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

## : ClaimsForm1-2 - TTL Representation

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    @prefix fhir: <http://hl7.org/fhir/> .
    @prefix owl: <http://www.w3.org/2002/07/owl#> .
    @prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
    @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
    @prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

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

     a fhir:Bundle ;
      fhir:nodeRole fhir:treeRoot ;
      fhir:id [ fhir:v "ClaimsForm1-2"] ; #
      fhir:identifier [
    fhir:system [
    fhir:v "http://nhdr.gov.ph/fhir/ValueSet-form-type"^^xsd:anyURI ;
    fhir:l <http://nhdr.gov.ph/fhir/ValueSet-form-type>     ] ;
    fhir:value [ fhir:v "CF1" ]
      ] ; #
      fhir:type [ fhir:v "transaction"] ; #
      fhir:entry ( [
    fhir:fullUrl [
    fhir:v "urn:uuid:relatedperson"^^xsd:anyURI ;
    fhir:l <urn:uuid:relatedperson>     ] ;
        ( fhir:resource <urn:uuid:relatedperson> ) ;
    fhir:request [
    fhir:method [ fhir:v "POST" ] ;
    fhir:url [
    fhir:v "RelatedPerson"^^xsd:anyURI ;
    fhir:l fhir:RelatedPerson       ]     ]
      ] [
    fhir:fullUrl [
    fhir:v "urn:uuid:patient"^^xsd:anyURI ;
    fhir:l <urn:uuid:patient>     ] ;
        ( fhir:resource <urn:uuid:patient> ) ;
    fhir:request [
    fhir:method [ fhir:v "POST" ] ;
    fhir:url [
    fhir:v "Patient"^^xsd:anyURI ;
    fhir:l fhir:Patient       ]     ]
      ] [
    fhir:fullUrl [
    fhir:v "urn:uuid:organization"^^xsd:anyURI ;
    fhir:l <urn:uuid:organization>     ] ;
        ( fhir:resource <urn:uuid:organization> ) ;
    fhir:request [
    fhir:method [ fhir:v "POST" ] ;
    fhir:url [
    fhir:v "Organization"^^xsd:anyURI ;
    fhir:l fhir:Organization       ]     ]
      ] [
    fhir:fullUrl [
    fhir:v "urn:uuid:questionnaire"^^xsd:anyURI ;
    fhir:l <urn:uuid:questionnaire>     ] ;
        ( fhir:resource <urn:uuid:questionnaire> ) ;
    fhir:request [
    fhir:method [ fhir:v "POST" ] ;
    fhir:url [
    fhir:v "Questionnaire"^^xsd:anyURI ;
    fhir:l fhir:Questionnaire       ]     ]
      ] [
    fhir:fullUrl [
    fhir:v "urn:uuid:questionnaireresponse"^^xsd:anyURI ;
    fhir:l <urn:uuid:questionnaireresponse>     ] ;
        ( fhir:resource <urn:uuid:questionnaireresponse> ) ;
    fhir:request [
    fhir:method [ fhir:v "POST" ] ;
    fhir:url [
    fhir:v "QuestionnaireResponse"^^xsd:anyURI ;
    fhir:l fhir:QuestionnaireResponse       ]     ]
      ] [
    fhir:fullUrl [
    fhir:v "urn:uuid:provenance"^^xsd:anyURI ;
    fhir:l <urn:uuid:provenance>     ] ;
        ( fhir:resource <urn:uuid:provenance> ) ;
    fhir:request [
    fhir:method [ fhir:v "POST" ] ;
    fhir:url [
    fhir:v "Provenance"^^xsd:anyURI ;
    fhir:l fhir:Provenance       ]     ]
      ] [
    fhir:fullUrl [
    fhir:v "urn:uuid:coverage"^^xsd:anyURI ;
    fhir:l <urn:uuid:coverage>     ] ;
        ( fhir:resource <urn:uuid:coverage> ) ;
    fhir:request [
    fhir:method [ fhir:v "POST" ] ;
    fhir:url [
    fhir:v "Coverage"^^xsd:anyURI ;
    fhir:l fhir:Coverage       ]     ]
      ] [
    fhir:fullUrl [
    fhir:v "urn:uuid:claim"^^xsd:anyURI ;
    fhir:l <urn:uuid:claim>     ] ;
        ( fhir:resource <urn:uuid:claim> ) ;
    fhir:request [
    fhir:method [ fhir:v "POST" ] ;
    fhir:url [
    fhir:v "Claim"^^xsd:anyURI ;
    fhir:l fhir:Claim       ]     ]
      ] ) . #

