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

Example Parameters: ExampleSearchResult

Generated Narrative: Parameters ExampleSearchResult

Parameters

TIN123485858
Payer
 PayerID52415
 PayerNameAcme Payment Inc
Claim
 ProviderClaimID12345V54321
 ClaimReceivedDate2023-10-05
 ProviderID52415
 PayerClaimIDTYU7894562
 PaymentInfo
  PaymentDate2023-11-02
  PaymentNumberA12385858
  PaymentAmount$30.00 (USD)
  Remittance
   RemittanceAdviceIdentifierA123456BCDEF
   RemittanceAdviceTypeapplication/EDI-X12
   RemittanceAdviceDate2023-11-02
   RemittanceAdviceFileSize1536
Claim
 ProviderClaimID12345V54321
 ClaimReceivedDate2023-10-04
 ProviderID52415
 PayerClaimIDTYU7894566
 PaymentInfo
  PaymentDate2023-11-03
  PaymentNumberA12385859
  PaymentAmount$30.00 (USD)
  Remittance
   RemittanceAdviceIdentifierA123456BCDXY
   RemittanceAdviceTypeapplication/EDI-X12
   RemittanceAdviceDate2023-11-04
   RemittanceAdviceFileSize2048
Patient
 DateOfBirth1970-11-27
 PatientIDM12345513215
 PatientFirstNameAdam
 PatientLastNamePatient