# hr_schedule

schedule_id: f7a7fc59de2e47cc86a2900bec2a6a48
name: Omar Khadija Al-Mansour - Day Shift
description: Day Shift schedule for Radiologist
schedule_type: REGULAR
effective_date: 2025-07-12
end_date: 2026-02-22
notes: Standard day shift for clinical staff
created_at: 2025-08-19 20:09:20.953743
updated_at: 2025-08-19 20:09:20.953747
schedule_pattern:
  {"sunday": {"start": "07:00", "end": "19:00"}, "monday": {"start": "07:00", "end": "19:00"}, "tuesday": {"start": "07:00", "end": "19:00"}, "wednesday": {"start": "07:00", "end": "19:00"}, "thursday": {"start": "07:00", "end": "19:00"}, "friday": {"start": "07:00", "end": "19:00"}, "saturday": {"start": "07:00", "end": "19:00"}}


schedule_id: 162c2e1f1e19486db056ca0209853e63
name: Omar Khadija Al-Mansour - Night Shift
description: Night Shift schedule for Radiologist
schedule_type: REGULAR
effective_date: 2025-05-02
end_date: 2025-12-10
notes: Standard night shift for clinical staff
created_at: 2025-08-19 20:09:20.954145
updated_at: 2025-08-19 20:09:20.954148
schedule_pattern:
  {"sunday": {"start": "19:00", "end": "07:00"}, "monday": {"start": "19:00", "end": "07:00"}, "tuesday": {"start": "19:00", "end": "07:00"}, "wednesday": {"start": "19:00", "end": "07:00"}, "thursday": {"start": "19:00", "end": "07:00"}, "friday": {"start": "19:00", "end": "07:00"}, "saturday": {"start": "19:00", "end": "07:00"}}


schedule_id: 4269d7c4827240a3bf822b93add06e33
name: Fatima Al-Khalil - Administrative Hours
description: Standard administrative working hours
schedule_type: REGULAR
effective_date: 2025-05-15
notes: Standard administrative schedule
created_at: 2025-08-19 20:09:20.986399
updated_at: 2025-08-19 20:09:20.986402
schedule_pattern:
  {"sunday": {"start": "08:00", "end": "17:00"}, "monday": {"start": "08:00", "end": "17:00"}, "tuesday": {"start": "08:00", "end": "17:00"}, "wednesday": {"start": "08:00", "end": "17:00"}, "thursday": {"start": "08:00", "end": "16:00"}, "friday": "off", "saturday": "off"}


# inpatients_ward

name: Intensive Care Unit
description: Specialized obstetrics ward providing comprehensive inpatient care
ward_type: EMERGENCY
specialty: OBSTETRICS
building: Emergency Services Building
floor: 5
wing: West Wing
admission_criteria: Patients requiring obstetrics specialized care
age_restrictions: "Adults only (18+)"
gender_restrictions: Mixed gender
closure_reason: Maintenance
phone_number: +966-11-713-9862
extension: 7908
created_at: 2025-08-19 21:15:06.344192
updated_at: 2025-08-19 21:15:06.344202
ward_id: c8dd06b1-2bbc-468b-a624-9a9c30d09456
equipment_list:
  ["Cardiac Monitors", "IV Pumps", "Ventilators", "Defibrillators", "Oxygen Supply", "Suction Units", "Patient Beds", "Wheelchairs"]

special_features:
  ["Prayer Room", "Family Waiting Area", "Isolation Rooms", "Nurse Station", "Clean Utility Room", "Dirty Utility Room"]


# inventory_supplier

supplier_id: b1ad41cbba2a46cab9a5ee1ec657ab5e
supplier_code: SUP-001
name: Saudi Medical Supply Co.
supplier_type: DISTRIBUTOR
contact_person: Manager - Saudi Medical Supply Co.
phone: +966-11-234-5678
email: contact@saudimedicalsupplyco.sa
website: https://www.saudimedicalsupplyco.sa
address_line_1: 733 King Abdullah Road
city: Riyadh
state: Riyadh Province
postal_code: 21633
country: Saudi Arabia
tax_id: TAX-875792291
payment_terms: COD
notes: Saudi medical supplier - Saudi Medical Supply Co.
created_at: 2025-08-19 20:21:35.339108
updated_at: 2025-08-19 20:21:35.339251
certifications:
  [{"name": "ISO 13485", "number": "ISO-37964", "expiry": "2025-12-31"}, {"name": "Saudi FDA", "number": "SFDA-49229", "expiry": "2025-06-30"}]


supplier_id: 46fb977e45a04ea59c4ff27fd7d64937
supplier_code: SUP-002
name: Gulf Medical Equipment
supplier_type: MANUFACTURER
contact_person: Manager - Gulf Medical Equipment
phone: +966-13-345-6789
email: contact@gulfmedicalequipment.sa
website: https://www.gulfmedicalequipment.sa
address_line_1: 778 King Abdullah Road
city: Dammam
state: Dammam Province
postal_code: 81802
country: Saudi Arabia
tax_id: TAX-937723323
payment_terms: NET_30
notes: Saudi medical supplier - Gulf Medical Equipment
created_at: 2025-08-19 20:21:35.340496
updated_at: 2025-08-19 20:21:35.340501
certifications:
  [{"name": "ISO 13485", "number": "ISO-91683", "expiry": "2025-12-31"}, {"name": "Saudi FDA", "number": "SFDA-61997", "expiry": "2025-06-30"}]


supplier_id: 6dcb1e242384426d8eca99afccee2afb
supplier_code: SUP-003
name: Arabian Healthcare Supplies
supplier_type: WHOLESALER
contact_person: Manager - Arabian Healthcare Supplies
phone: +966-12-456-7890
email: contact@arabianhealthcaresupplies.sa
website: https://www.arabianhealthcaresupplies.sa
address_line_1: 211 King Fahd Road
city: Jeddah
state: Jeddah Province
postal_code: 74741
country: Saudi Arabia
tax_id: TAX-723279838
payment_terms: NET_30
notes: Saudi medical supplier - Arabian Healthcare Supplies
created_at: 2025-08-19 20:21:35.341259
updated_at: 2025-08-19 20:21:35.341264
certifications:
  [{"name": "ISO 13485", "number": "ISO-59295", "expiry": "2025-12-31"}, {"name": "Saudi FDA", "number": "SFDA-38353", "expiry": "2025-06-30"}]


supplier_id: d6a52ac8d9144635900d3cc01141f91d
supplier_code: SUP-004
name: Riyadh Medical Trading
supplier_type: DISTRIBUTOR
contact_person: Manager - Riyadh Medical Trading
phone: +966-11-567-8901
email: contact@riyadhmedicaltrading.sa
website: https://www.riyadhmedicaltrading.sa
address_line_1: 75 King Saud Road
city: Riyadh
state: Riyadh Province
postal_code: 68190
country: Saudi Arabia
tax_id: TAX-688900420
payment_terms: NET_30
notes: Saudi medical supplier - Riyadh Medical Trading
created_at: 2025-08-19 20:21:35.341910
updated_at: 2025-08-19 20:21:35.341914
certifications:
  [{"name": "ISO 13485", "number": "ISO-47111", "expiry": "2025-12-31"}, {"name": "Saudi FDA", "number": "SFDA-50153", "expiry": "2025-06-30"}]


supplier_id: 50e173ae5c3a41f098c8474f2794a489
supplier_code: SUP-005
name: Al-Dawaa Medical
supplier_type: MANUFACTURER
contact_person: Manager - Al-Dawaa Medical
phone: +966-14-678-9012
email: contact@al-dawaamedical.sa
website: https://www.al-dawaamedical.sa
address_line_1: 119 King Saud Road
city: Medina
state: Medina Province
postal_code: 10760
country: Saudi Arabia
tax_id: TAX-125081400
payment_terms: COD
notes: Saudi medical supplier - Al-Dawaa Medical
created_at: 2025-08-19 20:21:35.342552
updated_at: 2025-08-19 20:21:35.342555
certifications:
  [{"name": "ISO 13485", "number": "ISO-42038", "expiry": "2025-12-31"}, {"name": "Saudi FDA", "number": "SFDA-77227", "expiry": "2025-06-30"}]


supplier_id: 178066568f4843c28499303e40927802
supplier_code: SUP-006
name: Nahdi Medical Company
supplier_type: RETAILER
contact_person: Manager - Nahdi Medical Company
phone: +966-12-789-0123
email: contact@nahdimedicalcompany.sa
website: https://www.nahdimedicalcompany.sa
address_line_1: 868 King Fahd Road
city: Jeddah
state: Jeddah Province
postal_code: 13498
country: Saudi Arabia
tax_id: TAX-511336391
payment_terms: COD
notes: Saudi medical supplier - Nahdi Medical Company
created_at: 2025-08-19 20:21:35.343168
updated_at: 2025-08-19 20:21:35.343172
certifications:
  [{"name": "ISO 13485", "number": "ISO-48728", "expiry": "2025-12-31"}, {"name": "Saudi FDA", "number": "SFDA-20796", "expiry": "2025-06-30"}]


supplier_id: 745ca848a5f5487ea7740d8a6a0d62fb
supplier_code: SUP-007
name: United Pharmaceuticals
supplier_type: MANUFACTURER
contact_person: Manager - United Pharmaceuticals
phone: +966-13-890-1234
email: contact@unitedpharmaceuticals.sa
website: https://www.unitedpharmaceuticals.sa
address_line_1: 899 King Saud Road
city: Khobar
state: Khobar Province
postal_code: 21787
country: Saudi Arabia
tax_id: TAX-363540628
payment_terms: NET_60
notes: Saudi medical supplier - United Pharmaceuticals
created_at: 2025-08-19 20:21:35.343759
updated_at: 2025-08-19 20:21:35.343762
certifications:
  [{"name": "ISO 13485", "number": "ISO-32027", "expiry": "2025-12-31"}, {"name": "Saudi FDA", "number": "SFDA-72727", "expiry": "2025-06-30"}]


supplier_id: d21bab4b86ea419289d5187858e8172a
supplier_code: SUP-008
name: Middle East Medical
supplier_type: DISTRIBUTOR
contact_person: Manager - Middle East Medical
phone: +966-12-901-2345
email: contact@middleeastmedical.sa
website: https://www.middleeastmedical.sa
address_line_1: 330 King Fahd Road
city: Taif
state: Taif Province
postal_code: 51366
country: Saudi Arabia
tax_id: TAX-274734335
payment_terms: NET_30
notes: Saudi medical supplier - Middle East Medical
created_at: 2025-08-19 20:21:35.344317
updated_at: 2025-08-19 20:21:35.344321
certifications:
  [{"name": "ISO 13485", "number": "ISO-59252", "expiry": "2025-12-31"}, {"name": "Saudi FDA", "number": "SFDA-33633", "expiry": "2025-06-30"}]


