理賠申請書(ClaimForm)之資料模型 - XML Representation

醫療保險理賠實作指引 - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
Logical Model: ClaimFormModel - XML Profile

Active as of 2024-07-23
XML representation of the ClaimFormModel logical model.
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<StructureDefinition xmlns="http://hl7.org/fhir">
  <id value="ClaimFormModel"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: StructureDefinition ClaimFormModel</b></p><a name="ClaimFormModel"> </a><a name="hcClaimFormModel"> </a><a name="ClaimFormModel-en-US"> </a><table border="0" cellpadding="0" cellspacing="0" style="border: 0px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="The logical name of the element">Name</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Information about the use of the element">Flags</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Minimum and Maximum # of times the element can appear in the instance">Card.</a></th><th style="width: 100px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Reference to the type of the element">Type</a></th><th style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Additional information about the element">Description &amp; Constraints</a><span style="float: right"><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_element.gif" alt="." style="background-color: white; background-color: inherit" title="Element" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel" title="理賠申請書(ClaimForm)之資料模型">ClaimFormModel</a><a name="ClaimFormModel"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><span style="opacity: 0.5">0</span><span style="opacity: 0.5">..</span><span style="opacity: 0.5">*</span></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://build.fhir.org/types.html#Base">Base</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">理賠申請書(ClaimForm)之資料模型<br/><span style="font-weight:bold">Instances of this logical model are not marked to be the target of a Reference</span></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.caseNo" title="案件編號">caseNo</a><a name="ClaimFormModel.caseNo"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/extensions/5.1.0/StructureDefinition-elementdefinition-identifier.html" title="Extension">Identifier(5.1.0)</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">案件編號</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.admissionNumber" title="住院號／就醫號">admissionNumber</a><a name="ClaimFormModel.admissionNumber"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/extensions/5.1.0/StructureDefinition-elementdefinition-identifier.html" title="Extension">Identifier(5.1.0)</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">住院號／就醫號</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.patient" title="病人的基本資料">patient</a><a name="ClaimFormModel.patient"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">病人的基本資料</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.patient.occupation" title="職業">occupation</a><a name="ClaimFormModel.patient.occupation"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">職業</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.patient.identifier" title="身分證字號">identifier</a><a name="ClaimFormModel.patient.identifier"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/extensions/5.1.0/StructureDefinition-elementdefinition-identifier.html" title="Extension">Identifier(5.1.0)</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">身分證字號</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.patient.patientNo" title="病歷號碼">patientNo</a><a name="ClaimFormModel.patient.patientNo"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/extensions/5.1.0/StructureDefinition-elementdefinition-identifier.html" title="Extension">Identifier(5.1.0)</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">病歷號碼</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.patient.name" title="病人之合法姓名。">name</a><a name="ClaimFormModel.patient.name"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#HumanName">HumanName</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">姓名</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.patient.gender" title="性別">gender</a><a name="ClaimFormModel.patient.gender"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">性別</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.patient.birthDate" title="病人的生日，如果有完整或部分的生日日期則必須提供，若無完整或部分的生日日期則以空字串''表示之。">birthDate</a><a name="ClaimFormModel.patient.birthDate"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#dateTime">dateTime</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">出生日期</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.patient.address" title="居住地址">address</a><a name="ClaimFormModel.patient.address"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#Address">Address</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">居住地址</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.organization" title="醫事機構">organization</a><a name="ClaimFormModel.organization"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">醫事機構</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.organization.identifier" title="醫事機構代碼">identifier</a><a name="ClaimFormModel.organization.identifier"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/extensions/5.1.0/StructureDefinition-elementdefinition-identifier.html" title="Extension">Identifier(5.1.0)</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">醫事機構代碼</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.certificateOfDiagnosis" title="診斷證明書">certificateOfDiagnosis</a><a name="ClaimFormModel.certificateOfDiagnosis"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">診斷證明書<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.certificateOfDiagnosis.patientSource" title="病人來源">patientSource</a><a name="ClaimFormModel.certificateOfDiagnosis.patientSource"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">病人來源</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.certificateOfDiagnosis.particularDiagnosis" title="特殊診斷類別">particularDiagnosis</a><a name="ClaimFormModel.certificateOfDiagnosis.particularDiagnosis"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">特殊診斷類別</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.certificateOfDiagnosis.department" title="應診科別">department</a><a name="ClaimFormModel.certificateOfDiagnosis.department"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">應診科別</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.certificateOfDiagnosis.departmentCode" title="應診科別代碼">departmentCode</a><a name="ClaimFormModel.certificateOfDiagnosis.departmentCode"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">應診科別代碼</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.certificateOfDiagnosis.firstExaminationDate" title="應診日期（始）">firstExaminationDate</a><a name="ClaimFormModel.certificateOfDiagnosis.firstExaminationDate"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#dateTime">dateTime</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">應診日期（始）</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.certificateOfDiagnosis.endExaminationDate" title="應診日期（末）">endExaminationDate</a><a name="ClaimFormModel.certificateOfDiagnosis.endExaminationDate"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#dateTime">dateTime</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">應診日期（末）</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.certificateOfDiagnosis.examinationDay" title="應診天數">examinationDay</a><a name="ClaimFormModel.certificateOfDiagnosis.examinationDay"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#Duration">Duration</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">應診天數</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.certificateOfDiagnosis.identifier" title="診斷證明書序號">identifier</a><a name="ClaimFormModel.certificateOfDiagnosis.identifier"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/extensions/5.1.0/StructureDefinition-elementdefinition-identifier.html" title="Extension">Identifier(5.1.0)</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">診斷證明書序號</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.certificateOfDiagnosis.diagnosis" title="診斷（病名）">diagnosis</a><a name="ClaimFormModel.certificateOfDiagnosis.diagnosis"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">診斷（病名）<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.certificateOfDiagnosis.diagnosisCode" title="病名代碼">diagnosisCode</a><a name="ClaimFormModel.certificateOfDiagnosis.diagnosisCode"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..