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

## : ClaimsForm2 - TTL Representation

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    @prefix fhir: <http://hl7.org/fhir/> .
    @prefix loinc: <https://loinc.org/rdf/> .
    @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 sct: <http://snomed.info/id/> .
    @prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

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

     a fhir:Bundle ;
      fhir:nodeRole fhir:treeRoot ;
      fhir:id [ fhir:v "ClaimsForm2"] ; #
      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 "CF2" ]
      ] ; #
      fhir:type [ fhir:v "transaction"] ; #
      fhir:entry ( [
    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: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: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:encounter"^^xsd:anyURI ;
    fhir:l <urn:uuid:encounter>     ] ;
        ( fhir:resource <urn:uuid:encounter> ) ;
    fhir:request [
    fhir:method [ fhir:v "POST" ] ;
    fhir:url [
    fhir:v "Encounter"^^xsd:anyURI ;
    fhir:l fhir:Encounter       ]     ]
      ] [
    fhir:fullUrl [
    fhir:v "urn:uuid:procedure"^^xsd:anyURI ;
    fhir:l <urn:uuid:procedure>     ] ;
        ( fhir:resource <urn:uuid:procedure> ) ;
    fhir:request [
    fhir:method [ fhir:v "POST" ] ;
    fhir:url [
    fhir:v "Procedure"^^xsd:anyURI ;
    fhir:l fhir:Procedure       ]     ]
      ] [
    fhir:fullUrl [
    fhir:v "urn:uuid:servicerequest"^^xsd:anyURI ;
    fhir:l <urn:uuid:servicerequest>     ] ;
        ( fhir:resource <urn:uuid:servicerequest> ) ;
    fhir:request [
    fhir:method [ fhir:v "POST" ] ;
    fhir:url [
    fhir:v "ServiceRequest"^^xsd:anyURI ;
    fhir:l fhir:ServiceRequest       ]     ]
      ] [
    fhir:fullUrl [
    fhir:v "urn:uuid:observation"^^xsd:anyURI ;
    fhir:l <urn:uuid:observation>     ] ;
        ( fhir:resource <urn:uuid:observation> ) ;
    fhir:request [
    fhir:method [ fhir:v "POST" ] ;
    fhir:url [
    fhir:v "Observation"^^xsd:anyURI ;
    fhir:l fhir:Observation       ]     ]
      ] [
    fhir:fullUrl [
    fhir:v "urn:uuid:practitioner"^^xsd:anyURI ;
    fhir:l <urn:uuid:practitioner>     ] ;
        ( fhir:resource <urn:uuid:practitioner> ) ;
    fhir:request [
    fhir:method [ fhir:v "POST" ] ;
    fhir:url [
    fhir:v "Practitioner"^^xsd:anyURI ;
    fhir:l fhir:Practitioner       ]     ]
      ] [
    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: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: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:patient> a fhir:Patient ;
      fhir:id [ fhir:v "CF2-Patient"] ; #
      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_CF2-Patient\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient CF2-Patient</b></p><a name=\"CF2-Patient\"> </a><a name=\"hcCF2-Patient\"> </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;\">John Harris Doe  (no stated gender), DoB Unknown</p><hr/></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:name ( [
    fhir:family [ fhir:v "Doe" ] ;
        ( fhir:given [ fhir:v "John" ] [ fhir:v "Harris" ] ) ;
        ( fhir:suffix [ fhir:v "Mr." ] )
      ] ) . #

