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 - XML Representation

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<Parameters xmlns="http://hl7.org/fhir">
  <id value="ExampleSearchByClaim"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/davinci-pr/StructureDefinition/searchByClaimParameters"/>
  </meta>
  <parameter>
    <name value="TIN"/>
    <valueString value="123456"/>
  </parameter>
  <parameter>
    <name value="DateOfService"/>
    <valuePeriod>
      <start value="2024-01-01"/>
      <end value="2024-01-31"/>
    </valuePeriod>
  </parameter>
  <parameter>
    <name value="PatientID"/>
    <valueString value="34567"/>
  </parameter>
  <parameter>
    <name value="Claim"/>
    <part>
      <name value="ProviderClaimID"/>
      <valueString value="12345"/>
    </part>
    <part>
      <name value="ProviderID"/>
      <valueString value="23456"/>
    </part>
    <part>
      <name value="PayerClaimID"/>
      <valueString value="34567"/>
    </part>
  </parameter>
</Parameters>