DentalClaim

{
    "type": "object",
    "properties": {
        "id": {
            "type": "string",
            "description": "The id of the dental claim."
        },
        "createdDate": {
            "type": "string",
            "format": "date-time",
            "description": "The date and time when this dental claim was created in our system."
        },
        "updatedDate": {
            "type": "string",
            "format": "date-time",
            "description": "The date and time when this dental claim was last updated in our system."
        },
        "expirationDate": {
            "type": "string",
            "format": "date-time",
            "description": "The date and time when this dental claim will expire from our system."
        },
        "message": {
            "type": "string",
            "description": "A message."
        },
        "customerId": {
            "type": "string",
            "description": "The id of the customer that owns this dental claim."
        },
        "requestTypeCode": {
            "type": "string",
            "description": "The requested type of claim. CLAIM, ENCOUNTER, etc."
        },
        "submitter": {
            "$ref": "#\/definitions\/Submitter"
        },
        "payer": {
            "$ref": "#\/definitions\/Payer"
        },
        "billingProvider": {
            "$ref": "#\/definitions\/BillingProvider"
        },
        "subscriber": {
            "$ref": "#\/definitions\/Subscriber"
        },
        "patient": {
            "$ref": "#\/definitions\/Patient"
        },
        "claimInformation": {
            "$ref": "#\/definitions\/ClaimInformation"
        }
    }
}
              

Submitter

{
    "type": "object",
    "properties": {
        "lastName": {
            "type": "string",
            "description": "The submitter's last name or organization name."
        },
        "firstName": {
            "type": "string",
            "description": "The submitter's first name."
        },
        "middleName": {
            "type": "string",
            "description": "The submitter's middle name."
        },
        "id": {
            "type": "string",
            "description": "The submitter's ETIN."
        },
        "contactName": {
            "type": "string",
            "description": "The submitter's contact name,"
        },
        "email": {
            "type": "string",
            "description": "The submitter's email address."
        },
        "phone": {
            "type": "string",
            "description": "The submitter's phone number."
        },
        "extension": {
            "type": "string",
            "description": "The submitter's phone number extension."
        },
        "fax": {
            "type": "string",
            "description": "The submitter's fax number."
        }
    }
}
              

Payer

{
    "type": "object",
    "properties": {
        "name": {
            "type": "string",
            "description": "The payer's name."
        },
        "id": {
            "type": "string",
            "description": "The payer's id."
        },
        "addressLine1": {
            "type": "string",
            "description": "The payer's address (line one)."
        },
        "addressLine2": {
            "type": "string",
            "description": "The payer's address (line two)."
        },
        "city": {
            "type": "string",
            "description": "The payer's city."
        },
        "stateCode": {
            "type": "string",
            "description": "The payer's state (two character code)."
        },
        "zipCode": {
            "type": "string",
            "description": "The payer's ZIP code."
        },
        "countryCode": {
            "type": "string",
            "description": "The payer's country code (US or CA)."
        },
        "ein": {
            "type": "string",
            "description": "The payer's EIN."
        },
        "claimOfficeNumber": {
            "type": "string",
            "description": "The payer's claim office number."
        },
        "naicCode": {
            "type": "string",
            "description": "The payer's NAIC."
        },
        "responsibilitySequenceCode": {
            "type": "string",
            "description": "The responsibility sequence of the payer (P, S, or T)."
        },
        "insuranceTypeCode": {
            "type": "string",
            "description": "The insurance type code of the payer."
        },
        "claimFilingIndicatorCode": {
            "type": "string",
            "description": "The claim filing indicator code of the payer."
        }
    }
}
              