    <urn:uuid:relatedperson> a fhir:RelatedPerson ;
      fhir:id [ fhir:v "CF2-RelatedPerson"] ; #
      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: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 "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"RelatedPerson_CF2-RelatedPerson\"> </a><p class=\"res-header-id\"><b>Generated Narrative: RelatedPerson CF2-RelatedPerson</b></p><a name=\"CF2-RelatedPerson\"> </a><a name=\"hcCF2-RelatedPerson\"> </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\">Profiles: <a href=\"StructureDefinition-PH-RelatedPerson.html\">PH RelatedPerson</a>, <code>https://nhdr.gov.ph/fhir/StructureDefinition/PH_RelatedPerson</code></p></div><p><b>patient</b>: <a href=\"Bundle-ClaimsForm2.html#Patient_CF2-Patient\">Patient</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-RoleCode MTH}\">mother</span></p><p><b>name</b>: Maria Dela Cruz </p></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:patient [
    fhir:l fhir:Patient/CF2-Patient ;
    fhir:reference [ fhir:v "Patient/CF2-Patient" ] ;
    fhir:display [ fhir:v "Patient" ]
      ] ; #
      fhir:relationship ( [
        ( fhir:coding [
    fhir:system [
    fhir:v "http://terminology.hl7.org/CodeSystem/v3-RoleCode"^^xsd:anyURI ;
    fhir:l <http://terminology.hl7.org/CodeSystem/v3-RoleCode>       ] ;
    fhir:code [ fhir:v "MTH" ] ;
    fhir:display [ fhir:v "mother" ]     ] )
      ] ) ; #
      fhir:name ( [
    fhir:family [ fhir:v "Dela Cruz" ] ;
        ( fhir:given [ fhir:v "Maria" ] )
      ] ) . #

    <urn:uuid:organization> a fhir:Organization ;
      fhir:id [ fhir:v "CF2-Organization"] ; #
      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_CF2-Organization\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization CF2-Organization</b></p><a name=\"CF2-Organization\"> </a><a name=\"hcCF2-Organization\"> </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 Accreditation Number (PAN)/AN199513893</p><p><b>name</b>: 6th General Hospital</p><p><b>address</b>: </p><ul><li>San Roque </li><li>Tarlac City </li><li>Tarlac </li></ul><h3>Contacts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Name</b></td></tr><tr><td style=\"display: none\">*</td><td>Dr. Maria Santos</td></tr></table></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:identifier ( [
    fhir:type [
          ( fhir:coding [
    fhir:code [ fhir:v "AN" ]       ] ) ;
    fhir:text [ fhir:v "PhilHealth Accreditation Number (PAN)" ]     ] ;
    fhir:value [ fhir:v "AN199513893" ]
      ] ) ; #
      fhir:name [ fhir:v "6th General Hospital"] ; #
      fhir:address ( [
        ( fhir:line [ fhir:v "San Roque" ] )
      ] [
        ( fhir:line [ fhir:v "Tarlac City" ] )
      ] [
        ( 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 "036916001" ] ;
    fhir:display [ fhir:v "San Roque" ]       ]     ] [
    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 "036916000" ] ;
    fhir:display [ fhir:v "Tarlac 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 "036900000" ] ;
    fhir:display [ fhir:v "Tarlac" ]       ]     ] ) ;
        ( fhir:line [ fhir:v "Tarlac" ] )
      ] ) ; #
      fhir:contact ( [
    fhir:name [
    fhir:text [ fhir:v "Dr. Maria Santos" ]     ]
      ] ) . #

    <urn:uuid:encounter> a fhir:Encounter ;
      fhir:id [ fhir:v "CF2-Encounter"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Encounter"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/PH-Encounter>     ] )
      ] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Encounter_CF2-Encounter\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Encounter CF2-Encounter</b></p><a name=\"CF2-Encounter\"> </a><a name=\"hcCF2-Encounter\"> </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-Encounter.html\">PH Encounter</a></p></div><p><b>status</b>: booked</p><p><b>class</b>: <a href=\"http://terminology.hl7.org/7.1.0/CodeSystem-v3-ActCode.html#v3-ActCode-AMB\">ActCode: AMB</a> (ambulatory)</p><p><b>period</b>: 2024-07-18 08:00:00+0800 --&gt; 2024-07-18 10:00:00+0800</p><h3>Hospitalizations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>DischargeDisposition</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/discharge-disposition home}\">Discharged to home</span></td></tr></table><p><b>serviceProvider</b>: <a href=\"Bundle-ClaimsForm2.html#Organization_CF2-Organization\">Organization</a></p></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:status [ fhir:v "booked"] ; #
      fhir:class [
    fhir:system [
    fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ;
    fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActCode>     ] ;
    fhir:code [ fhir:v "AMB" ]
      ] ; #
      fhir:period [
    fhir:start [ fhir:v "2024-07-18T08:00:00+08:00"^^xsd:dateTime ] ;
    fhir:end [ fhir:v "2024-07-18T10:00:00+08:00"^^xsd:dateTime ]
      ] ; #
      fhir:hospitalization [
    fhir:dischargeDisposition [
          ( fhir:coding [
    fhir:system [
    fhir:v "http://terminology.hl7.org/CodeSystem/discharge-disposition"^^xsd:anyURI ;
    fhir:l <http://terminology.hl7.org/CodeSystem/discharge-disposition>         ] ;
    fhir:code [ fhir:v "home" ] ;
    fhir:display [ fhir:v "Discharged to home" ]       ] )     ]
      ] ; #
      fhir:serviceProvider [
    fhir:l fhir:Organization/CF2-Organization ;
    fhir:reference [ fhir:v "Organization/CF2-Organization" ] ;
    fhir:display [ fhir:v "Organization" ]
      ] . #

