Error Al-Kholood Medical Company - AlHaj claim-response

All traces
Trace
8c824d50-2eb6-40de-b5a9-515f78569b37
Started
2026-10-31 14:18:39.552 +03:00
Branch
Al-Kholood Medical Company - AlHaj (9)
Mode
Middleware
Service URL
https://nphies.careofme.net/api/v1/nphies/send
HTTP
200 in 2051 ms
Bundle / Request
b6fc005e-e51c-436a-a47a-bd3e5575fad4 / 462316
Parsed items
0
Total duration
2054 ms
Error
Cannot open database "NitcoSysLog" requested by the login. The login failed. Login failed for user 'NitcoWebcenter'.
Open raw Download 5,152 characters
{
  "resourceType": "Bundle",
  "id": "b6fc005e-e51c-436a-a47a-bd3e5575fad4",
  "meta": {
    "profile": [
      "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
    ]
  },
  "type": "message",
  "timestamp": "2026-10-31T14:18:39.55\u002B03:00",
  "entry": [
    {
      "fullUrl": "urn:uuid:9ff6a065-1649-4dc9-b412-faa7364aab30",
      "resource": {
        "resourceType": "MessageHeader",
        "id": "9ff6a065-1649-4dc9-b412-faa7364aab30",
        "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": "poll-request"
        },
        "destination": [
          {
            "endpoint": "http://nphies.sa",
            "receiver": {
              "type": "Organization",
              "identifier": {
                "system": "http://nphies.sa/license/nphies",
                "value": "NPHIES"
              }
            }
          }
        ],
        "sender": {
          "type": "Organization",
          "identifier": {
            "system": "http://nphies.sa/license/provider-license",
            "value": "10000300062591"
          }
        },
        "source": {
          "endpoint": "http://nphies.sa/license/provider-license/10000300062591"
        },
        "focus": [
          {
            "reference": "http://www.ALKholood.com/Task/462316"
          }
        ]
      }
    },
    {
      "fullUrl": "http://www.ALKholood.com/Task/462316",
      "resource": {
        "resourceType": "Task",
        "id": "462316",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/task|1.0.0"
          ]
        },
        "identifier": [
          {
            "use": "official",
            "system": "http://www.ALKholood.com/Task",
            "value": "PlReq_920261031141839"
          }
        ],
        "status": "requested",
        "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\u002B03:00",
              "end": "2026-10-31T23:59:59.999\u002B03:00"
            }
          },
          {
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/CodeSystem/task-input-type",
                  "code": "count"
                }
              ]
            },
            "valuePositiveInt": 10
          }
        ]
      }
    },
    {
      "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"
      }
    }
  ]
}

The middleware wrapper exactly as posted. MessageBody is elided because it is only base64 of the FHIR bundle on the Request tab.

Open raw Download 271 characters
{
  "Credentials": {
    "user": "TEMP-NNIC-PROV",
    "password": "TEMP-NNIC-PROV",
    "providerno": "10000300062591"
  },
  "MessageBody": "\u003Cbase64 of the FHIR bundle omitted \u2014 3840 chars\u003E",
  "BundleID": "b6fc005e-e51c-436a-a47a-bd3e5575fad4"
}
Open raw Download 377,738 characters
{
  "resourceType": "Bundle",
  "id": "0766aa8b-80f7-4659-ad3e-ec5f8821e5ae",
  "meta": {
    "profile": [
      "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
    ]
  },
  "type": "message",
  "timestamp": "2026-10-31T14:18:40.831\u002B03:00",
  "entry": [
    {
      "fullUrl": "http://nphies.sa/MessageHeader/e61943cd-d781-4846-ab95-c79c80c3e3b8",
      "resource": {
        "resourceType": "MessageHeader",
        "id": "e61943cd-d781-4846-ab95-c79c80c3e3b8",
        "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": "9ff6a065-1649-4dc9-b412-faa7364aab30",
          "code": "ok"
        }
      }
    },
    {
      "fullUrl": "http://nphies.sa/Task/6f9ad638-5621-4039-a943-baf5ee22f3eb",
      "resource": {
        "resourceType": "Task",
        "id": "6f9ad638-5621-4039-a943-baf5ee22f3eb",
        "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": "132"
          }
        ],
        "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\u002B03:00",
              "end": "2026-10-31T23:59:59.999\u002B03:00"
            }
          },
          {
            "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": "2026-10-20T08:55:18.583\u002B00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/7f576ffe-ede6-4fc4-a0a1-16a5448950fb"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:18.600\u002B00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/db7d18db-e29a-4c7c-8e5d-0256aacd0504"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:18.604\u002B00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/e939f22b-8ce5-4a6c-8b70-8ede76a4218f"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:18.638\u002B00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/a4d95476-c908-4d4a-82c7-e2caa69ad3bf"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:18.660\u002B00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/864c7377-b190-4175-9f92-5db0e1774934"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:18.694\u002B00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/9d018d63-7cab-46b3-b89b-b2ed66998c87"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:18.714\u002B00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/4aa3798d-2e8c-4ea3-a19b-9f01035fdff4"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:18.741\u002B00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/c255c892-c354-42e3-a176-da3819489f0e"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:18.768\u002B00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/1637ee84-ddc7-490b-986c-00d64b8440cb"
            }
          },
          {
            "extension": [
              {
                "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-timestamp",
                "valueDateTime": "2026-10-20T08:55:18.824\u002B00:00"
              }
            ],
            "type": {
              "coding": [
                {
                  "system": "http://nphies.sa/terminology/ValueSet/task-output-type",
                  "code": "response"
                }
              ]
            },
            "valueReference": {
              "reference": "http://nphies.sa/Bundle/24cd46fb-cf26-48e6-8b17-79ff7f8421a9"
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/7f576ffe-ede6-4fc4-a0a1-16a5448950fb",
      "resource": {
        "resourceType": "Bundle",
        "id": "7f576ffe-ede6-4fc4-a0a1-16a5448950fb",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:18.212\u002B03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/3fa0fbf4-4421-43ee-8406-8c8f90f4b019",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "3fa0fbf4-4421-43ee-8406-8c8f90f4b019",
              "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": "f5e16491-92c1-4e26-b55c-51d3ad3d5b7f",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/8fed1d6e-5d6e-47f2-8fc9-c03d750d6c2d"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/8fed1d6e-5d6e-47f2-8fc9-c03d750d6c2d",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "8fed1d6e-5d6e-47f2-8fc9-c03d750d6c2d",
              "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": "2693"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "8fed1d6e-5d6e-47f2-8fc9-c03d750d6c2d"
                }
              ],
              "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/e022b225-6a77-4a05-b12b-14b2953d86f8"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/867c660d-3a98-4809-98f7-2ccde8a80f8e"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/f75b17e3-ab76-4c4d-9cb6-cf4bfb71cbf8"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "32295462260930"
                }
              },
              "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": "103754"
                      }
                    }
                  ],
                  "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-4-1"
                          }
                        ]
                      },
                      "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": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "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": "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": "rejected"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "103754"
                      }
                    }
                  ],
                  "itemSequence": 2,
                  "adjudication": [
                    {
                      "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": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.15,
                        "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": "benefit"
                          }
                        ]
                      },
                      "reason": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-reason",
                            "code": "CV-4-1"
                          }
