Kvittering for refusion/meddelelse om lukning af refusion

SED API version: 0.16.2 build 2
Model version: 4.2.0

Lokale sagsnumre [ CC ]

Lokalt sagsnummer [ CC ]

Land *

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Sagsnummer *

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Institution [ CC ]

Institutions-ID *

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Institutionens navn *

[ CDT ] {{metaSection.institutionName.$$error}} {{metaSection.institutionName.$$warning}}

Lokalt sagsnummer

Generelle oplysninger * [ SED ]

ID for refusionsanmodning *

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ID for meddelelse om betaling af refusion *

[ BDT ] {{metaSection.reimbursementPaymentNotificationID.$$error}} {{metaSection.reimbursementPaymentNotificationID.$$warning}}

ID for kvittering for refusion/meddelelse om lukning af refusion *

[ BDT ] {{metaSection.reimbursementReceiptOrClosingNotificationID.$$error}} {{metaSection.reimbursementReceiptOrClosingNotificationID.$$warning}}

Modtaget beløb * [ CC ]

Beløb *

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Valuta *

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Dato for betalingsmodtagelse *

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Refusionsanmodning lukket * [ SED ]

Refusionsanmodning lukket *

[ ENUM ] {{metaSection.reimbursementRequestClosedIndicator.$$error}} {{metaSection.reimbursementRequestClosedIndicator.$$warning}}

Hvis "Refusionsanmodning lukket" = "Nej", udfyldes følgende: [ SED ]

Begrundelse for ikke at lukke refusionsanmodning

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Hvis "Begrundelse for ikke at lukke refusionsanmodning" = "99 - Anden begrundelse", udfyldes følgende: [ SED ]

Grund

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