{
  "resourceType": "Bundle",
  "id": "e96f6395-9d14-41fb-9fa6-02577a02d79d",
  "meta": {
    "profile": [
      "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
    ]
  },
  "type": "message",
  "timestamp": "2026-10-31T13:41:32.583+03:00",
  "entry": [
    {
      "fullUrl": "http://nphies.sa/MessageHeader/b17a4e13-6aa0-47fb-8928-81d8f3ccae01",
      "resource": {
        "resourceType": "MessageHeader",
        "id": "b17a4e13-6aa0-47fb-8928-81d8f3ccae01",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/message-header|1.0.0"
          ],
          "tag": [
            {
              "system": "http://nphies.sa/terminology/CodeSystem/meta-tags",
              "code": "queued-messages"
            }
          ]
        },
        "eventCoding": {
          "system": "http://nphies.sa/terminology/CodeSystem/ksa-message-events",
          "code": "poll-response"
        },
        "destination": [
          {
            "endpoint": "http://nphies.sa/license/provider-license/10000300062591",
            "receiver": {
              "type": "Organization",
              "identifier": {
                "system": "http://nphies.sa/license/provider-license",
                "value": "10000300062591"
              }
            }
          }
        ],
        "sender": {
          "type": "Organization",
          "identifier": {
            "system": "http://nphies.sa/license/nphies",
            "value": "NPHIES"
          }
        },
        "source": {
          "endpoint": "http://nphies.sa/"
        },
        "response": {
          "identifier": "a72df09e-45df-4e17-92a2-b8054c49397a",
          "code": "ok"
        }
      }
    },
    {
      "fullUrl": "http://nphies.sa/Task/dfdaf0b9-30d9-47a2-91e5-e006f3d55f60",
      "resource": {
        "resourceType": "Task",
        "id": "dfdaf0b9-30d9-47a2-91e5-e006f3d55f60",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/task|1.0.0"
          ],
          "tag": [
            {
              "code": "NPHIES generated",
              "display": "NPHIES generated"
            }
          ]
        },
        "identifier": [
          {
            "system": "http://www.ALKholood.com/Task",
            "value": "109"
          }
        ],
        "status": "completed",
        "intent": "order",
        "priority": "stat",
        "code": {
          "coding": [
            {
              "system": "http://nphies.sa/terminology/CodeSystem/task-code",
              "code": "poll"
            }
          ]
        },
        "authoredOn": "2026-09-30",
        "lastModified": "2026-10-31",
        "requester": {
          "reference": "Organization/9"
        },
        "owner": {
          "identifier": {
            "system": "http://nphies.sa/license/nphies",
            "value": "NPHIES"
          }
        },
        "input": [
          {
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/CodeSystem/task-input-type",
                  "code": "include-message-type"
                }
              ]
            },
            "valueCode": "claim-response"
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/CodeSystem/task-input-type",
                  "code": "period"
                }
              ]
            },
            "valuePeriod": {
              "start": "2026-09-30T00:00:00.000+03:00",
              "end": "2026-10-31T23:59:59.999+03:00"
            }
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/CodeSystem/task-input-type",
                  "code": "count"
                }
              ]
            },
            "valuePositiveInt": 10
          }
        ],
        "output": [
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:15.176+00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/7db815a9-0204-4005-8758-dec3dca79162"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:15.186+00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/2f272007-0350-4b86-afb7-8a29d31d7155"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:15.201+00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/36fc62ba-ff3d-4330-9064-191b5e104a9d"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:15.207+00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/1f748c93-648a-4a9b-811f-17a7a216841f"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:15.228+00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/028912e7-a269-4665-9fa8-d2631f2ba42f"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:15.251+00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/e606f595-887f-4b7e-9cb7-00e698f398e9"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:15.265+00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/45cf21e8-089e-4b95-9da2-360759d6888d"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:15.346+00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/8326879a-cb39-4799-8026-7f5fd77a1ccd"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:15.347+00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/60b8f38e-5b39-4824-9d51-16f2bd05a3c4"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:15.419+00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/0a4c26a5-1eb9-45d3-a564-5c007fbc01f1"
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/7db815a9-0204-4005-8758-dec3dca79162",
      "resource": {
        "resourceType": "Bundle",
        "id": "7db815a9-0204-4005-8758-dec3dca79162",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:13.834+03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/101686b5-ddac-49d6-a521-e43da1f7d2a1",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "101686b5-ddac-49d6-a521-e43da1f7d2a1",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/message-header|1.0.0"
                ]
              },
              "eventCoding": {
                "system": "http://nphies.sa/terminology/CodeSystem/ksa-message-events",
                "code": "claim-response"
              },
              "destination": [
                {
                  "endpoint": "http://www.ALKholood.com",
                  "receiver": {
                    "type": "Organization",
                    "identifier": {
                      "system": "http://nphies.sa/license/provider-license",
                      "value": "10000300062591"
                    }
                  }
                }
              ],
              "sender": {
                "type": "Organization",
                "identifier": {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              },
              "source": {
                "endpoint": "https://tawuniya.com.sa"
              },
              "response": {
                "identifier": "23a0484b-9d06-47e3-bed1-a886f75bb097",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/d9da3f9e-9b67-4b09-ad15-3ba3236ae788"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/d9da3f9e-9b67-4b09-ad15-3ba3236ae788",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "d9da3f9e-9b67-4b09-ad15-3ba3236ae788",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/prior-auth-response|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                        "code": "partial"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-reissue",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/reissue-reason",
                        "code": "adjudication"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-batch-identifier",
                  "valueIdentifier": {
                    "system": "http://www.ALKholood.com/episode",
                    "value": "2473"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "d9da3f9e-9b67-4b09-ad15-3ba3236ae788"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/claim-type",
                    "code": "pharmacy"
                  }
                ]
              },
              "subType": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/claim-subtype",
                    "code": "op"
                  }
                ]
              },
              "use": "claim",
              "patient": {
                "reference": "https://tawuniya.com.sa/Patient/63e2873d-c1d2-4438-bc9d-b011ba9b2a76"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/fbbe0ee1-e10b-4d0b-8387-18cbb447cda7"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/502b101a-972d-4d6f-b191-a852435f59d9"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "36288653260928"
                }
              },
              "outcome": "complete",
              "disposition": "-",
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "rejected"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "101440"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 25.96,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 25.96,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "reason": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-reason",
                            "code": "CV-4-5"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 0
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "101440"
                      }
                    }
                  ],
                  "itemSequence": 2,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 35.01,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 35.01,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 35.01,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 2
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "101440"
                      }
                    }
                  ],
                  "itemSequence": 3,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 27.31,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 27.31,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 22.99,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "101440"
                      }
                    }
                  ],
                  "itemSequence": 4,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 17.23,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 17.23,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 17.23,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                }
              ],
              "total": [
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "submitted"
                      }
                    ]
                  },
                  "amount": {
                    "value": 105.51,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 75.23,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "deductible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "copay"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 105.51,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "tax"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                }
              ],
              "insurance": [
                {
                  "sequence": 1,
                  "focal": true,
                  "coverage": {
                    "reference": "https://tawuniya.com.sa/Coverage/047fa2a2-6209-4a81-9ccf-b15daea1e50c"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/63e2873d-c1d2-4438-bc9d-b011ba9b2a76",
            "resource": {
              "resourceType": "Patient",
              "id": "63e2873d-c1d2-4438-bc9d-b011ba9b2a76",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "NI",
                        "display": "National ID"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/nationalid",
                  "value": "1157575497"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "shaden  abdelgadir Abdulaziz",
                  "given": [
                    "shaden",
                    "abdelgadir",
                    "Abdulaziz"
                  ]
                }
              ],
              "gender": "female",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "female",
                          "display": "female"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "2006-11-19",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/502b101a-972d-4d6f-b191-a852435f59d9",
            "resource": {
              "resourceType": "Organization",
              "id": "502b101a-972d-4d6f-b191-a852435f59d9",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-provider-type",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/provider-type",
                        "code": "5",
                        "display": "Clinic"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "system": "http://nphies.sa/license/provider-license",
                  "value": "10000300062591"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "prov"
                    }
                  ]
                }
              ],
              "name": "Al-Kholood Medical Company - AlHaj"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/fbbe0ee1-e10b-4d0b-8387-18cbb447cda7",
            "resource": {
              "resourceType": "Organization",
              "id": "fbbe0ee1-e10b-4d0b-8387-18cbb447cda7",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/insurer-organization|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "ins"
                    }
                  ]
                }
              ],
              "name": "The Cooperative Company for Cooperative Insurance"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Coverage/047fa2a2-6209-4a81-9ccf-b15daea1e50c",
            "resource": {
              "resourceType": "Coverage",
              "id": "047fa2a2-6209-4a81-9ccf-b15daea1e50c",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "001022737793201"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/3c3b7cb9-cff1-4488-bbe7-2e26a925dc50"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/67980111-92e3-4935-b94e-a25d0164b409"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/63e2873d-c1d2-4438-bc9d-b011ba9b2a76"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/fbbe0ee1-e10b-4d0b-8387-18cbb447cda7"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "58359872",
                  "name": "TATWEER FOR TRANSPORT SERVICE CO"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/3c3b7cb9-cff1-4488-bbe7-2e26a925dc50",
            "resource": {
              "resourceType": "Organization",
              "id": "3c3b7cb9-cff1-4488-bbe7-2e26a925dc50",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/policyholder-organization|1.0.0"
                ]
              },
              "active": true,
              "name": "Policy Holder"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/67980111-92e3-4935-b94e-a25d0164b409",
            "resource": {
              "resourceType": "Patient",