BillingProvider

{
    "type": "object",
    "properties": {
        "specialtyCode": {
            "type": "string",
            "description": "The billing provider's specialty type code."
        },
        "lastName": {
            "type": "string",
            "description": "The billing provider's last name or organization name."
        },
        "firstName": {
            "type": "string",
            "description": "The billing provider's first name."
        },
        "middleName": {
            "type": "string",
            "description": "The billing provider's middle name."
        },
        "suffix": {
            "type": "string",
            "description": "The billing provider's suffix."
        },
        "npi": {
            "type": "string",
            "description": "The billing provider's NPI."
        },
        "addressLine1": {
            "type": "string",
            "description": "The billing provider's address (line one)."
        },
        "addressLine2": {
            "type": "string",
            "description": "The billing provider's address (line two)."
        },
        "city": {
            "type": "string",
            "description": "The billing provider's city."
        },
        "stateCode": {
            "type": "string",
            "description": "The billing provider's state (two character code)."
        },
        "zipCode": {
            "type": "string",
            "description": "The billing provider's ZIP code."
        },
        "countryCode": {
            "type": "string",
            "description": "The billing provider's country code (US or CA)."
        },
        "ein": {
            "type": "string",
            "description": "The billing provider's EIN."
        },
        "ssn": {
            "type": "string",
            "description": "The billing provider's SSN."
        },
        "stateLicenseNumber": {
            "type": "string",
            "description": "The billing provider's state license number."
        },
        "upin": {
            "type": "string",
            "description": "The billing provider's UPIN."
        },
        "payerAssignedProviderId": {
            "type": "string",
            "description": "The billing provider's payer assigned provider id."
        },
        "locationNumber": {
            "type": "string",
            "description": "The billing provider's location number."
        },
        "contactName": {
            "type": "string",
            "description": "The billing provider's contact name."
        },
        "phone": {
            "type": "string",
            "description": "The billing provider's phone number."
        },
        "extension": {
            "type": "string",
            "description": "The billing provider's phone extension."
        },
        "email": {
            "type": "string",
            "description": "The billing provider's email address."
        },
        "fax": {
            "type": "string",
            "description": "The billing provider's fax number."
        },
        "payTo": {
            "type": "object",
            "description": "The billing provider's pay-to address (if different from their physical address).",
            "properties": {
                "addressLine1": {
                    "type": "string",
                    "description": "The billing provider's pay-to address (line one)."
                },
                "addressLine2": {
                    "type": "string",
                    "description": "The billing provider's pay-to address (line two)."
                },
                "city": {
                    "type": "string",
                    "description": "The billing provider's pay-to city."
                },
                "stateCode": {
                    "type": "string",
                    "description": "The billing provider's pay-to state (two character code)."
                },
                "zipCode": {
                    "type": "string",
                    "description": "The billing provider's ZIP code."
                },
                "countryCode": {
                    "type": "string",
                    "description": "The billing provider's country code (US or CA)."
                }
            }
        }
    }
}
              

Subscriber

{
    "type": "object",
    "properties": {
        "groupNumber": {
            "type": "string",
            "description": "The subscriber's group number."
        },
        "groupName": {
            "type": "string",
            "description": "The subscriber's group name."
        },
        "lastName": {
            "type": "string",
            "description": "The subscriber's last name."
        },
        "firstName": {
            "type": "string",
            "description": "The subscriber's first name."
        },
        "middleName": {
            "type": "string",
            "description": "The subscriber's middle name."
        },
        "suffix": {
            "type": "string",
            "description": "The subscriber's suffix."
        },
        "memberId": {
            "type": "string",
            "description": "The subscriber's member id."
        },
        "addressLine1": {
            "type": "string",
            "description": "The subscriber's address (line one)."
        },
        "addressLine2": {
            "type": "string",
            "description": "The subscriber's address (line two)."
        },
        "city": {
            "type": "string",
            "description": "The subscriber's city."
        },
        "stateCode": {
            "type": "string",
            "description": "The subscriber's state (two character code)."
        },
        "zipCode": {
            "type": "string",
            "description": "The subscriber's ZIP code."
        },
        "countryCode": {
            "type": "string",
            "description": "The subscriber's country (US or CA)."
        },
        "ssn": {
            "type": "string",
            "description": "The subscriber's SSN."
        }
    }
}
              

