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# Szablon [4] Rozliczenie wydania leku

ID | 2.16.840.1.113883.3.4424.13.10.4.67 | Data obowiązywania | obowiązuje od 2020‑04‑22
Status | Active | Etykieta wersji | 1.3.1.3
Nazwa | plCdaDrugBillingEntry | Nazwa wyświetlana | [4] Rozliczenie wydania leku
Opis | Szablon CDA dla rozliczenia wydania leku
Kontekst | Węzły nadrzędne elementu szablonu o id 2.16.840.1.113883.3.4424.13.10.4.67
Typ | CDA Entry Level Template
Otwarty/Zamknięty | Zamknięty (tylko zdefiniowane elementy są dozwolone)
Używane przez / Używa |
Używane przez Transakcje 0 i szablony 4, Używa 1 szablon
Używane przez | jako | Nazwa | Wersja
--- | --- | --- | ---
2.16.840.1.113883.3.4424.13.10.4.62 | Ograniczanie | [4] Pozycja wydania leku (1.3.2) | 2020‑06‑08
2.16.840.1.113883.3.4424.13.10.3.70 |  | [3] Sekcja wydania leku (1.3) | 2018‑06‑30
2.16.840.1.113883.3.4424.13.10.2.80 |  | [2] Treść dokumentu realizacji recepty (1.3.1.1) | 2019‑05‑30
2.16.840.1.113883.3.4424.13.10.1.27 |  | [1] Realizacja recepty (1.3.2) | 2020‑06‑08
Używa | jako | Nazwa | Wersja
2.16.840.1.113883.3.4424.13.10.7.3 | Zawierać | [7] Opis wyrażenia klinicznego (1.3) | DYNAMICZNE
Relacje | Specialization: szablon 2.16.840.1.113883.3.4424.13.10.4.52 (2017‑04‑26)
Przykład |
Przykład
`<act classCode="ACT" moodCode="EVN"> <templateId root="2.16.840.1.113883.3.4424.13.10.4.67"/> <code code="TAKSL" codeSystem="2.16.840.1.113883.3.4424.13.5.1" displayName="Taksacja leku"/> <text> <reference value="#ACT_1"/> </text> <statusCode code="completed"/> <entryRelationship typeCode="COMP"> <observation classCode="OBS" moodCode="DEF"> <code code="WWL" codeSystem="2.16.840.1.113883.3.4424.13.5.1" displayName="Wartość wydanego leku"/> <statusCode code="completed"/> <value xsi:type="REAL" value="12.00"/> </observation> </entryRelationship> <entryRelationship typeCode="COMP"> <observation classCode="OBS" moodCode="DEF"> <code code="LIMU" codeSystem="2.16.840.1.113883.3.4424.13.5.1" displayName="Limit urzędowy"/> <statusCode code="completed"/> <value xsi:type="REAL" value="8.40"/> </observation> </entryRelationship> <entryRelationship typeCode="COMP"> <observation classCode="OBS" moodCode="DEF"> <code code="RLPO" codeSystem="2.16.840.1.113883.3.4424.13.5.1" displayName="Poziomy odpłatności leków refundowanych"/> <statusCode code="completed"/> <value xsi:type="CV" code="100%" codeSystem="2.16.840.1.113883.3.4424.11.1.1"/> </observation> </entryRelationship> <entryRelationship typeCode="COMP"> <observation classCode="OBS" moodCode="INT"> <code code="KREF" codeSystem="2.16.840.1.113883.3.4424.13.5.1" displayName="Kwota refundacji"/> <statusCode code="completed"/> <value xsi:type="REAL" value="0.00"/> </observation> </entryRelationship> <entryRelationship typeCode="COMP"> <observation classCode="OBS" moodCode="EVN"> <code code="ZAPL" codeSystem="2.16.840.1.113883.3.4424.13.5.1" displayName="Zapłacono"/> <statusCode code="completed"/> <value