                        ]
                      },
                      "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": "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": "rejected"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "103754"
                      }
                    }
                  ],
                  "itemSequence": 3,
                  "adjudication": [
                    {
                      "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": "benefit"
                          }
                        ]
                      },
                      "reason": {
                        "coding": [
                          {
                            "system": "http://nphies.sa/terminology/CodeSystem/adjudication-reason",
                            "code": "CV-4-1"
                          }
                        ]
                      },
                      "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": 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
                    }
                  ]
                }
              ],
              "total": [
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "submitted"
                      }
                    ]
                  },
                  "amount": {
                    "value": 58.23,
                    "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": 11.5,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 58.23,
                    "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/8c06e013-d3dc-40c9-9009-58e19ae4e5ee"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/e022b225-6a77-4a05-b12b-14b2953d86f8",
            "resource": {
              "resourceType": "Patient",
              "id": "e022b225-6a77-4a05-b12b-14b2953d86f8",
              "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": "2511514487"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "anas  muhammad ALI",
                  "given": [
                    "anas",
                    "muhammad",
                    "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": "1987-01-01",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/f75b17e3-ab76-4c4d-9cb6-cf4bfb71cbf8",
            "resource": {
              "resourceType": "Organization",
              "id": "f75b17e3-ab76-4c4d-9cb6-cf4bfb71cbf8",
              "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/867c660d-3a98-4809-98f7-2ccde8a80f8e",
            "resource": {
              "resourceType": "Organization",
              "id": "867c660d-3a98-4809-98f7-2ccde8a80f8e",
              "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/8c06e013-d3dc-40c9-9009-58e19ae4e5ee",
            "resource": {
              "resourceType": "Coverage",
              "id": "8c06e013-d3dc-40c9-9009-58e19ae4e5ee",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "002511514487001"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/841874bd-576b-4f89-9d36-388ffb5488ad"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/f9a8ef28-c946-4c47-8683-94dce96348e3"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/e022b225-6a77-4a05-b12b-14b2953d86f8"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/867c660d-3a98-4809-98f7-2ccde8a80f8e"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "51128052",
                  "name": "Burj Al Takhfidat Tr   Basic B"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/841874bd-576b-4f89-9d36-388ffb5488ad",
            "resource": {
              "resourceType": "Organization",
              "id": "841874bd-576b-4f89-9d36-388ffb5488ad",
              "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/f9a8ef28-c946-4c47-8683-94dce96348e3",
            "resource": {
              "resourceType": "Patient",
              "id": "f9a8ef28-c946-4c47-8683-94dce96348e3",
              "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": "2511514487"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "anas  muhammad ALI",
                  "given": [
                    "anas",
                    "muhammad",
                    "ALI"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0500958198"
                }
              ],
              "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": "1987-01-01",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/db7d18db-e29a-4c7c-8e5d-0256aacd0504",
      "resource": {
        "resourceType": "Bundle",
        "id": "db7d18db-e29a-4c7c-8e5d-0256aacd0504",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:18.234\u002B03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/4ef9b0c9-05f5-4c25-96b4-7470ac11528e",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "4ef9b0c9-05f5-4c25-96b4-7470ac11528e",
              "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": "16e9939b-79b1-44aa-a94c-5ad23f3ff287",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/5cc8b84d-17d3-456c-ad67-80c5f179a67c"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/5cc8b84d-17d3-456c-ad67-80c5f179a67c",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "5cc8b84d-17d3-456c-ad67-80c5f179a67c",
              "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": "1421"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "5cc8b84d-17d3-456c-ad67-80c5f179a67c"
                }
              ],
              "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/231772e1-c15f-44c1-88e2-94b3f9bf556c"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/06753289-bc1a-4f18-add3-7b2f71b7553d"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/94361478-8e1c-4fc1-b886-0e9915111019"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "99259418260917"
                }
              },
              "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": "90445"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.24,
                        "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": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "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": "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": "90445"
                      }
                    }
                  ],
                  "itemSequence": 2,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 26.59,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 5.32,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 26.59,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 21.27,
                        "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": "90445"
                      }
                    }
                  ],
                  "itemSequence": 3,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.01,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.41,
                        "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": 1.6,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.01,
                        "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": 44.9,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 35.92,
                    "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": 8.98,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 44.9,
                    "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/95a1dc31-e7d7-4cd3-a026-d6f861d5906f"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/231772e1-c15f-44c1-88e2-94b3f9bf556c",
            "resource": {
              "resourceType": "Patient",
              "id": "231772e1-c15f-44c1-88e2-94b3f9bf556c",
              "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": "1211614977"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "KANAN BASEM ABDULAZIZ FLEMBAN",
                  "given": [
                    "KANAN",
                    "ABDULAZIZ",
                    "FLEMBAN"
                  ]
                }
              ],
              "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": "2023-09-23",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/94361478-8e1c-4fc1-b886-0e9915111019",
            "resource": {
              "resourceType": "Organization",
              "id": "94361478-8e1c-4fc1-b886-0e9915111019",
              "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/06753289-bc1a-4f18-add3-7b2f71b7553d",
            "resource": {
              "resourceType": "Organization",
              "id": "06753289-bc1a-4f18-add3-7b2f71b7553d",
              "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/95a1dc31-e7d7-4cd3-a026-d6f861d5906f",
            "resource": {
              "resourceType": "Coverage",
              "id": "95a1dc31-e7d7-4cd3-a026-d6f861d5906f",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "001079849327201"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/af50dfb9-62b6-4c90-8986-e570254b6ba8"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/c8131ed3-72f9-41a4-8f3f-f4984aaf0395"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/231772e1-c15f-44c1-88e2-94b3f9bf556c"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/06753289-bc1a-4f18-add3-7b2f71b7553d"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "53987020",