Patient

{
    "type": "object",
    "properties": {
        "lastName": {
            "type": "string",
            "description": "The patient's last name."
        },
        "firstName": {
            "type": "string",
            "description": "The patient's first name."
        },
        "middleName": {
            "type": "string",
            "description": "The patient's middle name."
        },
        "suffix": {
            "type": "string",
            "description": "The patient's suffix."
        },
        "addressLine1": {
            "type": "string",
            "description": "The patient's address (line one)."
        },
        "addressLine2": {
            "type": "string",
            "description": "The patient's address (line two)."
        },
        "city": {
            "type": "string",
            "description": "The patient's city."
        },
        "stateCode": {
            "type": "string",
            "description": "The patient's state (two character code)."
        },
        "zipCode": {
            "type": "string",
            "description": "The patient's ZIP code."
        },
        "countryCode": {
            "type": "string",
            "description": "The patient's country (US or CA)."
        },
        "birthDate": {
            "type": "string",
            "format": "date",
            "description": "The patient's birth date."
        },
        "genderCode": {
            "type": "string",
            "description": "The patient's gender."
        },
        "subscriberRelationshipCode": {
            "type": "string",
            "description": "The patient's relationship to the subscriber."
        },
        "agencyClaimNumber": {
            "type": "string",
            "description": "The patient's agency claim number."
        }
    }
}
              

ClaimInformation

{
    "type": "object",
    "properties": {
        "controlNumber": {
            "type": "string",
            "description": "A control number of patient account number to use on this claim."
        },
        "placeOfServiceCode": {
            "type": "string",
            "description": "The place of service type."
        },
        "frequencyTypeCode": {
            "type": "string",
            "description": "The claim frequency type."
        },
        "providerSignatureOnFile": {
            "type": "boolean",
            "description": "Indicate whether or not the provider's signature is on file."
        },
        "providerAcceptAssignmentCode": {
            "type": "string",
            "description": "Assignment or plan participation code."
        },
        "benefitsAssignmentCertification": {
            "type": "boolean",
            "description": "The benefits assignment certification indicator."
        },
        "informationReleaseCode": {
            "type": "string",
            "description": "The release of information code."
        },
        "specialProgramCode": {
            "type": "string",
            "description": "The special dental program."
        },
        "delayReasonCode": {
            "type": "string",
            "description": "The delay reason."
        },
        "appliancePlacementDate": {
            "type": "string",
            "description": "The date the appliance was placed."
        },
        "serviceFromDate": {
            "type": "string",
            "format": "date",
            "description": "The service date (begin)."
        },
        "serviceToDate": {
            "type": "string",
            "format": "date",
            "description": "The service date (end)."
        },
        "orthodonticClaim": {
            "type": "boolean",
            "description": "Indicate whether or not this was an orthodontic claim."
        },
        "orthodonticTreatmentMonths": {
            "type": "string",
            "description": "The estimated number of orthodontic treatment months."
        },
        "orthodonticTreatmentRemainingMonths": {
            "type": "string",
            "description": "The number of orthodontic treatment months remaining."
        },
        "patientPaidAmount": {
            "type": "string",
            "description": "The amount the patient has paid."
        },
        "serviceAuthorizationExceptionCode": {
            "type": "string",
            "description": "The service authorization exception code for this claim."
        },
        "payerClaimControlNumber": {
            "type": "string",
            "description": "The payer claim control number for this claim."
        },
        "priorAuthorizationNumber": {
            "type": "string",
            "description": "The prior authorization number for this claim."
        },
        "claimIdentifier": {
            "type": "string",
            "description": "Trace number for this claim."
        },
        "accidentCauseCode1": {
            "type": "string",
            "description": "Related\/accident cause code."
        },
        "accidentCauseCode2": {
            "type": "string",
            "description": "Related\/accident cause code."
        },
        "accidentStateCode": {
            "type": "string",
            "description": "The state the accident happened in."
        },
        "accidentDate": {
            "type": "string",
            "format": "date",
            "description": "The date the accident occurred on."
        },
        "toothStatuses": {
            "type": "array",
            "description": "Status information about teeth.",
            "items": {
                "$ref": "#\/definitions\/ToothStatus"
            }
        },
        "supplementalInformation": {
            "type": "array",
            "description": "Supplemental information (additional paperwork).",
            "items": {
                "$ref": "#\/definitions\/SupplementalInformation"
            }
        },
        "contractTypeCode": {
            "type": "string",
            "description": "The type of contract."
        },
        "contractAmount": {
            "type": "string",
            "description": "The contracted amount."
        },
        "contractPercentage": {
            "type": "string",
            "description": "The contracted percentage."
        },
        "contractCode": {
            "type": "string",
            "description": "The contract code."
        },
        "contractTermsDiscountPercentage": {
            "type": "string",
            "description": "The contract terms discount percentage."
        },
        "contractVersion": {
            "type": "string",
            "description": "The contract version."
        },
        "notes": {
            "type": "array",
            "description": "Notes about this claim.",
            "items": {
                "$ref": "#\/definitions\/Note"
            }
        },
        "diagnoses": {
            "type": "array",
            "description": "Diagnoses related to this claim.",
            "items": {
                "$ref": "#\/definitions\/Diagnosis"
            }
        },
        "referringProvider": {
            "$ref": "#\/definitions\/Provider"
        },
        "primaryCareProvider": {
            "$ref": "#\/definitions\/Provider"
        },
        "renderingProvider": {
            "$ref": "#\/definitions\/Provider"
        },
        "serviceFacility": {
            "$ref": "#\/definitions\/Provider"
        },
        "assistantSurgeon": {
            "$ref": "#\/definitions\/Provider"
        },
        "supervisingProvider": {
            "$ref": "#\/definitions\/Provider"
        },
        "otherPayers": {
            "type": "array",
            "description": "Information about other payers.",
            "items": {
                "$ref": "#\/definitions\/OtherPayer"
            }
        },
        "serviceLines": {
            "type": "array",
            "description": "Information about the services performed.",
            "items": {
                "$ref": "#\/definitions\/ServiceLine"
            }
        }
    }
}
              

