NHDR Implementation Guide Release 1.0
0.1.0 - ci-build

NHDR Implementation Guide Release 1.0, published by NHDR. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/PROJ-PHILHEALTH-EA-NHDR/nhdr-fhir-ig-review-project-2/ and changes regularly. See the Directory of published versions

## Sample CF4 Bundle

      {
      "resourceType": "Bundle",
      "id": "Bundle-ClaimsForm4",
      "type": "transaction",
      "identifier": {
        "system": "http://nhdr.gov.ph/fhir/ValueSet-form-type",
        "value": "CF4"
      },
      "entry": [
        {
          "fullUrl": "urn:uuid:patient",
          "resource": {
            "resourceType": "Patient",
            "meta": {
              "profile": [
                "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Patient"
              ]
            },
            "extension": [
              {
                "url": "https://nhdr.gov.ph/fhir/StructureDefinition/Sex",
                "valueCode": "M"
              }
            ],
            "identifier": [
              {
                "system": "http://nhdr.gov.ph/fhir/Identifier/philhealth-id",
                "type": {
                  "text": "PhilHealth ID"
                },
                "value": "PH-00001"
              }
            ],
            "name": [
              {
                "family": "Apilyido",
                "given": [
                  "John",
                  "Mark"
                ],
                "suffix": [
                  "Mr."
                ]
              }
            ]
          },
          "request": {
            "method": "POST",
            "url": "Patient"
          }
        },
        {
          "fullUrl": "urn:uuid:organization",
          "resource": {
            "resourceType": "Organization",
            "meta": {
              "profile": [
                "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Organization"
              ]
            },
            "identifier": [
              {
                "type": {
                  "coding": [
                    {
                      "code": "AN"
                    }
                  ],
                  "text": "PhilHealth Accreditation Number (PAN)"
                },
                "value": "AN199513893"
              }
            ],
            "name": "6th General Hospital",
            "address": [
              {
                "line": [
                  "572 BLK 2 LOT 21",
                  "Maharlika Village"
                ],
                "postalCode": "2300",
                "extension": [
                  {
                    "url": "https://nhdr.gov.ph/fhir/StructureDefinition/Barangay",
                    "valueCoding": {
                      "code": "036916001",
                      "display": "San Roque"
                    }
                  },
                  {
                    "url": "https://nhdr.gov.ph/fhir/StructureDefinition/CityMunicipality",
                    "valueCoding": {
                      "code": "036916000",
                      "display": "Tarlac City"
                    }
                  },
                  {
                    "url": "https://nhdr.gov.ph/fhir/StructureDefinition/Province",
                    "valueCoding": {
                      "code": "036900000",
                      "display": "Tarlac"
                    }
                  }
                ]
              }
            ]
          },
          "request": {
            "method": "POST",
            "url": "Organization"
          }
        },
        {
          "fullUrl": "urn:uuid:encounter",
          "resource": {
            "resourceType": "Encounter",
            "meta": {
              "profile": [
                "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Encounter"
              ]
            },
            "extension": [
              {
                "url": "https://nhdr.gov.ph/fhir/StructureDefinition/AgeYears",
                "valueInteger": 35
              }
            ],
            "status": "finished",
            "class": {
              "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
              "code": "AMB",
              "display": "Ambulatory"
            },
            "period": {
              "start": "2026-03-11T08:00:00+08:00",
              "end": "2026-03-11T09:30:00+08:00"
            },
            "reasonReference": [
              {
                "reference": "Observation/CF4-Observation-Pertinent-Past-Medical-History"
              }
            ],
            "hospitalization": {
              "dischargeDisposition": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/discharge-disposition",
                    "code": "home",
                    "display": "Discharged to home"
                  }
                ]
              }
            }
          },
          "request": {
            "method": "POST",
            "url": "Encounter"
          }
        },
        {
          "fullUrl": "urn:uuid:condition",
          "resource": {
            "resourceType": "Condition",
            "meta": {
              "profile": [
                "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Condition"
              ]
            },
            "subject": {
              "reference": "urn:uuid:patient"
            },
            "code": {
              "coding": [
                {
                  "system": "http://hl7.org/fhir/sid/icd-10",
                  "code": "I10",
                  "display": "Essential (primary) hypertension"
                }
              ]
            },
            "note": [
              {
                "text": "Patient reports persistent headaches for the past 2 weeks."