supplier_id: 54b80a8ce4474398b0442adaf0722102
supplier_code: SUP-009
name: Kingdom Medical Supplies
supplier_type: WHOLESALER
contact_person: Manager - Kingdom Medical Supplies
phone: +966-16-012-3456
email: contact@kingdommedicalsupplies.sa
website: https://www.kingdommedicalsupplies.sa
address_line_1: 57 King Abdullah Road
city: Buraidah
state: Buraidah Province
postal_code: 78494
country: Saudi Arabia
tax_id: TAX-172829126
payment_terms: NET_30
notes: Saudi medical supplier - Kingdom Medical Supplies
created_at: 2025-08-19 20:21:35.345094
updated_at: 2025-08-19 20:21:35.345100
certifications:
  [{"name": "ISO 13485", "number": "ISO-33777", "expiry": "2025-12-31"}, {"name": "Saudi FDA", "number": "SFDA-69566", "expiry": "2025-06-30"}]


supplier_id: c8bb073c680e4db184416bd14a550fc4
supplier_code: SUP-010
name: Eastern Province Medical Co.
supplier_type: DISTRIBUTOR
contact_person: Manager - Eastern Province Medical Co.
phone: +966-13-123-4567
email: contact@easternprovincemedicalco.sa
website: https://www.easternprovincemedicalco.sa
address_line_1: 943 King Saud Road
city: Dhahran
state: Dhahran Province
postal_code: 24347
country: Saudi Arabia
tax_id: TAX-463287395
payment_terms: NET_30
notes: Saudi medical supplier - Eastern Province Medical Co.
created_at: 2025-08-19 20:21:35.345731
updated_at: 2025-08-19 20:21:35.345735
certifications:
  [{"name": "ISO 13485", "number": "ISO-38048", "expiry": "2025-12-31"}, {"name": "Saudi FDA", "number": "SFDA-18239", "expiry": "2025-06-30"}]


# operating_theatre_operating_room

room_id: 50fe0bd9a68b44ad87e015030a7fe6ee
room_number: OR-01
room_name: Operating Room 1
room_type: NEURO
status: CLEANING
building: Qassim Medical Block
wing: North Wing
created_at: 2025-09-03 23:37:25.546386
updated_at: 2025-09-03 23:37:25.546394
equipment_list:
  ["Dr\u00e4ger Anesthesia Machine", "GE Patient Monitor", "Valleylab Electrocautery", "Da Vinci Surgical Robot", "Karl Storz Laparoscopy Set", "Stryker 1688 AIM Camera"]

special_features:
  ["Integrated Boom", "Shadowless Lighting", "HEPA Filtration", "Negative Pressure Anteroom", "Sterile Core Access", "Dedicated Anesthesia Column"]


room_id: 535a853285db4f4b9697dcc0344ac928
room_number: OR-02
room_name: Operating Room 2
room_type: ENT
status: OCCUPIED
building: Jeddah Surgical Center
wing: Royal Wing
created_at: 2025-09-03 23:37:25.546414
updated_at: 2025-09-03 23:37:25.546417
equipment_list:
  ["Dr\u00e4ger Anesthesia Machine", "GE Patient Monitor", "Valleylab Electrocautery", "Stryker 1688 AIM Camera", "Karl Storz Laparoscopy Set"]

special_features:
  ["HEPA Filtration", "Laminar Flow", "Ceiling-Mounted Monitors", "Lead-Lined Walls", "Integrated Boom"]


room_id: 28526383a79740d991d90ef8fbc1e539
room_number: OR-03
room_name: Operating Room 3
room_type: PLASTIC
status: CLEANING
special_features: ["Shadowless Lighting", "Lead-Lined Walls", "Negative Pressure Anteroom"]
building: Madina Specialty Institute
wing: South Wing
created_at: 2025-09-03 23:37:25.546434
updated_at: 2025-09-03 23:37:25.546436
equipment_list:
  ["Valleylab Electrocautery", "Dr\u00e4ger Anesthesia Machine", "GE Patient Monitor", "Da Vinci Surgical Robot", "Karl Storz Laparoscopy Set", "Stryker 1688 AIM Camera"]


room_id: a1af7b7013dc4af789c62e358200d1c9
room_number: OR-04
room_name: Operating Room 4
room_type: EMERGENCY
status: AVAILABLE
building: King Abdulaziz Tower B
wing: East Wing
created_at: 2025-09-03 23:37:25.546451
updated_at: 2025-09-03 23:37:25.546453
equipment_list:
  ["Valleylab Electrocautery", "Dr\u00e4ger Anesthesia Machine", "GE Patient Monitor", "Stryker 1688 AIM Camera", "Karl Storz Laparoscopy Set"]

special_features:
  ["Dedicated Anesthesia Column", "Lead-Lined Walls", "Hybrid Imaging Suite", "Integrated Boom", "Ceiling-Mounted Monitors"]


room_id: c77add0f24134bbbaad2b30ed605e401
room_number: OR-05
room_name: Operating Room 5
room_type: ROBOTIC
status: CLEANING
building: Makkah Clinical Wing
wing: South Wing
created_at: 2025-09-03 23:37:25.546469
updated_at: 2025-09-03 23:37:25.546471
equipment_list:
  ["Dr\u00e4ger Anesthesia Machine", "Valleylab Electrocautery", "GE Patient Monitor", "Stryker 1688 AIM Camera", "Karl Storz Laparoscopy Set"]

special_features:
  ["Integrated Boom", "Negative Pressure Anteroom", "Laminar Flow", "Ceiling-Mounted Monitors", "Sterile Core Access"]


room_id: b488b45168a2415bbd2d994c31b203bd
room_number: OR-06
room_name: Operating Room 6
room_type: EMERGENCY
status: AVAILABLE
special_features: ["Ceiling-Mounted Monitors", "Hybrid Imaging Suite", "Integrated Boom", "Laminar Flow"]
building: Madina Specialty Institute
wing: Royal Wing
created_at: 2025-09-03 23:37:25.546485
updated_at: 2025-09-03 23:37:25.546487
equipment_list:
  ["Dr\u00e4ger Anesthesia Machine", "GE Patient Monitor", "Valleylab Electrocautery", "Karl Storz Laparoscopy Set", "Stryker 1688 AIM Camera"]


# radiology_report_template

template_id: f34be6ab318049dfac62b3d8dc251b09
name: Chest X-Ray Report
description: Standard template for Chest X-Ray Report
modality: CR
body_part: CHEST
clinical_history_template:
  CLINICAL HISTORY: [Clinical indication]

  TECHNIQUE: Standard PA and lateral chest radiographs

technique_template: Standard two-view chest radiography
impression_template:
  IMPRESSION:
  [Overall impression]

recommendations_template:
  RECOMMENDATIONS:
  [Follow-up recommendations]

structured_fields: ["clinical_history", "technique", "findings", "impression", "recommendations"]
created_at: 2025-08-24 09:23:00.974710
updated_at: 2025-08-24 09:23:00.974719
findings_template:
  FINDINGS:
  Heart: [Heart findings]
  Lungs: [Lung findings]
  Bones: [Bone findings]
  Soft tissues: [Soft tissue findings]


template_id: 22dc668d3340411d802a4ce75b065a3c
name: CT Head Report
description: Standard template for CT Head Report
modality: CT
body_part: HEAD
clinical_history_template:
  CLINICAL HISTORY: [Clinical indication]

  TECHNIQUE: Axial CT images of the head without contrast

technique_template: Non-contrast CT of the head
impression_template:
  IMPRESSION:
  [Overall impression]

recommendations_template:
  RECOMMENDATIONS:
  [Follow-up recommendations]

structured_fields: ["clinical_history", "technique", "findings", "impression", "recommendations"]
created_at: 2025-08-24 09:23:00.976171
updated_at: 2025-08-24 09:23:00.976175
findings_template:
  FINDINGS:
  Brain parenchyma: [Brain findings]
  Ventricular system: [Ventricular findings]
  Extraaxial spaces: [Extraaxial findings]
  Bone: [Bone findings]


template_id: 67c81af3a5374ee7920a35c9e7e723f2
name: Abdominal Ultrasound Report
description: Standard template for Abdominal Ultrasound Report
modality: US
body_part: ABDOMEN
clinical_history_template:
  CLINICAL HISTORY: [Clinical indication]

  TECHNIQUE: Real-time ultrasonography of the abdomen

technique_template: Transabdominal ultrasound examination
impression_template:
  IMPRESSION:
  [Overall impression]

recommendations_template:
  RECOMMENDATIONS:
  [Follow-up recommendations]

structured_fields: ["clinical_history", "technique", "findings", "impression", "recommendations"]
created_at: 2025-08-24 09:23:00.977131
updated_at: 2025-08-24 09:23:00.977136
findings_template:
  FINDINGS:
  Liver: [Liver findings]
  Gallbladder: [GB findings]
  Kidneys: [Kidney findings]
  Pancreas: [Pancreas findings]
  Spleen: [Spleen findings]


# radiology_radiology_report

report_id: f0ee94c0db144faf899067180d9ddc62
technique: CR CHEST performed according to standard protocol
findings:
  FINDINGS:
  The chest CR demonstrates no acute abnormalities. No focal lesions identified.

impression: Normal study
recommendations: Additional imaging if clinically indicated
status: FINAL
critical_communicated_datetime: 2025-07-29 08:38:00
dictated_datetime: 2025-07-29 05:01:00
transcribed_datetime: 2025-07-29 07:38:00
verified_datetime: 2025-07-29 08:18:00
finalized_datetime: 2025-07-29 08:28:00
structured_data: {"modality": "CR", "body_part": "CHEST", "indication": "Back pain", "quality": "EXCELLENT"}
addendum_datetime: 2025-07-30 03:28:00
created_at: 2025-08-24 09:23:13.354707
updated_at: 2025-08-24 09:23:13.354710
clinical_history:
  Clinical indication: Back pain

  History: Patient presents with recurrent symptoms requiring imaging evaluation


report_id: 16d9a70e5f784d73a6ee1f8bec708444
technique: CT VASCULAR performed according to standard protocol
findings:
  FINDINGS:
  The vascular CT demonstrates no acute abnormalities. Age-appropriate changes noted.