                  "name": "SAUDI BIN HAMOOD FOR TRADING"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/af50dfb9-62b6-4c90-8986-e570254b6ba8",
            "resource": {
              "resourceType": "Organization",
              "id": "af50dfb9-62b6-4c90-8986-e570254b6ba8",
              "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/c8131ed3-72f9-41a4-8f3f-f4984aaf0395",
            "resource": {
              "resourceType": "Patient",
              "id": "c8131ed3-72f9-41a4-8f3f-f4984aaf0395",
              "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": "1211614977"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "KANAN BASEM ABDULAZIZ FLEMBAN",
                  "given": [
                    "KANAN",
                    "ABDULAZIZ",
                    "FLEMBAN"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0562605468"
                }
              ],
              "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": "2023-09-23",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/e939f22b-8ce5-4a6c-8b70-8ede76a4218f",
      "resource": {
        "resourceType": "Bundle",
        "id": "e939f22b-8ce5-4a6c-8b70-8ede76a4218f",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:18.215\u002B03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/f1c9b7d4-b85a-4d62-af12-44f8d20e0394",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "f1c9b7d4-b85a-4d62-af12-44f8d20e0394",
              "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": "393dcf26-5822-4716-971f-4eb3ea22fccf",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/7bed6ac8-2d4d-4c11-8146-d746d23a6d2d"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/7bed6ac8-2d4d-4c11-8146-d746d23a6d2d",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "7bed6ac8-2d4d-4c11-8146-d746d23a6d2d",
              "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": "1484"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "7bed6ac8-2d4d-4c11-8146-d746d23a6d2d"
                }
              ],
              "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/652732fc-2a7c-4853-a35e-ca7c932d8fed"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/570e44b4-50dd-4d31-8f5f-c5b4abeda737"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/aa0b77c2-7329-4501-900c-c8c91d605b24"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "96261056260917"
                }
              },
              "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": "91012"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 22.5,
                        "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": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 22.5,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 18,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 4.5,
                        "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": "91012"
                      }
                    }
                  ],
                  "itemSequence": 2,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 1.12,
                        "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": 6.24,
                        "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": 6.24,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 4.46,
                        "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": "91012"
                      }
                    }
                  ],
                  "itemSequence": 3,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 18.65,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 18.65,
                        "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": 0.75,
                        "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": "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": "91012"
                      }
                    }
                  ],
                  "itemSequence": 4,
                  "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": 10.1,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 2.02,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 10.1,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.08,
                        "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": "91012"
                      }
                    }
                  ],
                  "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": "eligible"
                          }
                        ]
                      },
                      "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": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 11.11,
                        "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": "deductible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "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": 68.6,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 30.54,
                    "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": 10.61,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 68.6,
                    "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/d49a5b9d-23ef-4d34-9317-751a4c970d80"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/652732fc-2a7c-4853-a35e-ca7c932d8fed",
            "resource": {
              "resourceType": "Patient",
              "id": "652732fc-2a7c-4853-a35e-ca7c932d8fed",
              "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": "2144947682"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "ABRAHEM  madu OTHMAN",
                  "given": [
                    "ABRAHEM",
                    "madu",
                    "OTHMAN"
                  ]
                }
              ],
              "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": "1997-01-01",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/aa0b77c2-7329-4501-900c-c8c91d605b24",
            "resource": {
              "resourceType": "Organization",
              "id": "aa0b77c2-7329-4501-900c-c8c91d605b24",
              "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/570e44b4-50dd-4d31-8f5f-c5b4abeda737",
            "resource": {
              "resourceType": "Organization",
              "id": "570e44b4-50dd-4d31-8f5f-c5b4abeda737",
              "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/d49a5b9d-23ef-4d34-9317-751a4c970d80",
            "resource": {
              "resourceType": "Coverage",
              "id": "d49a5b9d-23ef-4d34-9317-751a4c970d80",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "002144947682001"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/54774742-c665-4077-89f4-4f706eac418d"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/f2967505-48ff-4a8f-9e72-cba54b9c7f79"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/652732fc-2a7c-4853-a35e-ca7c932d8fed"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/570e44b4-50dd-4d31-8f5f-c5b4abeda737"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "52106777",
                  "name": "Horizon Pioneers Com   Basic B"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/54774742-c665-4077-89f4-4f706eac418d",
            "resource": {
              "resourceType": "Organization",
              "id": "54774742-c665-4077-89f4-4f706eac418d",
              "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/f2967505-48ff-4a8f-9e72-cba54b9c7f79",
            "resource": {
              "resourceType": "Patient",
              "id": "f2967505-48ff-4a8f-9e72-cba54b9c7f79",
              "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": "2144947682"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "ABRAHEM  madu OTHMAN",
                  "given": [
                    "ABRAHEM",
                    "madu",
                    "OTHMAN"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0537769237"
                }
              ],
              "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": "1997-01-01",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/a4d95476-c908-4d4a-82c7-e2caa69ad3bf",
      "resource": {
        "resourceType": "Bundle",
        "id": "a4d95476-c908-4d4a-82c7-e2caa69ad3bf",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:18.167\u002B03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/a0f3a630-15dd-4148-85eb-2f9a077668de",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "a0f3a630-15dd-4148-85eb-2f9a077668de",
              "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": "079735d9-9f3e-4b46-918b-33006ae44513",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/fab36500-c76d-4844-a35a-d2ca0ef882ec"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/fab36500-c76d-4844-a35a-d2ca0ef882ec",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "fab36500-c76d-4844-a35a-d2ca0ef882ec",
              "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": "1585"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "fab36500-c76d-4844-a35a-d2ca0ef882ec"
                }
              ],
