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

## : ClaimsForm1-1 - XML Representation

Raw xml | Download

    <Bundle xmlns="http://hl7.org/fhir">
      <id value="ClaimsForm1-1"/>
      <identifier>
        <system value="http://nhdr.gov.ph/fhir/ValueSet-form-type"/>
        <value value="CF1"/>
      </identifier>
      <type value="transaction"/>
      <entry>
        <fullUrl value="urn:uuid:relatedperson"/>
        <resource>
          <RelatedPerson>
            <id value="CF1-RelatedPerson"/>
            <meta>
              <profile
                       value="https://nhdr.gov.ph/fhir/StructureDefinition/PH-RelatedPerson"/>
            </meta>
            <text>
              <status value="extensions"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="RelatedPerson_CF1-RelatedPerson"> </a><p class="res-header-id"><b>Generated Narrative: RelatedPerson CF1-RelatedPerson</b></p><a name="CF1-RelatedPerson"> </a><a name="hcCF1-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">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>
            </text>
            <extension url="https://nhdr.gov.ph/fhir/StructureDefinition/Sex">
              <valueCode value="F"/>
            </extension>
            <identifier>
              <type>
                <coding>
                  <code value="NIIP"/>
                </coding>
                <text value="PhilHealth Identification Number"/>
              </type>
              <value value="PH54321"/>
            </identifier>
            <patient>
              <reference value="Patient/CF1-Patient-2"/>
              <display value="Patient"/>
            </patient>
            <name>
              <family value="Bautista"/>
              <given value="Lorna Mae"/>
              <given value="Santos"/>
              <suffix value="Mrs."/>
            </name>
            <telecom>
              <system value="phone"/>
              <value value="912-00-00"/>
            </telecom>
            <telecom>
              <system value="phone"/>
              <value value="0927-000-0000"/>
            </telecom>
            <telecom>
              <system value="email"/>
              <value value="lmbautista@email.com"/>
            </telecom>
            <birthDate value="1971-02-11"/>
            <address>
              <extension
                         url="https://nhdr.gov.ph/fhir/StructureDefinition/Barangay">
                <valueCoding>
                  <code value="0123456789"/>
                  <display value="Blue Ridge"/>
                </valueCoding>
              </extension>
              <extension
                         url="https://nhdr.gov.ph/fhir/StructureDefinition/CityMunicipality">
                <valueCoding>
                  <code value="0123456"/>
                  <display value="Quezon City"/>
                </valueCoding>
              </extension>
              <extension
                         url="https://nhdr.gov.ph/fhir/StructureDefinition/Province">
                <valueCoding>
                  <code value="01234"/>
                  <display value="Metro Manila"/>
                </valueCoding>
              </extension>
              <line value="Fordham Road"/>
              <postalCode value="1110"/>
              <country value="PH"/>
            </address>
          </RelatedPerson>
        </resource>
        <request>
          <method value="POST"/>
          <url value="RelatedPerson"/>
        </request>
      </entry>
      <entry>
        <fullUrl value="urn:uuid:organization"/>
        <resource>
          <Organization>
            <id value="CF1-Organization"/>
            <meta>
              <profile
                       value="https://nhdr.gov.ph/fhir/StructureDefinition/PH-Organization"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_CF1-Organization"> </a><p class="res-header-id"><b>Generated Narrative: Organization CF1-Organization</b></p><a name="CF1-Organization"> </a><a name="hcCF1-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 Employer Number (PEN)/EN15243</p><p><b>name</b>: PhilHealth</p><p><b>telecom</b>: 080-00-00</p></div>
            </text>
            <identifier>
              <type>
                <coding>
                  <code value="EN"/>
                </coding>
                <text value="PhilHealth Employer Number (PEN)"/>
              </type>
              <value value="EN15243"/>
            </identifier>
            <name value="PhilHealth"/>
            <telecom>
              <value value="080-00-00"/>
            </telecom>
          </Organization>
        </resource>
        <request>