xsi:type="REAL" value="12.00"/> </observation> </entryRelationship> <entryRelationship typeCode="COMP"> <observation classCode="OBS" moodCode="DEF"> <code code="CDB" codeSystem="2.16.840.1.113883.3.4424.13.5.1" displayName="Cena detaliczna brutto"/> <statusCode code="completed"/> <value xsi:type="REAL" value="12.00"/> <entryRelationship typeCode="REFR"> <supply classCode="SPLY" moodCode="EVN"> <product> <manufacturedProduct> <manufacturedMaterial> <code code="5909991040123" codeSystem="1.3.160" codeSystemName="GS1"/> </manufacturedMaterial> </manufacturedProduct> </product> </supply> </entryRelationship> </observation> </entryRelationship> <entryRelationship typeCode="COMP"> <observation classCode="OBS" moodCode="DEF"> <code code="CHB" codeSystem="2.16.840.1.113883.3.4424.13.5.1" displayName="Cena hurtowa brutto"/> <statusCode code="completed"/> <value xsi:type="REAL" value="6.00"/> <entryRelationship typeCode="REFR"> <supply classCode="SPLY" moodCode="EVN"> <product> <manufacturedProduct> <manufacturedMaterial> <code code="5909991040123" codeSystem="1.3.160" codeSystemName="GS1"/> </manufacturedMaterial> </manufacturedProduct> </product> </supply> </entryRelationship> </observation> </entryRelationship></act>`
Pozycja | Typ danych | Krotność | Wymagalność | Opis | Etykieta
--- | --- | --- | --- | --- | ---
`hl7:act` |  |  |  |  | (plCtry)
`@classCode` | cs | 1 … 1 | R |
| CONF |
@classCode musi mieć wartość "ACT"
`@moodCode` | cs | 1 … 1 | R |
| CONF |
@moodCode musi mieć wartość "EVN"
`hl7:templateId` | II | 1 … 1 | M |  | (plCtry)
`@root` |  | 1 … 1 | F | 2.16.840.1.113883.3.4424.13.10.4.67
`hl7:code` | CD | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | TAKSL
`@codeSystem` | 1 … 1 | F | 2.16.840.1.113883.3.4424.13.5.1
`@displayName` | 1 … 1 | F | Taksacja leku
Dołączony | 1 … 1 | M | z 2.16.840.1.113883.3.4424.13.10.7.3 [7] Opis wyrażenia klinicznego (DYNAMICZNE)
`hl7:text` | ED | 1 … 1 | M |  | (plCtry)
`hl7:reference` | TEL | 0 … 1 |  |  | (plCtry)
`@value` | st | 1 … 1 | R |
| Schematron assert | rola | error |
| test | ancestor::hl7:section//*[@ID=substring(current()/@value,2)] |
| Komunikat | Referencja musi wskazywać na konkretny element tekstu sekcji o danym ID. |
| Schematron report | rola | error |
| test | ancestor::hl7:section/hl7:templateId[@root='2.16.840.1.113883.3.4424.13.10.3.55'] and hl7:reference |
| Komunikat | Nie może istnieć referencja do treści w sekcji postaci binarnej dokumentu. |
`hl7:statusCode` | CS | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | completed
`hl7:entryRelationship` |  | 1 … 1 | M |  | (plCtry)
| gdzie [hl7:observation/hl7:code/@code='WWL']
`@typeCode` |  | 1 … 1 | F | COMP
`hl7:observation` |  | 1 … 1 | M |  | (plCtry)
`@classCode` | cs | 1 … 1 | R |
| CONF |
@classCode musi mieć wartość "OBS"
`@moodCode` | cs | 1 … 1 | R |
| CONF |
@moodCode musi mieć wartość "DEF"
`hl7:code` | CD | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | WWL