    <urn:uuid:relatedperson> a fhir:RelatedPerson ;
      fhir:id [ fhir:v "CF1-RelatedPerson-2"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/PH-RelatedPerson"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/PH-RelatedPerson>     ] )
      ] ; #
      fhir:text [
    fhir:status [ fhir:v "extensions" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"RelatedPerson_CF1-RelatedPerson-2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: RelatedPerson CF1-RelatedPerson-2</b></p><a name=\"CF1-RelatedPerson-2\"> </a><a name=\"hcCF1-RelatedPerson-2\"> </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-PH-RelatedPerson.html\">PH RelatedPerson</a></p></div><p><b>Sex at birth</b>: F</p><p><b>identifier</b>: PhilHealth Identification Number/PH54321</p><p><b>patient</b>: <a href=\"Bundle-ClaimsForm1-2.html#Patient_CF1-Patient-2\">Patient</a></p><p><b>name</b>: Lorna Mae Santos Bautista </p><p><b>telecom</b>: ph: 912-00-00, ph: 0927-000-0000, <a href=\"mailto:lmbautista@email.com\">lmbautista@email.com</a></p><p><b>birthDate</b>: 1971-02-11</p><p><b>address</b>: Fordham Road 1110 PH </p></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:extension ( [
    fhir:url [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/Sex"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/Sex>     ] ;
    fhir:value [
    a fhir:Code ;
    fhir:v "F"     ]
      ] ) ; #
      fhir:identifier ( [
    fhir:type [
          ( fhir:coding [
    fhir:code [ fhir:v "NIIP" ]       ] ) ;
    fhir:text [ fhir:v "PhilHealth Identification Number" ]     ] ;
    fhir:value [ fhir:v "PH54321" ]
      ] ) ; #
      fhir:patient [
    fhir:l fhir:Patient/CF1-Patient-2 ;
    fhir:reference [ fhir:v "Patient/CF1-Patient-2" ] ;
    fhir:display [ fhir:v "Patient" ]
      ] ; #
      fhir:name ( [
    fhir:family [ fhir:v "Bautista" ] ;
        ( fhir:given [ fhir:v "Lorna Mae" ] [ fhir:v "Santos" ] ) ;
        ( fhir:suffix [ fhir:v "Mrs." ] )
      ] ) ; #
      fhir:telecom ( [
    fhir:system [ fhir:v "phone" ] ;
    fhir:value [ fhir:v "912-00-00" ]
      ] [
    fhir:system [ fhir:v "phone" ] ;
    fhir:value [ fhir:v "0927-000-0000" ]
      ] [
    fhir:system [ fhir:v "email" ] ;
    fhir:value [ fhir:v "lmbautista@email.com" ]
      ] ) ; #
      fhir:birthDate [ fhir:v "1971-02-11"^^xsd:date] ; #
      fhir:address ( [
        ( fhir:extension [
    fhir:url [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/Barangay"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/Barangay>       ] ;
    fhir:value [
    a fhir:Coding ;
    fhir:code [ fhir:v "0123456789" ] ;
    fhir:display [ fhir:v "Blue Ridge" ]       ]     ] [
    fhir:url [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/CityMunicipality"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/CityMunicipality>       ] ;
    fhir:value [
    a fhir:Coding ;
    fhir:code [ fhir:v "0123456" ] ;
    fhir:display [ fhir:v "Quezon City" ]       ]     ] [
    fhir:url [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/Province"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/Province>       ] ;
    fhir:value [
    a fhir:Coding ;
    fhir:code [ fhir:v "01234" ] ;
    fhir:display [ fhir:v "Metro Manila" ]       ]     ] ) ;
        ( fhir:line [ fhir:v "Fordham Road" ] ) ;
    fhir:postalCode [ fhir:v "1110" ] ;
    fhir:country [ fhir:v "PH" ]
      ] ) . #

