מדריך למטמיע - טופס 17
1.0.0 - ci-build
This page is part of the T17 IG (v1.0.0: draft-1 Draft) 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
Generated Narrative: Bundle new-request-multiple-codes
version: 4; Last updated: 2023-10-30 17:21:14+0000;
Information Source: #HSSKFZAR14F07q4F
Bundle new-request-multiple-codes of type collection
Entry 1 - fullUrl = urn:uuid:1b808cf4-0643-4c04-a8d2-c555ec26ddad
Resource CoverageEligibilityRequest:
Generated Narrative: CoverageEligibilityRequest Inline-Instance-for-3813-1
identifier:
http://fhir.tlvmc.gov.il/identifier/preauth-req-no/3772status: Active
purpose: Coverage Validation
patient: Bundle: type = collection
serviced: 2023-07-02
created: 2023-07-04 04:52:03+0000
provider: בי"ח איכילוב (Identifier: Israeli Legal Entity/500106919)
insurer: מאוחדת (Identifier: Israeli Legal Entity/5899584495)
facility: Bundle: type = collection
supportingInfo
sequence: 1
information: Bundle: type = collection
supportingInfo
sequence: 2
information: מסמך סיכום ביקור עם המלצה לביקור חוזר
item
productOrService: בדיקת רופא ילדים במרפאה
quantity: 2
UnitPrices
Value Currency 210 ILS item
productOrService: בדיקת רופא כירורג בית החזה במרפאה
quantity: 1
UnitPrices
Value Currency 242 ILS item
productOrService: בדיקת רופא כירורג שד במרפאה
quantity: 2
UnitPrices
Value Currency 136 ILS item
productOrService: בדיקת רופא מומחה במרפאה, למעט בדיקות להן קוד מיוחד
quantity: 2
UnitPrices
Value Currency 80 ILS
Entry 2 - fullUrl = urn:uuid:8be7c2eb-07a2-4dfb-b27d-821863201199
Resource Patient:
Generated Narrative: Patient Inline-Instance-for-3813-2
שרה Female, DoB: 1969-07-16 ( http://fhir.leumit.co.il/identifier/magnetic-card#1-123456-123456-789)
Active: true Contact Detail ph: 054-99999999(Mobile)
Entry 3 - fullUrl = urn:uuid:792cc202-b6dd-4b45-bbf9-31358841836a
Resource Appointment:
Generated Narrative: Appointment Inline-Instance-for-3813-3
identifier:
http://fhir.tlvmc.gov.il/Appointment/identifier/A-10005status: Booked
appointmentType: A follow up visit from a previous appointment
description: תור לביקור חוזר
start: 2023-09-01 09:00:00+0000
end: 2023-09-01 10:00:00+0000
created: 2023-07-02
participant
type: subject
actor: Bundle: type = collection
status: Accepted
participant
type: primary performer
actor: Identifier: Israeli Ministry of Health practitioner license/1-4281388
status: Accepted
Entry 4 - fullUrl = urn:uuid:6e77f7eb-1693-4d19-b64b-b6ae92ec4aba
Resource Location:
Generated Narrative: Location Inline-Instance-for-3813-4
mode: Instance
type: מרפאות - עיניים
managingOrganization: בי"ח איכילוב (Identifier: Israeli Legal Entity/500106919)
Entry 5 - fullUrl = urn:uuid:df9c48ad-f1a2-41a0-9755-7a5726cf6050
Resource DocumentReference:
Generated Narrative: DocumentReference Inline-Instance-for-3813-5
Ext: ILCore Documented Event Date: 2023-06-21 07:13:21+1100
identifier: URI/urn:uuid:cb512709-9276-4afd-9271-4990e5ef2889
status: Current
docStatus: Final
type: סיכום ביקור הכולל המלצה לקביעת תור המשך
subject: Bundle: type = collection
date: 2023-07-02 09:43:41+1100
description:
מסמך סיכום ביקור עם המלצה לביקור חוזר
content
Attachments
ContentType Data application/pdf (base64 data - 34,124 base64 chars)