58. EPMO Open Source Coordination Office Redaction File Detail Report

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58.1 Files compared

# Location File Last Modified
1 PC_CP4_CiF.zip\FPPS_Frontend\fpps-app\Testing\json-server db.json Fri Dec 8 17:53:00 2017 UTC
2 PC_CP4_CiF.zip\FPPS_Frontend\fpps-app\Testing\json-server db.json Fri Dec 8 19:16:26 2017 UTC

58.2 Comparison summary

Description Between
Files 1 and 2
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Changed 8 16
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58.3 Comparison options

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58.4 Active regular expressions

No regular expressions were active.

58.5 Comparison detail

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  731         "cla imDate": " 05/05/2017 ",
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  736         "ass ignedTo":  "John",
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  745         "com ments": "u pdated rec ently",
  746         "his tory": "co mpleted",
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  1539         "vet eranName":  "Sabrina  Osborne",
  1540         "ssn ": 7491957 10,
  1541         "cla imDate": " 06/18/2017 ",
  1542         "cla imAmount":  "$370658. 7035",
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  1547         "day sInProcess ": "06/18/ 2017",
  1548         "lin esClosed":  9796,
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  1553         "rea son": 2446 ,
  1554         "exp lanation":  "Rejected  Claim",
  1555         "com ments": "u p to date" ,
  1556         "his tory": "pr ocessed",
  1557         "pat ientContro lNumber":  21493761,
  1558         "ser viceDate":  "03/03/20 17",
  1559         "prT in": 19886 608,
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  1561       },
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  1565         "cla imId": 163 2803,
  1566         "cla imStatus":  "ESTABLIS H",
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  1568         "her o": "Y",
  1569         "vet eranName":  "Madeline  Witt",
  1570         "ssn ": 3959899 17,
  1571         "cla imDate": " 01/11/2017 ",
  1572         "cla imAmount":  "$175650. 5998",
  1573         "pro viderName" : "Mercy H ospital",
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  1576         "ass ignedTo":  "Michael",
  1577         "day sInProcess ": "04/27/ 2017",
  1578         "lin esClosed":  4696,
  1579         "rec oncile": " N",
  1580         "pat ientId": 1 765816,
  1581         "dis approvedBy ": "Michae l",
  1582         "dis approvedDa te": "02/0 1/2017",
  1583         "rea son": 1486 ,
  1584         "exp lanation":  "Rejected  Claim",
  1585         "com ments": "u p to date" ,
  1586         "his tory": "pr ocessed",
  1587         "pat ientContro lNumber":  60918784,
  1588         "ser viceDate":  "06/09/20 17",
  1589         "prT in": 89361 068,
  1590         "prN pi": 66679 631
  1591       },
  1592       {
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  1596         "cla imStatus":  "INPROCES S",
  1597         "cla imType": " INST",
  1598         "her o": "N",
  1599         "vet eranName":  "Millicen t Hunt",
  1600         "ssn ": 7000502 47,
  1601         "cla imDate": " 04/01/2017 ",
  1602         "cla imAmount":  "$169782. 6923",
  1603         "pro viderName" : "AJS Hos pital",
  1604         "lin es": 142,
  1605         "fac ility": 20 8,
  1606         "ass ignedTo":  "John",
  1607         "day sInProcess ": "06/19/ 2017",
  1608         "lin esClosed":  7637,
  1609         "rec oncile": " Y",
  1610         "pat ientId": 7 005525,
  1611         "dis approvedBy ": "David" ,
  1612         "dis approvedDa te": "06/1 3/2017",
  1613         "rea son": 5630 ,
  1614         "exp lanation":  "Out of s ystem paym ents",
  1615         "com ments": "u p to date" ,
  1616         "his tory": "co mpleted",
  1617         "pat ientContro lNumber":  28738396,
