POST api/CopyClaim

Request Information

URI Parameters

None.

Body Parameters

ClaimsModel
NameDescriptionTypeAdditional information
RefNo

globally unique identifier

None.

Id

integer

None.

pHospitalTransmittalNo

string

None.

pUserName

string

None.

pHospitalCode

string

None.

pPIN

string

None.

pClaimNumber

string

None.

EligibilityTrackingNo

string

None.

CaseNo

string

None.

pClaimSeriesLhio

string

None.

pStatus

string

None.

pProcessStage

string

None.

pProcessDate

string

None.

pDeniedReason

string

None.

pStatusXml

string

None.

pVoucherDetailsXml

string

None.

pMemberLastName

string

None.

pMemberFirstName

string

None.

pMemberMiddleName

string

None.

pMemberSuffix

string

None.

pMemberSex

string

None.

pMemberBirthDate

date

None.

pMailingAddress

string

None.

pZipCode

string

None.

pLandlineNo

string

None.

pMobileNo

string

None.

pEmailAddress

string

None.

pPatientIs

string

None.

pAdmissionDate

date

None.

pDischargeDate

date

None.

pPatientLastName

string

None.

pPatientFirstName

string

None.

pPatientMiddleName

string

None.

pPatientSuffix

string

None.

pPatientPIN

string

None.

pPatientBirthDate

date

None.

pPatientSex

string

None.

pMemberShipType

string

None.

pPEN

string

None.

pEmployerName

string

None.

pForm3

string

None.

pRVS

string

None.

pTotalAmountActual

string

None.

pTotalAmountClaimed

string

None.

pIsFinal

string

None.

isok

string

None.

with3over6

string

None.

with9over12

string

None.

remainingdays

string

None.

asof

string

None.

reason

string

None.

docneeded

string

None.

SubmitResultEnc

string

None.

SubmitResult

string

None.

SubmitResultError

string

None.

pReceiptTicketNumber

string

None.

pTransmissionDateTime

date

None.

CreatedBy

string

None.

DateCreated

date

None.

UpdatedBy

string

None.

DateUpdated

date

None.

Deleted

boolean

None.

DeletedBy

string

None.

DateDeleted

date

None.

LastDateTransmitted

date

None.

pVoucherNo

string

None.

pVoucherDate

string

None.

pCheckNo

string

None.

pCheckDate

string

None.

pCheckAmount

string

None.

pClaimAmount

string

None.

pClaimPayeeName

string

None.

pDeficiency

string

None.

pRequirement

string

None.

SubmittedBy

string

None.

DateSubmitted

date

None.

SendToHims

boolean

None.

SendToHimsErrorDesc

string

None.

SentToHims

boolean

None.

SentToHimsDate

date

None.

pCivilStatus

string

None.

RefiledBy

string

None.

DateRefiled

string

None.

Captured

boolean

None.

MEMBER_CATEGORY_ID

string

None.

MEMBER_CATEGORY_DESC

string

None.

LastDateCheckStatus

date

None.

PatientType

string

None.

pPatientName

string

None.

pAdmissionDateStr

string

None.

pDischargeDateStr

string

None.

isMember

boolean

None.

pChiefComplaint

string

None.

isForOPDHemodialysisClaim

string

None.

v2

boolean

None.

referenceno

string

None.

FKtblClaimsRefNo

globally unique identifier

None.

pPatientReferred

string

None.

pReferredIHCPAccreCode

string

None.

pIsEmergency

string

None.

pPatientType

string

None.

pDisposition

string

None.

pExpiredDateTime

string

None.

pReferralIHCPAccreCode

string

None.

pReferralReasons

string

None.

pAccommodationType

string

None.

pAdmissionDiagnosis

string

None.

pHemodialysis

string

None.

pPeritoneal

string

None.

pLinac

string

None.

pCobalt

string

None.

pTransfusion

string

None.

pBrachytheraphy

string

None.

pChemotherapy

string

None.

pDebridement

string

None.

pImrt

string

None.

pCheckUpDate1

string

None.

pCheckUpDate2

string

None.

pCheckUpDate3

string

None.

pCheckUpDate4

string

None.

pTBType

string

None.

pNTPCardNo

string

None.

pDay0ARV

string

None.

pDay3ARV

string

None.

pDay7ARV

string

None.

pRIG

string

None.

pABPOthers

string

None.

pABPSpecify

string

None.

pNewBorn

string

None.

pEssentialNewbornCare

string

None.

pNewbornHearingScreeningTest

string

None.

pNewbornScreeningTest

string

None.

pFilterCardNo

string

None.

pDrying

string

None.

