Vi du: Giai trinh quyen loi BHYT noi tru - TTL Representation - VN Core FHIR Implementation Guide — Bộ Hướng dẫn Triển khai FHIR Cốt lõi cho Việt Nam v0.1.0

VN Core FHIR Implementation Guide — Bộ Hướng dẫn Triển khai FHIR Cốt lõi cho Việt Nam - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
: Vi du: Giai trinh quyen loi BHYT noi tru - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:ExplanationOfBenefit ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "ExampleExplanationOfBenefitBHYT"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-explanation-of-benefit"^^xsd:anyURI ;
fhir:l <http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-explanation-of-benefit>     ] )
  ] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ExplanationOfBenefit ExampleExplanationOfBenefitBHYT</b></p><a name=\"ExampleExplanationOfBenefitBHYT\"> </a><a name=\"hcExampleExplanationOfBenefitBHYT\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-vn-core-explanation-of-benefit.html\">Giai trinh quyen loi BHYT VN Core — VN Core ExplanationOfBenefit Profile</a></p></div><blockquote><p><b>Tổng chi phí theo nhóm — Claim Cost Summary Extension</b></p><ul><li>totalMedication: <span title=\"Vietnamese Dong\">₫73,500</span> (VND)</li><li>totalInsurance: <span title=\"Vietnamese Dong\">₫10,080,000</span> (VND)</li><li>totalPatientCopay: <span title=\"Vietnamese Dong\">₫2,520,000</span> (VND)</li><li>totalPatientSelfPay: <span title=\"Vietnamese Dong\">₫1,770,000</span> (VND)</li></ul></blockquote><blockquote><p><b>Kỳ thanh toán — Claim Payment Period Extension</b></p><ul><li>year: 2026</li><li>month: 3</li></ul></blockquote><p><b>Phương thức thanh toán — Payment Method Extension</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-payment-method-cs 1}\">Phí dịch vụ (FFS)</span></p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type institutional}\">Institutional</span></p><p><b>use</b>: Claim</p><p><b>patient</b>: <a href=\"Patient-ExamplePatientNguyenVanAn.html\">Nguyen Van An</a></p><p><b>created</b>: 2026-03-19</p><p><b>insurer</b>: <a href=\"Organization-ExampleOrganizationBHXH.html\">Bao hiem xa hoi Viet Nam</a></p><p><b>provider</b>: <a href=\"Organization-ExampleOrganizationChoRay.html\">Benh vien Cho Ray</a></p><p><b>outcome</b>: Processing Complete</p><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td><td><b>Type</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://hl7.org/fhir/sid/icd-10 K35.8}\">Acute appendicitis, other and unspecified</span></td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-diagnosistype principal}\">Principal Diagnosis</span></td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>true</td><td><a href=\"Coverage-ExampleCoverageBHYTNew.html\">Coverage: extension = Người lao động trong doanh nghiệp,-&gt;Bệnh viện Chợ Rẫy; identifier = http://fhir.hl7.org.vn/core/sid/bhyt#VNBHYT#001085012345; status = active; type = ; period = 2025-08-01 --&gt; 2026-07-31</a></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs 1}\">Khám bệnh</span></p><p><b>productOrService</b>: <span title=\"Codes:\">Kham chuyen khoa</span></p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted Amount</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>150000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication eligible}\">Eligible Amount</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>150000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}\">Benefit Amount</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>120000</td><td>Vietnamese đồng</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><p><b>sequence</b>: 2</p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs 8}\">Thuốc, dịch truyền</span></p><p><b>productOrService</b>: <span title=\"Codes:\">Amoxicillin 500mg</span></p><p><b>quantity</b>: 21</p><h3>UnitPrices</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>3500</td><td>Vietnamese đồng</td></tr></table><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>73500</td><td>Vietnamese đồng</td></tr></table><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted Amount</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>73500</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}\">Benefit Amount</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>58800</td><td>Vietnamese