identifier0..*Identifier
statusΣ ?!0..1codeBinding
created0..1dateTime
requestProviderI0..1Reference(Practitioner)
requestOrganizationI0..1Reference(Organization)
requestI0..1Reference(EligibilityRequest)
outcome0..1CodeableConceptBinding
disposition0..1string
insurerI0..1Reference(Organization)
inforce0..1boolean
form0..1CodeableConcept