pSkinToSkin

string

None.

pCordClamping

string

None.

pProphylaxis

string

None.

pWeighing

string

None.

pVitaminK

string

None.

pBCG

string

None.

pNonSeparation

string

None.

pHepatitisB

string

None.

pLaboratoryNumber

string

None.

pCataractPreAuth

string

None.

pLeftEyeIOLStickerNumber

string

None.

pLeftEyeIOLExpiryDate

string

None.

pRightEyeIOLStickerNumber

string

None.

pRightEyeIOLExpiryDate

string

None.

pCaseRate1Type

string

None.

pItemCode1

string

None.

pCaseRateCode1

string

None.

pCaseRateAmount1

string

None.

pCaseRate2Type

string

None.

pItemCode2

string

None.

pCaseRateCode2

string

None.

pCaseRateAmount2

string

None.

pEnoughBenefits

string

None.

pTotalHCIFees

string

None.

pTotalProfFees

string

None.

pGrandTotal

string

None.

pTotalActualCharges

string

None.

pDiscount

string

None.

pPhilhealthBenefit

string

None.

pTotalAmount

string

None.

pMemberPatient

string

None.

pHMO

string

None.

pOthers

string

None.

pTotalActualChargesPf

string

None.

pDiscountPf

string

None.

pPhilhealthBenefitPf

string

None.

pTotalAmountPf

string

None.

pMemberPatientPf

string

None.

pHMOPf

string

None.

pOthersPf

string

None.

pDrugsMedicinesSupplies

string

None.

pDMSTotalAmount

string

None.

pExaminations

string

None.

pExamTotalAmount

string

None.

pHasAttachedSOA

string

None.

pDateSigned

string

None.

pAprConsentToAccess

string

None.

pThumbmarkedBy

string

None.

pRelCode

string

None.

pRelDesc

string

None.

pReasonCode

string

None.

pReasonDesc

string

None.

AddedBy

string

None.

DateAdded

date

None.

FktblClaimsRefNo

globally unique identifier

None.

pIllnessHistory

string

None.

pSpecificDesc

string

None.

pLastMensPeriod

string

None.

pPregCnt

string

None.

pDeliveryCnt

string

None.

pOtherComplaint

string

None.

pGenSurveyId

string

None.

pGenSurveyRem

string

None.

pPainSite

string

None.

pSystolic

string

None.

pDiastolic

string

None.

pHr

string

None.

pRr

string

None.

pTemp

string

None.

Symptoms

string

None.

Heent

string

None.

Chest

string

None.

Cvs

string

None.

Abdomen

string

None.

GuIe

string

None.

Skin

string

None.

Neuro

string

None.

pHeentRem

string

None.

pChestRem

string

None.

pHeartRem

string

None.

pAbdomenRem

string

None.

pGuRem

string

None.

pSkinRem

string

None.

pNeuroRem

string

None.

pFullTermCnt

string

None.

pPrematureCnt

string

None.

pAbortionCnt

string

None.

pLivChildrenCnt

string

None.

pHeight

string

None.

pWeight

string

None.

AgeYears

string

None.

AgeMonths

string

None.

AgeDays

string

None.

Age

string

None.

PatientName

string

None.

CaseRate1Amount

decimal number

None.

CaseRate2Amount

decimal number

None.

CaseRate1PfAmount

decimal number

None.

CaseRate2PfAmount

decimal number

None.

OtherFundSourcePfAmount

decimal number

None.

OtherFundSourcePfDescription

string

None.

pPatientReferredStreet

string

None.

pPatientReferredCity

string

None.

pPatientReferredProvince

string

None.

pPatientReferredZipCode

string

None.

HospitalBenefit

decimal number

None.

PfBenefit

decimal number

None.

Doctors

string

None.

Diagnosis

string

None.

WithCF4

string

None.

CR1Amount

decimal number

None.

CR2Amount

decimal number

None.