  1618         "ser viceDate":  "04/29/20 17",
  1619         "prT in": 16211 534,
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  1621       },
  1622       {
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  1624         "use r": 54,
  1625         "cla imId": 811 1387,
  1626         "cla imStatus":  "AGED",
  1627         "cla imType": " PROF",
  1628         "her o": "N",
  1629         "vet eranName":  "Janet As hley",
  1630         "ssn ": 7694936 48,
  1631         "cla imDate": " 03/31/2017 ",
  1632         "cla imAmount":  "$441032. 8235",
  1633         "pro viderName" : "Memoria l Hospital ",
  1634         "lin es": 861,
  1635         "fac ility": 33 8,
  1636         "ass ignedTo":  "Michael",
  1637         "day sInProcess ": "02/24/ 2017",
  1638         "lin esClosed":  7183,
  1639         "rec oncile": " N",
  1640         "pat ientId": 2 115562,
  1641         "dis approvedBy ": "Joseph ",
  1642         "dis approvedDa te": "04/0 6/2017",
  1643         "rea son": 2535 ,
  1644         "exp lanation":  "Out of s ystem paym ents",
  1645         "com ments": "u p to date" ,
  1646         "his tory": "pr ocessed",
  1647         "pat ientContro lNumber":  99658713,
  1648         "ser viceDate":  "05/27/20 17",
  1649         "prT in": 51711 616,
  1650         "prN pi": 86736 665
  1651       }
  1652     ],
  1653     "Diagnos isCode": [ {
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  1655         "Seq uenceNumbe r": 1,
  1656         "Dia gnosisCode ": "ABC123 ",
  1657         "POA Indicator" : "UNK",
  1658         "Des cription":  "ABC123",
  1659         "DXT ype": "Pri mary"
  1660       },
  1661       {
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  1663         "Seq uenceNumbe r": 1,
  1664         "Dia gnosisCode ": "ABC123 ",
  1665         "POA Indicator" : "UNK",
  1666         "Des cription":  "ABC123",
  1667         "DXT ype": "Pri mary"
  1668       },
  1669       {
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  1671         "Seq uenceNumbe r": 1,
  1672         "Dia gnosisCode ": "ABC123 ",
  1673         "POA Indicator" : "UNK",
  1674         "Des cription":  "ABC123",
  1675         "DXT ype": "Pri mary"
  1676       },
  1677       {
  1678         "id" : 4,
  1679         "Seq uenceNumbe r": 1,
  1680         "Dia gnosisCode ": "ABC123 ",
  1681         "POA Indicator" : "UNK",
  1682         "Des cription":  "ABC123",
  1683         "DXT ype": "Pri mary"
  1684       },
  1685       {
  1686         "id" : 5,
  1687         "Seq uenceNumbe r": 1,
  1688         "Dia gnosisCode ": "ABC123 ",
  1689         "POA Indicator" : "UNK",
  1690         "Des cription":  "ABC123",
  1691         "DXT ype": "Pri mary"
  1692       },
  1693       {
  1694         "id" : 6,
  1695         "Seq uenceNumbe r": 1,
  1696         "Dia gnosisCode ": "ABC123 ",
  1697         "POA Indicator" : "UNK",
  1698         "Des cription":  "ABC123",
  1699         "DXT ype": "Pri mary"
  1700       },
  1701       {
  1702         "id" : 7,
  1703         "Seq uenceNumbe r": 1,
  1704         "Dia gnosisCode ": "ABC123 ",
  1705         "POA Indicator" : "UNK",
  1706         "Des cription":  "ABC123",
  1707         "DXT ype": "Pri mary"
  1708       },
  1709       {
  1710         "id" : 8,
  1711         "Seq uenceNumbe r": 1,
  1712         "Dia gnosisCode ": "ABC123 ",
  1713         "POA Indicator" : "UNK",
  1714         "Des cription":  "ABC123",
  1715         "DXT ype": "Pri mary"
  1716       }
  1717     ],
  1718     "LineIte ms": [{
  1719         "id" : 1,
  1720         "Lin eId": 1,
  1721         "Med icalCode":  "ABC123",
  1722         "Rev anueCode":  "12345",
  1723         "SVC FromDate":  "01/01/20 17",
  1724         "SVC ToDate": " 01/01/2017 ",
  1725         "Bil ledAmt": " $999,999.0 0",
  1726         "Lin eStatus":  "UNK",
  1727         "Tre asuryPmtDa te": "01/0 1/2017",
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  1729         "Che ck_EFT_TRN ": "123456 ",