              "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/df5d288c-a423-4f8b-9c96-6a8349b42c8a"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/2c9876aa-09e6-4357-8c2f-03fe27bc3fdc"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/2c09b47f-009e-4e1a-9e13-cb5a32080edf"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "28263809260919"
                }
              },
              "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": "92156"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 32.11,
                        "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": "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://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.03,
                        "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": "92156"
                      }
                    }
                  ],
                  "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": 6.55,
                        "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": 1
                    }
                  ]
                }
              ],
              "total": [
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "submitted"
                      }
                    ]
                  },
                  "amount": {
                    "value": 48.33,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 38.66,
                    "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": 9.67,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 48.33,
                    "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/04cddbfe-af4a-40e1-9027-8fc24af8f51e"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/df5d288c-a423-4f8b-9c96-6a8349b42c8a",
            "resource": {
              "resourceType": "Patient",
              "id": "df5d288c-a423-4f8b-9c96-6a8349b42c8a",
              "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": "2215483138"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "hemdan abdelmonem abdelmonem abdelmonem",
                  "given": [
                    "hemdan",
                    "abdelmonem",
                    "abdelmonem"
                  ]
                }
              ],
              "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": "2005-03-25",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/2c09b47f-009e-4e1a-9e13-cb5a32080edf",
            "resource": {
              "resourceType": "Organization",
              "id": "2c09b47f-009e-4e1a-9e13-cb5a32080edf",
              "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/2c9876aa-09e6-4357-8c2f-03fe27bc3fdc",
            "resource": {
              "resourceType": "Organization",
              "id": "2c9876aa-09e6-4357-8c2f-03fe27bc3fdc",
              "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/04cddbfe-af4a-40e1-9027-8fc24af8f51e",
            "resource": {
              "resourceType": "Coverage",
              "id": "04cddbfe-af4a-40e1-9027-8fc24af8f51e",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "002215483138001"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/de93742d-4fc0-4cee-982f-8fe8a18314c0"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/42a9c4ad-d300-4503-8918-6f3b688fd12b"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/df5d288c-a423-4f8b-9c96-6a8349b42c8a"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/2c9876aa-09e6-4357-8c2f-03fe27bc3fdc"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "55236616",
                  "name": "RADISSON HOTEL THAKHER"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/de93742d-4fc0-4cee-982f-8fe8a18314c0",
            "resource": {
              "resourceType": "Organization",
              "id": "de93742d-4fc0-4cee-982f-8fe8a18314c0",
              "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/42a9c4ad-d300-4503-8918-6f3b688fd12b",
            "resource": {
              "resourceType": "Patient",
              "id": "42a9c4ad-d300-4503-8918-6f3b688fd12b",
              "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": "2215483138"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "hemdan abdelmonem abdelmonem abdelmonem",
                  "given": [
                    "hemdan",
                    "abdelmonem",
                    "abdelmonem"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0550662977"
                }
              ],
              "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": "2005-03-25",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/864c7377-b190-4175-9f92-5db0e1774934",
      "resource": {
        "resourceType": "Bundle",
        "id": "864c7377-b190-4175-9f92-5db0e1774934",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:17.791\u002B03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/03266a6f-3650-4bc7-968f-9694e0e2ca96",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "03266a6f-3650-4bc7-968f-9694e0e2ca96",
              "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": "cc25d260-073f-4a2e-83c1-69743762eb5d",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/2c488a87-7bd4-4b5e-8cf4-205e71e45e11"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/2c488a87-7bd4-4b5e-8cf4-205e71e45e11",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "2c488a87-7bd4-4b5e-8cf4-205e71e45e11",
              "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": "1233"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "2c488a87-7bd4-4b5e-8cf4-205e71e45e11"
                }
              ],
              "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/bbd6fa52-38c9-4404-9cf4-7a4d7cf47487"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/f4286091-d5ca-4c1e-ab79-4d1abe74d6a2"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/feece510-49c9-4abb-9bed-0e78ccac62a4"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "90253974260915"
                }
              },
              "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": "88421"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 46.15,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 57.69,
                        "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": 57.69,
                        "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": 11.54,
                        "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": "88421"
                      }
                    }
                  ],
                  "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": 64.71,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 51.77,
                    "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": "copay"
                      }
                    ]
                  },
                  "amount": {
                    "value": 12.94,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 64.71,
                    "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/7c6d8ef9-c546-4eb4-925d-ff826cacfc02"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/bbd6fa52-38c9-4404-9cf4-7a4d7cf47487",
            "resource": {
              "resourceType": "Patient",
              "id": "bbd6fa52-38c9-4404-9cf4-7a4d7cf47487",
              "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": "1138958424"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "SAOUD  ahmed ALSUAYRI",
                  "given": [
                    "SAOUD",
                    "ahmed",
                    "ALSUAYRI"
                  ]
                }
              ],
              "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": "2006-11-19",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/feece510-49c9-4abb-9bed-0e78ccac62a4",
            "resource": {
              "resourceType": "Organization",
              "id": "feece510-49c9-4abb-9bed-0e78ccac62a4",
              "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/f4286091-d5ca-4c1e-ab79-4d1abe74d6a2",
            "resource": {
              "resourceType": "Organization",
              "id": "f4286091-d5ca-4c1e-ab79-4d1abe74d6a2",
              "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/7c6d8ef9-c546-4eb4-925d-ff826cacfc02",
            "resource": {
              "resourceType": "Coverage",
              "id": "7c6d8ef9-c546-4eb4-925d-ff826cacfc02",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "001073320168211"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/444da7c7-a784-4bfd-ae8c-d9063553fb53"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/75d462b6-c2eb-4fef-9956-174022a85490"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/bbd6fa52-38c9-4404-9cf4-7a4d7cf47487"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/f4286091-d5ca-4c1e-ab79-4d1abe74d6a2"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "51913450",
                  "name": "Masag For Gold and Jewerly Company"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/444da7c7-a784-4bfd-ae8c-d9063553fb53",
            "resource": {
              "resourceType": "Organization",
              "id": "444da7c7-a784-4bfd-ae8c-d9063553fb53",
