{
  "payerId": "BCBS001",
  "provider": {
    "npi": "1234567890",
    "taxId": "123456789"
  },
  "subscriber": {
    "memberId": "MEM123456",
    "firstName": "Jane",
    "lastName": "Smith",
    "dateOfBirth": "1980-01-15"
  },
  "claimNumber": "CLM-2025-001234",
  "fromDate": "2025-01-01",
  "toDate": "2025-12-31"
}