`@codeSystem` | 1 … 1 | F | 2.16.840.1.113883.3.4424.13.5.1
`@displayName` | 1 … 1 | F | Wartość wydanego leku
`hl7:statusCode` | CS | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | completed
`hl7:value` | REAL | 1 … 1 | M |  | (plCtry)
| Schematron report | rola | error |
| test | /hl7:ClinicalDocument/hl7:code/hl7:translation/hl7:qualifier[hl7:name/@code='RRREC']/hl7:value/@code='W' and xs:decimal(hl7:value/@value)!=0 |
| Komunikat | Dla wycofującej realizacji recepty wartość wydanego leku powinna wynosić 0. |
`hl7:entryRelationship` |  | 0 … 1 |  |  | (plCtry)
| gdzie [hl7:observation/hl7:code/@code='LIMU']
`@typeCode` |  | 1 … 1 | F | COMP
`hl7:observation` |  | 1 … 1 | M |  | (plCtry)
`@classCode` | cs | 1 … 1 | R |
| CONF |
@classCode musi mieć wartość "OBS"
`@moodCode` | cs | 1 … 1 | R |
| CONF |
@moodCode musi mieć wartość "DEF"
`hl7:code` | CD | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | LIMU
`@codeSystem` | 1 … 1 | F | 2.16.840.1.113883.3.4424.13.5.1
`@displayName` | 1 … 1 | F | Limit urzędowy
`hl7:statusCode` | CS | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | completed
`hl7:value` | REAL | 1 … 1 | M |  | (plCtry)
`hl7:entryRelationship` |  | 1 … 1 | M |  | (plCtry)
| gdzie [hl7:observation/hl7:code/@code='RLPO']
`@typeCode` |  | 1 … 1 | F | COMP
`hl7:observation` |  | 1 … 1 | M |  | (plCtry)
`@classCode` | cs | 1 … 1 | R |
| CONF |
@classCode musi mieć wartość "OBS"
`@moodCode` | cs | 1 … 1 | R |
| CONF |
@moodCode musi mieć wartość "DEF"
`hl7:code` | CD | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | RLPO
`@codeSystem` | 1 … 1 | F | 2.16.840.1.113883.3.4424.13.5.1
`@displayName` | 1 … 1 | F | Poziomy odpłatności leków refundowanych
`hl7:statusCode` | CS | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | completed
`hl7:value` | CV | 1 … 1 | M |  | (plCtry)
| CONF |
Wartość @code musi pochodzić ze zbioru wartości 2.16.840.1.113883.3.4424.13.11.16 Poziom odpłatności za leki (DYNAMICZNE)
`hl7:entryRelationship` |  | 1 … 1 | M |  | (plCtry)
| gdzie [hl7:observation/hl7:code/@code='KREF']
`@typeCode` |  | 1 … 1 | F | COMP
`hl7:observation` |  | 1 … 1 | M |  | (plCtry)
`@classCode` | cs | 1 … 1 | R |
| CONF |
@classCode musi mieć wartość "OBS"
`@moodCode` | cs | 1 … 1 | R |
| CONF |
@moodCode musi mieć wartość "INT"
`hl7:code` | CD | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | KREF
`@codeSystem` | 1 … 1 | F | 2.16.840.1.113883.3.4424.13.5.1
`@displayName` | 1 … 1 | F | Kwota refundacji
`hl7:statusCode` | CS | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | completed
`hl7:value` | REAL | 1 … 1 | M |  | (plCtry)
`hl7:entryRelationship` |  | 1 … 1 | M |  | (plCtry)
| gdzie [hl7:observation/hl7:code/@code='ZAPL']
`@typeCode` |  | 1 … 1 | F | COMP
`hl7:observation` |  | 1 … 1 | M |  | (plCtry)
`@classCode` | cs | 1 … 1 | R |
| CONF |
@classCode musi mieć wartość "OBS"
`@moodCode` | cs | 1 … 1 | R |
| CONF |
@moodCode musi mieć wartość "EVN"
`hl7:code` | CD | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | ZAPL