đồng</td></tr></table></blockquote></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication submitted}\">Submitted Amount</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>14370000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>total</b></p><p><b>category</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/adjudication benefit}\">Benefit Amount</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>10080000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>payment</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/ex-paymenttype complete}\">Complete</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>10080000</td><td>Vietnamese đồng</td></tr></table></blockquote><p><b>benefitPeriod</b>: 2026-01-01 --&gt; 2026-12-31</p></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:extension ( [
    ( fhir:extension [
fhir:url [
fhir:v "totalMedication"^^xsd:anyURI ;
fhir:l fhir:totalMedication       ] ;
fhir:value [
a fhir:Money ;
fhir:value [ fhir:v "73500"^^xsd:decimal ] ;
fhir:currency [ fhir:v "VND" ]       ]     ] [
fhir:url [
fhir:v "totalInsurance"^^xsd:anyURI ;
fhir:l fhir:totalInsurance       ] ;
fhir:value [
a fhir:Money ;
fhir:value [ fhir:v "10080000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "VND" ]       ]     ] [
fhir:url [
fhir:v "totalPatientCopay"^^xsd:anyURI ;
fhir:l fhir:totalPatientCopay       ] ;
fhir:value [
a fhir:Money ;
fhir:value [ fhir:v "2520000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "VND" ]       ]     ] [
fhir:url [
fhir:v "totalPatientSelfPay"^^xsd:anyURI ;
fhir:l fhir:totalPatientSelfPay       ] ;
fhir:value [
a fhir:Money ;
fhir:value [ fhir:v "1770000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "VND" ]       ]     ] ) ;
fhir:url [
fhir:v "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary"^^xsd:anyURI ;
fhir:l <http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-cost-summary>     ]
  ] [
    ( fhir:extension [
fhir:url [
fhir:v "year"^^xsd:anyURI ;
fhir:l fhir:year       ] ;
fhir:value [
a fhir:Integer ;
fhir:v 2026       ]     ] [
fhir:url [
fhir:v "month"^^xsd:anyURI ;
fhir:l fhir:month       ] ;
fhir:value [
a fhir:Integer ;
fhir:v 3       ]     ] ) ;
fhir:url [
fhir:v "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period"^^xsd:anyURI ;
fhir:l <http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-claim-payment-period>     ]
  ] [
fhir:url [
fhir:v "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method"^^xsd:anyURI ;
fhir:l <http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-payment-method>     ] ;
fhir:value [
a fhir:CodeableConcept ;
      ( fhir:coding [
fhir:system [
fhir:v "http://fhir.hl7.org.vn/core/CodeSystem/vn-payment-method-cs"^^xsd:anyURI ;
fhir:l <http://fhir.hl7.org.vn/core/CodeSystem/vn-payment-method-cs>         ] ;
fhir:code [ fhir:v "1" ] ;
fhir:display [ fhir:v "Phí dịch vụ (FFS)" ]       ] )     ]
  ] ) ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:type [
    ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/claim-type>       ] ;
fhir:code [ fhir:v "institutional" ] ;
fhir:display [ fhir:v "Institutional" ]     ] )
  ] ; # 
  fhir:use [ fhir:v "claim"] ; # 
  fhir:patient [
fhir:l fhir:Patient/ExamplePatientNguyenVanAn ;
fhir:reference [ fhir:v "Patient/ExamplePatientNguyenVanAn" ] ;
fhir:display [ fhir:v "Nguyen Van An" ]
  ] ; # 
  fhir:created [ fhir:v "2026-03-19"^^xsd:date] ; # 
  fhir:insurer [
fhir:l fhir:Organization/ExampleOrganizationBHXH ;
fhir:reference [ fhir:v "Organization/ExampleOrganizationBHXH" ] ;
fhir:display [ fhir:v "Bao hiem xa hoi Viet Nam" ]
  ] ; # 
  fhir:provider [
fhir:l fhir:Organization/ExampleOrganizationChoRay ;
fhir:reference [ fhir:v "Organization/ExampleOrganizationChoRay" ] ;
fhir:display [ fhir:v "Benh vien Cho Ray" ]
  ] ; # 
  fhir:outcome [ fhir:v "complete"] ; # 
  fhir:diagnosis ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:diagnosis [
a fhir:CodeableConcept ;
      ( fhir:coding [
fhir:system [
fhir:v "http://hl7.org/fhir/sid/icd-10"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/sid/icd-10>         ] ;
fhir:code [ fhir:v "K35.8" ] ;
fhir:display [ fhir:v "Acute appendicitis, other and unspecified" ]       ] )     ] ;
    ( fhir:type [
      ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/ex-diagnosistype"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/ex-diagnosistype>         ] ;
fhir:code [ fhir:v "principal" ] ;
fhir:display [ fhir:v "Principal Diagnosis" ]       ] )     ] )
  ] ) ; # 
  fhir:insurance ( [
fhir:focal [ fhir:v true ] ;
fhir:coverage [
fhir:l fhir:Coverage/ExampleCoverageBHYTNew ;
fhir:reference [ fhir:v "Coverage/ExampleCoverageBHYTNew" ]     ]
  ] ) ; # 
  fhir:item ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:category [
      ( fhir:coding [
fhir:system [
fhir:v "http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs"^^xsd:anyURI ;
fhir:l <http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs>         ] ;
fhir:code [ fhir:v "1" ] ;
fhir:display [ fhir:v "Khám bệnh" ]       ] )     ] ;
fhir:productOrService [
fhir:text [ fhir:v "Kham chuyen khoa" ]     ] ;
    ( fhir:adjudication [
fhir:category [
        ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/adjudication>           ] ;
fhir:code [ fhir:v "submitted" ] ;
fhir:display [ fhir:v "Submitted Amount" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "150000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "VND" ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/adjudication>           ] ;
fhir:code [ fhir:v "eligible" ] ;
fhir:display [ fhir:v "Eligible Amount" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "150000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "VND" ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/adjudication>           ] ;
fhir:code [ fhir:v "benefit" ] ;
fhir:display [ fhir:v "Benefit Amount" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "120000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "VND" ]       ]     ] )
  ] [
fhir:sequence [ fhir:v "2"^^xsd:positiveInteger ] ;
fhir:category [
      ( fhir:coding [
fhir:system [
fhir:v "http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs"^^xsd:anyURI ;
fhir:l <http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs>         ] ;
fhir:code [ fhir:v "8" ] ;
fhir:display [ fhir:v "Thuốc, dịch truyền" ]       ] )     ] ;
fhir:productOrService [
fhir:text [ fhir:v "Amoxicillin 500mg" ]     ] ;
fhir:quantity [
fhir:value [ fhir:v "21"^^xsd:decimal ]     ] ;
fhir:unitPrice [
fhir:value [ fhir:v "3500"^^xsd:decimal ] ;
fhir:currency [ fhir:v "VND" ]     ] ;
fhir:net [
fhir:value [ fhir:v "73500"^^xsd:decimal ] ;
fhir:currency [ fhir:v "VND" ]     ] ;
    ( fhir:adjudication [
fhir:category [
        ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/adjudication>           ] ;
fhir:code [ fhir:v "submitted" ] ;
fhir:display [ fhir:v "Submitted Amount" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "73500"^^xsd:decimal ] ;
fhir:currency [ fhir:v "VND" ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/adjudication>           ] ;
fhir:code [ fhir:v "benefit" ] ;
fhir:display [ fhir:v "Benefit Amount" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "58800"^^xsd:decimal ] ;
fhir:currency [ fhir:v "VND" ]       ]     ] )
  ] ) ; # 
  fhir:total ( [
fhir:category [
      ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/adjudication>         ] ;
fhir:code [ fhir:v "submitted" ] ;
fhir:display [ fhir:v "Submitted Amount" ]       ] )     ] ;
fhir:amount [
fhir:value [ fhir:v "14370000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "VND" ]     ]
  ] [
fhir:category [
      ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/adjudication"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/adjudication>         ] ;
fhir:code [ fhir:v "benefit" ] ;
fhir:display [ fhir:v "Benefit Amount" ]       ] )     ] ;
fhir:amount [
fhir:value [ fhir:v "10080000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "VND" ]     ]
  ] ) ; # 
  fhir:payment [
fhir:type [
      ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/ex-paymenttype"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/ex-paymenttype>         ] ;
fhir:code [ fhir:v "complete" ] ;
fhir:display [ fhir:v "Complete" ]       ] )     ] ;
fhir:amount [
fhir:value [ fhir:v "10080000"^^xsd:decimal ] ;
fhir:currency [ fhir:v "VND" ]     ]
  ] ; # 
  fhir:benefitPeriod [
fhir:start [ fhir:v "2026-01-01"^^xsd:date ] ;
fhir:end [ fhir:v "2026-12-31"^^xsd:date ]
  ] . #