*</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">病名代碼<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.certificateOfDiagnosis.recordedDate" title="診斷證明書日期">recordedDate</a><a name="ClaimFormModel.certificateOfDiagnosis.recordedDate"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#dateTime">dateTime</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">診斷證明書日期</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.certificateOfDiagnosis.primaryPhysician" title="主治醫師">primaryPhysician</a><a name="ClaimFormModel.certificateOfDiagnosis.primaryPhysician"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#HumanName">HumanName</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">主治醫師</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.certificateOfDiagnosis.primaryPhysicianNo" title="醫師證號">primaryPhysicianNo</a><a name="ClaimFormModel.certificateOfDiagnosis.primaryPhysicianNo"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/extensions/5.1.0/StructureDefinition-elementdefinition-identifier.html" title="Extension">Identifier(5.1.0)</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">醫師證號</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.certificateOfDiagnosis.medicalSummary" title="醫療摘要">medicalSummary</a><a name="ClaimFormModel.certificateOfDiagnosis.medicalSummary"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#markdown">markdown</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">醫療摘要</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.certificateOfDiagnosis.responsiblePhysician" title="負責醫師（院長）">responsiblePhysician</a><a name="ClaimFormModel.certificateOfDiagnosis.responsiblePhysician"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#HumanName">HumanName</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">負責醫師（院長）</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.invoice" title="收據正本及費用明細表">invoice</a><a name="ClaimFormModel.invoice"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">收據正本及費用明細表<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.invoice.chargeItem" title="費用項目">chargeItem</a><a name="ClaimFormModel.invoice.chargeItem"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">費用項目<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.invoice.medicalIdentity" title="就醫身分">medicalIdentity</a><a name="ClaimFormModel.invoice.medicalIdentity"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">就醫身分</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.invoice.invoiceDate" title="收據日期">invoiceDate</a><a name="ClaimFormModel.invoice.invoiceDate"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#date">date</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">收據日期</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.invoice.selfPayAmount" title="自付金額">selfPayAmount</a><a name="ClaimFormModel.invoice.selfPayAmount"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#Money">Money</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">自付金額</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.invoice.discount" title="減免">discount</a><a name="ClaimFormModel.invoice.discount"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#Money">Money</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">減免</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck110.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.invoice.nationalHealthInsuranePoint" title="健保點數">nationalHealthInsuranePoint</a><a name="ClaimFormModel.invoice.nationalHealthInsuranePoint"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#Money">Money</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">健保點數</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.invoice.invoiceAmount" title="收據金額">invoiceAmount</a><a name="ClaimFormModel.invoice.invoiceAmount"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#Money">Money</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">收據金額</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.laboratoryReport" title="相關檢驗/檢查報告">laboratoryReport</a><a name="ClaimFormModel.laboratoryReport"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">相關檢驗/檢查報告<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.laboratoryReport.laboratoryReportName" title="檢驗報告名稱">laboratoryReportName</a><a name="ClaimFormModel.laboratoryReport.laboratoryReportName"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">檢驗報告名稱</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.laboratoryReport.laboratoryReportNo" title="收件編號(檢驗單號)">laboratoryReportNo</a><a name="ClaimFormModel.laboratoryReport.laboratoryReportNo"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/extensions/5.1.0/StructureDefinition-elementdefinition-identifier.html" title="Extension">Identifier(5.1.0)</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">收件編號(檢驗單號)</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.laboratoryReport.laboratoryItemName" title="檢驗項目名稱">laboratoryItemName</a><a name="ClaimFormModel.laboratoryReport.laboratoryItemName"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">檢驗項目名稱<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.laboratoryReport.samplingDate" title="採檢日期">samplingDate</a><a name="ClaimFormModel.laboratoryReport.samplingDate"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#dateTime">dateTime</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">採檢日期</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.laboratoryReport.reportDate" title="報告日期">reportDate</a><a name="ClaimFormModel.laboratoryReport.reportDate"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#instant">instant</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">報告日期</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.laboratoryReport.medicalTechnologist" title="醫檢師">medicalTechnologist</a><a name="ClaimFormModel.laboratoryReport.medicalTechnologist"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#HumanName">HumanName</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">醫檢師</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.laboratoryReport.reporter" title="報告者">reporter</a><a name="ClaimFormModel.laboratoryReport.reporter"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#HumanName">HumanName</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">報告者</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.laboratoryReport.laboratoryValue" title="檢測值">laboratoryValue</a><a name="ClaimFormModel.laboratoryReport.laboratoryValue"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..