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Source1

{
  "resourceType": "Parameters",
  "id": "adjudication-details-out-sample",
  "parameter": [
    {
      "name": "TraceNumber",
      "valueIdentifier": {
        "value": "9876543210"
      }
    },
    {
      "name": "ReferenceNumber",
      "valueIdentifier": {
        "value": "RFN-20251111-001"
      }
    },
    {
      "name": "ResponseStatus",
      "valueCode": "Z"
    },
    {
      "name": "ResponseCodes",
      "valueCode": "0000"
    },
    {
      "name": "TimePeriod",
      "valuePeriod": {
        "start": "2025-11-01",
        "end": "2025-11-30"
      }
    },
    {
      "name": "TotalAmtForPeriod",
      "valueMoney": {
        "value": 75,
        "currency": "CAD"
      }
    },
    {
      "name": "ReversalTotalAmtForPeriod",
      "valueMoney": {
        "value": 25,
        "currency": "CAD"
      }
    },
    {
      "name": "ClaimTotalAmtForPeriod",
      "valueMoney": {
        "value": 100,
        "currency": "CAD"
      }
    },
    {
      "name": "AdjudicationDate",
      "valueDateTime": "2025-11-10T14:30:00-05:00",
      "part": [
        {
          "name": "CurrentRXNumber",
          "valueIdentifier": {
            "value": "1234567890"
          }
        },
        {
          "name": "TraceNumber",
          "valueIdentifier": {
            "value": "0011223344"
          }
        },
        {
          "name": "AmountPayable/ReversedPatient",
          "valueMoney": {
            "value": 0,
            "currency": "CAD"
          }
        },
        {
          "name": "AmountPayable/ReversedPharmacy",
          "valueMoney": {
            "value": 100,
            "currency": "CAD"
          }
        },
        {
          "name": "CarrierID",
          "valueIdentifier": {
            "value": "CARRIER-A"
          }
        },
        {
          "name": "CurrentRXNumber",
          "valueIdentifier": {
            "value": "0987654321"
          }
        },
        {
          "name": "TraceNumber",
          "valueIdentifier": {
            "value": "5566778899"
          }
        },
        {
          "name": "AmountPayable/ReversedPatient",
          "valueMoney": {
            "value": -25,
            "currency": "CAD"
          }
        },
        {
          "name": "AmountPayable/ReversedPharmacy",
          "valueMoney": {
            "value": 0,
            "currency": "CAD"
          }
        },
        {
          "name": "CarrierID",
          "valueIdentifier": {
            "value": "CARRIER-B"
          }
        }
      ]
    }
  ]
}