{
    "createdDate": "2014-04-28T21:59:29.000+0000",
    "updatedDate": "2014-04-29T08:28:01.000+0000",
    "expirationDate": "2014-05-14T21:59:29.000+0000",
    "customerId": "11314",
    "updatable": false,
    "status": "Certified in Total",
    "statusCode": "A1",
    "certificationIssueDate": "2014-04-29",
    "certificationEffectiveDate": "2014-05-01",
    "certificationExpirationDate": "2014-05-03",
    "certificationNumber": "129738127",
    "payer": {
        "id": "ACMEHP",
        "name": "Acme Healthplan",
        "contactName": "Billing Dept",
        "phone": "1-555-555-5555"
    },
    "requestingProvider": {
        "lastName": "Slice n Dice Discount Surgery",
        "npi": "1234567893"
    },
    "subscriber": {
        "memberId": "XBH1823812"
    },
    "patient": {
        "lastName": "Smith",
        "firstName": "Bob",
        "birthDate": "1956-01-29",
        "subscriberRelationship": "Self",
        "subscriberRelationshipCode": "18"
    },
    "diagnoses": [
        {
            "qualifier": "ICD-10",
            "qualifierCode": "ABF",
            "value": "Struck by dolphin, initial encounter",
            "code": "W5602XA"
        }
    ],
    "requestType": "Admission Review",
    "requestTypeCode": "AR",
    "serviceType": "Medical Care",
    "serviceTypeCode": "1",
    "placeOfService": "Office",
    "placeOfServiceCode": "11",
    "fromDate": "2014-05-01",
    "toDate": "2014-05-03",
    "quantity": "3",
    "quantityType": "Days",
    "quantityTypeCode": "DA",
    "admissionType": "Emergency",
    "admissionTypeCode": "1",
    "renderingProviders": [
        {
            "role": "Attending Provider",
            "roleCode": "71",
            "lastName": "Jones",
            "firstName": "Jane",
            "npi": "1231231238"
        },
        {
            "role": "Facility",
            "roleCode": "FA",
            "lastName": "Slice and Dice Surgery Center",
            "npi": "1234912380"
        }
    ],
    "procedures": [
        {
            "qualifier": "HCPCS",
            "qualifierCode": "HC",
            "value": "Low-level laser treatment, 15 minutes",
            "code": "S8948",
            "quantity": "1",
            "quantityType": "Units",
            "quantityTypeCode": "UN"
        }
    ]
}