Athletic API Dashboard
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API Endpoints
Total rows: 63,271
| created_at | updated_at | id | athelas_task_id | cmds_task_id | raw_request | raw_response_url | check_source | has_error | created_by | date_of_service | parsed_data_url | parsed_data | oon_parsed_data | suggested_copay_amt | is_deductible_met | is_in_network | plan_info | service_type_codes | is_proactive_visit | is_archived | failed_to_parse_response_reason | payer_plan_info | medicare_part | waystar_inquiry_id | created_by_user_id | appointment_id | patient_insurance_info_id | site_id | facility_id | eligibility_coverage_id | mapped_insurance_company_id | patient_id | eligibility_checks_updated_at | patients_updated_at |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2025-07-16 23:21:40.849895 | 2025-07-16 23:21:42.464261 | 9900079 | N/A | N/A | {'payer_id': 'VCHCP', 'payer_name': 'Ventura County Health Care Plan', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1965-10-24', 'date_of_service': '2025-07-16', 'subscriber_gender': 'M', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 2815, 'subscriber_last_name': 'Wold', 'subscriber_member_id': '00900105302', 'subscriber_first_name': 'Tony'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6681119/check_9900079_a3d888c1-197d-40cf-a901-1127a06548c2.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | N/A | N/A | N/A | N/A | N/A | N/A | {'member_id': '00900105302', 'plan_type': None, 'group_name': None, 'payer_name': 'VENTURA COUNTY HEALTH CARE PLAN', 'payer_note': None, 'patient_dob': '1965-10-24', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'WOLD', 'plan_sponsor_name': None, 'patient_first_name': 'TONY', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | 9482 | N/A | 6681119 | 2222 | N/A | N/A | N/A | 5290108 | 2025-07-16 23:21:42.464261 | 2025-07-30 01:01:58.188731 |
| 2025-07-16 23:20:23.325898 | 2025-07-16 23:20:25.038187 | 9900069 | N/A | N/A | {'payer_id': 'VCHCP', 'payer_name': 'Ventura County Health Care Plan', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1965-10-24', 'date_of_service': '2025-07-16', 'subscriber_gender': 'M', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 2815, 'subscriber_last_name': 'Wold', 'subscriber_member_id': '00900105302', 'subscriber_first_name': 'Tony'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6681119/check_9900069_b9ca0f15-f464-448d-8354-16e5a8b2c904.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6681119/check_9900069_39ca2d59-c032-42b7-8b3e-518806978b8d.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '00900105302', 'plan_type': None, 'group_name': None, 'payer_name': 'VENTURA COUNTY HEALTH CARE PLAN', 'payer_note': None, 'patient_dob': '1965-10-24', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'WOLD', 'plan_sponsor_name': None, 'patient_first_name': 'TONY', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | 9482 | N/A | 6681119 | 2222 | N/A | 9632863 | N/A | 5290108 | 2025-07-16 23:20:25.038187 | 2025-07-30 01:01:58.188731 |
| 2025-07-16 23:20:21.788694 | 2025-07-16 23:20:23.324000 | 9900068 | N/A | N/A | {'payer_id': 'VCHCP', 'payer_name': 'Ventura County Health Care Plan', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1965-10-24', 'date_of_service': '2025-07-16', 'subscriber_gender': 'M', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 2815, 'subscriber_last_name': 'Wold', 'subscriber_member_id': '00900105302', 'subscriber_first_name': 'Tony'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6681119/check_9900068_710c8ada-5a22-4e4a-a165-36883933adad.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | N/A | N/A | N/A | N/A | N/A | N/A | {'member_id': '00900105302', 'plan_type': None, 'group_name': None, 'payer_name': 'VENTURA COUNTY HEALTH CARE PLAN', 'payer_note': None, 'patient_dob': '1965-10-24', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'WOLD', 'plan_sponsor_name': None, 'patient_first_name': 'TONY', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | 9482 | N/A | 6681119 | 2222 | N/A | N/A | N/A | 5290108 | 2025-07-16 23:20:23.324000 | 2025-07-30 01:01:58.188731 |
| 2025-07-16 23:19:53.239451 | 2025-07-16 23:19:54.992847 | 9900064 | N/A | N/A | {'payer_id': 'VCHCP', 'payer_name': 'Ventura County Health Care Plan', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1965-10-24', 'date_of_service': '2025-07-16', 'subscriber_gender': 'M', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 2815, 'subscriber_last_name': 'Wold', 'subscriber_member_id': '00900105302', 'subscriber_first_name': 'Tony'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6681119/check_9900064_0bb70b01-ee1d-457d-b6fa-10fc3a79cd82.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6681119/check_9900064_8c6902a3-add3-43b8-bfd1-844f3e110e73.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '00900105302', 'plan_type': None, 'group_name': None, 'payer_name': 'VENTURA COUNTY HEALTH CARE PLAN', 'payer_note': None, 'patient_dob': '1965-10-24', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'WOLD', 'plan_sponsor_name': None, 'patient_first_name': 'TONY', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | 9482 | N/A | 6681119 | 2222 | N/A | 9632856 | N/A | 5290108 | 2025-07-16 23:19:54.992847 | 2025-07-30 01:01:58.188731 |
