<?xml version="1.0" encoding="UTF-8"?><CoverageEligibilityResponse xmlns="http://hl7.org/fhir">
  <id value="E2501"/>
  <meta>
    <security>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
      <code value="HTEST"/>
      <display value="test health data"/>
    </security>
  </meta>
  <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="881234"/>
  </identifier>
  <status value="active"/>
  <purpose value="validation"/>
  <purpose value="benefits"/>
  <patient>
    <reference value="Patient/pat1"/>
  </patient>
  <servicedDate value="2014-09-17"/>
  <!-- Anticipated service date -->
  <created value="2014-08-16"/>
  <request>
    <reference value="http://www.BenefitsInc.com/fhir/coverageeligibilityresponse/225476332402"/>
  </request>
  <outcome value="complete"/>
  <disposition value="Policy is currently in-force."/>
  <insurer>
    <reference value="Organization/2"/>
  </insurer>
  <insurance>
    <coverage>
      <reference value="Coverage/9876B1"/>
    </coverage>
    <inforce value="true"/>
    <item>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
          <code value="30"/>
          <display value="Health Benefit Plan Coverage"/>
        </coding>
      </category>
      <network>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/benefit-network"/>
          <code value="in"/>
        </coding>
      </network>
      <unit>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/benefit-unit"/>
          <code value="individual"/>
        </coding>
      </unit>
      <term>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/benefit-term"/>
          <code value="annual"/>
        </coding>
      </term>
      <benefit>
        <type>
          <coding>
            <code value="benefit"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="500000"/>
          <currency value="SAR"/>
        </allowedMoney>
      </benefit>
      <benefit>
        <type>
          <coding>
            <code value="copay-maximum"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="100"/>
          <currency value="SAR"/>
        </allowedMoney>
      </benefit>
      <benefit>
        <type>
          <coding>
            <code value="copay-percent"/>
          </coding>
        </type>
        <allowedUnsignedInt value="20"/>
      </benefit>
    </item>
    <item>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
          <code value="69"/>
          <display value="Maternity"/>
        </coding>
      </category>
      <network>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/benefit-network"/>
          <code value="in"/>
        </coding>
      </network>
      <unit>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/benefit-unit"/>
          <code value="individual"/>
        </coding>
      </unit>
      <term>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/benefit-term"/>
          <code value="annual"/>
        </coding>
      </term>
      <benefit>
        <type>
          <coding>
            <code value="benefit"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="15000"/>
          <currency value="SAR"/>
        </allowedMoney>
      </benefit>
    </item>
    <item>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
          <code value="F3"/>
          <display value="Dental Coverage"/>
        </coding>
      </category>
      <network>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/benefit-network"/>
          <code value="in"/>
        </coding>
      </network>
      <unit>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/benefit-unit"/>
          <code value="individual"/>
        </coding>
      </unit>
      <term>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/benefit-term"/>
          <code value="annual"/>
        </coding>
      </term>
      <benefit>
        <type>
          <coding>
            <code value="benefit"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="2000"/>
          <currency value="SAR"/>
        </allowedMoney>
      </benefit>
    </item>
    <item>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
          <code value="F6"/>
          <display value="Vision Coverage"/>
        </coding>
      </category>
      <network>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/benefit-network"/>
          <code value="in"/>
        </coding>
      </network>
      <unit>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/benefit-unit"/>
          <code value="individual"/>
        </coding>
      </unit>
      <term>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/benefit-term"/>
          <code value="annual"/>
        </coding>
      </term>
      <benefit>
        <type>
          <coding>
            <code value="benefit"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="400"/>
          <currency value="SAR"/>
        </allowedMoney>
      </benefit>
    </item>
    <item>
      <category>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
          <code value="49"/>
          <display value="Hospital Room and Board"/>
        </coding>
      </category>
      <network>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/benefit-network"/>
          <code value="in"/>
        </coding>
      </network>
      <unit>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/benefit-unit"/>
          <code value="individual"/>
        </coding>
      </unit>
      <term>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/benefit-term"/>
          <code value="day"/>
        </coding>
      </term>
      <benefit>
        <type>
          <coding>
            <code value="room"/>
          </coding>
        </type>
        <allowedString value="shared"/>
      </benefit>
      <benefit>
        <type>
          <coding>
            <code value="benefit"/>
          </coding>
        </type>
        <allowedMoney>
          <value value="600"/>
          <currency value="SAR"/>
        </allowedMoney>
      </benefit>
    </item>
  </insurance>
</CoverageEligibilityResponse>