Release 5 Preview #3

This page is part of the FHIR Specification (v4.5.0: R5 Preview #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

Enrollmentrequest-example.xml

Financial Management Work Group

Maturity Level: N/A

Standards Status: Informative

Compartments: Patient

Raw XML (canonical form + also see XML Format Specification)

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General Simple Enrollment Example (id = "22345")

<?xml version="1.0" encoding="UTF-8"?>

<EnrollmentRequest xmlns="http://hl7.org/fhir">
 <id value="22345"/> 

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

  <identifier> 
    <system value="http://happyvalley.com/enrollmentrequest"/> 
    <value value="EN22345"/> 
  </identifier> 
 
  <status value="active"/> 
 
  <created value="2014-08-16"/> 

  <insurer> 
    <reference value="Organization/2"/> 
  </insurer> 
  
  <provider> 
    <reference value="Organization/1"/> 
  </provider> 

  <candidate> 
    <reference value="Patient/1"/> 
  </candidate> 
  
  <coverage> 
     <reference value="Coverage/9876B1"/> 
  </coverage> 
 </EnrollmentRequest>

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.