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

This page is part of the DaVinci Postable Remittance FHIR Implementation Guide (v1.0.0: STU 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: ExampleSearchPaymentResult - XML Representation

Raw xml | Download


<Parameters xmlns="http://hl7.org/fhir">
  <id value="ExampleSearchPaymentResult"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/davinci-pr/StructureDefinition/searchByPaymentResultParameters"/>
  </meta>
  <parameter>
    <name value="TIN"/>
    <valueString value="123485858"/>
  </parameter>
  <parameter>
    <name value="Payer"/>
    <part>
      <name value="PayerID"/>
      <valueString value="52415"/>
    </part>
    <part>
      <name value="PayerName"/>
      <valueString value="Acme Payment Inc"/>
    </part>
  </parameter>
  <parameter>
    <name value="PaymentInfo"/>
    <part>
      <name value="PaymentIssueDate"/>
      <valueDate value="2023-11-02"/>
    </part>
    <part>
      <name value="PaymentNumber"/>
      <valueString value="A12385858"/>
    </part>
    <part>
      <name value="PaymentAmount"/>
      <valueMoney>
        <value value="30"/>
        <currency value="USD"/>
      </valueMoney>
    </part>
    <part>
      <name value="Remittance"/>
      <part>
        <name value="RemittanceAdviceIdentifier"/>
        <valueString value="A123456BCDEF"/>
      </part>
      <part>
        <name value="RemittanceAdviceType"/>
        <valueCode value="application/EDI-X12"/>
      </part>
      <part>
        <name value="RemittanceAdviceDate"/>
        <valueDate value="2023-11-02"/>
      </part>
      <part>
        <name value="RemittanceAdviceFileSize"/>
        <valueInteger value="1536"/>
      </part>
    </part>
  </parameter>
  <parameter>
    <name value="PaymentInfo"/>
    <part>
      <name value="PaymentIssueDate"/>
      <valueDate value="2023-11-03"/>
    </part>
    <part>
      <name value="PaymentNumber"/>
      <valueString value="A12385859"/>
    </part>
    <part>
      <name value="PaymentAmount"/>
      <valueMoney>
        <value value="30"/>
        <currency value="USD"/>
      </valueMoney>
    </part>
    <part>
      <name value="Remittance"/>
      <part>
        <name value="RemittanceAdviceIdentifier"/>
        <valueString value="A123456BCDXY"/>
      </part>
      <part>
        <name value="RemittanceAdviceType"/>
        <valueCode value="application/EDI-X12"/>
      </part>
      <part>
        <name value="RemittanceAdviceDate"/>
        <valueDate value="2023-11-03"/>
      </part>
      <part>
        <name value="RemittanceAdviceFileSize"/>
        <valueInteger value="2048"/>
      </part>
    </part>
  </parameter>
</Parameters>