*</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">檢測值<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.laboratoryReport.unit" title="單位">unit</a><a name="ClaimFormModel.laboratoryReport.unit"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#string">string</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">單位</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.laboratoryReport.hL" title="H/L">hL</a><a name="ClaimFormModel.laboratoryReport.hL"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">H/L</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_primitive.png" alt="." style="background-color: white; background-color: inherit" title="Primitive Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.laboratoryReport.note" title="註記">note</a><a name="ClaimFormModel.laboratoryReport.note"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#markdown">markdown</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">註記</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.laboratoryReport.bodySite" title="檢驗部位">bodySite</a><a name="ClaimFormModel.laboratoryReport.bodySite"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">檢驗部位</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.laboratoryReport.referenceRange" title="參考值">referenceRange</a><a name="ClaimFormModel.laboratoryReport.referenceRange"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..*</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#BackboneElement">BackboneElement</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">參考值<br/></td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck010.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: #F7F7F7; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.laboratoryReport.recordedPhysician" title="開單醫師">recordedPhysician</a><a name="ClaimFormModel.laboratoryReport.recordedPhysician"> </a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#HumanName">HumanName</a></td><td style="vertical-align: top; text-align : left; background-color: #F7F7F7; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">開單醫師</td></tr>
<tr style="border: 0px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_datatype.gif" alt="." style="background-color: white; background-color: inherit" title="Data Type" class="hierarchy"/> <a href="StructureDefinition-ClaimFormModel-definitions.html#ClaimFormModel.laboratoryReport.recordedDepartment" title="開單科別">recordedDepartment</a><a name="ClaimFormModel.laboratoryReport.recordedDepartment"> </a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">1..1</td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="http://hl7.org/fhir/R4/datatypes.html#CodeableConcept">CodeableConcept</a></td><td style="vertical-align: top; text-align : left; background-color: white; border: 0px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">開單科別</td></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="https://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#table-views" title="Legend for this format"><img src="data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAABAAAAAQCAYAAAAf8/9hAAAABmJLR0QA/wD/AP+gvaeTAAAACXBIWXMAAAsTAAALEwEAmpwYAAAAB3RJTUUH3goXBCwdPqAP0wAAAldJREFUOMuNk0tIlFEYhp9z/vE2jHkhxXA0zJCMitrUQlq4lnSltEqCFhFG2MJFhIvIFpkEWaTQqjaWZRkp0g26URZkTpbaaOJkDqk10szoODP//7XIMUe0elcfnPd9zsfLOYplGrpRwZaqTtw3K7PtGem7Q6FoidbGgqHVy/HRb669R+56zx7eRV1L31JGxYbBtjKK93cxeqfyQHbehkZbUkK20goELEuIzEd+dHS+qz/Y8PTSif0FnGkbiwcAjHaU1+QWOptFiyCLp/LnKptpqIuXHx6rbR26kJcBX3yLgBfnd7CxwJmflpP2wUg0HIAoUUpZBmKzELGWcN8nAr6Gpu7tLU/CkwAaoKTWRSQyt89Q8w6J+oVQkKnBoblH7V0PPvUOvDYXfopE/SJmALsxnVm6LbkotrUtNowMeIrVrBcBpaMmdS0j9df7abpSuy7HWehwJdt1lhVwi/J58U5beXGAF6c3UXLycw1wdFklArBn87xdh0ZsZtArghBdAA3+OEDVubG4UEzP6x1FOWneHh2VDAHBAt80IbdXDcesNoCvs3E5AFyNSU5nbrDPZpcUEQQTFZiEVx+51fxMhhyJEAgvlriadIJZZksRuwBYMOPBbO3hePVVqgEJhFeUuFLhIPkRP6BQLIBrmMenujm/3g4zc398awIe90Zb5A1vREALqneMcYgP/xVQWlG+Ncu5vgwwlaUNx+3799rfe96u9K0JSDXcOzOTJg4B6IgmXfsygc7/Bvg9g9E58/cDVmGIBOP/zT8Bz1zqWqpbXIsd0O9hajXfL6u4BaOS6SeWAAAAAElFTkSuQmCC" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table></div>
  </text>
  <url
       value="https://claim.cgh.org.tw/iclaim/StructureDefinition/ClaimFormModel"/>
  <version value="1.0.0"/>
  <name value="ClaimFormModel"/>
  <title value="理賠申請書(ClaimForm)之資料模型"/>
  <status value="active"/>
  <date value="2024-07-23T01:16:30+08:00"/>
  <publisher value="國泰金控"/>
  <contact>
    <name value="國泰金控"/>
    <telecom>
      <system value="url"/>
      <value value="https://www.cathayholdings.com/holdings/"/>
    </telecom>
  </contact>
  <description value="理賠申請書(ClaimForm)之資料模型"/>
  <fhirVersion value="4.0.1"/>
  <mapping>
    <identity value="IClaim"/>
    <uri value="https://claim.cgh.org.tw/iclaim"/>
    <name value="iClaim IG"/>
  </mapping>
  <kind value="logical"/>
  <abstract value="false"/>
  <type
        value="https://claim.cgh.org.tw/iclaim/StructureDefinition/ClaimFormModel"/>
  <baseDefinition value="http://hl7.org/fhir/StructureDefinition/Base"/>
  <derivation value="specialization"/>
  <snapshot>
    <element id="ClaimFormModel">
      <path value="ClaimFormModel"/>
      <short value="理賠申請書(ClaimForm)之資料模型"/>
      <definition value="理賠申請書(ClaimForm)之資料模型"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Base"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <isModifier value="false"/>
      <mapping>
        <identity value="IClaim"/>
        <map value="BundleiClaim"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.caseNo">
      <path value="ClaimFormModel.caseNo"/>
      <short value="案件編號"/>
      <definition value="案件編號"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.caseNo"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/elementdefinition-identifier"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:IClaim.identifier"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.admissionNumber">
      <path value="ClaimFormModel.admissionNumber"/>
      <short value="住院號／就醫號"/>
      <definition value="住院號／就醫號"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.admissionNumber"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/elementdefinition-identifier"/>
      </type>
    </element>
    <element id="ClaimFormModel.patient">
      <path value="ClaimFormModel.patient"/>
      <short value="病人的基本資料"/>
      <definition value="病人的基本資料"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.patient"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
    </element>
    <element id="ClaimFormModel.patient.id">
      <path value="ClaimFormModel.patient.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.patient.extension">
      <path value="ClaimFormModel.patient.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.patient.modifierExtension">
      <path value="ClaimFormModel.patient.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.patient.occupation">
      <path value="ClaimFormModel.patient.occupation"/>
      <short value="職業"/>
      <definition value="職業"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.patient.occupation"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:patient.occupation"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.patient.identifier">
      <path value="ClaimFormModel.patient.identifier"/>
      <short value="身分證字號"/>
      <definition value="身分證字號"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.patient.identifier"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/elementdefinition-identifier"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:patient.identifier:idCardNumber"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.patient.patientNo">
      <path value="ClaimFormModel.patient.patientNo"/>
      <short value="病歷號碼"/>
      <definition value="病歷號碼"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.patient.patientNo"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/elementdefinition-identifier"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:patient.identifier:medicalRecord"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.patient.name">
      <path value="ClaimFormModel.patient.name"/>
      <short value="姓名"/>
      <definition value="病人之合法姓名。"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.patient.name"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="HumanName"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:patient.name"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.patient.gender">
      <path value="ClaimFormModel.patient.gender"/>
      <short value="性別"/>