              "id": "67980111-92e3-4935-b94e-a25d0164b409",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "https://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-nationality",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "https://nphies.sa/terminology/CodeSystem/nationality",
                        "code": "PAK"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-religion",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/religion",
                        "code": "0",
                        "display": "other"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others",
                        "display": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "NI",
                        "display": "National ID"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/nationalid",
                  "value": "1157575497"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "shaden  abdelgadir Abdulaziz",
                  "given": [
                    "shaden",
                    "abdelgadir",
                    "Abdulaziz"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0548423801"
                }
              ],
              "gender": "female",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "female",
                          "display": "female"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "2006-11-19",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/2f272007-0350-4b86-afb7-8a29d31d7155",
      "resource": {
        "resourceType": "Bundle",
        "id": "2f272007-0350-4b86-afb7-8a29d31d7155",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:14.404+03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/fc607b1f-997b-4687-b22a-016adb4ca8c4",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "fc607b1f-997b-4687-b22a-016adb4ca8c4",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/message-header|1.0.0"
                ]
              },
              "eventCoding": {
                "system": "http://nphies.sa/terminology/CodeSystem/ksa-message-events",
                "code": "claim-response"
              },
              "destination": [
                {
                  "endpoint": "http://www.ALKholood.com",
                  "receiver": {
                    "type": "Organization",
                    "identifier": {
                      "system": "http://nphies.sa/license/provider-license",
                      "value": "10000300062591"
                    }
                  }
                }
              ],
              "sender": {
                "type": "Organization",
                "identifier": {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              },
              "source": {
                "endpoint": "https://tawuniya.com.sa"
              },
              "response": {
                "identifier": "c7fa4411-1d3d-4aa3-84f4-4a25ff164e8b",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/dcdbb87e-d7b4-49f8-8f93-0c73e2e09ab5"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/dcdbb87e-d7b4-49f8-8f93-0c73e2e09ab5",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "dcdbb87e-d7b4-49f8-8f93-0c73e2e09ab5",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/prior-auth-response|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                        "code": "approved"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-reissue",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/reissue-reason",
                        "code": "adjudication"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-batch-identifier",
                  "valueIdentifier": {
                    "system": "http://www.ALKholood.com/episode",
                    "value": "1227"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "dcdbb87e-d7b4-49f8-8f93-0c73e2e09ab5"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/claim-type",
                    "code": "pharmacy"
                  }
                ]
              },
              "subType": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/claim-subtype",
                    "code": "op"
                  }
                ]
              },
              "use": "claim",
              "patient": {
                "reference": "https://tawuniya.com.sa/Patient/499325a1-2527-4e7c-8e5c-b4796edac9f7"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/5aa1dc49-f74e-471c-b00e-71bd59ef52f6"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/d4a04923-a11a-49d6-b3ca-6d8289af2ab5"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "69253906260915"
                }
              },
              "outcome": "complete",
              "disposition": "-",
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "88398"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 12.27,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 15.34,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 3.07,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 15.34,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "88398"
                      }
                    }
                  ],
                  "itemSequence": 2,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 67.77,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 13.55,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 67.77,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 54.22,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 2
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "88398"
                      }
                    }
                  ],
                  "itemSequence": 3,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 20.02,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 16.02,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 4,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 20.02,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                }
              ],
              "total": [
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "submitted"
                      }
                    ]
                  },
                  "amount": {
                    "value": 103.13,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 82.51,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "deductible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "copay"
                      }
                    ]
                  },
                  "amount": {
                    "value": 20.62,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 103.13,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "tax"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                }
              ],
              "insurance": [
                {
                  "sequence": 1,
                  "focal": true,
                  "coverage": {
                    "reference": "https://tawuniya.com.sa/Coverage/c24563c3-f199-4fe2-b98f-960d0c1c4284"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/499325a1-2527-4e7c-8e5c-b4796edac9f7",
            "resource": {
              "resourceType": "Patient",
              "id": "499325a1-2527-4e7c-8e5c-b4796edac9f7",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "PRC",
                        "display": "iqama"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/iqama",
                  "value": "2133195806"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "safiah  muhammad hussain",
                  "given": [
                    "safiah",
                    "muhammad",
                    "hussain"
                  ]
                }
              ],
              "gender": "female",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "female",
                          "display": "female"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "1974-01-01",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/d4a04923-a11a-49d6-b3ca-6d8289af2ab5",
            "resource": {
              "resourceType": "Organization",
              "id": "d4a04923-a11a-49d6-b3ca-6d8289af2ab5",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-provider-type",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/provider-type",
                        "code": "5",
                        "display": "Clinic"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "system": "http://nphies.sa/license/provider-license",
                  "value": "10000300062591"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "prov"
                    }
                  ]
                }
              ],
              "name": "Al-Kholood Medical Company - AlHaj"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/5aa1dc49-f74e-471c-b00e-71bd59ef52f6",
            "resource": {
              "resourceType": "Organization",
              "id": "5aa1dc49-f74e-471c-b00e-71bd59ef52f6",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/insurer-organization|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "ins"
                    }
                  ]
                }
              ],
              "name": "The Cooperative Company for Cooperative Insurance"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Coverage/c24563c3-f199-4fe2-b98f-960d0c1c4284",
            "resource": {
              "resourceType": "Coverage",
              "id": "c24563c3-f199-4fe2-b98f-960d0c1c4284",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "002030398164101"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/5c5e365c-589b-47e0-8081-588633ea7073"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/ede08034-595f-42de-9c18-d61ccb60d714"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/499325a1-2527-4e7c-8e5c-b4796edac9f7"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/5aa1dc49-f74e-471c-b00e-71bd59ef52f6"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "55901572",
                  "name": "ABBAR AND SONS FOOD CO"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/5c5e365c-589b-47e0-8081-588633ea7073",
            "resource": {
              "resourceType": "Organization",
              "id": "5c5e365c-589b-47e0-8081-588633ea7073",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/policyholder-organization|1.0.0"
                ]
              },
              "active": true,
              "name": "Policy Holder"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/ede08034-595f-42de-9c18-d61ccb60d714",
            "resource": {
              "resourceType": "Patient",
              "id": "ede08034-595f-42de-9c18-d61ccb60d714",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "https://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-nationality",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "https://nphies.sa/terminology/CodeSystem/nationality",
                        "code": "PAK"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-religion",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/religion",
                        "code": "0",
                        "display": "other"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others",
                        "display": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "PRC",
                        "display": "iqama"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/iqama",
                  "value": "2133195806"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "safiah  muhammad hussain",
                  "given": [
                    "safiah",
                    "muhammad",
                    "hussain"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0535489561"
                }
              ],
              "gender": "female",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "female",
                          "display": "female"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "1974-01-01",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/36fc62ba-ff3d-4330-9064-191b5e104a9d",
      "resource": {
        "resourceType": "Bundle",
        "id": "36fc62ba-ff3d-4330-9064-191b5e104a9d",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:14.332+03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/6ad8b723-7451-460c-81ce-4378094a968a",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "6ad8b723-7451-460c-81ce-4378094a968a",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/message-header|1.0.0"
                ]
              },
              "eventCoding": {
                "system": "http://nphies.sa/terminology/CodeSystem/ksa-message-events",
                "code": "claim-response"
              },
              "destination": [
                {
                  "endpoint": "http://www.ALKholood.com",
                  "receiver": {
                    "type": "Organization",
                    "identifier": {
                      "system": "http://nphies.sa/license/provider-license",
                      "value": "10000300062591"
                    }
                  }
                }
              ],
              "sender": {
                "type": "Organization",
                "identifier": {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              },
              "source": {
                "endpoint": "https://tawuniya.com.sa"
              },
              "response": {
                "identifier": "e9150525-8fea-4066-8725-c405df504f67",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/db56b93a-4cdf-487e-9056-4a45eaa8bbc2"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/db56b93a-4cdf-487e-9056-4a45eaa8bbc2",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "db56b93a-4cdf-487e-9056-4a45eaa8bbc2",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/prior-auth-response|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                        "code": "partial"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-reissue",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/reissue-reason",
                        "code": "adjudication"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-batch-identifier",
                  "valueIdentifier": {
                    "system": "http://www.ALKholood.com/episode",
                    "value": "1891"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "db56b93a-4cdf-487e-9056-4a45eaa8bbc2"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/claim-type",
                    "code": "pharmacy"
                  }
                ]
              },
              "subType": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/claim-subtype",
                    "code": "op"
                  }
                ]
              },
              "use": "claim",
              "patient": {
