| Name | Flags | Card. | Type | Description & Constraints![]() |
|---|---|---|---|---|
| DomainResource | PaymentReconciliation resource | |||
| 0..* | Identifier | Business Identifier | ||
| ?!Σ | 1..1 | code | active | cancelled | draft | entered-in-error PaymentReconciliationStatus (Required) | |
| 0..1 | Claim reference | |||
| Identifier | ||||
| Reference(ProcessRequest) | ||||
| 0..1 | code | complete | error | partial RemittanceOutcome (Required) | ||
| 0..1 | string | Disposition Message | ||
| 0..1 | Coding | Resource version Ruleset Codes (Example) | ||
| 0..1 | Coding | Original version Ruleset Codes (Example) | ||
| 0..1 | dateTime | Creation date | ||
| 0..1 | Period | Period covered | ||
| 0..1 | Insurer | |||
| Identifier | ||||
| Reference(Organization) | ||||
| 0..1 | Responsible practitioner | |||
| Identifier | ||||
| Reference(Practitioner) | ||||
| 0..1 | Responsible organization | |||
| Identifier | ||||
| Reference(Organization) | ||||
| 0..* | BackboneElement | Details | ||
| 1..1 | Coding | Type code Payment Type Codes (Example) | ||
| 0..1 | Claim | |||
| Identifier | ||||
| Reference(Any) | ||||
| 0..1 | Claim Response | |||
| Identifier | ||||
| Reference(Any) | ||||
| 0..1 | Submitter | |||
| Identifier | ||||
| Reference(Organization) | ||||
| 0..1 | Payee | |||
| Identifier | ||||
| Reference(Organization) | ||||
| 0..1 | date | Invoice date | ||
| 0..1 | Money | Detail amount | ||
| 0..1 | Coding | Printed Form Identifier Form Codes (Required) | ||
| 1..1 | Money | Total amount of Payment | ||
| 0..* | BackboneElement | Note text | ||
| 0..1 | Coding | display | print | printoper NoteType (Required) | ||
| 0..1 | string | Notes text | ||
Documentation for this format | ||||