FHIR IG analytics| Package | tw.iii.ltc |
| Resource Type | Bundle |
| Id | Bundle-ltc-bundle-feeapply-da01-example.json |
| FHIR Version | R4 |
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FHIR
FHIRsmith{
"resourceType": "Bundle",
"id": "ltc-bundle-feeapply-da01-example",
"meta": {
"profile": [
"http://ltc-ig.fhir.tw/StructureDefinition/LTCBundleFeeApply"
]
},
"identifier": {
"system": "http://ltc-ig.fhir.tw/identifier/feeaudit/trans-no",
"value": "A0001"
},
"type": "collection",
"timestamp": "2019-02-05T10:00:00+08:00",
"entry": [
{
"fullUrl": "http://example.org/Claim/ltc-claim-feeapply-da01-example",
"resource": {
"resourceType": "Claim",
"id": "ltc-claim-feeapply-da01-example",
"meta": {
"profile": [
"http://ltc-ig.fhir.tw/StructureDefinition/LTCClaimFeeApply"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_ltc-claim-feeapply-da01-example\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim ltc-claim-feeapply-da01-example</b></p><a name=\"ltc-claim-feeapply-da01-example\"> </a><a name=\"hcltc-claim-feeapply-da01-example\"> </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-LTCClaimFeeApply.html\">長照支付審查－個案服務紀錄申報</a></p></div><p><b>identifier</b>: <code>http://ltc-ig.fhir.tw/identifier/feeaudit/objid</code>/00000000000000000006, <code>http://ltc-ig.fhir.tw/identifier/feeaudit/trans-no</code>/A0001, <code>http://ltc-ig.fhir.tw/identifier/feeaudit/yyyymm</code>/201901</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type professional}\">Professional</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: <a href=\"Patient-ltc-patient-sdk-example.html\">王小明 Male, DoB: 1950-01-01 ( Provider number (use: official, ))</a></p><p><b>created</b>: 2019-02-05 10:00:00+0800</p><p><b>provider</b>: <a href=\"Organization-ltc-organization-sdk-example.html\">Organization OOO長期照顧管理中心</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><h3>CareTeams</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><a href=\"Practitioner-ltc-practitioner-sdk-example.html\">Practitioner 李小華</a></td></tr></table><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 1</p><p><b>category</b>: <span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info addrFrom}\">出發地</span></p><p><b>value</b>: <a href=\"Location-ltc-location-feeapply-home-example.html\">Location 個案住家</a></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 2</p><p><b>category</b>: <span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info addrTo}\">目的地</span></p><p><b>value</b>: <a href=\"Location-ltc-location-feeapply-hospital-example.html\">Location 亞東醫院</a></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 3</p><p><b>category</b>: <span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info carNo}\">車號</span></p><p><b>value</b>: 1111-AA</p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 4</p><p><b>category</b>: <span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info driver}\">駕駛員</span></p><p><b>value</b>: 黃OO</p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 5</p><p><b>category</b>: <span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info milage}\">里程數</span></p><p><b>value</b>: 12 公里<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM codekm = 'km')</span></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 6</p><p><b>category</b>: <span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info lastSvc}\">臨終日照顧</span></p><p><b>value</b>: false</p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 7</p><p><b>category</b>: <span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info missedVisit}\">訪視/服務未遇</span></p><p><b>value</b>: false</p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 8</p><p><b>category</b>: <span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info applyAA09}\">是否申報AA09</span></p><p><b>value</b>: false</p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 9</p><p><b>category</b>: <span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info aa10Status}\">AA10申報狀態</span></p><p><b>code</b>: <span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-aa10-status 0}\">未申報</span></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 10</p><p><b>category</b>: <span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info remark}\">備註</span></p><p><b>value</b>: 1</p></blockquote><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>長期照顧給付及支付基準</td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>category</b>: <span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-fee-type 1}\">補助</span></p><p><b>productOrService</b>: <span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-service-item DA01}\">交通接送</span></p><p><b>serviced</b>: 2019-01-05 13:30:00+0800 --> 2019-01-05 14:00:00+0800</p><p><b>location</b>: <a href=\"Location-ltc-location-feeapply-hospital-example.html\">Location 亞東醫院</a></p><p><b>quantity</b>: 1</p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>430</td><td>New Taiwan dollar</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>430</td><td>New Taiwan dollar</td></tr></table></blockquote><h3>Totals</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>430</td><td>New Taiwan dollar</td></tr></table></div>"
