STU 3 Candidate

This page is part of the FHIR Specification (v1.4.0: STU 3 Ballot 3). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Paymentnotice-example.xml

Raw XML (canonical form)

Claim PaymentNotice Example (id = "77654")

<PaymentNotice xmlns="http://hl7.org/fhir">
 <id value="77654"/>

 <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the PaymentNotice</div>
  </text>

  <identifier>
  <system value="http://benefitsinc.com/paymentnotice"/>
  <value value="776543"/>
  </identifier>
 
  <created value="2014-08-16"/>

  <organizationReference>
    <reference value="Organization/1"/>
  </organizationReference>
  
  <requestReference>
    <reference value="http://benefitsinc.com/fhir/oralhealthclaim/12345"/>
  </requestReference>

  <paymentStatus>
    <system value="http://hl7.org/fhir/paymentstatus"/>
    <code value="paid"/>
  </paymentStatus>

 </PaymentNotice>

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.