                "reference": "https://tawuniya.com.sa/Patient/42d4cd99-63b0-4d86-b1ae-056a58f36b9f"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/40ac37f5-17ac-4646-bf86-dceab3d5b278"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/09bc17b5-4a75-4906-a811-46f817be99a3"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "87272072260922"
                }
              },
              "outcome": "complete",
              "disposition": "-",
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "95311"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 10.08,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 7.2,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 1.8,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 10.08,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "rejected"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "95311"
                      }
                    }
                  ],
                  "itemSequence": 2,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.21,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "reason": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-reason",
                            "code": "CV-4-5"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.21,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 1.24,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 0
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "95311"
                      }
                    }
                  ],
                  "itemSequence": 3,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 59.82,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 59.82,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 42.73,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 10.68,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "rejected"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "95311"
                      }
                    }
                  ],
                  "itemSequence": 4,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.37,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.37,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 1.67,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "reason": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-reason",
                            "code": "CV-4-5"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 0
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "95311"
                      }
                    }
                  ],
                  "itemSequence": 5,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 10.3,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 2.06,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 10.3,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.24,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "95311"
                      }
                    }
                  ],
                  "itemSequence": 6,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.26,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 1.48,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.26,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 5.9,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                }
              ],
              "total": [
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "submitted"
                      }
                    ]
                  },
                  "amount": {
                    "value": 103.04,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 64.07,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "deductible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "copay"
                      }
                    ]
                  },
                  "amount": {
                    "value": 18.93,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 103.04,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "tax"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                }
              ],
              "insurance": [
                {
                  "sequence": 1,
                  "focal": true,
                  "coverage": {
                    "reference": "https://tawuniya.com.sa/Coverage/4e0ec1be-e853-42d1-858c-536aed5f5703"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/42d4cd99-63b0-4d86-b1ae-056a58f36b9f",
            "resource": {
              "resourceType": "Patient",
              "id": "42d4cd99-63b0-4d86-b1ae-056a58f36b9f",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "NI",
                        "display": "National ID"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/nationalid",
                  "value": "1216951598"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "NAYEF ABDULELLAH hathal AL-MAJNONEI",
                  "given": [
                    "NAYEF",
                    "hathal",
                    "AL-MAJNONEI"
                  ]
                }
              ],
              "gender": "male",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "male",
                          "display": "male"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "2024-12-10",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/09bc17b5-4a75-4906-a811-46f817be99a3",
            "resource": {
              "resourceType": "Organization",
              "id": "09bc17b5-4a75-4906-a811-46f817be99a3",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-provider-type",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/provider-type",
                        "code": "5",
                        "display": "Clinic"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "system": "http://nphies.sa/license/provider-license",
                  "value": "10000300062591"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "prov"
                    }
                  ]
                }
              ],
              "name": "Al-Kholood Medical Company - AlHaj"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/40ac37f5-17ac-4646-bf86-dceab3d5b278",
            "resource": {
              "resourceType": "Organization",
              "id": "40ac37f5-17ac-4646-bf86-dceab3d5b278",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/insurer-organization|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "ins"
                    }
                  ]
                }
              ],
              "name": "The Cooperative Company for Cooperative Insurance"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Coverage/4e0ec1be-e853-42d1-858c-536aed5f5703",
            "resource": {
              "resourceType": "Coverage",
              "id": "4e0ec1be-e853-42d1-858c-536aed5f5703",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "001112247406211"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/20c1d48c-070f-47a4-b2dd-fe8682cf8c81"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/d79b852f-0e6a-4618-ad8a-b550f0c24596"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/42d4cd99-63b0-4d86-b1ae-056a58f36b9f"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/40ac37f5-17ac-4646-bf86-dceab3d5b278"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "57111997",
                  "name": "AL SUBAIE INDUSTRIAL COMPANY"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/20c1d48c-070f-47a4-b2dd-fe8682cf8c81",
            "resource": {
              "resourceType": "Organization",
              "id": "20c1d48c-070f-47a4-b2dd-fe8682cf8c81",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/policyholder-organization|1.0.0"
                ]
              },
              "active": true,
              "name": "Policy Holder"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/d79b852f-0e6a-4618-ad8a-b550f0c24596",
            "resource": {
              "resourceType": "Patient",
              "id": "d79b852f-0e6a-4618-ad8a-b550f0c24596",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "https://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-nationality",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "https://nphies.sa/terminology/CodeSystem/nationality",
                        "code": "PAK"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-religion",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/religion",
                        "code": "0",
                        "display": "other"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others",
                        "display": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "NI",
                        "display": "National ID"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/nationalid",
                  "value": "1216951598"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "NAYEF ABDULELLAH hathal AL-MAJNONEI",
                  "given": [
                    "NAYEF",
                    "hathal",
                    "AL-MAJNONEI"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0537612149"
                }
              ],
              "gender": "male",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "male",
                          "display": "male"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "2024-12-10",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/1f748c93-648a-4a9b-811f-17a7a216841f",
      "resource": {
        "resourceType": "Bundle",
        "id": "1f748c93-648a-4a9b-811f-17a7a216841f",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:14.429+03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/2258e0a0-67e7-4767-97bf-3a7ca3148091",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "2258e0a0-67e7-4767-97bf-3a7ca3148091",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/message-header|1.0.0"
                ]
              },
              "eventCoding": {
                "system": "http://nphies.sa/terminology/CodeSystem/ksa-message-events",
                "code": "claim-response"
              },
              "destination": [
                {
                  "endpoint": "http://www.ALKholood.com",
                  "receiver": {
                    "type": "Organization",
                    "identifier": {
                      "system": "http://nphies.sa/license/provider-license",
                      "value": "10000300062591"
                    }
                  }
                }
              ],
              "sender": {
                "type": "Organization",
                "identifier": {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              },
              "source": {
                "endpoint": "https://tawuniya.com.sa"
              },
              "response": {
                "identifier": "0cddc814-02b6-42c3-8e97-fb78d710e3f6",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/3e129352-e129-45f1-8266-1007ca469780"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/3e129352-e129-45f1-8266-1007ca469780",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "3e129352-e129-45f1-8266-1007ca469780",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/prior-auth-response|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                        "code": "rejected"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-reissue",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/reissue-reason",
                        "code": "adjudication"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-batch-identifier",
                  "valueIdentifier": {
                    "system": "http://www.ALKholood.com/episode",
                    "value": "1818"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "3e129352-e129-45f1-8266-1007ca469780"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/claim-type",
                    "code": "pharmacy"
                  }
                ]
              },
              "subType": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/claim-subtype",
                    "code": "op"
                  }
                ]
              },
              "use": "claim",
              "patient": {
                "reference": "https://tawuniya.com.sa/Patient/437d25a9-1d44-45cf-878f-2f680e90b346"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/a6479eeb-0723-4c38-9e90-d478be0f872d"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/d4875fd1-4a39-409f-ac35-73048efa6005"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "61269884260921"
                }
              },
              "outcome": "complete",
              "disposition": "-",
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "rejected"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "94490"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "reason": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-reason",
                            "code": "AD-2-4"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 7.02,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 7.02,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 1.4,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 0
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "rejected"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "94490"
                      }
                    }
                  ],
                  "itemSequence": 2,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "reason": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-reason",
                            "code": "AD-2-4"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 1.64,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.19,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.19,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 0
                    }
                  ]
                }
              ],
              "total": [
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "submitted"
                      }
                    ]
                  },
                  "amount": {
                    "value": 15.21,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "deductible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "copay"
                      }
                    ]
                  },
                  "amount": {
                    "value": 3.04,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 15.21,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "tax"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                }
              ],
              "insurance": [
                {
                  "sequence": 1,
                  "focal": true,
                  "coverage": {
                    "reference": "https://tawuniya.com.sa/Coverage/17c53613-b42a-4f64-93a3-2e51084554ce"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/437d25a9-1d44-45cf-878f-2f680e90b346",
