Details of Ambulatory Care Orders

1. This file contains multiple order records for a single outpatient visit. 2. Records sharing the same FEE_YM + APPL_TYPE + APPL_DATE + CASE_TYPE + SEQ_NO + HOSP_ID are treated as orders from the same visit. 3. Each record includes the order code, quantity, and points, among other items. 4. The file formats and data descriptions listed in this manual are based on the "National Health Insurance Medical Institution (Outpatient, Inpatient, and Referral Institution) Medical Expense Points Reporting Format and Form Instructions," available at: National Health Insurance Administration, Ministry of Health and Welfare homepage / NHI Services / NHI Medical Expenses / Medical Expense Reporting and Payment / Medical Expense Payment / Medical Expense Reporting Regulations / Medical Expense XML Reporting Format / National Health Insurance Medical Institution (Outpatient, Inpatient, and Referral Institution) Medical Expense Points Reporting Format and Form Instructions (revision date 2020-08-13).

1. 為一次門診多筆醫令資料。 2. 相同之 FEE_YM＋APPL_TYPE＋APPL_DATE＋CASE_TYPE＋SEQ_NO＋ HOSP_ID視為同一次就醫之醫令。 3. 每一筆資料包括醫令碼、數量及點數等。 4. 本手冊所列之檔案格式及資料描述係參考「全民健康保險醫事服務機構(門診、住 院及交付機構)醫療費用點數申報格式及填表說明」，路徑：衛生福利部中央健康 保險署首頁/健保服務/健保醫療費用/醫療費用申報與給付/醫療費用支付/醫療費 用申報規定/醫療費用 XML 申報格式/全民健康保險醫事服務機構(門診、住院及 交付機構)醫療費用點數申報格式及填表說明(版更日期109.08.13)

1. The sum of the order points field (ORDER_QTY) across all records of the same outpatient visit equals the total points (EXP_DOT) in the Outpatient Detail File (H_NHI_OPDTE). ※ This center's database has been de-identified: directly identifying fields such as name and address have been removed, and fields such as ID number, facility code, insured unit code, tax ID number, date of birth, visit date, and admission date have been masked. The data may only be used within the independent workspace established by the Ministry, and only approved aggregate statistical results may be taken out, ensuring that the data and its disclosure method can no longer identify specific individuals.

1. 同一次門診之各筆醫令點數欄位(ORDER_QTY)加總等於門診明細檔 (H_NHI_OPDTE)之合計點數(EXP_DOT)。 ※本中心資料庫業經去識別化處理，刪除姓名、地址等可直接識別欄位，如有身分證 字號、院所代碼、投保單位代號、統一編號、出生日期、就醫日期、入院日期等欄位 均經屏蔽處理，且相關資料僅能於本部設置之獨立作業區內使用，並攜出經審核通過 之統計結果，以確保資料應用及其揭露方式已無從識別特定當事人。

1. Medical institution code (HOSP_ID) is encrypted. 2. This file does not contain patient ID number, use FEE_YM + APPL_TYPE + APPL_DATE + CASE_TYPE + SEQ_NO + HOSP_ID as key to match with outpatient detail file (H_NHI_OPDTE). 3. Key value for medical institution grouping and medical institution data matching: HOSP_ID.

1. 醫療機構代碼(HOSP_ID)經加密處理。 2. 本檔無病人身份證字號 ， 以 FEE_YM ＋ APPL_TYPE ＋ APPL_DATE ＋ CASE_TYPE＋SEQ_NO＋HOSP_ID為鍵值與門診明細檔(H_NHI_OPDTE)對照。 3. 醫療機構歸戶及醫療機構資料對照的鍵值：HOSP_ID。

• 2025/06/24 初版 · first edition
• 2026/01/27 修訂 · revised