2nd DSTU Draft For Comment

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

Reversal.questionnaire

This is an example form generated from the questionnaire. See also the XML or JSON format.

Reversal.questionnaire - FHIR v0.4.0 Form
2nd DSTU Draft For Comment

This is an example form generated from the questionnaire. See also the XML or JSON format

Reversal request

Reversal
Reversal.id
Reversal.id.value Logical id of this artefact
Reversal.id 1

Metadata about the resource

Reversal.meta
Reversal.meta 1
Reversal.implicitRules
Reversal.implicitRules.value A set of rules under which this content was created
Reversal.implicitRules 1
Reversal.language
Reversal.language.value language
Reversal.language 1

Text summary of the resource, for human interpretation

Reversal.text
Reversal.text 1

Contained, inline Resources

Reversal.contained
Reversal.contained 1

Business Identifier

Reversal.identifier
Reversal.identifier.label label:
Reversal.identifier.system system:
Reversal.identifier.value value:
Reversal.identifier 1
Reversal.ruleset
Reversal.ruleset.value Resource version
Reversal.ruleset 1
Reversal.originalRuleset
Reversal.originalRuleset.value Original version
Reversal.originalRuleset 1
Reversal.created
Reversal.created.value Creation date
Reversal.created 1
Reversal.target
Reversal.target.value Insurer
Reversal.target 1
Reversal.provider
Reversal.provider.value Responsible practitioner
Reversal.provider 1
Reversal.organization
Reversal.organization.value Responsible organization
Reversal.organization 1

Request reference

Reversal.request
Reversal.request._type type
Reversal.request._OralHealthClaim
Reversal.request._OralHealthClaim.value OralHealthClaim
Reversal.request._OralHealthClaim 1
Reversal.request._PharmacyClaim
Reversal.request._PharmacyClaim.value PharmacyClaim
Reversal.request._PharmacyClaim 1
Reversal.request._VisionClaim
Reversal.request._VisionClaim.value VisionClaim
Reversal.request._VisionClaim 1
Reversal.request._ProfessionalClaim
Reversal.request._ProfessionalClaim.value ProfessionalClaim
Reversal.request._ProfessionalClaim 1
Reversal.request._InstitutionalClaim
Reversal.request._InstitutionalClaim.value InstitutionalClaim
Reversal.request._InstitutionalClaim 1
Reversal.request._SupportingDocumentation
Reversal.request._SupportingDocumentation.value SupportingDocumentation
Reversal.request._SupportingDocumentation 1
Reversal.request 1

Response reference

Reversal.response
Reversal.response._type type
Reversal.response._ClaimResponse
Reversal.response._ClaimResponse.value ClaimResponse
Reversal.response._ClaimResponse 1
Reversal.response._StatusResponse
Reversal.response._StatusResponse.value StatusResponse
Reversal.response._StatusResponse 1
Reversal.response 1

Payee

Reversal.payee
Reversal.payee.id
Reversal.payee.id.value xml:id (or equivalent in JSON)
Reversal.payee.id 1
Reversal.payee.type
Reversal.payee.type.value Payee Type
Reversal.payee.type 1
Reversal.payee.provider
Reversal.payee.provider.value Provider who is the payee
Reversal.payee.provider 1
Reversal.payee.organization
Reversal.payee.organization.value Organization who is the payee
Reversal.payee.organization 1
Reversal.payee.person
Reversal.payee.person.value Other person who is the payee
Reversal.payee.person 1
Reversal.payee 1

Insurance or medical plan

Reversal.coverage
Reversal.coverage.id
Reversal.coverage.id.value xml:id (or equivalent in JSON)
Reversal.coverage.id 1
Reversal.coverage.sequence
Reversal.coverage.sequence.value Service instance
Reversal.coverage.sequence 1
Reversal.coverage.focal
Reversal.coverage.focal.value Is the focal Coverage
Reversal.coverage.focal 1
Reversal.coverage.coverage
Reversal.coverage.coverage.value Insurance information
Reversal.coverage.coverage 1
Reversal.coverage.businessArrangement
Reversal.coverage.businessArrangement.value Business agreement
Reversal.coverage.businessArrangement 1
Reversal.coverage.relationship
Reversal.coverage.relationship.value Patient relationship to subscriber
Reversal.coverage.relationship 1
Reversal.coverage 1
Reversal.nullify
Reversal.nullify.value Nullify
Reversal.nullify 1
Reversal 1