| 2025-07-16 23:19:51.658125 | 2025-07-16 23:19:53.237007 | 9900063 | N/A | N/A | {'payer_id': 'VCHCP', 'payer_name': 'Ventura County Health Care Plan', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1965-10-24', 'date_of_service': '2025-07-16', 'subscriber_gender': 'M', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 2815, 'subscriber_last_name': 'Wold', 'subscriber_member_id': '00900105302', 'subscriber_first_name': 'Tony'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6681119/check_9900063_68fffae8-f2e3-4322-9b7e-54df881cd791.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | N/A | N/A | N/A | N/A | N/A | N/A | {'member_id': '00900105302', 'plan_type': None, 'group_name': None, 'payer_name': 'VENTURA COUNTY HEALTH CARE PLAN', 'payer_note': None, 'patient_dob': '1965-10-24', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'WOLD', 'plan_sponsor_name': None, 'patient_first_name': 'TONY', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | 9482 | N/A | 6681119 | 2222 | N/A | N/A | N/A | 5290108 | 2025-07-16 23:19:53.237007 | 2025-07-30 01:01:58.188731 |
| 2025-07-16 23:19:35.727097 | 2025-07-16 23:19:45.513527 | 9900060 | N/A | N/A | {'payer_id': 'VCHCP', 'payer_name': 'Ventura County Health Care Plan', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1965-10-24', 'date_of_service': '2025-07-16', 'subscriber_gender': 'M', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 2815, 'subscriber_last_name': 'Wold', 'subscriber_member_id': '00900105302', 'subscriber_first_name': 'Tony'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6681119/check_9900060_a2e70a39-506e-4417-811e-d6020060db44.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6681119/check_9900060_c447eba1-9f06-41a8-8373-a35b2bb3c4d6.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '00900105302', 'plan_type': None, 'group_name': None, 'payer_name': 'VENTURA COUNTY HEALTH CARE PLAN', 'payer_note': None, 'patient_dob': '1965-10-24', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'WOLD', 'plan_sponsor_name': None, 'patient_first_name': 'TONY', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | 9482 | N/A | 6681119 | 2222 | N/A | 9632853 | N/A | 5290108 | 2025-07-16 23:19:45.513527 | 2025-07-30 01:01:58.188731 |
| 2025-07-16 23:19:34.121196 | 2025-07-16 23:19:35.723409 | 9900059 | N/A | N/A | {'payer_id': 'VCHCP', 'payer_name': 'Ventura County Health Care Plan', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1965-10-24', 'date_of_service': '2025-07-16', 'subscriber_gender': 'M', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 2815, 'subscriber_last_name': 'Wold', 'subscriber_member_id': '00900105302', 'subscriber_first_name': 'Tony'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6681119/check_9900059_f78d33f4-1fe2-4f95-bce4-2b2292169b91.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | N/A | N/A | N/A | N/A | N/A | N/A | {'member_id': '00900105302', 'plan_type': None, 'group_name': None, 'payer_name': 'VENTURA COUNTY HEALTH CARE PLAN', 'payer_note': None, 'patient_dob': '1965-10-24', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'WOLD', 'plan_sponsor_name': None, 'patient_first_name': 'TONY', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | 9482 | N/A | 6681119 | 2222 | N/A | N/A | N/A | 5290108 | 2025-07-16 23:19:35.723409 | 2025-07-30 01:01:58.188731 |
| 2025-07-16 23:07:49.622188 | 2025-07-16 23:07:52.372823 | 9900030 | N/A | N/A | {'payer_id': 'LACAR', 'payer_name': 'LA Care Health Plan (Los Angeles Care Health Plan)', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1978-10-13', 'date_of_service': '2025-07-15', 'subscriber_gender': 'F', 'service_type_codes': ['PT', 'AE'], 'insurance_company_id': 5538, 'subscriber_last_name': 'Martinez', 'subscriber_member_id': '92374371A', 'subscriber_first_name': 'Christina'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6823241/check_9900030_1094109a-ea24-46d1-9440-e4305006a7c4.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-15 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6823241/check_9900030_6c735ad6-5719-41ad-8c95-7c070f5275d7.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '92374371A', 'plan_type': None, 'group_name': 'MCLA WELL ND ME>=21', 'payer_name': 'LA CARE HEALTH PLAN', 'payer_note': None, 'patient_dob': '1978-10-13', 'plan_number': 'MCLA', 'group_number': 'MWLLNMEG21', 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'MARTINEZ', 'plan_sponsor_name': None, 'patient_first_name': 'CHRISTINA', 'patient_middle_name': None, 'date_time_period_end': '2078-12-31', 'date_time_period_start': '2017-09-01', 'plan_coverage_description': 'LACARE MEDICAL', 'relationship_to_subscriber': None} | ['PT', 'AE'] | N/A | N/A | N/A | N/A | N/A | 8284241122 | 7927 | N/A | 6823241 | 2222 | N/A | 9632780 | N/A | 5865584 | 2025-07-16 23:07:52.372823 | 2025-07-07 23:44:58.423901 |
