RejectionResponseExample

active

ClaimResponse-RejectionResponseExample.json

Resource Details

Resource Type: ClaimResponse
Resource ID: RejectionResponseExample
Identifier: http://example.org/PATIENT_EVENT_TRACE_NUMBER|111099
Conforms To: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse

Example Metadata

Index metadata for this example. The full FHIR resource body is not loaded in the workbench.

{
  "resourceType": "ClaimResponse",
  "id": "RejectionResponseExample",
  "filename": "ClaimResponse-RejectionResponseExample.json",
  "profile": [
    "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-claimresponse"
  ],
  "identifier": {
    "system": "http://example.org/PATIENT_EVENT_TRACE_NUMBER",
    "value": "111099"
  },
  "status": "active"
}