Ví dụ: Bảng kê chi phí KCB đổi mức hưởng trong cùng đợt — Example: Itemized healthcare cost claim with a mid-encounter benefit change - TTL Representation - Hướng dẫn triển khai FHIR cốt lõi Việt Nam

Hướng dẫn triển khai FHIR cốt lõi Việt Nam — VN Core FHIR Implementation Guide - Draft for Community Review (v0.9.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
: Ví dụ: Bảng kê chi phí KCB đổi mức hưởng trong cùng đợt — Example: Itemized healthcare cost claim with a mid-encounter benefit change

Bản thô ttl | Tải xuống
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

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

<http://hl7.org/fhir/Claim/ExampleClaimItemizedMultiStage> a fhir:Claim ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "ExampleClaimItemizedMultiStage"] ;
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-itemized-healthcare-cost-claim" ;
       fhir:index -1 ;
       fhir:link <http://fhir.hl7.org.vn/core/StructureDefinition/vn-core-itemized-healthcare-cost-claim>
     ]
  ] ;
  fhir:Resource.language [ fhir:value "vi"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "extensions" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Claim ExampleClaimItemizedMultiStage</b></p><a name=\"ExampleClaimItemizedMultiStage\"> </a><a name=\"hcExampleClaimItemizedMultiStage\"> </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-itemized-healthcare-cost-claim.html\">Yêu cầu bảng kê chi phí KCB chi tiết — VN Core Itemized Healthcare Cost Claim</a></p></div><p><b>identifier</b>: Mã liên kết hồ sơ BHYT/LK-ITEMIZED-2026-0001</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\">Nguyễn Văn An</a></p><p><b>billablePeriod</b>: 2026-03-01 --&gt; 2026-03-07</p><p><b>created</b>: 2026-03-10</p><p><b>insurer</b>: <a href=\"Organization-ExampleOrganizationBHXH.html\">Bảo hiểm xã hội Việt Nam</a></p><p><b>provider</b>: <a href=\"Organization-ExampleOrganizationChoRay.html\">Bệnh viện Chợ Rẫy</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></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><blockquote><p><b>insurance</b></p><blockquote><p><b>Giai đoạn hưởng bảo hiểm — Coverage Benefit Stage</b></p><ul><li>sequence: 1</li><li>period: 2026-03-01 --&gt; 2026-03-04</li><li>benefitLevel: 80</li></ul></blockquote><blockquote><p><b>Giai đoạn hưởng bảo hiểm — Coverage Benefit Stage</b></p><ul><li>sequence: 2</li><li>period: 2026-03-05 --&gt; 2026-03-07</li><li>benefitLevel: 100</li></ul></blockquote><p><b>sequence</b>: 1</p><p><b>focal</b>: true</p><p><b>coverage</b>: <a href=\"Coverage-ExampleCoverageBHYTNew.html\">Thẻ BHYT Nguyễn Văn An được giám định</a></p></blockquote><blockquote><p><b>item</b></p><blockquote><p><b>Thông tin chi phí BHYT — Insurance Cost Info Extension</b></p><ul><li>scope: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs 1}\">Trong phạm vi hưởng BHYT</span></li><li>paymentRatio: 100</li><li>benefitLevel: 80</li><li>servicePaymentRatio: 100</li><li>insuranceUnitPrice: <span title=\"Vietnamese Dong\">₫200.000</span> (VND)</li><li>insuranceLineAmount: <span title=\"Vietnamese Dong\">₫200.000</span> (VND)</li></ul></blockquote><p><b>Liên kết dòng chi phí với giai đoạn hưởng — Item Benefit Stage Sequence</b>: 1</p><blockquote><p><b>Phân bổ nguồn thanh toán theo dòng — Line Payment Allocation</b></p><ul><li>insuranceFund: <span title=\"Vietnamese Dong\">₫160.000</span> (VND)</li><li>patientCopay: <span title=\"Vietnamese Dong\">₫40.000</span> (VND)</li><li>otherSource: <span title=\"Vietnamese Dong\">₫0</span> (VND)</li><li>patientSelfPay: <span title=\"Vietnamese Dong\">₫0</span> (VND)</li></ul></blockquote><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:{http://fhir.hl7.org.vn/core/CodeSystem/vn-examination-code-cs 10.22}\">Khám chuyên khoa Ngoại tiêu hóa</span></p><p><b>serviced</b>: 2026-03-02</p><p><b>quantity</b>: 1 lần</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>200000</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>200000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>item</b></p><blockquote><p><b>Thông tin chi phí BHYT — Insurance Cost Info