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corbinbs/corbin_claims_status_api_response.json

Last active August 29, 2015 14:07
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PokitDok Platform Claims status API response
Raw
corbin_claims_status_api_response.json
{
"patient": {
"claims": [
{
"adjudication_finalized_date": "2014-10-11",
"applied_to_deductible": true,
"claim_control_number": "E535HB9CW00",
"claim_payment_amount": {
"amount": "0",
"currency": "USD"
},
"service_date": "2014-09-30",
"service_end_date": "2014-09-30",
"services": [
{
"charge_amount": {
"amount": "30",
"currency": "USD"
},
"cpt_code": "86803",
"payment_amount": {
"amount": "0",
"currency": "USD"
},
"service_date": "2014-09-30",
"service_end_date": "2014-09-30",
"statuses": [
{
"status_category": "Finalized/Denial-The claim/line has been denied.",
"status_code": "Payment reflects usual and customary charges.",
"status_effective_date": "2014-10-13"
}
]
},
{
"charge_amount": {
"amount": "30",
"currency": "USD"
},
"cpt_code": "86706",
"payment_amount": {
"amount": "0",
"currency": "USD"
},
"service_date": "2014-09-30",
"service_end_date": "2014-09-30",
"statuses": [
{
"status_category": "Finalized/Denial-The claim/line has been denied.",
"status_code": "Payment reflects usual and customary charges.",
"status_effective_date": "2014-10-13"
}
]
},
{
"charge_amount": {
"amount": "30",
"currency": "USD"
},
"cpt_code": "86704",
"payment_amount": {
"amount": "0",
"currency": "USD"
},
"service_date": "2014-09-30",
"service_end_date": "2014-09-30",
"statuses": [
{
"status_category": "Finalized/Denial-The claim/line has been denied.",
"status_code": "Payment reflects usual and customary charges.",
"status_effective_date": "2014-10-13"
}
]
},
{
"charge_amount": {
"amount": "30",
"currency": "USD"
},
"cpt_code": "86703",
"payment_amount": {
"amount": "0",
"currency": "USD"
},
"service_date": "2014-09-30",
"service_end_date": "2014-09-30",
"statuses": [
{
"status_category": "Finalized/Denial-The claim/line has been denied.",
"status_code": "Payment reflects usual and customary charges.",
"status_effective_date": "2014-10-13"
}
]
},
{
"charge_amount": {
"amount": "25",
"currency": "USD"
},
"cpt_code": "86141",
"payment_amount": {
"amount": "0",
"currency": "USD"
},
"service_date": "2014-09-30",
"service_end_date": "2014-09-30",
"statuses": [
{
"status_category": "Finalized/Denial-The claim/line has been denied.",
"status_code": "Payment reflects usual and customary charges.",
"status_effective_date": "2014-10-13"
}
]
},
{
"charge_amount": {
"amount": "25",
"currency": "USD"
},
"cpt_code": "85027",
"payment_amount": {
"amount": "0",
"currency": "USD"
},
"service_date": "2014-09-30",
"service_end_date": "2014-09-30",
"statuses": [
{
"status_category": "Finalized/Denial-The claim/line has been denied.",
"status_code": "Payment reflects usual and customary charges.",
"status_effective_date": "2014-10-13"
}
]
}
],
"statuses": [
{
"adjudication_finalized_date": "2014-10-11",
"claim_payment_amount": {
"amount": "0",
"currency": "USD"
},
"status_category": "Finalized/Denial-The claim/line has been denied.",
"status_code": "Payment reflects usual and customary charges.",
"status_effective_date": "2014-10-13",
"total_claim_amount": {
"amount": "170",
"currency": "USD"
}
}
],
"total_claim_amount": {
"amount": "170",
"currency": "USD"
},
"tracking_id": "3D1F380F-00D2-4D30-983E-B636EC"
},
{
"adjudication_finalized_date": "2014-10-11",
"applied_to_deductible": true,
"claim_control_number": "E535HB9CW01",
"claim_payment_amount": {
"amount": "0",
"currency": "USD"
},
"service_date": "2014-09-30",
"service_end_date": "2014-09-30",
"services": [
{
"charge_amount": {
"amount": "25",
"currency": "USD"
},
"cpt_code": "80061",
"payment_amount": {
"amount": "0",
"currency": "USD"
},
"service_date": "2014-09-30",
"service_end_date": "2014-09-30",
"statuses": [
{
"status_category": "Finalized/Denial-The claim/line has been denied.",
"status_code": "Payment reflects usual and customary charges.",
"status_effective_date": "2014-10-13"
}
]
},
{
"charge_amount": {
"amount": "25",
"currency": "USD"
},
"cpt_code": "80053",
"payment_amount": {
"amount": "0",
"currency": "USD"
},
"service_date": "2014-09-30",
"service_end_date": "2014-09-30",
"statuses": [
{
"status_category": "Finalized/Denial-The claim/line has been denied.",
"status_code": "Payment reflects usual and customary charges.",
"status_effective_date": "2014-10-13"
}
]
}
],
"statuses": [
{
"adjudication_finalized_date": "2014-10-11",
"claim_payment_amount": {
"amount": "0",
"currency": "USD"
},
"status_category": "Finalized/Denial-The claim/line has been denied.",
"status_code": "Payment reflects usual and customary charges.",
"status_effective_date": "2014-10-13",
"total_claim_amount": {
"amount": "50",
"currency": "USD"
}
}
],
"total_claim_amount": {
"amount": "50",
"currency": "USD"
},
"tracking_id": "3D1F380F-00D2-4D30-983E-B636EC"
}
],
"first_name": "BRIAN",
"id": "WXXXXXXXXX",
"last_name": "CORBIN"
},
"providers": [
{
"first_name": "CHRISTINA",
"last_name": "BERTOLAMI",
"npi": "1619131232"
}
],
"trading_partner_id": "aetna"
}
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