impression: Normal study
recommendations: Clinical correlation recommended
status: FINAL
critical_communicated_to: Hala Al-Harbi
dictated_datetime: 2025-07-29 08:13:00
transcribed_datetime: 2025-07-29 10:09:00
verified_datetime: 2025-07-29 10:47:00
finalized_datetime: 2025-07-29 11:12:00
structured_data: {"modality": "CT", "body_part": "VASCULAR", "indication": "Back pain", "quality": "EXCELLENT"}
addendum_datetime: 2025-07-29 22:12:00
created_at: 2025-08-24 09:23:13.355180
updated_at: 2025-08-24 09:23:13.355182
clinical_history:
  Clinical indication: Back pain

  History: Patient presents with acute symptoms requiring imaging evaluation


report_id: 3cf3821c28f844d987fb7dcc7bcd4caa
technique: NM THYROID performed according to standard protocol
findings:
  FINDINGS:
  The thyroid NM demonstrates no acute abnormalities. Age-appropriate changes noted.

impression: Follow-up recommended
recommendations: Clinical correlation recommended
status: FINAL
dictated_datetime: 2025-07-29 00:24:00
transcribed_datetime: 2025-07-29 00:58:00
verified_datetime: 2025-07-29 01:40:00
finalized_datetime: 2025-07-29 02:24:00
created_at: 2025-08-24 09:23:13.355549
updated_at: 2025-08-24 09:23:13.355551
clinical_history:
  Clinical indication: Preoperative assessment

  History: Patient presents with chronic symptoms requiring imaging evaluation

structured_data:
  {"modality": "NM", "body_part": "THYROID", "indication": "Preoperative assessment", "quality": "EXCELLENT"}


report_id: d806f6eb71804b7780dba1e7372c1935
technique: CT CHEST performed according to standard protocol
impression: No acute abnormalities
recommendations: No follow-up needed
status: FINAL
critical_communicated_to: Hala Al-Harbi
critical_communicated_datetime: 2025-07-28 12:13:00
dictated_datetime: 2025-07-28 08:02:00
transcribed_datetime: 2025-07-28 10:54:00
verified_datetime: 2025-07-28 11:12:00
finalized_datetime: 2025-07-28 12:03:00
addendum_datetime: 2025-07-29 02:03:00
created_at: 2025-08-24 09:23:13.355938
updated_at: 2025-08-24 09:23:13.355940
clinical_history:
  Clinical indication: Preoperative assessment

  History: Patient presents with recurrent symptoms requiring imaging evaluation

findings:
  FINDINGS:
  The chest CT demonstrates no acute abnormalities. Normal anatomical structures are visualized.

structured_data:
  {"modality": "CT", "body_part": "CHEST", "indication": "Preoperative assessment", "quality": "GOOD"}


report_id: d902a63ef8174e54b741ae28d6d97513
technique: CR ABDOMEN performed according to standard protocol
impression: Mild degenerative changes
recommendations: Additional imaging if clinically indicated
status: FINAL
critical_communicated_to: Rania Al-Subai
critical_communicated_datetime: 2025-07-30 09:19:00
dictated_datetime: 2025-07-30 04:46:00
transcribed_datetime: 2025-07-30 07:36:00
verified_datetime: 2025-07-30 08:39:00
finalized_datetime: 2025-07-30 09:09:00
structured_data: {"modality": "CR", "body_part": "ABDOMEN", "indication": "Joint pain", "quality": "EXCELLENT"}
created_at: 2025-08-24 09:23:13.356363
updated_at: 2025-08-24 09:23:13.356366
clinical_history:
  Clinical indication: Joint pain

  History: Patient presents with acute symptoms requiring imaging evaluation

findings:
  FINDINGS:
  The abdomen CR demonstrates no acute abnormalities. Normal anatomical structures are visualized.


report_id: 2ca87898b5344f2b89165b9780d45bac
technique: CT HEAD performed according to standard protocol
impression: Mild degenerative changes
recommendations: Additional imaging if clinically indicated
status: FINAL
critical_communicated_datetime: 2025-07-28 13:59:00
dictated_datetime: 2025-07-28 12:00:00
transcribed_datetime: 2025-07-28 12:42:00
verified_datetime: 2025-07-28 13:39:00
finalized_datetime: 2025-07-28 13:49:00
structured_data: {"modality": "CT", "body_part": "HEAD", "indication": "Headache workup", "quality": "EXCELLENT"}
created_at: 2025-08-24 09:23:13.356734
updated_at: 2025-08-24 09:23:13.356737
clinical_history:
  Clinical indication: Headache workup

  History: Patient presents with chronic symptoms requiring imaging evaluation

findings:
  FINDINGS:
  The head CT demonstrates no acute abnormalities. Normal anatomical structures are visualized.


report_id: 653e78c216b84fc4aa233ae945b15ef2
technique: CR EXTREMITY performed according to standard protocol
findings:
  FINDINGS:
  The extremity CR demonstrates no acute abnormalities. No focal lesions identified.

impression: No acute abnormalities
recommendations: Follow-up in 6 months
status: FINAL
critical_communicated_to: Rana Al-Anzi
critical_communicated_datetime: 2025-07-29 18:59:00
dictated_datetime: 2025-07-29 14:43:00
transcribed_datetime: 2025-07-29 16:53:00
verified_datetime: 2025-07-29 18:16:00
finalized_datetime: 2025-07-29 18:49:00
created_at: 2025-08-24 09:23:13.357090
updated_at: 2025-08-24 09:23:13.357092
clinical_history:
  Clinical indication: Abdominal pain

  History: Patient presents with chronic symptoms requiring imaging evaluation

structured_data:
  {"modality": "CR", "body_part": "EXTREMITY", "indication": "Abdominal pain", "quality": "EXCELLENT"}


report_id: 7d0ae46988054fbd87f7905030baf74d
technique: US ABDOMEN performed according to standard protocol
findings:
  FINDINGS:
  The abdomen US demonstrates no acute abnormalities. Mild degenerative changes present.

impression: No acute abnormalities
recommendations: Clinical correlation recommended
status: FINAL
critical_communicated_to: Salman Al-Sudairy
dictated_datetime: 2025-07-30 04:15:00
transcribed_datetime: 2025-07-30 05:54:00
verified_datetime: 2025-07-30 07:31:00
finalized_datetime: 2025-07-30 07:41:00
addendum: Addendum: Additional review confirms initial findings.
created_at: 2025-08-24 09:23:13.357823
updated_at: 2025-08-24 09:23:13.357825
clinical_history:
  Clinical indication: Preoperative assessment

  History: Patient presents with acute symptoms requiring imaging evaluation

structured_data:
  {"modality": "US", "body_part": "ABDOMEN", "indication": "Preoperative assessment", "quality": "EXCELLENT"}


report_id: 0110839a3c7648bb9bd5db9c5250a255
technique: MR SPINE performed according to standard protocol
findings:
  FINDINGS:
  The spine MR demonstrates no acute abnormalities. No focal lesions identified.

impression: No acute abnormalities
recommendations: Additional imaging if clinically indicated
status: FINAL
critical_communicated_to: Rana Al-Anzi
dictated_datetime: 2025-07-31 05:33:00
transcribed_datetime: 2025-07-31 07:54:00
verified_datetime: 2025-07-31 09:00:00
finalized_datetime: 2025-07-31 09:17:00
structured_data: {"modality": "MR", "body_part": "SPINE", "indication": "Headache workup", "quality": "EXCELLENT"}
created_at: 2025-08-24 09:23:13.358207
updated_at: 2025-08-24 09:23:13.358209
clinical_history:
  Clinical indication: Headache workup

  History: Patient presents with recurrent symptoms requiring imaging evaluation


report_id: 308fb1e208a7410393cbdfb7e1179d5e
technique: US OBSTETRIC performed according to standard protocol
impression: Mild degenerative changes
recommendations: Additional imaging if clinically indicated
status: FINAL
critical_communicated_to: Salman Al-Sudairy
dictated_datetime: 2025-07-30 23:10:00
transcribed_datetime: 2025-07-30 23:42:00
verified_datetime: 2025-07-31 01:15:00
finalized_datetime: 2025-07-31 01:56:00
structured_data: {"modality": "US", "body_part": "OBSTETRIC", "indication": "Screening study", "quality": "GOOD"}
created_at: 2025-08-24 09:23:13.358578
updated_at: 2025-08-24 09:23:13.358580
clinical_history:
  Clinical indication: Screening study

  History: Patient presents with recurrent symptoms requiring imaging evaluation

findings:
  FINDINGS:
  The obstetric US demonstrates no acute abnormalities. Normal anatomical structures are visualized.


report_id: 1bdf116353004aa3bb3110cae978a303
technique: CR EXTREMITY performed according to standard protocol
findings:
  FINDINGS:
  The extremity CR demonstrates no acute abnormalities. Mild degenerative changes present.

impression: Mild degenerative changes
recommendations: Clinical correlation recommended
status: FINAL
critical_communicated_to: Salman Al-Rajhi
dictated_datetime: 2025-07-28 18:22:00
transcribed_datetime: 2025-07-28 19:04:00
verified_datetime: 2025-07-28 21:04:00
finalized_datetime: 2025-07-28 21:26:00
addendum_datetime: 2025-07-29 12:26:00
created_at: 2025-08-24 09:23:13.359008
updated_at: 2025-08-24 09:23:13.359010
clinical_history:
  Clinical indication: Trauma evaluation

  History: Patient presents with acute symptoms requiring imaging evaluation

structured_data:
  {"modality": "CR", "body_part": "EXTREMITY", "indication": "Trauma evaluation", "quality": "EXCELLENT"}


report_id: a67932be5c044801b47180eb69054841
technique: MR SPINE performed according to standard protocol
findings:
  FINDINGS:
  The spine MR demonstrates no acute abnormalities. No focal lesions identified.

impression: Mild degenerative changes
recommendations: Clinical correlation recommended
status: FINAL
critical_communicated_to: Hala Al-Harbi
dictated_datetime: 2025-07-30 11:56:00
transcribed_datetime: 2025-07-30 14:43:00
verified_datetime: 2025-07-30 16:29:00
finalized_datetime: 2025-07-30 16:38:00
structured_data: {"modality": "MR", "body_part": "SPINE", "indication": "Shortness of breath", "quality": "GOOD"}
addendum_datetime: 2025-07-31 09:38:00
created_at: 2025-08-24 09:23:13.359501
updated_at: 2025-08-24 09:23:13.359504
clinical_history:
  Clinical indication: Shortness of breath

