{ "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" : "

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\u00a0(use:\u00a0official,\u00a0))

created: 2019-02-05 10:00:00+0800

provider: Organization OOO長期照顧管理中心

priority: Normal

CareTeams

-SequenceProvider
*1Practitioner 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

Insurances

-SequenceFocalCoverage
*1true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

-ValueCurrency
*430New Taiwan dollar

Nets

-ValueCurrency
*430New Taiwan dollar

Totals

-ValueCurrency
*430New Taiwan dollar
" }, "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" : "

Generated Narrative: Patient ltc-patient-sdk-example

Profile: 長期照顧－住民基本資料

王小明 Male, DoB: 1950-01-01 ( Provider number\u00a0(use:\u00a0official,\u00a0))

Contact Detail
  • ph: 0912345678
  • 台北市中山區中山北路100號(home)
Next-of-Kin:
  • 王大明
  • ph: 0987654321
" }, "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" : "

Generated Narrative: Organization ltc-organization-sdk-example

Profile: 長期照顧－機構

identifier: http://www.moi.gov.tw/0131060099

type: Healthcare Provider

name: OOO長期照顧管理中心

" }, "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" : "

Generated Narrative: Practitioner ltc-practitioner-sdk-example

Profile: 長期照顧－照顧服務提供者

identifier: http://example.org/fhir/NamingSystem/practitioner-id/P001

name: 李小華

" }, "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" : "

Generated Narrative: Location ltc-location-feeapply-home-example

Profile: 長照支付審查－交通接送起訖地

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: Patient's Residence

address: 台北市中山區中山北路100號(home)

Positions

-LongitudeLatitude
*121.52425.0625
" }, "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" : "

Generated Narrative: Location ltc-location-feeapply-hospital-example

Profile: 長照支付審查－交通接送起訖地

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: Hospital

address: 新北市板橋區南雅南路二段21號(work)

Positions

-LongitudeLatitude
*121.452725.0022
" }, "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 } } }] }