This page is part of the FHIR Specification (v0.0.82: DSTU 1). 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")

Raw XML

<PaymentNotice xmlns="http://hl7.org/fhir">
  <id value="77654"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div>
  </text>
  <identifier>
    <system value="http://benefitsinc.com/paymentnotice"/>
    <value value="776543"/>
  </identifier>
  <created value="2014-08-16"/>
  <organization>
    <reference value="Organization/1"/>
  </organization>
  <request>
    <reference value="http://benefitsinc.com/fhir/oralhealthclaim/12345"/>
  </request>
  <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.