11-Reversal Request

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"timestamp": "2025-01-06T22:03:23+00:00",
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"endpoint": "urn:oid:2.16.840.1.113883.3.7066.1",
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"value": "Device-123"
}
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}
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"sender": {
"reference": "Organization/12345",
"identifier": {
"system": "urn:oid:setbyPOSvendor",
"value": "SoftwareVendorClientName"
}
},
"source": {
"name": "thename",
"software": "POS software name",
"version": "POSversion",
"endpoint": "urn:uuid:2fcd0a14-4ad6-11e8-9c2d-fa7ae01bbebc"
},
"responsible": {
"reference": "Organization/086968a8c716",
"identifier": {
"system": "http://pharmacyeclaims.ca/FHIR/PharmacyID",
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}
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},
{
"name": "TraceNumber",
"valueIdentifier": {
"system": "http://pharmacyeclaims.ca/FHIR/TraceNumber",
"value": "TRC-9876543210"
}
},
{
"name": "ReferenceNumber",
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"value": "REF-1234567890"
}
},
{
"name": "CurrentRXNumber",
"valueIdentifier": {
"system": "http://pharmacyeclaims.ca/FHIR/rx",
"value": "RX-00012345"
}
},
{
"name": "ProviderTransactionDate",
"valueDateTime": "2025-07-31T14:45:00Z"
}
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<endpoint value="urn:oid:2.16.840.1.113883.3.7066.1" />
<receiver>
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<value value="Device-123" />
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<reference value="Organization/12345" />
<identifier>
<system value="urn:oid:setbyPOSvendor" />
<value value="SoftwareVendorClientName" />
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<software value="POS software name" />
<version value="POSversion" />
<endpoint value="urn:uuid:2fcd0a14-4ad6-11e8-9c2d-fa7ae01bbebc" />
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<reference value="Organization/086968a8c716" />
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<parameter>
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<valueDateTime value="2025-08-01T10:00:00Z" />
</parameter>
<parameter>
<name value="TraceNumber" />
<valueIdentifier>
<system value="http://pharmacyeclaims.ca/FHIR/TraceNumber" />
<value value="TRC-9876543210" />
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<valueIdentifier>
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<value value="REF-1234567890" />
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<parameter>
<name value="CurrentRXNumber" />
<valueIdentifier>
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<value value="RX-00012345" />
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<parameter>
<name value="ProviderTransactionDate" />
<valueDateTime value="2025-07-31T14:45:00Z" />
</parameter>
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Bundle.meta[0].tag[0].system[0]http://pharmacyeclaims.ca/FHIR/CodeSystem/message-version
Bundle.meta[0].tag[0].code[0]1.0
Bundle.type[0]message
Bundle.timestamp[0]2025-01-06T22:03:23+00:00
Bundle.entry[0].fullUrl[0]urn:uuid:6d8041af-7963-4bff-baf4-968d600fbd1e
Bundle.entry[0].resource[0].id[0]6d8041af-7963-4bff-baf4-968d600fbd1e
Bundle.entry[0].resource[0].event[0].system[0]http://pharmacyeclaims.ca/fhir/CodeSystem/message-events
Bundle.entry[0].resource[0].event[0].code[0]11
Bundle.entry[0].resource[0].destination[0].name[0]Name of Adjudicator
Bundle.entry[0].resource[0].destination[0].endpoint[0]urn:oid:2.16.840.1.113883.3.7066.1
Bundle.entry[0].resource[0].destination[0].receiver[0].reference[0]Organization/12345
Bundle.entry[0].resource[0].destination[0].receiver[0].identifier[0].system[0]urn:oid:http://pharmacyeclaims.ca/FHIR/CPHA-identifier/IIN
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Bundle.entry[0].resource[0].sender[0].reference[0]Organization/12345
Bundle.entry[0].resource[0].sender[0].identifier[0].system[0]urn:oid:setbyPOSvendor
Bundle.entry[0].resource[0].sender[0].identifier[0].value[0]SoftwareVendorClientName
Bundle.entry[0].resource[0].source[0].name[0]thename
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Bundle.entry[1].resource[0].parameter[1].value[0].value[0]TRC-9876543210
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Bundle.entry[1].resource[0].parameter[2].value[0].system[0]http://pharmacyeclaims.ca/FHIR/reference
Bundle.entry[1].resource[0].parameter[2].value[0].value[0]REF-1234567890
Bundle.entry[1].resource[0].parameter[3].name[0]CurrentRXNumber
Bundle.entry[1].resource[0].parameter[3].value[0].system[0]http://pharmacyeclaims.ca/FHIR/rx
Bundle.entry[1].resource[0].parameter[3].value[0].value[0]RX-00012345
Bundle.entry[1].resource[0].parameter[4].name[0]ProviderTransactionDate
Bundle.entry[1].resource[0].parameter[4].value[0]2025-07-31T14:45:00Z