Inquiry Request Body

{
  "senderId": "201985AAS",
  "submitterTransactionIdentifier": "1234567890",
  "payerId": "BCBSSC",
  "payerName": "South Carolina Blue Cross Blue",
  "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": "8033952200"
  },
  "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"
        }
      }
    ]
  }
}

{
    "x12": "ISA*00*          *00*          *ZZ*943207296      *ZZ*INQDEMO        *230810*1021*^*00501*916040697*0*P*:~GS*HI*943207296*INQDEMO*20230810*102137*3294199*X*005010X215~ST*278*0001*005010X215~BHT*0007*28*1402448037*20230810*102137~HL*1**20*1~NM1*PR*2*INQDEMO*****PI*INQDEMO~HL*2*1*21*1~NM1*1P*2*Demo Hospital*****XX*1234567890~REF*EI*123456789~N4*Nashville*TN*12345~PER*IC**TE*1112223333*FX*2223334444~HL*3*2*22*1~NM1*IL*1*DOE*JOE****MI*TST1~REF*6P*00000000~DMG*D8*19010101~HL*4*3*EV*0~UM*HS*I*1*11:B~DTP*AAH*D8*20230802~HI*ABK:C34.32~NM1*SJ*2*Demo Hospital*****XX*1234567890~NM1*DN*2*Demo Hospital*****XX*1234567890~REF*ZH*123456789~SE*21*0001~GE*1*3294199~IEA*1*916040697~"
}