An exam finding using pattern 3 described in the "Using Codes in Observation" Section

{
  "resourceType": "Observation",
  "id": "abdo-tender",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: abdo-tender</p><p><b>status</b>: final</p><p><b>category</b>: Exam <span>(Details : {http://terminology.hl7.org/CodeSystem/observation-category code 'exam' = 'Exam', given as 'Exam'})</span></p><p><b>code</b>: Abdominal tenderness <span>(Details : {SNOMED CT code '43478001' = 'Abdominal tenderness', given as 'Abdominal tenderness (finding)'})</span></p><p><b>subject</b>: <a>Patient/example</a></p><p><b>encounter</b>: <a>Encounter/example</a></p><p><b>effective</b>: 02/04/2018 10:30:10 AM --&gt; (ongoing)</p><p><b>issued</b>: 03/04/2018 3:30:10 PM</p><p><b>value</b>: true</p><p><b>interpretation</b>: Abnormal <span>(Details : {http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation code 'A' = 'Abnormal', given as 'Abnormal'})</span></p></div>"

  "resourceType" : "Observation",
  "id" : "abdo-tender",
  "status" : "final",
  "category" : [{
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/observation-category",
      "code" : "exam",
      "display" : "Exam"
    }]
  }],
  "code" : {
    "coding" : [{
      "system" : "http://snomed.info/sct",
      "code" : "43478001",
      "display" : "Abdominal tenderness (finding)"
    }],
    "text" : "Abdominal tenderness"

  },
  "status": "final",
  "category": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/observation-category",
          "code": "exam",
          "display": "Exam"
        }
      ]
    }
  ],
  "code": {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "43478001",
        "display": "Abdominal tenderness (finding)"
      }
    ],
    "text": "Abdominal tenderness"

  "subject" : {
    "reference" : "Patient/example"

  },
  "subject": {
    "reference": "Patient/example"

  "encounter" : {
    "reference" : "Encounter/example"

  },
  "encounter": {
    "reference": "Encounter/example"

  "effectivePeriod" : {
    "start" : "2018-04-02T10:30:10+01:00"

  },
  "effectivePeriod": {
    "start": "2018-04-02T10:30:10+01:00"

  "issued" : "2018-04-03T15:30:10+01:00",
  "valueCodeableConcept" : {
    "coding" : [{
      "system" : "http://snomed.info/sct",
      "code" : "52101004",
      "display" : "Present (qualifier value)"
    }],
    "text" : "Present"

  },
  "issued": "2018-04-03T15:30:10+01:00",
  "valueBoolean": true,
  "interpretation": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
          "code": "A",
          "display": "Abnormal"
        }
      ],
      "text": "Abnormal"
    }
  ]

  "interpretation" : [{
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
      "code" : "A",
      "display" : "Abnormal"
    }],
    "text" : "Abnormal"
  }]

}