            "resource": {
              "resourceType": "Patient",
              "id": "437d25a9-1d44-45cf-878f-2f680e90b346",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "NI",
                        "display": "National ID"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/nationalid",
                  "value": "1066174077"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "RANA TALAL  مكاوي",
                  "given": [
                    "RANA",
                    "مكاوي",
                    "مكاوي"
                  ]
                }
              ],
              "gender": "female",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "female",
                          "display": "female"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "1990-05-08",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/d4875fd1-4a39-409f-ac35-73048efa6005",
            "resource": {
              "resourceType": "Organization",
              "id": "d4875fd1-4a39-409f-ac35-73048efa6005",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-provider-type",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/provider-type",
                        "code": "5",
                        "display": "Clinic"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "system": "http://nphies.sa/license/provider-license",
                  "value": "10000300062591"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "prov"
                    }
                  ]
                }
              ],
              "name": "Al-Kholood Medical Company - AlHaj"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/a6479eeb-0723-4c38-9e90-d478be0f872d",
            "resource": {
              "resourceType": "Organization",
              "id": "a6479eeb-0723-4c38-9e90-d478be0f872d",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/insurer-organization|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "ins"
                    }
                  ]
                }
              ],
              "name": "The Cooperative Company for Cooperative Insurance"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Coverage/17c53613-b42a-4f64-93a3-2e51084554ce",
            "resource": {
              "resourceType": "Coverage",
              "id": "17c53613-b42a-4f64-93a3-2e51084554ce",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "001066174077001"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/c040ce14-67f6-49a5-a7b9-6de5f8206874"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/c2e128d0-5d05-4828-b9f4-bff9b1ebdcca"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/437d25a9-1d44-45cf-878f-2f680e90b346"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/a6479eeb-0723-4c38-9e90-d478be0f872d"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "56361159",
                  "name": "al barwon    Basic"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/c040ce14-67f6-49a5-a7b9-6de5f8206874",
            "resource": {
              "resourceType": "Organization",
              "id": "c040ce14-67f6-49a5-a7b9-6de5f8206874",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/policyholder-organization|1.0.0"
                ]
              },
              "active": true,
              "name": "Policy Holder"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/c2e128d0-5d05-4828-b9f4-bff9b1ebdcca",
            "resource": {
              "resourceType": "Patient",
              "id": "c2e128d0-5d05-4828-b9f4-bff9b1ebdcca",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "https://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-nationality",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "https://nphies.sa/terminology/CodeSystem/nationality",
                        "code": "PAK"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-religion",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/religion",
                        "code": "0",
                        "display": "other"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others",
                        "display": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "NI",
                        "display": "National ID"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/nationalid",
                  "value": "1066174077"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "RANA TALAL  مكاوي",
                  "given": [
                    "RANA",
                    "مكاوي",
                    "مكاوي"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0566976048"
                }
              ],
              "gender": "female",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "female",
                          "display": "female"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "1990-05-08",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/028912e7-a269-4665-9fa8-d2631f2ba42f",
      "resource": {
        "resourceType": "Bundle",
        "id": "028912e7-a269-4665-9fa8-d2631f2ba42f",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:14.432+03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/e6173a61-1fc1-41a5-b50d-78e6ebd1cc5a",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "e6173a61-1fc1-41a5-b50d-78e6ebd1cc5a",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/message-header|1.0.0"
                ]
              },
              "eventCoding": {
                "system": "http://nphies.sa/terminology/CodeSystem/ksa-message-events",
                "code": "claim-response"
              },
              "destination": [
                {
                  "endpoint": "http://www.ALKholood.com",
                  "receiver": {
                    "type": "Organization",
                    "identifier": {
                      "system": "http://nphies.sa/license/provider-license",
                      "value": "10000300062591"
                    }
                  }
                }
              ],
              "sender": {
                "type": "Organization",
                "identifier": {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              },
              "source": {
                "endpoint": "https://tawuniya.com.sa"
              },
              "response": {
                "identifier": "6b052c98-0b7d-4732-833f-048ac1723fa6",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/3ab021aa-bb73-4190-88c0-3813fe2c3e37"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/3ab021aa-bb73-4190-88c0-3813fe2c3e37",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "3ab021aa-bb73-4190-88c0-3813fe2c3e37",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/prior-auth-response|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                        "code": "partial"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-reissue",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/reissue-reason",
                        "code": "adjudication"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-batch-identifier",
                  "valueIdentifier": {
                    "system": "http://www.ALKholood.com/episode",
                    "value": "2697"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "3ab021aa-bb73-4190-88c0-3813fe2c3e37"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/claim-type",
                    "code": "pharmacy"
                  }
                ]
              },
              "subType": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/claim-subtype",
                    "code": "op"
                  }
                ]
              },
              "use": "claim",
              "patient": {
                "reference": "https://tawuniya.com.sa/Patient/75ed505c-6c86-49e3-8b29-3cfdc5bee072"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/3916711f-d3c5-4358-ad88-94a1a4389170"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/90654d63-5619-47fc-b6c9-74ba97be585c"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "6295548260930"
                }
              },
              "outcome": "complete",
              "disposition": "-",
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "103789"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 9.61,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 12.01,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 2.4,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 12.01,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "rejected"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "103789"
                      }
                    }
                  ],
                  "itemSequence": 2,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 40.77,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 40.77,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.15,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "reason": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-reason",
                            "code": "MN-1-1"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 0
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "103789"
                      }
                    }
                  ],
                  "itemSequence": 3,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 1.03,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 5.13,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 5.13,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 4.1,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "103789"
                      }
                    }
                  ],
                  "itemSequence": 4,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 32.67,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 26.14,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.53,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 32.67,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "rejected"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "103789"
                      }
                    }
                  ],
                  "itemSequence": 5,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "reason": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-reason",
                            "code": "MN-1-1"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 11.11,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 2.22,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 11.11,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 0
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "103789"
                      }
                    }
                  ],
                  "itemSequence": 6,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.35,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 1.13,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.35,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 4.54,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "103789"
                      }
                    }
                  ],
                  "itemSequence": 7,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.37,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 1.67,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.37,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.7,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                }
              ],
              "total": [
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "submitted"
                      }
                    ]
                  },
                  "amount": {
                    "value": 116.41,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 51.09,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "deductible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "copay"
                      }
                    ]
                  },
                  "amount": {
                    "value": 23.13,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 116.41,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "tax"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                }
              ],
              "insurance": [
                {
                  "sequence": 1,
                  "focal": true,
                  "coverage": {
                    "reference": "https://tawuniya.com.sa/Coverage/111c91ef-0dea-439a-8f85-e88e6f660b3c"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/75ed505c-6c86-49e3-8b29-3cfdc5bee072",
            "resource": {
              "resourceType": "Patient",
              "id": "75ed505c-6c86-49e3-8b29-3cfdc5bee072",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "NI",
                        "display": "National ID"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/nationalid",
                  "value": "1214771204"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "nawaf  abdrhman jamil",
                  "given": [
                    "nawaf",
                    "abdrhman",
                    "jamil"
                  ]
                }
              ],
              "gender": "male",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "male",
                          "display": "male"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "2024-05-15",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/90654d63-5619-47fc-b6c9-74ba97be585c",
            "resource": {
              "resourceType": "Organization",
              "id": "90654d63-5619-47fc-b6c9-74ba97be585c",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-provider-type",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/provider-type",
                        "code": "5",
                        "display": "Clinic"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "system": "http://nphies.sa/license/provider-license",
                  "value": "10000300062591"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "prov"
                    }
                  ]
                }
              ],
              "name": "Al-Kholood Medical Company - AlHaj"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/3916711f-d3c5-4358-ad88-94a1a4389170",
            "resource": {
              "resourceType": "Organization",
              "id": "3916711f-d3c5-4358-ad88-94a1a4389170",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/insurer-organization|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "ins"
                    }
                  ]
                }
              ],
              "name": "The Cooperative Company for Cooperative Insurance"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Coverage/111c91ef-0dea-439a-8f85-e88e6f660b3c",
            "resource": {
