{

"resourceType": "PaymentNotice",
"id": "77654",
"text": {
  "status": "generated",
  "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">A human-readable rendering of the PaymentNotice</div>"
},
"identifier": [
  {
    "system": "http://benefitsinc.com/paymentnotice",
    "value": "776543"
  }
],
"status": "active",
"request": {
  "reference": "http://benefitsinc.com/fhir/claim/12345"
},
"response": {
  "reference": "http://benefitsinc.com/fhir/claimresponse/CR12345"
},
"statusDate": "2014-08-15",
"created": "2014-08-16",
"target": {
  "identifier": {
    "system": "http://regulators.gov",
    "value": "AB123"
  }
},
"provider": {
  "identifier": {
    "system": "http://npid.org/provider",
    "value": "PR957857"
  }
},
"organization": {
  "reference": "Organization/1"
},
"paymentStatus": {
  "coding": [
    {
      "system": "http://hl7.org/fhir/paymentstatus",
      "code": "paid"
    }
  ]
}

}