},
"identifier": [
{
"system": "http://ltc-ig.fhir.tw/identifier/feeaudit/objid",
"value": "00000000000000000006"
},
{
"system": "http://ltc-ig.fhir.tw/identifier/feeaudit/trans-no",
"value": "A0001"
},
{
"system": "http://ltc-ig.fhir.tw/identifier/feeaudit/yyyymm",
"value": "201901"
}
],
"status": "active",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "professional"
}
]
},
"use": "claim",
"patient": {
"reference": "Patient/ltc-patient-sdk-example"
},
"created": "2019-02-05T10:00:00+08:00",
"provider": {
"reference": "Organization/ltc-organization-sdk-example"
},
"priority": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal"
}
]
},
"careTeam": [
{
"sequence": 1,
"provider": {
"reference": "Practitioner/ltc-practitioner-sdk-example"
}
}
],
"supportingInfo": [
{
"sequence": 1,
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info",
"code": "addrFrom"
}
]
},
"valueReference": {
"reference": "Location/ltc-location-feeapply-home-example"
}
},
{
"sequence": 2,
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info",
"code": "addrTo"
}
]
},
"valueReference": {
"reference": "Location/ltc-location-feeapply-hospital-example"
}
},
{
"sequence": 3,
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info",
"code": "carNo"
}
]
},
"valueString": "1111-AA"
},
{
"sequence": 4,
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info",
"code": "driver"
}
]
},
"valueString": "黃OO"
},
{
"sequence": 5,
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info",
"code": "milage"
}
]
},
"valueQuantity": {
"value": 12,
"unit": "公里",
"system": "http://unitsofmeasure.org",
"code": "km"
}
},
{
"sequence": 6,
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info",
"code": "lastSvc"
}
]
},
"valueBoolean": false
},
{
"sequence": 7,
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info",
"code": "missedVisit"
}
]
},
"valueBoolean": false
},
{
"sequence": 8,
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info",
"code": "applyAA09"
}
]
},
"valueBoolean": false
},
{
"sequence": 9,
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info",
"code": "aa10Status"
}
]
},
"code": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-aa10-status",
"code": "0",
"display": "未申報"
}
]
}
},
{
"sequence": 10,
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info",
"code": "remark"
}
]
},
"valueString": "1"
}
],
"insurance": [
{
"sequence": 1,
"focal": true,
"coverage": {
"display": "長期照顧給付及支付基準"
}
}
],
"item": [
{
"sequence": 1,
"category": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-fee-type",
"code": "1",
"display": "補助"
}
]
},
"productOrService": {
"coding": [
{
"system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-service-item",
"code": "DA01",
"display": "交通接送"
}
]
},
"servicedPeriod": {
"start": "2019-01-05T13:30:00+08:00",
"end": "2019-01-05T14:00:00+08:00"
},
"locationReference": {
"reference": "Location/ltc-location-feeapply-hospital-example"
},
"quantity": {
"value": 1
},
"unitPrice": {
"value": 430,
"currency": "TWD"
},
"net": {
"value": 430,
"currency": "TWD"
}
}
],
"total": {
"value": 430,
"currency": "TWD"
}
}
},
{
"fullUrl": "http://example.org/Patient/ltc-patient-sdk-example",
"resource": {
"resourceType": "Patient",
"id": "ltc-patient-sdk-example",
"meta": {
"profile": [
"http://ltc-ig.fhir.tw/StructureDefinition/LTCPatient"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_ltc-patient-sdk-example\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient ltc-patient-sdk-example</b></p><a name=\"ltc-patient-sdk-example\"> </a><a name=\"hcltc-patient-sdk-example\"> </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-LTCPatient.html\">長期照顧－住民基本資料</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">王小明 Male, DoB: 1950-01-01 ( Provider number (use: official, ))</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\"><ul><li>ph: 0912345678</li><li>台北市中山區中山北路100號(home)</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Nominated Contact: Next-of-Kin\">Next-of-Kin:</td><td colspan=\"3\"><ul><li>王大明</li><li>ph: 0987654321</li></ul></td></tr></table></div>"
},
"identifier": [
{
"use": "official",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "PRN"
}
]
},
"system": "https://example.org/mrn",
"value": "A0001"
}
],
"name": [
{
"use": "usual",
"text": "王小明"
}
],
"telecom": [
{
"system": "phone",
"value": "0912345678"
}
],
"gender": "male",
"birthDate": "1950-01-01",
"address": [
{
"use": "home",
"text": "台北市中山區中山北路100號"
}
],
"contact": [
{
"relationship": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0131",
"code": "N",
"display": "Next-of-Kin"
}
]
}
],
"name": {
"text": "王大明"
},
"telecom": [
{
"system": "phone",
"value": "0987654321"
}
]
}
]
}
},
{
"fullUrl": "http://example.org/Organization/ltc-organization-sdk-example",