| 2025-07-16 22:56:01.020672 | 2025-07-16 22:56:12.972543 | 9899969 | N/A | N/A | {'payer_id': '60054', 'payer_name': 'Aetna', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1986-01-20', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 3948, 'subscriber_last_name': 'DAVIS', 'subscriber_member_id': 'W258779471', 'subscriber_first_name': 'MARTINA'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/5993951/check_9899969_3c127b55-40b0-4ae3-ae08-a360ea48bd3b.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/5993951/check_9899969_b7273f4b-be8c-46ba-b1b0-5034e5f396b1.json | N/A | N/A | N/A | N/A | N/A | {'member_id': 'W258779471', 'plan_type': 'Point of Service (POS)', 'group_name': 'ADP TOTALSOURCE SERVICES, INC.', 'payer_name': 'AETNA', 'payer_note': None, 'patient_dob': '1986-01-20', 'plan_number': '0251371', 'group_number': '025137101900020', 'insurance_type': None, 'plan_type_code': 'PS', 'enrolled_in_qmb': False, 'patient_last_name': 'DAVIS', 'plan_sponsor_name': None, 'patient_first_name': 'ASTIN', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': 'OPEN ACCESS MC', 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | 8284204918 | 160084 | N/A | 5993951 | 2222 | N/A | 9632677 | N/A | 4642884 | 2025-07-16 22:56:12.972543 | 2025-12-02 20:19:19.910444 |
| 2025-07-16 22:44:09.363233 | 2025-07-16 22:44:13.157792 | 9899914 | N/A | N/A | {'payer_id': '87726', 'payer_name': 'United Healthcare', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1996-09-04', 'date_of_service': '2025-07-16', 'subscriber_gender': 'M', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 6411, 'subscriber_last_name': 'Popish', 'subscriber_member_id': '31433817600', 'subscriber_first_name': 'Elijah'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6104677/check_9899914_0b51bdfb-8bd8-4ee8-a51b-65e47bbd82a5.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6104677/check_9899914_c5de5b6d-299c-49b0-8fe2-51caa4eaf69f.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '31433817600', 'plan_type': 'Commercial', 'group_name': None, 'payer_name': 'UNITEDHEALTHCARE BENEFITS PLAN OF CALIFORNIA', 'payer_note': 'FUNDING TYPE = FULLY INSURED - SMALL GROUP', 'patient_dob': '1996-09-04', 'plan_number': None, 'group_number': '1626005', 'insurance_type': None, 'plan_type_code': 'C1', 'enrolled_in_qmb': False, 'patient_last_name': 'POPISH', 'plan_sponsor_name': None, 'patient_first_name': 'ELIJAH', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': 'SELECT PLUS', 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | 8284175750 | 160084 | N/A | 6104677 | 2222 | N/A | 9632582 | N/A | 4749059 | 2025-07-16 22:44:13.157792 | 2025-06-02 16:35:32.560533 |
| 2025-07-16 22:15:00.854218 | 2025-07-16 22:15:02.627401 | 9899755 | N/A | N/A | {'payer_id': 'LMG01', 'payer_name': 'Lakeside Medical Group', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1976-12-21', 'date_of_service': '2025-07-21', 'subscriber_gender': 'M', 'service_type_codes': ['PT'], 'insurance_company_id': 23320, 'subscriber_last_name': 'Plante', 'subscriber_member_id': 'AJC910453879', 'subscriber_first_name': 'John'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/7022325/check_9899755_6fe8e3c6-5964-4a50-8af8-2bd22687d199.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-21 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/7022325/check_9899755_67eaac0f-fcff-491c-98b6-44a8edf7b28b.json | N/A | N/A | N/A | N/A | N/A | {'member_id': 'AJC910453879', 'plan_type': None, 'group_name': None, 'payer_name': 'LAKESIDE MEDICAL GROUP', 'payer_note': None, 'patient_dob': '1976-12-21', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'PLANTE', 'plan_sponsor_name': None, 'patient_first_name': 'JOHN', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 7022325 | 2222 | N/A | 9632341 | N/A | 6037494 | 2025-07-16 22:15:02.627401 | 2025-07-15 21:00:08.282965 |
| 2025-07-16 22:14:58.274427 | 2025-07-16 22:15:00.851267 | 9899754 | N/A | N/A | {'payer_id': 'LMG01', 'payer_name': 'Lakeside Medical Group', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1976-12-21', 'date_of_service': '2025-07-21', 'subscriber_gender': 'M', 'service_type_codes': ['PT'], 'insurance_company_id': 23320, 'subscriber_last_name': 'Plante', 'subscriber_member_id': 'AJC910453879', 'subscriber_first_name': 'John'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/7022325/check_9899754_b2a8bb0c-6038-4ce7-9ef1-e429d9e763cb.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-21 | N/A | N/A | N/A | N/A | N/A | N/A | {'member_id': 'AJC910453879', 'plan_type': None, 'group_name': None, 'payer_name': 'LAKESIDE MEDICAL GROUP', 'payer_note': None, 'patient_dob': '1976-12-21', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'PLANTE', 'plan_sponsor_name': None, 'patient_first_name': 'JOHN', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 7022325 | 2222 | N/A | N/A | N/A | 6037494 | 2025-07-16 22:15:00.851267 | 2025-07-15 21:00:08.282965 |
