src/applications/combined-debt-portal/combined/utils/mocks/mockStatements.json
[
{
"id": "13251580-44a6-4cef-a48e-95f333b4f279",
"pSSeqNum": 653,
"pSTotSeqNum": 931,
"pSFacilityNum": "618",
"pSFacPhoneNum": "1-866-347-2352",
"pSTotStatement": 28,
"pSStatementVal": "0000073049F",
"pSStatementDate": "04052020",
"pSStatementDateOutput": "04/05/2020",
"pSProcessDate": "04012020",
"pSProcessDateOutput": "04/01/2020",
"pHPatientLstNme": "STARK",
"pHPatientFstNme": "TONY",
"pHPatientMidNme": "EDWARD",
"pHAddress1": "123 FAKE ST",
"pHAddress2": null,
"pHAddress3": null,
"pHCity": "ROBBINSDALE",
"pHState": "MN",
"pHZipCde": "554223714",
"pHZipCdeOutput": "55422-3714",
"pHCtryNme": null,
"pHAmtDue": 24,
"pHAmtDueOutput": "24.00 ",
"pHPrevBal": 24,
"pHPrevBalOutput": "24.00 ",
"pHTotCharges": 0,
"pHTotChargesOutput": ".00 ",
"pHTotCredits": 0,
"pHTotCreditsOutput": ".00 ",
"pHNewBalance": 24,
"pHNewBalanceOutput": "24.00 ",
"pHSpecialNotes": "To pay your statement online, go to www.pay.gov or call 1-888-827-4817.",
"pHroParaCdes": "90",
"pHNumOfLines": 2,
"pHDfnNumber": 295576,
"pHCernerStatementNumber": 0,
"pHCernerPatientId": null,
"pHCernerAccountNumber": null,
"pHIcnNumber": null,
"pHAccountNumber": 2000000000000000,
"pHLargeFontIndcator": 0,
"details": [
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "No Activity in the Last 30 Days!",
"pDTransDescOutput": " No Activity in the Last 30 Days!",
"pDTransAmt": 0,
"pDTransAmtOutput": ".00 ",
"pDRefNo": null
},
{
"pDDatePosted": null,
"pDDatePostedOutput": "",
"pDTransDesc": "Please refer to previous statement of rights.",
"pDTransDescOutput": " Please refer to previous statement of rights.",
"pDTransAmt": 0,
"pDTransAmtOutput": ".00 ",
"pDRefNo": null
}
],
"station": {
"facilitYNum": "618",
"visNNum": "23",
"facilitYDesc": "MINNEAPOLIS MEDICAL CENTER (618)",
"cyclENum": "004",
"remiTToFlag": "L",
"maiLInsertFlag": "0",
"staTAddress1": "1 VETERANS DR",
"staTAddress2": null,
"staTAddress3": null,
"city": "MINNEAPOLIS",
"state": "MN",
"ziPCde": "554172300",
"ziPCdeOutput": "55417-2300",
"baRCde": "*554172300012*",
"teLNumFlag": "S",
"teLNum": "1-866-347-2352",
"teLNum2": null,
"contacTInfo": null,
"dM2TelNum": null,
"contacTInfo2": null,
"toPTelNum": null,
"lbXFedexAddress1": null,
"lbXFedexAddress2": null,
"lbXFedexAddress3": null,
"lbXFedexCity": null,
"lbXFedexState": null,
"lbXFedexZipCde": null,
"lbXFedexBarCde": null,
"lbXFedexContact": null,
"lbXFedexContactTelNum": null
}
},
{
"id": "1963f471-5e78-4f58-88a4-d036daf0c224",
"pSSeqNum": 2253,
"pSTotSeqNum": 3142,
"pSFacilityNum": "618",
"pSFacPhoneNum": "1-888-827-4817",
"pSTotStatement": 11,
"pSStatementVal": "0000007852I",
"pSStatementDate": "12052021",
"pSStatementDateOutput": "12/05/2021",
"pSProcessDate": "12012021",
"pSProcessDateOutput": "12/01/2021",
"pHPatientLstNme": "STARK",
"pHPatientFstNme": "TONY",
"pHPatientMidNme": "EDWARD",
"pHAddress1": "123 FAKE ST",
"pHAddress2": null,
"pHAddress3": null,
"pHCity": "ROBBINSDALE",
"pHState": "MN",