Extension</b></p><ul><li>scope: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs 1}\">Trong phạm vi hưởng BHYT</span></li><li>paymentRatio: 100</li><li>benefitLevel: 80</li><li>servicePaymentRatio: 100</li><li>insuranceUnitPrice: <span title=\"Vietnamese Dong\">₫300.000</span> (VND)</li><li>insuranceLineAmount: <span title=\"Vietnamese Dong\">₫300.000</span> (VND)</li></ul></blockquote><p><b>Liên kết dòng chi phí với giai đoạn hưởng — Item Benefit Stage Sequence</b>: 1</p><blockquote><p><b>Phân bổ nguồn thanh toán theo dòng — Line Payment Allocation</b></p><ul><li>insuranceFund: <span title=\"Vietnamese Dong\">₫240.000</span> (VND)</li><li>patientCopay: <span title=\"Vietnamese Dong\">₫60.000</span> (VND)</li><li>otherSource: <span title=\"Vietnamese Dong\">₫0</span> (VND)</li><li>patientSelfPay: <span title=\"Vietnamese Dong\">₫0</span> (VND)</li></ul></blockquote><p><b>sequence</b>: 2</p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs 3}\">Xét nghiệm</span></p><p><b>productOrService</b>: <span title=\"Codes:\">Xét nghiệm công thức máu toàn phần</span></p><p><b>serviced</b>: 2026-03-04</p><p><b>quantity</b>: 1 lần</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>300000</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>300000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>item</b></p><blockquote><p><b>Thông tin chi phí BHYT — Insurance Cost Info Extension</b></p><ul><li>scope: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs 1}\">Trong phạm vi hưởng BHYT</span></li><li>paymentRatio: 100</li><li>benefitLevel: 100</li><li>servicePaymentRatio: 100</li><li>insuranceUnitPrice: <span title=\"Vietnamese Dong\">₫1.000.000</span> (VND)</li><li>insuranceLineAmount: <span title=\"Vietnamese Dong\">₫1.000.000</span> (VND)</li></ul></blockquote><p><b>Liên kết dòng chi phí với giai đoạn hưởng — Item Benefit Stage Sequence</b>: 2</p><blockquote><p><b>Phân bổ nguồn thanh toán theo dòng — Line Payment Allocation</b></p><ul><li>insuranceFund: <span title=\"Vietnamese Dong\">₫1.000.000</span> (VND)</li><li>patientCopay: <span title=\"Vietnamese Dong\">₫0</span> (VND)</li><li>otherSource: <span title=\"Vietnamese Dong\">₫0</span> (VND)</li><li>patientSelfPay: <span title=\"Vietnamese Dong\">₫0</span> (VND)</li></ul></blockquote><p><b>sequence</b>: 3</p><p><b>category</b>: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs 9}\">Thiết bị y tế</span></p><p><b>productOrService</b>: <span title=\"Codes:\">Gói thiết bị y tế can thiệp mạch</span></p><p><b>serviced</b>: 2026-03-05</p><p><b>quantity</b>: 1 lần</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>1000000</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>1000000</td><td>Vietnamese đồng</td></tr></table><blockquote><p><b>detail</b></p><blockquote><p><b>Thông tin chi phí BHYT — Insurance Cost Info Extension</b></p><ul><li>scope: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs 1}\">Trong phạm vi hưởng BHYT</span></li><li>paymentRatio: 100</li><li>servicePaymentRatio: 100</li><li>insuranceUnitPrice: <span title=\"Vietnamese Dong\">₫800.000</span> (VND)</li><li>insuranceLineAmount: <span title=\"Vietnamese Dong\">₫800.000</span> (VND)</li></ul></blockquote><p><b>sequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:\">Stent mạch vành</span></p><p><b>quantity</b>: 1 cái</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>800000</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>800000</td><td>Vietnamese đồng</td></tr></table></blockquote><blockquote><p><b>detail</b></p><blockquote><p><b>Thông tin chi phí BHYT — Insurance Cost Info Extension</b></p><ul><li>scope: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs 1}\">Trong phạm vi hưởng BHYT</span></li><li>paymentRatio: 100</li><li>servicePaymentRatio: 100</li><li>insuranceUnitPrice: <span title=\"Vietnamese Dong\">₫200.000</span> (VND)</li><li>insuranceLineAmount: <span title=\"Vietnamese Dong\">₫200.000</span> (VND)</li></ul></blockquote><p><b>sequence</b>: 2</p><p><b>productOrService</b>: <span title=\"Codes:\">Bóng nong mạch vành</span></p><p><b>quantity</b>: 1 