              "resourceType": "Coverage",
              "id": "111c91ef-0dea-439a-8f85-e88e6f660b3c",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "001071421752231"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/96a9f9de-5b80-4ef4-94b1-8c2c326522d2"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/f683f753-d3f7-43a9-a51d-de45a24177ac"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/75ed505c-6c86-49e3-8b29-3cfdc5bee072"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/3916711f-d3c5-4358-ad88-94a1a4389170"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "56078461",
                  "name": "ABDULLAH HASHEM"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/96a9f9de-5b80-4ef4-94b1-8c2c326522d2",
            "resource": {
              "resourceType": "Organization",
              "id": "96a9f9de-5b80-4ef4-94b1-8c2c326522d2",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/policyholder-organization|1.0.0"
                ]
              },
              "active": true,
              "name": "Policy Holder"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/f683f753-d3f7-43a9-a51d-de45a24177ac",
            "resource": {
              "resourceType": "Patient",
              "id": "f683f753-d3f7-43a9-a51d-de45a24177ac",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "https://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-nationality",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "https://nphies.sa/terminology/CodeSystem/nationality",
                        "code": "PAK"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-religion",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/religion",
                        "code": "0",
                        "display": "other"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others",
                        "display": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "NI",
                        "display": "National ID"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/nationalid",
                  "value": "1214771204"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "nawaf  abdrhman jamil",
                  "given": [
                    "nawaf",
                    "abdrhman",
                    "jamil"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0507620757"
                }
              ],
              "gender": "male",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "male",
                          "display": "male"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "2024-05-15",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/e606f595-887f-4b7e-9cb7-00e698f398e9",
      "resource": {
        "resourceType": "Bundle",
        "id": "e606f595-887f-4b7e-9cb7-00e698f398e9",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:14.400+03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/147883c0-8823-4f54-a68a-dec91215bb2a",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "147883c0-8823-4f54-a68a-dec91215bb2a",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/message-header|1.0.0"
                ]
              },
              "eventCoding": {
                "system": "http://nphies.sa/terminology/CodeSystem/ksa-message-events",
                "code": "claim-response"
              },
              "destination": [
                {
                  "endpoint": "http://www.ALKholood.com",
                  "receiver": {
                    "type": "Organization",
                    "identifier": {
                      "system": "http://nphies.sa/license/provider-license",
                      "value": "10000300062591"
                    }
                  }
                }
              ],
              "sender": {
                "type": "Organization",
                "identifier": {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              },
              "source": {
                "endpoint": "https://tawuniya.com.sa"
              },
              "response": {
                "identifier": "f645d5ae-cd9c-4257-9338-7de91fa57218",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/72bb0385-6116-4c4e-b79c-a5b9dfb8276d"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/72bb0385-6116-4c4e-b79c-a5b9dfb8276d",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "72bb0385-6116-4c4e-b79c-a5b9dfb8276d",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/prior-auth-response|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                        "code": "approved"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-reissue",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/reissue-reason",
                        "code": "adjudication"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-batch-identifier",
                  "valueIdentifier": {
                    "system": "http://www.ALKholood.com/episode",
                    "value": "1258"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "72bb0385-6116-4c4e-b79c-a5b9dfb8276d"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/claim-type",
                    "code": "pharmacy"
                  }
                ]
              },
              "subType": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/claim-subtype",
                    "code": "op"
                  }
                ]
              },
              "use": "claim",
              "patient": {
                "reference": "https://tawuniya.com.sa/Patient/05921844-aa43-4b53-8a2b-36838f5d347f"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/6e8ae864-4a8b-417f-b97f-336120ee1940"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/6ba68fac-c3ce-4d46-bcac-da16dd6c3d76"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "96254681260915"
                }
              },
              "outcome": "complete",
              "disposition": "-",
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "88661"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 33.3,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 41.62,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.32,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 41.62,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "88661"
                      }
                    }
                  ],
                  "itemSequence": 2,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 16.87,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 3.37,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 16.87,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 13.5,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 2.03,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "88661"
                      }
                    }
                  ],
                  "itemSequence": 3,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.84,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 5.47,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 1.37,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.84,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                }
              ],
              "total": [
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "submitted"
                      }
                    ]
                  },
                  "amount": {
                    "value": 65.33,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 52.27,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "deductible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "copay"
                      }
                    ]
                  },
                  "amount": {
                    "value": 13.06,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 65.33,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "tax"
                      }
                    ]
                  },
                  "amount": {
                    "value": 2.03,
                    "currency": "SAR"
                  }
                }
              ],
              "insurance": [
                {
                  "sequence": 1,
                  "focal": true,
                  "coverage": {
                    "reference": "https://tawuniya.com.sa/Coverage/3e2882fc-b7be-4386-abb6-dcf186e45080"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/05921844-aa43-4b53-8a2b-36838f5d347f",
            "resource": {
              "resourceType": "Patient",
              "id": "05921844-aa43-4b53-8a2b-36838f5d347f",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "PRC",
                        "display": "iqama"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/iqama",
                  "value": "2010602577"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "NASER ALDIEN HASAN HMIDAH",
                  "given": [
                    "NASER",
                    "HASAN",
                    "HMIDAH"
                  ]
                }
              ],
              "gender": "male",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "male",
                          "display": "male"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "1958-07-01",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/6ba68fac-c3ce-4d46-bcac-da16dd6c3d76",
            "resource": {
              "resourceType": "Organization",
              "id": "6ba68fac-c3ce-4d46-bcac-da16dd6c3d76",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-provider-type",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/provider-type",
                        "code": "5",
                        "display": "Clinic"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "system": "http://nphies.sa/license/provider-license",
                  "value": "10000300062591"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "prov"
                    }
                  ]
                }
              ],
              "name": "Al-Kholood Medical Company - AlHaj"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/6e8ae864-4a8b-417f-b97f-336120ee1940",
            "resource": {
              "resourceType": "Organization",
              "id": "6e8ae864-4a8b-417f-b97f-336120ee1940",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/insurer-organization|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "ins"
                    }
                  ]
                }
              ],
              "name": "The Cooperative Company for Cooperative Insurance"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Coverage/3e2882fc-b7be-4386-abb6-dcf186e45080",
            "resource": {
              "resourceType": "Coverage",
              "id": "3e2882fc-b7be-4386-abb6-dcf186e45080",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "002010602577001"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/608e6023-47a0-446a-8b15-ab6e4c8ac05d"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/0f735add-c0af-494a-ad4a-38b9bd81d72c"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/05921844-aa43-4b53-8a2b-36838f5d347f"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/6e8ae864-4a8b-417f-b97f-336120ee1940"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "57901572",
                  "name": "Asloob Al Omran Engi   Basic B"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/608e6023-47a0-446a-8b15-ab6e4c8ac05d",
            "resource": {
              "resourceType": "Organization",
              "id": "608e6023-47a0-446a-8b15-ab6e4c8ac05d",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/policyholder-organization|1.0.0"
                ]
              },
              "active": true,
              "name": "Policy Holder"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/0f735add-c0af-494a-ad4a-38b9bd81d72c",
            "resource": {
              "resourceType": "Patient",
              "id": "0f735add-c0af-494a-ad4a-38b9bd81d72c",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "https://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-nationality",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "https://nphies.sa/terminology/CodeSystem/nationality",
                        "code": "PAK"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-religion",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/religion",
                        "code": "0",
                        "display": "other"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others",
                        "display": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "PRC",
                        "display": "iqama"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/iqama",
                  "value": "2010602577"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "NASER ALDIEN HASAN HMIDAH",
                  "given": [
                    "NASER",
                    "HASAN",
                    "HMIDAH"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0506529218"
                }
              ],
              "gender": "male",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "male",
                          "display": "male"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "1958-07-01",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/45cf21e8-089e-4b95-9da2-360759d6888d",
      "resource": {
        "resourceType": "Bundle",
        "id": "45cf21e8-089e-4b95-9da2-360759d6888d",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:14.323+03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/a49fc494-8c0e-4a06-ad65-1d235d8a2ef8",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "a49fc494-8c0e-4a06-ad65-1d235d8a2ef8",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/message-header|1.0.0"
                ]
              },
              "eventCoding": {
                "system": "http://nphies.sa/terminology/CodeSystem/ksa-message-events",
                "code": "claim-response"
              },
              "destination": [
                {
                  "endpoint": "http://www.ALKholood.com",
                  "receiver": {
                    "type": "Organization",
                    "identifier": {
                      "system": "http://nphies.sa/license/provider-license",
                      "value": "10000300062591"
                    }
                  }
                }
              ],
              "sender": {
                "type": "Organization",
                "identifier": {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              },
              "source": {
                "endpoint": "https://tawuniya.com.sa"
              },
              "response": {
