<?xml version="1.0" encoding="UTF-8"?><Claim xmlns="http://hl7.org/fhir">
  <id value="100152"/>
  <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 Oral Health Claim</div>
  </text>
  <contained>
    <Organization>
      <id value="org-insurer"/>
      <identifier>
        <system value="http://www.bindb.com/bin"/>
        <value value="123456"/>
      </identifier>
    </Organization>
  </contained>
  <contained>
    <Organization>
      <id value="org-org"/>
      <identifier>
        <system value="http://www.jurisdiction.com/oralhealthoffices"/>
        <value value="3456"/>
      </identifier>
    </Organization>
  </contained>
  <contained>
    <Practitioner>
      <id value="provider-1"/>
      <identifier>
        <system value="http://www.jurisdiction.com/oralhealthproviders"/>
        <value value="123456789"/>
      </identifier>
    </Practitioner>
  </contained>
  <contained>
    <Patient>
      <id value="patient-1"/>
      <name>
        <use value="official"/>
        <family value="Donald"/>
        <given value="Duck"/>
      </name>
      <gender value="male"/>
      <birthDate value="1986-05-17"/>
      <address>
        <use value="home"/>
        <line value="1234 Main Street"/>
        <city value="Vancouver"/>
        <postalCode value="V2H1Y3"/>
        <country value="CAD"/>
      </address>
    </Patient>
  </contained>
  <contained>
    <Coverage>
      <id value="coverage-1"/>
      <identifier>
        <system value="http://benefitsinc.com/certificate"/>
        <value value="12345"/>
      </identifier>
      <status value="active"/>
      <kind value="insurance"/>
      <type>
        <coding>
          <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
          <code value="EHCPOL"/>
        </coding>
      </type>
      <subscriber>
        <reference value="#patient-1"/>
      </subscriber>
      <beneficiary>
        <reference value="#patient-1"/>
      </beneficiary>
      <dependent value="1"/>
      <relationship>
        <coding>
          <code value="self"/>
        </coding>
      </relationship>
      <insurer>
        <identifier>
          <system value="http://www.bindb.com/bin"/>
          <value value="123456"/>
        </identifier>
      </insurer>
      <class>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
            <code value="plan"/>
          </coding>
        </type>
        <value>
          <value value="CBI35"/>
        </value>
        <name value="Corporate Baker's Inc. Plan#35"/>
      </class>
      <class>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
            <code value="subplan"/>
          </coding>
        </type>
        <value>
          <value value="123"/>
        </value>
        <name value="Trainee Part-time Benefits"/>
      </class>
      <class>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
            <code value="sequence"/>
          </coding>
        </type>
        <value>
          <value value="1"/>
        </value>
      </class>
    </Coverage>
  </contained>
  <identifier>
    <system value="http://happyvalley.com/claim"/>
    <value value="12347"/>
  </identifier>
  <status value="active"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
      <code value="oral"/>
    </coding>
  </type>
  <use value="claim"/>
  <subject>
    <reference value="#patient-1"/>
  </subject>
  <created value="2014-08-16"/>
  <insurer>
    <reference value="#org-insurer"/>
  </insurer>
  <provider>
    <reference value="#org-org"/>
  </provider>
  <priority>
    <coding>
      <code value="normal"/>
    </coding>
  </priority>
  <payee>
    <type>
      <coding>
        <code value="provider"/>
      </coding>
    </type>
  </payee>
  <careTeam>
    <sequence value="1"/>
    <provider>
      <reference value="#provider-1"/>
    </provider>
  </careTeam>
  <diagnosis>
    <sequence value="1"/>
    <diagnosisCodeableConcept>
      <coding>
        <code value="123456"/>
      </coding>
    </diagnosisCodeableConcept>
  </diagnosis>
  <insurance>
    <sequence value="1"/>
    <focal value="true"/>
    <coverage>
      <reference value="#coverage-1"/>
    </coverage>
  </insurance>
  <item>
    <sequence value="1"/>
    <careTeamSequence value="1"/>
    <productOrService>
      <coding>
        <code value="1200"/>
      </coding>
    </productOrService>
    <servicedDate value="2014-08-16"/>
    <unitPrice>
      <value value="135.57"/>
      <currency value="USD"/>
    </unitPrice>
    <net>
      <value value="135.57"/>
      <currency value="USD"/>
    </net>
  </item>
</Claim>