臺灣健保事前審查實作指引
1.2.4 - STU1.2.4

This page is part of the 臺灣健保癌症用藥事前審查實作指引(TWPAS IG) (v1.2.4: STU1.2.4) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: 免疫製劑事前審查 - 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-imm> a fhir:Claim ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "cla-imm"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-immunologic-agent-twpas" ;
       fhir:index 0 ;
       fhir:link <https://nhicore.nhi.gov.tw/pas/StructureDefinition/Claim-immunologic-agent-twpas>
     ]
  ] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "extensions" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Claim cla-imm</b></p><a name=\"cla-imm\"> </a><a name=\"hccla-imm\"> </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-Claim-immunologic-agent-twpas.html\">免疫製劑事前審查-Claim Immunologic Aagent TWPAS</a></p></div><p><b>ClaimEncounter</b>: <a href=\"Encounter-enc-min.html\">Encounter: status = planned; class = ambulatory (ActCode#AMB); serviceType = 胸腔暨重症加護</a></p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type institutional}\">Institutional</span></p><p><b>subType</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-apply-type 1}\">送核</span></p><p><b>use</b>: Preauthorization</p><p><b>patient</b>: <a href=\"Patient-pat-min.html\">王大明 Male, DoB: 2001-01-01 ( Medical record number (use: official, ))</a></p><p><b>created</b>: 2024-05-30</p><p><b>enterer</b>: <a href=\"Practitioner-pra-min.html\">Practitioner: identifier = National Person Identifier where the xxx is the ISO table 3166 3-character (alphabetic) country code,Medical License number</a></p><p><b>provider</b>: <a href=\"Organization-org-hosp-example.html\">Organization 臺北市立聯合醫院</a></p><p><b>priority</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-tmhb-type 1}\">一般事前審查申請</span></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/pas/CodeSystem/nhi-supporting-info-type weight}\">病人體重</span></p><p><b>value</b>: 59.65 kg<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  codekg = 'kg')</span></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 2</p><p><b>category</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type height}\">病人身高</span></p><p><b>value</b>: 170 cm<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  codecm = 'cm')</span></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 3</p><p><b>category</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type bloodgroup}\">病人血型</span></p><p><b>value</b>: <a href=\"Observation-obs-blood-group.html\">Observation ABO and Rh group [Type] in Blood</a></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 4</p><p><b>category</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type imagingReport}\">影像報告</span></p><p><b>value</b>: <a href=\"DiagnosticReport-diaRep-ima-min.html\">Diagnostic Report for '左上肢動脈血管內超音波' for '-&gt;王大明 Male, DoB: 2001-01-01 ( Medical record number (use: official, ))'</a></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 6</p><p><b>category</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type examinationReport}\">檢查報告</span></p><p><b>value</b>: <a href=\"DiagnosticReport-diaRep-min.html\">Diagnostic Report for 'Prostate Pathology biopsy report' for '-&gt;王大明 Male, DoB: 2001-01-01 ( Medical record number (use: official, ))'</a></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 8</p><p><b>category</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type tests}\">檢驗(查)</span></p><p><b>value</b>: <a href=\"Observation-obs-lab-min.html\">Observation Platelets [#/volume] in Blood by Automated count</a></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 9</p><p><b>category</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type tests}\">檢驗(查)</span></p><p><b>value</b>: <a href=\"Observation-obs-lab-cbc.html\">Observation CBC panel - Blood by Automated count</a></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 10</p><p><b>category</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type patientAssessment}\">病人狀態評估</span></p><p><b>value</b>: <a href=\"Observation-obs-pat-nyha.html\">Observation Functional capacity NYHA</a></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 11</p><p><b>category</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type medicationRequest}\">用藥品項</span></p><p><b>value</b>: <a href=\"MedicationRequest-medReq-treat.html\">MedicationRequest: status = completed; statusReason = Try another treatment first; intent = order; category = 健保; medication[x] = ANTI-COUGH SYRUP \"WASHINGTON\"</a></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 12</p><p><b>category</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type radiotherapy}\">放射治療</span></p><p><b>value</b>: <a href=\"Procedure-pro-min.html\">Procedure 腦部光子&lt;1MeV之光束放射治療</a></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 13</p><p><b>category</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type carePlanDocument}\">治療計畫文件</span></p><p><b>value</b>: <a href=\"DocumentReference-doc-careplan-min.html\">DocumentReference: status = current; category = 