cái</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>200000</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>200000</td><td>Vietnamese đồng</td></tr></table></blockquote></blockquote><blockquote><p><b>item</b></p><blockquote><p><b>Thông tin chi phí BHYT — Insurance Cost Info Extension</b></p><ul><li>scope: <span title=\"Codes:{http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs 1}\">Trong phạm vi hưởng BHYT</span></li><li>paymentRatio: 80</li><li>benefitLevel: 100</li><li>servicePaymentRatio: 100</li><li>insuranceUnitPrice: <span title=\"Vietnamese Dong\">₫50.000</span> (VND)</li><li>insuranceLineAmount: <span title=\"Vietnamese Dong\">₫400.000</span> (VND)</li></ul></blockquote><p><b>Liên kết dòng chi phí với giai đoạn hưởng — Item Benefit Stage Sequence</b>: 2</p><blockquote><p><b>Phân bổ nguồn thanh toán theo dòng — Line Payment Allocation</b></p><ul><li>insuranceFund: <span title=\"Vietnamese Dong\">₫400.000</span> (VND)</li><li>patientCopay: <span title=\"Vietnamese Dong\">₫0</span> (VND)</li><li>otherSource: <span title=\"Vietnamese Dong\">₫50.000</span> (VND)</li><li>patientSelfPay: <span title=\"Vietnamese Dong\">₫50.000</span> (VND)</li></ul></blockquote><blockquote><p><b>Chi tiết nguồn khác chi trả theo dòng — Other Fund Breakdown Extension</b></p><ul><li>stateBudget: <span title=\"Vietnamese Dong\">₫50.000</span> (VND)</li></ul></blockquote><p><b>sequence</b>: 4</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:{http://www.whocc.no/atc J01DD04}\">Ceftriaxone 2 g bột pha tiêm</span></p><p><b>serviced</b>: 2026-03-06</p><p><b>quantity</b>: 10 lọ</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>50000</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>500000</td><td>Vietnamese đồng</td></tr></table></blockquote><h3>Totals</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>2000000</td><td>Vietnamese đồng</td></tr></table></div>"
  ] ;
  fhir:Claim.identifier [
     fhir:index -1 ;
     fhir:Identifier.type [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://fhir.hl7.org.vn/core/CodeSystem/vn-identifier-type-cs" ] ;
         fhir:Coding.code [ fhir:value "MA_LK" ] ;
         fhir:Coding.display [ fhir:value "Mã liên kết hồ sơ BHYT" ]
       ]
     ] ;
     fhir:Identifier.system [ fhir:value "http://fhir.hl7.org.vn/core/sid/ma-lk" ] ;
     fhir:Identifier.value [ fhir:value "LK-ITEMIZED-2026-0001" ]
  ] ;
  fhir:Claim.status [ fhir:value "active"] ;
  fhir:Claim.type [
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ] ;
       fhir:Coding.code [ fhir:value "institutional" ] ;
       fhir:Coding.display [ fhir:value "Institutional" ]
     ]
  ] ;
  fhir:Claim.use [ fhir:value "claim"] ;
  fhir:Claim.patient [
     fhir:link <http://hl7.org/fhir/Patient/ExamplePatientNguyenVanAn> ;
     fhir:Reference.reference [ fhir:value "Patient/ExamplePatientNguyenVanAn" ] ;
     fhir:Reference.display [ fhir:value "Nguyễn Văn An" ]
  ] ;
  fhir:Claim.billablePeriod [
     fhir:Period.start [ fhir:value "2026-03-01"^^xsd:date ] ;
     fhir:Period.end [ fhir:value "2026-03-07"^^xsd:date ]
  ] ;
  fhir:Claim.created [ fhir:value "2026-03-10"^^xsd:date] ;
  fhir:Claim.insurer [
     fhir:link <http://hl7.org/fhir/Organization/ExampleOrganizationBHXH> ;
     fhir:Reference.reference [ fhir:value "Organization/ExampleOrganizationBHXH" ] ;
     fhir:Reference.display [ fhir:value "Bảo hiểm xã hội Việt Nam" ]
  ] ;
  fhir:Claim.provider [
     fhir:link <http://hl7.org/fhir/Organization/ExampleOrganizationChoRay> ;
     fhir:Reference.reference [ fhir:value "Organization/ExampleOrganizationChoRay" ] ;
     fhir:Reference.display [ fhir:value "Bệnh viện Chợ Rẫy" ]
  ] ;
  fhir:Claim.priority [
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/processpriority" ] ;
       fhir:Coding.code [ fhir:value "normal" ] ;
       fhir:Coding.display [ fhir:value "Normal" ]
     ]
  ] ;
  fhir:Claim.diagnosis [
     fhir:index -1 ;
     fhir:Claim.diagnosis.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
     fhir:Claim.diagnosis.diagnosisCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/sid/icd-10" ] ;
         fhir:Coding.code [ fhir:value "K35.8" ] ;