              },
              {
                "text": "Past medical history includes type 2 diabetes mellitus."
              }
            ]
          },
          "request": {
            "method": "POST",
            "url": "Condition"
          }
        },
        {
          "fullUrl": "urn:uuid:observation-1",
          "resource": {
            "resourceType": "Observation",
            "meta": {
              "profile": [
                "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Observation"
              ]
            },
            "status": "final",
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "57075-4",
                  "display": "Pregnancy history panel"
                }
              ]
            },
            "component": [
              {
                "code": {
                  "text": "OB/GYN History (G)"
                },
                "valueInteger": 3
              },
              {
                "code": {
                  "text": "OB/GYN History (P)"
                },
                "valueInteger": 2
              },
              {
                "code": {
                  "text": "OB/GYN History (P)(T)"
                },
                "valueInteger": 1
              },
              {
                "code": {
                  "text": "OB/GYN History (P)(P)"
                },
                "valueInteger": 1
              },
              {
                "code": {
                  "text": "OB/GYN History (P)(A)"
                },
                "valueInteger": 0
              },
              {
                "code": {
                  "text": "OB/GYN History (P)(L)"
                },
                "valueInteger": 2
              },
              {
                "code": {
                  "text": "OB/GYN History - LMP"
                },
                "valueDateTime": "2026-02-01"
              }
            ],
            "dataAbsentReason": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/data-absent-reason",
                  "code": "not-applicable"
                }
              ]
            }
          },
          "request": {
            "method": "POST",
            "url": "Observation"
          }
        },
        {
          "fullUrl": "urn:uuid:observation-2",
          "resource": {
            "resourceType": "Observation",
            "meta": {
              "profile": [
                "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Observation"
              ]
            },
            "status": "final",
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "75325-1",
                  "display": "Pertinent signs and symptoms on admission"
                }
              ]
            },
            "component": [
              {
                "code": {
                  "text": "Altered mental sensorium"
                },
                "valueBoolean": true
              },
              {
                "code": {
                  "text": "Abdominal cramp/pain"
                },
                "valueBoolean": true
              },
              {
                "code": {
                  "text": "Anorexia"
                },
                "valueBoolean": false
              },
              {
                "code": {
                  "text": "Bleeding gum"
                },
                "valueBoolean": false
              },
              {
                "code": {
                  "text": "Body weakness"
                },
                "valueBoolean": true
              }
            ]
          },
          "request": {
            "method": "POST",
            "url": "Observation"
          }
        },
        {
          "fullUrl": "urn:uuid:observation-3",
          "resource": {
            "resourceType": "Observation",
            "meta": {
              "profile": [
                "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Observation"
              ]
            },
            "status": "final",
            "code": {
              "coding": [
                {
                  "system": "http://loinc.org",
                  "code": "29545-1",
                  "display": "Physical findings on admission"
                }
              ]
            },
            "component": [
              {
                "code": {
                  "coding": [
                    {
                      "system": "http://loinc.org",
                      "code": "8302-2",
                      "display": "Body height"
                    }
                  ]
                },
                "valueQuantity": {
                  "value": 160,
                  "unit": "cm"
                }
              },
              {
                "code": {
                  "coding": [
                    {
                      "system": "http://loinc.org",
                      "code": "29463-7",
                      "display": "Body weight"
                    }
                  ]
                },
                "valueQuantity": {
                  "value": 65,
                  "unit": "kg"
                }
              },
              {
                "code": {
                  "coding": [
                    {
                      "system": "http://loinc.org",
                      "code": "80313-0",
                      "display": "Mental status - level of consciousness"
                    }