| 2025-07-16 20:32:56.721185 | 2025-07-16 20:32:58.627346 | 9899201 | N/A | N/A | {'payer_id': 'SB040', 'payer_name': 'Blue Cross California', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1967-03-31', 'date_of_service': '2025-07-11', 'subscriber_gender': 'F', 'service_type_codes': ['PT', 'AE'], 'insurance_company_id': 4185, 'subscriber_last_name': 'BARRERA', 'subscriber_member_id': 'XEH903839121', 'subscriber_first_name': 'LOLA'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/7038375/check_9899201_92ef8009-f4ce-4f6c-8408-4105cd2d3125.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-11 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/7038375/check_9899201_a4880b1a-54e5-4a00-bf24-2e8e37534bf2.json | N/A | N/A | N/A | N/A | N/A | {'member_id': 'XEH903839121', 'plan_type': 'Health Maintenance Organization (HMO)', 'group_name': 'CVT MOORPARK USD', 'payer_name': 'ANTHEM BLUE CROSS', 'payer_note': None, 'patient_dob': '1967-03-31', 'plan_number': '1000HMOX0005', 'group_number': 'W0052266', 'insurance_type': None, 'plan_type_code': 'HM', 'enrolled_in_qmb': False, 'patient_last_name': 'BARRERA', 'plan_sponsor_name': None, 'patient_first_name': 'LOLA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': 'CALIFORNIA S VALUED TRUST CUSTOM HMO 10 0', 'relationship_to_subscriber': None} | ['PT', 'AE'] | N/A | N/A | N/A | N/A | N/A | 8283551865 | 9330 | N/A | 7038375 | 2222 | N/A | 9631577 | N/A | 5230345 | 2025-07-16 20:32:58.627346 | 2025-07-11 20:32:03.183345 |
| 2025-07-16 20:32:15.396421 | 2025-07-16 20:32:17.207258 | 9899192 | N/A | N/A | {'payer_id': 'SB040', 'payer_name': 'Blue Cross California', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1967-03-31', 'date_of_service': '2025-07-11', 'subscriber_gender': 'F', 'service_type_codes': ['PT', 'AE'], 'insurance_company_id': 4185, 'subscriber_last_name': 'BARRERA', 'subscriber_member_id': 'XEH903389121', 'subscriber_first_name': 'LOLA'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6611912/check_9899192_064c1f4c-980c-4625-8550-e571c976574b.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-11 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6611912/check_9899192_d554f2a2-6dcf-4712-9eb1-424d42a62c9b.json | N/A | N/A | N/A | N/A | N/A | {'member_id': 'XEH903389121', 'plan_type': None, 'group_name': None, 'payer_name': 'ANTHEM BLUE CROSS', 'payer_note': None, 'patient_dob': '1967-03-31', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'BARRERA', 'plan_sponsor_name': None, 'patient_first_name': 'LOLA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['PT', 'AE'] | N/A | N/A | N/A | N/A | N/A | N/A | 9330 | N/A | 6611912 | 2222 | N/A | 9631567 | N/A | 5230345 | 2025-07-16 20:32:17.207258 | 2025-07-11 20:32:03.183345 |
| 2025-07-16 20:32:11.713579 | 2025-07-16 20:32:15.393270 | 9899191 | N/A | N/A | {'payer_id': 'SB040', 'payer_name': 'Blue Cross California', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1967-03-31', 'date_of_service': '2025-07-11', 'subscriber_gender': 'F', 'service_type_codes': ['PT', 'AE'], 'insurance_company_id': 4185, 'subscriber_last_name': 'BARRERA', 'subscriber_member_id': 'XEH903389121', 'subscriber_first_name': 'LOLA'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6611912/check_9899191_0505c389-3ae1-4a00-95c2-5fce1406d625.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-11 | N/A | N/A | N/A | N/A | N/A | N/A | {'member_id': 'XEH903389121', 'plan_type': None, 'group_name': None, 'payer_name': 'ANTHEM BLUE CROSS', 'payer_note': None, 'patient_dob': '1967-03-31', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'BARRERA', 'plan_sponsor_name': None, 'patient_first_name': 'LOLA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['PT', 'AE'] | N/A | N/A | N/A | N/A | N/A | N/A | 9330 | N/A | 6611912 | 2222 | N/A | N/A | N/A | 5230345 | 2025-07-16 20:32:15.393270 | 2025-07-11 20:32:03.183345 |
