Sha256: aa5e11b0ef2b8f4db9f48428dfbd667aa52e3340b43ab3e41d62bd108d50e58b
Contents?: true
Size: 1.24 KB
Versions: 10
Compression:
Stored size: 1.24 KB
Contents
<?xml version="1.0" encoding="UTF-8"?>
<PaymentNotice xmlns="http://hl7.org/fhir">
<id value="77654"/>
<meta>
<security>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
<code value="HTEST"/>
<display value="test health data"/>
</security>
</meta>
<identifier>
<system value="http://benefitsinc.com/paymentnotice"/>
<value value="776543"/>
</identifier>
<status value="active"/>
<request>
<reference value="http://benefitsinc.com/fhir/claim/12345"/>
</request>
<response>
<reference value="http://benefitsinc.com/fhir/claimresponse/CR12345"/>
</response>
<created value="2014-08-16"/>
<provider>
<reference value="Organization/1"/>
</provider>
<payment>
<reference value="PaymentReconciliation/ER2500"/>
</payment>
<paymentDate value="2014-08-15"/>
<payee>
<reference value="Organization/1"/>
</payee>
<recipient>
<identifier>
<system value="http://regulators.gov"/>
<value value="AB123"/>
</identifier>
</recipient>
<amount>
<value value="12500.00"/>
<currency value="USD"/>
</amount>
<paymentStatus>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/paymentstatus"/>
<code value="paid"/>
</coding>
</paymentStatus>
</PaymentNotice>
Version data entries
10 entries across 10 versions & 1 rubygems