          <method value="POST"/>
          <url value="Organization"/>
        </request>
      </entry>
      <entry>
        <fullUrl value="urn:uuid:questionnaire"/>
        <resource>
          <Questionnaire>
            <id value="CF1-Questionnaire"/>
            <meta>
              <profile
                       value="https://nhdr.gov.ph/fhir/StructureDefinition/PH-Questionnaire"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Questionnaire_CF1-Questionnaire"> </a><p class="res-header-id"><b>Generated Narrative: Questionnaire CF1-Questionnaire</b></p><a name="CF1-Questionnaire"> </a><a name="hcCF1-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>
    <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>
    <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>
            </text>
            <status value="active"/>
            <item>
              <linkId value="CF1-Q1"/>
              <text value="Patient is the member?"/>
              <type value="boolean"/>
            </item>
          </Questionnaire>
        </resource>
        <request>
          <method value="POST"/>
          <url value="Questionnaire"/>
        </request>
      </entry>
      <entry>
        <fullUrl value="urn:uuid:questionnaireresponse"/>
        <resource>
          <QuestionnaireResponse>
            <id value="CF1-QuestionnaireResponse"/>
            <meta>
              <profile
                       value="https://nhdr.gov.ph/fhir/StructureDefinition/PH-QuestionnaireResponse"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="QuestionnaireResponse_CF1-QuestionnaireResponse"> </a><p class="res-header-id"><b>Generated Narrative: QuestionnaireResponse CF1-QuestionnaireResponse</b></p><a name="CF1-QuestionnaireResponse"> </a><a name="hcCF1-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"/> CF1-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>
    <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">true</td></tr>
    <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>
            </text>
            <status value="completed"/>
            <item>
              <linkId value="CF1-Q1"/>
              <answer>
                <valueBoolean value="true"/>
              </answer>
            </item>
          </QuestionnaireResponse>
        </resource>
        <request>
          <method value="POST"/>
          <url value="QuestionnaireResponse"/>
        </request>
      </entry>
      <entry>
        <fullUrl value="urn:uuid:provenance"/>
        <resource>
          <Provenance>
            <id value="CF1-Provenance"/>
            <meta>
              <profile
                       value="https://nhdr.gov.ph/fhir/StructureDefinition/PH-Provenance"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Provenance_CF1-Provenance"> </a><p class="res-header-id"><b>Generated Narrative: Provenance CF1-Provenance</b></p><a name="CF1-Provenance"> </a><a name="hcCF1-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-ClaimsForm1-1.html#Claim_CF1-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-ClaimsForm1-1.html#Organization_CF1-Organization">Organization</a></td></tr></table></div>
            </text>
            <target>
              <reference value="Claim/CF1-Claim"/>
              <display value="Claim"/>
            </target>
            <recorded value="2026-02-03T09:00:00+08:00"/>
            <agent>
              <who>
                <reference value="Organization/CF1-Organization"/>
                <display value="Organization"/>
              </who>
            </agent>
            <signature>
              <extension
                         url="https://nhdr.gov.ph/fhir/StructureDefinition/SignatureReason">
                <valueString value="Claim Approval"/>
              </extension>
              <type>
                <system value="urn:iso-astm:E1762-95:2013"/>
                <code value="1.2.840.10065.1.12.1.20"/>
                <display value="Electronic Signature"/>
              </type>
              <when value="2026-02-03T10:30:00+08:00"/>
              <who>
                <reference value="RelatedPerson/CF1-RelatedPerson"/>
                <display value="Related Person"/>
              </who>
              <data value="QkFTRTY0X1NJR05BVFVSRV9QQVRJRU5U"/>
            </signature>
            <signature>
              <type>
                <system value="urn:iso-astm:E1762-95:2013"/>
                <code value="1.2.840.10065.1.12.1.20"/>
                <display value="Electronic Signature"/>
              </type>
              <when value="2026-02-03T10:30:00+08:00"/>
              <who>
