340B FHIR Exchange Implementation Guide
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: claim-example-correlation - 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:Claim ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "claim-example-correlation"] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Claim claim-example-correlation</b></p><a name=\"claim-example-correlation\"> </a><a name=\"hcclaim-example-correlation\"> </a><p><b>340B Correlation ID Extension</b>: corr-a13d8e2</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=\"Patient-p-001.html\">Pat Example  (no stated gender), DoB Unknown</a></p><p><b>created</b>: 2026-04-24</p><p><b>insurer</b>: <a href=\"Organization-manufacturer-77.html\">Organization Example Manufacturer 77</a></p><p><b>provider</b>: <a href=\"Organization-pharmacy-22.html\">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=\"Coverage-cov-001.html\">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-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-a13d8e2"     ]
  ] ) ; # 
  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 fhir:Patient/p-001 ;
fhir:reference [ fhir:v "Patient/p-001" ]
  ] ; # 
  fhir:created [ fhir:v "2026-04-24"^^xsd:date] ; # 
  fhir:insurer [
fhir:l fhir:Organization/manufacturer-77 ;
fhir:reference [ fhir:v "Organization/manufacturer-77" ]
  ] ; # 
  fhir:provider [
fhir:l fhir:Organization/pharmacy-22 ;
fhir:reference [ fhir:v "Organization/pharmacy-22" ]
  ] ; # 
  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 fhir:Coverage/cov-001 ;
fhir:reference [ fhir:v "Coverage/cov-001" ]     ]
  ] ) ; # 
  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" ]       ] )     ]
  ] ) . #