<?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>

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

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

 <request>
   <reference value="http://benefitsinc.com/fhir/oralhealthclaim/12345"/>
 </request>

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

</PaymentNotice>