  History: Patient presents with chronic symptoms requiring imaging evaluation


report_id: 5e086612fe3b4cb6aa66a44ec97c7725
technique: MR SPINE performed according to standard protocol
findings:
  FINDINGS:
  The spine MR demonstrates no acute abnormalities. Mild degenerative changes present.

impression: No acute abnormalities
recommendations: Additional imaging if clinically indicated
status: FINAL
critical_communicated_datetime: 2025-07-29 20:12:00
dictated_datetime: 2025-07-29 18:19:00
transcribed_datetime: 2025-07-29 18:52:00
verified_datetime: 2025-07-29 19:09:00
finalized_datetime: 2025-07-29 20:02:00
structured_data: {"modality": "MR", "body_part": "SPINE", "indication": "Joint pain", "quality": "EXCELLENT"}
addendum_datetime: 2025-07-30 07:02:00
created_at: 2025-08-24 09:23:13.360023
updated_at: 2025-08-24 09:23:13.360026
clinical_history:
  Clinical indication: Joint pain

  History: Patient presents with chronic symptoms requiring imaging evaluation


report_id: 098112aa5add477a83ce14e36e7eaba8
technique: CT HEAD performed according to standard protocol
findings:
  FINDINGS:
  The head CT demonstrates no acute abnormalities. Mild degenerative changes present.

impression: No acute abnormalities
recommendations: Follow-up in 6 months
status: FINAL
critical_communicated_to: Salman Al-Rajhi
dictated_datetime: 2025-08-02 10:44:00
transcribed_datetime: 2025-08-02 12:26:00
verified_datetime: 2025-08-02 14:17:00
finalized_datetime: 2025-08-02 15:07:00
structured_data: {"modality": "CT", "body_part": "HEAD", "indication": "Screening study", "quality": "FAIR"}
addendum_datetime: 2025-08-03 05:07:00
created_at: 2025-08-24 09:23:13.360504
updated_at: 2025-08-24 09:23:13.360507
clinical_history:
  Clinical indication: Screening study

  History: Patient presents with acute symptoms requiring imaging evaluation


report_id: a80c57712ba045478e48abb0493fdc51
technique: MR EXTREMITY performed according to standard protocol
findings:
  FINDINGS:
  The extremity MR demonstrates no acute abnormalities. Mild degenerative changes present.

impression: Normal study
recommendations: Additional imaging if clinically indicated
status: FINAL
critical_communicated_to: Salman Al-Sudairy
critical_communicated_datetime: 2025-08-02 04:09:00
dictated_datetime: 2025-08-01 22:33:00
transcribed_datetime: 2025-08-02 01:24:00
verified_datetime: 2025-08-02 02:59:00
finalized_datetime: 2025-08-02 03:59:00
created_at: 2025-08-24 09:23:13.361017
updated_at: 2025-08-24 09:23:13.361019
clinical_history:
  Clinical indication: Shortness of breath

  History: Patient presents with recurrent symptoms requiring imaging evaluation

structured_data:
  {"modality": "MR", "body_part": "EXTREMITY", "indication": "Shortness of breath", "quality": "GOOD"}


report_id: 7a2b7641a2cf499b986cb22278551a16
technique: CR CHEST performed according to standard protocol
impression: Normal study
recommendations: Follow-up in 6 months
status: FINAL
dictated_datetime: 2025-07-31 15:07:00
transcribed_datetime: 2025-07-31 16:27:00
verified_datetime: 2025-07-31 16:50:00
finalized_datetime: 2025-07-31 17:25:00
addendum_datetime: 2025-07-31 22:25:00
created_at: 2025-08-24 09:23:13.362024
updated_at: 2025-08-24 09:23:13.362026
clinical_history:
  Clinical indication: Shortness of breath

  History: Patient presents with recurrent symptoms requiring imaging evaluation

findings:
  FINDINGS:
  The chest CR demonstrates no acute abnormalities. Normal anatomical structures are visualized.

structured_data:
  {"modality": "CR", "body_part": "CHEST", "indication": "Shortness of breath", "quality": "EXCELLENT"}


report_id: 22557b70cc83409b8d9d809bc1e130aa
technique: CR CHEST performed according to standard protocol
findings:
  FINDINGS:
  The chest CR demonstrates no acute abnormalities. Age-appropriate changes noted.

impression: No acute abnormalities
recommendations: No follow-up needed
status: FINAL
dictated_datetime: 2025-07-31 21:29:00
transcribed_datetime: 2025-07-31 23:25:00
verified_datetime: 2025-08-01 00:46:00
finalized_datetime: 2025-08-01 01:46:00
structured_data: {"modality": "CR", "body_part": "CHEST", "indication": "Back pain", "quality": "EXCELLENT"}
addendum: Addendum: Additional review confirms initial findings.
addendum_datetime: 2025-08-01 02:46:00
created_at: 2025-08-24 09:23:13.362565
updated_at: 2025-08-24 09:23:13.362567
clinical_history:
  Clinical indication: Back pain

  History: Patient presents with chronic symptoms requiring imaging evaluation


report_id: 54d9cb8fba04487bb78b301e1b73defc
technique: MR EXTREMITY performed according to standard protocol
findings:
  FINDINGS:
  The extremity MR demonstrates no acute abnormalities. No focal lesions identified.

impression: Follow-up recommended
recommendations: No follow-up needed
status: FINAL
critical_communicated_to: Rana Al-Anzi
critical_communicated_datetime: 2025-08-01 06:54:00
dictated_datetime: 2025-08-01 04:47:00
transcribed_datetime: 2025-08-01 05:53:00
verified_datetime: 2025-08-01 06:30:00
finalized_datetime: 2025-08-01 06:44:00
structured_data: {"modality": "MR", "body_part": "EXTREMITY", "indication": "Screening study", "quality": "FAIR"}
addendum_datetime: 2025-08-02 01:44:00
created_at: 2025-08-24 09:23:13.363013
updated_at: 2025-08-24 09:23:13.363015
clinical_history:
  Clinical indication: Screening study

  History: Patient presents with chronic symptoms requiring imaging evaluation


report_id: be5a3c4fbff14a1690c4f0c2ca1e88a6
technique: CR SPINE performed according to standard protocol
findings:
  FINDINGS:
  The spine CR demonstrates no acute abnormalities. Mild degenerative changes present.

impression: Mild degenerative changes
recommendations: Clinical correlation recommended
status: FINAL
critical_communicated_to: Salman Al-Rajhi
dictated_datetime: 2025-07-30 23:49:00
transcribed_datetime: 2025-07-31 01:28:00
verified_datetime: 2025-07-31 02:37:00
finalized_datetime: 2025-07-31 03:04:00
structured_data: {"modality": "CR", "body_part": "SPINE", "indication": "Shortness of breath", "quality": "GOOD"}
addendum_datetime: 2025-07-31 06:04:00
created_at: 2025-08-24 09:23:13.363471
updated_at: 2025-08-24 09:23:13.363473
clinical_history:
  Clinical indication: Shortness of breath

  History: Patient presents with acute symptoms requiring imaging evaluation


report_id: 16ee06ae938a447498cd02a88b7624ce
technique: NM BONE performed according to standard protocol
impression: Clinical correlation suggested
recommendations: Follow-up in 6 months
status: FINAL
critical_communicated_datetime: 2025-07-30 23:26:00
dictated_datetime: 2025-07-30 20:20:00
transcribed_datetime: 2025-07-30 21:33:00
verified_datetime: 2025-07-30 22:25:00
finalized_datetime: 2025-07-30 23:16:00
structured_data: {"modality": "NM", "body_part": "BONE", "indication": "Follow-up imaging", "quality": "EXCELLENT"}
created_at: 2025-08-24 09:23:13.363953
updated_at: 2025-08-24 09:23:13.363955
clinical_history:
  Clinical indication: Follow-up imaging

  History: Patient presents with acute symptoms requiring imaging evaluation

findings:
  FINDINGS:
  The bone NM demonstrates no acute abnormalities. Normal anatomical structures are visualized.


report_id: 5e7cb458ce4b41d8909950e75da612f4
technique: CR SPINE performed according to standard protocol
findings:
  FINDINGS:
  The spine CR demonstrates no acute abnormalities. No focal lesions identified.

impression: Normal study
recommendations: Additional imaging if clinically indicated
status: FINAL
critical_communicated_datetime: 2025-08-02 11:26:00
dictated_datetime: 2025-08-02 07:38:00
transcribed_datetime: 2025-08-02 09:59:00
verified_datetime: 2025-08-02 10:48:00
finalized_datetime: 2025-08-02 11:16:00
structured_data: {"modality": "CR", "body_part": "SPINE", "indication": "Follow-up imaging", "quality": "GOOD"}
created_at: 2025-08-24 09:23:13.364365
updated_at: 2025-08-24 09:23:13.364367
clinical_history:
  Clinical indication: Follow-up imaging

  History: Patient presents with recurrent symptoms requiring imaging evaluation


report_id: fe5248a614d1499cbda1743cce8063ec
technique: CT CHEST performed according to standard protocol
findings:
  FINDINGS:
  The chest CT demonstrates no acute abnormalities. No focal lesions identified.

impression: Mild degenerative changes
recommendations: Follow-up in 6 months
status: FINAL
dictated_datetime: 2025-08-05 09:11:00
transcribed_datetime: 2025-08-05 11:05:00
verified_datetime: 2025-08-05 12:59:00
finalized_datetime: 2025-08-05 13:10:00
structured_data: {"modality": "CT", "body_part": "CHEST", "indication": "Joint pain", "quality": "EXCELLENT"}
addendum_datetime: 2025-08-06 05:10:00
created_at: 2025-08-24 09:23:13.364828
updated_at: 2025-08-24 09:23:13.364830
clinical_history:
  Clinical indication: Joint pain

  History: Patient presents with recurrent symptoms requiring imaging evaluation


report_id: 0152761395424094a98760da9a478fd3
technique: US OBSTETRIC performed according to standard protocol
findings:
  FINDINGS:
  The obstetric US demonstrates no acute abnormalities. Mild degenerative changes present.

impression: Mild degenerative changes
recommendations: No follow-up needed
status: FINAL
critical_communicated_datetime: 2025-08-05 01:05:00
dictated_datetime: 2025-08-04 22:41:00
transcribed_datetime: 2025-08-05 00:03:00
verified_datetime: 2025-08-05 00:43:00
finalized_datetime: 2025-08-05 00:55:00
created_at: 2025-08-24 09:23:13.366177
updated_at: 2025-08-24 09:23:13.366180
clinical_history:
  Clinical indication: Preoperative assessment