                  ]
                },
                "valueString": "Awake and alert"
              },
              {
                "code": {
                  "coding": [
                    {
                      "system": "http://loinc.org",
                      "code": "85354-9",
                      "display": "Blood pressure panel"
                    }
                  ]
                },
                "valueString": "120/80 mmHg"
              },
              {
                "code": {
                  "coding": [
                    {
                      "system": "http://loinc.org",
                      "code": "8867-4",
                      "display": "Heart rate"
                    }
                  ]
                },
                "valueQuantity": {
                  "value": 82,
                  "unit": "beats/min"
                }
              },
              {
                "code": {
                  "coding": [
                    {
                      "system": "http://loinc.org",
                      "code": "9279-1",
                      "display": "Respiratory rate"
                    }
                  ]
                },
                "valueQuantity": {
                  "value": 20,
                  "unit": "breaths/min"
                }
              },
              {
                "code": {
                  "coding": [
                    {
                      "system": "http://loinc.org",
                      "code": "8310-5",
                      "display": "Body temperature"
                    }
                  ]
                },
                "valueQuantity": {
                  "value": 37,
                  "unit": "°C"
                }
              },
              {
                "code": {
                  "text": "HEENT"
                },
                "valueString": "Essentially Normal"
              },
              {
                "code": {
                  "text": "Chest/Lungs"
                },
                "valueString": "Symmetrical chest expansion"
              },
              {
                "code": {
                  "text": "CVS"
                },
                "valueString": "Displaced apex beat"
              },
              {
                "code": {
                  "text": "Abdomen"
                },
                "valueString": "Abdominal rigidity"
              },
              {
                "code": {
                  "text": "GU (IE)"
                },
                "valueString": "Blood stained on examining finger"
              },
              {
                "code": {
                  "text": "Skin/Extremities"
                },
                "valueString": "Rashes/petechiae"
              },
              {
                "code": {
                  "text": "Neuro Exam"
                },
                "valueString": "Essentially normal"
              }
            ]
          },
          "request": {
            "method": "POST",
            "url": "Observation"
          }
        },
        {
          "fullUrl": "urn:uuid:servicerequest",
          "resource": {
            "resourceType": "ServiceRequest",
            "meta": {
              "profile": [
                "https://nhdr.gov.ph/fhir/StructureDefinition/PH-ServiceRequest"
              ]
            },
            "status": "completed",
            "intent": "order",
            "subject": {
              "reference": "urn:uuid:patient"
            },
            "requester": {
              "reference": "urn:uuid:organization"
            },
            "reasonReference": [
              {
                "reference": "urn:uuid:observation-1"
              }
            ]
          },
          "request": {
            "method": "POST",
            "url": "ServiceRequest"
          }
        },
        {
          "fullUrl": "urn:uuid:clinicalimpression",
          "resource": {
            "resourceType": "ClinicalImpression",
            "meta": {
              "profile": [
                "https://nhdr.gov.ph/fhir/StructureDefinition/PH-ClinicalImpression"
              ]
            },
            "status": "completed",
            "description": "Clinical impression on admission based on history, pertinent signs and symptoms, and physical examination.",
            "effectiveDateTime": "2026-03-12T09:30:00+08:00",
            "subject": {
              "reference": "urn:uuid:patient"
            }
          },
          "request": {
            "method": "POST",
            "url": "ClinicalImpression"
          }
        },
        {
          "fullUrl": "urn:uuid:medicationrequest",
          "resource": {
            "resourceType": "MedicationRequest",
            "meta": {
              "profile": [
                "https://nhdr.gov.ph/fhir/StructureDefinition/PH-MedicationRequest"
              ]
            },
            "status": "active",
            "intent": "order",
            "medicationReference": {
              "reference": "urn:uuid:medication"
            },
            "subject": {
              "reference": "urn:uuid:patient"
            },
            "dosageInstruction": [
              {
                "doseAndRate": [
                  {
                    "doseQuantity": {
                      "value": 1,
                      "unit": "tablet"
                    }
                  }