ToothStatus

{
    "type": "object",
    "properties": {
        "toothCode": {
            "type": "string",
            "description": "A tooth."
        },
        "toothStatusCode": {
            "type": "string",
            "description": "A tooth status."
        }
    }
}
              

SupplementalInformation

{
    "type": "object",
    "properties": {
        "reportTypeCode": {
            "type": "string",
            "description": "The report type."
        },
        "reportTransmissionCode": {
            "type": "string",
            "description": "The report transmission method."
        },
        "controlNumber": {
            "type": "string",
            "description": "The control number."
        }
    }
}
              

Note

{
    "type": "object",
    "properties": {
        "message": {
            "type": "string",
            "description": "A message about this claim."
        }
    }
}
              

Diagnosis

{
    "type": "object",
    "properties": {
        "qualifierCode": {
            "type": "string",
            "description": "The qualifier for this diagnosis."
        },
        "code": {
            "type": "string",
            "description": "The code for this diagnosis."
        }
    }
}
              

Provider

{
    "type": "object",
    "properties": {
        "lastName": {
            "type": "string",
            "description": "This provider's last name or organization name."
        },
        "firstName": {
            "type": "string",
            "description": "This provider's first name."
        },
        "middleName": {
            "type": "string",
            "description": "This provider's middle name."
        },
        "suffix": {
            "type": "string",
            "description": "This provider's suffix."
        },
        "npi": {
            "type": "string",
            "description": "This provider's NPI."
        },
        "specialtyCode": {
            "type": "string",
            "description": "This provider's specialty code."
        },
        "stateLicenseNumber": {
            "type": "string",
            "description": "This provider's state license number."
        },
        "upin": {
            "type": "string",
            "description": "This provider's UPIN."
        },
        "payerAssignedProviderId": {
            "type": "string",
            "description": "This provider's payer assigned provider id."
        },
        "locationNumber": {
            "type": "string",
            "description": "This provider's location number."
        },
        "addressLine1": {
            "type": "string",
            "description": "This provider's address (line one)."
        },
        "addressLine2": {
            "type": "string",
            "description": "This provider's address (line two)."
        },
        "city": {
            "type": "string",
            "description": "This provider's city."
        },
        "stateCode": {
            "type": "string",
            "description": "This provider's state (two character code)."
        },
        "zipCode": {
            "type": "string",
            "description": "This provider's ZIP code."
        },
        "countryCode": {
            "type": "string",
            "description": "This provider's country (US or CA)."
        },
        "referralNumber": {
            "type": "string",
            "description": "The referral number."
        }
    }
}
              

