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Merge pull request #35 from gematik/dav_update
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Update examples 01.07.2023
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@Hendrejvr
Hendrejvr authored May 29, 2024
2 parents ef12f22 + 219b451 commit 4b12b34
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Binary file modified End-to-End-Examples/4_01.07.2023/PKV/Freitext-Verordnung/FT_Kostenbeleg.pdf
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2 changes: 1 addition & 1 deletion End-to-End-Examples/4_01.07.2023/PKV/Freitext-Verordnung/FT_MedicationDispense.xml
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<subject>
<identifier>
<system value="http://fhir.de/sid/pkv/kvid-10"/>
<value value="P123464237"/>
<value value="P123464233"/>
</identifier>
</subject>
<performer>
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2 changes: 1 addition & 1 deletion End-to-End-Examples/4_01.07.2023/PKV/Freitext-Verordnung/FT_VerordnungArzt.html
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padding: 0;
}
}
</style></head><body><div id="gesamtrahmen"><div id="kaestchen_bereich_links"><ul class="mittig"><li class="tiny">Gebühr<br/>frei</li><li class="kaestchen">☐</li><li class="tiny">Geb.-<br/>pfl.</li><li class="kaestchen">☐</li><li class="tiny"><br/>noctu</li><li class="kaestchen abstand_unten">☐</li><li class="tiny">Unfall</li><li class="kaestchen">☐</li><li class="tiny">Arbeits-<br/>unfall</li><li class="kaestchen">☐</li><li class="tiny">Berufs-<br/>krankheit</li><li class="kaestchen abstand_unten">☐</li><li class="tiny">aut<br/>idem</li><li class="kaestchen">☒</li></ul></div><table><tbody><tr><td><table cellspacing="10"><colgroup><col style="width:27em"/><col style="width:20em"/></colgroup><tbody><tr><td valign="top"><table style="width: 27em; border-spacing:0; cellspacing:0; border-collapse:collapse; "><colgroup><col style="width:27em"/></colgroup><tbody><tr><td><table style=" border: 1px solid black; width:27em; border-spacing: 0; cellspacing: 0; border-collapse: collapse; background-color:white; "><tbody><tr><td><table style="border-bottom:1px solid black; border-collapse: collapse; width: 27em; height: 2em; border-spacing: 0; cellspacing: 0; table-layout:fixed "><colgroup><col style="width:9em"/><col style="width:9em"/><col style="width:9em"/></colgroup><tbody><tr><td colspan="3" class="in-black">Krankenkasse bzw. Kostenträger</td></tr><tr><td colspan="2" class="daten nowrap">Allianz Private Krankenversicherung</td><td colspan="1" class="daten" style="text-align:right;"/></tr></tbody></table></td></tr><tr><td><table style=" border-collapse: collapse; border-spacing: 0; cellspacing: 0; width: 27em; table-layout:fixed "><colgroup><col style="width:7em; "/><col style="width:13em; "/><col style="width:7em; "/></colgroup><tbody><tr><td class="in-black" colspan="3">Name, Vorname des Versicherten</td></tr><tr><td colspan="2" width="100%" class="nowrap daten overflow">Privati</td><td class="in-black mittig"><div>geb. am</div></td></tr><tr><td colspan="2" width="100%" class="nowrap daten overflow">Paolo </td><td class="daten" style="text-align:right; ">06.01.1935</td></tr><tr><td colspan="3" style="border-bottom:1px solid black; width: 100%" class="nowrap daten overflow">Blumenweg 18<br/>D 26427 Esens</td></tr></tbody></table></td></tr><tr><td><table style="border-collapse: collapse; border-bottom:1px solid black; width: 27em; border-spacing: 0; cellspacing: 0; height: 2em; table-layout:fixed"><colgroup><col style="width:9em;"/><col style="width:10em;"/><col style="width:8em;"/></colgroup><tbody><tr><td class="in-black">Kostenträgerkennung</td><td class="in-black">Versicherten-Nr.</td><td class="in-black">Status </td></tr><tr><td class="nowrap daten">123456789</td><td style="border-left:1px solid black;" class="daten">P123464237</td><td style=" border-left:1px solid black;" class="nowrap"><span class="daten">1</span><span class="thin-space"> </span><span class="daten">00</span><span class="thin-space"> </span><span class="daten">00</span><span class="thin-space"> </span><span class="daten">00</span></td></tr></tbody></table></td></tr><tr><td><table style="border-collapse: collapse; width: 27em; border-spacing: 0; cellspacing: 0; height: 2em; table-layout:fixed "><colgroup><col style="width: 9em"/><col style="width: 9em"/><col style="width: 9em"/></colgroup><tbody><tr><td class="in-black">Betriebsstätten-Nr.