{
  "resourceType" : "Claim",
  "id" : "ltc-claim-feeapply-c-code-example",
  "meta" : {
    "profile" : ["http://ltc-ig.fhir.tw/StructureDefinition/LTCClaimFeeApply"]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Claim ltc-claim-feeapply-c-code-example</b></p><a name=\"ltc-claim-feeapply-c-code-example\"> </a><a name=\"hcltc-claim-feeapply-c-code-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>/00000000000000000102, <code>http://ltc-ig.fhir.tw/identifier/feeaudit/trans-no</code>/C000000101, <code>http://ltc-ig.fhir.tw/identifier/feeaudit/yyyymm</code>/202507</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\u00a0(use:\u00a0official,\u00a0))</a></p><p><b>created</b>: 2025-08-05 10:30:00+0800</p><p><b>insurer</b>: <a href=\"Organization-ltc-organization-sdk-example.html\">Organization OOO長期照顧管理中心</a></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-example.html\">王美玲（C 單位專業服務人員）</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 svccGoalType}\">專業服務復能目標達成情形</span></p><p><b>code</b>: <span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-svcc-goal-type 3}\">已滿1照顧組合之次數，但尚未達目標</span></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 svccGoal}\">專業服務復能目標</span></p><p><b>value</b>: 三個月內提升長照需要者下肢肌力與床邊坐站轉位能力，達到在他人口頭提示下可自行完成床邊坐站轉位。</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 svccContentTarget}\">專業服務指導對象</span></p><p><b>value</b>: 長照需要者本人及其主要家庭照顧者（配偶）。</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 svccContent}\">專業服務服務內容</span></p><p><b>value</b>: 執行下肢肌力訓練與床邊坐站轉位訓練共 40 分鐘，並實地指導家庭照顧者正確之轉位協助技巧、輔具（助行器）使用方式及居家環境安全注意事項。</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 svccSuggest}\">專業服務指導建議摘要</span></p><p><b>value</b>: 建議家庭照顧者每日協助長照需要者進行坐站訓練 2 次、每次 10 下，並於床邊加裝安全扶手；下次訪視時再評估轉位獨立程度並調整訓練強度。</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 missedVisit}\">訪視/服務未遇</span></p><p><b>value</b>: false</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><a href=\"Coverage-ltc-coverage-sdk-example.html\">Coverage: status = active</a></td></tr></table><h3>Items</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>ProductOrService</b></td><td><b>Serviced[x]</b></td><td><b>Quantity</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-fee-type 1}\">補助</span></td><td><span title=\"Codes:{http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-service-item CA03}\">ADLs復能照護--居家</span></td><td>2025-07-15 14:00:00+0800 --&gt; 2025-07-15 15:00:00+0800</td><td>1</td></tr></table></div>"
  },
  "identifier" : [{
    "system" : "http://ltc-ig.fhir.tw/identifier/feeaudit/objid",
    "value" : "00000000000000000102"
  },
  {
    "system" : "http://ltc-ig.fhir.tw/identifier/feeaudit/trans-no",
    "value" : "C000000101"
  },
  {
    "system" : "http://ltc-ig.fhir.tw/identifier/feeaudit/yyyymm",
    "value" : "202507"
  }],
  "status" : "active",
  "type" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
      "code" : "professional",
      "display" : "Professional"
    }]
  },
  "use" : "claim",
  "patient" : {
    "reference" : "Patient/ltc-patient-sdk-example"
  },
  "created" : "2025-08-05T10:30:00+08:00",
  "insurer" : {
    "reference" : "Organization/ltc-organization-sdk-example"
  },
  "provider" : {
    "reference" : "Organization/ltc-organization-sdk-example"
  },
  "priority" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
      "code" : "normal",
      "display" : "Normal"
    }]
  },
  "careTeam" : [{
    "sequence" : 1,
    "provider" : {
      "reference" : "Practitioner/ltc-practitioner-example",
      "identifier" : {
        "system" : "http://www.moi.gov.tw",
        "value" : "B223456789"
      },
      "display" : "王美玲（C 單位專業服務人員）"
    }
  }],
  "supportingInfo" : [{
    "sequence" : 1,
    "category" : {
      "coding" : [{
        "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info",
        "code" : "svccGoalType",
        "display" : "專業服務復能目標達成情形"
      }]
    },
    "code" : {
      "coding" : [{
        "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-svcc-goal-type",
        "code" : "3",
        "display" : "已滿1照顧組合之次數，但尚未達目標"
      }]
    }
  },
  {
    "sequence" : 2,
    "category" : {
      "coding" : [{
        "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info",
        "code" : "svccGoal",
        "display" : "專業服務復能目標"
      }]
    },
    "valueString" : "三個月內提升長照需要者下肢肌力與床邊坐站轉位能力，達到在他人口頭提示下可自行完成床邊坐站轉位。"
  },
  {
    "sequence" : 3,
    "category" : {
      "coding" : [{
        "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info",
        "code" : "svccContentTarget",
        "display" : "專業服務指導對象"
      }]
    },
    "valueString" : "長照需要者本人及其主要家庭照顧者（配偶）。"
  },
  {
    "sequence" : 4,
    "category" : {
      "coding" : [{
        "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info",
        "code" : "svccContent",
        "display" : "專業服務服務內容"
      }]
    },
    "valueString" : "執行下肢肌力訓練與床邊坐站轉位訓練共 40 分鐘，並實地指導家庭照顧者正確之轉位協助技巧、輔具（助行器）使用方式及居家環境安全注意事項。"
  },
  {
    "sequence" : 5,
    "category" : {
      "coding" : [{
        "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info",
        "code" : "svccSuggest",
        "display" : "專業服務指導建議摘要"
      }]
    },
    "valueString" : "建議家庭照顧者每日協助長照需要者進行坐站訓練 2 次、每次 10 下，並於床邊加裝安全扶手；下次訪視時再評估轉位獨立程度並調整訓練強度。"
  },
  {
    "sequence" : 6,
    "category" : {
      "coding" : [{
        "system" : "http://ltc-ig.fhir.tw/CodeSystem/cs-tw-ltc-feeaudit-supporting-info",
        "code" : "missedVisit",
        "display" : "訪視/服務未遇"
      }]
    },
    "valueBoolean" : false
  }],
  "insurance" : [{
    "sequence" : 1,
    "focal" : true,
    "coverage" : {
      "reference" : "Coverage/ltc-coverage-sdk-example"
    }
  }],
  "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" : "CA03",
        "display" : "ADLs復能照護--居家"
      }]
    },
    "servicedPeriod" : {
      "start" : "2025-07-15T14:00:00+08:00",
      "end" : "2025-07-15T15:00:00+08:00"
    },
    "quantity" : {
      "value" : 1
    }
  }]
}