                <reference value="Organization/CF1-Organization"/>
                <display value="PhilHealth Regional Office"/>
              </who>
              <data value="QkFTRTY0X1NJR05BVFVSRV9PUkdBTklaVElPTg=="/>
            </signature>
          </Provenance>
        </resource>
        <request>
          <method value="POST"/>
          <url value="Provenance"/>
        </request>
      </entry>
      <entry>
        <fullUrl value="urn:uuid:coverage"/>
        <resource>
          <Coverage>
            <id value="CF1-Coverage"/>
            <meta>
              <profile
                       value="https://nhdr.gov.ph/fhir/StructureDefinition/PH-Coverage"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Coverage_CF1-Coverage"> </a><p class="res-header-id"><b>Generated Narrative: Coverage CF1-Coverage</b></p><a name="CF1-Coverage"> </a><a name="hcCF1-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>policyHolder</b>: <a href="Bundle-ClaimsForm1-1.html#Organization_CF1-Organization">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-ClaimsForm1-1.html#Organization_CF1-Organization">Organization</a></p></div>
            </text>
            <status value="active"/>
            <policyHolder>
              <reference value="Organization/CF1-Organization"/>
              <display value="Organization"/>
            </policyHolder>
            <beneficiary>
              <reference value="Patient/CF1-Patient-2"/>
              <display value="Patient"/>
            </beneficiary>
            <payor>
              <reference value="Organization/CF1-Organization"/>
              <display value="Organization"/>
            </payor>
          </Coverage>
        </resource>
        <request>
          <method value="POST"/>
          <url value="Coverage"/>
        </request>
      </entry>
      <entry>
        <fullUrl value="urn:uuid:claim"/>
        <resource>
          <Claim>
            <id value="CF1-Claim"/>
            <meta>
              <profile
                       value="https://nhdr.gov.ph/fhir/StructureDefinition/PH-Claim"/>
            </meta>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Claim_CF1-Claim"> </a><p class="res-header-id"><b>Generated Narrative: Claim CF1-Claim</b></p><a name="CF1-Claim"> </a><a name="hcCF1-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>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-ClaimsForm1-1.html#Organization_CF1-Organization">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-ClaimsForm1-1.html#RelatedPerson_CF1-RelatedPerson">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-ClaimsForm1-1.html#Coverage_CF1-Coverage">Coverage</a></td></tr></table></div>
            </text>
            <identifier>
              <system value="https://philhealth.gov.ph/claim"/>
              <value value="CF1-CLM-00001"/>
            </identifier>
            <status value="active"/>
            <type>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
                <code value="institutional"/>
                <display value="Institutional"/>
              </coding>
            </type>
            <use value="claim"/>
            <patient>
              <reference value="Patient/CF1-Patient-2"/>
              <display value="Patient"/>
            </patient>
            <created value="2026-02-03T08:00:00+08:00"/>
            <provider>
              <reference value="Organization/CF1-Organization"/>
              <display value="Organization"/>
            </provider>
            <priority>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/processpriority"/>
                <code value="normal"/>
                <display value="Normal"/>
              </coding>
            </priority>
            <payee>
              <type>
                <coding>
                  <system
                          value="http://terminology.hl7.org/CodeSystem/payeetype"/>
                  <code value="subscriber"/>
                  <display value="Subscriber"/>
                </coding>
              </type>
              <party>
                <reference value="RelatedPerson/CF1-RelatedPerson"/>
                <display value="RelatedPerson"/>
              </party>
            </payee>
            <insurance>
              <sequence value="1"/>
              <focal value="true"/>
              <coverage>
                <reference value="Coverage/CF1-Coverage"/>
                <display value="Coverage"/>
              </coverage>
            </insurance>
          </Claim>
        </resource>
        <request>
          <method value="POST"/>
          <url value="Claim"/>
        </request>
      </entry>
    </Bundle>