      <definition value="性別"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.patient.gender"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:patient.gender"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.patient.birthDate">
      <path value="ClaimFormModel.patient.birthDate"/>
      <short value="出生日期"/>
      <definition value="病人的生日，如果有完整或部分的生日日期則必須提供，若無完整或部分的生日日期則以空字串''表示之。"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.patient.birthDate"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:patient.birthDate"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.patient.address">
      <path value="ClaimFormModel.patient.address"/>
      <short value="居住地址"/>
      <definition value="居住地址"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.patient.address"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Address"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:patient.address"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.organization">
      <path value="ClaimFormModel.organization"/>
      <short value="醫事機構"/>
      <definition value="醫事機構"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.organization"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
    </element>
    <element id="ClaimFormModel.organization.id">
      <path value="ClaimFormModel.organization.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.organization.extension">
      <path value="ClaimFormModel.organization.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.organization.modifierExtension">
      <path value="ClaimFormModel.organization.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.organization.identifier">
      <path value="ClaimFormModel.organization.identifier"/>
      <short value="醫事機構代碼"/>
      <definition value="醫事機構代碼"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.organization.identifier"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/elementdefinition-identifier"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:provider.identifier"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis">
      <path value="ClaimFormModel.certificateOfDiagnosis"/>
      <short value="診斷證明書"/>
      <definition value="診斷證明書"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ClaimFormModel.certificateOfDiagnosis"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.id">
      <path value="ClaimFormModel.certificateOfDiagnosis.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.extension">
      <path value="ClaimFormModel.certificateOfDiagnosis.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.modifierExtension">
      <path value="ClaimFormModel.certificateOfDiagnosis.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.patientSource">
      <path value="ClaimFormModel.certificateOfDiagnosis.patientSource"/>
      <short value="病人來源"/>
      <definition value="病人來源"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.certificateOfDiagnosis.patientSource"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:encounter.class"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.particularDiagnosis">
      <path
            value="ClaimFormModel.certificateOfDiagnosis.particularDiagnosis"/>
      <short value="特殊診斷類別"/>
      <definition value="特殊診斷類別"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path
              value="ClaimFormModel.certificateOfDiagnosis.particularDiagnosis"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:encounter.type"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.department">
      <path value="ClaimFormModel.certificateOfDiagnosis.department"/>
      <short value="應診科別"/>
      <definition value="應診科別"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.certificateOfDiagnosis.department"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:encounter.serviceType.coding.display"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.departmentCode">
      <path value="ClaimFormModel.certificateOfDiagnosis.departmentCode"/>
      <short value="應診科別代碼"/>
      <definition value="應診科別代碼"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.certificateOfDiagnosis.departmentCode"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:encounter.serviceType.coding.code"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.firstExaminationDate">
      <path
            value="ClaimFormModel.certificateOfDiagnosis.firstExaminationDate"/>
      <short value="應診日期（始）"/>
      <definition value="應診日期（始）"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path
              value="ClaimFormModel.certificateOfDiagnosis.firstExaminationDate"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:encounter.period.start"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.endExaminationDate">
      <path value="ClaimFormModel.certificateOfDiagnosis.endExaminationDate"/>
      <short value="應診日期（末）"/>
      <definition value="應診日期（末）"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path
              value="ClaimFormModel.certificateOfDiagnosis.endExaminationDate"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:encounter.period.end"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.examinationDay">
      <path value="ClaimFormModel.certificateOfDiagnosis.examinationDay"/>
      <short value="應診天數"/>
      <definition value="應診天數"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.certificateOfDiagnosis.examinationDay"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Duration"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:encounter.length"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.identifier">
      <path value="ClaimFormModel.certificateOfDiagnosis.identifier"/>
      <short value="診斷證明書序號"/>
      <definition value="診斷證明書序號"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.certificateOfDiagnosis.identifier"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/elementdefinition-identifier"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:condition.identifier"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.diagnosis">
      <path value="ClaimFormModel.certificateOfDiagnosis.diagnosis"/>
      <short value="診斷（病名）"/>
      <definition value="診斷（病名）"/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="ClaimFormModel.certificateOfDiagnosis.diagnosis"/>
        <min value="1"/>
        <max value="*"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:condition.code.coding:icd10-cm-2021.display 或 entry:condition.code.coding:icd10-cm-2014.display 或 entry:condition.code.coding:icd9-cm.display"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.diagnosisCode">
      <path value="ClaimFormModel.certificateOfDiagnosis.diagnosisCode"/>
      <short value="病名代碼"/>
      <definition value="病名代碼"/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="ClaimFormModel.certificateOfDiagnosis.diagnosisCode"/>
        <min value="1"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:condition.code.coding:icd10-cm-2021.code 或 entry:condition.code.coding:icd10-cm-2014.code 或 entry:condition.code.coding:icd9-cm.code"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.recordedDate">
      <path value="ClaimFormModel.certificateOfDiagnosis.recordedDate"/>
      <short value="診斷證明書日期"/>
      <definition value="診斷證明書日期"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.certificateOfDiagnosis.recordedDate"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:condition.recordedDate"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.primaryPhysician">
      <path value="ClaimFormModel.certificateOfDiagnosis.primaryPhysician"/>
      <short value="主治醫師"/>
      <definition value="主治醫師"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.certificateOfDiagnosis.primaryPhysician"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="HumanName"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:condition.recorder.Reference(PractitionerRole iClaim).where(code = '405279007').practitioner.Reference(Practitioner iClaim).name"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.primaryPhysicianNo">