  History: Patient presents with acute symptoms requiring imaging evaluation

structured_data:
  {"modality": "US", "body_part": "OBSTETRIC", "indication": "Preoperative assessment", "quality": "GOOD"}


report_id: 4c30cdee8b634fe3b208d2a0952719b6
technique: US OBSTETRIC performed according to standard protocol
findings:
  FINDINGS:
  The obstetric US demonstrates no acute abnormalities. Age-appropriate changes noted.

impression: Clinical correlation suggested
recommendations: Clinical correlation recommended
status: FINAL
critical_communicated_datetime: 2025-08-04 22:10:00
dictated_datetime: 2025-08-04 18:08:00
transcribed_datetime: 2025-08-04 20:53:00
verified_datetime: 2025-08-04 21:52:00
finalized_datetime: 2025-08-04 22:00:00
addendum_datetime: 2025-08-05 19:00:00
created_at: 2025-08-24 09:23:13.366606
updated_at: 2025-08-24 09:23:13.366609
clinical_history:
  Clinical indication: Follow-up imaging

  History: Patient presents with chronic symptoms requiring imaging evaluation

structured_data:
  {"modality": "US", "body_part": "OBSTETRIC", "indication": "Follow-up imaging", "quality": "EXCELLENT"}


report_id: e65f1594158c4d93805da73fb037d5bc
technique: CR ABDOMEN performed according to standard protocol
findings:
  FINDINGS:
  The abdomen CR demonstrates no acute abnormalities. Age-appropriate changes noted.

impression: Clinical correlation suggested
recommendations: No follow-up needed
status: FINAL
critical_communicated_to: Maryam Al-Ghamdi
dictated_datetime: 2025-08-04 05:17:00
transcribed_datetime: 2025-08-04 06:03:00
verified_datetime: 2025-08-04 07:49:00
finalized_datetime: 2025-08-04 08:11:00
structured_data: {"modality": "CR", "body_part": "ABDOMEN", "indication": "Abdominal pain", "quality": "GOOD"}
addendum_datetime: 2025-08-05 00:11:00
created_at: 2025-08-24 09:23:13.367006
updated_at: 2025-08-24 09:23:13.367008
clinical_history:
  Clinical indication: Abdominal pain

  History: Patient presents with recurrent symptoms requiring imaging evaluation


report_id: 74eb52b4cf8a412dbbdcc6295412cb8f
technique: CT HEAD performed according to standard protocol
findings:
  FINDINGS:
  The head CT demonstrates no acute abnormalities. No focal lesions identified.

impression: Follow-up recommended
recommendations: No follow-up needed
status: FINAL
critical_communicated_datetime: 2025-08-06 11:36:00
dictated_datetime: 2025-08-06 06:52:00
transcribed_datetime: 2025-08-06 09:36:00
verified_datetime: 2025-08-06 11:02:00
finalized_datetime: 2025-08-06 11:26:00
structured_data: {"modality": "CT", "body_part": "HEAD", "indication": "Trauma evaluation", "quality": "GOOD"}
created_at: 2025-08-24 09:23:13.368231
updated_at: 2025-08-24 09:23:13.368234
clinical_history:
  Clinical indication: Trauma evaluation

  History: Patient presents with chronic symptoms requiring imaging evaluation


report_id: df9fe5744af54311ac854a3eca9da084
technique: CT ABDOMEN performed according to standard protocol
impression: Normal study
recommendations: Follow-up in 6 months
status: FINAL
critical_communicated_to: Rania Al-Subai
dictated_datetime: 2025-08-07 05:17:00
transcribed_datetime: 2025-08-07 07:15:00
verified_datetime: 2025-08-07 08:23:00
finalized_datetime: 2025-08-07 09:18:00
addendum_datetime: 2025-08-07 14:18:00
created_at: 2025-08-24 09:23:13.368625
updated_at: 2025-08-24 09:23:13.368627
clinical_history:
  Clinical indication: Follow-up imaging

  History: Patient presents with chronic symptoms requiring imaging evaluation

findings:
  FINDINGS:
  The abdomen CT demonstrates no acute abnormalities. Normal anatomical structures are visualized.

structured_data:
  {"modality": "CT", "body_part": "ABDOMEN", "indication": "Follow-up imaging", "quality": "EXCELLENT"}


report_id: 41a73c0c37e441958bfaca18b4910f96
technique: CR ABDOMEN performed according to standard protocol
impression: Clinical correlation suggested
recommendations: No follow-up needed
status: FINAL
dictated_datetime: 2025-08-05 01:47:00
transcribed_datetime: 2025-08-05 04:07:00
verified_datetime: 2025-08-05 04:34:00
finalized_datetime: 2025-08-05 05:03:00
addendum_datetime: 2025-08-05 10:03:00
created_at: 2025-08-24 09:23:13.369045
updated_at: 2025-08-24 09:23:13.369047
clinical_history:
  Clinical indication: Follow-up imaging

  History: Patient presents with chronic symptoms requiring imaging evaluation

findings:
  FINDINGS:
  The abdomen CR demonstrates no acute abnormalities. Normal anatomical structures are visualized.

structured_data:
  {"modality": "CR", "body_part": "ABDOMEN", "indication": "Follow-up imaging", "quality": "EXCELLENT"}


report_id: f76b2883042847968cba10b51abdb4c0
technique: NM THYROID performed according to standard protocol
impression: No acute abnormalities
recommendations: Follow-up in 6 months
status: FINAL
critical_communicated_datetime: 2025-08-04 12:51:00
dictated_datetime: 2025-08-04 10:25:00
transcribed_datetime: 2025-08-04 12:13:00
verified_datetime: 2025-08-04 12:30:00
finalized_datetime: 2025-08-04 12:41:00
structured_data: {"modality": "NM", "body_part": "THYROID", "indication": "Joint pain", "quality": "GOOD"}
created_at: 2025-08-24 09:23:13.369810
updated_at: 2025-08-24 09:23:13.369812
clinical_history:
  Clinical indication: Joint pain

  History: Patient presents with recurrent symptoms requiring imaging evaluation

findings:
  FINDINGS:
  The thyroid NM demonstrates no acute abnormalities. Normal anatomical structures are visualized.


report_id: 8541588d511349e1918933f8debf8d17
technique: MR EXTREMITY performed according to standard protocol
findings:
  FINDINGS:
  The extremity MR demonstrates no acute abnormalities. No focal lesions identified.

impression: Follow-up recommended
recommendations: Clinical correlation recommended
status: FINAL
critical_communicated_to: Rania Al-Subai
dictated_datetime: 2025-08-04 06:02:00
transcribed_datetime: 2025-08-04 07:10:00
verified_datetime: 2025-08-04 07:48:00
finalized_datetime: 2025-08-04 08:14:00
created_at: 2025-08-24 09:23:13.370189
updated_at: 2025-08-24 09:23:13.370192
clinical_history:
  Clinical indication: Preoperative assessment

  History: Patient presents with acute symptoms requiring imaging evaluation

structured_data:
  {"modality": "MR", "body_part": "EXTREMITY", "indication": "Preoperative assessment", "quality": "EXCELLENT"}


report_id: 9b39d86585a3458bb3d5962ac40c0f81
technique: US OBSTETRIC performed according to standard protocol
findings:
  FINDINGS:
  The obstetric US demonstrates no acute abnormalities. Mild degenerative changes present.

impression: Mild degenerative changes
recommendations: No follow-up needed
status: FINAL
critical_communicated_datetime: 2025-08-08 04:48:00
dictated_datetime: 2025-08-08 02:15:00
transcribed_datetime: 2025-08-08 02:59:00
verified_datetime: 2025-08-08 04:15:00
finalized_datetime: 2025-08-08 04:38:00
created_at: 2025-08-24 09:23:13.370547
updated_at: 2025-08-24 09:23:13.370550
clinical_history:
  Clinical indication: Chest pain evaluation

  History: Patient presents with chronic symptoms requiring imaging evaluation

structured_data:
  {"modality": "US", "body_part": "OBSTETRIC", "indication": "Chest pain evaluation", "quality": "GOOD"}


report_id: 4a3a0a0081be46e4a7eb6880a785507e
technique: CT CHEST performed according to standard protocol
impression: Normal study
recommendations: No follow-up needed
status: FINAL
critical_communicated_datetime: 2025-08-08 14:42:00
dictated_datetime: 2025-08-08 09:56:00
transcribed_datetime: 2025-08-08 12:31:00
verified_datetime: 2025-08-08 14:00:00
finalized_datetime: 2025-08-08 14:32:00
created_at: 2025-08-24 09:23:13.371672
updated_at: 2025-08-24 09:23:13.371675
clinical_history:
  Clinical indication: Chest pain evaluation

  History: Patient presents with chronic symptoms requiring imaging evaluation

findings:
  FINDINGS:
  The chest CT demonstrates no acute abnormalities. Normal anatomical structures are visualized.

structured_data:
  {"modality": "CT", "body_part": "CHEST", "indication": "Chest pain evaluation", "quality": "EXCELLENT"}


report_id: 1c35273949134aca90eced340ad5069e
technique: US PELVIS performed according to standard protocol
impression: Mild degenerative changes
recommendations: Clinical correlation recommended
status: FINAL
critical_communicated_to: Rania Al-Subai
critical_communicated_datetime: 2025-08-06 23:34:00
dictated_datetime: 2025-08-06 19:28:00
transcribed_datetime: 2025-08-06 21:53:00
verified_datetime: 2025-08-06 22:37:00
finalized_datetime: 2025-08-06 23:24:00
structured_data: {"modality": "US", "body_part": "PELVIS", "indication": "Screening study", "quality": "EXCELLENT"}
addendum: Addendum: Additional review confirms initial findings.
addendum_datetime: 2025-08-07 05:24:00
created_at: 2025-08-24 09:23:13.372417
updated_at: 2025-08-24 09:23:13.372420
clinical_history:
[cell repeats an earlier one in this file: 114 characters]

findings:
  FINDINGS:
  The pelvis US demonstrates no acute abnormalities. Normal anatomical structures are visualized.


report_id: 670d148d22484736a05cfb68b75128b1
technique: NM BONE performed according to standard protocol
findings:
  FINDINGS:
  The bone NM demonstrates no acute abnormalities. Mild degenerative changes present.

impression: No acute abnormalities
recommendations: Additional imaging if clinically indicated
status: FINAL
dictated_datetime: 2025-08-08 18:21:00
transcribed_datetime: 2025-08-08 19:25:00
verified_datetime: 2025-08-08 20:41:00
finalized_datetime: 2025-08-08 20:49:00
structured_data: {"modality": "NM", "body_part": "BONE", "indication": "Chest pain evaluation", "quality": "GOOD"}
addendum_datetime: 2025-08-09 00:49:00
created_at: 2025-08-24 09:23:13.373129
updated_at: 2025-08-24 09:23:13.373131
clinical_history:
  Clinical indication: Chest pain evaluation