    <urn:uuid:patient> a fhir:Patient ;
      fhir:id [ fhir:v "CF1-Patient-2"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Patient"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/PH-Patient>     ] )
      ] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_CF1-Patient-2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient CF1-Patient-2</b></p><a name=\"CF1-Patient-2\"> </a><a name=\"hcCF1-Patient-2\"> </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-PH-Patient.html\">PH Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Antonio Jerome Morales Manipol  (no stated gender), DoB: 1994-02-25 ( PhilHealth Identification Number: PH12345)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Nominated Contact: Employer\">Employer:</td><td colspan=\"3\"><ul><li>ph: 09171234567</li></ul></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Extension to capture the sex of a patient, practitioner, or person.\"><a href=\"StructureDefinition-Sex.html\">Sex at birth</a></td><td colspan=\"3\">M</td></tr></table></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:extension ( [
    fhir:url [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/Sex"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/Sex>     ] ;
    fhir:value [
    a fhir:Code ;
    fhir:v "M"     ]
      ] ) ; #
      fhir:identifier ( [
    fhir:type [
          ( fhir:coding [
    fhir:code [ fhir:v "NIIP" ]       ] ) ;
    fhir:text [ fhir:v "PhilHealth Identification Number" ]     ] ;
    fhir:value [ fhir:v "PH12345" ]
      ] ) ; #
      fhir:name ( [
    fhir:family [ fhir:v "Manipol" ] ;
        ( fhir:given [ fhir:v "Antonio Jerome" ] [ fhir:v "Morales" ] ) ;
        ( fhir:suffix [ fhir:v "Mr." ] )
      ] ) ; #
      fhir:birthDate [ fhir:v "1994-02-25"^^xsd:date] ; #
      fhir:contact ( [
        ( fhir:relationship [
          ( fhir:coding [
    fhir:code [ fhir:v "E" ] ;
    fhir:display [ fhir:v "Employer" ]       ] )     ] ) ;
        ( fhir:telecom [
    fhir:system [ fhir:v "phone" ] ;
    fhir:value [ fhir:v "09171234567" ]     ] )
      ] ) . #

    <urn:uuid:organization> a fhir:Organization ;
      fhir:id [ fhir:v "CF1-Organization-2"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Organization"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/PH-Organization>     ] )
      ] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_CF1-Organization-2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization CF1-Organization-2</b></p><a name=\"CF1-Organization-2\"> </a><a name=\"hcCF1-Organization-2\"> </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-PH-Organization.html\">PH Organization</a></p></div><p><b>identifier</b>: PhilHealth Employer Number (PEN)/EN15243</p><p><b>name</b>: PhilHealth</p><p><b>telecom</b>: 080-00-00</p></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:identifier ( [
    fhir:type [
          ( fhir:coding [
    fhir:code [ fhir:v "EN" ]       ] ) ;
    fhir:text [ fhir:v "PhilHealth Employer Number (PEN)" ]     ] ;
    fhir:value [ fhir:v "EN15243" ]
      ] ) ; #
      fhir:name [ fhir:v "PhilHealth"] ; #
      fhir:telecom ( [
    fhir:value [ fhir:v "080-00-00" ]
      ] ) . #

    <urn:uuid:questionnaire> a fhir:Questionnaire ;
      fhir:id [ fhir:v "CF1-Questionnaire-2"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Questionnaire"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/PH-Questionnaire>     ] )
      ] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Questionnaire_CF1-Questionnaire-2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire CF1-Questionnaire-2</b></p><a name=\"CF1-Questionnaire-2\"> </a><a name=\"hcCF1-Questionnaire-2\"> </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-PH-Questionnaire.html\">PH Questionnaire</a></p></div><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Cardinality</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Type</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Additional information about the item\">Description &amp; Constraints</a><span style=\"float: right\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64, \" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireRoot\" class=\"hierarchy\"/> </td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" id=\"item.CF1-Q1\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-boolean.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"boolean\" class=\"hierarchy\"/> CF1-Q1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Patient is the member?</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">0..1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-boolean\">boolean</a></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/></tr>#xD;\n<tr><td colspan=\"5\" class=\"hierarchy\"><br/><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64, \" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:status [ fhir:v "active"] ; #
      fhir:item ( [
    fhir:linkId [ fhir:v "CF1-Q1" ] ;
    fhir:text [ fhir:v "Patient is the member?" ] ;
    fhir:type [ fhir:v "boolean" ]
      ] ) . #