  1730         "Adj Amount": " $999,999.0 0",
  1731         "Adj ReasonCode ": "ABC123 "
  1732       },
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  1737         "Rev anueCode":  "12345",
  1738         "SVC FromDate":  "01/01/20 17",
  1739         "SVC ToDate": " 01/01/2017 ",
  1740         "Bil ledAmt": " $999,999.0 0",
  1741         "Lin eStatus":  "UNK",
  1742         "Tre asuryPmtDa te": "01/0 1/2017",
  1743         "Pai dAmt": "$9 99,999.00" ,
  1744         "Che ck_EFT_TRN ": "123456 ",
  1745         "Adj Amount": " $999,999.0 0",
  1746         "Adj ReasonCode ": "ABC123 "
  1747       },
  1748       {
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  1752         "Rev anueCode":  "12345",
  1753         "SVC FromDate":  "01/01/20 17",
  1754         "SVC ToDate": " 01/01/2017 ",
  1755         "Bil ledAmt": " $999,999.0 0",
  1756         "Lin eStatus":  "UNK",
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  1758         "Pai dAmt": "$9 99,999.00" ,
  1759         "Che ck_EFT_TRN ": "123456 ",
  1760         "Adj Amount": " $999,999.0 0",
  1761         "Adj ReasonCode ": "ABC123 "
  1762       },
  1763       {
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  1766         "Med icalCode":  "ABC123",
  1767         "Rev anueCode":  "12345",
  1768         "SVC FromDate":  "01/01/20 17",
  1769         "SVC ToDate": " 01/01/2017 ",
  1770         "Bil ledAmt": " $999,999.0 0",
  1771         "Lin eStatus":  "UNK",
  1772         "Tre asuryPmtDa te": "01/0 1/2017",
  1773         "Pai dAmt": "$9 99,999.00" ,
  1774         "Che ck_EFT_TRN ": "123456 ",
  1775         "Adj Amount": " $999,999.0 0",
  1776         "Adj ReasonCode ": "ABC123 "
  1777       },
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  1782         "Rev anueCode":  "12345",
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  1784         "SVC ToDate": " 01/01/2017 ",
  1785         "Bil ledAmt": " $999,999.0 0",
  1786         "Lin eStatus":  "UNK",
  1787         "Tre asuryPmtDa te": "01/0 1/2017",
  1788         "Pai dAmt": "$9 99,999.00" ,
  1789         "Che ck_EFT_TRN ": "123456 ",
  1790         "Adj Amount": " $999,999.0 0",
  1791         "Adj ReasonCode ": "ABC123 "
  1792       },
  1793       {
  1794         "id" : 6,
  1795         "Lin eId": 1,
  1796         "Med icalCode":  "ABC123",
  1797         "Rev anueCode":  "12345",
  1798         "SVC FromDate":  "01/01/20 17",
  1799         "SVC ToDate": " 01/01/2017 ",
  1800         "Bil ledAmt": " $999,999.0 0",
  1801         "Lin eStatus":  "UNK",
  1802         "Tre asuryPmtDa te": "01/0 1/2017",
  1803         "Pai dAmt": "$9 99,999.00" ,
  1804         "Che ck_EFT_TRN ": "123456 ",
  1805         "Adj Amount": " $999,999.0 0",
  1806         "Adj ReasonCode ": "ABC123 "
  1807       },
  1808       {
  1809         "id" : 7,
  1810         "Lin eId": 1,
  1811         "Med icalCode":  "ABC123",
  1812         "Rev anueCode":  "12345",
  1813         "SVC FromDate":  "01/01/20 17",
  1814         "SVC ToDate": " 01/01/2017 ",
  1815         "Bil ledAmt": " $999,999.0 0",
  1816         "Lin eStatus":  "UNK",
  1817         "Tre asuryPmtDa te": "01/0 1/2017",
  1818         "Pai dAmt": "$9 99,999.00" ,
  1819         "Che ck_EFT_TRN ": "123456 ",
  1820         "Adj Amount": " $999,999.0 0",
  1821         "Adj ReasonCode ": "ABC123 "
  1822       }
  1823     ],
  1824     "Rerouti ngHistory" : [{
  1825         "id" : 1,
  1826         "Dat e": "01/01 /2017",
  1827         "Rea son": "Ser vice Autho rized by a nother VA  facility i n another  state",
  1828         "Exp lanation":  "ABC123",
  1829         "Tra nsferredTo ": "VISN:2 /ABC",
  1830         "Tra nsferredFr om": "VISN :2/ABC",
  1831         "Tra nsferredBy ": "VHAMCA DPQSDFDP"
  1832       },
  1833       {
  1834         "id" : 2,
  1835         "Dat e": "01/01 /2017",
  1836         "Rea son": "Rea son Statme nt will go  here",
  1837         "Exp lanation":  "ABC123",
