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June 6, 2014 19:26
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{ | |
'Charges':[ | |
{ | |
'ChargeData':{ | |
'PrimaryInsuranceInsuranceAllowed':None, | |
'ServiceStartDate':u'05/26/2014', | |
'TotalCharges':u'0.0000', | |
'BatchNumber':None, | |
'TertiaryInsuranceCompanyPlanName':u'Medicare CA', | |
'OtherPaymentAmount':None, | |
'SecondaryInsuranceLastBillDate':None, | |
'CaseName':u'CASE 1', | |
'SecondaryInsurancePaymentPostingDate':None, | |
'SecondaryInsuranceInsuranceDeductible':None, | |
'PrimaryInsurancePaymentPostingDate':None, | |
'SecondaryInsuranceZipCode':None, | |
'TertiaryInsurancePaymentRef':None, | |
'EClaimNote':None, | |
'SecondaryInsurancePaymentMethodDesc':None, | |
'PatientPaymentRef':None, | |
'AppointmentID':u'31ENZ', | |
'BilledTo':u'BC/BS of Southern California', | |
'PatientBatchID':None, | |
'SecondaryInsuranceInsuranceCoinsurance':None, | |
'SecondaryInsuranceFirstBillDate':None, | |
'TertiaryInsuranceAddressLine1':u'1344 Pacific Coast Hwy', | |
'PrimaryInsuranceInsurancePayment':None, | |
'EncounterProcedureID':u'2240', | |
'PracticeName':u'American Medicine Associates', | |
'ServiceLocationFaxExt':None, | |
'Minutes':u'0', | |
'PatientName':u'Joannie Traker', | |
'TertiaryInsuranceAddressLine2':None, | |
'SecondaryInsuranceInsuranceSecondaryAdjustmentReason':None, | |
'OtherPaymentRef':None, | |
'TertiaryInsuranceInsuranceDeductible':u'0.0000', | |
'OtherAdjustment':u'0.0000', | |
'TertiaryInsuranceBatchID':u'777', | |
'ServiceLocationBillingName':u'HB', | |
'ServiceLocationId':u'4', | |
'SecondaryInsuranceCountry':None, | |
'PrimaryInsurancePlanName':u'BC/BS of Southern California', | |
'PrimaryInsuranceInsuranceDeductible':None, | |
'ReferringProviderName':u' Sally Ortega, | |
MD', | |
'PrimaryInsuranceAdjudicationDate':None, | |
'EClaimNoteType':None, | |
'ProcedureModifier2':None, | |
'ProcedureModifier3':None, | |
'ProcedureModifier1':None, | |
'ProcedureModifier4':None, | |
'SecondaryInsurancePaymentCategoryDesc':None, | |
'TertiaryInsuranceInsuranceAllowed':u'777.0000', | |
'TertiaryInsuranceInsuranceCoinsurance':u'0.0000', | |
'TertiaryInsuranceState':u'CA', | |
'PrimaryInsuranceCompanyName':u'BC/BS of Southern California', | |
'TertiaryInsuranceCompanyName':u'Medicare CA', | |
'Units':u'1.0000', | |
'SchedulingProviderID':u'2', | |
'PrimaryInsuranceInsuranceSecondaryAdjustmentReason':None, | |
'TertiaryInsuranceInsuranceSecondaryAdjustmentReason':None, | |
'OtherPaymentCategoryDesc':None, | |
'TotalBalance':u'-777.0000', | |
'PatientDateOfBirth':u'02/08/1973', | |
'PatientFirstName':u'Joannie', | |
'PrimaryInsuranceInsuranceCopay':None, | |
'CopayReference':None, | |
'SecondaryInsuranceInsuranceContractAdjustmentReason':None, | |
'ServiceLocationNameZipCode':u'92388', | |
'TertiaryInsuranceCountry':None, | |
'TertiaryInsuranceZipCode':u'92233', | |
'LocalUseBox10d':None, | |
'DoNotSendElectronicallyToSecondary':u'False', | |
'SupervisingProviderName':None, | |
