FHIR IG analytics| Package | tw.gov.mohw.nhi.pas |
| Resource Type | Claim |
| Id | Claim-cla-3.json |
| FHIR Version | R4 |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Profile: 癌藥事前審查-Claim TWPAS
狀態：Active
類型：Institutional (ClaimTypeCodes#institutional)
就醫科別：Encounter/enc-min "胸腔暨重症加護"
原受理編號：202405301000002
申報類別：申復 (NHI-申報類別值集#3)
目的：Preauthorization
病人：Patient/pat-min "王大明"
申請日期：2024-05-30
申請醫師：Practitioner/pra-min
醫事機構代碼：Organization/org-hosp-example
申請案件類別：一般事前審查申請 (NHI-申請案件類別值集#1)
supportingInfo
sequence：1
category：病人體重
value：59.65 kg (Details: UCUM codekg = 'kg')
supportingInfo
sequence：2
category：病人身高
value：170 cm (Details: UCUM codecm = 'cm')
supportingInfo
sequence：3
category：是否懷孕或哺乳
value：false
supportingInfo
sequence：4
category：影像報告
supportingInfo
sequence：5
category：癌症分期量表
supportingInfo
sequence：6
category：檢查報告
supportingInfo
sequence：7
category：基因資訊
supportingInfo
sequence：8
category：檢驗(查)
value：Observation/obs-lab-min
supportingInfo
sequence：9
category：病人狀態評估
value：Observation/obs-pat-nyha
supportingInfo
sequence：10
category：用藥品項
supportingInfo
sequence：11
category：放射/照光治療
value：Procedure/pro-min
supportingInfo
sequence：12
category：治療計畫文件
supportingInfo
sequence：13
category：病歷資料
supportingInfo
sequence：14
category：結果資訊
value：Observation/obs-tx-min
診斷日期：2024-01-01
國際疾病分類代碼：慢性右心臟衰竭 (臺灣健保署2023年中文版ICD-10-CM值集#I50.812)
共病：第一型糖尿病，伴有糖尿病的神經病變 (臺灣健保署2023年中文版ICD-10-CM值集#E10.40)
簡要病摘：Adenocarcinoma, descending colon, cT3N2M1a, cStage IVA, KRAS G12V, with multiple liver metastases, status post FOLFIRI
手術(或其他處置)日期：2024-01-01
手術(或其他處置)項目：經由自體開口或人工造口心包腔近接放射性同位素抗腫瘤液態藥劑輸入 (臺灣健保署2023年中文版ICD-10-PCS值集#3E0Y704)
sequence：1
coverage：Coverage/cov-min
事前審查品項：MedicationRequest/medReq-apply-2
事前審查申請數量(單位)：70 (tablets (Common UCUM units#{tbl}))
醫令類別：藥品 (NHI-健保事前審查-醫令類別值集#1)
續用註記：初次使用 (NHI-續用註記值集#1)
用藥線別：第一線治療 (NHI-用藥線別值集#1)
給付適應症：C50P1 (NHI-給付適應症值集#C50P1)
FHIR
FHIRsmith{
"resourceType": "Claim",
"id": "cla-3",
"meta": {
"profile": [
"https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-twpas"
]
},
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"url": "https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-claim-encounter",
"valueReference": {
"reference": "Encounter/enc-min"
}
}
],
"identifier": [
{
"value": "202405301000002"
}
],
"status": "active",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "institutional"
}
]
},
"subType": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-apply-type",
"code": "3",
"display": "申復"
}
]
},
"use": "preauthorization",
"patient": {
"reference": "Patient/pat-min"
},
"created": "2024-05-30",
"enterer": {
"reference": "Practitioner/pra-min"
},
"provider": {
"reference": "Organization/org-hosp-example"
},
"priority": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-tmhb-type",
"code": "1",
"display": "一般事前審查申請"
}
]
},
"supportingInfo": [
{
"sequence": 1,
"category": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type",
"code": "weight"
}
]
},
"valueQuantity": {
"value": 59.65,
"system": "http://unitsofmeasure.org",
"code": "kg"
}
},
{
"sequence": 2,
"category": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type",
"code": "height"
}
]
},
"valueQuantity": {
"value": 170,
"system": "http://unitsofmeasure.org",
"code": "cm"
}
},
{
"sequence": 3,
"category": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type",
"code": "pregnancyBreastfeedingStatus"
}
]
},
"valueBoolean": false
},
{
"sequence": 4,
"category": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type",
"code": "imagingReport"
}
]
},
"valueReference": {
"reference": "DiagnosticReport/diaRep-ima-min"