| 2025-07-16 20:30:40.246379 | 2025-07-16 20:30:44.059156 | 9899168 | N/A | N/A | {'payer_id': 'SB040', 'payer_name': 'Blue Cross California', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1967-03-31', 'date_of_service': '2025-07-11', 'subscriber_gender': 'F', 'service_type_codes': ['PT', 'AE'], 'insurance_company_id': 4185, 'subscriber_last_name': 'BARRERA', 'subscriber_member_id': 'XEH903839121', 'subscriber_first_name': 'LOLA'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/7038375/check_9899168_392049da-3884-4e1f-88b9-65df14f0711f.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-11 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/7038375/check_9899168_6a7308e6-a8c4-4171-b909-61603c2e5730.json | N/A | N/A | N/A | N/A | N/A | {'member_id': 'XEH903839121', 'plan_type': 'Health Maintenance Organization (HMO)', 'group_name': 'CVT MOORPARK USD', 'payer_name': 'ANTHEM BLUE CROSS', 'payer_note': None, 'patient_dob': '1967-03-31', 'plan_number': '1000HMOX0005', 'group_number': 'W0052266', 'insurance_type': None, 'plan_type_code': 'HM', 'enrolled_in_qmb': False, 'patient_last_name': 'BARRERA', 'plan_sponsor_name': None, 'patient_first_name': 'LOLA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': 'CALIFORNIA S VALUED TRUST CUSTOM HMO 10 0', 'relationship_to_subscriber': None} | ['PT', 'AE'] | N/A | N/A | N/A | N/A | N/A | 8283536446 | 9330 | N/A | 7038375 | 2222 | N/A | 9631543 | N/A | 5230345 | 2025-07-16 20:30:44.059156 | 2025-07-11 20:32:03.183345 |
| 2025-07-16 19:06:21.245174 | 2025-07-16 19:06:23.056694 | 9898584 | N/A | N/A | {'payer_id': '87726', 'payer_name': 'United Healthcare', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1995-01-07', 'date_of_service': '2025-07-16', 'subscriber_gender': 'M', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 6411, 'subscriber_last_name': 'ANTSELIOVICH', 'subscriber_member_id': '969585566', 'subscriber_first_name': 'ANATOLY'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6885473/check_9898584_40bb0af2-0a0c-4fd3-945b-eeab2c56da7c.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6885473/check_9898584_d7bd6734-1bc5-4ceb-bb8c-b254549c9202.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '969585566', 'plan_type': 'Commercial', 'group_name': 'PUBLICIS GROUPE', 'payer_name': 'UNITEDHEALTHCARE', 'payer_note': 'FUNDING TYPE = SELF INSURED - LARGE GROUP A PRIOR AUTHORIZATION OR NOTIFICATION INQUIRY REQUEST MAY BE SUBMITTED', 'patient_dob': '1995-01-07', 'plan_number': '0149 0149', 'group_number': '936200', 'insurance_type': None, 'plan_type_code': 'C1', 'enrolled_in_qmb': False, 'patient_last_name': 'ANTSELIOVICH', 'plan_sponsor_name': None, 'patient_first_name': 'ANATOLY', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': 'SELECT PLUS', 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | 8282986068 | N/A | N/A | 6885473 | 2222 | N/A | 9630815 | N/A | 5919587 | 2025-07-16 19:06:23.056694 | 2025-07-16 18:18:52.989121 |
| 2025-07-16 19:05:14.793442 | 2025-07-16 19:05:18.599120 | 9898571 | N/A | N/A | {'payer_id': '87726', 'payer_name': 'United Healthcare', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1995-01-07', 'date_of_service': '2025-07-16', 'subscriber_gender': 'M', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 6411, 'subscriber_last_name': 'ANTSELIOVICH', 'subscriber_member_id': '969585566', 'subscriber_first_name': 'ANATOLY'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6885473/check_9898571_2acdfcb5-4e1d-4b24-b65f-5a104c2bb4fc.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6885473/check_9898571_3a6dbf7a-ba7e-42c8-9d15-d136ea08399e.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '969585566', 'plan_type': 'Commercial', 'group_name': 'PUBLICIS GROUPE', 'payer_name': 'UNITEDHEALTHCARE', 'payer_note': 'FUNDING TYPE = SELF INSURED - LARGE GROUP A PRIOR AUTHORIZATION OR NOTIFICATION INQUIRY REQUEST MAY BE SUBMITTED', 'patient_dob': '1995-01-07', 'plan_number': '0149 0149', 'group_number': '936200', 'insurance_type': None, 'plan_type_code': 'C1', 'enrolled_in_qmb': False, 'patient_last_name': 'ANTSELIOVICH', 'plan_sponsor_name': None, 'patient_first_name': 'ANATOLY', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': 'SELECT PLUS', 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | 8282977870 | N/A | N/A | 6885473 | 2222 | N/A | 9630798 | N/A | 5919587 | 2025-07-16 19:05:18.599120 | 2025-07-16 18:18:52.989121 |
| 2025-07-16 18:48:25.229652 | 2025-07-16 18:48:26.954077 | 9898454 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1407668064, 'trace_number': None, 'provider_name': 'Jacklyn Kokuashvili', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9898454_3881d7d1-9fba-41c6-8dc8-c0146ad38b3b.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9898454_025d4c48-5642-40c8-8cfb-82a1c340400f.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT', '30', '98'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9630650 | N/A | 5248742 | 2025-07-16 18:48:26.954077 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:48:23.315151 | 2025-07-16 18:48:25.165801 | 9898453 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9898453_16b751fa-94d2-4551-bd08-c37b9ed1677b.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9898453_d096a7e7-594c-429d-8329-07d220e0d438.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9630649 | N/A | 5248742 | 2025-07-16 18:48:25.165801 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:48:21.724292 | 2025-07-16 18:48:23.309220 | 9898452 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9898452_b8b50a96-2ccd-4528-b54a-ffa2a4605d8a.