<?xml version="1.0" encoding="UTF-8"?>

<Organization xmlns="http://hl7.org/fhir">
  <id value="SamplePayer"/>
  <meta>
    <lastUpdated value="2026-07-01T13:26:22.0314215+00:00"/>
    <profile value="http://hl7.org/fhir/us/ndh/StructureDefinition/ndh-Organization"/>
  </meta>
  <language value="en"/>
  <text>
    <status value="extensions"/>
  </text>
  <extension url="http://hl7.org/fhir/us/ndh/StructureDefinition/base-ext-insuranceplan-reference">
    <valueReference>
      <reference value="InsurancePlan/AcmeQHPBronze"/>
    </valueReference>
  </extension>
  <identifier>
    <type>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
        <code value="PAYERID"/>
      </coding>
    </type>
    <system value="http://example.org/Identifiers"/>
    <value value="123456789"/>
  </identifier>
  <active value="true"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/organization-type"/>
      <version value="2.0.1"/>
      <code value="pay"/>
      <display value="Payer"/>
    </coding>
  </type>
  <name value="Sample of Medicare Payer"/>
  <telecom>
    <system value="phone"/>
    <value value="(111)-222-3333"/>
    <rank value="2"/>
  </telecom>
  <telecom>
    <system value="url"/>
    <value value="https://www.example.com"/>
    <rank value="1"/>
  </telecom>
  <address>
    <line value="456 Main Street"/>
    <city value="Norwalk"/>
    <state value="CT"/>
    <postalCode value="00014-1234"/>
  </address>
</Organization>