}
},
{
"sequence": 5,
"category": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type",
"code": "cancerStage"
}
]
},
"valueReference": {
"reference": "Observation/obs-cancer-figo"
}
},
{
"sequence": 6,
"category": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type",
"code": "examinationReport"
}
]
},
"valueReference": {
"reference": "DiagnosticReport/diaRep-min"
}
},
{
"sequence": 7,
"category": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type",
"code": "geneInfo"
}
]
},
"valueReference": {
"reference": "Observation/obs-diagnostic-min"
}
},
{
"sequence": 8,
"category": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type",
"code": "tests"
}
]
},
"valueReference": {
"reference": "Observation/obs-lab-min"
}
},
{
"sequence": 9,
"category": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type",
"code": "patientAssessment"
}
]
},
"valueReference": {
"reference": "Observation/obs-pat-nyha"
}
},
{
"sequence": 10,
"category": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type",
"code": "medicationRequest"
}
]
},
"valueReference": {
"reference": "MedicationRequest/medReq-treat"
}
},
{
"sequence": 11,
"category": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type",
"code": "radiotherapy"
}
]
},
"valueReference": {
"reference": "Procedure/pro-min"
}
},
{
"sequence": 12,
"category": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type",
"code": "carePlanDocument"
}
]
},
"valueReference": {
"reference": "DocumentReference/doc-careplan-min"
}
},
{
"sequence": 13,
"category": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type",
"code": "medicalRecord"
}
]
},
"valueReference": {
"reference": "DocumentReference/doc-medicalRecord-min"
}
},
{
"sequence": 14,
"category": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type",
"code": "treatmentAssessment"
}
]
},
"valueReference": {
"reference": "Observation/obs-tx-min"
}
}
],
"diagnosis": [
{
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate",
"valueDate": "2024-01-01"
}
],
"sequence": 1,
"diagnosisCodeableConcept": {
"coding": [
{
"system": "https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw",
"code": "I50.812"
}
]
},
"type": [
{
"text": "Adenocarcinoma, descending colon, cT3N2M1a, cStage IVA, KRAS G12V, with multiple liver metastases, status post FOLFIRI"
}
]
},
{
"sequence": 2,
"diagnosisCodeableConcept": {
"coding": [
{
"system": "https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw",
"code": "E10.40"
}
]
}
}
],
"procedure": [
{
"sequence": 1,
"date": "2024-01-01",
"procedureCodeableConcept": {
"coding": [
{
"system": "https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2023-tw",
"code": "3E0Y704"
}
]
}
}
],
"insurance": [
{
"sequence": 1,
"focal": true,
"coverage": {
"reference": "Coverage/cov-min"
}
}
],
"item": [
{
"extension": [
{
"url": "https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-requestedService",
"valueReference": {
"reference": "MedicationRequest/medReq-apply-2"
}
}
],
"sequence": 1,
"productOrService": {
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-order-type",
"code": "1",
"display": "藥品"
}
]
},
"modifier": [
{
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status",
"code": "1",
"display": "初次使用"
}
]
},
{
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-line-of-therapy",
"code": "1",
"display": "第一線治療"
}
]
}
],
"programCode": [
{
"coding": [
{
"system": "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-apply-reason",
"code": "C50P1"
}
]
}
],
"quantity": {
"value": 70,
"system": "http://unitsofmeasure.org",
"code": "{tbl}"
}
}
]
}