FHIR IG analytics| Package | tw.iii.ltc |
| Resource Type | Claim |
| Id | Claim-ltc-claim-feeapply-da01-example.json |
| FHIR Version | R4 |
No resources found
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: Claim ltc-claim-feeapply-da01-example
Profile: 長照支付審查－個案服務紀錄申報
identifier: http://ltc-ig.fhir.tw/identifier/feeaudit/objid/00000000000000000006, http://ltc-ig.fhir.tw/identifier/feeaudit/trans-no/A0001, http://ltc-ig.fhir.tw/identifier/feeaudit/yyyymm/201901
status: Active
type: Professional
use: Claim
patient: 王小明 Male, DoB: 1950-01-01 ( Provider number (use: official, ))
created: 2019-02-05 10:00:00+0800
provider: Organization OOO長期照顧管理中心
priority: Normal
| Sequence | Provider |
| 1 | Practitioner 李小華 |
supportingInfo
sequence: 1
category: 出發地
value: Location 個案住家
supportingInfo
sequence: 2
category: 目的地
value: Location 亞東醫院
supportingInfo
sequence: 3
category: 車號
value: 1111-AA
supportingInfo
sequence: 4
category: 駕駛員
value: 黃OO
supportingInfo
sequence: 5
category: 里程數
value: 12 公里 (Details: UCUM codekm = 'km')
supportingInfo
sequence: 6
category: 臨終日照顧
value: false
supportingInfo
sequence: 7
category: 訪視/服務未遇
value: false
supportingInfo
sequence: 8
category: 是否申報AA09
value: false
supportingInfo
sequence: 9
category: AA10申報狀態
code: 未申報
supportingInfo
sequence: 10
category: 備註
value: 1
| Sequence | Focal | Coverage |
| 1 | true | 長期照顧給付及支付基準 |
item
sequence: 1
category: 補助
productOrService: 交通接送
serviced: 2019-01-05 13:30:00+0800 --> 2019-01-05 14:00:00+0800
location: Location 亞東醫院
quantity: 1
UnitPrices
Value Currency 430 New Taiwan dollar Nets
Value Currency 430 New Taiwan dollar
| Value | Currency |
| 430 | New Taiwan dollar |
FHIR
FHIRsmith{
"resourceType": "Claim",
"id": "ltc-claim-feeapply-da01-example",
"meta": {
"profile": [
"http://ltc-ig.fhir.tw/StructureDefinition/LTCClaimFeeApply"
]
},
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"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"
}
}