{ "DatasetId": "296a41f4-3c13-43a4-293c-08dd828d8c5f", "AccountNumber": 549336806, "ExternalAccountNumber": "ABC123457", "Patient": { "FirstName": "Jane", "MiddleName": "Maria", "LastName": "Doe", "Suffix": "Jr", "SSN": "123-45-6789", "MedicalRecordNumber": "ABC123458", "BirthDate": "1986-01-01T00:00:00", "Gender": "Female", "Address1": "123 Main St", "Address2": "Ste 101", "City": "Springfield", "StateCode": "CA", "Zip": "12345", "CountryCode": "US", "HomePhone": "(555) 555-1234", "WorkPhone": "(555) 555-1234", "MobilePhone": "", "Email": "guarantor@email.com", "UseAlternateMailingAddress": true, "AlternateName": "Jane Doe", "AlternateAddress1": "456 First St", "AlternateAddress2": "Apt 25", "AlternateCity": "Springfield", "AlternateStateCode": "CA", "AlternateZip": "12345", "AlternateCountryCode": "", "EmployerName": "XYZ Publishing", "EmployerAddress1": "4000 Seattle Ave", "EmployerAddress2": "Ste 400", "EmployerCity": "Matthews", "EmployerStateCode": "WA", "EmployerZip": "12345", "EmployerCountryCode": "US", "EmployerPhone": "(555) 555-1234" }, "Guarantor": { "FirstName": "Jane", "MiddleName": "Marie", "LastName": "Doe", "Suffix": "Jr", "SSN": "123-45-6789", "BirthDate": "1986-01-01T00:00:00", "Gender": "Female", "Address1": "123 Main St", "Address2": "Ste 101", "City": "Springfield", "StateCode": "CA", "Zip": "12345", "CountryCode": "", "HomePhone": "(555) 555-1234", "WorkPhone": "(555) 555-1234", "MobilePhone": "", "Email": "guarantor@email.com", "UseAlternateMailingAddress": true, "AlternateName": "Jane Doe", "AlternateAddress1": "456 First St", "AlternateAddress2": "Apt 25", "AlternateCity": "Springfield", "AlternateStateCode": "CA", "AlternateZip": "12345", "AlternateCountryCode": "", "EmployerName": "XYZ Publishing", "EmployerAddress1": "4000 Seattle Ave", "EmployerAddress2": "Ste 400", "EmployerCity": "Matthews", "EmployerStateCode": "CA", "EmployerZip": "12345", "EmployerCountryCode": "", "EmployerPhone": "(555) 555-1234", "EmployerCode": "", "EmergencyContactFirstName": "Janette", "EmergencyContactLastName": "Doe", "EmergencyContactRelation": "Mom", "EmergencyContactPhone": "(555) 555-1234", "DriverLicenseNumber": "CA456789", "SameAsPatient": false }, "Insurances": [ { "InsuranceLevel": "Primary", "InsuranceType": "", "PolicyNumber": "1RF7GQ1TC23", "GroupNumber": "1NT1FC3G", "PlanName": "Walter-Tremblay", "InsuredRelation": "Child", "InsuredLastName": "Smith", "InsuredFirstName": "Jane", "InsuredMiddleName": "Doe", "InsuredSuffix": "Jr", "InsuredBirthDate": "2022-01-01T00:00:00", "InsuredGender": "Female", "UseGuarantorContactInfo": false, "InsuredAddress1": "123 Main St", "InsuredAddress2": "Apt 100", "InsuredCity": "Springfield", "InsuredStateCode": "CA", "InsuredZip": "12345", "InsuredCountryCode": "US", "InsuredPhone": "", "PolicyEffectiveFrom": "2024-01-01T00:00:00", "PolicyEffectiveTo": "2025-12-31T00:00:00", "AcceptAssignment": true, "CarrierCode": "UHC", "CarrierName": "United Health Care", "CarrierAddress1": "0057 Daryl Field", "CarrierAddress2": "", "CarrierCity": "Sidside", "CarrierStateCode": "CA", "CarrierZip": "07214", "CarrierCountryCode": "US", "CarrierPhoneNumber": "", "CarrierType": "Commercial", "PayerId": "20866", "ExternalId": "", "Id": "d2273707-1248-4742-0572-08dd87faec0d" } ], "Visits": [], "DatesOfService": [], "PatientBalance": 0.0, "InsuranceBalance": 0.0 }