{
  "resourceType" : "Organization",
  "id" : "IC-1",
  "meta" : {
    "lastUpdated" : "2025-11-27T20:27:11.000-06:00",
    "profile" : ["https://docs.mydata.athenahealth.com/fhir-r4/StructureDefinition/athena-pas-insurer-organization-profile"]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><table width=\"100%\"><tbody><tr><td width=\"25%\">Aetna Life and Casualty</td><td width=\"42%\">P O Box 1458 Carrollton, TX 75006 US Phone: 9726621350 Phone: 9876543211</td></tr></tbody></table></div>"
  },
  "identifier" : [{
    "extension" : [{
      "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierSubDepartment",
      "valueString" : "Aetna Life and Casualty"
    },
    {
      "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierJurisdiction",
      "valueCodeableConcept" : {
        "coding" : [{
          "system" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-identifierJurisdiction",
          "code" : "TX ",
          "display" : "Texas"
        }]
      }
    }],
    "system" : "http://hl7.org/fhir/sid/us-npi",
    "value" : "0"
  },
  {
    "type" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
        "code" : "TIN",
        "display" : "Tax Identification Number"
      }]
    },
    "system" : "http://terminology.hl7.org/NamingSystem/USEIN",
    "value" : "12345"
  },
  {
    "type" : {
      "coding" : [{
        "system" : "http://hl7.org/fhir/us/carin-bb/CodeSystem/C4BBIdentifierType",
        "code" : "payerid",
        "display" : "Payer ID"
      }]
    },
    "value" : "11223344"
  }],
  "active" : true,
  "type" : [{
    "coding" : [{
      "system" : "https://valueset.x12.org/x217/005010/request/2010A/NM1/1/01/00/98",
      "code" : "93",
      "display" : "Insurance Institute"
    }],
    "text" : "Insurance Institute"
  }],
  "name" : "Aetna Life and Casualty",
  "telecom" : [{
    "system" : "phone",
    "value" : "9726621350",
    "use" : "work"
  },
  {
    "system" : "phone",
    "value" : "9876543211",
    "use" : "mobile"
  }],
  "address" : [{
    "line" : ["P O Box 1458"],
    "city" : "Carrollton",
    "state" : "TX",
    "postalCode" : "75006",
    "country" : "US"
  }]
}