Determination Response Body

{
  "determination": {
    "x12": "ISA*00*          *00*          *ZZ*INQAIMSPECHLTH *ZZ*943207296      *160610*1004*^*00501*638746083*0*P*:~GS*HI*INQAIMSPECHLTH*943207296*20160610*100457*638746083*X*005010X215~ST*278*638746083*005010X215~BHT*0007*49*1201713193*20160610*100457*18~HL*1**20*1~NM1*PR*2*Health First Health Plan*****PI*HEALTHFIRSTFL~HL*2*1*21*1~NM1*1P*2*Medical Group*****XX*1164474276~REF*EI*461243081~HL*3*2*22*1~NM1*IL*1*MYERS*EDWIN****MI*81060103800~REF*SY*285427924~DMG*D8*19450109~HL*4*3*EV*1~UM*HS*I*AG*12:B~HCR*NA~DTP*AAH*D8*20160615~HI*BK:I49.3~NM1*SJ*2*MEDICAL CENTER*HOLMES REGIONAL****XX*1295702728~HL*5*4*SS*0~HCR*NA~DTP*472*D8*20160615~SV1*HC:93016~MSG*AUTHORIZATION IS NOT REQUIRED FOR THIS PROCEDURE~HL*6*4*SS*0~HCR*NA~DTP*472*D8*20160615~SV1*HC:93306~MSG*AUTHORIZATION IS NOT REQUIRED FOR THIS PROCEDURE~SE*28*638746083~GE*1*638746083~IEA*1*638746083~",
    "json": {
      "submitterTransactionIdentifier": "1201713193",
      "payerId": "HEALTHFIRSTFL",
      "payerName": "Health First Health Plan",
      "umClearingHouseId": "943207296",
      "umRequestValidation": null,
      "requester": {
        "requesterType": "1P",
        "organizationName": "Medical Group",
        "requesterIdentification": {
          "employerIdentificationNumber": "461243081"
        },
        "npi": "1164474276"
      },
      "subscriber": {
        "lastName": "MYERS",
        "firstName": "EDWIN",
        "memberId": "81060103800",
        "dateOfBirth": "19450109",
        "supplementalIdentification": {
          "ssn": "285427924"
        }
      },
      "dependent": {
        "supplementalIdentification": {}
      },
      "patientEventDetail": {
        "requestCategoryCode": "HS",
        "certificationTypeCode": "I",
        "serviceTypeCode": "AG",
        "facilityTypeCode": "12",
        "facilityCodeQualifier": "B",
        "certificationActionCode": "NA",
        "eventDateBegin": "20160615",
        "diagnosisTypeCode": "BK",
        "diagnosisCode": "I49.3",
        "patientEventProviderName": [
          {
            "entityIdentifierCode": "SJ",
            "organizationName": "MEDICAL CENTER",
            "identificationCodeQualifier": "XX",
            "identifier": "1295702728",
            "providerSupplementalInformation": {}
          }
        ],
        "serviceLevel": [
          {
            "certificationActionCode": "NA",
            "serviceDateBegin": "20160615",
            "professionalService": {
              "productOrServiceIDQualifier": "HC",
              "procedureCode": "93016"
            },
            "institutionalService": {},
            "dentalService": {},
            "freeFormMessageText": "AUTHORIZATION IS NOT REQUIRED FOR THIS PROCEDURE"
          },
          {
            "certificationActionCode": "NA",
            "serviceDateBegin": "20160615",
            "professionalService": {
              "productOrServiceIDQualifier": "HC",
              "procedureCode": "93306"
            },
            "institutionalService": {},
            "dentalService": {},
            "freeFormMessageText": "AUTHORIZATION IS NOT REQUIRED FOR THIS PROCEDURE"
          }
        ]
      }
    }
  },
  "determinationExceptions": [
    {
      "procedureCode": "93016"
    },
    {
      "procedureCode": "93306"
    }
  ]
}

{
  "senderId": "201985AAS",
  "submitterTransactionIdentifier": "1234567890",
  "payerId": "BCBSSC",
  "payerName": "South Carolina Blue Cross Blue",
  "rhPayerId": "UHCDEMODV1",
  "planId": "41",
  "umClearingHouseId": "000000000000001",
  "requester": {
    "requesterType": "1P",
    "organizationName": "Regional Medical Center",
    "lastName": "Regional Medical Center",
    "requesterIdentification": {
      "employerIdentificationNumber": "123456789"
    },
    "city": "Orangeburg",
    "state": "SC",
    "postalCode": "12345",
    "npi": "1234567890",
    "contactTelephone": "803-395-2200"
  },
  "subscriber": {
    "lastName": "TEST",
    "firstName": "BRITTANY",
    "memberId": "ZCS12345678",
    "dateOfBirth": "19701231",
    "supplementalIdentification": {
      "groupNumber": "123456789",
      "ssn": "111223333"
    }
  },
  "patientEventDetail": {
    "requestCategoryCode": "HS",
    "certificationTypeCode": "I",
    "serviceTypeCode": "1",
    "facilityTypeCode": "11",
    "facilityCodeQualifier": "B",
    "eventDateBegin": "20231017",
    "eventDateEnd": "20231017",
    "patientEventProviderName": [
      {
        "entityIdentifierCode": "SJ",
        "lastName": "TEST",
        "firstName": "STEVEN",
        "identificationCodeQualifier": "XX",
        "identifier": "1234567890"
      },
      {
        "entityIdentifierCode": "DN",
        "lastName": "TEST",
        "firstName": "STEVEN",
        "identificationCodeQualifier": "XX",
        "identifier": "1234567890"
      }
    ],
    "serviceLevel": [
      {
        "requestCategoryCode": "HS",
        "facilityTypeCode": "11",
        "facilityCodeQualifier": "B",
        "serviceDateBegin": "20231017",
        "serviceDateEnd": "20231017",
        "professionalService": {
          "productOrServiceIDQualifier": "HC",
          "procedureCode": "71260"
        }
      },
      {
        "requestCategoryCode": "HS",
        "facilityTypeCode": "11",
        "facilityCodeQualifier": "B",
        "serviceDateBegin": "20231017",
        "serviceDateEnd": "20231017",
        "professionalService": {
          "productOrServiceIDQualifier": "HC",
          "procedureCode": "74177"
        }
      }
    ]
  }
}