              "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/75d462b6-c2eb-4fef-9956-174022a85490",
            "resource": {
              "resourceType": "Patient",
              "id": "75d462b6-c2eb-4fef-9956-174022a85490",
              "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": "1138958424"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "SAOUD  ahmed ALSUAYRI",
                  "given": [
                    "SAOUD",
                    "ahmed",
                    "ALSUAYRI"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0555563286"
                }
              ],
              "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": "2006-11-19",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/9d018d63-7cab-46b3-b89b-b2ed66998c87",
      "resource": {
        "resourceType": "Bundle",
        "id": "9d018d63-7cab-46b3-b89b-b2ed66998c87",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:18.160\u002B03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/7453d3b3-7f31-46e9-a1d1-613de6c91d39",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "7453d3b3-7f31-46e9-a1d1-613de6c91d39",
              "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": "79e729db-df78-4767-b18f-1e64bed37900",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/62ec5e99-db29-4802-b767-195796502283"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/62ec5e99-db29-4802-b767-195796502283",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "62ec5e99-db29-4802-b767-195796502283",
              "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": "2116"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "62ec5e99-db29-4802-b767-195796502283"
                }
              ],
              "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/9afcf3f8-ef65-4f08-9233-cc24266f37bd"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/4850c0cc-b4f6-4227-9a63-4423ca1b6b43"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/6e251f37-5094-4884-89d4-16dffb85e177"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "47278250260924"
                }
              },
              "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": "97677"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "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": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.37,
                        "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": 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://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": "97677"
                      }
                    }
                  ],
                  "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": 6.35,
                        "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": 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": "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": "97677"
                      }
                    }
                  ],
                  "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": 2.4,
                        "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": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 12.01,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 9.61,
                        "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": "97677"
                      }
                    }
                  ],
                  "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": "approved"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "97677"
                      }
                    }
                  ],
                  "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"
                          }
                        ]
                      },
                      "amount": {
                        "value": 4.95,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 7.42,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 1.49,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 7.42,
                        "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": "97677"
                      }
                    }
                  ],
                  "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": 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": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 40.77,
                        "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": "rejected"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "97677"
                      }
                    }
                  ],
                  "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": 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": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 11.11,
                        "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": "tax"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0,
                        "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": 118.7,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 51.94,
                    "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": 23.59,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 118.7,
                    "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/c26e6310-9a58-4763-b782-e651009fc45c"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/9afcf3f8-ef65-4f08-9233-cc24266f37bd",
            "resource": {
              "resourceType": "Patient",
              "id": "9afcf3f8-ef65-4f08-9233-cc24266f37bd",
              "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": "2501449686"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "alian ALAA SALEM QASSEM",
                  "given": [
                    "alian",
                    "SALEM",
                    "QASSEM"
                  ]
                }
              ],
              "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": "2021-07-31",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/6e251f37-5094-4884-89d4-16dffb85e177",
            "resource": {
              "resourceType": "Organization",
              "id": "6e251f37-5094-4884-89d4-16dffb85e177",
              "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/4850c0cc-b4f6-4227-9a63-4423ca1b6b43",
            "resource": {
              "resourceType": "Organization",
              "id": "4850c0cc-b4f6-4227-9a63-4423ca1b6b43",
              "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/c26e6310-9a58-4763-b782-e651009fc45c",
            "resource": {
              "resourceType": "Coverage",
              "id": "c26e6310-9a58-4763-b782-e651009fc45c",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "002052496680231"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/2c38fd98-32a1-4502-b431-ef62a35c2166"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/fe9bb8d4-9f0f-424d-b178-602ba3a145df"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/9afcf3f8-ef65-4f08-9233-cc24266f37bd"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/4850c0cc-b4f6-4227-9a63-4423ca1b6b43"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "53623116",
                  "name": "Arabian Paths Tradin   Basic B"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/2c38fd98-32a1-4502-b431-ef62a35c2166",
            "resource": {
              "resourceType": "Organization",
              "id": "2c38fd98-32a1-4502-b431-ef62a35c2166",
              "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/fe9bb8d4-9f0f-424d-b178-602ba3a145df",
            "resource": {
              "resourceType": "Patient",
              "id": "fe9bb8d4-9f0f-424d-b178-602ba3a145df",
              "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": "2501449686"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "alian ALAA SALEM QASSEM",
                  "given": [
                    "alian",
                    "SALEM",
                    "QASSEM"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0545955031"
                }
              ],
              "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": "2021-07-31",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/4aa3798d-2e8c-4ea3-a19b-9f01035fdff4",
      "resource": {
        "resourceType": "Bundle",
        "id": "4aa3798d-2e8c-4ea3-a19b-9f01035fdff4",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:18.405\u002B03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/e9225398-b21d-4673-ac17-56f88589c66d",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "e9225398-b21d-4673-ac17-56f88589c66d",
              "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": "f8d70ece-2953-4358-a756-e9b203d9e61f",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/544bde53-e6e8-4da6-9cff-ed1fe45b3f7d"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/544bde53-e6e8-4da6-9cff-ed1fe45b3f7d",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "544bde53-e6e8-4da6-9cff-ed1fe45b3f7d",
              "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": "2188"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "544bde53-e6e8-4da6-9cff-ed1fe45b3f7d"