Request Formats

application/json, text/json

Sample:
{
  "RefNo": "855400c8-56b5-45c4-9208-14c205221bf7",
  "Id": 2,
  "pHospitalTransmittalNo": "sample string 3",
  "pUserName": "sample string 4",
  "pHospitalCode": "sample string 5",
  "pPIN": "sample string 6",
  "pClaimNumber": "sample string 7",
  "EligibilityTrackingNo": "sample string 8",
  "CaseNo": "sample string 9",
  "pClaimSeriesLhio": "sample string 10",
  "pStatus": "sample string 11",
  "pProcessStage": "sample string 12",
  "pProcessDate": "sample string 13",
  "pDeniedReason": "sample string 14",
  "pStatusXml": "sample string 15",
  "pVoucherDetailsXml": "sample string 16",
  "pMemberLastName": "sample string 17",
  "pMemberFirstName": "sample string 18",
  "pMemberMiddleName": "sample string 19",
  "pMemberSuffix": "sample string 20",
  "pMemberSex": "sample string 21",
  "pMemberBirthDate": "2025-12-06T11:23:41.8219038+08:00",
  "pMailingAddress": "sample string 22",
  "pZipCode": "sample string 23",
  "pLandlineNo": "sample string 24",
  "pMobileNo": "sample string 25",
  "pEmailAddress": "sample string 26",
  "pPatientIs": "sample string 27",
  "pAdmissionDate": "2025-12-06T11:23:41.8219038+08:00",
  "pDischargeDate": "2025-12-06T11:23:41.8219038+08:00",
  "pPatientLastName": "sample string 28",
  "pPatientFirstName": "sample string 29",
  "pPatientMiddleName": "sample string 30",
  "pPatientSuffix": "sample string 31",
  "pPatientPIN": "sample string 32",
  "pPatientBirthDate": "2025-12-06T11:23:41.8219038+08:00",
  "pPatientSex": "sample string 33",
  "pMemberShipType": "sample string 34",
  "pPEN": "sample string 35",
  "pEmployerName": "sample string 36",
  "pForm3": "sample string 37",
  "pRVS": "sample string 38",
  "pTotalAmountActual": "sample string 39",
  "pTotalAmountClaimed": "sample string 40",
  "pIsFinal": "sample string 41",
  "isok": "sample string 42",
  "with3over6": "sample string 43",
  "with9over12": "sample string 44",
  "remainingdays": "sample string 45",
  "asof": "sample string 46",
  "reason": "sample string 47",
  "docneeded": "sample string 48",
  "SubmitResultEnc": "sample string 49",
  "SubmitResult": "sample string 50",
  "SubmitResultError": "sample string 51",
  "pReceiptTicketNumber": "sample string 52",
  "pTransmissionDateTime": "2025-12-06T11:23:41.8219038+08:00",
  "CreatedBy": "sample string 53",
  "DateCreated": "2025-12-06T11:23:41.8219038+08:00",
  "UpdatedBy": "sample string 55",
  "DateUpdated": "2025-12-06T11:23:41.8219038+08:00",
  "Deleted": true,
  "DeletedBy": "sample string 57",
  "DateDeleted": "2025-12-06T11:23:41.8219038+08:00",
  "LastDateTransmitted": "2025-12-06T11:23:41.8219038+08:00",
  "pVoucherNo": "sample string 58",
  "pVoucherDate": "sample string 59",
  "pCheckNo": "sample string 60",
  "pCheckDate": "sample string 61",
  "pCheckAmount": "sample string 62",
  "pClaimAmount": "sample string 63",
  "pClaimPayeeName": "sample string 64",
  "pDeficiency": "sample string 65",
  "pRequirement": "sample string 66",
  "SubmittedBy": "sample string 67",
  "DateSubmitted": "2025-12-06T11:23:41.8219038+08:00",
  "SendToHims": true,
  "SendToHimsErrorDesc": "sample string 68",
  "SentToHims": true,
  "SentToHimsDate": "2025-12-06T11:23:41.8219038+08:00",
  "pCivilStatus": "sample string 69",
  "RefiledBy": "sample string 70",
  "DateRefiled": "sample string 71",
  "Captured": true,
  "MEMBER_CATEGORY_ID": "sample string 73",
  "MEMBER_CATEGORY_DESC": "sample string 74",
  "LastDateCheckStatus": "2025-12-06T11:23:41.8219038+08:00",
  "PatientType": "sample string 75",
  "pPatientName": "sample string 76",
  "pAdmissionDateStr": "sample string 77",
  "pDischargeDateStr": "sample string 78",
  "isMember": true,
  "pChiefComplaint": "sample string 80",
  "isForOPDHemodialysisClaim": "sample string 81",
  "v2": true,
  "referenceno": "sample string 83",
  "FKtblClaimsRefNo": "74fcb475-4790-4e8d-bd4e-c50fced7d526",
  "pPatientReferred": "sample string 84",
  "pReferredIHCPAccreCode": "sample string 85",
  "pIsEmergency": "sample string 86",
  "pPatientType": "sample string 87",
  "pDisposition": "sample string 88",
  "pExpiredDateTime": "sample string 89",
  "pReferralIHCPAccreCode": "sample string 90",
  "pReferralReasons": "sample string 91",
  "pAccommodationType": "sample string 92",
  "pAdmissionDiagnosis": "sample string 93",
  "pHemodialysis": "sample string 94",
  "pPeritoneal": "sample string 95",
  "pLinac": "sample string 96",
  "pCobalt": "sample string 97",
  "pTransfusion": "sample string 98",
  "pBrachytheraphy": "sample string 99",
  "pChemotherapy": "sample string 100",
  "pDebridement": "sample string 101",
  "pImrt": "sample string 102",
  "pCheckUpDate1": "sample string 103",
  "pCheckUpDate2": "sample string 104",
  "pCheckUpDate3": "sample string 105",
  "pCheckUpDate4": "sample string 106",
