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Source1

{
  "resourceType": "Coverage",
  "id": "1",
  "meta": {
    "versionId": "1",
    "lastUpdated": "2019-06-06T03:04:12.348-04:00"
  },
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/us/davinci-atr/StructureDefinition/ext-insuranceProductType",
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsuranceProductTypeCS",
            "code": "commppo",
            "display": "Commercial PPO"
          }
        ]
      }
    }
  ],
  "identifier": [
    {
      "use": "official",
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "MB",
            "display": "Member Number"
          }
        ]
      },
      "system": "https://example.org",
      "value": "123456"
    }
  ],
  "status": "active",
  "policyHolder": {
    "reference": "Patient/1"
  },
  "subscriber": {
    "reference": "Patient/1"
  },
  "subscriberId": "AB3658",
  "beneficiary": {
    "reference": "Patient/1"
  },
  "dependent": "00",
  "relationship": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
        "code": "self",
        "display": "Self"
      }
    ]
  },
  "period": {
    "start": "2011-05-23",
    "end": "2012-05-23"
  },
  "payor": [
    {
      "reference": "Organization/2"
    }
  ],
  "class": [
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code": "plan"
          }
        ]
      },
      "value": "PPO"
    }
  ]
}