{ "data": { "demographics": { "name": { "first": "JOHN", "last": "DOE" }, "dob": { "point": { "date": "1910-01-01T00:00:00.000Z", "precision": "day" } }, "email": [ { "address": "JOHNDOE@example.com" } ], "phone": [ { "number": "123-456-7890", "type": "primary home" } ], "addresses": [ { "use": "primary home", "street_lines": [ "123 ANY ROAD" ], "city": "ANYTOWN", "state": "VA", "zip": "00001", "country": "US" } ] }, "vitals": [ { "vital": { "code": "8480-6", "name": "Intravascular Systolic", "code_system_name": "LOINC" }, "date_time": { "point": { "date": "2011-07-22T00:00:00.000Z", "precision": "day" } }, "value": 120, "unit": "mm[Hg]", "status": "completed" }, { "vital": { "code": "8462-4", "name": "Intravascular Diastolic", "code_system_name": "LOINC" }, "date_time": { "point": { "date": "2011-07-22T00:00:00.000Z", "precision": "day" } }, "value": 80, "unit": "mm[Hg]", "status": "completed" }, { "vital": { "name": "Glucose" }, "date_time": { "point": { "date": "2012-03-20T00:00:00.000Z", "precision": "day" } }, "value": 110, "unit": "mg/dL", "status": "completed" } ], "results": [ { "result_set": { "name": "Glucose Level" }, "results": [ { "date_time": { "point": { "date": "2008-03-21T00:00:00.000Z", "precision": "day" } }, "result": { "name": "FBS" }, "status": "completed", "value": 135, "unit": "mg/dL" }, { "date_time": { "point": { "date": "2008-03-21T00:00:00.000Z", "precision": "day" } }, "result": { "name": "RBS" }, "status": "completed", "value": 170, "unit": "mg/dL" }, { "date_time": { "point": { "date": "2008-03-21T00:00:00.000Z", "precision": "day" } }, "result": { "name": "RBS" }, "status": "completed", "value": 150, "unit": "mg/dL" }, { "date_time": { "point": { "date": "2008-03-21T00:00:00.000Z", "precision": "day" } }, "result": { "name": "RBS" }, "status": "completed", "value": 120, "unit": "mg/dL" } ] } ], "medications": [ { "product": { "product": { "name": "Aspirin" }, "unencoded_name": "Aspirin" }, "sig": "Aspirin", "status": "Completed" } ], "allergies": [ { "observation": { "allergen": { "name": "Antibotic" }, "date_time": { "low": { "date": "1926-01-08T00:00:00.000Z", "precision": "day" }, "high": { "date": "1955-03-13T00:00:00.000Z", "precision": "day" } }, "reactions": [ { "reaction": { "name": "Vomiting" }, "severity": { "code": { "code": "24484000", "name": "Severe", "code_system_name": "SNOMED CT" } } } ], "status": { "name": "Active", "code": "55561003", "code_system_name": "SNOMED CT" } } }, { "observation": { "allergen": { "name": "Grasses" }, "date_time": { "low": { "date": "1973-05-13T00:00:00.000Z", "precision": "day" }, "high": { "date": "1996-07-20T00:00:00.000Z", "precision": "day" } }, "reactions": [ { "reaction": { "name": "Sneezing" }, "severity": { "code": { "code": "24484000", "name": "Severe", "code_system_name": "SNOMED CT" } } } ], "status": { "name": "Active", "code": "55561003", "code_system_name": "SNOMED CT" } } } ], "immunizations": [ { "status": "complete", "administration": { "route": { "name": "Nasal Spray(mist)" } }, "product": { "product": { "name": "Varicella/Chicken Pox" } }, "date_time": { "point": { "date": "2002-04-21T00:00:00.000Z", "precision": "day" } } }, { "status": "complete", "administration": { "route": { "name": "Nasal Spray(mist)" } }, "product": { "product": { "name": "Varicella/Chicken Pox (booster 1)" } }, "date_time": { "point": { "date": "1990-02-02T00:00:00.000Z", "precision": "day" } } }, { "status": "complete", "administration": { "route": { "name": "Injection" } }, "product": { "product": { "name": "typhoid" } }, "date_time": { "point": { "date": "2009-01-02T00:00:00.000Z", "precision": "day" } } } ], "problems": [ { "problem": { "code": { "name": "Arthritis" } }, "date_time": { "low": { "date": "2005-08-09T00:00:00.000Z", "precision": "day" }, "high": { "date": "2011-02-28T00:00:00.000Z", "precision": "day" } } }, { "problem": { "code": { "name": "Asthma" } }, "date_time": { "low": { "date": "2008-01-25T00:00:00.000Z", "precision": "day" }, "high": { "date": "2010-01-25T00:00:00.000Z", "precision": "day" } } } ], "payers": [ { "participant": { "performer": { "identifiers": [ { "identifier": "H9999/9999" } ] }, "date_time": { "low": { "date": "2011-09-01T00:00:00.000Z", "precision": "day" } } }, "policy_holder": { "performer": { "identifiers": [ { "identifier": "H9999/9999" } ] } }, "policy": { "insurance": { "performer": { "organization": [ { "name": [ "A Medicare Plan Plus (HMO)", "HealthCare Payer", "3 - Coordinated Care Plan (HMO, PPO, PSO, SNP)" ], "address": [ { "use": "primary home", "street_lines": [ "123 Any Road" ], "city": "Anytown", "state": "PA", "zip": "00003", "country": "United States" } ] } ] } } } }, { "participant": { "performer": { "identifiers": [ { "identifier": "S9999/000" } ] }, "date_time": { "low": { "date": "2010-01-01T00:00:00.000Z", "precision": "day" } } }, "policy_holder": { "performer": { "identifiers": [ { "identifier": "S9999/000" } ] } }, "policy": { "insurance": { "performer": { "organization": [ { "name": [ "A Medicare Rx Plan (PDP)", "Another HealthCare Payer", "11 - Medicare Prescription Drug Plan" ], "address": [ { "use": "primary home", "street_lines": [ "123 Any Road" ], "city": "Anytown", "state": "PA", "zip": "00003", "country": "United States" } ] } ] } } } }, { "policy": { "insurance": { "performer": { "organization": [ { "name": [ "STATE HEALTH BENEFITS PROGRAM", "EMPLOYER SUBSIDY" ] } ] } } }, "participant": { "date_time": { "low": { "date": "2011-01-01T00:00:00.000Z", "precision": "day" }, "high": { "date": "2011-12-31T00:00:00.000Z", "precision": "day" } } } }, { "participant": { "performer": { "identifiers": [ { "identifier": "1234567890" } ] }, "date_time": { "low": { "date": "2011-01-01T00:00:00.000Z", "precision": "day" }, "high": { "date": "2011-09-30T00:00:00.000Z", "precision": "day" } } }, "policy_holder": { "performer": { "identifiers": [ { "identifier": "1234567890" } ] } }, "policy": { "insurance": { "performer": { "organization": [ { "name": [ "Insurer1", "Medicare MSP: End stage Renal Disease (ESRD)" ], "address": [ { "use": "primary home", "street_lines": [ "PO BOX 0000" ], "city": "Anytown", "state": "CO", "zip": "00002-0000", "country": "United States" } ] } ] } } } }, { "participant": { "performer": { "identifiers": [ { "identifier": "12345678901" } ] }, "date_time": { "low": { "date": "2010-01-01T00:00:00.000Z", "precision": "day" }, "high": { "date": "2010-12-31T00:00:00.000Z", "precision": "day" } } }, "policy_holder": { "performer": { "identifiers": [ { "identifier": "12345678901" } ] } }, "policy": { "insurance": { "performer": { "organization": [ { "name": [ "Insurer2", "Medicare MSP: End stage Renal Disease (ESRD)" ], "address": [ { "use": "primary home", "street_lines": [ "0000 Any ROAD" ], "city": "ANYWHERE", "state": "VA", "zip": "00000-0000", "country": "United States" } ] } ] } } } }, { "participant": { "performer": { "identifiers": [ { "identifier": "00001" } ] }, "date_time": { "low": { "date": "1984-10-01T00:00:00.000Z", "precision": "day" }, "high": { "date": "2008-11-30T00:00:00.000Z", "precision": "day" } } }, "policy_holder": { "performer": { "identifiers": [ { "identifier": "00001" } ] } }, "policy": { "insurance": { "performer": { "organization": [ { "name": [ "Insurer" ], "address": [ { "use": "primary home", "street_lines": [ "00 Address