                "identifier": "93e455c9-0243-4bb1-91c3-1f5eeda367bc",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/ed33687a-df87-4f5b-8107-f03eb657688a"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/ed33687a-df87-4f5b-8107-f03eb657688a",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "ed33687a-df87-4f5b-8107-f03eb657688a",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/prior-auth-response|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                        "code": "partial"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-reissue",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/reissue-reason",
                        "code": "adjudication"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-batch-identifier",
                  "valueIdentifier": {
                    "system": "http://www.ALKholood.com/episode",
                    "value": "1385"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "ed33687a-df87-4f5b-8107-f03eb657688a"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/claim-type",
                    "code": "pharmacy"
                  }
                ]
              },
              "subType": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/claim-subtype",
                    "code": "op"
                  }
                ]
              },
              "use": "claim",
              "patient": {
                "reference": "https://tawuniya.com.sa/Patient/b263ba2b-5235-401d-812b-3477f3d58d2b"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/aa2ce52b-2a81-47c2-a266-a8d36b363565"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/ddc0289f-8443-4f1c-8c11-fe8e10bb7865"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "74258005260916"
                }
              },
              "outcome": "complete",
              "disposition": "-",
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "89888"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.77,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.77,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.77,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "rejected"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "89888"
                      }
                    }
                  ],
                  "itemSequence": 2,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 11.11,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 11.11,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "reason": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-reason",
                            "code": "MN-1-1"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 0
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "89888"
                      }
                    }
                  ],
                  "itemSequence": 3,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.79,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.79,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.79,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "89888"
                      }
                    }
                  ],
                  "itemSequence": 4,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 4.54,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 4.54,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 4.54,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                }
              ],
              "total": [
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "submitted"
                      }
                    ]
                  },
                  "amount": {
                    "value": 31.21,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 20.1,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "deductible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "copay"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 31.21,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "tax"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                }
              ],
              "insurance": [
                {
                  "sequence": 1,
                  "focal": true,
                  "coverage": {
                    "reference": "https://tawuniya.com.sa/Coverage/355c6b30-e150-4338-941f-eab74da4c9d4"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/b263ba2b-5235-401d-812b-3477f3d58d2b",
            "resource": {
              "resourceType": "Patient",
              "id": "b263ba2b-5235-401d-812b-3477f3d58d2b",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "PRC",
                        "display": "iqama"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/iqama",
                  "value": "2135409296"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "NABEEL HAFEZ GHALAM ALI",
                  "given": [
                    "NABEEL",
                    "GHALAM",
                    "ALI"
                  ]
                }
              ],
              "gender": "male",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "male",
                          "display": "male"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "1985-09-15",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/ddc0289f-8443-4f1c-8c11-fe8e10bb7865",
            "resource": {
              "resourceType": "Organization",
              "id": "ddc0289f-8443-4f1c-8c11-fe8e10bb7865",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-provider-type",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/provider-type",
                        "code": "5",
                        "display": "Clinic"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "system": "http://nphies.sa/license/provider-license",
                  "value": "10000300062591"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "prov"
                    }
                  ]
                }
              ],
              "name": "Al-Kholood Medical Company - AlHaj"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/aa2ce52b-2a81-47c2-a266-a8d36b363565",
            "resource": {
              "resourceType": "Organization",
              "id": "aa2ce52b-2a81-47c2-a266-a8d36b363565",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/insurer-organization|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "ins"
                    }
                  ]
                }
              ],
              "name": "The Cooperative Company for Cooperative Insurance"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Coverage/355c6b30-e150-4338-941f-eab74da4c9d4",
            "resource": {
              "resourceType": "Coverage",
              "id": "355c6b30-e150-4338-941f-eab74da4c9d4",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "002135409296001"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/2c281f3b-6a10-4c79-a7be-fdd8e802b43e"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/b36954d9-e566-4e13-8de2-7ca71fa26e44"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/b263ba2b-5235-401d-812b-3477f3d58d2b"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/aa2ce52b-2a81-47c2-a266-a8d36b363565"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "50345512",
                  "name": "Snowd Hotel Company   Basic B"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/2c281f3b-6a10-4c79-a7be-fdd8e802b43e",
            "resource": {
              "resourceType": "Organization",
              "id": "2c281f3b-6a10-4c79-a7be-fdd8e802b43e",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/policyholder-organization|1.0.0"
                ]
              },
              "active": true,
              "name": "Policy Holder"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/b36954d9-e566-4e13-8de2-7ca71fa26e44",
            "resource": {
              "resourceType": "Patient",
              "id": "b36954d9-e566-4e13-8de2-7ca71fa26e44",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "https://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-nationality",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "https://nphies.sa/terminology/CodeSystem/nationality",
                        "code": "PAK"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-religion",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/religion",
                        "code": "0",
                        "display": "other"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others",
                        "display": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "PRC",
                        "display": "iqama"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/iqama",
                  "value": "2135409296"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "NABEEL HAFEZ GHALAM ALI",
                  "given": [
                    "NABEEL",
                    "GHALAM",
                    "ALI"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0597774991"
                }
              ],
              "gender": "male",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "male",
                          "display": "male"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "1985-09-15",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/8326879a-cb39-4799-8026-7f5fd77a1ccd",
      "resource": {
        "resourceType": "Bundle",
        "id": "8326879a-cb39-4799-8026-7f5fd77a1ccd",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:14.904+03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/e0f5c338-27ec-4e65-ba23-c35dfc2a7ae3",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "e0f5c338-27ec-4e65-ba23-c35dfc2a7ae3",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/message-header|1.0.0"
                ]
              },
              "eventCoding": {
                "system": "http://nphies.sa/terminology/CodeSystem/ksa-message-events",
                "code": "claim-response"
              },
              "destination": [
                {
                  "endpoint": "http://www.ALKholood.com",
                  "receiver": {
                    "type": "Organization",
                    "identifier": {
                      "system": "http://nphies.sa/license/provider-license",
                      "value": "10000300062591"
                    }
                  }
                }
              ],
              "sender": {
                "type": "Organization",
                "identifier": {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              },
              "source": {
                "endpoint": "https://tawuniya.com.sa"
              },
              "response": {
                "identifier": "d8a59e11-1357-4d2f-9556-86747178a2d4",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/7b80c06f-0261-4ba4-8163-00d2b2ab79f0"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/7b80c06f-0261-4ba4-8163-00d2b2ab79f0",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "7b80c06f-0261-4ba4-8163-00d2b2ab79f0",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/prior-auth-response|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                        "code": "approved"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-reissue",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/reissue-reason",
                        "code": "adjudication"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-batch-identifier",
                  "valueIdentifier": {
                    "system": "http://www.ALKholood.com/episode",
                    "value": "1692"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "7b80c06f-0261-4ba4-8163-00d2b2ab79f0"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/claim-type",
                    "code": "pharmacy"
                  }
                ]
              },
              "subType": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/claim-subtype",
                    "code": "op"
                  }
                ]
              },
              "use": "claim",
              "patient": {
                "reference": "https://tawuniya.com.sa/Patient/36f16b6a-4c27-4b8b-ada5-d677598d396b"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/55eb6156-a89b-450d-aa14-33afd92e8db2"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/02c164d1-52b2-4200-8360-cb8b1cb77567"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "12266812260920"
                }
              },
              "outcome": "complete",
              "disposition": "-",
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "93356"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 22.06,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 27.58,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 27.58,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 5.52,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "93356"
                      }
                    }
                  ],
                  "itemSequence": 2,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 5.62,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 1.4,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 7.02,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 7.02,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                }
              ],
              "total": [
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "submitted"
                      }
                    ]
                  },
                  "amount": {
                    "value": 34.6,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 27.68,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "deductible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "copay"
                      }
                    ]
                  },
                  "amount": {
                    "value": 6.92,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 34.6,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "tax"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                }
              ],
              "insurance": [
                {
                  "sequence": 1,
                  "focal": true,
                  "coverage": {
                    "reference": "https://tawuniya.com.sa/Coverage/94145221-0cb5-457a-bba6-d46f1eb90a88"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/36f16b6a-4c27-4b8b-ada5-d677598d396b",
            "resource": {
              "resourceType": "Patient",
              "id": "36f16b6a-4c27-4b8b-ada5-d677598d396b",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "PRC",
                        "display": "iqama"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/iqama",
                  "value": "2298724200"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "JAMAL ABDULSABOUR ahmed abdulaal",