         fhir:Coding.display [ fhir:value "Acute appendicitis, other and unspecified" ]
       ]
     ] ;
     fhir:Claim.diagnosis.type [
       fhir:index -1 ;
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/ex-diagnosistype" ] ;
         fhir:Coding.code [ fhir:value "principal" ] ;
         fhir:Coding.display [ fhir:value "Principal Diagnosis" ]
       ]
     ]
  ] ;
  fhir:Claim.insurance [
     fhir:index -1 ;
     fhir:Element.extension [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "sequence" ] ;
         fhir:Extension.valuePositiveInt [ fhir:value "1"^^xsd:positiveInteger ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "period" ] ;
         fhir:Extension.valuePeriod [
           fhir:Period.start [ fhir:value "2026-03-01"^^xsd:date ] ;
           fhir:Period.end [ fhir:value "2026-03-04"^^xsd:date ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "benefitLevel" ] ;
         fhir:Extension.valueDecimal [ fhir:value "80"^^xsd:decimal ]
       ] ;
       fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage" ]
     ], [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "sequence" ] ;
         fhir:Extension.valuePositiveInt [ fhir:value "2"^^xsd:positiveInteger ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "period" ] ;
         fhir:Extension.valuePeriod [
           fhir:Period.start [ fhir:value "2026-03-05"^^xsd:date ] ;
           fhir:Period.end [ fhir:value "2026-03-07"^^xsd:date ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "benefitLevel" ] ;
         fhir:Extension.valueDecimal [ fhir:value "100"^^xsd:decimal ]
       ] ;
       fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-coverage-benefit-stage" ]
     ] ;
     fhir:Claim.insurance.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
     fhir:Claim.insurance.focal [ fhir:value "true"^^xsd:boolean ] ;
     fhir:Claim.insurance.coverage [
       fhir:link <http://hl7.org/fhir/Coverage/ExampleCoverageBHYTNew> ;
       fhir:Reference.reference [ fhir:value "Coverage/ExampleCoverageBHYTNew" ] ;
       fhir:Reference.display [ fhir:value "Thẻ BHYT Nguyễn Văn An được giám định" ]
     ]
  ] ;
  fhir:Claim.item [
     fhir:index -1 ;
     fhir:Element.extension [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "scope" ] ;
         fhir:Extension.valueCodeableConcept [
           fhir:CodeableConcept.coding [
             fhir:index -1 ;
             fhir:Coding.system [ fhir:value "http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs" ] ;
             fhir:Coding.code [ fhir:value "1" ] ;
             fhir:Coding.display [ fhir:value "Trong phạm vi hưởng BHYT" ]
           ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "paymentRatio" ] ;
         fhir:Extension.valueDecimal [ fhir:value "100"^^xsd:decimal ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "benefitLevel" ] ;
         fhir:Extension.valueDecimal [ fhir:value "80"^^xsd:decimal ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "servicePaymentRatio" ] ;
         fhir:Extension.valueDecimal [ fhir:value "100"^^xsd:decimal ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "insuranceUnitPrice" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "200000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "insuranceLineAmount" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "200000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ] ;
       fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info" ]
     ], [
       fhir:index -1 ;
       fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence" ] ;
       fhir:Extension.valuePositiveInt [ fhir:value "1"^^xsd:positiveInteger ]
     ], [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "insuranceFund" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "160000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "patientCopay" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "40000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "otherSource" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "0"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "patientSelfPay" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "0"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ] ;
       fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation" ]
     ] ;
     fhir:Claim.item.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
     fhir:Claim.item.category [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs" ] ;
         fhir:Coding.code [ fhir:value "1" ] ;
         fhir:Coding.display [ fhir:value "Khám bệnh" ]
       ]
     ] ;
     fhir:Claim.item.productOrService [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://fhir.hl7.org.vn/core/CodeSystem/vn-examination-code-cs" ] ;
         fhir:Coding.code [ fhir:value "10.22" ] ;
         fhir:Coding.display [ fhir:value "Ngoại tiêu hóa" ]
       ] ;
       fhir:CodeableConcept.text [ fhir:value "Khám chuyên khoa Ngoại tiêu hóa" ]
     ] ;
     fhir:Claim.item.servicedDate [ fhir:value "2026-03-02"^^xsd:date ] ;
     fhir:Claim.item.quantity [
       fhir:Quantity.value [ fhir:value "1"^^xsd:decimal ] ;
       fhir:Quantity.unit [ fhir:value "lần" ]
     ] ;
     fhir:Claim.item.unitPrice [
       fhir:Money.value [ fhir:value "200000"^^xsd:decimal ] ;
       fhir:Money.currency [ fhir:value "VND" ]
     ] ;
     fhir:Claim.item.net [
       fhir:Money.value [ fhir:value "200000"^^xsd:decimal ] ;
       fhir:Money.currency [ fhir:value "VND" ]
     ]
  ], [
     fhir:index -1 ;
     fhir:Element.extension [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "scope" ] ;
         fhir:Extension.valueCodeableConcept [
           fhir:CodeableConcept.coding [
             fhir:index -1 ;
             fhir:Coding.system [ fhir:value "http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs" ] ;
             fhir:Coding.code [ fhir:value "1" ] ;
             fhir:Coding.display [ fhir:value "Trong phạm vi hưởng BHYT" ]
           ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "paymentRatio" ] ;
         fhir:Extension.valueDecimal [ fhir:value "100"^^xsd:decimal ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "benefitLevel" ] ;
         fhir:Extension.valueDecimal [ fhir:value "80"^^xsd:decimal ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "servicePaymentRatio" ] ;
         fhir:Extension.valueDecimal [ fhir:value "100"^^xsd:decimal ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "insuranceUnitPrice" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "300000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "insuranceLineAmount" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "300000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ] ;
       fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info" ]
     ], [
       fhir:index -1 ;
       fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence" ] ;
       fhir:Extension.valuePositiveInt [ fhir:value "1"^^xsd:positiveInteger ]
     ], [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "insuranceFund" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "240000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "patientCopay" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "60000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "otherSource" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "0"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "patientSelfPay" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "0"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ] ;
       fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation" ]
     ] ;
     fhir:Claim.item.sequence [ fhir:value "2"^^xsd:positiveInteger ] ;
     fhir:Claim.item.category [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs" ] ;
         fhir:Coding.code [ fhir:value "3" ] ;
         fhir:Coding.display [ fhir:value "Xét nghiệm" ]
       ]
     ] ;
     fhir:Claim.item.productOrService [
       fhir:CodeableConcept.text [ fhir:value "Xét nghiệm công thức máu toàn phần" ]
     ] ;
     fhir:Claim.item.servicedDate [ fhir:value "2026-03-04"^^xsd:date ] ;
     fhir:Claim.item.quantity [
       fhir:Quantity.value [ fhir:value "1"^^xsd:decimal ] ;
       fhir:Quantity.unit [ fhir:value "lần" ]
     ] ;