"pHZipCde": "554223714",
"pHZipCdeOutput": "55422-3714",
"pHCtryNme": null,
"pHAmtDue": 26,
"pHAmtDueOutput": "26.00 ",
"pHPrevBal": 24,
"pHPrevBalOutput": "24.00 ",
"pHTotCharges": 69,
"pHTotChargesOutput": "69.00 ",
"pHTotCredits": -67,
"pHTotCreditsOutput": "67.00- ",
"pHNewBalance": 26,
"pHNewBalanceOutput": "26.00 ",
"pHSpecialNotes": "To pay your statement, go online to www.pay.gov or call 866-347-2352",
"pHroParaCdes": "254050556065708085",
"pHNumOfLines": 13,
"pHDfnNumber": 295576,
"pHCernerStatementNumber": 0,
"pHCernerPatientId": " ",
"pHCernerAccountNumber": " ",
"pHIcnNumber": " ",
"pHAccountNumber": 2000000000000000,
"pHLargeFontIndcator": 0,
"details": [
{
"pDDatePosted": "04292020",
"pDDatePostedOutput": "04/29/2020",
"pDTransDesc": "PAYMENT",
"pDTransDescOutput": "PAYMENT POSTED ON 04/29/2020",
"pDTransAmt": -24,
"pDTransAmtOutput": "24.00- ",
"pDRefNo": "618-K00K9ZK"
},
{
"pDDatePosted": "08312021",
"pDDatePostedOutput": "08/31/2021",
"pDTransDesc": "COPAY RX:14028906A FD:09/01/2021",
"pDTransDescOutput": "COPAY RX#14028906A FILL DATE: 09/01/2021",
"pDTransAmt": 8,
"pDTransAmtOutput": "8.00 ",
"pDRefNo": "618-K10ZAH2"
},
{
"pDDatePosted": "08312021",
"pDDatePostedOutput": "08/31/2021",
"pDTransDesc": "COPAY RX:11737464F FD:08/30/2021",
"pDTransDescOutput": "COPAY RX#11737464F FILL DATE: 08/30/2021",
"pDTransAmt": 15,
"pDTransAmtOutput": "15.00 ",
"pDRefNo": "618-K10ZARX"
},
{
"pDDatePosted": "08312021",
"pDDatePostedOutput": "08/31/2021",
"pDTransDesc": "COPAY RX:14494051 FD:08/30/2021",
"pDTransDescOutput": "COPAY RX#14494051 FILL DATE: 08/30/2021",
"pDTransAmt": 5,
"pDTransAmtOutput": "5.00 ",
"pDRefNo": "618-K10ZARY"
},
{
"pDDatePosted": "09012021",
"pDDatePostedOutput": "09/01/2021",
"pDTransDesc": "RX CO-PAYMENT/SC VET",
"pDTransDescOutput": "PAYMENT POSTED ON 09/01/2021",
"pDTransAmt": -8,
"pDTransAmtOutput": "8.00- ",
"pDRefNo": "618-K10ZAH2"
},
{
"pDDatePosted": "09012021",
"pDDatePostedOutput": "09/01/2021",
"pDTransDesc": "RX CO-PAYMENT/SC VET",
"pDTransDescOutput": "PAYMENT POSTED ON 09/01/2021",
"pDTransAmt": -15,
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "618-K10ZARX"
},
{
"pDDatePosted": "09012021",
"pDDatePostedOutput": "09/01/2021",
"pDTransDesc": "RX CO-PAYMENT/SC VET",
"pDTransDescOutput": "PAYMENT POSTED ON 09/01/2021",
"pDTransAmt": -5,
"pDTransAmtOutput": "5.00- ",
"pDRefNo": "618-K10ZARY"
},
{
"pDDatePosted": "09012021",
"pDDatePostedOutput": "09/01/2021",
"pDTransDesc": "COPAY RX:12066441E FD:08/30/2021",
"pDTransDescOutput": "COPAY RX#12066441E FILL DATE: 08/30/2021",
"pDTransAmt": 15,
"pDTransAmtOutput": "15.00 ",
"pDRefNo": "618-K10ZCW5"
},
{
"pDDatePosted": "09022021",
"pDDatePostedOutput": "09/02/2021",
"pDTransDesc": "RX CO-PAYMENT/SC VET",
"pDTransDescOutput": "PAYMENT POSTED ON 09/02/2021",
"pDTransAmt": -15,
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "618-K10ZCW5"
},
{
"pDDatePosted": "10142021",
"pDDatePostedOutput": "10/14/2021",
"pDTransDesc": "COPAY RX:14028906A FD:10/13/2021",