`@codeSystem` | 1 … 1 | F | 2.16.840.1.113883.3.4424.13.5.1
`@displayName` | 1 … 1 | F | Zapłacono
`hl7:statusCode` | CS | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | completed
`hl7:value` | REAL | 1 … 1 | M |  | (plCtry)
| Schematron report | rola | error |
| test | /hl7:ClinicalDocument/hl7:code/hl7:translation/hl7:qualifier[hl7:name/@code='RRREC']/hl7:value/@code='W' and xs:decimal(hl7:value/@value)!=0 |
| Komunikat | Dla wycofującej realizacji recepty kwota zapłacona powinna wynosić 0. |
`hl7:entryRelationship` |  | 0 … 1 |  |  | (plCtry)
| gdzie [hl7:observation/hl7:code/@code='TAKL']
`@typeCode` |  | 1 … 1 | F | COMP
`hl7:observation` |  | 1 … 1 | M |  | (plCtry)
`@classCode` | cs | 1 … 1 | R |
| CONF |
@classCode musi mieć wartość "OBS"
`@moodCode` | cs | 1 … 1 | R |
| CONF |
@moodCode musi mieć wartość "EVN"
`hl7:code` | CD | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | TAKL
`@codeSystem` | 1 … 1 | F | 2.16.840.1.113883.3.4424.13.5.1
`@displayName` | 1 … 1 | F | Taksa laborum
`hl7:statusCode` | CS | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | completed
`hl7:value` | REAL | 1 … 1 | M |  | (plCtry)
`hl7:entryRelationship` |  | 0 … * |  |  | (plCtry)
| gdzie [hl7:observation/hl7:code/@code='CDB']
`@typeCode` |  | 1 … 1 | F | COMP
| Przykład | Cena detaliczna leku gotowego `<entryRelationship typeCode="COMP"> <observation classCode="OBS" moodCode="DEF"> <code code="CDB" codeSystem="2.16.840.1.113883.3.4424.13.5.1" displayName="Cena detaliczna brutto"/> <statusCode code="completed"/> <value xsi:type="REAL" value="12.00"/> <entryRelationship typeCode="REFR"> <supply classCode="SPLY" moodCode="EVN"> <product> <manufacturedProduct> <manufacturedMaterial> <code code="5909991040123" codeSystem="1.3.160" codeSystemName="GS1"/> </manufacturedMaterial> </manufacturedProduct> </product> </supply> </entryRelationship> </observation></entryRelationship>`
| Przykład | Cena detaliczna składnika leku recepturowego `<entryRelationship typeCode="COMP"> <observation classCode="OBS" moodCode="DEF"> <code code="CDB" codeSystem="2.16.840.1.113883.3.4424.13.5.1" displayName="Cena detaliczna brutto"/> <statusCode code="completed"/> <value xsi:type="REAL" value="4.00"/> <entryRelationship typeCode="REFR"> <supply classCode="SPLY" moodCode="EVN"> <product> <manufacturedProduct> <manufacturedMaterial> <code code="34543" codeSystem="2.16.840.1.113883.3.4424.6.3"/> </manufacturedMaterial> </manufacturedProduct> </product> </supply> </entryRelationship> </observation></entryRelationship>`
`hl7:observation` |  | 1 … 1 | M |  | (plCtry)
`@classCode` | cs | 1 … 1 | R |
| CONF |
@classCode musi mieć wartość "OBS"
`@moodCode` | cs | 1 … 1 | R |
| CONF |
@moodCode musi mieć wartość "DEF"
`hl7:code` | CD | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | CDB
`@codeSystem` | 1 … 1 | F | 2.16.840.1.113883.3.4424.13.5.1
`@displayName` | 1 … 1 | F | Cena detaliczna brutto
