Transaction ID 236316981 Customer ID {{vm.response.customerId}}
Certification Number

{{vm.response.certificationNumber}}

Patient Name

{{vm.response.patient.firstName}} {{vm.response.patient.lastName}}

Patient Date of Birth

{{vm.response.patient.birthDate}}

Member ID

{{vm.response.subscriber.memberId}}

Status

{{vm.response.status}}

Diagnosis Version

{{vm.response.diagnoses[0].qualifier}}

Request Type

{{vm.response.requestType}}

Payer

{{vm.response.payer.name}}