  "pTBType": "sample string 107",
  "pNTPCardNo": "sample string 108",
  "pDay0ARV": "sample string 109",
  "pDay3ARV": "sample string 110",
  "pDay7ARV": "sample string 111",
  "pRIG": "sample string 112",
  "pABPOthers": "sample string 113",
  "pABPSpecify": "sample string 114",
  "pNewBorn": "sample string 115",
  "pEssentialNewbornCare": "sample string 116",
  "pNewbornHearingScreeningTest": "sample string 117",
  "pNewbornScreeningTest": "sample string 118",
  "pFilterCardNo": "sample string 119",
  "pDrying": "sample string 120",
  "pSkinToSkin": "sample string 121",
  "pCordClamping": "sample string 122",
  "pProphylaxis": "sample string 123",
  "pWeighing": "sample string 124",
  "pVitaminK": "sample string 125",
  "pBCG": "sample string 126",
  "pNonSeparation": "sample string 127",
  "pHepatitisB": "sample string 128",
  "pLaboratoryNumber": "sample string 129",
  "pCataractPreAuth": "sample string 130",
  "pLeftEyeIOLStickerNumber": "sample string 131",
  "pLeftEyeIOLExpiryDate": "sample string 132",
  "pRightEyeIOLStickerNumber": "sample string 133",
  "pRightEyeIOLExpiryDate": "sample string 134",
  "pCaseRate1Type": "sample string 135",
  "pItemCode1": "sample string 136",
  "pCaseRateCode1": "sample string 137",
  "pCaseRateAmount1": "sample string 138",
  "pCaseRate2Type": "sample string 139",
  "pItemCode2": "sample string 140",
  "pCaseRateCode2": "sample string 141",
  "pCaseRateAmount2": "sample string 142",
  "pEnoughBenefits": "sample string 143",
  "pTotalHCIFees": "sample string 144",
  "pTotalProfFees": "sample string 145",
  "pGrandTotal": "sample string 146",
  "pTotalActualCharges": "sample string 147",
  "pDiscount": "sample string 148",
  "pPhilhealthBenefit": "sample string 149",
  "pTotalAmount": "sample string 150",
  "pMemberPatient": "sample string 151",
  "pHMO": "sample string 152",
  "pOthers": "sample string 153",
  "pTotalActualChargesPf": "sample string 154",
  "pDiscountPf": "sample string 155",
  "pPhilhealthBenefitPf": "sample string 156",
  "pTotalAmountPf": "sample string 157",
  "pMemberPatientPf": "sample string 158",
  "pHMOPf": "sample string 159",
  "pOthersPf": "sample string 160",
  "pDrugsMedicinesSupplies": "sample string 161",
  "pDMSTotalAmount": "sample string 162",
  "pExaminations": "sample string 163",
  "pExamTotalAmount": "sample string 164",
  "pHasAttachedSOA": "sample string 165",
  "pDateSigned": "sample string 166",
  "pAprConsentToAccess": "sample string 167",
  "pThumbmarkedBy": "sample string 168",
  "pRelCode": "sample string 169",
  "pRelDesc": "sample string 170",
  "pReasonCode": "sample string 171",
  "pReasonDesc": "sample string 172",
  "AddedBy": "sample string 173",
  "DateAdded": "2025-12-06T11:23:41.8219038+08:00",
  "FktblClaimsRefNo": "fd0246a4-220a-4d01-bffe-41989d192255",
  "pIllnessHistory": "sample string 174",
  "pSpecificDesc": "sample string 175",
  "pLastMensPeriod": "sample string 176",
  "pPregCnt": "sample string 177",
  "pDeliveryCnt": "sample string 178",
  "pOtherComplaint": "sample string 179",
  "pGenSurveyId": "sample string 180",
  "pGenSurveyRem": "sample string 181",
  "pPainSite": "sample string 182",
  "pSystolic": "sample string 183",
  "pDiastolic": "sample string 184",
  "pHr": "sample string 185",
  "pRr": "sample string 186",
  "pTemp": "sample string 187",
  "Symptoms": "sample string 188",
  "Heent": "sample string 189",
  "Chest": "sample string 190",
  "Cvs": "sample string 191",
  "Abdomen": "sample string 192",
  "GuIe": "sample string 193",
  "Skin": "sample string 194",
  "Neuro": "sample string 195",
  "pHeentRem": "sample string 196",
  "pChestRem": "sample string 197",
  "pHeartRem": "sample string 198",
  "pAbdomenRem": "sample string 199",
  "pGuRem": "sample string 200",
  "pSkinRem": "sample string 201",
  "pNeuroRem": "sample string 202",
  "pFullTermCnt": "sample string 203",
  "pPrematureCnt": "sample string 204",
  "pAbortionCnt": "sample string 205",
  "pLivChildrenCnt": "sample string 206",
  "pHeight": "sample string 207",
  "pWeight": "sample string 208",
  "AgeYears": "sample string 209",
  "AgeMonths": "sample string 210",
  "AgeDays": "sample string 211",
  "Age": "sample string 212",
  "PatientName": "sample string 213",
  "CaseRate1Amount": 214.0,
  "CaseRate2Amount": 215.0,
  "CaseRate1PfAmount": 216.0,
  "CaseRate2PfAmount": 217.0,
  "OtherFundSourcePfAmount": 1.0,
  "OtherFundSourcePfDescription": "sample string 218",
  "pPatientReferredStreet": "sample string 219",
  "pPatientReferredCity": "sample string 220",
  "pPatientReferredProvince": "sample string 221",
  "pPatientReferredZipCode": "sample string 222",
  "HospitalBenefit": 223.0,
  "PfBenefit": 224.0,
  "Doctors": "sample string 225",
  "Diagnosis": "sample string 226",
  "WithCF4": "sample string 227",
  "CR1Amount": 228.0,
  "CR2Amount": 229.0
}

