Name Flags Card. Type Description & Constraints doco
. . PaymentReconciliation Σ DomainResource PaymentReconciliation resource
. . . identifier Σ 0..* Identifier Business Identifier
. . . request Σ 0..1 Reference( ProcessRequest) Claim reference
. . . outcome Σ 0..1 code complete | error
RemittanceOutcome ( Required)
. . . disposition Σ 0..1 string Disposition Message
. . . ruleset Σ 0..1 Coding Resource version
Ruleset Codes ( Example)
. . . originalRuleset Σ 0..1 Coding Original version
Ruleset Codes ( Example)
. . . created Σ 0..1 dateTime Creation date
. . . period Σ 0..1 Period Period covered
. . . organization Σ 0..1 Reference( Organization) Insurer
. . . requestProvider Σ 0..1 Reference( Practitioner) Responsible practitioner
. . . requestOrganization Σ 0..1 Reference( Organization) Responsible organization
. . . detail Σ 0..* BackboneElement Details
. . . . type Σ 1..1 Coding Type code
Payment Type Codes ( Example)
. . . . request Σ 0..1 Reference( Any) Claim
. . . . responce Σ 0..1 Reference( Any) Claim Response
. . . . submitter Σ 0..1 Reference( Organization) Submitter
. . . . payee Σ 0..1 Reference( Organization) Payee
. . . . date Σ 0..1 date Invoice date
. . . . amount Σ 0..1 Money Detail amount
. . . form Σ 0..1 Coding Printed Form Identifier
Form Codes ( Required)
. . . total Σ 1..1 Money Total amount of Payment
. . . note Σ 0..* BackboneElement Note text
. . . . type Σ 0..1 Coding display | print | printoper
NoteType ( Required)
. . . . text Σ 0..1 string Notes text

doco Documentation for this format