      <path value="ClaimFormModel.certificateOfDiagnosis.primaryPhysicianNo"/>
      <short value="醫師證號"/>
      <definition value="醫師證號"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path
              value="ClaimFormModel.certificateOfDiagnosis.primaryPhysicianNo"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/elementdefinition-identifier"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:condition.recorder.Reference(PractitionerRole iClaim).where(code = '405279007').practitioner.Reference(Practitioner iClaim).identifier"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.medicalSummary">
      <path value="ClaimFormModel.certificateOfDiagnosis.medicalSummary"/>
      <short value="醫療摘要"/>
      <definition value="醫療摘要"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.certificateOfDiagnosis.medicalSummary"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="markdown"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:condition.note.text"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.responsiblePhysician">
      <path
            value="ClaimFormModel.certificateOfDiagnosis.responsiblePhysician"/>
      <short value="負責醫師（院長）"/>
      <definition value="負責醫師（院長）"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path
              value="ClaimFormModel.certificateOfDiagnosis.responsiblePhysician"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="HumanName"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:condition.asserter.Reference(PractitionerRole iClaim).where(code = 'responsiblePhysician').practitioner.Reference(Practitioner iClaim).name"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice">
      <path value="ClaimFormModel.invoice"/>
      <short value="收據正本及費用明細表"/>
      <definition value="收據正本及費用明細表"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ClaimFormModel.invoice"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
    </element>
    <element id="ClaimFormModel.invoice.id">
      <path value="ClaimFormModel.invoice.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice.extension">
      <path value="ClaimFormModel.invoice.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice.modifierExtension">
      <path value="ClaimFormModel.invoice.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice.chargeItem">
      <path value="ClaimFormModel.invoice.chargeItem"/>
      <short value="費用項目"/>
      <definition value="費用項目"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ClaimFormModel.invoice.chargeItem"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:IClaim.item.productOrService"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice.medicalIdentity">
      <path value="ClaimFormModel.invoice.medicalIdentity"/>
      <short value="就醫身分"/>
      <definition value="就醫身分"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.invoice.medicalIdentity"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:IClaim.item.modifier"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice.invoiceDate">
      <path value="ClaimFormModel.invoice.invoiceDate"/>
      <short value="收據日期"/>
      <definition value="收據日期"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.invoice.invoiceDate"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="date"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:IClaim.item.servicedDate"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice.selfPayAmount">
      <path value="ClaimFormModel.invoice.selfPayAmount"/>
      <short value="自付金額"/>
      <definition value="自付金額"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.invoice.selfPayAmount"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Money"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:IClaim.item.where(category = 'base' and modifier = 'pay').net，透過「就醫身分(claim.item.modifier)」和「自付金額/減免(claim.item.category)」來判斷claim.item.net填的金額為「健保點數」／「自費金額」／「減免」，「就醫身分(claim.item.modifier)」為自費，自付金額/減免」為自付金額，則claim.item.net內為「自付金額」。"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice.discount">
      <path value="ClaimFormModel.invoice.discount"/>
      <short value="減免"/>
      <definition value="減免"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.invoice.discount"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Money"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:IClaim.item.where(category = 'discount' and modifier = 'pay').net，透過「就醫身分(claim.item.modifier)」和「自付金額/減免(claim.item.category)」來判斷claim.item.net填的金額為「健保點數」／「自費金額」／「減免」，「就醫身分(claim.item.modifier)」為自費，自付金額/減免」為減免，則claim.item.net內為「減免」。"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice.nationalHealthInsuranePoint">
      <path value="ClaimFormModel.invoice.nationalHealthInsuranePoint"/>
      <short value="健保點數"/>
      <definition value="健保點數"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.invoice.nationalHealthInsuranePoint"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Money"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:IClaim.item.where(modifier = 'PUBLICPOL').net，透過「就醫身分(claim.item.modifier)」和「自付金額/減免(claim.item.category)」來判斷claim.item.net填的金額為「健保點數」／「自費金額」／「減免」，「就醫身分(claim.item.modifier)」為健保，則claim.item.net內為「健保點數」。"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice.invoiceAmount">
      <path value="ClaimFormModel.invoice.invoiceAmount"/>
      <short value="收據金額"/>
      <definition value="收據金額"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.invoice.invoiceAmount"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Money"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:IClaim.total"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport">
      <path value="ClaimFormModel.laboratoryReport"/>
      <short value="相關檢驗/檢查報告"/>
      <definition value="相關檢驗/檢查報告"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="ClaimFormModel.laboratoryReport"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
    </element>
    <element id="ClaimFormModel.laboratoryReport.id">
      <path value="ClaimFormModel.laboratoryReport.id"/>
      <representation value="xmlAttr"/>
      <short value="Unique id for inter-element referencing"/>
      <definition
                  value="Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces."/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="Element.id"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <extension
                   url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type">
          <valueUrl value="string"/>
        </extension>
        <code value="http://hl7.org/fhirpath/System.String"/>
      </type>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.extension">
      <path value="ClaimFormModel.laboratoryReport.extension"/>
      <slicing>
        <discriminator>
          <type value="value"/>
          <path value="url"/>
        </discriminator>
        <description value="Extensions are always sliced by (at least) url"/>
        <rules value="open"/>
      </slicing>
      <short value="Additional content defined by implementations"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance  applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="Element.extension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="false"/>
      <isSummary value="false"/>
      <mapping>
        <identity value="rim"/>
        <map value="n/a"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.modifierExtension">
      <path value="ClaimFormModel.laboratoryReport.modifierExtension"/>
      <short value="Extensions that cannot be ignored even if unrecognized"/>
      <definition
                  value="May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.

Modifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself)."/>
      <comment
               value="There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions.  The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone."/>
      <requirements
                    value="Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored.  This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](http://hl7.org/fhir/R4/extensibility.html#modifierExtension)."/>
      <alias value="extensions"/>
      <alias value="user content"/>
      <alias value="modifiers"/>
      <min value="0"/>
      <max value="*"/>
      <base>
        <path value="BackboneElement.modifierExtension"/>
        <min value="0"/>
        <max value="*"/>
      </base>
      <type>
        <code value="Extension"/>
      </type>
      <constraint>
        <key value="ele-1"/>
        <severity value="error"/>
        <human value="All FHIR elements must have a @value or children"/>
        <expression
                    value="hasValue() or (children().count() &gt; id.count())"/>
        <xpath value="@value|f:*|h:div"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Element"/>
      </constraint>
      <constraint>
        <key value="ext-1"/>
        <severity value="error"/>
        <human value="Must have either extensions or value[x], not both"/>
        <expression value="extension.exists() != value.exists()"/>
        <xpath
               value="exists(f:extension)!=exists(f:*[starts-with(local-name(.), &quot;value&quot;)])"/>
        <source value="http://hl7.org/fhir/StructureDefinition/Extension"/>
      </constraint>
      <isModifier value="true"/>
      <isModifierReason
                        value="Modifier extensions are expected to modify the meaning or interpretation of the element that contains them"/>
      <isSummary value="true"/>
      <mapping>
        <identity value="rim"/>
        <map value="N/A"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.laboratoryReportName">
      <path value="ClaimFormModel.laboratoryReport.laboratoryReportName"/>
      <short value="檢驗報告名稱"/>
      <definition value="檢驗報告名稱"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.laboratoryReport.laboratoryReportName"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:diagnosticReport.code"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.laboratoryReportNo">
      <path value="ClaimFormModel.laboratoryReport.laboratoryReportNo"/>
      <short value="收件編號(檢驗單號)"/>
      <definition value="收件編號(檢驗單號)"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.laboratoryReport.laboratoryReportNo"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/elementdefinition-identifier"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.identifier"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.laboratoryItemName">
      <path value="ClaimFormModel.laboratoryReport.laboratoryItemName"/>
      <short value="檢驗項目名稱"/>
      <definition value="檢驗項目名稱"/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="ClaimFormModel.laboratoryReport.laboratoryItemName"/>
        <min value="1"/>
        <max value="*"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.code.coding"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.samplingDate">
      <path value="ClaimFormModel.laboratoryReport.samplingDate"/>
      <short value="採檢日期"/>
      <definition value="採檢日期"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.laboratoryReport.samplingDate"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="dateTime"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.effectiveDateTime"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.reportDate">
      <path value="ClaimFormModel.laboratoryReport.reportDate"/>
      <short value="報告日期"/>
      <definition value="報告日期"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.laboratoryReport.reportDate"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="instant"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.issued"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.medicalTechnologist">
      <path value="ClaimFormModel.laboratoryReport.medicalTechnologist"/>
      <short value="醫檢師"/>
      <definition value="醫檢師"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.laboratoryReport.medicalTechnologist"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="HumanName"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:observation.performer.Reference(PractitionerRole iClaim).where(code = '307988006').practitioner.Reference(Practitioner iClaim).name"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.reporter">
      <path value="ClaimFormModel.laboratoryReport.reporter"/>
      <short value="報告者"/>
      <definition value="報告者"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.laboratoryReport.reporter"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="HumanName"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:observation.performer.Reference(PractitionerRole iClaim).where(code = 'reporter').practitioner.Reference(Practitioner iClaim).name"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.laboratoryValue">
      <path value="ClaimFormModel.laboratoryReport.laboratoryValue"/>
      <short value="檢測值"/>
      <definition value="檢測值"/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="ClaimFormModel.laboratoryReport.laboratoryValue"/>
        <min value="1"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.value"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.unit">
      <path value="ClaimFormModel.laboratoryReport.unit"/>
      <short value="單位"/>
      <definition value="單位"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.laboratoryReport.unit"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.valueQuantity.unit"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.hL">
      <path value="ClaimFormModel.laboratoryReport.hL"/>
      <short value="H/L"/>
      <definition value="H/L"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.laboratoryReport.hL"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.interpretation"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.note">
      <path value="ClaimFormModel.laboratoryReport.note"/>
      <short value="註記"/>
      <definition value="註記"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.laboratoryReport.note"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="markdown"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.note.text"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.bodySite">
      <path value="ClaimFormModel.laboratoryReport.bodySite"/>
      <short value="檢驗部位"/>
      <definition value="檢驗部位"/>
      <min value="0"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.laboratoryReport.bodySite"/>
        <min value="0"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.bodySite"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.referenceRange">
      <path value="ClaimFormModel.laboratoryReport.referenceRange"/>
      <short value="參考值"/>
      <definition value="參考值"/>
      <min value="1"/>
      <max value="*"/>
      <base>
        <path value="ClaimFormModel.laboratoryReport.referenceRange"/>
        <min value="1"/>
        <max value="*"/>
      </base>
      <type>
        <code value="BackboneElement"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.referenceRange"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.recordedPhysician">
      <path value="ClaimFormModel.laboratoryReport.recordedPhysician"/>
      <short value="開單醫師"/>
      <definition value="開單醫師"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.laboratoryReport.recordedPhysician"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="HumanName"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:encounter.participant.individual.Reference(PractitionerRole iClaim).where(code = 'recordedPhysician').practitioner.Reference(Practitioner iClaim).name"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.recordedDepartment">
      <path value="ClaimFormModel.laboratoryReport.recordedDepartment"/>
      <short value="開單科別"/>
      <definition value="開單科別"/>
      <min value="1"/>
      <max value="1"/>
      <base>
        <path value="ClaimFormModel.laboratoryReport.recordedDepartment"/>
        <min value="1"/>
        <max value="1"/>
      </base>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:encounter.serviceType.coding"/>
      </mapping>
    </element>
  </snapshot>
  <differential>
    <element id="ClaimFormModel">
      <path value="ClaimFormModel"/>
      <short value="理賠申請書(ClaimForm)之資料模型"/>
      <definition value="理賠申請書(ClaimForm)之資料模型"/>
      <mapping>
        <identity value="IClaim"/>
        <map value="BundleiClaim"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.caseNo">
      <path value="ClaimFormModel.caseNo"/>
      <short value="案件編號"/>