"resource": {
"resourceType": "Organization",
"id": "ltc-organization-sdk-example",
"meta": {
"profile": [
"http://ltc-ig.fhir.tw/StructureDefinition/Organization-twltc"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_ltc-organization-sdk-example\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization ltc-organization-sdk-example</b></p><a name=\"ltc-organization-sdk-example\"> </a><a name=\"hcltc-organization-sdk-example\"> </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-Organization-twltc.html\">長期照顧－機構</a></p></div><p><b>identifier</b>: <code>http://www.moi.gov.tw</code>/0131060099</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/organization-type prov}\">Healthcare Provider</span></p><p><b>name</b>: OOO長期照顧管理中心</p></div>"
},
"identifier": [
{
"system": "http://www.moi.gov.tw",
"value": "0131060099"
}
],
"type": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/organization-type",
"code": "prov",
"display": "Healthcare Provider"
}
]
}
],
"name": "OOO長期照顧管理中心"
}
},
{
"fullUrl": "http://example.org/Practitioner/ltc-practitioner-sdk-example",
"resource": {
"resourceType": "Practitioner",
"id": "ltc-practitioner-sdk-example",
"meta": {
"profile": [
"http://ltc-ig.fhir.tw/StructureDefinition/LTCPractitioner"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_ltc-practitioner-sdk-example\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner ltc-practitioner-sdk-example</b></p><a name=\"ltc-practitioner-sdk-example\"> </a><a name=\"hcltc-practitioner-sdk-example\"> </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-LTCPractitioner.html\">長期照顧－照顧服務提供者</a></p></div><p><b>identifier</b>: <code>http://example.org/fhir/NamingSystem/practitioner-id</code>/P001</p><p><b>name</b>: 李小華</p></div>"
},
"identifier": [
{
"system": "http://example.org/fhir/NamingSystem/practitioner-id",
"value": "P001"
}
],
"name": [
{
"text": "李小華"
}
]
}
},
{
"fullUrl": "http://example.org/Location/ltc-location-feeapply-home-example",
"resource": {
"resourceType": "Location",
"id": "ltc-location-feeapply-home-example",
"meta": {
"profile": [
"http://ltc-ig.fhir.tw/StructureDefinition/LTCLocationFeeAuditPlace"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Location_ltc-location-feeapply-home-example\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Location ltc-location-feeapply-home-example</b></p><a name=\"ltc-location-feeapply-home-example\"> </a><a name=\"hcltc-location-feeapply-home-example\"> </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-LTCLocationFeeAuditPlace.html\">長照支付審查－交通接送起訖地</a></p></div><p><b>status</b>: Active</p><p><b>name</b>: 個案住家</p><p><b>description</b>: 個案王小明之住家，為本次交通接送（DA01）之出發地。</p><p><b>mode</b>: Instance</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-RoleCode PTRES}\">Patient's Residence</span></p><p><b>address</b>: 台北市中山區中山北路100號(home)</p><h3>Positions</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Longitude</b></td><td><b>Latitude</b></td></tr><tr><td style=\"display: none\">*</td><td>121.524</td><td>25.0625</td></tr></table></div>"
},
"status": "active",
"name": "個案住家",
"description": "個案王小明之住家，為本次交通接送（DA01）之出發地。",
"mode": "instance",
"type": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code": "PTRES",
"display": "Patient's Residence"
}
]
}
],
"address": {
"use": "home",
"type": "physical",
"text": "台北市中山區中山北路100號"
},
"position": {
"longitude": 121.524,
"latitude": 25.0625
}
}
},
{
"fullUrl": "http://example.org/Location/ltc-location-feeapply-hospital-example",
"resource": {
"resourceType": "Location",
"id": "ltc-location-feeapply-hospital-example",
"meta": {
"profile": [
"http://ltc-ig.fhir.tw/StructureDefinition/LTCLocationFeeAuditPlace"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Location_ltc-location-feeapply-hospital-example\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Location ltc-location-feeapply-hospital-example</b></p><a name=\"ltc-location-feeapply-hospital-example\"> </a><a name=\"hcltc-location-feeapply-hospital-example\"> </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-LTCLocationFeeAuditPlace.html\">長照支付審查－交通接送起訖地</a></p></div><p><b>status</b>: Active</p><p><b>name</b>: 亞東醫院</p><p><b>description</b>: 本次交通接送（DA01）之目的地，個案前往就醫之醫療機構。</p><p><b>mode</b>: Instance</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-RoleCode HOSP}\">Hospital</span></p><p><b>address</b>: 新北市板橋區南雅南路二段21號(work)</p><h3>Positions</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Longitude</b></td><td><b>Latitude</b></td></tr><tr><td style=\"display: none\">*</td><td>121.4527</td><td>25.0022</td></tr></table></div>"
},
"status": "active",
"name": "亞東醫院",
"description": "本次交通接送（DA01）之目的地，個案前往就醫之醫療機構。",
"mode": "instance",
"type": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
"code": "HOSP",
"display": "Hospital"
}
]
}
],
"address": {
"use": "work",
"type": "physical",
"text": "新北市板橋區南雅南路二段21號"
},
"position": {
"longitude": 121.4527,
"latitude": 25.0022
}
}
}
]
}