{

"resourceType": "Claim",
"id": "100152",
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    "resourceType": "Organization",
    "id": "org-insurer",
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      {
        "system": "http://www.bindb.com/bin",
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      }
    ]
  },
  {
    "resourceType": "Organization",
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      {
        "system": "http://www.jurisdiction.com/oralhealthoffices",
        "value": "3456"
      }
    ]
  },
  {
    "resourceType": "Practitioner",
    "id": "provider-1",
    "identifier": [
      {
        "system": "http://www.jurisdiction.com/oralhealthproviders",
        "value": "123456789"
      }
    ]
  },
  {
    "resourceType": "Patient",
    "id": "patient-1",
    "name": [
      {
        "use": "official",
        "family": "Donald",
        "given": [
          "Duck"
        ]
      }
    ],
    "gender": "male",
    "birthDate": "1986-05-17",
    "address": [
      {
        "use": "home",
        "line": [
          "1234 Main Street"
        ],
        "city": "Vancouver",
        "postalCode": "V2H1Y3",
        "country": "CAD"
      }
    ]
  },
  {
    "resourceType": "Coverage",
    "id": "coverage-1",
    "identifier": [
      {
        "system": "http://benefitsinc.com/certificate",
        "value": "12345"
      }
    ],
    "status": "active",
    "type": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
          "code": "EHCPOL"
        }
      ]
    },
    "subscriber": {
      "reference": "#patient-1"
    },
    "beneficiary": {
      "reference": "#patient-1"
    },
    "dependent": "1",
    "relationship": {
      "coding": [
        {
          "code": "self"
        }
      ]
    },
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      {
        "identifier": {
          "system": "http://www.bindb.com/bin",
          "value": "123456"
        }
      }
    ],
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            {
              "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
              "code": "plan"
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          ]
        },
        "value": "CBI35",
        "name": "Corporate Baker's Inc. Plan#35"
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      {
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            {
              "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
              "code": "subplan"
            }
          ]
        },
        "value": "123",
        "name": "Trainee Part-time Benefits"
      },
      {
        "type": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
              "code": "sequence"
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],
"identifier": [
  {
    "system": "http://happyvalley.com/claim",
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  }
],
"status": "active",
"type": {
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    {
      "system": "http://terminology.hl7.org/CodeSystem/claim-type",
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},
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"patient": {
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},
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"insurer": {
  "reference": "#org-insurer"
},
"provider": {
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},
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},
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},
"careTeam": [
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],
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          "code": "123456"
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],
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    }
  }
],
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    "careTeamSequence": [
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    "productOrService": {
      "coding": [
        {
          "code": "1200"
        }
      ]
    },
    "servicedDate": "2014-08-16",
    "unitPrice": {
      "value": 135.57,
      "currency": "USD"
    },
    "net": {
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  }
],
"meta": {
  "tag": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
      "code": "HTEST",
      "display": "test health data"
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  ]
}

}