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Source1

{
  "resourceType": "Organization",
  "id": "SamplePayer",
  "meta": {
    "lastUpdated": "2026-07-01T13:26:22.0314215+00:00",
    "profile": [
      "http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-Organization"
    ]
  },
  "language": "en-US",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "extension": [
    {
      "url": "http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-insuranceplan-reference",
      "valueReference": {
        "reference": "InsurancePlan/AcmeQHPBronze"
      }
    }
  ],
  "identifier": [
    {
      "type": {
        "coding": [
          {
            "system": "http://terminology.hl7.org/CodeSystem/v2-0203",
            "code": "PAYERID"
          }
        ]
      },
      "system": "http://example.org/Identifiers",
      "value": "123456789"
    }
  ],
  "active": true,
  "type": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/organization-type",
          "version": "2.0.1",
          "code": "pay",
          "display": "Payer"
        }
      ]
    }
  ],
  "name": "Sample of Medicare Payer",
  "telecom": [
    {
      "system": "phone",
      "value": "(111)-222-3333",
      "rank": 2
    },
    {
      "system": "url",
      "value": "https://www.example.com",
      "rank": 1
    }
  ],
  "address": [
    {
      "line": [
        "456 Main Street"
      ],
      "city": "Norwalk",
      "state": "CT",
      "postalCode": "00014-1234"
    }
  ]
}