FHIR Release 3 (STU) 4

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Paymentnotice-example.json

Financial Management Work Group Maturity Level : N/A Ballot Standards Status : Informative Compartments : Practitioner

Raw JSON ( canonical form + also see JSON Format Specification )

Claim PaymentNotice Example 

{
  "resourceType": "PaymentNotice",
  "id": "77654",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the PaymentNotice</div>"
  },
  "identifier": [
    {
      "system": "http://benefitsinc.com/paymentnotice",
      "value": "776543"
    }
  ],
  "status": "active",
  "request": {
    "reference": "http://benefitsinc.com/fhir/claim/12345"
  },
  "response": {
    "reference": "http://benefitsinc.com/fhir/claimresponse/CR12345"
  },
  "statusDate": "2014-08-15",

  "created": "2014-08-16",
  "target": {

  "provider": {
    "reference": "Organization/1"
  },
  "payment": {
    "reference": "PaymentReconciliation/ER2500"
  },
  "paymentDate": "2014-08-15",
  "payee": {
    "reference": "Organization/1"
  },
  "recipient": {

    "identifier": {
      "system": "http://regulators.gov",
      "value": "AB123"
    }
  },
  "provider": {
    "identifier": {
      "system": "http://npid.org/provider",
      "value": "PR957857"
    }
  },
  "organization": {
    "reference": "Organization/1"

  "amount": {
    "value": 12500.00,
    "currency": "USD"

  },
  "paymentStatus": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/paymentstatus",

        "system": "http://terminology.hl7.org/CodeSystem/paymentstatus",

        "code": "paid"
      }
    ]
  }
}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.