"pDTransDescOutput": "COPAY RX#14028906A FILL DATE: 10/13/2021",
"pDTransAmt": 8,
"pDTransAmtOutput": "8.00 ",
"pDRefNo": "618-K20E00I"
},
{
"pDDatePosted": "10142021",
"pDDatePostedOutput": "10/14/2021",
"pDTransDesc": "COPAY RX:14494051 FD:10/13/2021",
"pDTransDescOutput": "COPAY RX#14494051 FILL DATE: 10/13/2021",
"pDTransAmt": 5,
"pDTransAmtOutput": "5.00 ",
"pDRefNo": "618-K20E0IG"
},
{
"pDDatePosted": "12012021",
"pDDatePostedOutput": "12/01/2021",
"pDTransDesc": "COPAY RX:14494051 FD:11/28/2021",
"pDTransDescOutput": "COPAY RX#14494051 FILL DATE: 11/28/2021",
"pDTransAmt": 5,
"pDTransAmtOutput": "5.00 ",
"pDRefNo": "618-K20GVR7"
},
{
"pDDatePosted": "12012021",
"pDDatePostedOutput": "12/01/2021",
"pDTransDesc": "COPAY RX:14028906A FD:11/28/2021",
"pDTransDescOutput": "COPAY RX#14028906A FILL DATE: 11/28/2021",
"pDTransAmt": 8,
"pDTransAmtOutput": "8.00 ",
"pDRefNo": "618-K20GXC0"
}
],
"station": {
"facilitYNum": "618",
"visNNum": "23",
"facilitYDesc": "MINNEAPOLIS MEDICAL CENTER (618)",
"cyclENum": "004",
"remiTToFlag": "L",
"maiLInsertFlag": "0",
"staTAddress1": "1 VETERANS DR",
"staTAddress2": null,
"staTAddress3": null,
"city": "MINNEAPOLIS",
"state": "MN",
"ziPCde": "554172300",
"ziPCdeOutput": "55417-2300",
"baRCde": "*554172300012*",
"teLNumFlag": "S",
"teLNum": "1-866-347-2352",
"teLNum2": null,
"contacTInfo": null,
"dM2TelNum": null,
"contacTInfo2": null,
"toPTelNum": null,
"lbXFedexAddress1": null,
"lbXFedexAddress2": null,
"lbXFedexAddress3": null,
"lbXFedexCity": null,
"lbXFedexState": null,
"lbXFedexZipCde": null,
"lbXFedexBarCde": null,
"lbXFedexContact": null,
"lbXFedexContactTelNum": null
}
},
{
"id": "cf644a25-bfaf-4ef7-8e16-646cc0ee45e0",
"pSSeqNum": 2016,
"pSTotSeqNum": 2765,
"pSFacilityNum": "618",
"pSFacPhoneNum": "1-888-827-4817",
"pSTotStatement": 10,
"pSStatementVal": "0000007737B",
"pSStatementDate": "11052021",
"pSStatementDateOutput": "11/05/2021",
"pSProcessDate": "11012021",
"pSProcessDateOutput": "11/01/2021",
"pHPatientLstNme": "STARK",
"pHPatientFstNme": "TONY",
"pHPatientMidNme": "EDWARD",
"pHAddress1": "123 FAKE ST",
"pHAddress2": null,
"pHAddress3": null,
"pHCity": "ROBBINSDALE",
"pHState": "MN",
"pHZipCde": "554223714",
"pHZipCdeOutput": "55422-3714",
"pHCtryNme": null,
"pHAmtDue": 13,
"pHAmtDueOutput": "13.00 ",
"pHPrevBal": 24,
"pHPrevBalOutput": "24.00 ",
"pHTotCharges": 56,
"pHTotChargesOutput": "56.00 ",
"pHTotCredits": -67,
"pHTotCreditsOutput": "67.00- ",
"pHNewBalance": 13,
"pHNewBalanceOutput": "13.00 ",
"pHSpecialNotes": "To pay your statement, go online to www.pay.gov or call 866-347-2352",
"pHroParaCdes": "254050556065708085",
"pHNumOfLines": 11,
"pHDfnNumber": 295576,
"pHCernerStatementNumber": 0,
"pHCernerPatientId": " ",
"pHCernerAccountNumber": " ",
"pHIcnNumber": " ",
"pHAccountNumber": 2000000000000000,
"pHLargeFontIndcator": 0,
"details": [
{
"pDDatePosted": "04292020",
"pDDatePostedOutput": "04/29/2020",
"pDTransDesc": "PAYMENT",
"pDTransDescOutput": "PAYMENT POSTED ON 04/29/2020",
