{
  "resourceType" : "Coverage",
  "id" : "example",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Coverage example</b></p><a name=\"example\"> </a><a name=\"hcexample\"> </a><p><b>identifier</b>: Member Number/12345</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/v3-ActCode EHCPOL}\">extended healthcare</span></p><p><b>policyHolder</b>: <a href=\"http://example.org/FHIR/Organization/CBI35\">http://example.org/FHIR/Organization/CBI35</a></p><p><b>subscriber</b>: <a href=\"Patient-example.html\">Amy V. Shaw  Female, DoB: 1987-02-20 ( Medical Record Number:\u00a01032702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>beneficiary</b>: <a href=\"Patient-example.html\">Amy V. Shaw  Female, DoB: 1987-02-20 ( Medical Record Number:\u00a01032702\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>dependent</b>: 0</p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>period</b>: 2011-05-23 --&gt; 2012-05-23</p><p><b>payor</b>: <a href=\"http://example.org/fhir/Organization/example-payer\">Payer XYZ</a></p><h3>Classes</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Value</b></td><td><b>Name</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class group}\">Group</span></td><td>CB135</td><td>Corporate Baker's Inc. Local #35</td></tr></table></div>"
  },
  "identifier" : [{
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
        "code" : "MB"
      }]
    },
    "system" : "http://example.org/fhir/NampingSystem/certificate",
    "value" : "12345"
  }],
  "status" : "active",
  "type" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
      "code" : "EHCPOL",
      "display" : "extended healthcare"
    }]
  },
  "policyHolder" : {
    "reference" : "http://example.org/FHIR/Organization/CBI35"
  },
  "subscriber" : {
    "reference" : "Patient/example"
  },
  "beneficiary" : {
    "reference" : "Patient/example"
  },
  "dependent" : "0",
  "relationship" : {
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
      "code" : "self"
    }]
  },
  "period" : {
    "start" : "2011-05-23",
    "end" : "2012-05-23"
  },
  "payor" : [{
    "reference" : "http://example.org/fhir/Organization/example-payer",
    "display" : "Payer XYZ"
  }],
  "class" : [{
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
        "code" : "group"
      }]
    },
    "value" : "CB135",
    "name" : "Corporate Baker's Inc. Local #35"
  }]
}