  1838         "Tra nsferredTo ": "VISN:2 /ABC",
  1839         "Tra nsferredFr om": "VISN :2/ABC",
  1840         "Tra nsferredBy ": "VHAMCA DPQSDFDP"
  1841       },
  1842       {
  1843         "id" : 3,
  1844         "Dat e": "01/01 /2017",
  1845         "Rea son": "Rea son Statme nt will go  here",
  1846         "Exp lanation":  "ABC123",
  1847         "Tra nsferredTo ": "VISN:2 /ABC",
  1848         "Tra nsferredFr om": "VISN :2/ABC",
  1849         "Tra nsferredBy ": "VHAMCA DPQSDFDP"
  1850       },
  1851       {
  1852         "id" : 4,
  1853         "Dat e": "01/01 /2017",
  1854         "Rea son": "Rea son Statme nt will go  here",
  1855         "Exp lanation":  "ABC123",
  1856         "Tra nsferredTo ": "VISN:2 /ABC",
  1857         "Tra nsferredFr om": "VISN :2/ABC",
  1858         "Tra nsferredBy ": "VHAMCA DPQSDFDP"
  1859       },
  1860       {
  1861         "id" : 5,
  1862         "Dat e": "01/01 /2017",
  1863         "Rea son": "Rea son Statme nt will go  here",
  1864         "Exp lanation":  "ABC123",
  1865         "Tra nsferredTo ": "VISN:2 /ABC",
  1866         "Tra nsferredFr om": "VISN :2/ABC",
  1867         "Tra nsferredBy ": "VHAMCA DPQSDFDP"
  1868       },
  1869       {
  1870         "id" : 6,
  1871         "Dat e": "01/01 /2017",
  1872         "Rea son": "Rea son Statme nt will go  here",
  1873         "Exp lanation":  "ABC123",
  1874         "Tra nsferredTo ": "VISN:2 /ABC",
  1875         "Tra nsferredFr om": "VISN :2/ABC",
  1876         "Tra nsferredBy ": "VHAMCA DPQSDFDP"
  1877       },
  1878       {
  1879         "id" : 7,
  1880         "Dat e": "01/01 /2017",
  1881         "Rea son": "Rea son Statme nt will go  here",
  1882         "Exp lanation":  "ABC123",
  1883         "Tra nsferredTo ": "VISN:2 /ABC",
  1884         "Tra nsferredFr om": "VISN :2/ABC",
  1885         "Tra nsferredBy ": "VHAMCA DPQSDFDP"
  1886       }
  1887     ],
  1888     "Rejecti onHistory" : [{
  1889         "id" : 1,
  1890         "Dat e": "01/01 /2017",
  1891           "RejectedB y": " DNS     ABCPDQ",
  1892         "Rea son": "Ser vice Autho rized by a nother VA  facility i n another  state",
  1893         "Exp lanation":  "Unknown" ,
  1894           "ReviewedB y": " DNS     ABCPDQ",
  1895         "Out Come": "UN KNOWN",
  1896         "Rev iewrCommen ts": "Clai m Rejected "
  1897       },
  1898       {
  1899         "id" : 2,
  1900         "Dat e": "01/01 /2017",
  1901           "RejectedB y": " DNS     ABCPDQ",
  1902         "Rea son": "Ser vice Autho rized by a nother VA  facility i n another  state",
  1903         "Exp lanation":  "Unknown" ,
  1904           "ReviewedB y": " DNS     ABCPDQ",
  1905         "Out Come": "UN KNOWN",
  1906         "Rev iewrCommen ts": "Clai m Rejected "
  1907       }
  1908     ],
  1909     "userSta tions": [{
  1910       "userN ame": "VHA IS_USER",
  1911       "lastL ogin": "Fr i 05/10/20 17 12:00 M ST",
  1912       "activ eStations" : [
  1913         1060 ,
  1914         2238
  1915       ],
  1916       "roles ": [
  1917         "FEE  SUPERVISO R",
  1918         "FPP S HELP DES K",
  1919         "ADM IN"
  1920       ],
  1921       "visnC laims": {
  1922         "nam e": "VISN  Claims",
  1923         "num berOfClaim sAssigned" : 83686,
  1924         "num berOfClaim sAwaiting" : 68116,
  1925         "num berOfClaim sInProcess ": 54247,
  1926         "num berOfClaim sRejected" : 74444,
  1927         "num berOfClaim sError": 6 4875
  1928       },
  1929       "assig nedStation s": [{
  1930           "a ctivedChec ked": true ,
  1931           "s tationNumb er": 1060,
  1932           "n umberOfCla imsAssigne d": 65224,
  1933           "n umberOfCla imsAwaitin g": 27178,
  1934           "n umberOfCla imsInProce ss": 87350 ,
  1935           "n umberOfCla imsRejecte d": 60531,
  1936           "n umberOfCla imsError":  44545
  1937         },
  1938         {
  1939           "a ctivedChec ked": fals e,
  1940           "s tationNumb er": 2118,