application/xml, text/xml

Sample:
<ClaimsModel xmlns:i="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://schemas.datacontract.org/2004/07/ClaimsAssureApi.Models">
  <Abdomen>sample string 192</Abdomen>
  <AddedBy>sample string 173</AddedBy>
  <Age>sample string 212</Age>
  <AgeDays>sample string 211</AgeDays>
  <AgeMonths>sample string 210</AgeMonths>
  <AgeYears>sample string 209</AgeYears>
  <CR1Amount>228</CR1Amount>
  <CR2Amount>229</CR2Amount>
  <Captured>true</Captured>
  <CaseNo>sample string 9</CaseNo>
  <CaseRate1Amount>214</CaseRate1Amount>
  <CaseRate1PfAmount>216</CaseRate1PfAmount>
  <CaseRate2Amount>215</CaseRate2Amount>
  <CaseRate2PfAmount>217</CaseRate2PfAmount>
  <Chest>sample string 190</Chest>
  <CreatedBy>sample string 53</CreatedBy>
  <Cvs>sample string 191</Cvs>
  <DateAdded>2025-12-06T11:23:41.8219038+08:00</DateAdded>
  <DateCreated>2025-12-06T11:23:41.8219038+08:00</DateCreated>
  <DateDeleted>2025-12-06T11:23:41.8219038+08:00</DateDeleted>
  <DateRefiled>sample string 71</DateRefiled>
  <DateSubmitted>2025-12-06T11:23:41.8219038+08:00</DateSubmitted>
  <DateUpdated>2025-12-06T11:23:41.8219038+08:00</DateUpdated>
  <Deleted>true</Deleted>
  <DeletedBy>sample string 57</DeletedBy>
  <Diagnosis>sample string 226</Diagnosis>
  <Doctors>sample string 225</Doctors>
  <EligibilityTrackingNo>sample string 8</EligibilityTrackingNo>
  <FKtblClaimsRefNo>74fcb475-4790-4e8d-bd4e-c50fced7d526</FKtblClaimsRefNo>
  <FktblClaimsRefNo>fd0246a4-220a-4d01-bffe-41989d192255</FktblClaimsRefNo>
  <GuIe>sample string 193</GuIe>
  <Heent>sample string 189</Heent>
  <HospitalBenefit>223</HospitalBenefit>
  <Id>2</Id>
  <LastDateCheckStatus>2025-12-06T11:23:41.8219038+08:00</LastDateCheckStatus>
  <LastDateTransmitted>2025-12-06T11:23:41.8219038+08:00</LastDateTransmitted>
  <MEMBER_CATEGORY_DESC>sample string 74</MEMBER_CATEGORY_DESC>
  <MEMBER_CATEGORY_ID>sample string 73</MEMBER_CATEGORY_ID>
  <Neuro>sample string 195</Neuro>
  <OtherFundSourcePfAmount>1</OtherFundSourcePfAmount>
  <OtherFundSourcePfDescription>sample string 218</OtherFundSourcePfDescription>
  <PatientName>sample string 213</PatientName>
  <PatientType>sample string 75</PatientType>
  <PfBenefit>224</PfBenefit>
  <RefNo>855400c8-56b5-45c4-9208-14c205221bf7</RefNo>
  <RefiledBy>sample string 70</RefiledBy>
  <SendToHims>true</SendToHims>
  <SendToHimsErrorDesc>sample string 68</SendToHimsErrorDesc>
  <SentToHims>true</SentToHims>
  <SentToHimsDate>2025-12-06T11:23:41.8219038+08:00</SentToHimsDate>
  <Skin>sample string 194</Skin>
  <SubmitResult>sample string 50</SubmitResult>
  <SubmitResultEnc>sample string 49</SubmitResultEnc>
  <SubmitResultError>sample string 51</SubmitResultError>
  <SubmittedBy>sample string 67</SubmittedBy>
  <Symptoms>sample string 188</Symptoms>
  <UpdatedBy>sample string 55</UpdatedBy>
  <WithCF4>sample string 227</WithCF4>
  <asof>sample string 46</asof>
  <docneeded>sample string 48</docneeded>
  <isForOPDHemodialysisClaim>sample string 81</isForOPDHemodialysisClaim>
  <isMember>true</isMember>
  <isok>sample string 42</isok>
  <pABPOthers>sample string 113</pABPOthers>