</td><td class="in-black">Arzt-Nr.</td><td class="in-black">Datum</td></tr><tr><td class="daten">721111100</td><td style="border-left:1px solid black;" class="daten">987789324</td><td style="border-left:1px solid black;" class="daten">03.07.2023</td></tr></tbody></table></td></tr></tbody></table></td></tr></tbody></table></td><td valign="top"><table style="width:19.4em; table-layout:fixed"><tbody><tr><td><table cellpadding="0" cellspacing="0"><tbody><tr class="mittig"><td><ul><li class="tiny"><br/>BVG</li><li class="kaestchen">☐</li></ul></td><td><ul><li class="tiny">Impf-<br/>stoff</li><li class="kaestchen">☐</li></ul></td><td><ul><li class="tiny">Spr.St.-<br/>Bedarf</li><li class="kaestchen">☐</li></ul></td></tr></tbody></table></td></tr><tr><td><div style="background-color:white; width:20em; border:1px solid black;" class="daten overflow breakword">MVZ<br/>721111100<br/>Herbert-Lewin-Platz 2<br/>10623 Berlin<br/>
</style></head><body><div id="gesamtrahmen"><div id="kaestchen_bereich_links"><ul class="mittig"><li class="tiny">Gebühr<br/>frei</li><li class="kaestchen">☐</li><li class="tiny">Geb.-<br/>pfl.</li><li class="kaestchen">☐</li><li class="tiny"><br/>noctu</li><li class="kaestchen abstand_unten">☐</li><li class="tiny">Unfall</li><li class="kaestchen">☐</li><li class="tiny">Arbeits-<br/>unfall</li><li class="kaestchen">☐</li><li class="tiny">Berufs-<br/>krankheit</li><li class="kaestchen abstand_unten">☐</li><li class="tiny">aut<br/>idem</li><li class="kaestchen">☒</li></ul></div><table><tbody><tr><td><table cellspacing="10"><colgroup><col style="width:27em"/><col style="width:20em"/></colgroup><tbody><tr><td valign="top"><table style="width: 27em; border-spacing:0; cellspacing:0; border-collapse:collapse; "><colgroup><col style="width:27em"/></colgroup><tbody><tr><td><table style=" border: 1px solid black; width:27em; border-spacing: 0; cellspacing: 0; border-collapse: collapse; background-color:white; "><tbody><tr><td><table style="border-bottom:1px solid black; border-collapse: collapse; width: 27em; height: 2em; border-spacing: 0; cellspacing: 0; table-layout:fixed "><colgroup><col style="width:9em"/><col style="width:9em"/><col style="width:9em"/></colgroup><tbody><tr><td colspan="3" class="in-black">Krankenkasse bzw. Kostenträger</td></tr><tr><td colspan="2" class="daten nowrap">Allianz Private Krankenversicherungs-AG</td><td colspan="1" class="daten" style="text-align:right;"/></tr></tbody></table></td></tr><tr><td><table style=" border-collapse: collapse; border-spacing: 0; cellspacing: 0; width: 27em; table-layout:fixed "><colgroup><col style="width:7em; "/><col style="width:13em; "/><col style="width:7em; "/></colgroup><tbody><tr><td class="in-black" colspan="3">Name, Vorname des Versicherten</td></tr><tr><td colspan="2" width="100%" class="nowrap daten overflow">Privati</td><td class="in-black mittig"><div>geb. am</div></td></tr><tr><td colspan="2" width="100%" class="nowrap daten overflow">Paolo </td><td class="daten" style="text-align:right; ">06.01.1935</td></tr><tr><td colspan="3" style="border-bottom:1px solid black; width: 100%" class="nowrap daten overflow">Blumenweg 18<br/>D 26427 Esens</td></tr></tbody></table></td></tr><tr><td><table style="border-collapse: collapse; border-bottom:1px solid black; width: 27em; border-spacing: 0; cellspacing: 0; height: 2em; table-layout:fixed"><colgroup><col style="width:9em;"/><col style="width:10em;"/><col style="width:8em;"/></colgroup><tbody><tr><td class="in-black">Kostenträgerkennung</td><td class="in-black">Versicherten-Nr.</td><td class="in-black">Status </td></tr><tr><td class="nowrap daten">168140346</td><td style="border-left:1px solid black;" class="daten">P123464233</td><td style=" border-left:1px solid black;" class="nowrap"><span class="daten">1</span><span class="thin-space"> </span><span class="daten">00</span><span class="thin-space"> </span><span class="daten">00</span><span class="thin-space"> </span><span class="daten">00</span></td></tr></tbody></table></td></tr><tr><td><table style="border-collapse: collapse; width: 27em; border-spacing: 0; cellspacing: 0; height: 2em; table-layout:fixed "><colgroup><col style="width: 9em"/><col style="width: 9em"/><col style="width: 9em"/></colgroup><tbody><tr><td class="in-black">Betriebsstätten-Nr.</td><td class="in-black">Arzt-Nr.