FHIRsmith: Claim/Claim-ltc-claim-export-example.json

FHIR IG analytics

Package	tw.iii.ltc
Resource Type	Claim
Id	Claim-ltc-claim-export-example.json
FHIR Version	R4

Resources that use this resource

No resources found

Resources that this resource uses

No resources found

Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: Claim ltc-claim-export-example

Profile: 長照 SDK－照管全量匯出（Claim）

identifier: https://ltc-ig.fhir.tw/identifier/export/case-no/111301921, https://ltc-ig.fhir.tw/identifier/export/eva-id/7574654624, https://ltc-ig.fhir.tw/identifier/export/yyyymm-roc/11407

status: Active

type: Professional

use: Preauthorization

patient: 王小明 (no stated gender), DoB Unknown ( https://example.org/mrn#A0001)

created: 2025-07-04

provider: Organization 某某長照管理中心

priority: Normal

Insurances

Sequence

Focal

Coverage

true

Coverage: status = active

item
sequence: 1
productOrService: 日間照顧（全日）--第2型
programCode: PLAN-0001
quantity: 23
UnitPrices
- Value Currency
* 840 New Taiwan dollar
Nets
- Value Currency
* 19320 New Taiwan dollar

item
sequence: 2
productOrService: 交通接送
programCode: PLAN-0002
quantity: 1680
UnitPrices
- Value Currency
* 1 New Taiwan dollar
Nets
- Value Currency
* 1680 New Taiwan dollar

Source1

{
  "resourceType": "Claim",
  "id": "ltc-claim-export-example",
  "meta": {
    "profile": [
      "http://ltc-ig.fhir.tw/StructureDefinition/LTC-Claim-Export"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "identifier": [
    {
      "system": "https://ltc-ig.fhir.tw/identifier/export/case-no",
      "value": "111301921"
    },
    {
      "system": "https://ltc-ig.fhir.tw/identifier/export/eva-id",
      "value": "7574654624"
    },
    {
      "system": "https://ltc-ig.fhir.tw/identifier/export/yyyymm-roc",
      "value": "11407"
    }
  ],
  "status": "active",
  "type": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/claim-type",
        "code": "professional"
      }
    ]
  },
  "use": "preauthorization",
  "patient": {
    "reference": "Patient/ltc-patient-cs100-example"
  },
  "created": "2025-07-04",
  "provider": {
    "reference": "Organization/ltc-organization-cs100-example"
  },
  "priority": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/processpriority",
        "code": "normal"
      }
    ]
  },
  "insurance": [
    {
      "sequence": 1,
      "focal": true,
      "coverage": {
        "reference": "Coverage/ltc-coverage-cs100-example"
      }
    }
  ],
  "item": [
    {
      "sequence": 1,
      "productOrService": {
        "coding": [
          {
            "system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-service-item",
            "code": "BB03"
          }
        ]
      },
      "programCode": [
        {
          "coding": [
            {
              "system": "https://ltc-ig.fhir.tw/identifier/export/plan-id",
              "code": "PLAN-0001"
            }
          ]
        }
      ],
      "quantity": {
        "value": 23
      },
      "unitPrice": {
        "value": 840,
        "currency": "TWD"
      },
      "net": {
        "value": 19320,
        "currency": "TWD"
      }
    },
    {
      "sequence": 2,
      "productOrService": {
        "coding": [
          {
            "system": "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-service-item",
            "code": "DA01"
          }
        ]
      },
      "programCode": [
        {
          "coding": [
            {
              "system": "https://ltc-ig.fhir.tw/identifier/export/plan-id",
              "code": "PLAN-0002"
            }
          ]
        }
      ],
      "quantity": {
        "value": 1680
      },
      "unitPrice": {
        "value": 1,
        "currency": "TWD"
      },
      "net": {
        "value": 1680,
        "currency": "TWD"
      }
    }
  ]
}