Contents

<?xml version="1.0" encoding="UTF-8"?><PaymentReconciliation xmlns="http://hl7.org/fhir">
 <id value="ER2500"/>

 <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the PaymentReconciliation</div>
  </text>

  <identifier>
    <system value="http://www.BenefitsInc.com/fhir/enrollmentresponse"/>
    <value value="781234"/>
  </identifier>

  <requestReference>
	<reference value="http://www.BenefitsInc.com/fhir/ProcessRequest/225476332402"/>
  </requestReference>

  <outcome value="complete"/>

  <disposition value="2014 August mid-month settlement."/>

  <created value="2014-08-16"/>

  <organizationReference>
    <reference value="Organization/2"/>
  </organizationReference>

  <!--
  <requestOrganizationReference>
    <reference value="Organization/1"/>
  </requestOrganizationReference>
   -->

  <detail>
	<type>
	   <system value="http://hl7.org/fhir/paymenttype"/>
	   <code value="payment"/>
	</type>
	<requestReference>
		<reference value="http://www.BenefitsInc.com/fhir/oralhealthclaim/225476332402"/>
	</requestReference>
	<date value="2014-08-16"/>
	<amount>
		<value value="1000.00"/>
		<system value="urn:iso:std:iso:4217"/>
		<code value="USD"/>
	</amount>
  </detail>

  <detail>
	<type>
	   <system value="http://hl7.org/fhir/paymenttype"/>
	   <code value="payment"/>
	</type>
	<requestReference>
		<reference value="http://www.BenefitsInc.com/fhir/oralhealthclaim/225476332699"/>
	</requestReference>
	<date value="2014-08-12"/>
	<amount>
		<value value="4000.00"/>
		<system value="urn:iso:std:iso:4217"/>
		<code value="USD"/>
	</amount>
  </detail>

  <detail>
	<type>
	   <system value="http://hl7.org/fhir/paymenttype"/>
	   <code value="advance"/>
	</type>
	<date value="2014-08-16"/>
	<amount>
		<value value="-1500.00"/>
		<system value="urn:iso:std:iso:4217"/>
		<code value="USD"/>
	</amount>
  </detail>

  <total>
	<value value="3500.00"/>
	<system value="urn:iso:std:iso:4217"/>
	<code value="USD"/>
  </total>

</PaymentReconciliation>

Version data entries

2 entries across 2 versions & 1 rubygems

Version	Path
fhir_models-0.3.1	examples/xml/paymentreconciliation-example.xml
fhir_models-0.3.0	examples/xml/paymentreconciliation-example.xml