      <definition value="案件編號"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/elementdefinition-identifier"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:IClaim.identifier"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.admissionNumber">
      <path value="ClaimFormModel.admissionNumber"/>
      <short value="住院號／就醫號"/>
      <definition value="住院號／就醫號"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/elementdefinition-identifier"/>
      </type>
    </element>
    <element id="ClaimFormModel.patient">
      <path value="ClaimFormModel.patient"/>
      <short value="病人的基本資料"/>
      <definition value="病人的基本資料"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="BackboneElement"/>
      </type>
    </element>
    <element id="ClaimFormModel.patient.occupation">
      <path value="ClaimFormModel.patient.occupation"/>
      <short value="職業"/>
      <definition value="職業"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:patient.occupation"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.patient.identifier">
      <path value="ClaimFormModel.patient.identifier"/>
      <short value="身分證字號"/>
      <definition value="身分證字號"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/elementdefinition-identifier"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:patient.identifier:idCardNumber"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.patient.patientNo">
      <path value="ClaimFormModel.patient.patientNo"/>
      <short value="病歷號碼"/>
      <definition value="病歷號碼"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/elementdefinition-identifier"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:patient.identifier:medicalRecord"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.patient.name">
      <path value="ClaimFormModel.patient.name"/>
      <short value="姓名"/>
      <definition value="病人之合法姓名。"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="HumanName"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:patient.name"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.patient.gender">
      <path value="ClaimFormModel.patient.gender"/>
      <short value="性別"/>
      <definition value="性別"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:patient.gender"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.patient.birthDate">
      <path value="ClaimFormModel.patient.birthDate"/>
      <short value="出生日期"/>
      <definition value="病人的生日，如果有完整或部分的生日日期則必須提供，若無完整或部分的生日日期則以空字串''表示之。"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:patient.birthDate"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.patient.address">
      <path value="ClaimFormModel.patient.address"/>
      <short value="居住地址"/>
      <definition value="居住地址"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Address"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:patient.address"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.organization">
      <path value="ClaimFormModel.organization"/>
      <short value="醫事機構"/>
      <definition value="醫事機構"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="BackboneElement"/>
      </type>
    </element>
    <element id="ClaimFormModel.organization.identifier">
      <path value="ClaimFormModel.organization.identifier"/>
      <short value="醫事機構代碼"/>
      <definition value="醫事機構代碼"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/elementdefinition-identifier"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:provider.identifier"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis">
      <path value="ClaimFormModel.certificateOfDiagnosis"/>
      <short value="診斷證明書"/>
      <definition value="診斷證明書"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="BackboneElement"/>
      </type>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.patientSource">
      <path value="ClaimFormModel.certificateOfDiagnosis.patientSource"/>
      <short value="病人來源"/>
      <definition value="病人來源"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:encounter.class"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.particularDiagnosis">
      <path
            value="ClaimFormModel.certificateOfDiagnosis.particularDiagnosis"/>
      <short value="特殊診斷類別"/>
      <definition value="特殊診斷類別"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:encounter.type"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.department">
      <path value="ClaimFormModel.certificateOfDiagnosis.department"/>
      <short value="應診科別"/>
      <definition value="應診科別"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:encounter.serviceType.coding.display"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.departmentCode">
      <path value="ClaimFormModel.certificateOfDiagnosis.departmentCode"/>
      <short value="應診科別代碼"/>
      <definition value="應診科別代碼"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:encounter.serviceType.coding.code"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.firstExaminationDate">
      <path
            value="ClaimFormModel.certificateOfDiagnosis.firstExaminationDate"/>
      <short value="應診日期（始）"/>
      <definition value="應診日期（始）"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:encounter.period.start"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.endExaminationDate">
      <path value="ClaimFormModel.certificateOfDiagnosis.endExaminationDate"/>
      <short value="應診日期（末）"/>
      <definition value="應診日期（末）"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:encounter.period.end"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.examinationDay">
      <path value="ClaimFormModel.certificateOfDiagnosis.examinationDay"/>
      <short value="應診天數"/>
      <definition value="應診天數"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Duration"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:encounter.length"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.identifier">
      <path value="ClaimFormModel.certificateOfDiagnosis.identifier"/>
      <short value="診斷證明書序號"/>
      <definition value="診斷證明書序號"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/elementdefinition-identifier"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:condition.identifier"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.diagnosis">
      <path value="ClaimFormModel.certificateOfDiagnosis.diagnosis"/>
      <short value="診斷（病名）"/>
      <definition value="診斷（病名）"/>
      <min value="1"/>
      <max value="*"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:condition.code.coding:icd10-cm-2021.display 或 entry:condition.code.coding:icd10-cm-2014.display 或 entry:condition.code.coding:icd9-cm.display"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.diagnosisCode">
      <path value="ClaimFormModel.certificateOfDiagnosis.diagnosisCode"/>
      <short value="病名代碼"/>
      <definition value="病名代碼"/>
      <min value="1"/>
      <max value="*"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:condition.code.coding:icd10-cm-2021.code 或 entry:condition.code.coding:icd10-cm-2014.code 或 entry:condition.code.coding:icd9-cm.code"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.recordedDate">
      <path value="ClaimFormModel.certificateOfDiagnosis.recordedDate"/>
      <short value="診斷證明書日期"/>
      <definition value="診斷證明書日期"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:condition.recordedDate"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.primaryPhysician">
      <path value="ClaimFormModel.certificateOfDiagnosis.primaryPhysician"/>
      <short value="主治醫師"/>
      <definition value="主治醫師"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="HumanName"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:condition.recorder.Reference(PractitionerRole iClaim).where(code = '405279007').practitioner.Reference(Practitioner iClaim).name"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.primaryPhysicianNo">
      <path value="ClaimFormModel.certificateOfDiagnosis.primaryPhysicianNo"/>
      <short value="醫師證號"/>
      <definition value="醫師證號"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/elementdefinition-identifier"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:condition.recorder.Reference(PractitionerRole iClaim).where(code = '405279007').practitioner.Reference(Practitioner iClaim).identifier"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.medicalSummary">
      <path value="ClaimFormModel.certificateOfDiagnosis.medicalSummary"/>
      <short value="醫療摘要"/>
      <definition value="醫療摘要"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="markdown"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:condition.note.text"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.certificateOfDiagnosis.responsiblePhysician">
      <path
            value="ClaimFormModel.certificateOfDiagnosis.responsiblePhysician"/>
      <short value="負責醫師（院長）"/>
