identifier0..*Identifier
statusΣ ?!1..1codeBinding
periodΣ I0..1Period
createdΣ1..1dateTime
paymentIssuerΣ I0..1Reference(Organization)
requestI0..1Reference(Task)
requestorI0..1Reference(Practitioner | PractitionerRole | Organization)
outcome0..1codeBinding
disposition0..1string
paymentDateΣ1..1date
paymentAmountΣ1..1Money
paymentIdentifier0..1Identifier
formCode0..1CodeableConcept