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 rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

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

<http://hl7.org/fhir/Claim/cla-1> a fhir:Claim ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "cla-1"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "https://nhicore.nhi.gov.tw/base/StructureDefinition/Claim-twnhibase" ;
       fhir:index 0 ;
       fhir:link <https://nhicore.nhi.gov.tw/base/StructureDefinition/Claim-twnhibase>
     ]
  ] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<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>"
  ] ;
  fhir:Claim.status [ fhir:value "active"] ;
  fhir:Claim.type [
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ] ;
       fhir:Coding.code [ fhir:value "institutional" ]
     ]
  ] ;
  fhir:Claim.subType [
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-apply-type" ] ;
       fhir:Coding.code [ fhir:value "1" ] ;
       fhir:Coding.display [ fhir:value "送核" ]
     ]
  ] ;
  fhir:Claim.use [ fhir:value "preauthorization"] ;
  fhir:Claim.patient [
     fhir:link <http://hl7.org/fhir/Patient/pat-min> ;
     fhir:Reference.reference [ fhir:value "Patient/pat-min" ]
  ] ;
  fhir:Claim.created [ fhir:value "2024-05-30"^^xsd:date] ;
  fhir:Claim.provider [
     fhir:link <http://hl7.org/fhir/Organization/org-hosp-example> ;
     fhir:Reference.reference [ fhir:value "Organization/org-hosp-example" ]
  ] ;
  fhir:Claim.priority [
     fhir:CodeableConcept.coding [
       fhir:index 0 ;
       fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-tmhb-type" ] ;
       fhir:Coding.code [ fhir:value "1" ] ;
       fhir:Coding.display [ fhir:value "一般事前審查申請" ]
     ]
  ] ;
  fhir:Claim.supportingInfo [
     fhir:index 0 ;
     fhir:Claim.supportingInfo.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
     fhir:Claim.supportingInfo.category [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/base/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "geneInfo" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueReference [
       fhir:link <http://hl7.org/fhir/Observation/obs-diagnostic-min> ;
       fhir:Reference.reference [ fhir:value "Observation/obs-diagnostic-min" ]
     ]
  ] ;
  fhir:Claim.diagnosis [
     fhir:index 0 ;
     fhir:Element.extension [
       fhir:index 0 ;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-diagnosisRecordedDate" ] ;
       fhir:Extension.valueDate [ fhir:value "2024-01-01"^^xsd:date ]
     ] ;
     fhir:Claim.diagnosis.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
     fhir:Claim.diagnosis.diagnosisCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw" ] ;
         fhir:Coding.code [ fhir:value "I50.812" ]
       ]
     ] ;
     fhir:Claim.diagnosis.type [
       fhir:index 0 ;
       fhir:CodeableConcept.text [ fhir:value "Adenocarcinoma, descending colon, cT3N2M1a, cStage IVA, KRAS G12V, with multiple liver metastases, status post FOLFIRI" ]
     ]
  ] ;
  fhir:Claim.insurance [
     fhir:index 0 ;
     fhir:Claim.insurance.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
     fhir:Claim.insurance.focal [ fhir:value "true"^^xsd:boolean ] ;
     fhir:Claim.insurance.coverage [
       fhir:link <http://hl7.org/fhir/Coverage/cov-min> ;
       fhir:Reference.reference [ fhir:value "Coverage/cov-min" ]
     ]
  ] .

<http://hl7.org/fhir/Patient/pat-min> a fhir:Patient .

<http://hl7.org/fhir/Organization/org-hosp-example> a fhir:Organization .

<http://hl7.org/fhir/Observation/obs-diagnostic-min> a fhir:Observation .

<http://hl7.org/fhir/Coverage/cov-min> a fhir:Coverage .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/Claim/cla-1.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/Claim/cla-1.ttl> .