     fhir:Claim.item.unitPrice [
       fhir:Money.value [ fhir:value "300000"^^xsd:decimal ] ;
       fhir:Money.currency [ fhir:value "VND" ]
     ] ;
     fhir:Claim.item.net [
       fhir:Money.value [ fhir:value "300000"^^xsd:decimal ] ;
       fhir:Money.currency [ fhir:value "VND" ]
     ]
  ], [
     fhir:index -1 ;
     fhir:Element.extension [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "scope" ] ;
         fhir:Extension.valueCodeableConcept [
           fhir:CodeableConcept.coding [
             fhir:index -1 ;
             fhir:Coding.system [ fhir:value "http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs" ] ;
             fhir:Coding.code [ fhir:value "1" ] ;
             fhir:Coding.display [ fhir:value "Trong phạm vi hưởng BHYT" ]
           ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "paymentRatio" ] ;
         fhir:Extension.valueDecimal [ fhir:value "100"^^xsd:decimal ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "benefitLevel" ] ;
         fhir:Extension.valueDecimal [ fhir:value "100"^^xsd:decimal ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "servicePaymentRatio" ] ;
         fhir:Extension.valueDecimal [ fhir:value "100"^^xsd:decimal ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "insuranceUnitPrice" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "1000000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "insuranceLineAmount" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "1000000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ] ;
       fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info" ]
     ], [
       fhir:index -1 ;
       fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence" ] ;
       fhir:Extension.valuePositiveInt [ fhir:value "2"^^xsd:positiveInteger ]
     ], [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "insuranceFund" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "1000000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "patientCopay" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "0"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "otherSource" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "0"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "patientSelfPay" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "0"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ] ;
       fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation" ]
     ] ;
     fhir:Claim.item.sequence [ fhir:value "3"^^xsd:positiveInteger ] ;
     fhir:Claim.item.category [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs" ] ;
         fhir:Coding.code [ fhir:value "9" ] ;
         fhir:Coding.display [ fhir:value "Thiết bị y tế" ]
       ]
     ] ;
     fhir:Claim.item.productOrService [
       fhir:CodeableConcept.text [ fhir:value "Gói thiết bị y tế can thiệp mạch" ]
     ] ;
     fhir:Claim.item.servicedDate [ fhir:value "2026-03-05"^^xsd:date ] ;
     fhir:Claim.item.quantity [
       fhir:Quantity.value [ fhir:value "1"^^xsd:decimal ] ;
       fhir:Quantity.unit [ fhir:value "lần" ]
     ] ;
     fhir:Claim.item.unitPrice [
       fhir:Money.value [ fhir:value "1000000"^^xsd:decimal ] ;
       fhir:Money.currency [ fhir:value "VND" ]
     ] ;
     fhir:Claim.item.net [
       fhir:Money.value [ fhir:value "1000000"^^xsd:decimal ] ;
       fhir:Money.currency [ fhir:value "VND" ]
     ] ;
     fhir:Claim.item.detail [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Element.extension [
           fhir:index -1 ;
           fhir:Extension.url [ fhir:value "scope" ] ;
           fhir:Extension.valueCodeableConcept [
             fhir:CodeableConcept.coding [
               fhir:index -1 ;
               fhir:Coding.system [ fhir:value "http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs" ] ;
               fhir:Coding.code [ fhir:value "1" ] ;
               fhir:Coding.display [ fhir:value "Trong phạm vi hưởng BHYT" ]
             ]
           ]
         ], [
           fhir:index -1 ;
           fhir:Extension.url [ fhir:value "paymentRatio" ] ;
           fhir:Extension.valueDecimal [ fhir:value "100"^^xsd:decimal ]
