<?xml version="1.0" encoding="UTF-8"?>

<Task xmlns="http://hl7.org/fhir">
  <id value="task-example-chargeback-ref"/>
  <text>
    <status value="extensions"/><div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Task task-example-chargeback-ref</b></p><a name="task-example-chargeback-ref"> </a><a name="hctask-example-chargeback-ref"> </a><p><b>340B Chargeback Reference Extension</b>: <code>https://exchange.example.org/chargebacks</code>/cb-778899</p><p><b>status</b>: In Progress</p><p><b>intent</b>: order</p><p><b>focus</b>: <a href="Claim-claim-example-txid.html">Claim: extension = tx-9f2c4b67; status = active; type = Pharmacy; use = claim; created = 2026-04-24; priority = Normal</a></p><p><b>for</b>: <a href="Patient-p-001.html">Pat Example  (no stated gender), DoB Unknown</a></p><p><b>requester</b>: <a href="Organization-tpa-01.html">Organization Example TPA 01</a></p><p><b>owner</b>: <a href="Organization-manufacturer-77.html">Organization Example Manufacturer 77</a></p><p><b>reasonCode</b>: <span title="Codes:">Chargeback review</span></p></div>
  </text>
  <extension url="https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-chargeback-reference">
    <valueIdentifier>
      <system value="https://exchange.example.org/chargebacks"/>
      <value value="cb-778899"/>
    </valueIdentifier>
  </extension>
  <status value="in-progress"/>
  <intent value="order"/>
  <focus>
    <reference value="Claim/claim-example-txid"/>
  </focus>
  <for>
    <reference value="Patient/p-001"/>
  </for>
  <requester>
    <reference value="Organization/tpa-01"/>
  </requester>
  <owner>
    <reference value="Organization/manufacturer-77"/>
  </owner>
  <reasonCode>
    <text value="Chargeback review"/>
  </reasonCode>
</Task>