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 - JSON Representation

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    {
      "resourceType" : "Bundle",
      "id" : "ClaimsForm1-2",
      "identifier" : {
        "system" : "http://nhdr.gov.ph/fhir/ValueSet-form-type",
        "value" : "CF1"
      },
      "type" : "transaction",
      "entry" : [
        {
          "fullUrl" : "urn:uuid:relatedperson",
          "resource" : {
            "resourceType" : "RelatedPerson",
            "id" : "CF1-RelatedPerson-2",
            "meta" : {
              "profile" : [
                🔗 "https://nhdr.gov.ph/fhir/StructureDefinition/PH-RelatedPerson"
              ]
            },
            "text" : {
              "status" : "extensions",
              "div" : "<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>"
            },
            "extension" : [
              {
                "url" : "https://nhdr.gov.ph/fhir/StructureDefinition/Sex",
                "valueCode" : "F"
              }
            ],
            "identifier" : [
              {
                "type" : {
                  "coding" : [
                    {
                      "code" : "NIIP"
                    }
                  ],
                  "text" : "PhilHealth Identification Number"
                },
                "value" : "PH54321"
              }
            ],
            "patient" : {
              "reference" : "Patient/CF1-Patient-2",
              "display" : "Patient"
            },
            "name" : [
              {
                "family" : "Bautista",
                "given" : [
                  "Lorna Mae",
                  "Santos"
                ],
                "suffix" : [
                  "Mrs."
                ]
              }
            ],
            "telecom" : [
              {
                "system" : "phone",
                "value" : "912-00-00"
              },
              {
                "system" : "phone",
                "value" : "0927-000-0000"
              },
              {
                "system" : "email",
                "value" : "lmbautista@email.com"
              }
            ],
            "birthDate" : "1971-02-11",
            "address" : [
              {
                "extension" : [
                  {
                    "url" : "https://nhdr.gov.ph/fhir/StructureDefinition/Barangay",
                    "valueCoding" : {
                      "code" : "0123456789",
                      "display" : "Blue Ridge"
                    }
                  },
                  {
                    "url" : "https://nhdr.gov.ph/fhir/StructureDefinition/CityMunicipality",
                    "valueCoding" : {
                      "code" : "0123456",
                      "display" : "Quezon City"
                    }
                  },
                  {
                    "url" : "https://nhdr.gov.ph/fhir/StructureDefinition/Province",
                    "valueCoding" : {
                      "code" : "01234",
                      "display" : "Metro Manila"
                    }
                  }
                ],
                "line" : [
                  "Fordham Road"
                ],
                "postalCode" : "1110",
                "country" : "PH"
              }
            ]
          },
          "request" : {
            "method" : "POST",
            "url" : "RelatedPerson"
          }
        },
        {
          "fullUrl" : "urn:uuid:patient",
          "resource" : {
            "resourceType" : "Patient",
            "id" : "CF1-Patient-2",
            "meta" : {
              "profile" : [
                🔗 "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Patient"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<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:\u00a0PH12345)</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>"
            },
            "extension" : [
              {
                "url" : "https://nhdr.gov.ph/fhir/StructureDefinition/Sex",
                "valueCode" : "M"
              }
            ],
            "identifier" : [
              {
                "type" : {
                  "coding" : [
                    {
                      "code" : "NIIP"
                    }
                  ],
                  "text" : "PhilHealth Identification Number"
                },
                "value" : "PH12345"
              }
            ],
            "name" : [
              {
                "family" : "Manipol",
                "given" : [
                  "Antonio Jerome",
                  "Morales"
                ],
                "suffix" : [
                  "Mr."
