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