{
  "payerId": "BCBS001",
  "requestType": "INITIAL",
  "provider": {
    "npi": "1234567890",
    "taxId": "123456789"
  },
  "subscriber": {
    "memberId": "MEM123456",
    "firstName": "Jane",
    "lastName": "Smith"
  },
  "serviceInformation": {
    "procedureCodes": [
      "ABC123"
    ],
    "diagnosisCodes": [
      "ABC123"
    ],
    "serviceFromDate": "2025-04-15",
    "serviceToDate": "2025-04-15"
  }
}