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | N/A | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | N/A | N/A | 5248742 | 2025-07-16 18:48:23.309220 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:34:43.923772 | 2025-07-16 18:34:45.722748 | 9898065 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1407668064, 'trace_number': None, 'provider_name': 'Jacklyn Kokuashvili', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9898065_537bbbc5-767e-4477-b655-4f22a5f1cf28.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9898065_167111f5-87c4-4e1a-b598-7544403990d2.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT', '30', '98'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9630222 | N/A | 5248742 | 2025-07-16 18:34:45.722748 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:34:41.931081 | 2025-07-16 18:34:43.813617 | 9898061 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9898061_a6145699-d419-4133-ad82-f75e53f0884e.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9898061_8141342a-fb25-42f6-b5b4-8489cce3ffa3.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9630219 | N/A | 5248742 | 2025-07-16 18:34:43.813617 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:34:35.206963 | 2025-07-16 18:34:41.927225 | 9898041 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9898041_3afd04b2-5764-492e-9910-9878810e32e1.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | N/A | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | N/A | N/A | 5248742 | 2025-07-16 18:34:41.927225 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:34:22.774740 | 2025-07-16 18:34:27.582269 | 9898012 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1407668064, 'trace_number': None, 'provider_name': 'Jacklyn Kokuashvili', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9898012_7d6d7969-550f-4481-99ac-1f76f1ca8362.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9898012_e82c7500-12f1-463f-979f-2ac6d2b94d0d.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT', '30', '98'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9630167 | N/A | 5248742 | 2025-07-16 18:34:27.582269 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:34:20.860411 | 2025-07-16 18:34:22.621497 | 9898006 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9898006_a1714913-8cd5-42dd-948a-2b4bc42a2b51.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9898006_9e22d046-7be8-4d20-826a-9b6edf96a682.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9630153 | N/A | 5248742 | 2025-07-16 18:34:22.621497 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:34:19.272309 | 2025-07-16 18:34:20.855270 | 9898002 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9898002_9c17db15-beec-4e25-b8ef-49f3c9b52545.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | N/A | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | N/A | N/A | 5248742 | 2025-07-16 18:34:20.855270 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:32:36.294549 | 2025-07-16 18:32:42.062346 | 9897746 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1407668064, 'trace_number': None, 'provider_name': 'Jacklyn Kokuashvili', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897746_21704350-bad5-4895-80f5-ce206b9fb2a9.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9897746_844e7b74-0346-41d4-bec3-3d18c226be7d.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT', '30', '98'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9629891 | N/A | 5248742 | 2025-07-16 18:32:42.062346 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:32:34.439910 | 2025-07-16 18:32:36.206419 | 9897743 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897743_ea215151-177e-4731-ab43-6ae304111b04.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9897743_f6802c52-4cd9-438b-b4f0-95bc00e80a65.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9629887 | N/A | 5248742 | 2025-07-16 18:32:36.206419 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:32:32.839369 | 2025-07-16 18:32:34.436611 | 9897742 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897742_09cddc15-d5e7-4df2-ab21-9b907850e2c7.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | N/A | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | N/A | N/A | 5248742 | 2025-07-16 18:32:34.436611 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:32:16.610019 | 2025-07-16 18:32:18.384973 | 9897719 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1407668064, 'trace_number': None, 'provider_name': 'Jacklyn Kokuashvili', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897719_9b517e12-e795-46f9-aee6-bf0672f9ac73.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9897719_8023b871-3f0e-4eeb-a3b7-ae75af22e5bd.