<?xml version="1.0" encoding="UTF-8"?><Coverage xmlns="http://hl7.org/fhir">
  <id value="SP1234"/>
  <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 a Self Pay Agreement.</div>
  </text>
  <identifier>
    <system value="http://hospitalx.com/selfpayagreement"/>
    <value value="SP12345678"/>
  </identifier>
  <status value="active"/>
  <kind value="self-pay"/>
  <paymentBy>
    <party>
      <reference value="Patient/5"/>
    </party>
  </paymentBy>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/coverage-selfpay"/>
      <code value="pay"/>
      <display value="PAY"/>
    </coding>
  </type>
  <subscriber>
    <reference value="Patient/5"/>
  </subscriber>
  <beneficiary>
    <reference value="Patient/5"/>
  </beneficiary>
  <relationship>
    <coding>
      <code value="self"/>
    </coding>
  </relationship>
  <period>
    <end value="2012-03-17"/>
  </period>
</Coverage>