<Claim xmlns="http://hl7.org/fhir">
    <id value="core-examples-Claim-example4" />
    <meta>
        <versionId value="1" />
        <lastUpdated value="2016-09-08T11:37:45.967+00:00" />
    </meta>
    <text>
        <status value="generated" />
        --- We have skipped the narrative for better readability of the resource ---
    </text>
    <type value="institutional" />
    <identifier>
        <system value="http://happyhospital.com/claim" />
        <value value="9612345" />
    </identifier>
    <created value="2014-08-16" />
    <target>
        <reference value="Organization/2" />
    </target>
    <organization>
        <reference value="Organization/1" />
    </organization>
    <use value="complete" />
    <priority>
        <code value="normal" />
    </priority>
    <payee>
        <type>
            <code value="provider" />
        </type>
    </payee>
    <diagnosis>
        <sequence value="1" />
        <diagnosis>
            <code value="654456" />
        </diagnosis>
    </diagnosis>
    <patient>
        <reference value="Patient/1" />
    </patient>
    <coverage>
        <sequence value="1" />
        <focal value="true" />
        <coverage>
            <reference value="Coverage/9876B1" />
        </coverage>
        <relationship>
            <code value="self" />
        </relationship>
    </coverage>
    <item>
        <sequence value="1" />
        <type>
            <code value="service" />
        </type>
        <provider>
            <reference value="Practitioner/example" />
        </provider>
        <service>
            <system value="http://hl7.org/fhir/ex-serviceproduct" />
            <code value="exam" />
        </service>
        <serviceDate value="2014-08-16" />
        <unitPrice>
            <value value="125.00" />
            <system value="urn:iso:std:iso:4217" />
            <code value="USD" />
        </unitPrice>
        <net>
            <value value="125.00" />
            <system value="urn:iso:std:iso:4217" />
            <code value="USD" />
        </net>
    </item>
</Claim>