{

"resourceType": "PaymentNotice",
"id": "77654",
"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"
},
"created": "2014-08-16",
"provider": {
  "reference": "Organization/1"
},
"payment": {
  "reference": "PaymentReconciliation/ER2500"
},
"paymentDate": "2014-08-15",
"payee": {
  "reference": "Organization/1"
},
"recipient": {
  "identifier": {
    "system": "http://regulators.gov",
    "value": "AB123"
  }
},
"amount": {
  "value": 12500.0,
  "currency": "USD"
},
"paymentStatus": {
  "coding": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/paymentstatus",
      "code": "paid"
    }
  ]
},
"meta": {
  "tag": [
    {
      "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
      "code": "HTEST",
      "display": "test health data"
    }
  ]
}

}