    <urn:uuid:procedure> a fhir:Procedure ;
      fhir:id [ fhir:v "CF2-Procedure"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Procedure"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/PH-Procedure>     ] )
      ] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Procedure_CF2-Procedure\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Procedure CF2-Procedure</b></p><a name=\"CF2-Procedure\"> </a><a name=\"hcCF2-Procedure\"> </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-Procedure.html\">PH Procedure</a></p></div><p><b>status</b>: Completed</p><p><b>code</b>: <span title=\"Codes:{https://nhdr.gov.ph/fhir/ValueSet/ProcedureCodeVS 10060}\">INCISION AND DRAINAGE OF ABSCESS (E.G., CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS OR SUBCUTANEOUS ABSCESS, CYST, FURUNCLE, OR PARONYCHIA)</span></p><p><b>subject</b>: <a href=\"Bundle-ClaimsForm2.html#Patient_CF2-Patient\">Patient</a></p><p><b>bodySite</b>: <span title=\"Codes:{http://snomed.info/sct 66754008}\">Appendix structure</span></p></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:status [ fhir:v "completed"] ; #
      fhir:code [
        ( fhir:coding [
    fhir:system [
    fhir:v "https://nhdr.gov.ph/fhir/ValueSet/ProcedureCodeVS"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/ValueSet/ProcedureCodeVS>       ] ;
    fhir:code [ fhir:v "10060" ] ;
    fhir:display [ fhir:v "INCISION AND DRAINAGE OF ABSCESS (E.G., CARBUNCLE, SUPPURATIVE HIDRADENITIS, CUTANEOUS OR SUBCUTANEOUS ABSCESS, CYST, FURUNCLE, OR PARONYCHIA)" ]     ] )
      ] ; #
      fhir:subject [
    fhir:l fhir:Patient/CF2-Patient ;
    fhir:reference [ fhir:v "Patient/CF2-Patient" ] ;
    fhir:display [ fhir:v "Patient" ]
      ] ; #
      fhir:bodySite ( [
        ( fhir:coding [
    a sct:66754008 ;
    fhir:system [
    fhir:v "http://snomed.info/sct"^^xsd:anyURI ;
    fhir:l <http://snomed.info/sct>       ] ;
    fhir:code [ fhir:v "66754008" ] ;
    fhir:display [ fhir:v "Appendix structure" ]     ] )
      ] ) . #

    <urn:uuid:servicerequest> a fhir:ServiceRequest ;
      fhir:id [ fhir:v "CF2-ServiceRequest"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/PH-ServiceRequest"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/PH-ServiceRequest>     ] )
      ] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_CF2-ServiceRequest\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest CF2-ServiceRequest</b></p><a name=\"CF2-ServiceRequest\"> </a><a name=\"hcCF2-ServiceRequest\"> </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-ServiceRequest.html\">PH ServiceRequest</a></p></div><p><b>status</b>: Completed</p><p><b>intent</b>: Order</p><p><b>subject</b>: <a href=\"Bundle-ClaimsForm2.html#Patient_CF2-Patient\">Patient</a></p><p><b>requester</b>: <a href=\"Bundle-ClaimsForm3.html#Organization_CF3-Organization\">Organization</a></p><p><b>performer</b>: <a href=\"Bundle-ClaimsForm2.html#Organization_CF2-Organization\">Organization</a></p><p><b>reasonReference</b>: <a href=\"Bundle-ClaimsForm2.html#Observation_CF2-Observation\">Observation</a></p></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:status [ fhir:v "completed"] ; #
      fhir:intent [ fhir:v "order"] ; #
      fhir:subject [
    fhir:l fhir:Patient/CF2-Patient ;
    fhir:reference [ fhir:v "Patient/CF2-Patient" ] ;
    fhir:display [ fhir:v "Patient" ]
      ] ; #
      fhir:requester [
    fhir:l fhir:Organization/CF3-Organization ;
    fhir:reference [ fhir:v "Organization/CF3-Organization" ] ;
    fhir:display [ fhir:v "Organization" ]
      ] ; #
      fhir:performer ( [
    fhir:l fhir:Organization/CF2-Organization ;
    fhir:reference [ fhir:v "Organization/CF2-Organization" ] ;
    fhir:display [ fhir:v "Organization" ]
      ] ) ; #
      fhir:reasonReference ( [
    fhir:l fhir:Observation/CF2-Observation ;
    fhir:reference [ fhir:v "Observation/CF2-Observation" ] ;
    fhir:display [ fhir:v "Observation" ]
      ] ) . #