</td><td class="in-black">Datum</td></tr><tr><td class="daten">721111100</td><td style="border-left:1px solid black;" class="daten">987789324</td><td style="border-left:1px solid black;" class="daten">03.07.2023</td></tr></tbody></table></td></tr></tbody></table></td></tr></tbody></table></td><td valign="top"><table style="width:19.4em; table-layout:fixed"><tbody><tr><td><table cellpadding="0" cellspacing="0"><tbody><tr class="mittig"><td><ul><li class="tiny"><br/>BVG</li><li class="kaestchen">☐</li></ul></td><td><ul><li class="tiny">Impf-<br/>stoff</li><li class="kaestchen">☐</li></ul></td><td><ul><li class="tiny">Spr.St.-<br/>Bedarf</li><li class="kaestchen">☐</li></ul></td></tr></tbody></table></td></tr><tr><td><div style="background-color:white; width:20em; border:1px solid black;" class="daten overflow breakword">MVZ<br/>721111100<br/>Herbert-Lewin-Platz 2<br/>10623 Berlin<br/>
Tel: 030369258147<br/>Ernst Alder<br/>Facharzt für Augenheilkunde<br/>987789324<br/><div class="in-black" style=" width:100%; text-align: center; size:-2;">Angaben Praxis / verordnende Person</div></div></td></tr></tbody></table></td></tr></tbody></table></td></tr><tr><td><table><tbody><tr><td><fieldset><legend align="right" class="in-black">Freitext-Verordnung</legend><p class="daten" style="max-width: 50em;">1<text>x </text>Yellox 0,9 mg/ml Augentropfen<text> </text></p><p class="daten" style="max-width: 50em;"><text>Dosieranweisung / Medikationsplan mitgegeben</text></p></fieldset></td></tr><tr><td class="abstand_links in-black">Unfallinformationen</td></tr><tr><td class="abstand_links in-black"><table style="border-collapse: collapse; width: 100%; "><colgroup><col style="width:14%"/><col style="width:45%"/><col style="witdh:21%"/><col style="width:20%"/></colgroup><tbody><tr><td class="in-black" style="border-left:1px solid black; border-top:1px solid black; border-right:1px solid black;">Unfalltag</td><td class="in-black" style="border-left:1px solid black; border-top:1px solid black; border-right:1px solid black;">Unfallbetrieb oder Arbeitgebernummer</td><td> </td><td class="in-black" style="border-left:1px solid black; border-top:1px solid black; border-right:1px solid black;">Kostenträgertyp</td></tr><tr><td class="daten nowrap" style="border-left:1px solid black; border-bottom:1px solid black; border-right:1px solid black;"> </td><td class="daten nowrap" style="border-left:1px solid black; border-bottom:1px solid black; border-right:1px solid black;"> </td><td> </td><td class="daten nowrap" style="border-left:1px solid black; border-bottom:1px solid black; border-right:1px solid black;">PKV - 01</td></tr></tbody></table></td></tr><tr><td class="abstand_links"><table style=" width:42em; table-layout:fixed"><colgroup><col style="width:28em"/><col style="width:14em"/></colgroup><tbody><tr><td><span class="footer">Dokumentenversion: 
<span class="footer">1.1.0</span><br/>
Dokumententyp: 
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6 changes: 3 additions & 3 deletions End-to-End-Examples/4_01.07.2023/PKV/Freitext-Verordnung/FT_VerordnungArzt.xml
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</coding>
</type>
<system value="http://fhir.de/sid/pkv/kvid-10"/>
<value value="P123464237"/>
<value value="P123464233"/>
</identifier>
<name>
<use value="official"/>
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<payor>
<identifier>
<system value="http://fhir.de/sid/arge-ik/iknr"/>
<value value="123456789"/>
<value value="168140346"/>
</identifier>
<display value="Allianz Private Krankenversicherung"/>
<display value="Allianz Private Krankenversicherungs-AG"/>
</payor>
</Coverage>
</resource>
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4 changes: 2 additions & 2 deletions End-to-End-Examples/4_01.07.2023/PKV/PZN-Verordnung_Nr_1/PZN_Nr1_ChargeItem.xml
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<subject>
<identifier>
<system value="http://fhir.de/sid/gkv/kvid-10"/>
<value value="123456789" />
<value value="168140346" />
<assigner>
<display value="Allianz Private Krankenversicherung" />
<display value="Allianz Private Krankenversicherungs-AG" />
</assigner>
</identifier>
</subject>
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2 changes: 1 addition & 1 deletion End-to-End-Examples/4_01.07.2023/PKV/PZN-Verordnung_Nr_1/PZN_Nr1_MedicationDispense.xml
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<subject>
<identifier>
<system value="http://fhir.de/sid/pkv/kvid-10"/>
<value value="P123464113"/>
<value value="P123464117"/>
</identifier>
</subject>
<performer>
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