治療計畫文件</a></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 14</p><p><b>category</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type medicalRecord}\">病歷資料</span></p><p><b>value</b>: <a href=\"DocumentReference-doc-medicalRecord-min.html\">DocumentReference: status = current; category = 病歷資料</a></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 15</p><p><b>category</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type treatmentAssessment}\">結果資訊</span></p><p><b>value</b>: <a href=\"Observation-obs-tx-min.html\">Observation International Working Group(IWG) Consensus Criteria</a></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 16</p><p><b>category</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type opd}\">門診病歷</span></p><p><b>value</b>: <a href=\"Composition-opd.html\">Composition 門診病歷</a></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 17</p><p><b>category</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type allergy}\">過敏史</span></p><p><b>value</b>: <a href=\"AllergyIntolerance-all-min.html\">AllergyIntolerance </a></p></blockquote><blockquote><p><b>supportingInfo</b></p><p><b>sequence</b>: 18</p><p><b>category</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type phototherapy}\">照光治療</span></p><p><b>value</b>: <a href=\"Procedure-pro-phototherapy.html\">Procedure 窄頻UVB(nb-UVB)</a></p></blockquote><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Extension</b></td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td/><td>1</td><td><span title=\"Codes:{https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-cm-2023-tw I50.812}\">慢性右心臟衰竭</span></td><td><span title=\"Codes:\">Adenocarcinoma, descending colon, cT3N2M1a, cStage IVA, KRAS G12V, with multiple liver metastases, status post FOLFIRI</span></td></tr></table><h3>Procedures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Date</b></td><td><b>Procedure[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>2024-01-01</td><td><span title=\"Codes:{https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2023-tw 3E0Y704}\">經自然開口或人工造口心包腔液態近接放射性同位素抗腫瘤藥劑輸入</span></td></tr></table><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-cov-min.html\">Coverage: status = active</a></td></tr></table><blockquote><p><b>item</b></p><p><b>RequestedService</b>: <a href=\"MedicationRequest-medReq-apply.html\">MedicationRequest: status = on-hold; intent = plan; medication[x] = Alunbrig film-coated tablets 30mg</a></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-order-type 1}\">藥品</span></p><p><b>modifier</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status 1}\">初次使用</span>, <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-line-of-therapy 1}\">第一線治療</span></p><p><b>programCode</b>: <span title=\"Codes:\">ALK陽性的晚期非小細胞肺癌第一線治療</span></p><p><b>quantity</b>: 52 {tbl}<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  code{tbl} = '{tbl}')</span></p></blockquote><blockquote><p><b>item</b></p><p><b>RequestedService</b>: <a href=\"MedicationRequest-medReq-apply-2.html\">MedicationRequest: status = on-hold; intent = plan; medication[x] = Herzuma Inj. 440mg, Lyophilized powder for injection</a></p><p><b>sequence</b>: 2</p><p><b>productOrService</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-order-type 1}\">藥品</span></p><p><b>modifier</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status 1}\">初次使用</span>, <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-line-of-therapy 1}\">第一線治療</span></p><p><b>programCode</b>: <span title=\"Codes:{https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-apply-reason C50P1}\">早期乳癌-未發生腋下淋巴結轉移</span></p><p><b>quantity</b>: 70 {tbl}<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  code{tbl} = '{tbl}')</span></p></blockquote></div>"
  ] ;
  fhir:DomainResource.extension [
     fhir:index 0 ;
     fhir:Extension.url [ fhir:value "https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-claim-encounter" ] ;
     fhir:Extension.valueReference [
       fhir:link <http://hl7.org/fhir/Encounter/enc-min> ;
       fhir:Reference.reference [ fhir:value "Encounter/enc-min" ]
     ]
  ] ;
  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/pas/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.enterer [
     fhir:link <http://hl7.org/fhir/Practitioner/pra-min> ;
     fhir:Reference.reference [ fhir:value "Practitioner/pra-min" ]
  ] ;
  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/pas/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/pas/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "weight" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueQuantity [
       fhir:Quantity.value [ fhir:value "59.65"^^xsd:decimal ] ;
       fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ] ;
       fhir:Quantity.code [ fhir:value "kg" ]
     ]
  ], [
     fhir:index 1 ;
     fhir:Claim.supportingInfo.sequence [ fhir:value "2"^^xsd:positiveInteger ] ;
     fhir:Claim.supportingInfo.category [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "height" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueQuantity [
       fhir:Quantity.value [ fhir:value "170"^^xsd:decimal ] ;
       fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ] ;
       fhir:Quantity.code [ fhir:value "cm" ]
     ]
  ], [
     fhir:index 2 ;
     fhir:Claim.supportingInfo.sequence [ fhir:value "3"^^xsd:positiveInteger ] ;
     fhir:Claim.supportingInfo.category [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "bloodgroup" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueReference [
       fhir:link <http://hl7.org/fhir/Observation/obs-blood-group> ;
       fhir:Reference.reference [ fhir:value "Observation/obs-blood-group" ]
     ]
  ], [
     fhir:index 3 ;
     fhir:Claim.supportingInfo.sequence [ fhir:value "4"^^xsd:positiveInteger ] ;
     fhir:Claim.supportingInfo.category [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "imagingReport" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueReference [
       fhir:link <http://hl7.org/fhir/DiagnosticReport/diaRep-ima-min> ;
       fhir:Reference.reference [ fhir:value "DiagnosticReport/diaRep-ima-min" ]
     ]
  ], [
     fhir:index 4 ;
     fhir:Claim.supportingInfo.sequence [ fhir:value "6"^^xsd:positiveInteger ] ;
     fhir:Claim.supportingInfo.category [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "examinationReport" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueReference [
       fhir:link <http://hl7.org/fhir/DiagnosticReport/diaRep-min> ;
       fhir:Reference.reference [ fhir:value "DiagnosticReport/diaRep-min" ]
     ]
  ], [
     fhir:index 5 ;
     fhir:Claim.supportingInfo.sequence [ fhir:value "8"^^xsd:positiveInteger ] ;
     fhir:Claim.supportingInfo.category [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "tests" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueReference [
       fhir:link <http://hl7.org/fhir/Observation/obs-lab-min> ;
       fhir:Reference.reference [ fhir:value "Observation/obs-lab-min" ]
     ]
  ], [
     fhir:index 6 ;
     fhir:Claim.supportingInfo.sequence [ fhir:value "9"^^xsd:positiveInteger ] ;
     fhir:Claim.supportingInfo.category [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "tests" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueReference [
       fhir:link <http://hl7.org/fhir/Observation/obs-lab-cbc> ;
       fhir:Reference.reference [ fhir:value "Observation/obs-lab-cbc" ]
     ]
  ], [
     fhir:index 7 ;
     fhir:Claim.supportingInfo.sequence [ fhir:value "10"^^xsd:positiveInteger ] ;
     fhir:Claim.supportingInfo.category [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "patientAssessment" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueReference [
       fhir:link <http://hl7.org/fhir/Observation/obs-pat-nyha> ;
       fhir:Reference.reference [ fhir:value "Observation/obs-pat-nyha" ]
     ]
  ], [
     fhir:index 8 ;
     fhir:Claim.supportingInfo.sequence [ fhir:value "11"^^xsd:positiveInteger ] ;
     fhir:Claim.supportingInfo.category [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "medicationRequest" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueReference [
       fhir:link <http://hl7.org/fhir/MedicationRequest/medReq-treat> ;
       fhir:Reference.reference [ fhir:value "MedicationRequest/medReq-treat" ]
     ]
  ], [
     fhir:index 9 ;
     fhir:Claim.supportingInfo.sequence [ fhir:value "12"^^xsd:positiveInteger ] ;
     fhir:Claim.supportingInfo.category [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "radiotherapy" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueReference [
       fhir:link <http://hl7.org/fhir/Procedure/pro-min> ;
       fhir:Reference.reference [ fhir:value "Procedure/pro-min" ]
     ]
  ], [
     fhir:index 10 ;
     fhir:Claim.supportingInfo.sequence [ fhir:value "13"^^xsd:positiveInteger ] ;
     fhir:Claim.supportingInfo.category [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "carePlanDocument" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueReference [
       fhir:link <http://hl7.org/fhir/DocumentReference/doc-careplan-min> ;
       fhir:Reference.reference [ fhir:value "DocumentReference/doc-careplan-min" ]
     ]
  ], [
     fhir:index 11 ;
     fhir:Claim.supportingInfo.sequence [ fhir:value "14"^^xsd:positiveInteger ] ;
     fhir:Claim.supportingInfo.category [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "medicalRecord" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueReference [
       fhir:link <http://hl7.org/fhir/DocumentReference/doc-medicalRecord-min> ;
       fhir:Reference.reference [ fhir:value "DocumentReference/doc-medicalRecord-min" ]
     ]
  ], [
     fhir:index 12 ;
     fhir:Claim.supportingInfo.sequence [ fhir:value "15"^^xsd:positiveInteger ] ;
     fhir:Claim.supportingInfo.category [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "treatmentAssessment" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueReference [
       fhir:link <http://hl7.org/fhir/Observation/obs-tx-min> ;
       fhir:Reference.reference [ fhir:value "Observation/obs-tx-min" ]
     ]
  ], [
     fhir:index 13 ;
