臺灣健保署基礎實作指引
0.0.1 - ci-build

臺灣健保署基礎實作指引, published by 衛生福利部中央健康保險署. This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/TWNHIFHIR/base/ and changes regularly. See the Directory of published versions

: 事前審查-送核 - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:Claim ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "cla-1"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://nhicore.nhi.gov.tw/base/StructureDefinition/Claim-twnhibase"^^xsd:anyURI ;
fhir:l <https://nhicore.nhi.gov.tw/base/StructureDefinition/Claim-twnhibase>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><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\">Profile: <a href=\"StructureDefinition-Claim-twnhibase.html\">事前審查-Claim TWNHIBASE</a></p></div><p><b>狀態</b>：Active</p><p><b>類型</b>：Institutional<span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/CodeSystem/claim-type\">ClaimTypeCodes</a>#institutional)</span></p><p><b>申報類別</b>：送核<span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-nhi-apply-type.html\">NHI-申報類別值集</a>#1)</span></p><p><b>目的</b>：Preauthorization</p><p><b>病人</b>：<a href=\"Patient-pat-min.html\">Patient/pat-min</a> \"王大明\"</p><p><b>申請日期</b>：2024-05-30</p><p><b>醫事機構代碼</b>：<a href=\"Organization-org-hosp-example.html\">Organization/org-hosp-example</a></p><p><b>申請案件類別</b>：一般事前審查申請<span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"CodeSystem-nhi-tmhb-type.html\">NHI-申請案件類別值集</a>#1)</span></p><h3>Diagnoses</h3><p><b>診斷日期</b>：2024-01-01</p><p><b>國際疾病分類代碼</b>：慢性右心臟衰竭<span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw\">臺灣健保署2023年中文版ICD-10-CM值集</a>#I50.812)</span></p><p><b>簡要病摘</b>：Adenocarcinoma, descending colon, cT3N2M1a, cStage IVA, KRAS G12V, with multiple liver metastases, status post FOLFIRI</p><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>：1</p><p><b>category</b>：<span title=\"Codes:{https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-supporting-info-type geneInfo}\">基因資訊</span></p><p><b>value</b>：<a href=\"Observation-obs-diagnostic-min.html\">Observation/obs-diagnostic-min</a></p></blockquote><h3>Insurances</h3><p><b>sequence</b>：1</p><p><b>coverage</b>：<a href=\"Coverage-cov-min.html\">Coverage/cov-min</a></p></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:type [
    ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/claim-type>       ] ;
fhir:code [ fhir:v "institutional" ]     ] )
  ] ; # 
  fhir:subType [
    ( fhir:coding [
fhir:system [
fhir:v "https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-apply-type"^^xsd:anyURI ;
fhir:l <https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-apply-type>       ] ;
fhir:code [ fhir:v "1" ] ;
fhir:display [ fhir:v "送核" ]     ] )
  ] ; # 
  fhir:use [ fhir:v "preauthorization"] ; # 
  fhir:patient [
fhir:l fhir:Patient/pat-min ;
fhir:reference [ fhir:v "Patient/pat-min" ]
  ] ; # 
  fhir:created [ fhir:v "2024-05-30"^^xsd:date] ; # 
  fhir:provider [
fhir:l fhir:Organization/org-hosp-example ;
fhir:reference [ fhir:v "Organization/org-hosp-example" ]
  ] ; # 
  fhir:priority [
    ( fhir:coding [
fhir:system [
fhir:v "https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-tmhb-type"^^xsd:anyURI ;
fhir:l <https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-tmhb-type>       ] ;
fhir:code [ fhir:v "1" ] ;
fhir:display [ fhir:v "一般事前審查申請" ]     ] )
  ] ; # 
  fhir:supportingInfo ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:category [
      ( fhir:coding [
fhir:system [
fhir:v "https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-supporting-info-type"^^xsd:anyURI ;
fhir:l <https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-supporting-info-type>         ] ;
fhir:code [ fhir:v "geneInfo" ]       ] )     ] ;
fhir:value [
a fhir:Reference ;
fhir:l fhir:Observation/obs-diagnostic-min ;
fhir:reference [ fhir:v "Observation/obs-diagnostic-min" ]     ]
  ] ) ; # 
  fhir:diagnosis ( [
    ( fhir:extension [
fhir:url [
fhir:v "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate>       ] ;
fhir:value [
a fhir:Date ;
fhir:v "2024-01-01"^^xsd:date       ]     ] ) ;
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:diagnosis [
a fhir:CodeableConcept ;
      ( fhir:coding [
fhir:system [
fhir:v "https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw"^^xsd:anyURI ;
fhir:l <https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw>         ] ;
fhir:code [ fhir:v "I50.812" ]       ] )     ] ;
    ( fhir:type [
fhir:text [ fhir:v "Adenocarcinoma, descending colon, cT3N2M1a, cStage IVA, KRAS G12V, with multiple liver metastases, status post FOLFIRI" ]     ] )
  ] ) ; # 
  fhir:insurance ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:focal [ fhir:v true ] ;
fhir:coverage [
fhir:l fhir:Coverage/cov-min ;
fhir:reference [ fhir:v "Coverage/cov-min" ]     ]
  ] ) . #