`hl7:statusCode` | CS | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | completed
`hl7:value` | REAL | 1 … 1 | M |  | (plCtry)
`hl7:entryRelationship` |  | 1 … 1 | M |  | (plCtry)
`@typeCode` |  | 1 … 1 | F | REFR
`hl7:supply` |  | 1 … 1 | M |  | (plCtry)
`@classCode` | cs | 1 … 1 | R |
| CONF |
@classCode musi mieć wartość "SPLY"
`@moodCode` | cs | 1 … 1 | R |
| CONF |
@moodCode musi mieć wartość "EVN"
`hl7:product` |  | 1 … 1 | M |  | (plCtry)
`hl7:manufacturedProduct` |  | 1 … 1 | M |  | (plCtry)
`hl7:manufacturedMaterial` |  | 1 … 1 | M |  | (plCtry)
`hl7:code` | CE | 1 … 1 | M |  | (plCtry)
`hl7:entryRelationship` |  | 0 … * |  |  | (plCtry)
| gdzie [hl7:observation/hl7:code/@code='CHB']
`@typeCode` |  | 1 … 1 | F | COMP
| Przykład | Cena hurtowa brutto leku gotowego `<entryRelationship typeCode="COMP"> <observation classCode="OBS" moodCode="DEF"> <code code="CHB" codeSystem="2.16.840.1.113883.3.4424.13.5.1" displayName="Cena hurtowa brutto"/> <statusCode code="completed"/> <value xsi:type="REAL" value="6.00"/> <entryRelationship typeCode="REFR"> <supply classCode="SPLY" moodCode="EVN"> <product> <manufacturedProduct> <manufacturedMaterial> <code code="5909991040123" codeSystem="1.3.160" codeSystemName="GS1"/> </manufacturedMaterial> </manufacturedProduct> </product> </supply> </entryRelationship> </observation></entryRelationship>`
| Przykład | Cena hurtowa brutto składnika leku recepturowego `<entryRelationship typeCode="COMP"> <observation classCode="OBS" moodCode="DEF"> <code code="CHB" codeSystem="2.16.840.1.113883.3.4424.13.5.1" displayName="Cena hurtowa brutto"/> <statusCode code="completed"/> <value xsi:type="REAL" value="2.00"/> <entryRelationship typeCode="REFR"> <supply classCode="SPLY" moodCode="EVN"> <product> <manufacturedProduct> <manufacturedMaterial> <code code="34543" codeSystem="2.16.840.1.113883.3.4424.6.3"/> </manufacturedMaterial> </manufacturedProduct> </product> </supply> </entryRelationship> </observation></entryRelationship>`
`hl7:observation` |  | 1 … 1 | M |  | (plCtry)
`@classCode` | cs | 1 … 1 | R |
| CONF |
@classCode musi mieć wartość "OBS"
`@moodCode` | cs | 1 … 1 | R |
| CONF |
@moodCode musi mieć wartość "DEF"
`hl7:code` | CD | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | CHB
`@codeSystem` | 1 … 1 | F | 2.16.840.1.113883.3.4424.13.5.1
`@displayName` | 1 … 1 | F | Cena hurtowa brutto
`hl7:statusCode` | CS | 1 … 1 | M |  | (plCtry)
`@code` | CONF | 1 … 1 | F | completed
`hl7:value` | REAL | 1 … 1 | M |  | (plCtry)
`hl7:entryRelationship` |  | 1 … 1 | M |  | (plCtry)
`@typeCode` |  | 1 … 1 | F | REFR
`hl7:supply` |  | 1 … 1 | M |  | (plCtry)
`@classCode` | cs | 1 … 1 | R |
| CONF |
@classCode musi mieć wartość "SPLY"
`@moodCode` | cs | 1 … 1 | R |
| CONF |
@moodCode musi mieć wartość "EVN"
`hl7:product` |  | 1 … 1 | M |  | (plCtry)
`hl7:manufacturedProduct` |  | 1 … 1 | M |  | (plCtry)
`hl7:manufacturedMaterial` |  | 1 … 1 | M |  | (plCtry)
`hl7:code` | CE | 1 … 1 | M |  | (plCtry)