'TertiaryInsurancePaymentCategoryDesc':None, | |
'AllowedAmount':None, | |
'AdjustedCharges':u'0.0000', | |
'RefCode':None, | |
'PatientPaymentCategoryDesc':None, | |
'RenderingProviderName':u' Sara Smith, | |
MD', | |
'ServiceLocationCLIANumber':None, | |
'TertiaryInsuranceCity':u'Laguna Beach', | |
'UnitCharge':u'0.0000', | |
'OtherPaymentPostingDate':None, | |
'PrimaryInsuranceAddressLine1':u'PO Box 332939', | |
'PrimaryInsuranceAddressLine2':None, | |
'TertiaryInsuranceInsuranceContractAdjustmentReason':None, | |
'PrimaryInsuranceState':u'CA', | |
'TertiaryInsuranceAdjudicationDate':None, | |
'PatientFirstBillDate':None, | |
'TypeOfService':u'Medical Care', | |
'TertiaryInsurancePaymentID':u'1036', | |
'CreatedDate': u'6/3/2014 12:00:00 AM', | |
'SecondaryInsuranceAddressLine2':None, | |
'CopayCategory':None, | |
'SecondaryInsuranceAddressLine1':None, | |
'OtherPaymentMethodDesc':None, | |
'SecondaryInsurancePaymentRef':None, | |
'TertiaryInsuranceInsuranceCopay':u'0.0000', | |
'EncounterDiagnosisID4':None, | |
'SecondaryInsuranceInsuranceSecondaryAdjustment':None, | |
'EncounterDiagnosisID2':u'619.1', | |
'EncounterDiagnosisID3':None, | |
'HospitalizationStartDate':None, | |
'EncounterDiagnosisID1':u'305.60', | |
'ServiceLocationFacilityIdType':u'1J Facility ID Number', | |
'DoNotSendClaimElectronically':u'False', | |
'PrimaryInsurancePaymentRef':None, | |
'Status':u'Ready', | |
'ServiceLocationPhoneExt':None, | |
'SecondaryInsuranceInsuranceAllowed':None, | |
'LastModifiedDate':u'06/03/2014', | |
'ExpectedAmount':None, | |
'PatientBalance':u'0.0000', | |
'SecondaryInsuranceBatchID':None, | |
'CopayMethod':u'5 - Cash', | |
'PatientPaymentID':None, | |
'ServiceLocationFacilityID':None, | |
'Receipts':u'-777.0000', | |
'TertiaryInsuranceInsuranceSecondaryAdjustment':u'0.0000', | |
'PostingDate':u'06/03/2014', | |
'PrimaryInsuranceInsuranceContractAdjustmentReason':None, | |
'ProcedureCode':u'0001F', | |
'ServiceLocationPhone':u'(714) 273-3344', | |
'SecondaryInsuranceCompanyName':None, | |
'EncounterStatus':u'Approved', | |
'PatientLastName':u'Traker', | |
'InsuranceBalance':u'-777.0000', | |
'TertiaryInsurancePaymentPostingDate':u'06/04/2014', | |
'PatientLastBillDate':None, | |
'ServiceLocationName':u'Huntington Beach Office', | |
'PrimaryInsuranceCity':u'Orange', | |
'CopayAmount':u'250.0000', | |
'CasePayerScenario':u'Commercial', | |
'LocalUseBox19':None, | |
'TertiaryInsuranceInsurancePayment':u'777.0000', | |
'TertiaryInsurancePaymentMethodDesc':u'4 - Electronic Funds Transfer', | |
'PrimaryInsuranceZipCode':u'92831', | |
'PatientPaymentAmount':None, | |
'PrimaryInsurancePaymentID':None, | |
'PrimaryInsuranceFirstBillDate':None, | |
'PatientID':u'35', | |
'PrimaryInsurancePaymentCategoryDesc':None, | |
'ServiceLocationNPI':None, | |
'RenderingProviderID':u'1', | |
'PracticeID':u'1', | |
'PrimaryInsuranceInsuranceContractAdjustment':None, | |
'PatientPaymentMethodDesc':None, | |
'SecondaryInsuranceCity':None, | |
'ReferringProviderID':u'4', | |
