臺灣健保癌症用藥事前審查實作指引
1.0.3 - release

This page is part of the 臺灣癌症用藥事前審查實作指引(TWPAS IG) (v1.0.3: Release) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 1.0.4. For a full list of available versions, see the Directory of published versions

: 事前審查回覆 - 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:ClaimResponse ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "claim-response-example"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "https://nhicore.nhi.gov.tw/pas/StructureDefinition/ClaimResponse-twpas"^^xsd:anyURI ;
fhir:link <https://nhicore.nhi.gov.tw/pas/StructureDefinition/ClaimResponse-twpas>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir: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-ClaimResponse-twpas.html\">事前審查結果-ClaimResponse TWPAS</a></p></div><p><b>狀態</b>：Active</p><p><b>類型</b>：<span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type institutional}\">Institutional</span></p><p><b>用途</b>：Preauthorization</p><p><b>病人</b>：<a href=\"Patient-pat-min.html\">Patient/pat-min</a></p><p><b>核定日期</b>：2024-07-30</p><p><b>關聯的事前審查</b>：<a href=\"Claim-cla-1.html\">Claim/cla-1</a></p><p><b>保險商</b>：<a href=\"Organization-org-nhi.html\">Organization 衛生福利部中央健康保險署</a></p><p><b>處置狀態</b>：Processing Complete</p><p><b>案件受理狀態</b>：審畢結果</p><blockquote><p><b>item</b></p><p><b>itemSequence</b>：1</p><h3>受理審查案件核定註記</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>類型</b></td><td><b>受理審查案件核定註記</b></td><td><b>核定數量</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted Amount</span></td><td>同意備查 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">( <a href=\"CodeSystem-nhi-approve-comment.html\">NHI-健保事前審查-核定註記</a>#1) </span>)</td><td>2</td></tr></table><h3>個別醫令核定註記</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>類型</b></td><td><b>Claim.item.sequence</b></td><td><b>個別醫令核定註記</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted Amount</span></td><td>1</td><td>同意備查 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">( <a href=\"CodeSystem-nhi-approve-comment.html\">NHI-健保事前審查-核定註記</a>#1) </span>)</td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted Amount</span></td><td>2</td><td>同意備查 <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\">( <a href=\"CodeSystem-nhi-approve-comment.html\">NHI-健保事前審查-核定註記</a>#1) </span>)</td></tr></table></blockquote></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:code [ fhir:v "institutional" ]     ] )
  ] ; # 
  fhir:use [ fhir:v "preauthorization"] ; # 
  fhir:patient [
fhir:reference [ fhir:v "Patient/pat-min" ]
  ] ; # 
  fhir:created [ fhir:v "2024-07-30"^^xsd:date] ; # 
  fhir:insurer [
fhir:reference [ fhir:v "Organization/org-nhi" ]
  ] ; # 
  fhir:request [
fhir:reference [ fhir:v "Claim/cla-1" ]
  ] ; # 
  fhir:outcome [ fhir:v "complete"] ; # 
  fhir:disposition [ fhir:v "審畢結果"] ; # 
  fhir:item ( [
fhir:itemSequence [ fhir:v "1"^^xsd:positiveInteger ] ;
    ( fhir:adjudication [
fhir:category [
        ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ] ;
fhir:code [ fhir:v "submitted" ]         ] )       ] ;
fhir:reason [
        ( fhir:coding [
fhir:system [ fhir:v "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-approve-comment"^^xsd:anyURI ] ;
fhir:code [ fhir:v "1" ]         ] )       ] ;
fhir:value [ fhir:v "2"^^xsd:decimal ]     ] ) ;
    ( fhir:detail [
fhir:detailSequence [ fhir:v "1"^^xsd:positiveInteger ] ;
      ( fhir:adjudication [
fhir:category [
          ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ] ;
fhir:code [ fhir:v "submitted" ]           ] )         ] ;
fhir:reason [
          ( fhir:coding [
fhir:system [ fhir:v "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-approve-comment"^^xsd:anyURI ] ;
fhir:code [ fhir:v "1" ]           ] )         ]       ] )     ] [
fhir:detailSequence [ fhir:v "2"^^xsd:positiveInteger ] ;
      ( fhir:adjudication [
fhir:category [
          ( fhir:coding [
fhir:system [ fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ] ;
fhir:code [ fhir:v "submitted" ]           ] )         ] ;
fhir:reason [
          ( fhir:coding [
fhir:system [ fhir:v "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-approve-comment"^^xsd:anyURI ] ;
fhir:code [ fhir:v "1" ]           ] )         ]       ] )     ] )
  ] ) . #