{
  "resourceType" : "Coverage",
  "id" : "haau3-coverage-two-payors",
  "meta" : {
    "profile" : ["https://haau3.com/fhir/StructureDefinition/haau3-coverage"],
    "tag" : [{
      "system" : "https://haau3.com/fhir/CodeSystem/staging-transform-rule",
      "code" : "coverage.additional_payor_relocated",
      "display" : "An additional payer was moved onto the record"
    }]
  },
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Coverage haau3-coverage-two-payors</b></p><a name=\"haau3-coverage-two-payors\"> </a><a name=\"hchaau3-coverage-two-payors\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-haau3-coverage.html\">haau3 Coverage</a></p><p style=\"margin-bottom: 0px\">Tag: </p></div><p><b>haau3 Additional Payor</b>: Northgate Supplemental Benefits</p><p><b>identifier</b>: <code>https://haau3.com/fhir/NamingSystem/source-resource-id</code>/Coverage/example-source-record</p><p><b>status</b>: Active</p><p><b>subscriberId</b>: VM-88214</p><p><b>beneficiary</b>: <a href=\"Patient-haau3-patient.html\">Derrick Lin  Male, DoB: 1965-04-12 ( https://haau3.com/fhir/NamingSystem/haau3-patient-id#Haau3PatientId#example-haau3-patient\u00a0(use:\u00a0usual,\u00a0))</a></p><p><b>relationship</b>: <span title=\"Codes:{urn:oid:2.16.840.1.113883.3.221.5 01}\">01</span></p><p><b>payor</b>: <a href=\"Organization-c4bb-commercial-organization.html\">Organization Commercial Insurance Company</a></p><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:\">plan</span></p><p><b>value</b>: Valley Choice PPO</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:\">group</span></p><p><b>value</b>: GRP-4471</p></blockquote></div>"
  },
  "extension" : [{
    "url" : "https://haau3.com/fhir/StructureDefinition/haau3-additional-payor",
    "valueReference" : {
      "display" : "Northgate Supplemental Benefits"
    }
  }],
  "identifier" : [{
    "system" : "https://haau3.com/fhir/NamingSystem/source-resource-id",
    "value" : "Coverage/example-source-record"
  }],
  "status" : "active",
  "subscriberId" : "VM-88214",
  "beneficiary" : {
    "reference" : "Patient/haau3-patient"
  },
  "relationship" : {
    "coding" : [{
      "system" : "urn:oid:2.16.840.1.113883.3.221.5",
      "code" : "01"
    }]
  },
  "payor" : [{
    "reference" : "Organization/c4bb-commercial-organization"
  }],
  "class" : [{
    "type" : {
      "coding" : [{
        "code" : "plan"
      }]
    },
    "value" : "Valley Choice PPO"
  },
  {
    "type" : {
      "coding" : [{
        "code" : "group"
      }]
    },
    "value" : "GRP-4471"
  }]
}