    <urn:uuid:questionnaireresponse> a fhir:QuestionnaireResponse ;
      fhir:id [ fhir:v "CF1-QuestionnaireResponse-2"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/PH-QuestionnaireResponse"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/PH-QuestionnaireResponse>     ] )
      ] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"QuestionnaireResponse_CF1-QuestionnaireResponse-2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: QuestionnaireResponse CF1-QuestionnaireResponse-2</b></p><a name=\"CF1-QuestionnaireResponse-2\"> </a><a name=\"hcCF1-QuestionnaireResponse-2\"> </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-PH-QuestionnaireResponse.html\">PH QuestionnaireResponse</a></p></div><table border=\"1\" cellpadding=\"0\" cellspacing=\"0\" style=\"border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;\"><tr style=\"border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top\"><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The linkID for the item\">LinkID</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Text for the item\">Text</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Minimum and Maximum # of times the item can appear in the instance\">Definition</a></th><th style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px\" class=\"hierarchy\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"The type of the item\">Answer</a><span style=\"float: right\"><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64, \" alt=\"doco\" style=\"background-color: inherit\"/></a></span></th></tr><tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon_q_root.gif\" alt=\".\" style=\"background-color: white; background-color: inherit\" title=\"QuestionnaireResponseRoot\" class=\"hierarchy\"/> CF1-QuestionnaireResponse-2</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">Questionnaire:None specified</td></tr>#xD;\n<tr style=\"border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7\"><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck00.png)\" class=\"hierarchy\"><img src=\"tbl_spacer.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"tbl_vjoin_end.png\" alt=\".\" style=\"background-color: inherit\" class=\"hierarchy\"/><img src=\"icon-q-string.png\" alt=\".\" style=\"background-color: #F7F7F7; background-color: inherit\" title=\"Item\" class=\"hierarchy\"/> CF1-Q1</td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"></td><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\"/><td style=\"vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px\" class=\"hierarchy\">false</td></tr>#xD;\n<tr><td colspan=\"4\" class=\"hierarchy\"><br/><a href=\"https://hl7.org/fhir/R4/formats.html#table\" title=\"Legend for this format\"><img src=\"data:image/png;base64, \" alt=\"doco\" style=\"background-color: inherit\"/> Documentation for this format</a></td></tr></table></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:status [ fhir:v "completed"] ; #
      fhir:item ( [
    fhir:linkId [ fhir:v "CF1-Q1" ] ;
        ( fhir:answer [
    fhir:value [
    a fhir:Boolean ;
    fhir:v false       ]     ] )
      ] ) . #