  1941           "n umberOfCla imsAssigne d": 95274,
  1942           "n umberOfCla imsAwaitin g": 20235,
  1943           "n umberOfCla imsInProce ss": 29364 ,
  1944           "n umberOfCla imsRejecte d": 21311,
  1945           "n umberOfCla imsError":  19522
  1946         },
  1947         {
  1948           "a ctivedChec ked": true ,
  1949           "s tationNumb er": 2238,
  1950           "n umberOfCla imsAssigne d": 98857,
  1951           "n umberOfCla imsAwaitin g": 20200,
  1952           "n umberOfCla imsInProce ss": 79334 ,
  1953           "n umberOfCla imsRejecte d": 75339,
  1954           "n umberOfCla imsError":  89342
  1955         }
  1956       ],
  1957       "id":  1,
  1958       "user" : "VHAIS_U SER"
  1959     }],
  1960     "Diagnos isCode": [ {
  1961         "id" : 1,
  1962         "Seq uenceNumbe r": 1,
  1963         "Dia gnosisCode ": "ABC123 ",
  1964         "POA Indicator" : "UNK",
  1965         "Des cription":  "ABC123",
  1966         "DXT ype": "Pri mary"
  1967       },
  1968       {
  1969         "id" : 2,
  1970         "Seq uenceNumbe r": 1,
  1971         "Dia gnosisCode ": "ABC123 ",
  1972         "POA Indicator" : "UNK",
  1973         "Des cription":  "ABC123",
  1974         "DXT ype": "Pri mary"
  1975       },
  1976       {
  1977         "id" : 3,
  1978         "Seq uenceNumbe r": 1,
  1979         "Dia gnosisCode ": "ABC123 ",
  1980         "POA Indicator" : "UNK",
  1981         "Des cription":  "ABC123",
  1982         "DXT ype": "Pri mary"
  1983       },
  1984       {
  1985         "id" : 4,
  1986         "Seq uenceNumbe r": 1,
  1987         "Dia gnosisCode ": "ABC123 ",
  1988         "POA Indicator" : "UNK",
  1989         "Des cription":  "ABC123",
  1990         "DXT ype": "Pri mary"
  1991       },
  1992       {
  1993         "id" : 5,
  1994         "Seq uenceNumbe r": 1,
  1995         "Dia gnosisCode ": "ABC123 ",
  1996         "POA Indicator" : "UNK",
  1997         "Des cription":  "ABC123",
  1998         "DXT ype": "Pri mary"
  1999       },
  2000       {
  2001         "id" : 6,
  2002         "Seq uenceNumbe r": 1,
  2003         "Dia gnosisCode ": "ABC123 ",
  2004         "POA Indicator" : "UNK",
  2005         "Des cription":  "ABC123",
  2006         "DXT ype": "Pri mary"
  2007       },
  2008       {
  2009         "id" : 7,
  2010         "Seq uenceNumbe r": 1,
  2011         "Dia gnosisCode ": "ABC123 ",
  2012         "POA Indicator" : "UNK",
  2013         "Des cription":  "ABC123",
  2014         "DXT ype": "Pri mary"
  2015       },
  2016       {
  2017         "id" : 8,
  2018         "Seq uenceNumbe r": 1,
  2019         "Dia gnosisCode ": "ABC123 ",
  2020         "POA Indicator" : "UNK",
  2021         "Des cription":  "ABC123",
  2022         "DXT ype": "Pri mary"
  2023       }
  2024     ],
  2025     "LineIte ms": [{
  2026         "id" : 1,
  2027         "Lin eId": 1,
  2028         "Med icalCode":  "ABC123",
  2029         "Rev anueCode":  "12345",
  2030         "SVC FromDate":  "01/01/20 17",
  2031         "SVC ToDate": " 01/01/2017 ",
  2032         "Bil ledAmt": " $999,999.0 0",
  2033         "Lin eStatus":  "UNK",
  2034         "Tre asuryPmtDa te": "01/0 1/2017",
  2035         "Pai dAmt": "$9 99,999.00" ,
  2036         "Che ck_EFT_TRN ": "123456 ",
  2037         "Adj Amount": " $999,999.0 0",
  2038         "Adj ReasonCode ": "ABC123 "
  2039       },
  2040       {
  2041         "id" : 2,
  2042         "Lin eId": 1,
  2043         "Med icalCode":  "ABC123",
  2044         "Rev anueCode":  "12345",
  2045         "SVC FromDate":  "01/01/20 17",
  2046         "SVC ToDate": " 01/01/2017 ",
  2047         "Bil ledAmt": " $999,999.0 0",
  2048         "Lin eStatus":  "UNK",
  2049         "Tre asuryPmtDa te": "01/0 1/2017",
  2050         "Pai dAmt": "$9 99,999.00" ,
  2051         "Che ck_EFT_TRN ": "123456 ",
  2052         "Adj Amount": " $999,999.0 0",
  2053         "Adj ReasonCode ": "ABC123 "
  2054       },
  2055       {