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT', '30', '98'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9629863 | N/A | 5248742 | 2025-07-16 18:32:18.384973 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:32:14.682267 | 2025-07-16 18:32:16.503957 | 9897716 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897716_cc14fdf9-09a0-44b6-9455-9b39fdf63c85.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9897716_23046a8a-5d3c-43c3-b320-ca2c20cceee9.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9629859 | N/A | 5248742 | 2025-07-16 18:32:16.503957 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:32:13.104426 | 2025-07-16 18:32:14.678697 | 9897713 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897713_e2a19054-0708-4a1a-8a20-47ae7fff0b6e.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | N/A | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | N/A | N/A | 5248742 | 2025-07-16 18:32:14.678697 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:27:53.709035 | 2025-07-16 18:27:55.516563 | 9897563 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1407668064, 'trace_number': None, 'provider_name': 'Jacklyn Kokuashvili', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897563_7b42fb09-f579-46a3-b607-9b827488e871.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9897563_358240f5-cac2-47ab-ac33-f1a386ff4582.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT', '30', '98'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9629701 | N/A | 5248742 | 2025-07-16 18:27:55.516563 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:27:51.720734 | 2025-07-16 18:27:53.528889 | 9897562 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897562_e9a6d07f-5799-4ea2-83d3-760678e7a2f0.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9897562_c8614a3b-80d6-4950-b0c2-0c89e0fe45e7.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9629700 | N/A | 5248742 | 2025-07-16 18:27:53.528889 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:27:50.111613 | 2025-07-16 18:27:51.716995 | 9897561 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897561_11b52097-5146-410b-bfd6-c0da68773df3.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | N/A | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | N/A | N/A | 5248742 | 2025-07-16 18:27:51.716995 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:27:41.085421 | 2025-07-16 18:27:42.902554 | 9897560 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1407668064, 'trace_number': None, 'provider_name': 'Jacklyn Kokuashvili', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897560_72ceeaa8-5895-41c9-ac1e-6c9954221aef.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9897560_c9477dfc-b6cc-47da-b553-9b55495e0a8f.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT', '30', '98'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9629698 | N/A | 5248742 | 2025-07-16 18:27:42.902554 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:27:39.232608 | 2025-07-16 18:27:40.989227 | 9897559 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897559_a60199a7-1a15-48dd-8a64-5333272ded09.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9897559_aea82247-8f3c-4fac-89d6-0a3d93756465.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9629697 | N/A | 5248742 | 2025-07-16 18:27:40.989227 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:27:37.645421 | 2025-07-16 18:27:39.230509 | 9897558 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897558_2aaffa50-342c-43f4-b726-d9909269afad.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | N/A | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | N/A | N/A | 5248742 | 2025-07-16 18:27:39.230509 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:27:34.226904 | 2025-07-16 18:27:35.937825 | 9897557 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1407668064, 'trace_number': None, 'provider_name': 'Jacklyn Kokuashvili', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897557_dfff3227-8b28-47fb-9aff-ec9e86e52393.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9897557_1761c30f-c854-4835-aad7-6a7bce3a5f60.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT', '30', '98'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9629695 | N/A | 5248742 | 2025-07-16 18:27:35.937825 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:27:28.347875 | 2025-07-16 18:27:34.133824 | 9897556 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897556_f4a2b685-40cd-45ef-9f4b-ec4f22aba821.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9897556_f80eabe8-f67a-4160-bb8e-d679beafa050.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9629694 | N/A | 5248742 | 2025-07-16 18:27:34.133824 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:27:26.760584 | 2025-07-16 18:27:28.346253 | 9897555 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897555_2a493db8-3677-48be-bcd7-bb5c41c737e8.