    <urn:uuid:provenance> a fhir:Provenance ;
      fhir:id [ fhir:v "CF1-Provenance-2"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Provenance"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/PH-Provenance>     ] )
      ] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Provenance_CF1-Provenance-2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Provenance CF1-Provenance-2</b></p><a name=\"CF1-Provenance-2\"> </a><a name=\"hcCF1-Provenance-2\"> </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-PH-Provenance.html\">PH Provenance</a></p></div><p>Provenance for <a href=\"Bundle-ClaimsForm1-2.html#Claim_CF1-Claim-2\">Claim</a></p><p>Summary</p><table class=\"grid\"><tr><td>Recorded</td><td>2026-02-03 09:00:00+0800</td></tr></table><p><b>Agents</b></p><table class=\"grid\"><tr><td><b>who</b></td></tr><tr><td><a href=\"Bundle-ClaimsForm1-2.html#Organization_CF1-Organization-2\">Organization</a></td></tr></table></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:target ( [
    fhir:l fhir:Claim/CF1-Claim-2 ;
    fhir:reference [ fhir:v "Claim/CF1-Claim-2" ] ;
    fhir:display [ fhir:v "Claim" ]
      ] ) ; #
      fhir:recorded [ fhir:v "2026-02-03T09:00:00+08:00"^^xsd:dateTime] ; #
      fhir:agent ( [
    fhir:who [
    fhir:l fhir:Organization/CF1-Organization-2 ;
    fhir:reference [ fhir:v "Organization/CF1-Organization-2" ] ;
    fhir:display [ fhir:v "Organization" ]     ]
      ] ) ; #
      fhir:signature ( [
        ( fhir:extension [
    fhir:url [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/SignatureReason"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/SignatureReason>       ] ;
    fhir:value [
    a fhir:String ;
    fhir:v "Claim Approval"       ]     ] ) ;
        ( fhir:type [
    fhir:system [
    fhir:v "urn:iso-astm:E1762-95:2013"^^xsd:anyURI ;
    fhir:l <urn:iso-astm:E1762-95:2013>       ] ;
    fhir:code [ fhir:v "1.2.840.10065.1.12.1.20" ] ;
    fhir:display [ fhir:v "Electronic Signature" ]     ] ) ;
    fhir:when [ fhir:v "2026-02-03T10:30:00+08:00"^^xsd:dateTime ] ;
    fhir:who [
    fhir:l fhir:RelatedPerson/CF1-RelatedPerson-2 ;
    fhir:reference [ fhir:v "RelatedPerson/CF1-RelatedPerson-2" ] ;
    fhir:display [ fhir:v "Related Person" ]     ] ;
    fhir:data [ fhir:v "QkFTRTY0X1NJR05BVFVSRV9QQVRJRU5U"^^xsd:base64Binary ]
      ] [
        ( fhir:type [
    fhir:system [
    fhir:v "urn:iso-astm:E1762-95:2013"^^xsd:anyURI ;
    fhir:l <urn:iso-astm:E1762-95:2013>       ] ;
    fhir:code [ fhir:v "1.2.840.10065.1.12.1.20" ] ;
    fhir:display [ fhir:v "Electronic Signature" ]     ] ) ;
    fhir:when [ fhir:v "2026-02-03T10:30:00+08:00"^^xsd:dateTime ] ;
    fhir:who [
    fhir:l fhir:Organization/CF1-Organization-2 ;
    fhir:reference [ fhir:v "Organization/CF1-Organization-2" ] ;
    fhir:display [ fhir:v "PhilHealth Regional Office" ]     ] ;
    fhir:data [ fhir:v "QkFTRTY0X1NJR05BVFVSRV9PUkdBTklaVElPTg=="^^xsd:base64Binary ]
      ] ) . #

    <urn:uuid:coverage> a fhir:Coverage ;
      fhir:id [ fhir:v "CF1-Coverage-2"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Coverage"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/PH-Coverage>     ] )
      ] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_CF1-Coverage-2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage CF1-Coverage-2</b></p><a name=\"CF1-Coverage-2\"> </a><a name=\"hcCF1-Coverage-2\"> </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-PH-Coverage.html\">PH Coverage</a></p></div><p><b>status</b>: Active</p><p><b>policyHolder</b>: <a href=\"Bundle-ClaimsForm1-2.html#Organization_CF1-Organization-2\">Organization</a></p><p><b>beneficiary</b>: <a href=\"Bundle-ClaimsForm1-2.html#Patient_CF1-Patient-2\">Patient</a></p><p><b>payor</b>: <a href=\"Bundle-ClaimsForm1-2.html#Organization_CF1-Organization-2\">PhilHealth</a></p></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:status [ fhir:v "active"] ; #
      fhir:policyHolder [
    fhir:l fhir:Organization/CF1-Organization-2 ;
    fhir:reference [ fhir:v "Organization/CF1-Organization-2" ] ;
    fhir:display [ fhir:v "Organization" ]
      ] ; #
      fhir:beneficiary [
    fhir:l fhir:Patient/CF1-Patient-2 ;
    fhir:reference [ fhir:v "Patient/CF1-Patient-2" ] ;
    fhir:display [ fhir:v "Patient" ]
      ] ; #
      fhir:payor ( [
    fhir:l fhir:Organization/CF1-Organization-2 ;
    fhir:reference [ fhir:v "Organization/CF1-Organization-2" ] ;
    fhir:display [ fhir:v "PhilHealth" ]
      ] ) . #

