This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions
Example Index:
Claim Reversal Example | XML | JSON |
XML
Claim Reversal Example (id = "87654")
<Reversal xmlns="http://hl7.org/fhir"> <id value="87654"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div> </text> <identifier> <system value="http://happyvalley.com/reversal"/> <value value="76543"/> </identifier> <created value="2014-08-16"/> <organization> <reference value="Organization/1"/> </organization> <request> <reference value="http://BenefitsInc.com/fhir/oralhealthclaim/12345"/> </request> <coverage> <sequence value="1"/> <focal value="true"/> <coverage> <reference value="Coverage/9876B1"/> </coverage> <relationship> <code value="self"/> </relationship> </coverage> <nullify value="false"/> </Reversal>
JSON
Claim Reversal Example
{ "resourceType": "Reversal", "id": "87654", "text": { "status": "generated", "div": "<div>!-- Snipped for Brevity --></div>" }, "identifier": [ { "system": "http://happyvalley.com/reversal", "value": "76543" } ], "created": "2014-08-16", "organization": { "reference": "Organization/1" }, "request": { "reference": "http://BenefitsInc.com/fhir/oralhealthclaim/12345" }, "coverage": { "sequence": 1, "focal": true, "coverage": { "reference": "Coverage/9876B1" }, "relationship": { "code": "self" } }, "nullify": false }
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.