                ],
                "route": {
                  "coding": [
                    {
                      "system": "http://snomed.info/sct",
                      "code": "26643006",
                      "display": "Oral route"
                    }
                  ]
                },
                "timing": {
                  "repeat": {
                    "frequency": 2,
                    "period": 1,
                    "periodUnit": "d"
                  }
                }
              }
            ]
          },
          "request": {
            "method": "POST",
            "url": "MedicationRequest"
          }
        },
        {
          "fullUrl": "urn:uuid:provenance",
          "resource": {
            "resourceType": "Provenance",
            "meta": {
              "profile": [
                "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Provenance"
              ]
            },
            "target": [
              {
                "reference": "urn:uuid:claim"
              }
            ],
            "recorded": "2026-02-03T09:00:00+08:00",
            "agent": [
              {
                "who": {
                  "reference": "urn:uuid:practitioner"
                }
              }
            ],
            "signature": [
              {
                "type": [
                  {
                    "system": "urn:iso-astm:E1762-95:2013",
                    "code": "1.2.840.10065.1.12.1.20",
                    "display": "Electronic Signature"
                  }
                ],
                "when": "2026-02-03T10:30:00+08:00",
                "who": {
                  "reference": "urn:uuid:practitioner"
                },
                "data": "QkFTRTY0X1NJR05BVFVSRV9QQVRJRU5U"
              }
            ]
          },
          "request": {
            "method": "POST",
            "url": "Provenance"
          }
        },
        {
          "fullUrl": "urn:uuid:claim",
          "resource": {
            "resourceType": "Claim",
            "meta": {
              "profile": [
                "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Claim"
              ]
            },
            "extension": [
              {
                "url": "https://nhdr.gov.ph/fhir/StructureDefinition/EncounterExtension",
                "valueReference": {
                  "reference": "urn:uuid:encounter"
                }
              }
            ],
            "identifier": [
              {
                "system": "https://nhdr.gov.ph/claim",
                "value": "CLAIM-0001"
              }
            ],
            "status": "active",
            "type": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/claim-type",
                  "code": "institutional"
                }
              ]
            },
            "use": "claim",
            "patient": {
              "reference": "urn:uuid:patient"
            },
            "provider": {
              "reference": "urn:uuid:organization"
            },
            "created": "2026-03-17",
            "priority": {
              "coding": [
                {
                  "system": "http://terminology.hl7.org/CodeSystem/processpriority",
                  "code": "normal"
                }
              ]
            },
            "diagnosis": [
              {
                "sequence": 1,
                "diagnosisCodeableConcept": {
                  "text": "Hypertension"
                }
              }
            ],
            "supportingInfo": [
              {
                "sequence": 1,
                "category": { "text": "Pertinent Past Medical History" },
                "valueReference": {
                  "reference": "urn:uuid:obs-pmh"
                }
              },
              {
                "sequence": 2,
                "category": { "text": "Signs and Symptoms" },
                "valueReference": {
                  "reference": "urn:uuid:obs-ssa"
                }
              },
              {
                "sequence": 3,
                "category": { "text": "Physical Examination" },
                "valueReference": {
                  "reference": "urn:uuid:obs-pe"
                }
              }
            ],
            "procedure": [
              {
                "sequence": 1,
                "procedureReference": {
                  "reference": "urn:uuid:procedure"
                }
              }
            ],
            "insurance": [
              {
                "sequence": 1,
                "focal": true,
                "coverage": {
                  "reference": "urn:uuid:coverage"
                }
              }
            ],
            "item": [
              {
                "sequence": 1,
                "productOrService": {
                  "text": "General Ward"
                },
                "quantity": {
                  "value": 1
                },
                "net": {
                  "value": 1000,
                  "currency": "PHP"
                }
              }
            ],
            "referral": {
              "reference": "urn:uuid:servicerequest"
            },
            "prescription": {
              "reference": "urn:uuid:medicationrequest"
            }
          },
          "request": {
            "method": "POST",
            "url": "Claim"
          }
        }
      ]
    }