  History: Patient presents with recurrent symptoms requiring imaging evaluation


report_id: 43aa50f8481441669126e6b521a803de
technique: NM THYROID performed according to standard protocol
findings:
  FINDINGS:
  The thyroid NM demonstrates no acute abnormalities. Age-appropriate changes noted.

impression: Normal study
recommendations: Clinical correlation recommended
status: FINAL
critical_communicated_to: Rania Al-Subai
critical_communicated_datetime: 2025-08-09 07:54:00
dictated_datetime: 2025-08-09 03:58:00
transcribed_datetime: 2025-08-09 06:39:00
verified_datetime: 2025-08-09 07:24:00
finalized_datetime: 2025-08-09 07:44:00
addendum_datetime: 2025-08-10 04:44:00
created_at: 2025-08-24 09:23:13.373502
updated_at: 2025-08-24 09:23:13.373504
clinical_history:
  Clinical indication: Trauma evaluation

  History: Patient presents with recurrent symptoms requiring imaging evaluation

structured_data:
  {"modality": "NM", "body_part": "THYROID", "indication": "Trauma evaluation", "quality": "EXCELLENT"}


report_id: a4591e2b455945078410fee6d56bba49
technique: CT CHEST performed according to standard protocol
findings:
  FINDINGS:
  The chest CT demonstrates no acute abnormalities. Mild degenerative changes present.

impression: Mild degenerative changes
recommendations: Additional imaging if clinically indicated
status: FINAL
critical_communicated_to: Maryam Al-Ghamdi
dictated_datetime: 2025-08-10 16:41:00
transcribed_datetime: 2025-08-10 19:29:00
verified_datetime: 2025-08-10 21:09:00
finalized_datetime: 2025-08-10 22:08:00
addendum_datetime: 2025-08-11 04:08:00
created_at: 2025-08-24 09:23:13.374202
updated_at: 2025-08-24 09:23:13.374204
clinical_history:
  Clinical indication: Shortness of breath

  History: Patient presents with recurrent symptoms requiring imaging evaluation

structured_data:
  {"modality": "CT", "body_part": "CHEST", "indication": "Shortness of breath", "quality": "EXCELLENT"}


report_id: 3c8934d87af84739b885c0c8cf6b329d
technique: US ABDOMEN performed according to standard protocol
impression: Mild degenerative changes
recommendations: Follow-up in 6 months
status: FINAL
critical_communicated_datetime: 2025-08-10 05:58:00
dictated_datetime: 2025-08-10 02:56:00
transcribed_datetime: 2025-08-10 03:41:00
verified_datetime: 2025-08-10 04:52:00
finalized_datetime: 2025-08-10 05:48:00
structured_data: {"modality": "US", "body_part": "ABDOMEN", "indication": "Joint pain", "quality": "EXCELLENT"}
addendum_datetime: 2025-08-10 22:48:00
created_at: 2025-08-24 09:23:13.374546
updated_at: 2025-08-24 09:23:13.374548
clinical_history:
  Clinical indication: Joint pain

  History: Patient presents with acute symptoms requiring imaging evaluation

findings:
  FINDINGS:
  The abdomen US demonstrates no acute abnormalities. Normal anatomical structures are visualized.


report_id: c3b73c144c784996b11fba6066bcb2ab
technique: NM THYROID performed according to standard protocol
findings:
  FINDINGS:
  The thyroid NM demonstrates no acute abnormalities. Mild degenerative changes present.

impression: Clinical correlation suggested
recommendations: Additional imaging if clinically indicated
status: FINAL
dictated_datetime: 2025-08-08 23:27:00
transcribed_datetime: 2025-08-09 01:18:00
verified_datetime: 2025-08-09 02:53:00
finalized_datetime: 2025-08-09 03:52:00
addendum_datetime: 2025-08-09 15:52:00
created_at: 2025-08-24 09:23:13.374903
updated_at: 2025-08-24 09:23:13.374905
clinical_history:
[cell repeats an earlier one in this file: 120 characters]

structured_data:
  {"modality": "NM", "body_part": "THYROID", "indication": "Shortness of breath", "quality": "EXCELLENT"}


report_id: e44f0518f0d24ba886f3ef1dccb01c67
technique: US PELVIS performed according to standard protocol
impression: Normal study
recommendations: Follow-up in 6 months
status: FINAL
critical_communicated_to: Maryam Al-Ghamdi
critical_communicated_datetime: 2025-08-09 03:14:00
dictated_datetime: 2025-08-08 23:40:00
transcribed_datetime: 2025-08-09 01:01:00
verified_datetime: 2025-08-09 02:38:00
finalized_datetime: 2025-08-09 03:04:00
created_at: 2025-08-24 09:23:13.375990
updated_at: 2025-08-24 09:23:13.375992
clinical_history:
  Clinical indication: Follow-up imaging

  History: Patient presents with acute symptoms requiring imaging evaluation

findings:
  FINDINGS:
  The pelvis US demonstrates no acute abnormalities. Normal anatomical structures are visualized.

structured_data:
  {"modality": "US", "body_part": "PELVIS", "indication": "Follow-up imaging", "quality": "EXCELLENT"}


report_id: ab5fae4b37d840cfae39a351d7c69006
technique: US PELVIS performed according to standard protocol
findings:
  FINDINGS:
  The pelvis US demonstrates no acute abnormalities. Age-appropriate changes noted.

impression: Mild degenerative changes
recommendations: Additional imaging if clinically indicated
status: FINAL
critical_communicated_to: Rana Al-Anzi
dictated_datetime: 2025-08-09 18:19:00
transcribed_datetime: 2025-08-09 19:27:00
verified_datetime: 2025-08-09 20:32:00
finalized_datetime: 2025-08-09 21:21:00
addendum_datetime: 2025-08-10 21:21:00
created_at: 2025-08-24 09:23:13.376359
updated_at: 2025-08-24 09:23:13.376361
clinical_history:
  Clinical indication: Chest pain evaluation

  History: Patient presents with recurrent symptoms requiring imaging evaluation

structured_data:
  {"modality": "US", "body_part": "PELVIS", "indication": "Chest pain evaluation", "quality": "EXCELLENT"}


report_id: 6acf1776289f4d4ea13ef8f5b9ae66bb
technique: CT ABDOMEN performed according to standard protocol
findings:
  FINDINGS:
  The abdomen CT demonstrates no acute abnormalities. Age-appropriate changes noted.

impression: Mild degenerative changes
recommendations: No follow-up needed
status: FINAL
dictated_datetime: 2025-08-11 15:14:00
transcribed_datetime: 2025-08-11 16:20:00
verified_datetime: 2025-08-11 18:01:00
finalized_datetime: 2025-08-11 18:14:00
addendum_datetime: 2025-08-12 04:14:00
created_at: 2025-08-24 09:23:13.377509
updated_at: 2025-08-24 09:23:13.377511
clinical_history:
  Clinical indication: Trauma evaluation

  History: Patient presents with chronic symptoms requiring imaging evaluation

structured_data:
  {"modality": "CT", "body_part": "ABDOMEN", "indication": "Trauma evaluation", "quality": "EXCELLENT"}


report_id: 76e39e9d1a2242339f7ebf8f2ad9a67d
technique: MR HEAD performed according to standard protocol
impression: Mild degenerative changes
recommendations: Follow-up in 6 months
status: FINAL
critical_communicated_to: Maryam Al-Ghamdi
dictated_datetime: 2025-08-09 23:27:00
transcribed_datetime: 2025-08-10 00:38:00
verified_datetime: 2025-08-10 02:06:00
finalized_datetime: 2025-08-10 02:17:00
created_at: 2025-08-24 09:23:13.379437
updated_at: 2025-08-24 09:23:13.379440
clinical_history:
  Clinical indication: Preoperative assessment

  History: Patient presents with chronic symptoms requiring imaging evaluation

findings:
  FINDINGS:
  The head MR demonstrates no acute abnormalities. Normal anatomical structures are visualized.

structured_data:
  {"modality": "MR", "body_part": "HEAD", "indication": "Preoperative assessment", "quality": "EXCELLENT"}


report_id: 34390ee1480246b4994d3b4f46220b05
technique: MR EXTREMITY performed according to standard protocol
findings:
  FINDINGS:
  The extremity MR demonstrates no acute abnormalities. No focal lesions identified.

impression: Follow-up recommended
recommendations: Follow-up in 6 months
status: FINAL
critical_communicated_datetime: 2025-08-12 20:14:00
dictated_datetime: 2025-08-12 17:00:00
transcribed_datetime: 2025-08-12 18:46:00
verified_datetime: 2025-08-12 19:59:00
finalized_datetime: 2025-08-12 20:04:00
created_at: 2025-08-24 09:23:13.379824
updated_at: 2025-08-24 09:23:13.379827
clinical_history:
  Clinical indication: Headache workup

  History: Patient presents with chronic symptoms requiring imaging evaluation

structured_data:
  {"modality": "MR", "body_part": "EXTREMITY", "indication": "Headache workup", "quality": "EXCELLENT"}


report_id: 255e3b66f22245a2ba9300c2c207ce8f
technique: CT HEAD performed according to standard protocol
findings:
  FINDINGS:
  The head CT demonstrates no acute abnormalities. Mild degenerative changes present.

impression: Clinical correlation suggested
recommendations: No follow-up needed
status: FINAL
critical_communicated_to: Salman Al-Sudairy
critical_communicated_datetime: 2025-08-10 03:16:00
dictated_datetime: 2025-08-09 23:12:00
transcribed_datetime: 2025-08-10 01:35:00
verified_datetime: 2025-08-10 02:59:00
finalized_datetime: 2025-08-10 03:06:00
created_at: 2025-08-24 09:23:13.381272
updated_at: 2025-08-24 09:23:13.381275
clinical_history:
  Clinical indication: Preoperative assessment

  History: Patient presents with recurrent symptoms requiring imaging evaluation

structured_data:
  {"modality": "CT", "body_part": "HEAD", "indication": "Preoperative assessment", "quality": "EXCELLENT"}


report_id: 25f0643e56fc4b98952f520bac4f9583
technique: US OBSTETRIC performed according to standard protocol
findings:
  FINDINGS:
  The obstetric US demonstrates no acute abnormalities. Mild degenerative changes present.