  <pABPSpecify>sample string 114</pABPSpecify>
  <pAbdomenRem>sample string 199</pAbdomenRem>
  <pAbortionCnt>sample string 205</pAbortionCnt>
  <pAccommodationType>sample string 92</pAccommodationType>
  <pAdmissionDate>2025-12-06T11:23:41.8219038+08:00</pAdmissionDate>
  <pAdmissionDateStr>sample string 77</pAdmissionDateStr>
  <pAdmissionDiagnosis>sample string 93</pAdmissionDiagnosis>
  <pAprConsentToAccess>sample string 167</pAprConsentToAccess>
  <pBCG>sample string 126</pBCG>
  <pBrachytheraphy>sample string 99</pBrachytheraphy>
  <pCaseRate1Type>sample string 135</pCaseRate1Type>
  <pCaseRate2Type>sample string 139</pCaseRate2Type>
  <pCaseRateAmount1>sample string 138</pCaseRateAmount1>
  <pCaseRateAmount2>sample string 142</pCaseRateAmount2>
  <pCaseRateCode1>sample string 137</pCaseRateCode1>
  <pCaseRateCode2>sample string 141</pCaseRateCode2>
  <pCataractPreAuth>sample string 130</pCataractPreAuth>
  <pCheckAmount>sample string 62</pCheckAmount>
  <pCheckDate>sample string 61</pCheckDate>
  <pCheckNo>sample string 60</pCheckNo>
  <pCheckUpDate1>sample string 103</pCheckUpDate1>
  <pCheckUpDate2>sample string 104</pCheckUpDate2>
  <pCheckUpDate3>sample string 105</pCheckUpDate3>
  <pCheckUpDate4>sample string 106</pCheckUpDate4>
  <pChemotherapy>sample string 100</pChemotherapy>
  <pChestRem>sample string 197</pChestRem>
  <pChiefComplaint>sample string 80</pChiefComplaint>
  <pCivilStatus>sample string 69</pCivilStatus>
  <pClaimAmount>sample string 63</pClaimAmount>
  <pClaimNumber>sample string 7</pClaimNumber>
  <pClaimPayeeName>sample string 64</pClaimPayeeName>
  <pClaimSeriesLhio>sample string 10</pClaimSeriesLhio>
  <pCobalt>sample string 97</pCobalt>
  <pCordClamping>sample string 122</pCordClamping>
  <pDMSTotalAmount>sample string 162</pDMSTotalAmount>
  <pDateSigned>sample string 166</pDateSigned>
  <pDay0ARV>sample string 109</pDay0ARV>
  <pDay3ARV>sample string 110</pDay3ARV>
  <pDay7ARV>sample string 111</pDay7ARV>
  <pDebridement>sample string 101</pDebridement>
  <pDeficiency>sample string 65</pDeficiency>
  <pDeliveryCnt>sample string 178</pDeliveryCnt>
  <pDeniedReason>sample string 14</pDeniedReason>
  <pDiastolic>sample string 184</pDiastolic>
  <pDischargeDate>2025-12-06T11:23:41.8219038+08:00</pDischargeDate>
  <pDischargeDateStr>sample string 78</pDischargeDateStr>
  <pDiscount>sample string 148</pDiscount>
  <pDiscountPf>sample string 155</pDiscountPf>
  <pDisposition>sample string 88</pDisposition>
  <pDrugsMedicinesSupplies>sample string 161</pDrugsMedicinesSupplies>
  <pDrying>sample string 120</pDrying>
  <pEmailAddress>sample string 26</pEmailAddress>
  <pEmployerName>sample string 36</pEmployerName>
  <pEnoughBenefits>sample string 143</pEnoughBenefits>
  <pEssentialNewbornCare>sample string 116</pEssentialNewbornCare>
  <pExamTotalAmount>sample string 164</pExamTotalAmount>
  <pExaminations>sample string 163</pExaminations>
  <pExpiredDateTime>sample string 89</pExpiredDateTime>
  <pFilterCardNo>sample string 119</pFilterCardNo>
  <pForm3>sample string 37</pForm3>
  <pFullTermCnt>sample string 203</pFullTermCnt>
  <pGenSurveyId>sample string 180</pGenSurveyId>