                ]
              }
            ],
            "birthDate" : "1994-02-25",
            "contact" : [
              {
                "relationship" : [
                  {
                    "coding" : [
                      {
                        "code" : "E",
                        "display" : "Employer"
                      }
                    ]
                  }
                ],
                "telecom" : [
                  {
                    "system" : "phone",
                    "value" : "09171234567"
                  }
                ]
              }
            ]
          },
          "request" : {
            "method" : "POST",
            "url" : "Patient"
          }
        },
        {
          "fullUrl" : "urn:uuid:organization",
          "resource" : {
            "resourceType" : "Organization",
            "id" : "CF1-Organization-2",
            "meta" : {
              "profile" : [
                🔗 "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Organization"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<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>"
            },
            "identifier" : [
              {
                "type" : {
                  "coding" : [
                    {
                      "code" : "EN"
                    }
                  ],
                  "text" : "PhilHealth Employer Number (PEN)"
                },
                "value" : "EN15243"
              }
            ],
            "name" : "PhilHealth",
            "telecom" : [
              {
                "value" : "080-00-00"
              }
            ]
          },
          "request" : {
            "method" : "POST",
            "url" : "Organization"
          }
        },
        {
          "fullUrl" : "urn:uuid:questionnaire",
          "resource" : {
            "resourceType" : "Questionnaire",
            "id" : "CF1-Questionnaire-2",
            "meta" : {
              "profile" : [
                🔗 "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Questionnaire"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<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>\r\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>\r\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>"
            },
            "status" : "active",
            "item" : [
              {
                "linkId" : "CF1-Q1",
                "text" : "Patient is the member?",
                "type" : "boolean"
              }
            ]
          },
          "request" : {
            "method" : "POST",
            "url" : "Questionnaire"
          }
        },
        {
          "fullUrl" : "urn:uuid:questionnaireresponse",
          "resource" : {
            "resourceType" : "QuestionnaireResponse",
            "id" : "CF1-QuestionnaireResponse-2",
            "meta" : {
              "profile" : [
                🔗 "https://nhdr.gov.ph/fhir/StructureDefinition/PH-QuestionnaireResponse"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<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>\r\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>\r\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>"
            },
            "status" : "completed",
            "item" : [
              {
                "linkId" : "CF1-Q1",
                "answer" : [
                  {
                    "valueBoolean" : false
                  }
                ]
              }
            ]
          },
          "request" : {
            "method" : "POST",
            "url" : "QuestionnaireResponse"
          }
        },
        {
          "fullUrl" : "urn:uuid:provenance",
          "resource" : {
            "resourceType" : "Provenance",
            "id" : "CF1-Provenance-2",
            "meta" : {
              "profile" : [
                🔗 "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Provenance"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<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>"
            },
            "target" : [
              {
                "reference" : "Claim/CF1-Claim-2",
                "display" : "Claim"
              }
            ],
            "recorded" : "2026-02-03T09:00:00+08:00",
            "agent" : [
              {
                "who" : {
                  "reference" : "Organization/CF1-Organization-2",
                  "display" : "Organization"
                }
              }
            ],
            "signature" : [
              {
                "extension" : [
                  {
                    "url" : "https://nhdr.gov.ph/fhir/StructureDefinition/SignatureReason",
                    "valueString" : "Claim Approval"
                  }
                ],
                "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" : "RelatedPerson/CF1-RelatedPerson-2",
                  "display" : "Related Person"
                },
                "data" : "QkFTRTY0X1NJR05BVFVSRV9QQVRJRU5U"
              },
              {
                "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" : "Organization/CF1-Organization-2",
                  "display" : "PhilHealth Regional Office"
                },
                "data" : "QkFTRTY0X1NJR05BVFVSRV9PUkdBTklaVElPTg=="
              }
            ]
          },
          "request" : {
            "method" : "POST",
            "url" : "Provenance"
          }
        },
        {
          "fullUrl" : "urn:uuid:coverage",
          "resource" : {
            "resourceType" : "Coverage",
            "id" : "CF1-Coverage-2",
            "meta" : {
              "profile" : [
                🔗 "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Coverage"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<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>"
            },
            "status" : "active",
            "policyHolder" : {
              "reference" : "Organization/CF1-Organization-2",
              "display" : "Organization"
            },
            "beneficiary" : {
              "reference" : "Patient/CF1-Patient-2",
              "display" : "Patient"
            },
            "payor" : [
              {
                "reference" : "Organization/CF1-Organization-2",
                "display" : "PhilHealth"
              }
            ]
          },
          "request" : {
            "method" : "POST",
            "url" : "Coverage"
          }
        },
        {
          "fullUrl" : "urn:uuid:claim",
          "resource" : {
            "resourceType" : "Claim",
            "id" : "CF1-Claim-2",
            "meta" : {
              "profile" : [
                🔗 "https://nhdr.gov.ph/fhir/StructureDefinition/PH-Claim"
              ]
            },
            "text" : {
              "status" : "generated",
              "div" : "<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>"
            },
            "identifier" : [
              {
                "system" : "https://philhealth.gov.ph/claim",
                "value" : "CF1-CLM-00001"
              }
            ],
            "status" : "active",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
                  "code" : "institutional",
                  "display" : "Institutional"
                }
              ]
            },
            "use" : "claim",
            "patient" : {
              "reference" : "Patient/CF1-Patient-2",
              "display" : "Patient"
            },
            "created" : "2026-02-03T08:00:00+08:00",
            "provider" : {
              "reference" : "Organization/CF1-Organization-2",
              "display" : "Organization"
            },
            "priority" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
                  "code" : "normal",
                  "display" : "Normal"
                }
              ]
            },
            "payee" : {
              "type" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/payeetype",
                    "code" : "subscriber",
                    "display" : "Subscriber"
                  }
                ]
              },
              "party" : {
                "reference" : "RelatedPerson/CF1-RelatedPerson-2",
                "display" : "RelatedPerson"
              }
            },
            "insurance" : [
              {
                "sequence" : 1,
                "focal" : true,
                "coverage" : {
                  "reference" : "Coverage/CF1-Coverage-2",
                  "display" : "Coverage"
                }
              }
            ]
          },
          "request" : {
            "method" : "POST",
            "url" : "Claim"
          }
        }
      ]
    }