STREET" ], "city": "ANYWHERE", "state": "PA", "zip": "00000", "country": "United States" } ] } ] } } } } ], "claims": [ { "payer": [ "medicare" ], "number": "1234567890000", "date_time": { "low": { "date": "2012-10-18T00:00:00.000Z", "precision": "day" }, "high": { "date": "2012-10-18T00:00:00.000Z", "precision": "day" } }, "lines": [ { "line": "1", "date_time": { "low": { "date": "2012-10-18T00:00:00.000Z", "precision": "day" }, "high": { "date": "2012-10-18T00:00:00.000Z", "precision": "day" } }, "procedure": { "code": "98941", "description": "Chiropractic Manipulative Treatment (Cmt); Spinal, Three To Four Regions" }, "quantity": { "value": 1, "unit": "line" }, "modifier": [ { "code": "AT", "description": "Acute Treatment (This Modifier Should Be Used When Reporting Service 98940, 98941, 98942)" } ], "charges": { "price_billed": "$60.00", "insurance_paid": "$34.00", "patient_responsibility": "$26.00" }, "place_of_service": { "code": "11", "name": "Office" }, "type": { "code": "1", "name": "Medical Care" }, "performer": [ { "type": "rendering provider", "identifiers": [ { "identifier": "2.16.840.1.113883.4.6", "extension": "123456789" } ] } ] } ], "charges": { "price_billed": "$60.00", "insurance_paid": "$34.00", "provider_paid": "$27.20", "patient_responsibility": "$6.80" }, "type": [ "medicare PartB" ], "diagnosis": [ { "code": "3534" }, { "code": "7393" }, { "code": "7392" }, { "code": "3533" } ] }, { "payer": [ "medicare" ], "number": "12345678900000VAA", "date_time": { "low": { "date": "2012-09-22T00:00:00.000Z", "precision": "day" } }, "lines": [ { "line": "1", "date_time": { "low": { "date": "2012-09-22T00:00:00.000Z", "precision": "day" } }, "revenue": { "code": "0250", "description": "General Classification PHARMACY" }, "quantity": { "value": 1, "unit": "line" }, "charges": { "price_billed": "$14.30", "insurance_paid": "$14.30", "patient_responsibility": "$0.00" } }, { "line": "2", "date_time": { "low": { "date": "2012-09-22T00:00:00.000Z", "precision": "day" } }, "revenue": { "code": "0320", "description": "General Classification DX X" }, "procedure": { "code": "74020", "description": "Radiologic Examination, Abdomen; Complete, Including Decubitus And/Or Erect Views" }, "quantity": { "value": 1, "unit": "line" }, "charges": { "price_billed": "$175.50", "insurance_paid": "$175.50", "patient_responsibility": "$0.00" } }, { "line": "3", "date_time": { "low": { "date": "2012-09-22T00:00:00.000Z", "precision": "day" } }, "revenue": { "code": "0450", "description": "General Classification EMERG ROOM" }, "procedure": { "code": "99283", "description": "Emergency Department Visit For The Evaluation And Management Of A Patient, Which Requires Th" }, "quantity": { "value": 1, "unit": "line" }, "modifier": [ { "code": "25", "description": "Significant, Separately Identifiable Evaluation And Management Service By The Same Physician On" } ], "charges": { "price_billed": "$315.00", "insurance_paid": "$315.00", "patient_responsibility": "$0.00" } }, { "line": "4", "revenue": { "code": "0001", "description": "Total Charges" }, "quantity": { "value": 0, "unit": "line" }, "charges": { "price_billed": "$504.80", "insurance_paid": "$504.80", "patient_responsibility": "$0.00" } } ], "charges": { "price_billed": "$504.80", "insurance_paid": "$504.80", "provider_paid": "$126.31", "patient_responsibility": "$38.84" }, "type": [ "medicare Outpatient" ], "diagnosis": [ { "code": "56400" }, { "code": "7245" }, { "code": "V1588" } ] }, { "payer": [ "medicare" ], "number": "1234567890123", "lines": [ { "line": "1", "date_time": { 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"problems", "payers", "claims", "plan_of_care", "providers" ] } }