{
  "resourceType": "Coverage",
  "id": "Dental-Aetna",
  "meta": {
    "versionId": "6",
    "lastUpdated": "2020-08-06T17:04:20.329+00:00",
    "source": "#wVOzmfnx1oKPJar2",
    "profile": [
      "http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-coverage"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>identifier</b>: id: 12345</p><p><b>status</b>: active</p><p><b>type</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-ActCode DENTAL}\">dental care policy</span></p><p><b>subscriber</b>: <a href=\"Patient-example-dental.html\">Generated Summary: Medical Record Number: 5152020 (USUAL); active: true; Patient A ; Phone: 123-456-7890, testA@email.com; gender: male; birthDate: 1990-01-01</a></p><p><b>subscriberId</b>: 123456</p><p><b>beneficiary</b>: <a href=\"Patient-example-dental.html\">Generated Summary: Medical Record Number: 5152020 (USUAL); active: true; Patient A ; Phone: 123-456-7890, testA@email.com; gender: male; birthDate: 1990-01-01</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>: 2020-01-01 --&gt; 2020-01-01</p><p><b>payor</b>: <a href=\"Organization-Aetna-organization.html\">Generated Summary: id: 9316452725; active: true; <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/organization-type pay}\">Payer</span>; name: Aetna Insurance; Phone: (+1) 720-677-7777, customer2-service@Aetna.org</a></p><h3>Classes</h3><table class=\"grid\"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td><td><b>Name</b></td></tr><tr><td>*</td><td><span title=\"Codes: {http://terminology.hl7.org/CodeSystem/coverage-class plan}\">Plan</span></td><td>B37FC</td><td>Aetna Full Coverage: Medical, Dental, Pharmacy, Vision, EHC</td></tr></table></div>"
  },
  "identifier": [
    {
      "system": "http://benefitsAetna.com/certificate",
      "value": "12345"
    }
  ],
  "status": "active",
  "type": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "DENTAL",
        "display": "dental care policy"
      }
    ]
  },
  "subscriber": {
    "reference": "Patient/example-dental"
  },
  "subscriberId": "123456",
  "beneficiary": {
    "reference": "Patient/example-dental"
  },
  "dependent": "0",
  "relationship": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
        "code": "self",
        "display": "Self"
      }
    ]
  },
  "period": {
    "start": "2020-01-01",
    "end": "2020-01-01"
  },
  "payor": [
    {
      "reference": "Organization/Aetna-organization"
    }
  ],
  "class": [
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code": "plan"
          }
        ]
      },
      "value": "B37FC",
      "name": "Aetna Full Coverage: Medical, Dental, Pharmacy, Vision, EHC"
    }
  ]
}