    <urn:uuid:claim> a fhir:Claim ;
      fhir:id [ fhir:v "CF1-Claim-2"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Claim"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/PH-Claim>     ] )
      ] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_CF1-Claim-2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim CF1-Claim-2</b></p><a name=\"CF1-Claim-2\"> </a><a name=\"hcCF1-Claim-2\"> </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-PH-Claim.html\">PH Claim</a></p></div><p><b>identifier</b>: <code>https://philhealth.gov.ph/claim</code>/CF1-CLM-00001</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=\"Bundle-ClaimsForm1-2.html#Patient_CF1-Patient-2\">Patient</a></p><p><b>created</b>: 2026-02-03 08:00:00+0800</p><p><b>provider</b>: <a href=\"Bundle-ClaimsForm1-2.html#Organization_CF1-Organization-2\">Organization</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><h3>Payees</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Party</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/payeetype subscriber}\">Subscriber</span></td><td><a href=\"Bundle-ClaimsForm1-2.html#RelatedPerson_CF1-RelatedPerson-2\">RelatedPerson</a></td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"Bundle-ClaimsForm1-2.html#Coverage_CF1-Coverage-2\">Coverage</a></td></tr></table></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:identifier ( [
    fhir:system [
    fhir:v "https://philhealth.gov.ph/claim"^^xsd:anyURI ;
    fhir:l <https://philhealth.gov.ph/claim>     ] ;
    fhir:value [ fhir:v "CF1-CLM-00001" ]
      ] ) ; #
      fhir:status [ fhir:v "active"] ; #
      fhir:type [
        ( fhir:coding [
    fhir:system [
    fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ;
    fhir:l <http://terminology.hl7.org/CodeSystem/claim-type>       ] ;
    fhir:code [ fhir:v "institutional" ] ;
    fhir:display [ fhir:v "Institutional" ]     ] )
      ] ; #
      fhir:use [ fhir:v "claim"] ; #
      fhir:patient [
    fhir:l fhir:Patient/CF1-Patient-2 ;
    fhir:reference [ fhir:v "Patient/CF1-Patient-2" ] ;
    fhir:display [ fhir:v "Patient" ]
      ] ; #
      fhir:created [ fhir:v "2026-02-03T08:00:00+08:00"^^xsd:dateTime] ; #
      fhir:provider [
    fhir:l fhir:Organization/CF1-Organization-2 ;
    fhir:reference [ fhir:v "Organization/CF1-Organization-2" ] ;
    fhir:display [ fhir:v "Organization" ]
      ] ; #
      fhir:priority [
        ( fhir:coding [
    fhir:system [
    fhir:v "http://terminology.hl7.org/CodeSystem/processpriority"^^xsd:anyURI ;
    fhir:l <http://terminology.hl7.org/CodeSystem/processpriority>       ] ;
    fhir:code [ fhir:v "normal" ] ;
    fhir:display [ fhir:v "Normal" ]     ] )
      ] ; #
      fhir:payee [
    fhir:type [
          ( fhir:coding [
    fhir:system [
    fhir:v "http://terminology.hl7.org/CodeSystem/payeetype"^^xsd:anyURI ;
    fhir:l <http://terminology.hl7.org/CodeSystem/payeetype>         ] ;
    fhir:code [ fhir:v "subscriber" ] ;
    fhir:display [ fhir:v "Subscriber" ]       ] )     ] ;
    fhir:party [
    fhir:l fhir:RelatedPerson/CF1-RelatedPerson-2 ;
    fhir:reference [ fhir:v "RelatedPerson/CF1-RelatedPerson-2" ] ;
    fhir:display [ fhir:v "RelatedPerson" ]     ]
      ] ; #
      fhir:insurance ( [
    fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
    fhir:focal [ fhir:v true ] ;
    fhir:coverage [
    fhir:l fhir:Coverage/CF1-Coverage-2 ;
    fhir:reference [ fhir:v "Coverage/CF1-Coverage-2" ] ;
    fhir:display [ fhir:v "Coverage" ]     ]
      ] ) . #