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | N/A | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | N/A | N/A | 5248742 | 2025-07-16 18:27:28.346253 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:27:07.340733 | 2025-07-16 18:27:09.106007 | 9897552 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1407668064, 'trace_number': None, 'provider_name': 'Jacklyn Kokuashvili', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897552_fc8adc07-dea0-4394-a41e-e4437343156b.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9897552_c5c6a67b-d54f-4f2c-a94d-aaf047c6342b.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT', '30', '98'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9629690 | N/A | 5248742 | 2025-07-16 18:27:09.106007 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:27:05.580797 | 2025-07-16 18:27:07.264551 | 9897551 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897551_8cb53ac8-f78e-410d-b826-a8a59c7131f5.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9897551_b873764e-2446-41c4-8993-59e2b8d8b084.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9629689 | N/A | 5248742 | 2025-07-16 18:27:07.264551 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:27:04.077565 | 2025-07-16 18:27:05.578148 | 9897550 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897550_69a8934b-dc90-4e6d-be8e-25f39575ba64.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | N/A | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | N/A | N/A | 5248742 | 2025-07-16 18:27:05.578148 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:26:55.071323 | 2025-07-16 18:26:56.889367 | 9897547 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1407668064, 'trace_number': None, 'provider_name': 'Jacklyn Kokuashvili', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897547_5b78b200-6a15-492a-9540-bf138d97f9bc.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9897547_76c95125-9f01-4f89-89d0-c1093140abba.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT', '30', '98'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9629683 | N/A | 5248742 | 2025-07-16 18:26:56.889367 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:26:53.275122 | 2025-07-16 18:26:54.965722 | 9897546 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897546_fbeef026-89ed-448f-991a-918ee06b2655.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9897546_a05c63a2-7520-406b-a2fe-b067a6117767.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9629682 | N/A | 5248742 | 2025-07-16 18:26:54.965722 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:26:51.720881 | 2025-07-16 18:26:53.271879 | 9897545 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897545_eafb9014-5720-47da-b73a-380505bdf506.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | N/A | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | N/A | N/A | 5248742 | 2025-07-16 18:26:53.271879 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:26:43.919137 | 2025-07-16 18:26:45.628346 | 9897543 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1407668064, 'trace_number': None, 'provider_name': 'Jacklyn Kokuashvili', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897543_ad261e94-4b89-4645-a9d8-b0e17000648b.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9897543_6d193373-7878-483c-8a45-2cb5c0f92d81.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT', '30', '98'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9629678 | N/A | 5248742 | 2025-07-16 18:26:45.628346 | 2025-07-16 18:02:25.797343 |
| 2025-07-16 18:26:42.121612 | 2025-07-16 18:26:43.839731 | 9897542 | N/A | N/A | {'payer_id': 'Z1073', 'payer_name': 'Medicare B California Southern', 'provider_npi': 1114042165, 'trace_number': None, 'provider_name': 'Athletic Physical Therapy Inc', 'subscriber_dob': '1955-12-11', 'date_of_service': '2025-07-16', 'subscriber_gender': 'F', 'service_type_codes': ['AE', 'PT'], 'insurance_company_id': 4497, 'subscriber_last_name': 'Tatge', 'subscriber_member_id': '2DH1CG9VR90', 'subscriber_first_name': 'Glenda'} | https://storage.googleapis.com/normandy-eligibility-checks/2222/6641936/check_9897542_9496a7a8-c489-4284-a117-7361ec14756b.edi.txt | WAYSTAR | N/A | INSIGHTS | 2025-07-16 | https://storage.googleapis.com/normandy-eligibility-checks-jsons/2222/6641936/check_9897542_00ce8a49-1aa6-4434-9a66-7253c96c5740.json | N/A | N/A | N/A | N/A | N/A | {'member_id': '2DH1CG9VR90', 'plan_type': None, 'group_name': None, 'payer_name': 'MEDICARE B CALIFORNIA SOUTHERN', 'payer_note': None, 'patient_dob': '1955-12-11', 'plan_number': None, 'group_number': None, 'insurance_type': None, 'plan_type_code': None, 'enrolled_in_qmb': False, 'patient_last_name': 'TATGE', 'plan_sponsor_name': None, 'patient_first_name': 'GLENDA', 'patient_middle_name': None, 'date_time_period_end': None, 'date_time_period_start': None, 'plan_coverage_description': None, 'relationship_to_subscriber': None} | ['AE', 'PT'] | N/A | N/A | N/A | N/A | N/A | N/A | N/A | N/A | 6641936 | 2222 | N/A | 9629677 | N/A | 5248742 | 2025-07-16 18:26:43.839731 | 2025-07-16 18:02:25.797343 |