[
	{
		"placeOfService": "Inpatient",
		"type": "adultImmunizations",
		"plan": "PL123",
		"groupSize": "L",
		"inNetwork": "Y",
		"isCovered": "Y",
		"dateOfService": "2019-03-25",
		"coveredInFull": null,
		"copay": null,
		"coInsurance": null
	},
	{
		"placeOfService": "Office",
		"type": "allergyTesting",
		"plan": "PL123",
		"groupSize": "L",
		"inNetwork": "N",
		"isCovered": "Y",
		"dateOfService": "2018-03-25",
		"coveredInFull": null,
		"copay": null,
		"coInsurance": null
	},
	{
		"placeOfService": "Inpatient",
		"type": "nonRoutineGynExam",
		"plan": "PL555",
		"groupSize": "L",
		"inNetwork": "Y",
		"isCovered": "Y",
		"dateOfService": "2014-03-25",
		"coveredInFull": null,
		"copay": null,
		"coInsurance": null
	},
	{
		"placeOfService": "Office",
		"type": "prostateCaScreening",
		"plan": "PL622",
		"groupSize": "L",
		"inNetwork": "Y",
		"isCovered": "Y",
		"dateOfService": "2019-03-25",
		"coveredInFull": null,
		"copay": null,
		"coInsurance": null
	},
	{
		"placeOfService": "Inpatient",
		"type": "preferredLab",
		"plan": "PL898",
		"groupSize": "L",
		"inNetwork": "Y",
		"isCovered": "Y",
		"dateOfService": "2019-03-25",
		"coveredInFull": null,
		"copay": null,
		"coInsurance": null
	},
	{
		"placeOfService": "Inpatient",
		"type": "transgenderSurgery",
		"plan": "PL012",
		"groupSize": null,
		"inNetwork": "N",
		"isCovered": "N",
		"dateOfService": "2019-03-25",
		"coveredInFull": null,
		"copay": null,
		"coInsurance": null
	},
	{
		"placeOfService": "Office",
		"type": "organDonation",
		"plan": "PL012",
		"groupSize": null,
		"inNetwork": "N",
		"isCovered": "Y",
		"dateOfService": "2019-03-25",
		"coveredInFull": null,
		"copay": null,
		"coInsurance": null
	},
	{
		"placeOfService": "Office",
		"type": "catScans",
		"plan": "PL711",
		"groupSize": null,
		"inNetwork": "Y",
		"isCovered": "Y",
		"dateOfService": "2019-03-25",
		"coveredInFull": null,
		"copay": null,
		"coInsurance": null
	},
	{
		"placeOfService": "Office",
		"type": "diabeticTesting",
		"plan": "PL898",
		"groupSize": "L",
		"inNetwork": "N",
		"isCovered": "Y",
		"dateOfService": "2019-03-25",
		"coveredInFull": null,
		"copay": null,
		"coInsurance": null
	},
	{
		"placeOfService": "Outpatient",
		"type": "clinicServices",
		"plan": "PL788",
		"groupSize": "L",
		"inNetwork": "Y",
		"isCovered": "Y",
		"dateOfService": "2019-03-25",
		"coveredInFull": null,
		"copay": null,
		"coInsurance": null
	}
]