"pDTransAmt": -24,
"pDTransAmtOutput": "24.00- ",
"pDRefNo": "618-K00K9ZK"
},
{
"pDDatePosted": "08312021",
"pDDatePostedOutput": "08/31/2021",
"pDTransDesc": "COPAY RX:14028906A FD:09/01/2021",
"pDTransDescOutput": "COPAY RX#14028906A FILL DATE: 09/01/2021",
"pDTransAmt": 8,
"pDTransAmtOutput": "8.00 ",
"pDRefNo": "618-K10ZAH2"
},
{
"pDDatePosted": "08312021",
"pDDatePostedOutput": "08/31/2021",
"pDTransDesc": "COPAY RX:11737464F FD:08/30/2021",
"pDTransDescOutput": "COPAY RX#11737464F FILL DATE: 08/30/2021",
"pDTransAmt": 15,
"pDTransAmtOutput": "15.00 ",
"pDRefNo": "618-K10ZARX"
},
{
"pDDatePosted": "08312021",
"pDDatePostedOutput": "08/31/2021",
"pDTransDesc": "COPAY RX:14494051 FD:08/30/2021",
"pDTransDescOutput": "COPAY RX#14494051 FILL DATE: 08/30/2021",
"pDTransAmt": 5,
"pDTransAmtOutput": "5.00 ",
"pDRefNo": "618-K10ZARY"
},
{
"pDDatePosted": "09012021",
"pDDatePostedOutput": "09/01/2021",
"pDTransDesc": "RX CO-PAYMENT/SC VET",
"pDTransDescOutput": "PAYMENT POSTED ON 09/01/2021",
"pDTransAmt": -8,
"pDTransAmtOutput": "8.00- ",
"pDRefNo": "618-K10ZAH2"
},
{
"pDDatePosted": "09012021",
"pDDatePostedOutput": "09/01/2021",
"pDTransDesc": "RX CO-PAYMENT/SC VET",
"pDTransDescOutput": "PAYMENT POSTED ON 09/01/2021",
"pDTransAmt": -15,
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "618-K10ZARX"
},
{
"pDDatePosted": "09012021",
"pDDatePostedOutput": "09/01/2021",
"pDTransDesc": "RX CO-PAYMENT/SC VET",
"pDTransDescOutput": "PAYMENT POSTED ON 09/01/2021",
"pDTransAmt": -5,
"pDTransAmtOutput": "5.00- ",
"pDRefNo": "618-K10ZARY"
},
{
"pDDatePosted": "09012021",
"pDDatePostedOutput": "09/01/2021",
"pDTransDesc": "COPAY RX:12066441E FD:08/30/2021",
"pDTransDescOutput": "COPAY RX#12066441E FILL DATE: 08/30/2021",
"pDTransAmt": 15,
"pDTransAmtOutput": "15.00 ",
"pDRefNo": "618-K10ZCW5"
},
{
"pDDatePosted": "09022021",
"pDDatePostedOutput": "09/02/2021",
"pDTransDesc": "RX CO-PAYMENT/SC VET",
"pDTransDescOutput": "PAYMENT POSTED ON 09/02/2021",
"pDTransAmt": -15,
"pDTransAmtOutput": "15.00- ",
"pDRefNo": "618-K10ZCW5"
},
{
"pDDatePosted": "10142021",
"pDDatePostedOutput": "10/14/2021",
"pDTransDesc": "COPAY RX:14028906A FD:10/13/2021",
"pDTransDescOutput": "COPAY RX#14028906A FILL DATE: 10/13/2021",
"pDTransAmt": 8,
"pDTransAmtOutput": "8.00 ",
"pDRefNo": "618-K20E00I"
},
{
"pDDatePosted": "10142021",
"pDDatePostedOutput": "10/14/2021",
"pDTransDesc": "COPAY RX:14494051 FD:10/13/2021",
"pDTransDescOutput": "COPAY RX#14494051 FILL DATE: 10/13/2021",
"pDTransAmt": 5,
"pDTransAmtOutput": "5.00 ",
"pDRefNo": "618-K20E0IG"
}
],
"station": {
"facilitYNum": "618",
"visNNum": "23",
"facilitYDesc": "MINNEAPOLIS MEDICAL CENTER (618)",
"cyclENum": "004",
"remiTToFlag": "L",
"maiLInsertFlag": "0",
"staTAddress1": "1 VETERANS DR",
"staTAddress2": null,
"staTAddress3": null,
"city": "MINNEAPOLIS",
"state": "MN",
"ziPCde": "554172300",
"ziPCdeOutput": "55417-2300",
"baRCde": "*554172300012*",
"teLNumFlag": "S",
"teLNum": "1-866-347-2352",
