| Name | Description | Type | Additional information |
|---|---|---|---|
| Id | globally unique identifier |
None. |
|
| TypeOfClaimItem | integer |
None. |
|
| TypeOfClaimLabel | string |
None. |
|
| IsClaimTypeError | boolean |
None. |
|
| ProviderOfServices | string |
None. |
|
| IsProviderServiceError | boolean |
None. |
|
| DateIncurred | date |
None. |
|
| ViewDateIncurred | string |
None. |
|
| IsDateIncurredError | integer |
None. |
|
| AmountOfExpenseDollars | decimal number |
None. |
|
| IsAmountOfExpenseDollarsError | boolean |
None. |
|
| AmountEligibleDollars | decimal number |
None. |
|
| IsAmountEligibleDollarsError | boolean |
None. |
|
| PrimaryInsuranceIncludeDental | boolean |
None. |
|
| PrimaryInsuranceIncludeVision | boolean |
None. |
|
| Recurring | string |
None. |
|
| ReportingResultValue | integer |
None. |
|
| IsCoPay | boolean |
None. |
|
| ClaimItemStatus | string |
None. |
|
| ClaimItemStatus1 | string |
None. |
|
| ReasonDescription | string |
None. |
|
| SubmissionType | integer |
None. |
|
| ClaimType | string |
None. |