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Source1

{
  "resourceType": "Coverage",
  "id": "00000004",
  "extension": [
    {
      "url": "http://fhir.de/StructureDefinition/gkv/besondere-personengruppe",
      "valueCoding": {
        "system": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_PERSONENGRUPPE",
        "code": "00"
      }
    },
    {
      "url": "http://fhir.de/StructureDefinition/gkv/dmp-kennzeichen",
      "valueCoding": {
        "system": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_DMP",
        "code": "00"
      }
    },
    {
      "url": "http://fhir.de/StructureDefinition/gkv/wop",
      "valueCoding": {
        "system": "https://fhir.kbv.de/CodeSystem/74_CS_AW_Krankenversicherung_WOP",
        "code": "03"
      }
    },
    {
      "url": "http://fhir.de/StructureDefinition/gkv/versichertenart",
      "valueCoding": {
        "system": "https://fhir.kbv.de/CodeSystem/KBV_CS_SFHIR_KBV_VERSICHERTENSTATUS",
        "code": "1"
      }
    }
  ],
  "status": "active",
  "type": {
    "coding": [
      {
        "system": "http://fhir.de/CodeSystem/versicherungsart-de-basis",
        "code": "GKV"
      }
    ]
  },
  "beneficiary": {
    "reference": "http://FHIR-SERVER-URL.DE/Patient/00000001"
  },
  "payor": [
    {
      "identifier": {
        "system": "http://fhir.de/NamingSystem/arge-ik/iknr",
        "value": "104212059"
      },
      "display": "AOK Rheinland/Hamburg"
    }
  ]
}