<Claim xmlns="http://hl7.org/fhir"><id value="100150"/><text><status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the Oral Health Claim</div></text><identifier><system value="http://happyvalley.com/claim"/><value value="12345"/></identifier><status value="active"/><type><coding><system value="http://terminology.hl7.org/CodeSystem/claim-type"/><code value="oral"/></coding></type><use value="claim"/><subject><reference value="Patient/1"/></subject><created value="2014-08-16"/><insurer><reference value="Organization/2"/></insurer><provider><reference value="Organization/1"/></provider><priority><coding><code value="normal"/></coding></priority><payee><type><coding><code value="provider"/></coding></type></payee><careTeam><sequence value="1"/><provider><reference value="Practitioner/example"/></provider></careTeam><diagnosis><sequence value="1"/><diagnosisCodeableConcept><coding><code value="123456"/></coding></diagnosisCodeableConcept></diagnosis><insurance><sequence value="1"/><focal value="true"/><identifier><system value="http://happyvalley.com/claim"/><value value="12345"/></identifier><coverage><reference value="Coverage/9876B1"/></coverage></insurance><item><sequence value="1"/><careTeamSequence value="1"/><productOrService><coding><code value="1200"/></coding></productOrService><servicedDate value="2014-08-16"/><unitPrice><value value="135.57"/><currency value="USD"/></unitPrice><net><value value="135.57"/><currency value="USD"/></net></item></Claim>