<CoverageEligibilityResponse xmlns="http://hl7.org/fhir"><id value="E2503"/><text><status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the CoverageEligibilityResponse.</div></text><identifier><system value="http://www.BenefitsInc.com/fhir/coverageeligibilityresponse"/><value value="8812343"/></identifier><status value="active"/><purpose value="validation"/><patient><reference value="Patient/f201"/></patient><created value="2014-09-16"/><requestor><identifier><system value="http://national.org/clinic"/><value value="OR1234"/></identifier></requestor><request><reference value="http://www.BenefitsInc.com/fhir/coverageeligibilityresponse/225476332406"/></request><outcome value="error"/><disposition value="Eligibiliy request could not be processed, please address errors before submitting."/><insurer><reference value="Organization/2"/></insurer><form><coding><system value="http://national.org/form"/><code value="ELRSP/2017/01"/></coding></form><error><code><coding><system value="http://terminology.hl7.org/CodeSystem/adjudication-error"/><code value="a001"/></coding></code></error></CoverageEligibilityResponse>