                }
              ],
              "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/2d108fea-df41-46a4-b3e4-fc814baad796"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/e71f55f7-0ba6-43ad-838a-50f98631590a"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/129f17c5-7a31-4e80-80bb-5dbf2d60372c"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "92280121260926"
                }
              },
              "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": "98637"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 57.69,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 11.54,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 46.15,
                        "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": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 57.69,
                        "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": 57.69,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 46.15,
                    "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": 11.54,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 57.69,
                    "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/c1cc7de4-7216-4a24-bedc-7eb3063917a5"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/2d108fea-df41-46a4-b3e4-fc814baad796",
            "resource": {
              "resourceType": "Patient",
              "id": "2d108fea-df41-46a4-b3e4-fc814baad796",
              "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": "2199518776"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "DAWOOD  muhammad muhammad",
                  "given": [
                    "DAWOOD",
                    "muhammad",
                    "muhammad"
                  ]
                }
              ],
              "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": "2002-10-09",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/129f17c5-7a31-4e80-80bb-5dbf2d60372c",
            "resource": {
              "resourceType": "Organization",
              "id": "129f17c5-7a31-4e80-80bb-5dbf2d60372c",
              "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/e71f55f7-0ba6-43ad-838a-50f98631590a",
            "resource": {
              "resourceType": "Organization",
              "id": "e71f55f7-0ba6-43ad-838a-50f98631590a",
              "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/c1cc7de4-7216-4a24-bedc-7eb3063917a5",
            "resource": {
              "resourceType": "Coverage",
              "id": "c1cc7de4-7216-4a24-bedc-7eb3063917a5",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "002030078600201"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/ffa15660-2c40-425a-b2f9-0b89bc0851cd"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/dae743ac-c99e-4aba-a417-28ecd0a3da0a"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/2d108fea-df41-46a4-b3e4-fc814baad796"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/e71f55f7-0ba6-43ad-838a-50f98631590a"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "54456186",
                  "name": "BINDAWOOD SUPER STORES  TRADIR"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/ffa15660-2c40-425a-b2f9-0b89bc0851cd",
            "resource": {
              "resourceType": "Organization",
              "id": "ffa15660-2c40-425a-b2f9-0b89bc0851cd",
              "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/dae743ac-c99e-4aba-a417-28ecd0a3da0a",
            "resource": {
              "resourceType": "Patient",
              "id": "dae743ac-c99e-4aba-a417-28ecd0a3da0a",
              "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": "2199518776"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "DAWOOD  muhammad muhammad",
                  "given": [
                    "DAWOOD",
                    "muhammad",
                    "muhammad"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0531815671"
                }
              ],
              "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": "2002-10-09",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/c255c892-c354-42e3-a176-da3819489f0e",
      "resource": {
        "resourceType": "Bundle",
        "id": "c255c892-c354-42e3-a176-da3819489f0e",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:18.069\u002B03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/69bfc23c-1300-4736-9e3c-a5a020b421d2",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "69bfc23c-1300-4736-9e3c-a5a020b421d2",
              "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": "31504860-d601-435e-aa31-2e34e1ca1aa2",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/15eda399-fb40-481c-8fea-a61293814656"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/15eda399-fb40-481c-8fea-a61293814656",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "15eda399-fb40-481c-8fea-a61293814656",
              "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": "2074"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "15eda399-fb40-481c-8fea-a61293814656"
                }
              ],
              "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/fd46e2f1-beed-4d3d-94eb-685efa6598d1"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/b523407e-37fc-4200-8b49-4e11178efa8c"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/bbddf731-9202-4dfb-a775-a195f175d2bd"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "27277118260924"
                }
              },
              "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": "97263"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 30.6,
                        "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": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 30.6,
                        "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": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.12,
                        "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": "97263"
                      }
                    }
                  ],
                  "itemSequence": 2,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 2.11,
                        "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": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 10.53,
                        "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": 10.53,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 8.42,
                        "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": "97263"
                      }
                    }
                  ],
                  "itemSequence": 3,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 37.31,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 37.31,
                        "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": 7.46,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 29.84,
                        "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": "97263"
                      }
                    }
                  ],
                  "itemSequence": 4,
                  "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": 1.36,
                        "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"
                          }
                        ]
                      },
                      "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": "97263"
                      }
                    }
                  ],
                  "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": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 3.46,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "copay"
                          }
                        ]
                      },
                      "amount": {
                        "value": 0.69,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 3.46,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 2.77,
                        "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": 88.69,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 41.03,
                    "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": 17.74,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 88.69,
                    "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/f92b8766-0aaf-4eea-9ef6-b19155dfbc4f"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/fd46e2f1-beed-4d3d-94eb-685efa6598d1",
            "resource": {
              "resourceType": "Patient",
              "id": "fd46e2f1-beed-4d3d-94eb-685efa6598d1",
              "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": "1163505272"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "LAMAR bandar abdullah bassyouni",
                  "given": [
                    "LAMAR",
                    "abdullah",
                    "bassyouni"
                  ]
                }
              ],
              "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": "2013-03-25",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/bbddf731-9202-4dfb-a775-a195f175d2bd",
