Da Vinci Postable Remittance
1.0.0-ballot - STU 1 Ballot United States of America flag

This page is part of the DaVinci Postable Remittance FHIR Implementation Guide (v1.0.0-ballot: STU 1 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. . For a full list of available versions, see the Directory of published versions

: ExampleSearchByClaim - JSON Representation

Raw json | Download

{
  "resourceType" : "Parameters",
  "id" : "ExampleSearchByClaim",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/davinci-pr/StructureDefinition/searchByClaimParameters"
    ]
  },
  "parameter" : [
    {
      "name" : "TIN",
      "valueString" : "123456"
    },
    {
      "name" : "DateOfService",
      "valuePeriod" : {
        "start" : "2024-01-01",
        "end" : "2024-01-31"
      }
    },
    {
      "name" : "PatientID",
      "valueString" : "34567"
    },
    {
      "name" : "Claim",
      "part" : [
        {
          "name" : "ProviderClaimID",
          "valueString" : "12345"
        },
        {
          "name" : "ProviderID",
          "valueString" : "23456"
        },
        {
          "name" : "PayerClaimID",
          "valueString" : "34567"
        }
      ]
    }
  ]
}