{
  "resourceType" : "Parameters",
  "parameter" : [{
    "name" : "TrackingId",
    "valueIdentifier" : {
      "system" : "http://example.org/payer",
      "value" : "trackingid1012"
    }
  },
  {
    "name" : "AttachTo",
    "valueCode" : "preauthorization"
  },
  {
    "name" : "PayerId",
    "valueIdentifier" : {
      "system" : "http://example.org/cdex/payer/payer-ids",
      "value" : "payer123"
    }
  },
  {
    "name" : "OrganizationId",
    "valueIdentifier" : {
      "system" : "http://hl7.org/fhir/sid/us-npi",
      "value" : "1234567893"
    }
  },
  {
    "name" : "ProviderId",
    "valueIdentifier" : {
      "system" : "http://hl7.org/fhir/sid/us-npi",
      "value" : "9941339100"
    }
  },
  {
    "name" : "MemberId",
    "valueIdentifier" : {
      "system" : "http://example.org/cdex/payer/member-ids",
      "value" : "Member123"
    }
  },
  {
    "name" : "Attachment",
    "part" : [{
      "name" : "LineItem",
      "valueString" : "1"
    },
    {
      "name" : "Content",
      "resource" : {
        "resourceType" : "QuestionnaireResponse",
        "id" : "cdex-questionnaireresponse-example1",
        "questionnaire" : "http://example.org/cdex-questionnaire-example1",
        "status" : "completed",
        "subject" : {
          "identifier" : {
            "use" : "usual",
            "type" : {
              "coding" : [{
                "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                "code" : "MB",
                "display" : "Member Number"
              }],
              "text" : "Member Number"
            },
            "system" : "http://example.org/cdex/payer/member-ids",
            "value" : "Member123"
          },
          "display" : "Amy Shaw"
        },
        "authored" : "2022-06-17",
        "author" : {
          "identifier" : {
            "system" : "http://hl7.org/fhir/sid/us-npi",
            "value" : "9941339100"
          }
        },
        "item" : [{
          "linkId" : "1",
          "text" : "Relevant Patient Diagnoses (conditions that might be expected to improve with oxygen therapy)",
          "answer" : [{
            "valueString" : "Examplitis"
          }]
        },
        {
          "linkId" : "2",
          "text" : "Order Reason",
          "answer" : [{
            "valueCoding" : {
              "system" : "http://example.org",
              "code" : "4",
              "display" : "Replacement"
            }
          }]
        }]
      }
    }]
  }]
}