<?xml version=“1.0” encoding=“UTF-8”?><PaymentNotice xmlns=“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>

<statusDate value="2014-08-15"/>

<created value="2014-08-16"/>

<target>
        <identifier>
                <system value="http://regulators.gov"/>
                <value value="AB123"/>
        </identifier>
</target>

<provider>
        <identifier>
                <system value="http://npid.org/provider"/>
                <value value="PR957857"/>
        </identifier>
</provider>

<organization>
        <reference value="Organization/1"/>
</organization>

<paymentStatus>
        <coding>
                <system value="http://hl7.org/fhir/paymentstatus"/>
                <code value="paid"/>
        </coding>
</paymentStatus>

</PaymentNotice>