{
  "id": "<string>",
  "status": "SUCCESS",
  "creation_ts": "2020-01-01T00:00:00.000000Z",
  "summary": "Benefits retrieved successfully.",
  "results": {
    "call_details": [
      {
        "call_end_time": "2024-03-01T06:00:00.0000Z",
        "representative_name": "Deborah M",
        "reference_number": "2812129",
        "call_recording_url": "https://www.google.com/voice_recording.wav",
        "transcript": "..."
      }
    ],
    "plan_information": {
      "is_active": true,
      "plan_type": "PPO",
      "effective_date": "10-01-2020",
      "termination_date": "10-31-2021",
      "is_calendar_year_plan": true,
      "is_provider_in_network": true,
      "is_primary_insurance": true
    },
    "maximums": {
      "individual_deductible": "100",
      "individual_deductible_used": "80",
      "family_deductible": "200",
      "family_deductible_used": "100",
      "coverage_limit": "1000",
      "coverage_limit_remaining": "800",
      "orthodontics_coverage_limit": "1500"
    },
    "treatment_history": {
      "10-01-2020": [
        {
          "procedure_code": "D1110",
          "tooth_numbers": [
            "17"
          ],
          "surfaces": [
            "occlusal"
          ],
          "quadrant_numbers": [
            10
          ]
        },
        {
          "procedure_code": "D1120",
          "tooth_numbers": [
            "A"
          ],
          "surfaces": [
            "distal"
          ],
          "quadrant_numbers": [
            20
          ]
        }
      ]
    },
    "procedure_classes": {
      "DIAGNOSTIC": {
        "is_covered": true,
        "coverage_percentage": 100
      },
      "IMPLANTS": {
        "is_covered": false
      }
    },
    "procedure_codes": [
      [
        {
          "procedure_code": "D1110",
          "procedure_name": "Prophylaxis"
        },
        {
          "is_covered": true,
          "is_prior_auth_required": true,
          "prior_auth_info": "Call United Healthcare at 555-123-1234",
          "coverage_percentage": 100,
          "frequency_limitations": "1 every 6 floating months",
          "more_info": ""
        }
      ],
      [
        {
          "procedure_code": "D1206",
          "procedure_name": "Fluoride"
        },
        {
          "is_covered": true,
          "is_prior_auth_required": false,
          "age_limit": 16,
          "coverage_percentage": 100,
          "frequency_limitations": "1 every calendar year",
          "more_info": ""
        }
      ],
      [
        {
          "procedure_code": "D6058",
          "procedure_name": "Crowns"
        },
        {
          "is_covered": true,
          "is_prior_auth_required": false,
          "is_downgraded": true,
          "coverage_percentage": 50,
          "downgraded_info": "Downgraded to D6063 on molars.",
          "frequency_limitations": "1 every 5 years",
          "more_info": "Prior authorization is not required, however, predetermination is highly recommended."
        }
      ],
      [
        {
          "procedure_code": "D0364",
          "procedure_name": "CT Scan"
        },
        {
          "is_covered": false,
          "more_info": ""
        }
      ]
    ],
    "extra_info": {
      "waiting_periods": "None",
      "deductible_applies_to_preventive": false,
      "preventative_applies_to_maximum": true,
      "missing_tooth_clause": "coverage reduction of 50% for first 12 months",
      "has_pending_claims": true
    }
  },
  "request": {
    "type": "BENEFITS",
    "desired_completion_date": "03-19-2024",
    "patient_name": "Alex Martin",
    "dob": "01-31-2020",
    "member_id": "123456789",
    "group_id": "123456",
    "insurance_in_network": true,
    "npi": "1234567890",
    "tax_id": "123456789",
    "external_id": "<string>",
    "practice_billing_address": "123 Main St, New York, NY 10001",
    "diagnosis_codes": [
      "F41.1",
      "F42.23"
    ],
    "claims_date_of_service": "01-31-2020",
    "claim_number": "1234567890",
    "additional_info": "The patient is on a Medicare plan and we need to know their secondary insurance benefits.",
    "insurance": "CIGNA",
    "benefits_query": [
      "CODE_LOOKUP_BENEFITS"
    ],
    "benefits_codes": [
      "D1110",
      "D1120",
      "1130"
    ],
    "is_specialist": true,
    "insurance_payor_id": "60054"
  }
}