      <definition value="負責醫師（院長）"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="HumanName"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:condition.asserter.Reference(PractitionerRole iClaim).where(code = 'responsiblePhysician').practitioner.Reference(Practitioner iClaim).name"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice">
      <path value="ClaimFormModel.invoice"/>
      <short value="收據正本及費用明細表"/>
      <definition value="收據正本及費用明細表"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="BackboneElement"/>
      </type>
    </element>
    <element id="ClaimFormModel.invoice.chargeItem">
      <path value="ClaimFormModel.invoice.chargeItem"/>
      <short value="費用項目"/>
      <definition value="費用項目"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:IClaim.item.productOrService"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice.medicalIdentity">
      <path value="ClaimFormModel.invoice.medicalIdentity"/>
      <short value="就醫身分"/>
      <definition value="就醫身分"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:IClaim.item.modifier"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice.invoiceDate">
      <path value="ClaimFormModel.invoice.invoiceDate"/>
      <short value="收據日期"/>
      <definition value="收據日期"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="date"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:IClaim.item.servicedDate"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice.selfPayAmount">
      <path value="ClaimFormModel.invoice.selfPayAmount"/>
      <short value="自付金額"/>
      <definition value="自付金額"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Money"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:IClaim.item.where(category = 'base' and modifier = 'pay').net，透過「就醫身分(claim.item.modifier)」和「自付金額/減免(claim.item.category)」來判斷claim.item.net填的金額為「健保點數」／「自費金額」／「減免」，「就醫身分(claim.item.modifier)」為自費，自付金額/減免」為自付金額，則claim.item.net內為「自付金額」。"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice.discount">
      <path value="ClaimFormModel.invoice.discount"/>
      <short value="減免"/>
      <definition value="減免"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Money"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:IClaim.item.where(category = 'discount' and modifier = 'pay').net，透過「就醫身分(claim.item.modifier)」和「自付金額/減免(claim.item.category)」來判斷claim.item.net填的金額為「健保點數」／「自費金額」／「減免」，「就醫身分(claim.item.modifier)」為自費，自付金額/減免」為減免，則claim.item.net內為「減免」。"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice.nationalHealthInsuranePoint">
      <path value="ClaimFormModel.invoice.nationalHealthInsuranePoint"/>
      <short value="健保點數"/>
      <definition value="健保點數"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Money"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:IClaim.item.where(modifier = 'PUBLICPOL').net，透過「就醫身分(claim.item.modifier)」和「自付金額/減免(claim.item.category)」來判斷claim.item.net填的金額為「健保點數」／「自費金額」／「減免」，「就醫身分(claim.item.modifier)」為健保，則claim.item.net內為「健保點數」。"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.invoice.invoiceAmount">
      <path value="ClaimFormModel.invoice.invoiceAmount"/>
      <short value="收據金額"/>
      <definition value="收據金額"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="Money"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:IClaim.total"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport">
      <path value="ClaimFormModel.laboratoryReport"/>
      <short value="相關檢驗/檢查報告"/>
      <definition value="相關檢驗/檢查報告"/>
      <min value="0"/>
      <max value="*"/>
      <type>
        <code value="BackboneElement"/>
      </type>
    </element>
    <element id="ClaimFormModel.laboratoryReport.laboratoryReportName">
      <path value="ClaimFormModel.laboratoryReport.laboratoryReportName"/>
      <short value="檢驗報告名稱"/>
      <definition value="檢驗報告名稱"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:diagnosticReport.code"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.laboratoryReportNo">
      <path value="ClaimFormModel.laboratoryReport.laboratoryReportNo"/>
      <short value="收件編號(檢驗單號)"/>
      <definition value="收件編號(檢驗單號)"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="Extension"/>
        <profile
                 value="http://hl7.org/fhir/StructureDefinition/elementdefinition-identifier"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.identifier"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.laboratoryItemName">
      <path value="ClaimFormModel.laboratoryReport.laboratoryItemName"/>
      <short value="檢驗項目名稱"/>
      <definition value="檢驗項目名稱"/>
      <min value="1"/>
      <max value="*"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.code.coding"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.samplingDate">
      <path value="ClaimFormModel.laboratoryReport.samplingDate"/>
      <short value="採檢日期"/>
      <definition value="採檢日期"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="dateTime"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.effectiveDateTime"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.reportDate">
      <path value="ClaimFormModel.laboratoryReport.reportDate"/>
      <short value="報告日期"/>
      <definition value="報告日期"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="instant"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.issued"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.medicalTechnologist">
      <path value="ClaimFormModel.laboratoryReport.medicalTechnologist"/>
      <short value="醫檢師"/>
      <definition value="醫檢師"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="HumanName"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:observation.performer.Reference(PractitionerRole iClaim).where(code = '307988006').practitioner.Reference(Practitioner iClaim).name"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.reporter">
      <path value="ClaimFormModel.laboratoryReport.reporter"/>
      <short value="報告者"/>
      <definition value="報告者"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="HumanName"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:observation.performer.Reference(PractitionerRole iClaim).where(code = 'reporter').practitioner.Reference(Practitioner iClaim).name"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.laboratoryValue">
      <path value="ClaimFormModel.laboratoryReport.laboratoryValue"/>
      <short value="檢測值"/>
      <definition value="檢測值"/>
      <min value="1"/>
      <max value="*"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.value"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.unit">
      <path value="ClaimFormModel.laboratoryReport.unit"/>
      <short value="單位"/>
      <definition value="單位"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="string"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.valueQuantity.unit"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.hL">
      <path value="ClaimFormModel.laboratoryReport.hL"/>
      <short value="H/L"/>
      <definition value="H/L"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.interpretation"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.note">
      <path value="ClaimFormModel.laboratoryReport.note"/>
      <short value="註記"/>
      <definition value="註記"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="markdown"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.note.text"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.bodySite">
      <path value="ClaimFormModel.laboratoryReport.bodySite"/>
      <short value="檢驗部位"/>
      <definition value="檢驗部位"/>
      <min value="0"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.bodySite"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.referenceRange">
      <path value="ClaimFormModel.laboratoryReport.referenceRange"/>
      <short value="參考值"/>
      <definition value="參考值"/>
      <min value="1"/>
      <max value="*"/>
      <type>
        <code value="BackboneElement"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:observation.referenceRange"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.recordedPhysician">
      <path value="ClaimFormModel.laboratoryReport.recordedPhysician"/>
      <short value="開單醫師"/>
      <definition value="開單醫師"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="HumanName"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map
             value="entry:encounter.participant.individual.Reference(PractitionerRole iClaim).where(code = 'recordedPhysician').practitioner.Reference(Practitioner iClaim).name"/>
      </mapping>
    </element>
    <element id="ClaimFormModel.laboratoryReport.recordedDepartment">
      <path value="ClaimFormModel.laboratoryReport.recordedDepartment"/>
      <short value="開單科別"/>
      <definition value="開單科別"/>
      <min value="1"/>
      <max value="1"/>
      <type>
        <code value="CodeableConcept"/>
      </type>
      <mapping>
        <identity value="IClaim"/>
        <map value="entry:encounter.serviceType.coding"/>
      </mapping>
    </element>
  </differential>
</StructureDefinition>