  2056         "id" : 3,
  2057         "Lin eId": 1,
  2058         "Med icalCode":  "ABC123",
  2059         "Rev anueCode":  "12345",
  2060         "SVC FromDate":  "01/01/20 17",
  2061         "SVC ToDate": " 01/01/2017 ",
  2062         "Bil ledAmt": " $999,999.0 0",
  2063         "Lin eStatus":  "UNK",
  2064         "Tre asuryPmtDa te": "01/0 1/2017",
  2065         "Pai dAmt": "$9 99,999.00" ,
  2066         "Che ck_EFT_TRN ": "123456 ",
  2067         "Adj Amount": " $999,999.0 0",
  2068         "Adj ReasonCode ": "ABC123 "
  2069       },
  2070       {
  2071         "id" : 4,
  2072         "Lin eId": 1,
  2073         "Med icalCode":  "ABC123",
  2074         "Rev anueCode":  "12345",
  2075         "SVC FromDate":  "01/01/20 17",
  2076         "SVC ToDate": " 01/01/2017 ",
  2077         "Bil ledAmt": " $999,999.0 0",
  2078         "Lin eStatus":  "UNK",
  2079         "Tre asuryPmtDa te": "01/0 1/2017",
  2080         "Pai dAmt": "$9 99,999.00" ,
  2081         "Che ck_EFT_TRN ": "123456 ",
  2082         "Adj Amount": " $999,999.0 0",
  2083         "Adj ReasonCode ": "ABC123 "
  2084       },
  2085       {
  2086         "id" : 5,
  2087         "Lin eId": 1,
  2088         "Med icalCode":  "ABC123",
  2089         "Rev anueCode":  "12345",
  2090         "SVC FromDate":  "01/01/20 17",
  2091         "SVC ToDate": " 01/01/2017 ",
  2092         "Bil ledAmt": " $999,999.0 0",
  2093         "Lin eStatus":  "UNK",
  2094         "Tre asuryPmtDa te": "01/0 1/2017",
  2095         "Pai dAmt": "$9 99,999.00" ,
  2096         "Che ck_EFT_TRN ": "123456 ",
  2097         "Adj Amount": " $999,999.0 0",
  2098         "Adj ReasonCode ": "ABC123 "
  2099       },
  2100       {
  2101         "id" : 6,
  2102         "Lin eId": 1,
  2103         "Med icalCode":  "ABC123",
  2104         "Rev anueCode":  "12345",
  2105         "SVC FromDate":  "01/01/20 17",
  2106         "SVC ToDate": " 01/01/2017 ",
  2107         "Bil ledAmt": " $999,999.0 0",
  2108         "Lin eStatus":  "UNK",
  2109         "Tre asuryPmtDa te": "01/0 1/2017",
  2110         "Pai dAmt": "$9 99,999.00" ,
  2111         "Che ck_EFT_TRN ": "123456 ",
  2112         "Adj Amount": " $999,999.0 0",
  2113         "Adj ReasonCode ": "ABC123 "
  2114       },
  2115       {
  2116         "id" : 7,
  2117         "Lin eId": 1,
  2118         "Med icalCode":  "ABC123",
  2119         "Rev anueCode":  "12345",
  2120         "SVC FromDate":  "01/01/20 17",
  2121         "SVC ToDate": " 01/01/2017 ",
  2122         "Bil ledAmt": " $999,999.0 0",
  2123         "Lin eStatus":  "UNK",
  2124         "Tre asuryPmtDa te": "01/0 1/2017",
  2125         "Pai dAmt": "$9 99,999.00" ,
  2126         "Che ck_EFT_TRN ": "123456 ",
  2127         "Adj Amount": " $999,999.0 0",
  2128         "Adj ReasonCode ": "ABC123 "
  2129       }
  2130     ],
  2131     "Rerouti ngHistory" : [{
  2132         "id" : 1,
  2133         "Dat e": "01/01 /2017",
  2134         "Rea son": "Ser vice Autho rized by a nother VA  facility i n another  state",
  2135         "Exp lanation":  "ABC123",
  2136         "Tra nsferredTo ": "VISN:2 /ABC",
  2137         "Tra nsferredFr om": "VISN :2/ABC",
  2138         "Tra nsferredBy ": "VHAMCA DPQSDFDP"
  2139       },
  2140       {
  2141         "id" : 2,
  2142         "Dat e": "01/01 /2017",
  2143         "Rea son": "Rea son Statme nt will go  here",
  2144         "Exp lanation":  "ABC123",
  2145         "Tra nsferredTo ": "VISN:2 /ABC",
  2146         "Tra nsferredFr om": "VISN :2/ABC",
  2147         "Tra nsferredBy ": "VHAMCA DPQSDFDP"
  2148       },
  2149       {
  2150         "id" : 3,
  2151         "Dat e": "01/01 /2017",
  2152         "Rea son": "Rea son Statme nt will go  here",
  2153         "Exp lanation":  "ABC123",
  2154         "Tra nsferredTo ": "VISN:2 /ABC",
  2155         "Tra nsferredFr om": "VISN :2/ABC",
  2156         "Tra nsferredBy ": "VHAMCA DPQSDFDP"
  2157       },
  2158       {
  2159         "id" : 4,