impression: Mild degenerative changes
recommendations: Follow-up in 6 months
status: FINAL
critical_communicated_datetime: 2025-08-14 18:13:00
dictated_datetime: 2025-08-14 15:22:00
transcribed_datetime: 2025-08-14 17:10:00
verified_datetime: 2025-08-14 17:34:00
finalized_datetime: 2025-08-14 18:03:00
created_at: 2025-08-24 09:23:13.383029
updated_at: 2025-08-24 09:23:13.383031
clinical_history:
  Clinical indication: Shortness of breath

  History: Patient presents with acute symptoms requiring imaging evaluation

structured_data:
  {"modality": "US", "body_part": "OBSTETRIC", "indication": "Shortness of breath", "quality": "GOOD"}


report_id: 74e1e10ac4ae4eb48274b653ebcffcee
technique: CT CHEST performed according to standard protocol
impression: Mild degenerative changes
recommendations: Additional imaging if clinically indicated
status: FINAL
critical_communicated_datetime: 2025-08-12 18:34:00
dictated_datetime: 2025-08-12 16:07:00
transcribed_datetime: 2025-08-12 16:46:00
verified_datetime: 2025-08-12 17:50:00
finalized_datetime: 2025-08-12 18:24:00
created_at: 2025-08-24 09:23:13.383399
updated_at: 2025-08-24 09:23:13.383401
clinical_history:
  Clinical indication: Chest pain evaluation

  History: Patient presents with acute symptoms requiring imaging evaluation

findings:
  FINDINGS:
  The chest CT demonstrates no acute abnormalities. Normal anatomical structures are visualized.

structured_data:
  {"modality": "CT", "body_part": "CHEST", "indication": "Chest pain evaluation", "quality": "EXCELLENT"}


report_id: 347cc2c3e4d2447a8ecb5a58dca8e2c0
technique: CR ABDOMEN performed according to standard protocol
impression: Normal study
recommendations: Follow-up in 6 months
status: FINAL
critical_communicated_to: Rania Al-Subai
dictated_datetime: 2025-08-15 08:25:00
transcribed_datetime: 2025-08-15 10:12:00
verified_datetime: 2025-08-15 11:19:00
finalized_datetime: 2025-08-15 11:35:00
addendum: Addendum: Additional review confirms initial findings.
addendum_datetime: 2025-08-15 17:35:00
created_at: 2025-08-24 09:23:13.384141
updated_at: 2025-08-24 09:23:13.384143
clinical_history:
[cell repeats an earlier one in this file: 120 characters]

findings:
[cell repeats an earlier one in this file: 106 characters]

structured_data:
  {"modality": "CR", "body_part": "ABDOMEN", "indication": "Preoperative assessment", "quality": "EXCELLENT"}


report_id: 757a26b252ca4ae6b6759fdbf2ad55f3
technique: CR CHEST performed according to standard protocol
impression: No acute abnormalities
recommendations: Clinical correlation recommended
status: FINAL
critical_communicated_to: Maryam Al-Ghamdi
dictated_datetime: 2025-08-16 20:11:00
transcribed_datetime: 2025-08-16 21:57:00
verified_datetime: 2025-08-16 22:33:00
finalized_datetime: 2025-08-16 22:59:00
addendum_datetime: 2025-08-17 00:59:00
created_at: 2025-08-24 09:23:13.384498
updated_at: 2025-08-24 09:23:13.384500
clinical_history:
  Clinical indication: Preoperative assessment

  History: Patient presents with chronic symptoms requiring imaging evaluation

findings:
  FINDINGS:
  The chest CR demonstrates no acute abnormalities. Normal anatomical structures are visualized.

structured_data:
  {"modality": "CR", "body_part": "CHEST", "indication": "Preoperative assessment", "quality": "EXCELLENT"}


report_id: 65b8447d104641ac8151541cef9d80da
technique: CR EXTREMITY performed according to standard protocol
findings:
  FINDINGS:
  The extremity CR demonstrates no acute abnormalities. Mild degenerative changes present.

impression: Normal study
recommendations: Follow-up in 6 months
status: FINAL
critical_communicated_to: Maryam Al-Ghamdi
dictated_datetime: 2025-08-16 23:10:00
transcribed_datetime: 2025-08-17 00:03:00
verified_datetime: 2025-08-17 00:24:00
finalized_datetime: 2025-08-17 00:48:00
addendum_datetime: 2025-08-17 11:48:00
created_at: 2025-08-24 09:23:13.386337
updated_at: 2025-08-24 09:23:13.386339
clinical_history:
[cell repeats an earlier one in this file: 122 characters]

structured_data:
  {"modality": "CR", "body_part": "EXTREMITY", "indication": "Preoperative assessment", "quality": "EXCELLENT"}


report_id: 819f1c7b4a8f46b89655cbacc3568f2c
technique: CR SPINE performed according to standard protocol
impression: No acute abnormalities
recommendations: Follow-up in 6 months
status: FINAL
critical_communicated_datetime: 2025-08-14 20:18:00
dictated_datetime: 2025-08-14 17:08:00
transcribed_datetime: 2025-08-14 19:28:00
verified_datetime: 2025-08-14 19:48:00
finalized_datetime: 2025-08-14 20:08:00
structured_data: {"modality": "CR", "body_part": "SPINE", "indication": "Chest pain evaluation", "quality": "FAIR"}
addendum_datetime: 2025-08-15 18:08:00
created_at: 2025-08-24 09:23:13.386716
updated_at: 2025-08-24 09:23:13.386718
clinical_history:
  Clinical indication: Chest pain evaluation

  History: Patient presents with chronic symptoms requiring imaging evaluation

findings:
  FINDINGS:
  The spine CR demonstrates no acute abnormalities. Normal anatomical structures are visualized.


report_id: 62774d6efdd74704a66890c6091da1d6
technique: US OBSTETRIC performed according to standard protocol
findings:
  FINDINGS:
  The obstetric US demonstrates no acute abnormalities. No focal lesions identified.

impression: Clinical correlation suggested
recommendations: Additional imaging if clinically indicated
status: FINAL
critical_communicated_to: Hala Al-Harbi
dictated_datetime: 2025-08-17 02:42:00
transcribed_datetime: 2025-08-17 04:01:00
verified_datetime: 2025-08-17 04:49:00
finalized_datetime: 2025-08-17 05:06:00
created_at: 2025-08-24 09:23:13.387445
updated_at: 2025-08-24 09:23:13.387448
clinical_history:
  Clinical indication: Chest pain evaluation

  History: Patient presents with acute symptoms requiring imaging evaluation

structured_data:
  {"modality": "US", "body_part": "OBSTETRIC", "indication": "Chest pain evaluation", "quality": "EXCELLENT"}


report_id: 2fe6935b984546288fe316167dfe9815
technique: CR EXTREMITY performed according to standard protocol
findings:
  FINDINGS:
  The extremity CR demonstrates no acute abnormalities. Age-appropriate changes noted.

impression: Clinical correlation suggested
recommendations: Clinical correlation recommended
status: FINAL
critical_communicated_to: Hala Al-Harbi
critical_communicated_datetime: 2025-08-16 01:12:00
dictated_datetime: 2025-08-15 21:36:00
transcribed_datetime: 2025-08-15 22:54:00
verified_datetime: 2025-08-16 00:07:00
finalized_datetime: 2025-08-16 01:02:00
created_at: 2025-08-24 09:23:13.387798
updated_at: 2025-08-24 09:23:13.387800
clinical_history:
  Clinical indication: Chest pain evaluation

  History: Patient presents with acute symptoms requiring imaging evaluation

structured_data:
  {"modality": "CR", "body_part": "EXTREMITY", "indication": "Chest pain evaluation", "quality": "EXCELLENT"}


report_id: 7f61696bb1944c5d839756f7ec781749
technique: CT VASCULAR performed according to standard protocol
findings:
  FINDINGS:
  The vascular CT demonstrates no acute abnormalities. Age-appropriate changes noted.

impression: Normal study
recommendations: Clinical correlation recommended
status: FINAL
critical_communicated_to: Rana Al-Anzi
dictated_datetime: 2025-08-15 18:53:00
transcribed_datetime: 2025-08-15 19:58:00
verified_datetime: 2025-08-15 21:46:00
finalized_datetime: 2025-08-15 22:35:00
created_at: 2025-08-24 09:23:13.388933
updated_at: 2025-08-24 09:23:13.388935
clinical_history:
  Clinical indication: Chest pain evaluation

  History: Patient presents with recurrent symptoms requiring imaging evaluation

structured_data:
  {"modality": "CT", "body_part": "VASCULAR", "indication": "Chest pain evaluation", "quality": "EXCELLENT"}


report_id: 2885c76a04ef40ebbd9d9acd0a3325de
technique: MR HEAD performed according to standard protocol
findings:
  FINDINGS:
  The head MR demonstrates no acute abnormalities. No focal lesions identified.

impression: Mild degenerative changes
recommendations: No follow-up needed
status: FINAL
critical_communicated_to: Rania Al-Subai
critical_communicated_datetime: 2025-08-16 09:30:00
dictated_datetime: 2025-08-16 05:34:00
transcribed_datetime: 2025-08-16 07:20:00
verified_datetime: 2025-08-16 08:20:00
finalized_datetime: 2025-08-16 09:20:00
structured_data: {"modality": "MR", "body_part": "HEAD", "indication": "Abdominal pain", "quality": "EXCELLENT"}
addendum_datetime: 2025-08-16 13:20:00
created_at: 2025-08-24 09:23:13.390356
updated_at: 2025-08-24 09:23:13.390359
clinical_history:
  Clinical indication: Abdominal pain

  History: Patient presents with acute symptoms requiring imaging evaluation


report_id: 78eb2de075f746eca4c68733b3c059bd
technique: CT VASCULAR performed according to standard protocol
findings:
  FINDINGS:
  The vascular CT demonstrates no acute abnormalities. No focal lesions identified.

impression: No acute abnormalities
recommendations: No follow-up needed
status: FINAL
critical_communicated_datetime: 2025-08-18 10:39:00
dictated_datetime: 2025-08-18 07:07:00
transcribed_datetime: 2025-08-18 08:45:00
verified_datetime: 2025-08-18 10:23:00
finalized_datetime: 2025-08-18 10:29:00
addendum_datetime: 2025-08-18 17:29:00
created_at: 2025-08-24 09:23:13.394338
updated_at: 2025-08-24 09:23:13.394340
clinical_history:
  Clinical indication: Headache workup

