<?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"/>

	<patient>
		<reference value="#patient-1"/>
	</patient>

	<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>