<PaymentNotice xmlns="http://hl7.org/fhir"><id value="77654"/><text><status value="generated"/><div xmlns="http://www.w3.org/1999/xhtml">A human-readable rendering of the PaymentNotice</div></text><identifier><system value="http://benefitsinc.com/paymentnotice"/><value value="776543"/></identifier><status value="active"/><request><reference value="http://benefitsinc.com/fhir/claim/12345"/></request><response><reference value="http://benefitsinc.com/fhir/claimresponse/CR12345"/></response><created value="2014-08-16"/><reporter><reference value="Organization/1"/></reporter><payment><reference value="PaymentReconciliation/ER2500"/></payment><paymentDate value="2014-08-15"/><payee><reference value="Organization/1"/></payee><recipient><identifier><system value="http://regulators.gov"/><value value="AB123"/></identifier></recipient><amount><value value="12500.00"/><currency value="USD"/></amount><paymentStatus><coding><system value="http://terminology.hl7.org/CodeSystem/paymentstatus"/><code value="paid"/></coding></paymentStatus></PaymentNotice>