    <urn:uuid:observation> a fhir:Observation ;
      fhir:id [ fhir:v "CF2-Observation"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Observation"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/PH-Observation>     ] )
      ] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Observation_CF2-Observation\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Observation CF2-Observation</b></p><a name=\"CF2-Observation\"> </a><a name=\"hcCF2-Observation\"> </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-Observation.html\">PH Observation</a></p></div><p><b>status</b>: Final</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 81247-9}\">Preoperative assessment</span></p><p><b>subject</b>: <a href=\"Bundle-ClaimsForm2.html#Patient_CF2-Patient\">Patient</a></p><p><b>value</b>: <span title=\"Codes:\">Subject for Surgery</span></p></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:status [ fhir:v "final"] ; #
      fhir:code [
        ( fhir:coding [
    a loinc:81247-9 ;
    fhir:system [
    fhir:v "http://loinc.org"^^xsd:anyURI ;
    fhir:l <http://loinc.org>       ] ;
    fhir:code [ fhir:v "81247-9" ] ;
    fhir:display [ fhir:v "Preoperative assessment" ]     ] )
      ] ; #
      fhir:subject [
    fhir:l fhir:Patient/CF2-Patient ;
    fhir:reference [ fhir:v "Patient/CF2-Patient" ] ;
    fhir:display [ fhir:v "Patient" ]
      ] ; #
      fhir:value [
    a fhir:CodeableConcept ;
    fhir:text [ fhir:v "Subject for Surgery" ]
      ] . #

    <urn:uuid:practitioner> a fhir:Practitioner ;
      fhir:id [ fhir:v "CF2-Practitioner"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Practitioner"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/PH-Practitioner>     ] )
      ] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_CF2-Practitioner\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner CF2-Practitioner</b></p><a name=\"CF2-Practitioner\"> </a><a name=\"hcCF2-Practitioner\"> </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-Practitioner.html\">PH Practitioner</a></p></div><p><b>identifier</b>: <code>https://prc.gov.ph</code>/1234567</p><p><b>name</b>: Maria Santos </p></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:identifier ( [
    fhir:system [
    fhir:v "https://prc.gov.ph"^^xsd:anyURI ;
    fhir:l <https://prc.gov.ph>     ] ;
    fhir:value [ fhir:v "1234567" ]
      ] ) ; #
      fhir:name ( [
    fhir:family [ fhir:v "Santos" ] ;
        ( fhir:given [ fhir:v "Maria" ] ) ;
        ( fhir:suffix [ fhir:v "MD" ] )
      ] ) . #