'SecondaryInsurancePlanName':None, | |
'ServiceEndDate':u'06/04/2014', | |
'SecondaryInsurancePaymentID':None, | |
'SecondaryInsuranceInsurancePayment':None, | |
'ServiceLocationPlaceOfServiceName':u'Comprehensive Inpatient Rehabilitation Facility', | |
'ServiceLocationNameCountry':None, | |
'SchedulingProviderName':u' Paige McAndrews, | |
MD', | |
'PrimaryInsuranceCountry':None, | |
'PrimaryInsuranceInsuranceCoinsurance':None, | |
'LineNote':None, | |
'SecondaryInsuranceInsuranceContractAdjustment':None, | |
'PatientPaymentPostingDate':None, | |
'TertiaryInsuranceInsuranceContractAdjustment':u'0.0000', | |
'PatientMiddleName':None, | |
'OtherPaymentID':None, | |
'EncounterID':u'1140', | |
'PrimaryInsuranceLastBillDate':None, | |
'PrimaryInsuranceBatchID':None, | |
'PrimaryInsuranceInsuranceSecondaryAdjustment':None, | |
'ServiceLocationPlaceOfServiceCode':u'61', | |
'SecondaryInsuranceState':None, | |
'ID':u'2036', | |
'ServiceLocationNameAddressLine1':u'8123 Beach Blvd', | |
'ServiceLocationNameAddressLine2':None, | |
'HospitalizationEndDate':None, | |
'PrimaryInsurancePaymentMethodDesc':None, | |
'ServiceLocationNameCity':u'Huntington Beach', | |
'ServiceLocationNameState':u'CA', | |
'SecondaryInsuranceAdjudicationDate':None, | |
'ProcedureName':u'HRT FAILURE ASSESSED', | |
'ProcedureCodeCategory':None, | |
'SupervisingProviderID':None, | |
'SecondaryInsuranceInsuranceCopay':None, | |
'ServiceLocationFax':u'(714) 273-3345' | |
} | |
}, | |
{ | |
'ChargeData':{ | |
'PrimaryInsuranceInsuranceAllowed':None, | |
'ServiceStartDate':u'06/02/2014', | |
'TotalCharges':u'344.0000', | |
'BatchNumber':None, | |
'TertiaryInsuranceCompanyPlanName':None, | |
'OtherPaymentAmount':None, | |
'SecondaryInsuranceLastBillDate':None, | |
'CaseName':u'CASE 1', | |
'SecondaryInsurancePaymentPostingDate':None, | |
'SecondaryInsuranceInsuranceDeductible':None, | |
'PrimaryInsurancePaymentPostingDate':None, | |
'SecondaryInsuranceZipCode':None, | |
'TertiaryInsurancePaymentRef':None, | |
'EClaimNote':None, | |
'SecondaryInsurancePaymentMethodDesc':None, | |
'PatientPaymentRef':None, | |
'AppointmentID':u'6EOG', | |
'BilledTo':u'Emerald Insurance', | |
'PatientBatchID':None, | |
'SecondaryInsuranceInsuranceCoinsurance':None, | |
'SecondaryInsuranceFirstBillDate':None, | |
'TertiaryInsuranceAddressLine1':None, | |
'PrimaryInsuranceInsurancePayment':None, | |
'EncounterProcedureID':u'2241', | |
'PracticeName':u'American Medicine Associates', | |
'ServiceLocationFaxExt':None, | |
'Minutes':u'0', | |
'PatientName':u'Allison Thompson', | |
'TertiaryInsuranceAddressLine2':None, | |
'SecondaryInsuranceInsuranceSecondaryAdjustmentReason':None, | |
'OtherPaymentRef':None, | |
'TertiaryInsuranceInsuranceDeductible':None, | |
'OtherAdjustment':u'0.0000', | |
'TertiaryInsuranceBatchID':None, | |
'ServiceLocationBillingName':u'Tustin', | |
'ServiceLocationId':u'1', | |
'SecondaryInsuranceCountry':None, | |
'PrimaryInsurancePlanName':u'Emerald Insurance', | |
'PrimaryInsuranceInsuranceDeductible':None, | |