"teLNum2": null,
"contacTInfo": null,
"dM2TelNum": null,
"contacTInfo2": null,
"toPTelNum": null,
"lbXFedexAddress1": null,
"lbXFedexAddress2": null,
"lbXFedexAddress3": null,
"lbXFedexCity": null,
"lbXFedexState": null,
"lbXFedexZipCde": null,
"lbXFedexBarCde": null,
"lbXFedexContact": null,
"lbXFedexContactTelNum": null
}
},
{
"id": "1f553f77-a90b-43e3-86b4-23e4c4e28b6b",
"pSSeqNum": 623,
"pSTotSeqNum": 885,
"pSFacilityNum": "618",
"pSFacPhoneNum": "1-866-347-2352",
"pSTotStatement": 28,
"pSStatementVal": "0000058558A",
"pSStatementDate": "03052020",
"pSStatementDateOutput": "03/05/2020",
"pSProcessDate": "03012020",
"pSProcessDateOutput": "03/01/2020",
"pHPatientLstNme": "STARK",
"pHPatientFstNme": "TONY",
"pHPatientMidNme": "EDWARD",
"pHAddress1": "123 FAKE ST",
"pHAddress2": null,
"pHAddress3": null,
"pHCity": "ROBBINSDALE",
"pHState": "MN",
"pHZipCde": "554223714",
"pHZipCdeOutput": "55422-3714",
"pHCtryNme": null,
"pHAmtDue": 24,
"pHAmtDueOutput": "24.00 ",
"pHPrevBal": -18.96,
"pHPrevBalOutput": "18.96- ",
"pHTotCharges": 24,
"pHTotChargesOutput": "24.00 ",
"pHTotCredits": 0,
"pHTotCreditsOutput": ".00 ",
"pHNewBalance": 24,
"pHNewBalanceOutput": "24.00 ",
"pHSpecialNotes": "To pay your statement online, go to www.pay.gov or call 1-888-827-4817.",
"pHroParaCdes": "254050556065708085",
"pHNumOfLines": 2,
"pHDfnNumber": 295576,
"pHCernerStatementNumber": 0,
"pHCernerPatientId": null,
"pHCernerAccountNumber": null,
"pHIcnNumber": null,
"pHAccountNumber": 2000000000000000,
"pHLargeFontIndcator": 0,
"details": [
{
"pDDatePosted": "04092019",
"pDDatePostedOutput": "04/09/2019",
"pDTransDesc": "OVERPAYMENT REFUND",
"pDTransDescOutput": "PAYMENT POSTED ON 04/09/2019",
"pDTransAmt": -18.96,
"pDTransAmtOutput": "18.96- ",
"pDRefNo": "618-K90IQJW"
},
{
"pDDatePosted": "02252020",
"pDDatePostedOutput": "02/25/2020",
"pDTransDesc": "COPAY RX:13800236 FD:02/21/2020",
"pDTransDescOutput": "COPAY RX#13800236 FILL DATE: 02/21/2020",
"pDTransAmt": 24,
"pDTransAmtOutput": "24.00 ",
"pDRefNo": "618-K00K9ZK"
}
],
"station": {
"facilitYNum": "618",
"visNNum": "23",
"facilitYDesc": "MINNEAPOLIS MEDICAL CENTER (618)",
"cyclENum": "004",
"remiTToFlag": "L",
"maiLInsertFlag": "0",
"staTAddress1": "1 VETERANS DR",
"staTAddress2": null,
"staTAddress3": null,
"city": "MINNEAPOLIS",
"state": "MN",
"ziPCde": "554172300",
"ziPCdeOutput": "55417-2300",
"baRCde": "*554172300012*",
"teLNumFlag": "S",
"teLNum": "1-866-347-2352",
"teLNum2": null,
"contacTInfo": null,
"dM2TelNum": null,
"contacTInfo2": null,
"toPTelNum": null,
"lbXFedexAddress1": null,
"lbXFedexAddress2": null,
"lbXFedexAddress3": null,
"lbXFedexCity": null,
"lbXFedexState": null,
"lbXFedexZipCde": null,
"lbXFedexBarCde": null,
"lbXFedexContact": null,
"lbXFedexContactTelNum": null
}
},
{
"id": "3z553c77-a90b-1a9o-53e2-25a4c4e28b6b",
"pHAmtDue": 0,
"pSStatementDate": "12052021",
"pSStatementDateOutput": "12/05/2021",
"pHAccountNumber": 3000000000000000,
"station": {
"facilitYNum": "508",
"city": "DECATUR"
}
}
]