<?xml version="1.0" encoding="UTF-8"?>

<Claim xmlns="http://hl7.org/fhir">
  <id value="claim-min"/>
  <meta>
    <profile value="https://sfaa.gov.tw/base/StructureDefinition/Claim-twss-base"/>
  </meta>
  <text>
    <status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml"><h3><b>補助申請資料</b></h3><p><b>申請狀態</b>：Active</p><p><b>用途</b>：Claim</p><p><b>申請類型</b>：補助申請</p><p><b>個案</b>： <a href="Patient-pat-min.html">Patient/pat-min</a> &quot;王小明&quot;</p><p><b>申請建立日</b>：2026-06-30</p><p><b>登錄人員</b>： <a href="PractitionerRole-pracrole-min.html">PractitionerRole/pracrole-min</a> &quot;主責社工&quot;</p><p><b>核付單位</b>： <a href="Organization-org-min.html">Organization/org-min</a> &quot;社家署示範機構&quot;</p><p><b>服務提供者</b>： <a href="Organization-org-min.html">Organization/org-min</a> &quot;社家署示範機構&quot;</p><p><b>優先順序</b>：一般</p><p><b>支持資料</b>： <a href="EpisodeOfCare-episode-base.html">EpisodeOfCare/episode-base</a> &quot;個案服務案件基礎範例&quot;</p><p><b>補助資格</b>： <a href="Coverage-coverage-min.html">Coverage/coverage-min</a> &quot;中低收入戶&quot;</p><p><b>補助項目</b>：生活補助</p><p><b>補助日期</b>：2026-06-30</p><p><b>申請金額</b>：1000 TWD</p><p><b>申請總金額</b>：1000 TWD</p></div>
  </text>
  <status value="active"/>
  <type>
    <text value="補助申請"/>
  </type>
  <use value="claim"/>
  <patient>
    <reference value="Patient/pat-min"/>
  </patient>
  <created value="2026-06-30"/>
  <enterer>
    <reference value="PractitionerRole/pracrole-min"/>
  </enterer>
  <insurer>
    <reference value="Organization/org-min"/>
  </insurer>
  <provider>
    <reference value="Organization/org-min"/>
  </provider>
  <priority>
    <text value="一般"/>
  </priority>
  <supportingInfo>
    <sequence value="1"/>
    <category>
      <coding>
        <system value="https://sfaa.gov.tw/base/CodeSystem/twss-claim-supporting-info-type"/>
        <code value="service-case"/>
        <display value="服務案件"/>
      </coding>
    </category>
    <valueReference>
      <reference value="EpisodeOfCare/episode-base"/>
    </valueReference>
  </supportingInfo>
  <supportingInfo>
    <sequence value="2"/>
    <category>
      <coding>
        <system value="https://sfaa.gov.tw/base/CodeSystem/twss-claim-supporting-info-type"/>
        <code value="documents-complete"/>
        <display value="申請人證件備齊日"/>
      </coding>
    </category>
    <timingDate value="2026-06-29"/>
  </supportingInfo>
  <supportingInfo>
    <sequence value="3"/>
    <category>
      <coding>
        <system value="https://sfaa.gov.tw/base/CodeSystem/twss-claim-supporting-info-type"/>
        <code value="application-channel"/>
        <display value="申請管道"/>
      </coding>
    </category>
    <code>
      <coding>
        <system value="https://sfaa.gov.tw/base/CodeSystem/twss-application-channel"/>
        <code value="online"/>
        <display value="線上申辦"/>
      </coding>
    </code>
  </supportingInfo>
  <supportingInfo>
    <sequence value="4"/>
    <category>
      <coding>
        <system value="https://sfaa.gov.tw/base/CodeSystem/twss-claim-supporting-info-type"/>
        <code value="applicant"/>
        <display value="申請人"/>
      </coding>
    </category>
    <valueReference>
      <reference value="Patient/pat-min"/>
    </valueReference>
  </supportingInfo>
  <supportingInfo>
    <sequence value="5"/>
    <category>
      <coding>
        <system value="https://sfaa.gov.tw/base/CodeSystem/twss-claim-supporting-info-type"/>
        <code value="bank-account"/>
        <display value="申請人銀行帳戶"/>
      </coding>
    </category>
    <valueString value="012-123456789012"/>
  </supportingInfo>
  <insurance>
    <sequence value="1"/>
    <focal value="true"/>
    <coverage>
      <reference value="Coverage/coverage-min"/>
    </coverage>
  </insurance>
  <item>
    <sequence value="1"/>
    <productOrService>
      <text value="生活補助"/>
    </productOrService>
    <servicedDate value="2026-06-30"/>
    <net>
      <value value="1000"/>
      <currency value="TWD"/>
    </net>
  </item>
  <total>
    <value value="1000"/>
    <currency value="TWD"/>
  </total>
</Claim>