  2160         "Dat e": "01/01 /2017",
  2161         "Rea son": "Rea son Statme nt will go  here",
  2162         "Exp lanation":  "ABC123",
  2163         "Tra nsferredTo ": "VISN:2 /ABC",
  2164         "Tra nsferredFr om": "VISN :2/ABC",
  2165         "Tra nsferredBy ": "VHAMCA DPQSDFDP"
  2166       },
  2167       {
  2168         "id" : 5,
  2169         "Dat e": "01/01 /2017",
  2170         "Rea son": "Rea son Statme nt will go  here",
  2171         "Exp lanation":  "ABC123",
  2172         "Tra nsferredTo ": "VISN:2 /ABC",
  2173         "Tra nsferredFr om": "VISN :2/ABC",
  2174         "Tra nsferredBy ": "VHAMCA DPQSDFDP"
  2175       },
  2176       {
  2177         "id" : 6,
  2178         "Dat e": "01/01 /2017",
  2179         "Rea son": "Rea son Statme nt will go  here",
  2180         "Exp lanation":  "ABC123",
  2181         "Tra nsferredTo ": "VISN:2 /ABC",
  2182         "Tra nsferredFr om": "VISN :2/ABC",
  2183         "Tra nsferredBy ": "VHAMCA DPQSDFDP"
  2184       },
  2185       {
  2186         "id" : 7,
  2187         "Dat e": "01/01 /2017",
  2188         "Rea son": "Rea son Statme nt will go  here",
  2189         "Exp lanation":  "ABC123",
  2190         "Tra nsferredTo ": "VISN:2 /ABC",
  2191         "Tra nsferredFr om": "VISN :2/ABC",
  2192         "Tra nsferredBy ": "VHAMCA DPQSDFDP"
  2193       }
  2194     ],
  2195     "Rejecti onHistory" : [{
  2196         "id" : 1,
  2197         "Dat e": "01/01 /2017",
  2198           "RejectedB y": " DNS     ABCPDQ",
  2199         "Rea son": "Ser vice Autho rized by a nother VA  facility i n another  state",
  2200         "Exp lanation":  "Unknown" ,
  2201           "ReviewedB y": " DNS     ABCPDQ",
  2202         "Out Come": "UN KNOWN",
  2203         "Rev iewrCommen ts": "Clai m Rejected "
  2204       },
  2205       {
  2206         "id" : 2,
  2207         "Dat e": "01/01 /2017",
  2208           "RejectedB y": " DNS     ABCPDQ",
  2209         "Rea son": "Ser vice Autho rized by a nother VA  facility i n another  state",
  2210         "Exp lanation":  "Unknown" ,
  2211           "ReviewedB y": " DNS     ABCPDQ",
  2212         "Out Come": "UN KNOWN",
  2213         "Rev iewrCommen ts": "Clai m Rejected "
  2214       }
  2215     ],
  2216     "basic":  [{
  2217       "id":  1,
  2218       "claim Id": "9999 99999999",
  2219       "Patie ntControlN umber": "A BC123456",
  2220       "Claim Status": " INPROCESS" ,
  2221       "PreAu thorizatio nNumber":  "123456789 0"
  2222     }],
  2223     "Veteran Info": [{
  2224         "id" : 1,
  2225         "Fir stName": " Dominique" ,
  2226         "Las tName": "R odgers-Cro mart",
  2227         "Mid dleName":  "James",
  2228         "Add ress1": "1 12 maple s treet",
  2229         "Add ress2": "A pt B",
  2230         "Cit y": "New Y ork",
  2231         "Sta te": "NY",
  2232         "Zip ": "12345" ,
  2233         "Pho ne": "1234 56789"
  2234       },
  2235       {
  2236         "id" : 2,
  2237         "Fir stName": " Dominique" ,
  2238         "Las tName": "R odgers-Cro mart",
  2239         "Mid dleName":  "James",
  2240         "Add ress1": "1 12 maple s treet",
  2241         "Add ress2": "A pt B",
  2242         "Cit y": "New Y ork",
  2243         "Sta te": "NY",
  2244         "Zip ": "12345" ,
  2245         "Pho ne": "1234 56789"
  2246       }
  2247     ],
  2248     "Service ProviderIn fo": [{
  2249         "id" : 1,
  2250         "Nam e": "Memor ial Genera l",
  2251         "Add ress1": "1 122 Centra l Ave",
  2252         "Add ress2": "- -",
  2253         "Cit y": "New Y ork",
  2254         "Sta te": "NY",
  2255         "Zip ": "12345" ,
  2256         "Pho ne": "1234 56789",
  2257         "Tax ID": "NY",
  2258         "NPI ": "123456 ",
  2259         "Con tactName":  "A Smith" ,
  2260         "Fax ": "123456 7",
  2261         "Ema il": "addr ess@addres s.com"
  2262       },
  2263       {
  2264         "id" : 2,
  2265         "Nam e": "Memor ial Genera l",
