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PaymentNotice "77654" Version "1"

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A human-readable rendering of the PaymentNotice

{
  "resourceType" : "PaymentNotice",
  "id" : "77654",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-12-14T02:02:46.364Z"
  },
  "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"
  },
  "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" : 12500.00,
    "currency" : "USD"
  },
  "paymentStatus" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/paymentstatus",
        "code" : "paid"
      }
    ]
  }
}