OtherPayer

{
    "type": "object",
    "properties": {
        "responsibilitySequenceCode": {
            "type": "string",
            "description": "The responsibility sequence of this payer (P, S, or T)."
        },
        "insuranceTypeCode": {
            "type": "string",
            "description": "The insurance type of this payer."
        },
        "claimFilingIndicatorCode": {
            "type": "string",
            "description": "The claim filing indicator code of this payer."
        },
        "name": {
            "type": "string",
            "description": "The name of this payer."
        },
        "id": {
            "type": "string",
            "description": "The id of this payer."
        },
        "addressLine1": {
            "type": "string",
            "description": "This payer's address (line one)."
        },
        "addressLine2": {
            "type": "string",
            "description": "This payer's address (line two)."
        },
        "city": {
            "type": "string",
            "description": "This payer's city."
        },
        "stateCode": {
            "type": "string",
            "description": "This payer's state (two character code)."
        },
        "zipCode": {
            "type": "string",
            "description": "This payer's ZIP code."
        },
        "countryCode": {
            "type": "string",
            "description": "This payer's country (US or CA)."
        },
        "claimPaidDate": {
            "type": "string",
            "format": "date",
            "description": "The date this payer paid the claim."
        },
        "ein": {
            "type": "string",
            "description": "This payer's EIN."
        },
        "claimOfficeNumber": {
            "type": "string",
            "description": "This payer's claim office number."
        },
        "naicCode": {
            "type": "string",
            "description": "This payer's NAIC."
        },
        "priorAuthorizationNumber": {
            "type": "string",
            "description": "The prior authorization number assigned by this payer."
        },
        "referralNumber": {
            "type": "string",
            "description": "The referral number assigned by this payer."
        },
        "claimControlNumber": {
            "type": "string",
            "description": "This payer's claim control number."
        },
        "paidAmount": {
            "type": "string",
            "description": "The amount paid by this payer."
        },
        "remainingPatientLiabilityAmount": {
            "type": "string",
            "description": "The remaining patient liability."
        },
        "nonCoveredAmount": {
            "type": "string",
            "description": "The amount that this payer did not cover."
        },
        "benefitsAssignmentCertification": {
            "type": "boolean",
            "description": "The benefits assignment certification indicator for this payer."
        },
        "informationReleaseCode": {
            "type": "string",
            "description": "The information release code for this payer."
        },
        "subscriberRelationshipCode": {
            "type": "string",
            "description": "The patient's relationship to this payer's subscriber."
        },
        "subscriber": {
            "$ref": "#\/definitions\/Subscriber"
        },
        "medicareOutpatientAdjudicationInformation": {
            "type": "object",
            "description": "Information about medicare outpatient adjudication.",
            "properties": {
                "reimburseRate": {
                    "type": "string",
                    "description": "The medicare outpatient adjudication reimburse rate."
                },
                "payableAmount": {
                    "type": "string",
                    "description": "The medicare outpatient adjudication payable amount."
                },
                "claimPaymentRemarkCode1": {
                    "type": "string",
                    "description": "A medicare outpatient adjudication claim remark code."
                },
                "claimPaymentRemarkCode2": {
                    "type": "string",
                    "description": "A medicare outpatient adjudication claim remark code."
                },
                "claimPaymentRemarkCode3": {
                    "type": "string",
                    "description": "A medicare outpatient adjudication claim remark code."
                },
                "claimPaymentRemarkCode4": {
                    "type": "string",
                    "description": "A medicare outpatient adjudication claim remark code."
                },
                "claimPaymentRemarkCode5": {
                    "type": "string",
                    "description": "A medicare outpatient adjudication claim remark code."
                },
                "nonPayableProfessionalComponentBilledAmount": {
                    "type": "string",
                    "description": "The medicare outpatient adjudication non-payable professional component billed amount."
                }
            }
        },
        "claimAdjustmentGroups": {
            "type": "array",
            "description": "Claim level adjustments for this payer.",
            "items": {
                "$ref": "#\/definitions\/AdjustmentGroup"
            }
        }
    }
}
              

