{
  "$result_object_key": [
    {
      "accept_assignment": true,
      "additional_claim_information": "Patient requires ongoing treatment",
      "client_relationship_to_insured": "Self",
      "condition_related_to_auto_accident": false,
      "condition_related_to_employment": false,
      "condition_related_to_other_accident": false,
      "current_illness_date": "2024-01-01",
      "diagnosis": [
        "F32.1",
        "F41.1"
      ],
      "facility_city": "New York",
      "facility_name": "City Medical Center",
      "facility_npi": "1122334455",
      "facility_other_id": "FAC001",
      "facility_state": "NY",
      "facility_street_address": "100 Hospital Way",
      "facility_zip": "10003",
      "hospitalization_end": "2024-01-10",
      "hospitalization_start": "2024-01-02",
      "insurance_plan_name": "PPO Gold",
      "insured_city": "New York",
      "insured_date_of_birth": "1985-03-15",
      "insured_first_name": "John",
      "insured_gender": "M",
      "insured_group_id": "GRP001",
      "insured_id": "XYZ123456789",
      "insured_last_name": "Smith",
      "insured_middle_initial": "A",
      "insured_phone_area_code": "212",
      "insured_phone_number": "5551234",
      "insured_state": "NY",
      "insured_street_address": "123 Main St",
      "insured_zip": "10001",
      "other_date": "2024-01-20",
      "outside_lab": false,
      "patient_account_number": "ACCT123456",
      "patient_city": "New York",
      "patient_date_of_birth": "1985-03-15",
      "patient_first_name": "John",
      "patient_gender": "M",
      "patient_last_name": "Smith",
      "patient_middle_initial": "A",
      "patient_phone_area_code": "212",
      "patient_phone_number": "5551234",
      "patient_state": "NY",
      "patient_street_address": "123 Main St",
      "patient_zip": "10001",
      "payer_city": "Chicago",
      "payer_name": "Blue Cross Blue Shield",
      "payer_state": "IL",
      "payer_street_address": "456 Insurance Blvd",
      "payer_type": "CI",
      "payer_zip": "60601",
      "prior_authorization_number": "AUTH123456",
      "prior_paid_amount": 50,
      "procedures": [
        {
          "charges": 150,
          "date": "2024-01-15",
          "diagnosis": [
            "1",
            "2"
          ],
          "modifiers": [
            "95",
            "GT"
          ],
          "npi": "1234567890",
          "place_of_service": "11",
          "procedure": "90837",
          "units": 1
        }
      ],
      "provider_city": "New York",
      "provider_first_name": "Jane",
      "provider_last_name": "Doe",
      "provider_npi": "1234567890",
      "provider_other_id": "PROV001",
      "provider_phone_area_code": "212",
      "provider_phone_number": "5559876",
      "provider_state": "NY",
      "provider_street_address": "789 Medical Center Dr",
      "provider_zip": "10002",
      "referring_provider_first_name": "Robert",
      "referring_provider_last_name": "Johnson",
      "referring_provider_middle_initial": "B",
      "referring_provider_npi": "0987654321",
      "referring_provider_other_id": "REF001",
      "referring_qualifier": "DN",
      "resubmission_reference_number": "RESUB001",
      "status": 1,
      "tax_id": "12-3456789",
      "unable_to_work_end": "2024-01-15",
      "unable_to_work_start": "2024-01-05"
    }
  ]
}

{
  "$result_object_key": [
    {
      "accept_assignment": "Whether assignment is accepted",
      "additional_claim_information": "Additional claim information",
      "client_relationship_to_insured": "Client's relationship to insured",
      "condition_related_to_auto_accident": "Whether condition is related to auto accident",
      "condition_related_to_employment": "Whether condition is related to employment",
      "condition_related_to_other_accident": "Whether condition is related to other accident",
      "current_illness_date": "Date of current illness",
      "diagnosis": "Diagnosis codes",
      "facility_city": "Facility city",
      "facility_name": "Facility name",
      "facility_npi": "Facility NPI",
      "facility_other_id": "Facility other ID",
      "facility_state": "Facility state",
      "facility_street_address": "Facility street address",
      "facility_zip": "Facility ZIP code",
      "hospitalization_end": "Hospitalization end date",
      "hospitalization_start": "Hospitalization start date",
      "insurance_plan_name": "Insurance plan name",
      "insured_city": "Insured's city",
      "insured_date_of_birth": "Insured's date of birth",
      "insured_first_name": "Insured's first name",
      "insured_gender": "Insured's gender",
      "insured_group_id": "Insured's group ID",
      "insured_id": "Insured's ID",
      "insured_last_name": "Insured's last name",
      "insured_middle_initial": "Insured's middle initial",
      "insured_phone_area_code": "Insured's phone area code",
      "insured_phone_number": "Insured's phone number",
      "insured_state": "Insured's state",
      "insured_street_address": "Insured's street address",
      "insured_zip": "Insured's ZIP code",
      "other_date": "Other relevant date",
      "outside_lab": "Whether outside lab was used",
      "patient_account_number": "Patient account number",
      "patient_city": "Patient's city",
      "patient_date_of_birth": "Patient's date of birth",
      "patient_first_name": "Patient's first name",
      "patient_gender": "Patient's gender",
      "patient_last_name": "Patient's last name",
      "patient_middle_initial": "Patient's middle initial",
      "patient_phone_area_code": "Patient's phone area code",
      "patient_phone_number": "Patient's phone number",
      "patient_state": "Patient's state",
      "patient_street_address": "Patient's street address",
      "patient_zip": "Patient's ZIP code",
      "payer_city": "Payer city",
      "payer_name": "Payer name",
      "payer_state": "Payer state",
      "payer_street_address": "Payer street address",
      "payer_type": "Payer type",
      "payer_zip": "Payer ZIP code",
      "prior_authorization_number": "Prior authorization number",
      "prior_paid_amount": "Prior paid amount",
      "procedures": {
        "charges": "Charges for this procedure",
        "date": "Date of the procedure",
        "diagnosis": "Diagnosis codes for this procedure",
        "modifiers": "Procedure modifiers",
        "npi": "NPI of the provider",
        "place_of_service": "Place of service code",
        "procedure": "Procedure code",
        "units": "Number of units"
      },
      "provider_city": "Provider's city",
      "provider_first_name": "Provider's first name",
      "provider_last_name": "Provider's last name",
      "provider_npi": "Provider NPI",
      "provider_other_id": "Provider's other ID",
      "provider_phone_area_code": "Provider's phone area code",
      "provider_phone_number": "Provider's phone number",
      "provider_state": "Provider's state",
      "provider_street_address": "Provider's street address",
      "provider_zip": "Provider's ZIP code",
      "referring_provider_first_name": "Referring provider's first name",
      "referring_provider_last_name": "Referring provider's last name",
      "referring_provider_middle_initial": "Referring provider's middle initial",
      "referring_provider_npi": "Referring provider's NPI",
      "referring_provider_other_id": "Referring provider's other ID",
      "referring_qualifier": "Referring provider qualifier",
      "resubmission_reference_number": "Resubmission reference number",
      "status": "Claim status",
      "tax_id": "Tax ID",
      "unable_to_work_end": "End date patient unable to work",
      "unable_to_work_start": "Start date patient unable to work"
    }
  ]
}