"
},
"identifier" : [{
"type" : {
"coding" : [{
"system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
"code" : "MB",
"display" : "Member Number"
}]
},
"system" : "http://example.org/fhir/memberidentifier",
"value" : "88800933501"
}],
"status" : "active",
"type" : {
"coding" : [{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "9.0.0",
"code" : "SUBSIDIZ",
"display" : "subsidized health program"
}],
"text" : "MEDICAID"
},
"subscriberId" : "123456789",
"beneficiary" : {
"reference" : "Patient/patient-example-ach-daily-negativepcr"
},
"relationship" : {
"coding" : [{
"system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
"code" : "self"
}],
"text" : "Self"
},
"period" : {
"start" : "2023-01-01"
},
"payor" : [{
"display" : "Medicaid Coverage"
}],
"class" : [{
"type" : {
"coding" : [{
"system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
"code" : "group",
"display" : "Group"
}],
"text" : "Medicaid"
},
"value" : "Medicaid",
"name" : "Medicaid"
}]
}