STU 3 Ballot

This page is part of the FHIR Specification (v1.6.0: STU 3 Ballot 4). 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: R3 R2

Processrequest-example-reverse.xml

Raw XML (canonical form)

Claim Reversal Example (id = "87654")

<ProcessRequest xmlns="http://hl7.org/fhir">
 <id value="87654"/>

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

  <identifier>
       <system value="http://happyvalley.com/processrequest"/>
    <value value="76543"/>
  </identifier>

  <status value="active"/>
  
  <action value="cancel"/>
  
  <created value="2014-08-16"/>

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

  <nullify value="false"/>

 </ProcessRequest>

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.