Coverage-example-2.xml

General Person Secondary Coverage Example (id = "7546D")

<Coverage xmlns="http://hl7.org/fhir">
 <id value="7546D"/>

 <text>
   <status value="generated"/>
   <div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the coverage</div>
 </text>

 <identifier>
    <system value="http://xyz.com/codes/identifier"/>
    <value value="AB9876"/>
 </identifier>

 <status value="active"/>

 <type>
  <coding>
   <system value="http://hl7.org/fhir/v3/ActCode"/>
   <code value="EHCPOL"/>
   <display value="extended healthcare"/>
  </coding>
 </type>

 <subscriber>
  <reference value="Patient/5"/>
 </subscriber>
 
 <beneficiary>
  <reference value="Patient/5"/>
 </beneficiary>
 
 <relationship>
   <coding>
     <code value="self"/>
   </coding>   
 </relationship>
 
 <period> 
   <start value="2011-03-17"/>
   <end value="2012-03-17"/>
 </period>

 <payor>
  <reference value="Organization/2"/>
 </payor>
 
 <group>
   <group value="WESTAIR"/>
   <groupDisplay value="Western Airlines"/>
   <plan value="WESTAIR"/>
   <planDisplay value="Western Airlines"/>
   <subPlan value="D15C9"/>
   <subPlanDisplay value="Platinum"/>
 </group>
 
 <dependent value="1"/>
  
</Coverage>