    <urn:uuid:coverage> a fhir:Coverage ;
      fhir:id [ fhir:v "CF2-Coverage"] ; #
      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_CF2-Coverage\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage CF2-Coverage</b></p><a name=\"CF2-Coverage\"> </a><a name=\"hcCF2-Coverage\"> </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>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode EHCPOL}\">extended healthcare</span></p><p><b>beneficiary</b>: <a href=\"Bundle-ClaimsForm2.html#Patient_CF2-Patient\">Patient</a></p><p><b>payor</b>: <a href=\"Bundle-ClaimsForm2.html#Organization_CF2-Organization\">Organization</a></p><h3>CostToBeneficiaries</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-copay-type copay}\">Copayment</span></td><td><span title=\"Philippine Peso\">₱500.00</span> (PHP)</td></tr></table></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:status [ fhir:v "active"] ; #
      fhir:type [
        ( fhir:coding [
    fhir:system [
    fhir:v "http://terminology.hl7.org/CodeSystem/v3-ActCode"^^xsd:anyURI ;
    fhir:l <http://terminology.hl7.org/CodeSystem/v3-ActCode>       ] ;
    fhir:code [ fhir:v "EHCPOL" ] ;
    fhir:display [ fhir:v "extended healthcare" ]     ] )
      ] ; #
      fhir:beneficiary [
    fhir:l fhir:Patient/CF2-Patient ;
    fhir:reference [ fhir:v "Patient/CF2-Patient" ] ;
    fhir:display [ fhir:v "Patient" ]
      ] ; #
      fhir:payor ( [
    fhir:l fhir:Organization/CF2-Organization ;
    fhir:reference [ fhir:v "Organization/CF2-Organization" ] ;
    fhir:display [ fhir:v "Organization" ]
      ] ) ; #
      fhir:costToBeneficiary ( [
    fhir:type [
          ( fhir:coding [
    fhir:system [
    fhir:v "http://terminology.hl7.org/CodeSystem/coverage-copay-type"^^xsd:anyURI ;
    fhir:l <http://terminology.hl7.org/CodeSystem/coverage-copay-type>         ] ;
    fhir:code [ fhir:v "copay" ] ;
    fhir:display [ fhir:v "Copayment" ]       ] )     ] ;
    fhir:value [
    a fhir:Money ;
    fhir:value [ fhir:v "500"^^xsd:decimal ] ;
    fhir:currency [ fhir:v "PHP" ]     ]
      ] ) . #

    <urn:uuid:questionnaire> a fhir:Questionnaire ;
      fhir:id [ fhir:v "CF2-Questionnaire"] ; #
      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_CF2-Questionnaire\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Questionnaire CF2-Questionnaire</b></p><a name=\"CF2-Questionnaire\"> </a><a name=\"hcCF2-Questionnaire\"> </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.CF2-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\"/> CF2-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\">A. Certification of Consumption of Benefits (Y/N)</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 "CF2-Q1" ] ;
    fhir:text [ fhir:v "A. Certification of Consumption of Benefits (Y/N)" ] ;
    fhir:type [ fhir:v "boolean" ]
      ] ) . #

    <urn:uuid:questionnaireResponse> a fhir:QuestionnaireResponse ;
      fhir:id [ fhir:v "CF2-QuestionnaireResponse"] ; #
      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_CF2-QuestionnaireResponse\"> </a><p class=\"res-header-id\"><b>Generated Narrative: QuestionnaireResponse CF2-QuestionnaireResponse</b></p><a name=\"CF2-QuestionnaireResponse\"> </a><a name=\"hcCF2-QuestionnaireResponse\"> </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\"/> CF2-QuestionnaireResponse</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\"/> CF2-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\">true</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 "CF2-Q1" ] ;
        ( fhir:answer [
    fhir:value [
    a fhir:Boolean ;
    fhir:v true       ]     ] )
      ] ) . #

    <urn:uuid:provenance> a fhir:Provenance ;
      fhir:id [ fhir:v "CF2-Provenance"] ; #
      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_CF2-Provenance\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Provenance CF2-Provenance</b></p><a name=\"CF2-Provenance\"> </a><a name=\"hcCF2-Provenance\"> </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-ClaimsForm2.html#Claim_CF2-Claim\">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-ClaimsForm2.html#Practitioner_CF2-Practitioner\">Practitioner</a></td></tr></table></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:target ( [
    fhir:l fhir:Claim/CF2-Claim ;
    fhir:reference [ fhir:v "Claim/CF2-Claim" ] ;
    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:Practitioner/CF2-Practitioner ;
    fhir:reference [ fhir:v "Practitioner/CF2-Practitioner" ] ;
    fhir:display [ fhir:v "Practitioner" ]     ]
      ] ) ; #
      fhir:signature ( [
        ( fhir:extension [
    fhir:url [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/SignaturePosition"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/SignaturePosition>       ] ;
    fhir:value [
    a fhir:String ;
    fhir:v "Attending Physician"       ]     ] ) ;
        ( 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:Practitioner/CF2-Practitioner ;
    fhir:reference [ fhir:v "Practitioner/CF2-Practitioner" ] ;
    fhir:display [ fhir:v "Practitioner" ]     ] ;
    fhir:data [ fhir:v "U1VCTUlUU0lPTl9QUkFDVElUSU9ORVJfU0lHTg=="^^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:Patient/CF2-Patient ;
    fhir:reference [ fhir:v "Patient/CF2-Patient" ] ;
    fhir:display [ fhir:v "Patient" ]     ] ;
    fhir:data [ fhir:v "U1VCTUlUU0lPTl9QQVRJRU5UX1NJR04="^^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:RelatedPerson/CF2-RelatedPerson ;
    fhir:reference [ fhir:v "RelatedPerson/CF2-RelatedPerson" ] ;
    fhir:display [ fhir:v "RelatedPerson" ]     ] ;
    fhir:data [ fhir:v "U1VCTUlUU0lPTl9SRUxBVEVEX1NJR04="^^xsd:base64Binary ]
      ] ) . #

