> </a><p><b>name</b>: Example Pharmacy 22</p></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:name [ fhir:v "Example Pharmacy 22"] . # 

<urn:uuid:55555555-5555-4555-8555-555555555555> a fhir:Organization ;
  fhir:id [ fhir:v "manufacturer-77"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_manufacturer-77\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization manufacturer-77</b></p><a name=\"manufacturer-77\"> </a><a name=\"hcmanufacturer-77\"> </a><p><b>name</b>: Example Manufacturer 77</p></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:name [ fhir:v "Example Manufacturer 77"] . # 

<urn:uuid:66666666-6666-4666-8666-666666666666> a fhir:Coverage ;
  fhir:id [ fhir:v "cov-001"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_cov-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage cov-001</b></p><a name=\"cov-001\"> </a><a name=\"hccov-001\"> </a><p><b>status</b>: Active</p><p><b>beneficiary</b>: <a href=\"Bundle-bundle-chargeback-adjudicated.html#urn-uuid-33333333-3333-4333-8333-333333333333\">Pat Example  (no stated gender), DoB Unknown</a></p><p><b>payor</b>: <a href=\"Bundle-bundle-chargeback-adjudicated.html#urn-uuid-55555555-5555-4555-8555-555555555555\">Organization Example Manufacturer 77</a></p></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:beneficiary [
fhir:l <urn:uuid:33333333-3333-4333-8333-333333333333> ;
fhir:reference [ fhir:v "urn:uuid:33333333-3333-4333-8333-333333333333" ]
  ] ; # 
  fhir:payor ( [
fhir:l <urn:uuid:55555555-5555-4555-8555-555555555555> ;
fhir:reference [ fhir:v "urn:uuid:55555555-5555-4555-8555-555555555555" ]
  ] ) . #