'ReferringProviderName':None, | |
'PrimaryInsuranceAdjudicationDate':None, | |
'EClaimNoteType':None, | |
'ProcedureModifier2':None, | |
'ProcedureModifier3':None, | |
'ProcedureModifier1':None, | |
'ProcedureModifier4':None, | |
'SecondaryInsurancePaymentCategoryDesc':None, | |
'TertiaryInsuranceInsuranceAllowed':None, | |
'TertiaryInsuranceInsuranceCoinsurance':None, | |
'TertiaryInsuranceState':None, | |
'PrimaryInsuranceCompanyName':u'Emerald Insurance', | |
'TertiaryInsuranceCompanyName':None, | |
'Units':u'1.0000', | |
'SchedulingProviderID':u'1', | |
'PrimaryInsuranceInsuranceSecondaryAdjustmentReason':None, | |
'TertiaryInsuranceInsuranceSecondaryAdjustmentReason':None, | |
'OtherPaymentCategoryDesc':None, | |
'TotalBalance':u'344.0000', | |
'PatientDateOfBirth':u'12/21/1974', | |
'PatientFirstName':u'Allison', | |
'PrimaryInsuranceInsuranceCopay':None, | |
'CopayReference':None, | |
'SecondaryInsuranceInsuranceContractAdjustmentReason':None, | |
'ServiceLocationNameZipCode':u'92618', | |
'TertiaryInsuranceCountry':None, | |
'TertiaryInsuranceZipCode':None, | |
'LocalUseBox10d':None, | |
'DoNotSendElectronicallyToSecondary':u'False', | |
'SupervisingProviderName':None, | |
'TertiaryInsurancePaymentCategoryDesc':None, | |
'AllowedAmount':None, | |
'AdjustedCharges':u'344.0000', | |
'RefCode':None, | |
'PatientPaymentCategoryDesc':None, | |
'RenderingProviderName':u' Sara Smith, | |
MD', | |
'ServiceLocationCLIANumber':None, | |
'TertiaryInsuranceCity':None, | |
'UnitCharge':u'344.0000', | |
'OtherPaymentPostingDate':None, | |
'PrimaryInsuranceAddressLine1':u'883 Harbor Blvd', | |
'PrimaryInsuranceAddressLine2':None, | |
'TertiaryInsuranceInsuranceContractAdjustmentReason':None, | |
'PrimaryInsuranceState':u'CA', | |
'TertiaryInsuranceAdjudicationDate':None, | |
'PatientFirstBillDate':None, | |
'TypeOfService':u'Medical Care', | |
'TertiaryInsurancePaymentID':None, | |
'CreatedDate': u'6/6/2014 12:00:00 AM', | |
'SecondaryInsuranceAddressLine2':None, | |
'CopayCategory':None, | |
'SecondaryInsuranceAddressLine1':None, | |
'OtherPaymentMethodDesc':None, | |
'SecondaryInsurancePaymentRef':None, | |
'TertiaryInsuranceInsuranceCopay':None, | |
'EncounterDiagnosisID4':None, | |
'SecondaryInsuranceInsuranceSecondaryAdjustment':None, | |
'EncounterDiagnosisID2':None, | |
'EncounterDiagnosisID3':None, | |
'HospitalizationStartDate':None, | |
'EncounterDiagnosisID1':u'244.0', | |
'ServiceLocationFacilityIdType':u'1J Facility ID Number', | |
'DoNotSendClaimElectronically':u'False', | |
'PrimaryInsurancePaymentRef':None, | |
'Status':u'Ready', | |
'ServiceLocationPhoneExt':None, | |
'SecondaryInsuranceInsuranceAllowed':None, | |
'LastModifiedDate':u'06/06/2014', | |
'ExpectedAmount':None, | |
'PatientBalance':u'0.0000', | |
'SecondaryInsuranceBatchID':None, | |
'CopayMethod':u'1 - Check', | |
'PatientPaymentID':None, | |
'ServiceLocationFacilityID':None, | |
'Receipts':u'0.0000', | |
'TertiaryInsuranceInsuranceSecondaryAdjustment':None, | |
'PostingDate':u'06/06/2014', | |