    <urn:uuid:claim> a fhir:Claim ;
      fhir:id [ fhir:v "CF2-Claim"] ; #
      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 "extensions" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_CF2-Claim\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim CF2-Claim</b></p><a name=\"CF2-Claim\"> </a><a name=\"hcCF2-Claim\"> </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>Encounter (Extension)</b>: <a href=\"Bundle-ClaimsForm2.html#Encounter_CF2-Encounter\">Encounter</a></p><p><b>identifier</b>: <code>https://philhealth.gov.ph/claim</code>/CLM-2026-00001</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-ClaimsForm2.html#Patient_CF2-Patient\">Patient</a></p><p><b>created</b>: 2026-02-03 08:00:00+0800</p><p><b>provider</b>: <a href=\"Bundle-ClaimsForm2.html#Organization_CF2-Organization\">Organization</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><p><b>referral</b>: <a href=\"Bundle-ClaimsForm2.html#ServiceRequest_CF2-ServiceRequest\">ServiceRequest</a></p><h3>SupportingInfos</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Category</b></td><td><b>Value[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claiminformationcategory information}\">Supporting Information</span></td><td><a href=\"Bundle-ClaimsForm2.html#Practitioner_CF2-Practitioner\">Practitioner</a></td></tr></table><h3>Diagnoses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Diagnosis[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://hl7.org/fhir/sid/icd-10 I10}\">Essential (primary) hypertension</span></td></tr></table><h3>Procedures</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Date</b></td><td><b>Procedure[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>2026-02-03 09:00:00+0800</td><td><a href=\"Bundle-ClaimsForm2.html#Procedure_CF2-Procedure\">Procedure</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-ClaimsForm2.html#Coverage_CF2-Coverage\">Coverage</a></td></tr></table><blockquote><p><b>item</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/service-uscls 80146002}\">Appendectomy</span></p><p><b>serviced</b>: 2026-02-03</p><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>15000</td><td>Philippine piso</td></tr></table><blockquote><p><b>detail</b></p><p><b>sequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/service-uscls 80146002}\">Appendectomy Procedure Fee</span></p><h3>Nets</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>15000</td><td>Philippine piso</td></tr></table></blockquote></blockquote><h3>Totals</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>15000</td><td>Philippine piso</td></tr></table></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:extension ( [
    fhir:url [
    fhir:v "https://nhdr.gov.ph/fhir/StructureDefinition/EncounterExtension"^^xsd:anyURI ;
    fhir:l <https://nhdr.gov.ph/fhir/StructureDefinition/EncounterExtension>     ] ;
    fhir:value [
    a fhir:Reference ;
    fhir:l fhir:Encounter/CF2-Encounter ;
    fhir:reference [ fhir:v "Encounter/CF2-Encounter" ] ;
    fhir:display [ fhir:v "Encounter" ]     ]
      ] ) ; #
      fhir:identifier ( [
    fhir:system [
    fhir:v "https://philhealth.gov.ph/claim"^^xsd:anyURI ;
    fhir:l <https://philhealth.gov.ph/claim>     ] ;
    fhir:value [ fhir:v "CLM-2026-00001" ]
      ] ) ; #
      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/CF2-Patient ;
    fhir:reference [ fhir:v "Patient/CF2-Patient" ] ;
    fhir:display [ fhir:v "Patient" ]
      ] ; #
