Documentmanifest-fm-attachment.xml

Financial Supporting Documentation (id = "654789")

<DocumentManifest xmlns="http://hl7.org/fhir">
  <id value="654789"/> 
 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">A Financial Management Attachment example</div> 
  </text> 

  <contained> 
    <Organization> 
     <id value="org-1"/> 
     <identifier> 
       <system value="http://nationalidentifiers.org/insurers"/> 
       <value value="52345"/> 
     </identifier> 
    </Organization> 
  </contained> 

  <identifier> 
     <system value="http://happyvalley.com/supportingdocumentation"/> 
     <value value="52345"/> 
  </identifier> 
 
  <status value="current"/> 
  <created value="2014-09-21T11:50:23-05:00"/> 

  <recipient> 
    <reference value="#org-1"/> 
  </recipient> 

   
  <content> 
   <pAttachment> 
    <contentType value="application/pdf"/> 
    <data value="SGVsbG8="/> 
    <title value="accident notes 20100201.pdf"/> 
    <creation value="2010-02-01T11:50:23-05:00"/> 
   </pAttachment> 
  </content> 
 
  <content> 
   <pAttachment> 
    <contentType value="application/pdf"/> 
    <url value="http://happyvalley.com/docs/AB12345"/> 
    <size value="104274"/> 
    <hash value="SGVsbG8gdGhlcmU="/> 
    <creation value="2010-02-01T10:57:34+01:00"/> 
   </pAttachment> 
  </content> 
 
  <related>   <!--   Claim these docs are supporting   -->
    <identifier> 
     <system value="http://happyvalley.com/claim"/> 
     <value value="12345"/> 
    </identifier> 
  </related> 
  
  <related>   <!--   Insurers response to the Claim these docs are supporting   -->
    <identifier> 
      <system value="http://www.BenefitsInc.com/fhir/remittance"/> 
      <value value="R3500"/> 
    </identifier> 
  </related> 
  
 </DocumentManifest>