{"created":"2014-08-16","disposition":"Policy is currently in-force.","id":"E2501","identifier":[{"system":"http://www.BenefitsInc.com/fhir/coverageeligibilityresponse","value":"881234"}],"insurance":[{"coverage":{"reference":"Coverage/9876B1"},"inforce":true,"item":[{"benefit":[{"allowedMoney":{"currency":"SAR","value":500000},"type":{"coding":[{"code":"benefit"}]}},{"allowedMoney":{"currency":"SAR","value":100},"type":{"coding":[{"code":"copay-maximum"}]}},{"allowedUnsignedInt":20,"type":{"coding":[{"code":"copay-percent"}]}}],"category":{"coding":[{"code":"30","display":"Health Benefit Plan Coverage","system":"http://terminology.hl7.org/CodeSystem/ex-benefitcategory"}]},"network":{"coding":[{"code":"in","system":"http://terminology.hl7.org/CodeSystem/benefit-network"}]},"term":{"coding":[{"code":"annual","system":"http://terminology.hl7.org/CodeSystem/benefit-term"}]},"unit":{"coding":[{"code":"individual","system":"http://terminology.hl7.org/CodeSystem/benefit-unit"}]}},{"benefit":[{"allowedMoney":{"currency":"SAR","value":15000},"type":{"coding":[{"code":"benefit"}]}}],"category":{"coding":[{"code":"69","display":"Maternity","system":"http://terminology.hl7.org/CodeSystem/ex-benefitcategory"}]},"network":{"coding":[{"code":"in","system":"http://terminology.hl7.org/CodeSystem/benefit-network"}]},"term":{"coding":[{"code":"annual","system":"http://terminology.hl7.org/CodeSystem/benefit-term"}]},"unit":{"coding":[{"code":"individual","system":"http://terminology.hl7.org/CodeSystem/benefit-unit"}]}},{"benefit":[{"allowedMoney":{"currency":"SAR","value":2000},"type":{"coding":[{"code":"benefit"}]}}],"category":{"coding":[{"code":"F3","display":"Dental Coverage","system":"http://terminology.hl7.org/CodeSystem/ex-benefitcategory"}]},"network":{"coding":[{"code":"in","system":"http://terminology.hl7.org/CodeSystem/benefit-network"}]},"term":{"coding":[{"code":"annual","system":"http://terminology.hl7.org/CodeSystem/benefit-term"}]},"unit":{"coding":[{"code":"individual","system":"http://terminology.hl7.org/CodeSystem/benefit-unit"}]}},{"benefit":[{"allowedMoney":{"currency":"SAR","value":400},"type":{"coding":[{"code":"benefit"}]}}],"category":{"coding":[{"code":"F6","display":"Vision Coverage","system":"http://terminology.hl7.org/CodeSystem/ex-benefitcategory"}]},"network":{"coding":[{"code":"in","system":"http://terminology.hl7.org/CodeSystem/benefit-network"}]},"term":{"coding":[{"code":"annual","system":"http://terminology.hl7.org/CodeSystem/benefit-term"}]},"unit":{"coding":[{"code":"individual","system":"http://terminology.hl7.org/CodeSystem/benefit-unit"}]}},{"benefit":[{"allowedString":"shared","type":{"coding":[{"code":"room"}]}},{"allowedMoney":{"currency":"SAR","value":600},"type":{"coding":[{"code":"benefit"}]}}],"category":{"coding":[{"code":"49","display":"Hospital Room and Board","system":"http://terminology.hl7.org/CodeSystem/ex-benefitcategory"}]},"network":{"coding":[{"code":"in","system":"http://terminology.hl7.org/CodeSystem/benefit-network"}]},"term":{"coding":[{"code":"day","system":"http://terminology.hl7.org/CodeSystem/benefit-term"}]},"unit":{"coding":[{"code":"individual","system":"http://terminology.hl7.org/CodeSystem/benefit-unit"}]}}]}],"insurer":{"reference":"Organization/2"},"outcome":"complete","patient":{"reference":"Patient/pat1"},"purpose":["validation","benefits"],"request":{"reference":"http://www.BenefitsInc.com/fhir/coverageeligibilityresponse/225476332402"},"resourceType":"CoverageEligibilityResponse","servicedDate":"2014-09-17","status":"active","text":{"div":"<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the CoverageEligibilityResponse.</div>","status":"generated"}}