         ], [
           fhir:index -1 ;
           fhir:Extension.url [ fhir:value "servicePaymentRatio" ] ;
           fhir:Extension.valueDecimal [ fhir:value "100"^^xsd:decimal ]
         ], [
           fhir:index -1 ;
           fhir:Extension.url [ fhir:value "insuranceUnitPrice" ] ;
           fhir:Extension.valueMoney [
             fhir:Money.value [ fhir:value "800000"^^xsd:decimal ] ;
             fhir:Money.currency [ fhir:value "VND" ]
           ]
         ], [
           fhir:index -1 ;
           fhir:Extension.url [ fhir:value "insuranceLineAmount" ] ;
           fhir:Extension.valueMoney [
             fhir:Money.value [ fhir:value "800000"^^xsd:decimal ] ;
             fhir:Money.currency [ fhir:value "VND" ]
           ]
         ] ;
         fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info" ]
       ] ;
       fhir:Claim.item.detail.sequence [ fhir:value "1"^^xsd:positiveInteger ] ;
       fhir:Claim.item.detail.productOrService [
         fhir:CodeableConcept.text [ fhir:value "Stent mạch vành" ]
       ] ;
       fhir:Claim.item.detail.quantity [
         fhir:Quantity.value [ fhir:value "1"^^xsd:decimal ] ;
         fhir:Quantity.unit [ fhir:value "cái" ]
       ] ;
       fhir:Claim.item.detail.unitPrice [
         fhir:Money.value [ fhir:value "800000"^^xsd:decimal ] ;
         fhir:Money.currency [ fhir:value "VND" ]
       ] ;
       fhir:Claim.item.detail.net [
         fhir:Money.value [ fhir:value "800000"^^xsd:decimal ] ;
         fhir:Money.currency [ fhir:value "VND" ]
       ]
     ], [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Element.extension [
           fhir:index -1 ;
           fhir:Extension.url [ fhir:value "scope" ] ;
           fhir:Extension.valueCodeableConcept [
             fhir:CodeableConcept.coding [
               fhir:index -1 ;
               fhir:Coding.system [ fhir:value "http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs" ] ;
               fhir:Coding.code [ fhir:value "1" ] ;
               fhir:Coding.display [ fhir:value "Trong phạm vi hưởng BHYT" ]
             ]
           ]
         ], [
           fhir:index -1 ;
           fhir:Extension.url [ fhir:value "paymentRatio" ] ;
           fhir:Extension.valueDecimal [ fhir:value "100"^^xsd:decimal ]
         ], [
           fhir:index -1 ;
           fhir:Extension.url [ fhir:value "servicePaymentRatio" ] ;
           fhir:Extension.valueDecimal [ fhir:value "100"^^xsd:decimal ]
         ], [
           fhir:index -1 ;
           fhir:Extension.url [ fhir:value "insuranceUnitPrice" ] ;
           fhir:Extension.valueMoney [
             fhir:Money.value [ fhir:value "200000"^^xsd:decimal ] ;
             fhir:Money.currency [ fhir:value "VND" ]
           ]
         ], [
           fhir:index -1 ;
           fhir:Extension.url [ fhir:value "insuranceLineAmount" ] ;
           fhir:Extension.valueMoney [
             fhir:Money.value [ fhir:value "200000"^^xsd:decimal ] ;
             fhir:Money.currency [ fhir:value "VND" ]
           ]
         ] ;
         fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info" ]
       ] ;
       fhir:Claim.item.detail.sequence [ fhir:value "2"^^xsd:positiveInteger ] ;
       fhir:Claim.item.detail.productOrService [
         fhir:CodeableConcept.text [ fhir:value "Bóng nong mạch vành" ]
       ] ;
       fhir:Claim.item.detail.quantity [
         fhir:Quantity.value [ fhir:value "1"^^xsd:decimal ] ;
         fhir:Quantity.unit [ fhir:value "cái" ]
       ] ;
       fhir:Claim.item.detail.unitPrice [
         fhir:Money.value [ fhir:value "200000"^^xsd:decimal ] ;
         fhir:Money.currency [ fhir:value "VND" ]
       ] ;
       fhir:Claim.item.detail.net [
         fhir:Money.value [ fhir:value "200000"^^xsd:decimal ] ;
         fhir:Money.currency [ fhir:value "VND" ]
       ]
     ]
  ], [
     fhir:index -1 ;
     fhir:Element.extension [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "scope" ] ;
         fhir:Extension.valueCodeableConcept [
           fhir:CodeableConcept.coding [
             fhir:index -1 ;