'PrimaryInsuranceInsuranceContractAdjustmentReason':None, | |
'ProcedureCode':u'0001F', | |
'ServiceLocationPhone':u'(714) 654-7727', | |
'SecondaryInsuranceCompanyName':None, | |
'EncounterStatus':u'Approved', | |
'PatientLastName':u'Thompson', | |
'InsuranceBalance':u'344.0000', | |
'TertiaryInsurancePaymentPostingDate':None, | |
'PatientLastBillDate':None, | |
'ServiceLocationName':u'Tustin Office', | |
'PrimaryInsuranceCity':u'Fullerton', | |
'CopayAmount':u'344.0000', | |
'CasePayerScenario':u'Commercial', | |
'LocalUseBox19':None, | |
'TertiaryInsuranceInsurancePayment':None, | |
'TertiaryInsurancePaymentMethodDesc':None, | |
'PrimaryInsuranceZipCode':u'92835', | |
'PatientPaymentAmount':None, | |
'PrimaryInsurancePaymentID':None, | |
'PrimaryInsuranceFirstBillDate':None, | |
'PatientID':u'21', | |
'PrimaryInsurancePaymentCategoryDesc':None, | |
'ServiceLocationNPI':None, | |
'RenderingProviderID':u'1', | |
'PracticeID':u'1', | |
'PrimaryInsuranceInsuranceContractAdjustment':None, | |
'PatientPaymentMethodDesc':None, | |
'SecondaryInsuranceCity':None, | |
'ReferringProviderID':None, | |
'SecondaryInsurancePlanName':None, | |
'ServiceEndDate':None, | |
'SecondaryInsurancePaymentID':None, | |
'SecondaryInsuranceInsurancePayment':None, | |
'ServiceLocationPlaceOfServiceName':u'Office', | |
'ServiceLocationNameCountry':None, | |
'SchedulingProviderName':u' Sara Smith, | |
MD', | |
'PrimaryInsuranceCountry':None, | |
'PrimaryInsuranceInsuranceCoinsurance':None, | |
'LineNote':None, | |
'SecondaryInsuranceInsuranceContractAdjustment':None, | |
'PatientPaymentPostingDate':None, | |
'TertiaryInsuranceInsuranceContractAdjustment':None, | |
'PatientMiddleName':None, | |
'OtherPaymentID':None, | |
'EncounterID':u'1141', | |
'PrimaryInsuranceLastBillDate':None, | |
'PrimaryInsuranceBatchID':None, | |
'PrimaryInsuranceInsuranceSecondaryAdjustment':None, | |
'ServiceLocationPlaceOfServiceCode':u'11', | |
'SecondaryInsuranceState':None, | |
'ID':u'2037', | |
'ServiceLocationNameAddressLine1':u'17288 Newport Ave', | |
'ServiceLocationNameAddressLine2':None, | |
'HospitalizationEndDate':None, | |
'PrimaryInsurancePaymentMethodDesc':None, | |
'ServiceLocationNameCity':u'Tustin', | |
'ServiceLocationNameState':u'CA', | |
'SecondaryInsuranceAdjudicationDate':None, | |
'ProcedureName':u'HRT FAILURE ASSESSED', | |
'ProcedureCodeCategory':None, | |
'SupervisingProviderID':None, | |
'SecondaryInsuranceInsuranceCopay':None, | |
'ServiceLocationFax':u'(714) 654-7728' | |
} | |
} | |
], | |
'SecurityResponse':{ | |
'CustomerKeyValid':True, | |
'Authenticated':True, | |
'PermissionsMissing':{ | |
'Permission':[ | |
] | |
}, | |
'SecurityResultSuccess':True, | |
'Authorized':True, | |
'PracticesAuthorized':{ | |
'PracticeID':[ | |
{ | |
'int':1 | |
} | |
] | |
}, | |
'SecurityResult':u'Success', | |
'CustomerId':23745 | |
}, | |
'ErrorResponse':{ | |
'StackTrace':None, | |
'ErrorMessage':None, | |
'IsError':False | |
} | |
} |
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