  2266         "Add ress1": "1 122 Centra l Ave",
  2267         "Add ress2": "- -",
  2268         "Cit y": "New Y ork",
  2269         "Sta te": "NY",
  2270         "Zip ": "12345" ,
  2271         "Pho ne": "1234 56789",
  2272         "Tax ID": "NY",
  2273         "NPI ": "123456 ",
  2274         "Con tactName":  "A Smith" ,
  2275         "Fax ": "123456 7",
  2276         "Ema il": "addr ess@addres s.com"
  2277       }
  2278     ],
  2279     "Billing ProviderIn fo": [{
  2280         "id" : 1,
  2281         "Nam e": "Memor ial Genera l",
  2282         "Add ress1": "1 122 Centra l Ave",
  2283         "Add ress2": "- -",
  2284         "Cit y": "New Y ork",
  2285         "Sta te": "NY",
  2286         "Zip ": "12345" ,
  2287         "Pho ne": "1234 56789",
  2288         "Tax ID": "NY",
  2289         "NPI ": "123456 ",
  2290         "Con tactName":  "A Smith" ,
  2291         "Fax ": "123456 7",
  2292         "Ema il": "addr ess@addres s.com"
  2293       },
  2294       {
  2295         "id" : 2,
  2296         "Nam e": "Memor ial Genera l",
  2297         "Add ress1": "1 122 Centra l Ave",
  2298         "Add ress2": "- -",
  2299         "Cit y": "New Y ork",
  2300         "Sta te": "NY",
  2301         "Zip ": "12345" ,
  2302         "Pho ne": "1234 56789",
  2303         "Tax ID": "NY",
  2304         "NPI ": "123456 ",
  2305         "Con tactName":  "A Smith" ,
  2306         "Fax ": "123456 7",
  2307         "Ema il": "addr ess@addres s.com"
  2308       }
  2309     ],
  2310     "PayToPr oviderInfo ": [{
  2311         "id" : 1,
  2312         "Nam e": "Memor ial Genera l",
  2313         "Add ress1": "1 122 Centra l Ave",
  2314         "Add ress2": "- -",
  2315         "Cit y": "New Y ork",
  2316         "Sta te": "NY",
  2317         "Zip ": "12345" ,
  2318         "Pho ne": "1234 56789",
  2319         "Tax ID": "NY",
  2320         "NPI ": "123456 "
  2321       },
  2322       {
  2323         "id" : 2,
  2324         "Nam e": "Memor ial Genera l",
  2325         "Add ress1": "1 122 Centra l Ave",
  2326         "Add ress2": "- -",
  2327         "Cit y": "New Y ork",
  2328         "Sta te": "NY",
  2329         "Zip ": "12345" ,
  2330         "Pho ne": "1234 56789",
  2331         "Tax ID": "NY",
  2332         "NPI ": "123456 "
  2333       }
  2334     ],
  2335     "Additio nalInfo":  [{
  2336         "id" : 1,
  2337         "Oth erInsuranc eNum": "98 7654321",
  2338         "Oth erInsuranc ePlan": "I nsurance C ompany",
  2339         "Oth erInsuranc eNumTertia ry": "9876 54321",
  2340         "Oth erInsuranc ePlanTerti ary": "Ins urance Com pany",
  2341         "Adm issionDate ": "01/01/ 2017",
  2342         "Dis chargeDate ": "01/01/ 2017",
  2343         "Cov eredDate":  "01/01/20 17 to 01/0 1/2018",
  2344         "Pro viderDRG":  "-",
  2345         "Att endingPhys ician": "A . Gonzales ",
  2346         "Tre asuryPayme ntDatePD":  "01/01/20 17",
  2347         "Tot alPaidAmou ntperPD":  "$9.999.0" ,
  2348         "Che ck_EFT_TRN ": "123456 ",
  2349         "CAR C": "-",
  2350         "Tot alAmountPe rCARC": "$ 9.999.0"
  2351       },
  2352       {
  2353         "id" : 2,
  2354         "Oth erInsuranc eNum": "98 7654321",
  2355         "Oth erInsuranc ePlan": "I nsurance C ompany",
  2356         "Oth erInsuranc eNumTertia ry": "9876 54321",
  2357         "Oth erInsuranc ePlanTerti ary": "Ins urance Com pany",
  2358         "Adm issionDate ": "01/01/ 2017",
  2359         "Dis chargeDate ": "01/01/ 2017",
  2360         "Cov eredDate":  "01/01/20 17 to 01/0 1/2018",
  2361         "Pro viderDRG":  "-",
  2362         "Att endingPhys ician": "A . Gonzales ",
  2363         "Tre asuryPayme ntDate": " 01/01/2017 ",
  2364         "Tot alPaidAmou ntperPD":  "$9.999.0" ,
  2365         "Che ck_EFT_TRN ": "123456 ",
  2366         "CAR C": "-",
  2367         "Tot alAmountPe rCARC": "$ 9.999.0"
  2368       }
  2369     ]
  2370   }

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