             fhir:Coding.system [ fhir:value "http://fhir.hl7.org.vn/core/CodeSystem/vn-insurance-scope-cs" ] ;
             fhir:Coding.code [ fhir:value "1" ] ;
             fhir:Coding.display [ fhir:value "Trong phạm vi hưởng BHYT" ]
           ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "paymentRatio" ] ;
         fhir:Extension.valueDecimal [ fhir:value "80"^^xsd:decimal ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "benefitLevel" ] ;
         fhir:Extension.valueDecimal [ fhir:value "100"^^xsd:decimal ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "servicePaymentRatio" ] ;
         fhir:Extension.valueDecimal [ fhir:value "100"^^xsd:decimal ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "insuranceUnitPrice" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "50000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "insuranceLineAmount" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "400000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ] ;
       fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-insurance-cost-info" ]
     ], [
       fhir:index -1 ;
       fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-item-benefit-stage-sequence" ] ;
       fhir:Extension.valuePositiveInt [ fhir:value "2"^^xsd:positiveInteger ]
     ], [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "insuranceFund" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "400000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "patientCopay" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "0"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "otherSource" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "50000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ], [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "patientSelfPay" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "50000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ] ;
       fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-line-payment-allocation" ]
     ], [
       fhir:index -1 ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "stateBudget" ] ;
         fhir:Extension.valueMoney [
           fhir:Money.value [ fhir:value "50000"^^xsd:decimal ] ;
           fhir:Money.currency [ fhir:value "VND" ]
         ]
       ] ;
       fhir:Extension.url [ fhir:value "http://fhir.hl7.org.vn/core/StructureDefinition/vn-ext-other-fund-breakdown" ]
     ] ;
     fhir:Claim.item.sequence [ fhir:value "4"^^xsd:positiveInteger ] ;
     fhir:Claim.item.category [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://fhir.hl7.org.vn/core/CodeSystem/vn-cost-category-cs" ] ;
         fhir:Coding.code [ fhir:value "8" ] ;
         fhir:Coding.display [ fhir:value "Thuốc, dịch truyền" ]
       ]
     ] ;
     fhir:Claim.item.productOrService [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://www.whocc.no/atc" ] ;
         fhir:Coding.code [ fhir:value "J01DD04" ] ;
         fhir:Coding.display [ fhir:value "Ceftriaxone" ]
       ] ;
       fhir:CodeableConcept.text [ fhir:value "Ceftriaxone 2 g bột pha tiêm" ]
     ] ;
     fhir:Claim.item.servicedDate [ fhir:value "2026-03-06"^^xsd:date ] ;
     fhir:Claim.item.quantity [
       fhir:Quantity.value [ fhir:value "10"^^xsd:decimal ] ;
       fhir:Quantity.unit [ fhir:value "lọ" ]
     ] ;
     fhir:Claim.item.unitPrice [
       fhir:Money.value [ fhir:value "50000"^^xsd:decimal ] ;
       fhir:Money.currency [ fhir:value "VND" ]
     ] ;
     fhir:Claim.item.net [
       fhir:Money.value [ fhir:value "500000"^^xsd:decimal ] ;
       fhir:Money.currency [ fhir:value "VND" ]
     ]
  ] ;
  fhir:Claim.total [
     fhir:Money.value [ fhir:value "2000000"^^xsd:decimal ] ;
     fhir:Money.currency [ fhir:value "VND" ]
  ] .

<http://hl7.org/fhir/Patient/ExamplePatientNguyenVanAn> a fhir:Patient .

<http://hl7.org/fhir/Organization/ExampleOrganizationBHXH> a fhir:Organization .

<http://hl7.org/fhir/Organization/ExampleOrganizationChoRay> a fhir:Organization .

<http://hl7.org/fhir/Coverage/ExampleCoverageBHYTNew> a fhir:Coverage .

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

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