                  "given": [
                    "JAMAL",
                    "ahmed",
                    "abdulaal"
                  ]
                }
              ],
              "gender": "male",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "male",
                          "display": "male"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "1989-06-11",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/02c164d1-52b2-4200-8360-cb8b1cb77567",
            "resource": {
              "resourceType": "Organization",
              "id": "02c164d1-52b2-4200-8360-cb8b1cb77567",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-provider-type",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/provider-type",
                        "code": "5",
                        "display": "Clinic"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "system": "http://nphies.sa/license/provider-license",
                  "value": "10000300062591"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "prov"
                    }
                  ]
                }
              ],
              "name": "Al-Kholood Medical Company - AlHaj"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/55eb6156-a89b-450d-aa14-33afd92e8db2",
            "resource": {
              "resourceType": "Organization",
              "id": "55eb6156-a89b-450d-aa14-33afd92e8db2",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/insurer-organization|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "ins"
                    }
                  ]
                }
              ],
              "name": "The Cooperative Company for Cooperative Insurance"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Coverage/94145221-0cb5-457a-bba6-d46f1eb90a88",
            "resource": {
              "resourceType": "Coverage",
              "id": "94145221-0cb5-457a-bba6-d46f1eb90a88",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "002298724200001"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/714df942-8ccb-43fd-bce4-2f36296c8770"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/a49500ee-7e83-4f57-aa06-8f4c488f2a3e"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/36f16b6a-4c27-4b8b-ada5-d677598d396b"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/55eb6156-a89b-450d-aa14-33afd92e8db2"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "54157468",
                  "name": "IBLEC COMPANY"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/714df942-8ccb-43fd-bce4-2f36296c8770",
            "resource": {
              "resourceType": "Organization",
              "id": "714df942-8ccb-43fd-bce4-2f36296c8770",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/policyholder-organization|1.0.0"
                ]
              },
              "active": true,
              "name": "Policy Holder"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/a49500ee-7e83-4f57-aa06-8f4c488f2a3e",
            "resource": {
              "resourceType": "Patient",
              "id": "a49500ee-7e83-4f57-aa06-8f4c488f2a3e",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "https://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-nationality",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "https://nphies.sa/terminology/CodeSystem/nationality",
                        "code": "PAK"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-religion",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/religion",
                        "code": "0",
                        "display": "other"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others",
                        "display": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "PRC",
                        "display": "iqama"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/iqama",
                  "value": "2298724200"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "JAMAL ABDULSABOUR ahmed abdulaal",
                  "given": [
                    "JAMAL",
                    "ahmed",
                    "abdulaal"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0547271635"
                }
              ],
              "gender": "male",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "male",
                          "display": "male"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "1989-06-11",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/60b8f38e-5b39-4824-9d51-16f2bd05a3c4",
      "resource": {
        "resourceType": "Bundle",
        "id": "60b8f38e-5b39-4824-9d51-16f2bd05a3c4",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:14.372+03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/260a4221-799b-4809-b8a1-df719de5bc21",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "260a4221-799b-4809-b8a1-df719de5bc21",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/message-header|1.0.0"
                ]
              },
              "eventCoding": {
                "system": "http://nphies.sa/terminology/CodeSystem/ksa-message-events",
                "code": "claim-response"
              },
              "destination": [
                {
                  "endpoint": "http://www.ALKholood.com",
                  "receiver": {
                    "type": "Organization",
                    "identifier": {
                      "system": "http://nphies.sa/license/provider-license",
                      "value": "10000300062591"
                    }
                  }
                }
              ],
              "sender": {
                "type": "Organization",
                "identifier": {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              },
              "source": {
                "endpoint": "https://tawuniya.com.sa"
              },
              "response": {
                "identifier": "3b458a1c-9e93-46ab-80dc-cac73a00de15",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/2eb9e07b-1387-42e7-9704-b275dd315985"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/2eb9e07b-1387-42e7-9704-b275dd315985",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "2eb9e07b-1387-42e7-9704-b275dd315985",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/prior-auth-response|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                        "code": "partial"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-reissue",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/reissue-reason",
                        "code": "adjudication"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-batch-identifier",
                  "valueIdentifier": {
                    "system": "http://www.ALKholood.com/episode",
                    "value": "2530"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "2eb9e07b-1387-42e7-9704-b275dd315985"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/claim-type",
                    "code": "pharmacy"
                  }
                ]
              },
              "subType": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/claim-subtype",
                    "code": "op"
                  }
                ]
              },
              "use": "claim",
              "patient": {
                "reference": "https://tawuniya.com.sa/Patient/a263fd1d-e634-45f9-a326-79e5be6b5a6a"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/6ea1f032-183f-43d5-8145-71970717b516"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/61f8fa07-81f7-49b8-9d14-d1fa65a99662"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "12290552260929"
                }
              },
              "outcome": "complete",
              "disposition": "-",
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "rejected"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "102121"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "reason": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-reason",
                            "code": "CV-4-5"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 40.14,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.03,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 40.14,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 0
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "102121"
                      }
                    }
                  ],
                  "itemSequence": 2,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 4.54,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0.91,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 4.54,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 3.63,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "rejected"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "102121"
                      }
                    }
                  ],
                  "itemSequence": 3,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 18.54,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "reason": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-reason",
                            "code": "CV-4-5"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 3.71,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 18.54,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 0
                    }
                  ]
                }
              ],
              "total": [
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "submitted"
                      }
                    ]
                  },
                  "amount": {
                    "value": 63.22,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 3.63,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "deductible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "copay"
                      }
                    ]
                  },
                  "amount": {
                    "value": 12.65,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 63.22,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "tax"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                }
              ],
              "insurance": [
                {
                  "sequence": 1,
                  "focal": true,
                  "coverage": {
                    "reference": "https://tawuniya.com.sa/Coverage/70f34aa7-d887-4776-94ec-763a9c57d89e"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/a263fd1d-e634-45f9-a326-79e5be6b5a6a",
            "resource": {
              "resourceType": "Patient",
              "id": "a263fd1d-e634-45f9-a326-79e5be6b5a6a",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "NI",
                        "display": "National ID"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/nationalid",
                  "value": "1095176176"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "SHUROOQ  muhammad ALHARBI",
                  "given": [
                    "SHUROOQ",
                    "muhammad",
                    "ALHARBI"
                  ]
                }
              ],
              "gender": "female",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "female",
                          "display": "female"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "1995-08-10",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/61f8fa07-81f7-49b8-9d14-d1fa65a99662",
            "resource": {
              "resourceType": "Organization",
              "id": "61f8fa07-81f7-49b8-9d14-d1fa65a99662",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-provider-type",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/provider-type",
                        "code": "5",
                        "display": "Clinic"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "system": "http://nphies.sa/license/provider-license",
                  "value": "10000300062591"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "prov"
                    }
                  ]
                }
              ],
              "name": "Al-Kholood Medical Company - AlHaj"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/6ea1f032-183f-43d5-8145-71970717b516",
            "resource": {
              "resourceType": "Organization",
              "id": "6ea1f032-183f-43d5-8145-71970717b516",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/insurer-organization|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "ins"
                    }
                  ]
                }
              ],
              "name": "The Cooperative Company for Cooperative Insurance"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Coverage/70f34aa7-d887-4776-94ec-763a9c57d89e",
            "resource": {
              "resourceType": "Coverage",
              "id": "70f34aa7-d887-4776-94ec-763a9c57d89e",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "001005343650101"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/346b2a60-812b-494b-b3ff-7189d7608681"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/d2052e97-bda0-40f1-984d-db07d1e15385"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/a263fd1d-e634-45f9-a326-79e5be6b5a6a"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/6ea1f032-183f-43d5-8145-71970717b516"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "58173461",
                  "name": "SAAD SAEED D ALSAEDI CONTRACTING EST"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/346b2a60-812b-494b-b3ff-7189d7608681",
            "resource": {
              "resourceType": "Organization",
              "id": "346b2a60-812b-494b-b3ff-7189d7608681",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/policyholder-organization|1.0.0"
                ]
              },
              "active": true,
              "name": "Policy Holder"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/d2052e97-bda0-40f1-984d-db07d1e15385",
            "resource": {
              "resourceType": "Patient",
              "id": "d2052e97-bda0-40f1-984d-db07d1e15385",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "https://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-nationality",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "https://nphies.sa/terminology/CodeSystem/nationality",
                        "code": "PAK"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-religion",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/religion",
                        "code": "0",
                        "display": "other"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others",
                        "display": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "NI",
                        "display": "National ID"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/nationalid",
