340B FHIR Exchange Implementation Guide
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: claimresponse-example-ruleset - 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:ClaimResponse ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "claimresponse-example-ruleset"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-claim-response"^^xsd:anyURI ;
fhir:l <https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-claim-response>     ] )
  ] ; # 
  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: ClaimResponse claimresponse-example-ruleset</b></p><a name=\"claimresponse-example-ruleset\"> </a><a name=\"hcclaimresponse-example-ruleset\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-340b-claim-response.html\">340B Claim Response Profile</a></p></div><p><b>340B Correlation ID Extension</b>: corr-cb-7721</p><p><b>340B Exchange Transaction ID Extension</b>: tx-cb-7721</p><p><b>340B Rule Set Version Extension</b>: 1.2.0</p><p><b>340B Manufacturer ID Extension</b>: <code>https://exchange.example.org/manufacturers</code>/mfr-77</p><p><b>identifier</b>: <code>https://exchange.example.org/claimresponse-ids</code>/cr-7721</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>request</b>: <a href=\"Claim-claim-chargeback-001.html\">Claim: extension = corr-cb-7721,tx-cb-7721,1.2.0,https://exchange.example.org/chargeback#cb-7721; identifier = https://exchange.example.org/claim-ids#claim-7721; status = active; type = Pharmacy; use = claim; created = 2026-04-24; priority = Normal</a></p><p><b>outcome</b>: Processing Complete</p></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-cb-7721"     ]
  ] [
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-cb-7721"     ]
  ] [
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-manufacturer-id"^^xsd:anyURI ;
fhir:l <https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-manufacturer-id>     ] ;
fhir:value [
a fhir:Identifier ;
fhir:system [
fhir:v "https://exchange.example.org/manufacturers"^^xsd:anyURI ;
fhir:l <https://exchange.example.org/manufacturers>       ] ;
fhir:value [ fhir:v "mfr-77" ]     ]
  ] ) ; # 
  fhir:identifier ( [
fhir:system [
fhir:v "https://exchange.example.org/claimresponse-ids"^^xsd:anyURI ;
fhir:l <https://exchange.example.org/claimresponse-ids>     ] ;
fhir:value [ fhir:v "cr-7721" ]
  ] ) ; # 
  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:request [
fhir:l fhir:Claim/claim-chargeback-001 ;
fhir:reference [ fhir:v "Claim/claim-chargeback-001" ]
  ] ; # 
  fhir:outcome [ fhir:v "complete"] . #