            "resource": {
              "resourceType": "Organization",
              "id": "bbddf731-9202-4dfb-a775-a195f175d2bd",
              "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/b523407e-37fc-4200-8b49-4e11178efa8c",
            "resource": {
              "resourceType": "Organization",
              "id": "b523407e-37fc-4200-8b49-4e11178efa8c",
              "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/f92b8766-0aaf-4eea-9ef6-b19155dfbc4f",
            "resource": {
              "resourceType": "Coverage",
              "id": "f92b8766-0aaf-4eea-9ef6-b19155dfbc4f",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "001075083665231"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/92e4c803-2b76-4f31-ba1f-31df539f6985"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/d00c7005-dd31-4848-ae20-e8fb41eef72a"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/fd46e2f1-beed-4d3d-94eb-685efa6598d1"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/b523407e-37fc-4200-8b49-4e11178efa8c"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "54775772",
                  "name": "ETIHAD ETISALAT COMPANY MOBILY"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/92e4c803-2b76-4f31-ba1f-31df539f6985",
            "resource": {
              "resourceType": "Organization",
              "id": "92e4c803-2b76-4f31-ba1f-31df539f6985",
              "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/d00c7005-dd31-4848-ae20-e8fb41eef72a",
            "resource": {
              "resourceType": "Patient",
              "id": "d00c7005-dd31-4848-ae20-e8fb41eef72a",
              "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": "1163505272"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "LAMAR bandar abdullah bassyouni",
                  "given": [
                    "LAMAR",
                    "abdullah",
                    "bassyouni"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0555707729"
                }
              ],
              "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": "2013-03-25",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/1637ee84-ddc7-490b-986c-00d64b8440cb",
      "resource": {
        "resourceType": "Bundle",
        "id": "1637ee84-ddc7-490b-986c-00d64b8440cb",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:18.246\u002B03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/fbe6d9a2-a8eb-4347-8cec-06fedd13ab34",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "fbe6d9a2-a8eb-4347-8cec-06fedd13ab34",
              "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": "5ca81946-7cb0-4957-bccf-629e1f42f441",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/ad006f9b-2471-4007-8999-5bb92ff0c0d9"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/ad006f9b-2471-4007-8999-5bb92ff0c0d9",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "ad006f9b-2471-4007-8999-5bb92ff0c0d9",
              "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": "435"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "ad006f9b-2471-4007-8999-5bb92ff0c0d9"
                }
              ],
              "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/6a1560b9-b241-4561-a184-b066328d99d9"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/b664b9b1-b5e8-4e08-8518-1e1a8a447888"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/32d72355-390d-4509-8960-9325343948c8"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "35231998260906"
                }
              },
              "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": "79703"
                      }
                    }
                  ],
                  "itemSequence": 1,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 19.62,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 24.52,
                        "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": 24.52,
                        "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": 4.9,
                        "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": "79703"
                      }
                    }
                  ],
                  "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": 4.97,
                        "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": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.21,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 6.21,
                        "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": 30.73,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 24.59,
                    "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": 6.14,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 30.73,
                    "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/3569c343-a5c0-471f-94dc-0715ec2c4af9"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/6a1560b9-b241-4561-a184-b066328d99d9",
            "resource": {
              "resourceType": "Patient",
              "id": "6a1560b9-b241-4561-a184-b066328d99d9",
              "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": "2371037686"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "ASEI Hasan mehmood ali",
                  "given": [
                    "ASEI",
                    "mehmood",
                    "ali"
                  ]
                }
              ],
              "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": "1997-05-09",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/32d72355-390d-4509-8960-9325343948c8",
            "resource": {
              "resourceType": "Organization",
              "id": "32d72355-390d-4509-8960-9325343948c8",
              "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/b664b9b1-b5e8-4e08-8518-1e1a8a447888",
            "resource": {
              "resourceType": "Organization",
              "id": "b664b9b1-b5e8-4e08-8518-1e1a8a447888",
              "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/3569c343-a5c0-471f-94dc-0715ec2c4af9",
            "resource": {
              "resourceType": "Coverage",
              "id": "3569c343-a5c0-471f-94dc-0715ec2c4af9",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "002123103471101"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/bf6d30ae-d586-4c1e-8f9b-1a3d210cf877"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/94c89b9c-4b3f-42b4-b88f-ff27db758f9e"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/6a1560b9-b241-4561-a184-b066328d99d9"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/b664b9b1-b5e8-4e08-8518-1e1a8a447888"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "50539997",
                  "name": "SIAFA INTERNATIONAL MFG CO"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/bf6d30ae-d586-4c1e-8f9b-1a3d210cf877",
            "resource": {
              "resourceType": "Organization",
              "id": "bf6d30ae-d586-4c1e-8f9b-1a3d210cf877",
              "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/94c89b9c-4b3f-42b4-b88f-ff27db758f9e",
            "resource": {
              "resourceType": "Patient",
              "id": "94c89b9c-4b3f-42b4-b88f-ff27db758f9e",
              "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": "2371037686"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "ASEI Hasan mehmood ali",
                  "given": [
                    "ASEI",
                    "mehmood",
                    "ali"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0504898127"
                }
              ],
              "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": "1997-05-09",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "M"
                  }
                ]
              }
            }
          }
        ]
      }
    },
    {
      "fullUrl": "http://nphies.sa/Bundle/24cd46fb-cf26-48e6-8b17-79ff7f8421a9",
      "resource": {
        "resourceType": "Bundle",
        "id": "24cd46fb-cf26-48e6-8b17-79ff7f8421a9",
        "meta": {
          "profile": [
            "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/bundle|1.0.0"
          ]
        },
        "type": "message",
        "timestamp": "2026-10-20T11:55:17.121\u002B03:00",
        "entry": [
          {
            "fullUrl": "https://tawuniya.com.sa/MessageHeader/6a047d5a-eb95-432e-8d59-5ff09213ef15",
            "resource": {
              "resourceType": "MessageHeader",
              "id": "6a047d5a-eb95-432e-8d59-5ff09213ef15",
              "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": "1b06777c-7536-4e94-b27a-ae2c1a473062",
                "code": "ok"
              },
              "focus": [
                {
                  "reference": "https://tawuniya.com.sa/ClaimResponse/780d3b15-82d2-4786-b851-2fd39ccb3fe8"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/ClaimResponse/780d3b15-82d2-4786-b851-2fd39ccb3fe8",
            "resource": {
              "resourceType": "ClaimResponse",
              "id": "780d3b15-82d2-4786-b851-2fd39ccb3fe8",
              "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": "2332"
                  }