     fhir:Claim.supportingInfo.sequence [ fhir:value "16"^^xsd:positiveInteger ] ;
     fhir:Claim.supportingInfo.category [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "opd" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueReference [
       fhir:link <http://hl7.org/fhir/Composition/opd> ;
       fhir:Reference.reference [ fhir:value "Composition/opd" ]
     ]
  ], [
     fhir:index 14 ;
     fhir:Claim.supportingInfo.sequence [ fhir:value "17"^^xsd:positiveInteger ] ;
     fhir:Claim.supportingInfo.category [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "allergy" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueReference [
       fhir:link <http://hl7.org/fhir/AllergyIntolerance/all-min> ;
       fhir:Reference.reference [ fhir:value "AllergyIntolerance/all-min" ]
     ]
  ], [
     fhir:index 15 ;
     fhir:Claim.supportingInfo.sequence [ fhir:value "18"^^xsd:positiveInteger ] ;
     fhir:Claim.supportingInfo.category [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-supporting-info-type" ] ;
         fhir:Coding.code [ fhir:value "phototherapy" ]
       ]
     ] ;
     fhir:Claim.supportingInfo.valueReference [
       fhir:link <http://hl7.org/fhir/Procedure/pro-phototherapy> ;
       fhir:Reference.reference [ fhir:value "Procedure/pro-phototherapy" ]
     ]
  ] ;
  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.procedure [
     fhir:index 0 ;
     fhir:Claim.procedure.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
     fhir:Claim.procedure.date [ fhir:value "2024-01-01"^^xsd:date ] ;
     fhir:Claim.procedure.procedureCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://twcore.mohw.gov.tw/ig/twcore/CodeSystem/icd-10-pcs-2023-tw" ] ;
         fhir:Coding.code [ fhir:value "3E0Y704" ]
       ]
     ]
  ] ;
  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" ]
     ]
  ] ;
  fhir:Claim.item [
     fhir:index 0 ;
     fhir:Element.extension [
       fhir:index 0 ;
       fhir:Extension.url [ fhir:value "https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-requestedService" ] ;
       fhir:Extension.valueReference [
         fhir:link <http://hl7.org/fhir/MedicationRequest/medReq-apply> ;
         fhir:Reference.reference [ fhir:value "MedicationRequest/medReq-apply" ]
       ]
     ] ;
     fhir:Claim.item.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
     fhir:Claim.item.productOrService [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-order-type" ] ;
         fhir:Coding.code [ fhir:value "1" ] ;
         fhir:Coding.display [ fhir:value "藥品" ]
       ]
     ] ;
     fhir:Claim.item.modifier [
       fhir:index 0 ;
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status" ] ;
         fhir:Coding.code [ fhir:value "1" ] ;
         fhir:Coding.display [ fhir:value "初次使用" ]
       ]
     ], [
       fhir:index 1 ;
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-line-of-therapy" ] ;
         fhir:Coding.code [ fhir:value "1" ] ;
         fhir:Coding.display [ fhir:value "第一線治療" ]
       ]
     ] ;
     fhir:Claim.item.programCode [
       fhir:index 0 ;
       fhir:CodeableConcept.text [ fhir:value "ALK陽性的晚期非小細胞肺癌第一線治療" ]
     ] ;
     fhir:Claim.item.quantity [
       fhir:Quantity.value [ fhir:value "52"^^xsd:decimal ] ;
       fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ] ;
       fhir:Quantity.code [ fhir:value "{tbl}" ]
     ]
  ], [
     fhir:index 1 ;
     fhir:Element.extension [
       fhir:index 0 ;
       fhir:Extension.url [ fhir:value "https://nhicore.nhi.gov.tw/pas/StructureDefinition/extension-requestedService" ] ;
       fhir:Extension.valueReference [
         fhir:link <http://hl7.org/fhir/MedicationRequest/medReq-apply-2> ;
         fhir:Reference.reference [ fhir:value "MedicationRequest/medReq-apply-2" ]
       ]
     ] ;
     fhir:Claim.item.sequence [ fhir:value "2"^^xsd:positiveInteger ] ;
     fhir:Claim.item.productOrService [
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-order-type" ] ;
         fhir:Coding.code [ fhir:value "1" ] ;
         fhir:Coding.display [ fhir:value "藥品" ]
       ]
     ] ;
     fhir:Claim.item.modifier [
       fhir:index 0 ;
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-continuation-status" ] ;
         fhir:Coding.code [ fhir:value "1" ] ;
         fhir:Coding.display [ fhir:value "初次使用" ]
       ]
     ], [
       fhir:index 1 ;
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-line-of-therapy" ] ;
         fhir:Coding.code [ fhir:value "1" ] ;
         fhir:Coding.display [ fhir:value "第一線治療" ]
       ]
     ] ;
     fhir:Claim.item.programCode [
       fhir:index 0 ;
       fhir:CodeableConcept.coding [
         fhir:index 0 ;
         fhir:Coding.system [ fhir:value "https://nhicore.nhi.gov.tw/pas/CodeSystem/nhi-apply-reason" ] ;
         fhir:Coding.code [ fhir:value "C50P1" ]
       ]
     ] ;
     fhir:Claim.item.quantity [
       fhir:Quantity.value [ fhir:value "70"^^xsd:decimal ] ;
       fhir:Quantity.system [ fhir:value "http://unitsofmeasure.org" ] ;
       fhir:Quantity.code [ fhir:value "{tbl}" ]
     ]
  ] .

