{"beneficiary":{"reference":"Patient/5"},"id":"SP1234","identifier":[{"system":"http://hospitalx.com/selfpayagreement","value":"SP12345678"}],"kind":"self-pay","paymentBy":[{"party":{"reference":"Patient/5"}}],"period":{"end":"2012-03-17"},"relationship":{"coding":[{"code":"self"}]},"resourceType":"Coverage","status":"active","subscriber":{"reference":"Patient/5"},"text":{"div":"<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of a Self Pay Agreement.</div>","status":"generated"},"type":{"coding":[{"code":"pay","display":"PAY","system":"http://terminology.hl7.org/CodeSystem/coverage-selfpay"}]}}