QueryResponse

{
  "title": "Example",
  "value": [
    {
      "claim_id": "e4eaaaf2-d142-11e1-b3e4-080027620cdd",
      "claim": {
        "date_of_service_start": "2023-12-10",
        "date_of_service_end": "2023-12-20",
        "plan_id": "1234AB56789",
        "billing_provider_npi": 1457450116,
        "principal_diagnosis": {
          "code": "A40.9",
          "present_on_admission": "Y"
        },
        "secondary_diagnosis": [
          {
            "code": "J18. 9",
            "present_on_admission": "Y"
          }
        ],
        "admitting_diagnosis": {
          "code": "J18. 9",
          "present_on_admission": "Y"
        },
        "procedures": [],
        "discharge_status": 1
      },
      "discharge_summary": {
        "text": "Patient Name: John Doe Patient ID: 123456 Date of Birth: 01/01/1980 Date of Admission: 12/10/2023 Date of Discharge: 12/20/2023 Attending Physician: Dr. Jane Smith\nAdmission Diagnosis:\nPneumonia\nSurgical Procedure: None  Hospital Course: Mr. John Doe, a 40-year-old male, was admitted to the hospital with symptoms of high fever, cough, shortness of breath, and chest pain. Based on clinical examination and chest X-ray findings, he was diagnosed with bacterial pneumonia..."
      },
      "validation": [
        {
          "diagnosis": {
            "code": "A40.9",
            "present_on_admission": "Y"
          },
          "determination": {
            "result": "Unsupported",
            "confidence": 0.88,
            "reasoning": "Diagnosis not supported as the SOFA score threshold was not met when account for baseline creatinine",
            "evidence": [
              {
                "criteria": "Renal Dysfunction",
                "source": {
                  "start_index": 1319,
                  "end_index": 1362,
                  "text": "CKD baseline 1.3 elevated to 2.1 creatinine"
                },
                "evaluation": "Rejects"
              }
            ]
          }
        }
      ]
    }
  ]
}