| Name | Description | Type | Additional information |
|---|---|---|---|
| GBGMemberName | string |
None. |
|
| MobileNumber | string |
None. |
|
| PolicyId | string |
None. |
|
| DOS | string |
None. |
|
| ClaimNumber | string |
None. |
|
| TypeOfService | string |
None. |
|
| AppealCorrespondence | string |
None. |
|
| RequestorName | string |
None. |
|
| RelatioShipWithPatients | string |
None. |
|
| AuthorizationRequired | string |
None. |
|
| AppealList | Collection of string |
None. |
|
| ReasonForReview | string |
None. |
|
| ContractedProvider | string |
None. |
|
| Title | string |
None. |
|
| FirstName | string |
None. |
|
| LastName | string |
None. |
|
| MiddleName | string |
None. |
|
| string |
None. |
||
| Alias | string |
None. |
|
| DOB | string |
None. |
|
| GBGID | string |
None. |
|
| EmployerName | string |
None. |
|
| Address | string |
None. |
|
| City | string |
None. |
|
| Country | string |
None. |
|
| Phonenumber | string |
None. |
|
| Gender | string |
None. |
|
| State | string |
None. |
|
| AlternatePhone | string |
None. |
|
| ZipCode | string |
None. |