ServiceLine

{
    "type": "object",
    "properties": {
        "controlNumber": {
            "type": "string",
            "description": "The control number for this service line."
        },
        "procedureCode": {
            "type": "string",
            "description": "The procedure performed."
        },
        "modifierCode1": {
            "type": "string",
            "description": "A procedure modifier."
        },
        "modifierCode2": {
            "type": "string",
            "description": "A procedure modifier."
        },
        "modifierCode3": {
            "type": "string",
            "description": "A procedure modifier."
        },
        "modifierCode4": {
            "type": "string",
            "description": "A procedure modifier."
        },
        "procedureDescription": {
            "type": "string",
            "description": "A procedure description."
        },
        "amount": {
            "type": "string",
            "description": "The charge amount for this service."
        },
        "placeOfServiceCode": {
            "type": "string",
            "description": "The place where this service was performed."
        },
        "cavityDesignationCode1": {
            "type": "string",
            "description": "A cavity designation code."
        },
        "cavityDesignationCode2": {
            "type": "string",
            "description": "A cavity designation code."
        },
        "cavityDesignationCode3": {
            "type": "string",
            "description": "A cavity designation code."
        },
        "cavityDesignationCode4": {
            "type": "string",
            "description": "A cavity designation code."
        },
        "cavityDesignationCode5": {
            "type": "string",
            "description": "A cavity designation code."
        },
        "prostheticCode": {
            "type": "string",
            "description": "The presthetic code."
        },
        "quantity": {
            "type": "string",
            "description": "The quantity."
        },
        "diagnosisCodePointer1": {
            "type": "string",
            "description": "A diagnosis code pointer."
        },
        "diagnosisCodePointer2": {
            "type": "string",
            "description": "A diagnosis code pointer."
        },
        "diagnosisCodePointer3": {
            "type": "string",
            "description": "A diagnosis code pointer."
        },
        "diagnosisCodePointer4": {
            "type": "string",
            "description": "A diagnosis code pointer."
        },
        "serviceDate": {
            "type": "string",
            "format": "date",
            "description": "The date that this service was performed."
        },
        "priorPlacementDate": {
            "type": "string",
            "format": "date",
            "description": "The prior placement date."
        },
        "appliancePlacementDate": {
            "type": "string",
            "format": "date",
            "description": "The appliance placement date."
        },
        "replacementDate": {
            "type": "string",
            "format": "date",
            "description": "The replacement date."
        },
        "treatmentStartDate": {
            "type": "string",
            "format": "date",
            "description": "The date treatment started."
        },
        "treatmentEndDate": {
            "type": "string",
            "format": "date",
            "description": "The date treatment ended."
        },
        "toothInformation": {
            "type": "array",
            "description": "Information about the teeth involved in this service.",
            "items": {
                "$ref": "#\/definitions\/ToothInformation"
            }
        },
        "contractTypeCode": {
            "type": "string",
            "description": "The contract type."
        },
        "contractAmount": {
            "type": "string",
            "description": "The contract amount."
        },
        "contractPercentage": {
            "type": "string",
            "description": "The contract percentage."
        },
        "contractCode": {
            "type": "string",
            "description": "The contract code."
        },
        "contractTermsDiscountPercentage": {
            "type": "string",
            "description": "The contract terms discount percentage."
        },
        "contractVersion": {
            "type": "string",
            "description": "The contract version."
        },
        "priorAuthorizationNumber": {
            "type": "string",
            "description": "The prior authorization number for this service."
        },
        "referralNumber": {
            "type": "string",
            "description": "The referral number for this service.."
        },
        "salesTax": {
            "type": "string",
            "description": "The sales tax for this service."
        },
        "renderingProvider": {
            "$ref": "#\/definitions\/Provider"
        },
        "assistantSurgeon": {
            "$ref": "#\/definitions\/Provider"
        },
        "supervisingProvider": {
            "$ref": "#\/definitions\/Provider"
        },
        "serviceFacility": {
            "$ref": "#\/definitions\/Provider"
        },
        "adjudicationInformation": {
            "type": "array",
            "description": "Adjudication information for this service line.",
            "items": {
                "$ref": "#\/definitions\/AdjudicationInformation"
            }
        }
    }
}
              

