sample.json 3.4 KB

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  1. {
  2. "created_at": "2020-07-31T16:14:00Z",
  3. "eligible_id": "9CV9QVPUUDCQ8E",
  4. "known_issues": [],
  5. "date_of_death": null,
  6. "last_name": "FRANKLIN",
  7. "first_name": "BENJAMIN",
  8. "middle_name": "J",
  9. "member_id": "333333333A",
  10. "group_id": null,
  11. "group_name": null,
  12. "dob": "1967-09-09",
  13. "gender": "M",
  14. "address": {
  15. "street_line_1": "1842 Union Street",
  16. "street_line_2": null,
  17. "city": "San Francisco",
  18. "state": "OH",
  19. "zip": "94123"
  20. },
  21. "payer_name": "CMS",
  22. "payer_id": "00431","p
  23. lan_number":"","eligibilty_dates":{"start":"2019-02-27","end":null},"eligibility_dates":{"start":"2019-02-27","end":null},"inactivity_dates":{"start":null,"end":null},"plan_types":{"MA":"Medicare Part A (Hospital)","MB":"Medicare Part B (
  24. Professional Services)","MC":"Medicare Part C (Advantage)","MD":"Medicare Part D (Prescription drugs)","PR":"Primary insurance (Medicare Secondary, This Insurance is Primary)"},"plan_details":{"MA":{"active":true,"start_date":"1994-01-01",
  25. "end_date": null,
  26. "deductible": 1288.0,
  27. "deductible_remaining": 1288.0,
  28. "insurance_type": "MA",
  29. "insurance_type_label": "Medicare Part A",
  30. "coinsurance_percent": null,
  31. "copayment": null,
  32. "info_valid_until": "2020-12-31",
  33. "info_valid_till": "2020-12-31","
  34. comments":[]},"MB":{"active":true,"start_date":"1994-01-01","end_date":null,"deductible":166.0,"deductible_remaining":23.93,"insurance_type":"MB","insurance_type_label":"Medicare Part B","coinsurance_percent":20,"copayment":null,"info_val
  35. id_until":"2020-12-31","info_valid_till":"2020-12-31","comments":[]},"MC":{"active":false,"payer_name":null,"insurance_type":null,"insurance_type_label":null,"mco_bill_option_code":null,"mco_bill_option_label":null,"locked":null,"policy_n
  36. umber":null,"effective_date":null,"termination_date":null,"contacts":null,"address":{"street_line_1":null,"street_line_2":null,"city":null,"state":null,"zip":null},"comments":[]},"MD":{"active":true,"payer_name":"FRANKLIN","policy_number": "123123123",
  37. "effective_date": "2019-01-01",
  38. "termination_date": null,
  39. "contacts": [
  40. {
  41. "contact_type": "telephone",
  42. "contact_value": "8887116798"
  43. },
  44. {
  45. "contact_type": "url",
  46. "contact_value": "www.FirstHealthPartD.com"
  47. }
  48. ],
  49. "address": {
  50. "street_line_1":"1842 U
  51. nion Street","street_line_2":null,"city":"San Francisco","state":"IL","zip":"94123"},"comments":[]},"PR":[]},"requested_service_types":[{"type":"30","type_label":"Health Benefit Plan Coverage","plan_type":"MA","active":true,"start_date":"
  52. 1994-01-01","end_date":null,"deductible":1288.0,"deductible_remaining":1288.0,"insurance_type":"MA","insurance_type_label":"Medicare Part A","coinsurance_percent":null,"copayment":null,"info_valid_until":"2020-12-31","info_valid_till":"20
  53. 20-12-31"},{"type":"30","type_label":"Health Benefit Plan Coverage","plan_type":"MB","active":true,"start_date":"1994-01-01","end_date":null,"deductible":166.0,"deductible_remaining":23.93,"insurance_type":"MB","insurance_type_label":"Med
  54. icare Part B","coinsurance_percent":20,"copayment":null,"info_valid_until":"2020-12-31","info_valid_till":"2020-12-31"}],"requested_procedure_codes":[],"history":{"plan_details":{"MA":[],"MB":[],"MC":[],"MD":[],"PR":[]},"requested_service
  55. _types":[]}}