{
    "resourceType": "Claim",
    "id": "760151",
    "identifier": [
        {
            "system": "http://cvs.com/claim",
            "value": "7612345"
        }
    ],
    "status": "active",
    "type": {
        "coding": [
            {
                "system": "http://terminology.hl7.org/CodeSystem/claim-type",
                "code": "pharmacy"
            }
        ]
    },
    "use": "claim",
    "patient": {
        "reference": "Patient/id2"
    },
    "created": "2019-09-13",
    "insurer": {
        "reference": "Organization/2"
    },
    "provider": {
        "reference": "Organization/1456"
    },
    "priority": {
        "coding": [
            {
                "code": "stat"
            }
        ]
    },

    "prescription": {
        "reference": "http://pharmacy.org/MedicationRequest/AB1234G"
    },
    "originalPrescription": {
        "reference": "http://pharmacy.org/MedicationRequest/AB1202B"
    },
    "payee": {
        "type": {
            "coding": [
                {
                    "code": "provider"
                }
            ]
        }
    },
    "insurance": [
        {
            "sequence": 1,
            "focal": true,
            "coverage": {
                "reference": "Coverage/9876B1"
            }
        }
    ],
    "item": [
        {
            "sequence": 1,
            "careTeamSequence": [
                1
            ],
            "informationSequence": [
                1,
                2,
                3
            ],
            "productOrService": {
                "coding": [
                    {
                        "code": "51079-456-20",
                        "display": "Simvastatin"
                    }
                ]
            },
            "servicedDate": "2014-08-16",
            "quantity": {
                "value": 90,
                "unit": "TAB",
                "system": "http://unitsofmeasure.org",
                "code": "TAB"
            },
            "net": {
                "value": 90,
                "currency": "USD"
            }
        }
    ]
}