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Source1

{
  "resourceType": "CoverageEligibilityResponse",
  "id": "t17-response",
  "meta": {
    "profile": [
      "http://ig.fhir-il-community.org/T17/StructureDefinition/t17-response"
    ]
  },
  "text": {
    "div": "<!-- snip (see above) -->",
    "status": "generated"
  },
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:uuid:b3b72e7b-5390-43a0-9499-af300f6a8d7b"
    }
  ],
  "purpose": [
    "validation"
  ],
  "patient": {
    "identifier": {
      "system": "http://fhir.leumit.co.il/identifier/magnetic-card",
      "value": "1-123456-123456-789"
    }
  },
  "requestor": {
    "identifier": {
      "system": "http://fhir.health.gov.il/identifier/legal-entity",
      "value": "500106919"
    },
    "type": "Organization",
    "display": "בי\"ח איכילוב"
  },
  "request": {
    "identifier": {
      "system": "http://fhir.tlvmc.gov.il/identifier/preauth-req-no",
      "value": "3772"
    }
  },
  "insurer": {
    "identifier": {
      "system": "http://fhir.health.gov.il/identifier/legal-entity",
      "value": "580039899"
    },
    "display": "לאומית"
  },
  "insurance": [
    {
      "coverage": {
        "identifier": {
          "system": "http://fhir.leumit.co.il/identifier/obligation-num",
          "value": "1-1222223"
        },
        "reference": "Coverage/3819"
      },
      "benefitPeriod": {
        "start": "2023-05-25",
        "end": "2023-08-25"
      },
      "item": [
        {
          "benefit": [
            {
              "type": {
                "text": "benefit"
              },
              "allowedUnsignedInt": 3,
              "usedUnsignedInt": 1
            }
          ],
          "productOrService": {
            "coding": [
              {
                "system": "http://fhir.health.gov.il/cs/medical-service-moh",
                "code": "L9258",
                "display": "בדיקת רופא ילדים במרפאה"
              }
            ]
          },
          "excluded": false,
          "name": "בדיקת רופא - התמחות בכליות",
          "description": "בדיקת רופא ילדים עם התמחות לכליות"
        },
        {
          "modifier": [
            {
              "coding": [
                {
                  "code": "service-not-covered",
                  "system": "http://fhir.health.gov.il/cs/moh-form17-issue-code",
                  "display": "השירות אינו בסל"
                }
              ]
            }
          ],
          "productOrService": {
            "coding": [
              {
                "system": "http://fhir.health.gov.il/cs/medical-service-moh",
                "code": "L9261",
                "display": "תיאור קוד שירות L9261"
              }
            ]
          },
          "excluded": true,
          "name": "בדיקת רופא - התמחות כללית",
          "description": "התמחות כללית"
        },
        {
          "modifier": [
            {
              "coding": [
                {
                  "code": "service-not-covered",
                  "system": "http://fhir.health.gov.il/cs/moh-form17-issue-code",
                  "display": "השירות אינו בסל"
                }
              ]
            }
          ],
          "productOrService": {
            "coding": [
              {
                "system": "http://fhir.health.gov.il/cs/medical-service-moh",
                "code": "L9266",
                "display": "תיאור קוד שירות L9266"
              }
            ]
          },
          "excluded": true,
          "name": "בדיקת רופא - התמחות x מסוג",
          "description": "התמחות x"
        },
        {
          "modifier": [
            {
              "coding": [
                {
                  "code": "service-not-covered",
                  "system": "http://fhir.health.gov.il/cs/moh-form17-issue-code",
                  "display": "השירות אינו בסל"
                }
              ]
            }
          ],
          "productOrService": {
            "coding": [
              {
                "system": "http://fhir.health.gov.il/cs/medical-service-moh",
                "code": "99242",
                "display": "תיאור קוד שירות 99242"
              }
            ]
          },
          "excluded": true,
          "name": "בדיקת רופא - התמחות y מסוג",
          "description": "התמחות y"
        }
      ]
    }
  ],
  "status": "active",
  "created": "2023-07-02T13:44:58.429Z",
  "outcome": "complete",
  "disposition": "הבקשה להתחייבות אושרה חלקית"
}