<http://hl7.org/fhir/Encounter/enc-min> a fhir:Encounter .

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

<http://hl7.org/fhir/Practitioner/pra-min> a fhir:Practitioner .

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

<http://hl7.org/fhir/Observation/obs-blood-group> a fhir:Observation .

<http://hl7.org/fhir/DiagnosticReport/diaRep-ima-min> a fhir:DiagnosticReport .

<http://hl7.org/fhir/DiagnosticReport/diaRep-min> a fhir:DiagnosticReport .

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

<http://hl7.org/fhir/Observation/obs-lab-cbc> a fhir:Observation .

<http://hl7.org/fhir/Observation/obs-pat-nyha> a fhir:Observation .

<http://hl7.org/fhir/MedicationRequest/medReq-treat> a fhir:MedicationRequest .

<http://hl7.org/fhir/Procedure/pro-min> a fhir:Procedure .

<http://hl7.org/fhir/DocumentReference/doc-careplan-min> a fhir:DocumentReference .

<http://hl7.org/fhir/DocumentReference/doc-medicalRecord-min> a fhir:DocumentReference .

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

<http://hl7.org/fhir/Composition/opd> a fhir:Composition .

<http://hl7.org/fhir/AllergyIntolerance/all-min> a fhir:AllergyIntolerance .

<http://hl7.org/fhir/Procedure/pro-phototherapy> a fhir:Procedure .

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

<http://hl7.org/fhir/MedicationRequest/medReq-apply> a fhir:MedicationRequest .

<http://hl7.org/fhir/MedicationRequest/medReq-apply-2> a fhir:MedicationRequest .

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

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