  <pGenSurveyRem>sample string 181</pGenSurveyRem>
  <pGrandTotal>sample string 146</pGrandTotal>
  <pGuRem>sample string 200</pGuRem>
  <pHMO>sample string 152</pHMO>
  <pHMOPf>sample string 159</pHMOPf>
  <pHasAttachedSOA>sample string 165</pHasAttachedSOA>
  <pHeartRem>sample string 198</pHeartRem>
  <pHeentRem>sample string 196</pHeentRem>
  <pHeight>sample string 207</pHeight>
  <pHemodialysis>sample string 94</pHemodialysis>
  <pHepatitisB>sample string 128</pHepatitisB>
  <pHospitalCode>sample string 5</pHospitalCode>
  <pHospitalTransmittalNo>sample string 3</pHospitalTransmittalNo>
  <pHr>sample string 185</pHr>
  <pIllnessHistory>sample string 174</pIllnessHistory>
  <pImrt>sample string 102</pImrt>
  <pIsEmergency>sample string 86</pIsEmergency>
  <pIsFinal>sample string 41</pIsFinal>
  <pItemCode1>sample string 136</pItemCode1>
  <pItemCode2>sample string 140</pItemCode2>
  <pLaboratoryNumber>sample string 129</pLaboratoryNumber>
  <pLandlineNo>sample string 24</pLandlineNo>
  <pLastMensPeriod>sample string 176</pLastMensPeriod>
  <pLeftEyeIOLExpiryDate>sample string 132</pLeftEyeIOLExpiryDate>
  <pLeftEyeIOLStickerNumber>sample string 131</pLeftEyeIOLStickerNumber>
  <pLinac>sample string 96</pLinac>
  <pLivChildrenCnt>sample string 206</pLivChildrenCnt>
  <pMailingAddress>sample string 22</pMailingAddress>
  <pMemberBirthDate>2025-12-06T11:23:41.8219038+08:00</pMemberBirthDate>
  <pMemberFirstName>sample string 18</pMemberFirstName>
  <pMemberLastName>sample string 17</pMemberLastName>
  <pMemberMiddleName>sample string 19</pMemberMiddleName>
  <pMemberPatient>sample string 151</pMemberPatient>
  <pMemberPatientPf>sample string 158</pMemberPatientPf>
  <pMemberSex>sample string 21</pMemberSex>
  <pMemberShipType>sample string 34</pMemberShipType>
  <pMemberSuffix>sample string 20</pMemberSuffix>
  <pMobileNo>sample string 25</pMobileNo>
  <pNTPCardNo>sample string 108</pNTPCardNo>
  <pNeuroRem>sample string 202</pNeuroRem>
  <pNewBorn>sample string 115</pNewBorn>
  <pNewbornHearingScreeningTest>sample string 117</pNewbornHearingScreeningTest>
  <pNewbornScreeningTest>sample string 118</pNewbornScreeningTest>
  <pNonSeparation>sample string 127</pNonSeparation>
  <pOtherComplaint>sample string 179</pOtherComplaint>
  <pOthers>sample string 153</pOthers>
  <pOthersPf>sample string 160</pOthersPf>
  <pPEN>sample string 35</pPEN>
  <pPIN>sample string 6</pPIN>
  <pPainSite>sample string 182</pPainSite>
  <pPatientBirthDate>2025-12-06T11:23:41.8219038+08:00</pPatientBirthDate>
  <pPatientFirstName>sample string 29</pPatientFirstName>
  <pPatientIs>sample string 27</pPatientIs>
  <pPatientLastName>sample string 28</pPatientLastName>
  <pPatientMiddleName>sample string 30</pPatientMiddleName>
  <pPatientName>sample string 76</pPatientName>
  <pPatientPIN>sample string 32</pPatientPIN>
  <pPatientReferred>sample string 84</pPatientReferred>
  <pPatientReferredCity>sample string 220</pPatientReferredCity>
  <pPatientReferredProvince>sample string 221</pPatientReferredProvince>
  <pPatientReferredStreet>sample string 219</pPatientReferredStreet>