                  "value": "1095176176"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "SHUROOQ  muhammad ALHARBI",
                  "given": [
                    "SHUROOQ",
                    "muhammad",
                    "ALHARBI"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0560956107"
                }
              ],
              "gender": "female",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "female",
                          "display": "female"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "1995-08-10",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/0a4c26a5-1eb9-45d3-a564-5c007fbc01f1",
      "resource": {
        "resourceType": "Bundle",
        "id": "0a4c26a5-1eb9-45d3-a564-5c007fbc01f1",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:14.288+03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/2453272d-9d48-478a-8d7f-a9b08cbd4bd7",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "2453272d-9d48-478a-8d7f-a9b08cbd4bd7",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/message-header|1.0.0"
                ]
              },
              "eventCoding": {
                "system": "http://nphies.sa/terminology/CodeSystem/ksa-message-events",
                "code": "claim-response"
              },
              "destination": [
                {
                  "endpoint": "http://www.ALKholood.com",
                  "receiver": {
                    "type": "Organization",
                    "identifier": {
                      "system": "http://nphies.sa/license/provider-license",
                      "value": "10000300062591"
                    }
                  }
                }
              ],
              "sender": {
                "type": "Organization",
                "identifier": {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              },
              "source": {
                "endpoint": "https://tawuniya.com.sa"
              },
              "response": {
                "identifier": "fdcb013d-b9ed-40b6-a002-58db85763193",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/fdb38206-deb9-434b-962f-0ed25b9ec21c"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/fdb38206-deb9-434b-962f-0ed25b9ec21c",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "fdb38206-deb9-434b-962f-0ed25b9ec21c",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/prior-auth-response|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                        "code": "partial"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-reissue",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/reissue-reason",
                        "code": "adjudication"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-batch-identifier",
                  "valueIdentifier": {
                    "system": "http://www.ALKholood.com/episode",
                    "value": "2619"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "fdb38206-deb9-434b-962f-0ed25b9ec21c"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/claim-type",
                    "code": "pharmacy"
                  }
                ]
              },
              "subType": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/claim-subtype",
                    "code": "op"
                  }
                ]
              },
              "use": "claim",
              "patient": {
                "reference": "https://tawuniya.com.sa/Patient/3e390abe-69b4-47ed-9e1d-7d1b74a71d4c"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/e81fa491-ab0a-4c33-8c77-02fee9553a3d"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/5b025547-8840-452d-a556-3b1851504158"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "47293080260930"
                }
              },
              "outcome": "complete",
              "disposition": "-",
              "item": [
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "rejected"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "102961"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "reason": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-reason",
                            "code": "CV-4-5"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 31.5,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.3,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 31.5,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 0
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "102961"
                      }
                    }
                  ],
                  "itemSequence": 2,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.43,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 1.29,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.43,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 5.14,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                },
                {
                  "extension": [
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-adjudication-outcome",
                      "valueCodeableConcept": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-outcome",
                            "code": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "102961"
                      }
                    }
                  ],
                  "itemSequence": 3,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 52.02,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 41.62,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 10.4,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 52.02,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/ksa-adjudication",
                            "code": "approved-quantity"
                          }
                        ]
                      },
                      "value": 1
                    }
                  ]
                }
              ],
              "total": [
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "submitted"
                      }
                    ]
                  },
                  "amount": {
                    "value": 89.95,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 46.76,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "deductible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "copay"
                      }
                    ]
                  },
                  "amount": {
                    "value": 17.99,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 89.95,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "tax"
                      }
                    ]
                  },
                  "amount": {
                    "value": 0,
                    "currency": "SAR"
                  }
                }
              ],
              "insurance": [
                {
                  "sequence": 1,
                  "focal": true,
                  "coverage": {
                    "reference": "https://tawuniya.com.sa/Coverage/a8cae395-640d-443b-afb1-672e731cdf11"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/3e390abe-69b4-47ed-9e1d-7d1b74a71d4c",
            "resource": {
              "resourceType": "Patient",
              "id": "3e390abe-69b4-47ed-9e1d-7d1b74a71d4c",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "NI",
                        "display": "National ID"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/nationalid",
                  "value": "1127653127"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "abdulaziz muhammad  FAKRANY",
                  "given": [
                    "abdulaziz",
                    "FAKRANY",
                    "FAKRANY"
                  ]
                }
              ],
              "gender": "male",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "male",
                          "display": "male"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "2005-01-23",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/5b025547-8840-452d-a556-3b1851504158",
            "resource": {
              "resourceType": "Organization",
              "id": "5b025547-8840-452d-a556-3b1851504158",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-provider-type",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/provider-type",
                        "code": "5",
                        "display": "Clinic"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "system": "http://nphies.sa/license/provider-license",
                  "value": "10000300062591"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "prov"
                    }
                  ]
                }
              ],
              "name": "Al-Kholood Medical Company - AlHaj"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/e81fa491-ab0a-4c33-8c77-02fee9553a3d",
            "resource": {
              "resourceType": "Organization",
              "id": "e81fa491-ab0a-4c33-8c77-02fee9553a3d",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/insurer-organization|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "http://nphies.sa/license/payer-license",
                  "value": "7000911508"
                }
              ],
              "active": true,
              "type": [
                {
                  "coding": [
                    {
                      "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                      "code": "ins"
                    }
                  ]
                }
              ],
              "name": "The Cooperative Company for Cooperative Insurance"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Coverage/a8cae395-640d-443b-afb1-672e731cdf11",
            "resource": {
              "resourceType": "Coverage",
              "id": "a8cae395-640d-443b-afb1-672e731cdf11",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "001127653127001"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/ca9954fb-3867-469c-995b-829e9af5c5bd"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/abcc47ed-4309-4a47-8e00-26c26719d50a"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/3e390abe-69b4-47ed-9e1d-7d1b74a71d4c"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/e81fa491-ab0a-4c33-8c77-02fee9553a3d"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "55244266",
                  "name": "Al Qafelah company   Basic B"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/ca9954fb-3867-469c-995b-829e9af5c5bd",
            "resource": {
              "resourceType": "Organization",
              "id": "ca9954fb-3867-469c-995b-829e9af5c5bd",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/policyholder-organization|1.0.0"
                ]
              },
              "active": true,
              "name": "Policy Holder"
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/abcc47ed-4309-4a47-8e00-26c26719d50a",
            "resource": {
              "resourceType": "Patient",
              "id": "abcc47ed-4309-4a47-8e00-26c26719d50a",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/patient|1.0.0"
                ]
              },
              "extension": [
                {
                  "url": "https://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-nationality",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "https://nphies.sa/terminology/CodeSystem/nationality",
                        "code": "PAK"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patient-religion",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/religion",
                        "code": "0",
                        "display": "other"
                      }
                    ]
                  }
                },
                {
                  "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-occupation",
                  "valueCodeableConcept": {
                    "coding": [
                      {
                        "system": "http://nphies.sa/terminology/CodeSystem/occupation",
                        "code": "others",
                        "display": "others"
                      }
                    ]
                  }
                }
              ],
              "identifier": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
                        "code": "NI",
                        "display": "National ID"
                      }
                    ]
                  },
                  "system": "http://nphies.sa/identifier/nationalid",
                  "value": "1127653127"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "abdulaziz muhammad  FAKRANY",
                  "given": [
                    "abdulaziz",
                    "FAKRANY",
                    "FAKRANY"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0549603233"
                }
              ],
              "gender": "male",
              "_gender": {
                "extension": [
                  {
                    "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-ksa-administrative-gender",
                    "valueCodeableConcept": {
                      "coding": [
                        {
                          "system": "http://nphies.sa/terminology/CodeSystem/ksa-administrative-gender",
                          "code": "male",
                          "display": "male"
                        }
                      ]
                    }
                  }
                ]
              },
              "birthDate": "2005-01-23",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://www.ALKholood.com/Organization/9",
      "resource": {
        "resourceType": "Organization",
        "id": "9",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/provider-organization|1.0.0"
          ]
        },
        "extension": [
          {
            "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-provider-type",
            "valueCodeableConcept": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/CodeSystem/provider-type",
                  "code": "5",
                  "display": "Clinic"
                }
              ]
            }
          }
        ],
        "identifier": [
          {
            "use": "official",
            "system": "http://nphies.sa/license/provider-license",
            "value": "10000300062591"
          }
        ],
        "active": true,
        "type": [
          {
            "coding": [
              {
                "system": "http://nphies.sa/terminology/CodeSystem/organization-type",
                "code": "prov"
              }
            ]
          }
        ],
        "name": "Al-Kholood Medical Company - AlHaj"
      }
    }
  ]
}