{
  "DatasetId": "c08da252-a46b-4c81-8dce-08dd8ee0ce18",
  "AccountNumber": 830920829,
  "ExternalAccountNumber": "10051",
  "Patient": {
    "FirstName": "SIE Test 1",
    "MiddleName": "",
    "LastName": "SIE Test 1",
    "Suffix": "",
    "SSN": "",
    "MedicalRecordNumber": "10552",
    "BirthDate": "1981-01-01T00:00:00",
    "Gender": "Male",
    "Address1": "213",
    "Address2": "",
    "City": "HOUSATONIC",
    "StateCode": "MA",
    "Zip": "01236",
    "CountryCode": "",
    "HomePhone": "",
    "WorkPhone": "",
    "MobilePhone": "(214) 312-0000",
    "Email": "",
    "UseAlternateMailingAddress": false,
    "AlternateName": "",
    "AlternateAddress1": "",
    "AlternateAddress2": "",
    "AlternateCity": "",
    "AlternateStateCode": "",
    "AlternateZip": "",
    "AlternateCountryCode": "",
    "EmployerName": "",
    "EmployerAddress1": "",
    "EmployerAddress2": "",
    "EmployerCity": "",
    "EmployerStateCode": "",
    "EmployerZip": "",
    "EmployerCountryCode": "",
    "EmployerPhone": ""
  },
  "Guarantor": {
    "FirstName": "SIE Test 1",
    "MiddleName": "",
    "LastName": "SIE Test 1",
    "Suffix": "",
    "SSN": "",
    "BirthDate": "1981-01-01T00:00:00",
    "Gender": "Male",
    "Address1": "213",
    "Address2": "",
    "City": "HOUSATONIC",
    "StateCode": "MA",
    "Zip": "01236",
    "CountryCode": "",
    "HomePhone": "",
    "WorkPhone": "",
    "MobilePhone": "(214) 312-0000",
    "Email": "",
    "UseAlternateMailingAddress": false,
    "AlternateName": "",
    "AlternateAddress1": "",
    "AlternateAddress2": "",
    "AlternateCity": "",
    "AlternateStateCode": "",
    "AlternateZip": "",
    "AlternateCountryCode": "",
    "EmployerName": "",
    "EmployerAddress1": "",
    "EmployerAddress2": "",
    "EmployerCity": "",
    "EmployerStateCode": "",
    "EmployerZip": "",
    "EmployerCountryCode": "",
    "EmployerPhone": "",
    "EmployerCode": "",
    "EmergencyContactFirstName": "",
    "EmergencyContactLastName": "",
    "EmergencyContactRelation": "",
    "EmergencyContactPhone": "",
    "DriverLicenseNumber": "",
    "SameAsPatient": false
  },
  "Insurances": [
    {
      "InsuranceLevel": "Primary",
      "InsuranceType": "",
      "PolicyNumber": "123",
      "GroupNumber": "",
      "PlanName": "",
      "InsuredRelation": "Self",
      "InsuredLastName": "SIE Test 1",
      "InsuredFirstName": "SIE Test 1",
      "InsuredMiddleName": "",
      "InsuredSuffix": "",
      "InsuredBirthDate": "1981-01-01T00:00:00",
      "InsuredGender": "Male",
      "UseGuarantorContactInfo": false,
      "InsuredAddress1": "213",
      "InsuredAddress2": "",
      "InsuredCity": "HOUSATONIC",
      "InsuredStateCode": "MA",
      "InsuredZip": "01236",
      "InsuredCountryCode": "",
      "InsuredPhone": "",
      "PolicyEffectiveFrom": "2025-10-02T00:00:00",
      "PolicyEffectiveTo": null,
      "AcceptAssignment": true,
      "CarrierCode": "126",
      "CarrierName": "Sunflower State Health Plan",
      "CarrierAddress1": "",
      "CarrierAddress2": "",
      "CarrierCity": "",
      "CarrierStateCode": "",
      "CarrierZip": "00000-000",
      "CarrierCountryCode": "",
      "CarrierPhoneNumber": "",
      "CarrierType": "Commercial",
      "PayerId": "",
      "ExternalId": "10051_75",
      "Id": "d2015e18-58c9-4927-5543-08de00eeff05"
    }
  ],
  "Visits": [],
  "DatesOfService": [],
  "PatientBalance": 0.0,
  "InsuranceBalance": 0.0
}