                }
              ],
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/claimResponse",
                  "value": "780d3b15-82d2-4786-b851-2fd39ccb3fe8"
                }
              ],
              "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/c92a8f20-0dbf-46a6-9a28-bea0d85a155d"
              },
              "created": "2026-10-20",
              "insurer": {
                "reference": "https://tawuniya.com.sa/Organization/6effd449-c053-4bbd-bafb-064f6dd2414d"
              },
              "requestor": {
                "reference": "https://tawuniya.com.sa/Organization/92441a17-4a05-41f3-a967-44e111ddce78"
              },
              "request": {
                "identifier": {
                  "system": "http://www.ALKholood.com/claim",
                  "value": "59284062260927"
                }
              },
              "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": "99959"
                      }
                    }
                  ],
                  "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": 8.19,
                        "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": 1.64,
                        "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": "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": "rejected"
                          }
                        ]
                      }
                    },
                    {
                      "url": "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/extension-patientInvoice",
                      "valueIdentifier": {
                        "system": "http://www.ALKholood.com/patientInvoice",
                        "value": "99959"
                      }
                    }
                  ],
                  "itemSequence": 2,
                  "adjudication": [
                    {
                      "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": "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": "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": "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": 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": "99959"
                      }
                    }
                  ],
                  "itemSequence": 3,
                  "adjudication": [
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "submitted"
                          }
                        ]
                      },
                      "amount": {
                        "value": 24.97,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "benefit"
                          }
                        ]
                      },
                      "amount": {
                        "value": 19.98,
                        "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": 4.99,
                        "currency": "SAR"
                      }
                    },
                    {
                      "category": {
                        "coding": [
                          {
                            "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                            "code": "eligible"
                          }
                        ]
                      },
                      "amount": {
                        "value": 24.97,
                        "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": 40.18,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "benefit"
                      }
                    ]
                  },
                  "amount": {
                    "value": 19.98,
                    "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": 8.03,
                    "currency": "SAR"
                  }
                },
                {
                  "category": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/adjudication",
                        "code": "eligible"
                      }
                    ]
                  },
                  "amount": {
                    "value": 40.18,
                    "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/c11fe647-7622-4dea-b6a7-a91b3eecfcc1"
                  }
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Patient/c92a8f20-0dbf-46a6-9a28-bea0d85a155d",
            "resource": {
              "resourceType": "Patient",
              "id": "c92a8f20-0dbf-46a6-9a28-bea0d85a155d",
              "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": "1085242574"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "ayisha  ahmed muhammad",
                  "given": [
                    "ayisha",
                    "ahmed",
                    "muhammad"
                  ]
                }
              ],
              "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": "1994-03-12",
              "maritalStatus": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/v3-MaritalStatus",
                    "code": "U"
                  }
                ]
              }
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/92441a17-4a05-41f3-a967-44e111ddce78",
            "resource": {
              "resourceType": "Organization",
              "id": "92441a17-4a05-41f3-a967-44e111ddce78",
              "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/6effd449-c053-4bbd-bafb-064f6dd2414d",
            "resource": {
              "resourceType": "Organization",
              "id": "6effd449-c053-4bbd-bafb-064f6dd2414d",
              "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/c11fe647-7622-4dea-b6a7-a91b3eecfcc1",
            "resource": {
              "resourceType": "Coverage",
              "id": "c11fe647-7622-4dea-b6a7-a91b3eecfcc1",
              "meta": {
                "profile": [
                  "http://nphies.sa/fhir/ksa/nphies-fs/StructureDefinition/coverage|1.0.0"
                ]
              },
              "identifier": [
                {
                  "system": "https://tawuniya.com.sa/memberid",
                  "value": "001085242574001"
                }
              ],
              "status": "active",
              "type": {
                "coding": [
                  {
                    "system": "http://nphies.sa/terminology/CodeSystem/coverage-type",
                    "code": "EHCPOL"
                  }
                ]
              },
              "policyHolder": {
                "reference": "https://tawuniya.com.sa/Organization/69999947-00f1-4163-8f35-47065a32d8b2"
              },
              "subscriber": {
                "reference": "https://tawuniya.com.sa/Patient/d4a0209f-2a44-49f3-b038-5f868d202ddc"
              },
              "beneficiary": {
                "reference": "https://tawuniya.com.sa/Patient/c92a8f20-0dbf-46a6-9a28-bea0d85a155d"
              },
              "relationship": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
                    "code": "self",
                    "display": "self"
                  }
                ]
              },
              "payor": [
                {
                  "reference": "https://tawuniya.com.sa/Organization/6effd449-c053-4bbd-bafb-064f6dd2414d"
                }
              ],
              "class": [
                {
                  "type": {
                    "coding": [
                      {
                        "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code": "plan"
                      }
                    ]
                  },
                  "value": "54456146",
                  "name": "BINDAWOOD SUPER STORES  TRADIR"
                }
              ]
            }
          },
          {
            "fullUrl": "https://tawuniya.com.sa/Organization/69999947-00f1-4163-8f35-47065a32d8b2",
            "resource": {
              "resourceType": "Organization",
              "id": "69999947-00f1-4163-8f35-47065a32d8b2",
              "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/d4a0209f-2a44-49f3-b038-5f868d202ddc",
            "resource": {
              "resourceType": "Patient",
              "id": "d4a0209f-2a44-49f3-b038-5f868d202ddc",
              "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": "1085242574"
                }
              ],
              "active": true,
              "name": [
                {
                  "use": "official",
                  "text": "ayisha  ahmed muhammad",
                  "given": [
                    "ayisha",
                    "ahmed",
                    "muhammad"
                  ]
                }
              ],
              "telecom": [
                {
                  "system": "phone",
                  "value": "0535407551"
                }
              ],
              "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": "1994-03-12",
              "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"
      }
    }
  ]
}

No stored-procedure executions recorded

Either the poll failed before reaching the database, or SQL capture is switched off in the Diagnostics configuration section.