| identifier | No | Identifier[] | Business Identifier for a payment reconciliation |
| status | Yes | code | active / cancelled / draft / entered-in-error |
| period | No | Period | Period covered |
| created | Yes | dateTime | Creation date |
| paymentIssuer | No | Reference<Organization> | Party generating payment |
| request | No | Reference<Task> | Reference to requesting resource |
| requestor | No | Reference<Practitioner / PractitionerRole / Organization> | Responsible practitioner |
| outcome | No | code | queued / complete / error / partial |
| disposition | No | string | Disposition message |
| paymentDate | Yes | date | When payment issued |
| paymentAmount | Yes | Money | Total amount of Payment |
| paymentIdentifier | No | Identifier | Business identifier for the payment |
| detail | No | PaymentReconciliationDetail | Settlement particulars |
| - id | No | string | Unique id for inter-element referencing |
| - extension | No | Extension[] | Additional content defined by implementations |
| - modifierExtension | No | Extension[] | Extensions that cannot be ignored even if unrecognized |
| - identifier | No | Identifier | Business identifier of the payment detail |
| - predecessor | No | Identifier | Business identifier of the prior payment detail |
| - type | Yes | CodeableConcept | Category of payment |
| - request | No | Reference<Resource> | Request giving rise to the payment |
| - submitter | No | Reference<Practitioner / PractitionerRole / Organization> | Submitter of the request |
| - response | No | Reference<Resource> | Response committing to a payment |
| - date | No | date | Date of commitment to pay |
| - responsible | No | Reference<PractitionerRole> | Contact for the response |
| - payee | No | Reference<Practitioner / PractitionerRole / Organization> | Recipient of the payment |
| - amount | No | Money | Amount allocated to this payable |
| formCode | No | CodeableConcept | Printed form identifier |
| processNote | No | PaymentReconciliationProcessNote | Note concerning processing |
| - id | No | string | Unique id for inter-element referencing |
| - extension | No | Extension[] | Additional content defined by implementations |
| - modifierExtension | No | Extension[] | Extensions that cannot be ignored even if unrecognized |
| - type | No | code | display / print / printoper |
| - text | No | string | Note explanatory text |
