Healthcare Financial Services IG Edition 1 - Local Development build (v0.3.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
Generated Narrative: PaymentReconciliation 90581
Profile: Nphies Payment Reconciliation
identifier: http://sni.com.sa/identifiers/paymentreconciliation
/90581
status: Active
period: 2023-12-01 --> 2023-12-06
created: 2023-12-06
paymentIssuer: Bundle: type = message; timestamp = 2023-12-19 08:20:29+0000
requestor: Bundle: type = message; timestamp = 2023-12-02 19:36:29+0000
outcome: Processing Complete
disposition: Payment made for the month of December, 2023
paymentDate: 2023-12-06
Value | Currency |
239.55 | Saudi riyal |
paymentIdentifier: EFT/URN-987590432322
detail
Component - Payment: SAR241.50 (SAR)
Component - Early Fee: SAR0.00 (SAR)
Component - Payment: SAR-1.95 (SAR)
type: Payment
request: Identifier:
http://saudidentalclinic.com.sa/identifiers/claim
/req_29309905401submitter: Bundle: type = message; timestamp = 2023-12-02 19:36:29+0000
response: Identifier:
http://sni.com.sa/identifiers/claimresponse
/res_10411448401date: 2023-12-06
payee: Bundle: type = message; timestamp = 2023-12-02 19:36:29+0000
Amounts
Value Currency 239.55 Saudi riyal