      fhir:created [ fhir:v "2026-02-03T08:00:00+08:00"^^xsd:dateTime] ; #
      fhir:provider [
    fhir:l fhir:Organization/CF2-Organization ;
    fhir:reference [ fhir:v "Organization/CF2-Organization" ] ;
    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:referral [
    fhir:l fhir:ServiceRequest/CF2-ServiceRequest ;
    fhir:reference [ fhir:v "ServiceRequest/CF2-ServiceRequest" ] ;
    fhir:display [ fhir:v "ServiceRequest" ]
      ] ; #
      fhir:supportingInfo ( [
    fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
    fhir:category [
          ( fhir:coding [
    fhir:system [
    fhir:v "http://terminology.hl7.org/CodeSystem/claiminformationcategory"^^xsd:anyURI ;
    fhir:l <http://terminology.hl7.org/CodeSystem/claiminformationcategory>         ] ;
    fhir:code [ fhir:v "information" ] ;
    fhir:display [ fhir:v "Supporting Information" ]       ] )     ] ;
    fhir:value [
    a fhir:Reference ;
    fhir:l fhir:Practitioner/CF2-Practitioner ;
    fhir:reference [ fhir:v "Practitioner/CF2-Practitioner" ] ;
    fhir:display [ fhir:v "Practitioner" ]     ]
      ] ) ; #
      fhir:diagnosis ( [
    fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
    fhir:diagnosis [
    a fhir:CodeableConcept ;
          ( fhir:coding [
    fhir:system [
    fhir:v "http://hl7.org/fhir/sid/icd-10"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/sid/icd-10>         ] ;
    fhir:code [ fhir:v "I10" ] ;
    fhir:display [ fhir:v "Essential (primary) hypertension" ]       ] )     ]
      ] ) ; #
      fhir:procedure ( [
    fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
    fhir:date [ fhir:v "2026-02-03T09:00:00+08:00"^^xsd:dateTime ] ;
    fhir:procedure [
    a fhir:Reference ;
    fhir:l fhir:Procedure/CF2-Procedure ;
    fhir:reference [ fhir:v "Procedure/CF2-Procedure" ] ;
    fhir:display [ fhir:v "Procedure" ]     ]
      ] ) ; #
      fhir:insurance ( [
    fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
    fhir:focal [ fhir:v true ] ;
    fhir:coverage [
    fhir:l fhir:Coverage/CF2-Coverage ;
    fhir:reference [ fhir:v "Coverage/CF2-Coverage" ] ;
    fhir:display [ fhir:v "Coverage" ]     ]
      ] ) ; #
      fhir:item ( [
    fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
    fhir:productOrService [
          ( fhir:coding [
    fhir:system [
    fhir:v "http://terminology.hl7.org/CodeSystem/service-uscls"^^xsd:anyURI ;
    fhir:l <http://terminology.hl7.org/CodeSystem/service-uscls>         ] ;
    fhir:code [ fhir:v "80146002" ] ;
    fhir:display [ fhir:v "Appendectomy" ]       ] )     ] ;
    fhir:serviced [
    a fhir:Date ;
    fhir:v "2026-02-03"^^xsd:date     ] ;
    fhir:net [
    fhir:value [ fhir:v "15000"^^xsd:decimal ] ;
    fhir:currency [ fhir:v "PHP" ]     ] ;
        ( fhir:detail [
    fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
    fhir:productOrService [
            ( fhir:coding [
    fhir:system [
    fhir:v "http://terminology.hl7.org/CodeSystem/service-uscls"^^xsd:anyURI ;
    fhir:l <http://terminology.hl7.org/CodeSystem/service-uscls>           ] ;
    fhir:code [ fhir:v "80146002" ] ;
    fhir:display [ fhir:v "Appendectomy Procedure Fee" ]         ] )       ] ;
    fhir:net [
    fhir:value [ fhir:v "15000"^^xsd:decimal ] ;
    fhir:currency [ fhir:v "PHP" ]       ]     ] )
      ] ) ; #
      fhir:total [
    fhir:value [ fhir:v "15000"^^xsd:decimal ] ;
    fhir:currency [ fhir:v "PHP" ]
      ] . #