  <pPatientReferredZipCode>sample string 222</pPatientReferredZipCode>
  <pPatientSex>sample string 33</pPatientSex>
  <pPatientSuffix>sample string 31</pPatientSuffix>
  <pPatientType>sample string 87</pPatientType>
  <pPeritoneal>sample string 95</pPeritoneal>
  <pPhilhealthBenefit>sample string 149</pPhilhealthBenefit>
  <pPhilhealthBenefitPf>sample string 156</pPhilhealthBenefitPf>
  <pPregCnt>sample string 177</pPregCnt>
  <pPrematureCnt>sample string 204</pPrematureCnt>
  <pProcessDate>sample string 13</pProcessDate>
  <pProcessStage>sample string 12</pProcessStage>
  <pProphylaxis>sample string 123</pProphylaxis>
  <pRIG>sample string 112</pRIG>
  <pRVS>sample string 38</pRVS>
  <pReasonCode>sample string 171</pReasonCode>
  <pReasonDesc>sample string 172</pReasonDesc>
  <pReceiptTicketNumber>sample string 52</pReceiptTicketNumber>
  <pReferralIHCPAccreCode>sample string 90</pReferralIHCPAccreCode>
  <pReferralReasons>sample string 91</pReferralReasons>
  <pReferredIHCPAccreCode>sample string 85</pReferredIHCPAccreCode>
  <pRelCode>sample string 169</pRelCode>
  <pRelDesc>sample string 170</pRelDesc>
  <pRequirement>sample string 66</pRequirement>
  <pRightEyeIOLExpiryDate>sample string 134</pRightEyeIOLExpiryDate>
  <pRightEyeIOLStickerNumber>sample string 133</pRightEyeIOLStickerNumber>
  <pRr>sample string 186</pRr>
  <pSkinRem>sample string 201</pSkinRem>
  <pSkinToSkin>sample string 121</pSkinToSkin>
  <pSpecificDesc>sample string 175</pSpecificDesc>
  <pStatus>sample string 11</pStatus>
  <pStatusXml>sample string 15</pStatusXml>
  <pSystolic>sample string 183</pSystolic>
  <pTBType>sample string 107</pTBType>
  <pTemp>sample string 187</pTemp>
  <pThumbmarkedBy>sample string 168</pThumbmarkedBy>
  <pTotalActualCharges>sample string 147</pTotalActualCharges>
  <pTotalActualChargesPf>sample string 154</pTotalActualChargesPf>
  <pTotalAmount>sample string 150</pTotalAmount>
  <pTotalAmountActual>sample string 39</pTotalAmountActual>
  <pTotalAmountClaimed>sample string 40</pTotalAmountClaimed>
  <pTotalAmountPf>sample string 157</pTotalAmountPf>
  <pTotalHCIFees>sample string 144</pTotalHCIFees>
  <pTotalProfFees>sample string 145</pTotalProfFees>
  <pTransfusion>sample string 98</pTransfusion>
  <pTransmissionDateTime>2025-12-06T11:23:41.8219038+08:00</pTransmissionDateTime>
  <pUserName>sample string 4</pUserName>
  <pVitaminK>sample string 125</pVitaminK>
  <pVoucherDate>sample string 59</pVoucherDate>
  <pVoucherDetailsXml>sample string 16</pVoucherDetailsXml>
  <pVoucherNo>sample string 58</pVoucherNo>
  <pWeighing>sample string 124</pWeighing>
  <pWeight>sample string 208</pWeight>
  <pZipCode>sample string 23</pZipCode>
  <reason>sample string 47</reason>
  <referenceno>sample string 83</referenceno>
  <remainingdays>sample string 45</remainingdays>
  <v2>true</v2>
  <with3over6>sample string 43</with3over6>
  <with9over12>sample string 44</with9over12>
</ClaimsModel>

application/x-www-form-urlencoded

Sample:

Sample not available.

Response Information

Resource Description

IHttpActionResult

None.

Response Formats

application/json, text/json, application/xml, text/xml

Sample:

Sample not available.