AdjustmentGroup

{
    "type": "object",
    "properties": {
        "groupCode": {
            "type": "string",
            "description": "The adjustment group."
        },
        "adjustments": {
            "type": "array",
            "description": "A list of adjustments to this claim.",
            "items": {
                "$ref": "#\/definitions\/Adjustment"
            }
        }
    }
}
              

Adjustment

{
    "type": "object",
    "properties": {
        "reasonCode": {
            "type": "string",
            "description": "The adjustment reason code."
        },
        "amount": {
            "type": "string",
            "description": "The adjustment amount."
        },
        "quantity": {
            "type": "string",
            "description": "The adjustment quantity."
        }
    }
}
              

ToothInformation

{
    "type": "object",
    "properties": {
        "toothCode": {
            "type": "string",
            "description": "The tooth."
        },
        "toothSurfaceCode1": {
            "type": "string",
            "description": "A tooth surface."
        },
        "toothSurfaceCode2": {
            "type": "string",
            "description": "A tooth surface."
        },
        "toothSurfaceCode3": {
            "type": "string",
            "description": "A tooth surface."
        },
        "toothSurfaceCode4": {
            "type": "string",
            "description": "A tooth surface."
        },
        "toothSurfaceCode5": {
            "type": "string",
            "description": "A tooth surface."
        }
    }
}
              

AdjudicationInformation

{
    "type": "object",
    "properties": {
        "payerId": {
            "type": "string",
            "description": "The payer id for this adjudication information."
        },
        "paidAmount": {
            "type": "string",
            "description": "The amount this payer paid."
        },
        "procedureCode": {
            "type": "string",
            "description": "The procedure performed."
        },
        "modifierCode1": {
            "type": "string",
            "description": "A procedure modifier."
        },
        "modifierCode2": {
            "type": "string",
            "description": "A procedure modifier."
        },
        "modifierCode3": {
            "type": "string",
            "description": "A procedure modifier."
        },
        "modifierCode4": {
            "type": "string",
            "description": "A procedure modifier."
        },
        "procedureDescription": {
            "type": "string",
            "description": "A procedure description."
        },
        "quantity": {
            "type": "string",
            "description": "The quantity."
        },
        "lineNumber": {
            "type": "string",
            "description": "The line number."
        },
        "claimPaidDate": {
            "type": "string",
            "format": "date",
            "description": "The claim paid date."
        },
        "remainingPatientLiabilityAmount": {
            "type": "string",
            "description": "The remaining patient liability amount."
        },
        "claimAdjustmentGroups": {
            "type": "array",
            "description": "Claim line adjustments.",
            "items": {
                "$ref": "#\/definitions\/AdjustmentGroup"
            }
        }
    }
}
              

ErrorResponse

{
    "type": "object",
    "properties": {
        "userMessage": {
            "type": "string",
            "description": "A high level error message."
        },
        "developerMessage": {
            "type": "string",
            "description": "A more technical error message."
        },
        "reasonCode": {
            "type": "integer",
            "description": "A reason code."
        },
        "statusCode": {
            "type": "integer",
            "description": "The status code."
        },
        "errors": {
            "type": "array",
            "description": "A list of detailed user friendly messages.",
            "items": {
                "$ref": "#\/definitions\/FieldError"
            }
        }
    }
}
              

FieldError

{
    "type": "object",
    "properties": {
        "field": {
            "type": "string",
            "description": "The field or parameter associated with this error."
        },
        "code": {
            "type": "string",
            "description": "A code for the error."
        },
        "errorMessage": {
            "type": "string",
            "description": "The message associated with this error."
        },
        "index": {
            "type": "integer",
            "description": "The array index of the item associated with this error."
        }
    }
}