  History: Patient presents with acute symptoms requiring imaging evaluation

structured_data:
  {"modality": "CT", "body_part": "VASCULAR", "indication": "Headache workup", "quality": "EXCELLENT"}


report_id: 4d2e47cedeb140ec8b39ec54b199da97
technique: US OBSTETRIC performed according to standard protocol
findings:
  FINDINGS:
  The obstetric US demonstrates no acute abnormalities. No focal lesions identified.

impression: Clinical correlation suggested
recommendations: No follow-up needed
status: FINAL
dictated_datetime: 2025-08-18 06:58:00
transcribed_datetime: 2025-08-18 09:53:00
verified_datetime: 2025-08-18 11:13:00
finalized_datetime: 2025-08-18 12:06:00
created_at: 2025-08-24 09:23:13.395052
updated_at: 2025-08-24 09:23:13.395054
clinical_history:
  Clinical indication: Headache workup

  History: Patient presents with acute symptoms requiring imaging evaluation

structured_data:
  {"modality": "US", "body_part": "OBSTETRIC", "indication": "Headache workup", "quality": "EXCELLENT"}


report_id: 368187ca541a4c5b9eb908e65126f1bf
technique: NM THYROID performed according to standard protocol
findings:
  FINDINGS:
  The thyroid NM demonstrates no acute abnormalities. Age-appropriate changes noted.

impression: Clinical correlation suggested
recommendations: Clinical correlation recommended
status: FINAL
critical_communicated_to: Rana Al-Anzi
dictated_datetime: 2025-08-22 00:00:00
transcribed_datetime: 2025-08-22 01:50:00
verified_datetime: 2025-08-22 03:28:00
finalized_datetime: 2025-08-22 03:50:00
addendum_datetime: 2025-08-22 04:50:00
created_at: 2025-08-24 09:23:13.398311
updated_at: 2025-08-24 09:23:13.398313
clinical_history:
[cell repeats an earlier one in this file: 122 characters]

structured_data:
  {"modality": "NM", "body_part": "THYROID", "indication": "Chest pain evaluation", "quality": "EXCELLENT"}


report_id: c3eab87d4ff644deb09a25aa7cec3b79
technique: CT VASCULAR performed according to standard protocol
findings:
  FINDINGS:
  The vascular CT demonstrates no acute abnormalities. Age-appropriate changes noted.

impression: Normal study
recommendations: Follow-up in 6 months
status: FINAL
critical_communicated_datetime: 2025-08-21 17:01:00
dictated_datetime: 2025-08-21 11:56:00
transcribed_datetime: 2025-08-21 14:20:00
verified_datetime: 2025-08-21 16:19:00
finalized_datetime: 2025-08-21 16:51:00
addendum_datetime: 2025-08-22 06:51:00
created_at: 2025-08-24 09:23:13.398662
updated_at: 2025-08-24 09:23:13.398664
clinical_history:
[cell repeats an earlier one in this file: 124 characters]

structured_data:
  {"modality": "CT", "body_part": "VASCULAR", "indication": "Preoperative assessment", "quality": "FAIR"}


report_id: 50d013e23b7540e09a163e2ea6341b46
technique: MR EXTREMITY performed according to standard protocol
findings:
  FINDINGS:
  The extremity MR demonstrates no acute abnormalities. No focal lesions identified.

impression: Normal study
recommendations: No follow-up needed
status: FINAL
critical_communicated_to: Salman Al-Sudairy
dictated_datetime: 2025-08-21 06:51:00
transcribed_datetime: 2025-08-21 08:49:00
verified_datetime: 2025-08-21 09:10:00
finalized_datetime: 2025-08-21 09:39:00
addendum: Addendum: Additional review confirms initial findings.
created_at: 2025-08-24 09:23:13.400447
updated_at: 2025-08-24 09:23:13.400449
clinical_history:
[cell repeats an earlier one in this file: 124 characters]

structured_data:
  {"modality": "MR", "body_part": "EXTREMITY", "indication": "Preoperative assessment", "quality": "GOOD"}


report_id: d6c4cb24048f48b4a530d09f27ee21a5
technique: MR SPINE performed according to standard protocol
findings:
  FINDINGS:
  The spine MR demonstrates no acute abnormalities. No focal lesions identified.

impression: Clinical correlation suggested
recommendations: No follow-up needed
status: FINAL
dictated_datetime: 2025-08-25 23:46:00
transcribed_datetime: 2025-08-26 01:01:00
verified_datetime: 2025-08-26 02:51:00
finalized_datetime: 2025-08-26 03:40:00
created_at: 2025-08-24 09:23:13.403897
updated_at: 2025-08-24 09:23:13.403899
clinical_history:
[cell repeats an earlier one in this file: 124 characters]

structured_data:
  {"modality": "MR", "body_part": "SPINE", "indication": "Preoperative assessment", "quality": "GOOD"}


report_id: 457499761fad4d56be8e4535288ba141
technique: CT VASCULAR performed according to standard protocol
impression: Follow-up recommended
recommendations: Clinical correlation recommended
status: FINAL
critical_communicated_to: Hala Al-Harbi
dictated_datetime: 2025-08-23 08:53:00
transcribed_datetime: 2025-08-23 10:17:00
verified_datetime: 2025-08-23 10:56:00
finalized_datetime: 2025-08-23 11:38:00
structured_data: {"modality": "CT", "body_part": "VASCULAR", "indication": "Abdominal pain", "quality": "EXCELLENT"}
addendum_datetime: 2025-08-23 23:38:00
created_at: 2025-08-24 09:23:13.404593
updated_at: 2025-08-24 09:23:13.404596
clinical_history:
[cell repeats an earlier one in this file: 113 characters]

findings:
  FINDINGS:
  The vascular CT demonstrates no acute abnormalities. Normal anatomical structures are visualized.


report_id: 95006aedfcfc4d15adc4b49ad1254a7a
technique: NM BONE performed according to standard protocol
findings:
  FINDINGS:
  The bone NM demonstrates no acute abnormalities. Age-appropriate changes noted.

impression: Follow-up recommended
recommendations: No follow-up needed
status: FINAL
critical_communicated_to: Rania Al-Subai
dictated_datetime: 2025-08-25 23:10:00
transcribed_datetime: 2025-08-26 01:18:00
verified_datetime: 2025-08-26 03:03:00
finalized_datetime: 2025-08-26 03:48:00
created_at: 2025-08-24 09:23:13.405312
updated_at: 2025-08-24 09:23:13.405315
clinical_history:
[cell repeats an earlier one in this file: 122 characters]

structured_data:
  {"modality": "NM", "body_part": "BONE", "indication": "Chest pain evaluation", "quality": "EXCELLENT"}


report_id: 3f58deb2e877406d872a4308de24684c
technique: US ABDOMEN performed according to standard protocol
impression: Clinical correlation suggested
recommendations: No follow-up needed
status: FINAL
critical_communicated_to: Hala Al-Harbi
dictated_datetime: 2025-08-23 12:28:00
transcribed_datetime: 2025-08-23 13:17:00
verified_datetime: 2025-08-23 14:12:00
finalized_datetime: 2025-08-23 14:40:00
addendum_datetime: 2025-08-24 01:40:00
created_at: 2025-08-24 09:23:13.406400
updated_at: 2025-08-24 09:23:13.406402
clinical_history:
[cell repeats an earlier one in this file: 118 characters]

findings:
  FINDINGS:
  The abdomen US demonstrates no acute abnormalities. Normal anatomical structures are visualized.

structured_data:
  {"modality": "US", "body_part": "ABDOMEN", "indication": "Follow-up imaging", "quality": "EXCELLENT"}


report_id: ba7c5c9d80654b248a989db67dc5c70e
technique: US PELVIS performed according to standard protocol
findings:
  FINDINGS:
  The pelvis US demonstrates no acute abnormalities. No focal lesions identified.

impression: Mild degenerative changes
recommendations: No follow-up needed
status: FINAL
critical_communicated_to: Salman Al-Rajhi
dictated_datetime: 2025-08-25 17:52:00
transcribed_datetime: 2025-08-25 19:46:00
verified_datetime: 2025-08-25 20:01:00
finalized_datetime: 2025-08-25 20:54:00
created_at: 2025-08-24 09:23:13.407463
updated_at: 2025-08-24 09:23:13.407466
clinical_history:
[cell repeats an earlier one in this file: 122 characters]

structured_data:
  {"modality": "US", "body_part": "PELVIS", "indication": "Preoperative assessment", "quality": "EXCELLENT"}


# patients_insurance_claim

claim_number: CLM2025438172
claim_type: DIAGNOSTIC
status: PAID
priority: NORMAL
service_date: 2025-07-07
service_provider: د. يوسف علي البقمي
service_provider_license: SML74487
facility_name: مستشفى دلة
facility_license: MOH452372
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
secondary_diagnosis_codes: []
submitted_date: 2025-07-16 21:00:00
payment_date: 2025-08-11 21:00:00
saudi_id_number: 2094459649
insurance_card_number: IC124550405
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.463463
updated_at: 2025-09-03 14:42:14.463467
procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 7922.3071224730065}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "LAB_RESULT", "name": "\u0646\u062a\u0627\u0626\u062c \u0627\u0644\u0645\u062e\u062a\u0628\u0631.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025733577
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-05-21
service_provider: د. أحمد محمد العبدالله
service_provider_license: SML18426
facility_name: مستشفى الملك خالد الجامعي
facility_license: MOH495621
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-04-04 21:00:00
payment_date: 2025-05-02 21:00:00
saudi_id_number: 2717907868
insurance_card_number: IC433508331
authorization_number: AUTH164753
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.464754
updated_at: 2025-09-03 14:42:14.464757
secondary_diagnosis_codes:
  [{"code": "N18.6", "description": "End stage renal disease", "description_ar": "\u0627\u0644\u0645\u0631\u062d\u0644\u0629 \u0627\u0644\u0623\u062e\u064a\u0631\u0629 \u0645\u0646 \u0645\u0631\u0636 \u0627\u0644\u0643\u0644\u0649"}]

procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 359.31906960855156}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025693594
claim_type: OUTPATIENT
status: PAID
priority: LOW
service_date: 2025-04-05
service_provider: د. يوسف علي البقمي
service_provider_license: SML26297
facility_name: مستشفى الملك سعود
facility_license: MOH771781
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-06-24 21:00:00
payment_date: 2025-07-11 21:00:00
saudi_id_number: 2258364877
insurance_card_number: IC518617913
authorization_number: AUTH733796
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.465159
updated_at: 2025-09-03 14:42:14.465161
procedure_codes:
  [{"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1205.5974575223254}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025977800
claim_type: PHARMACY
status: PAID
priority: NORMAL
service_date: 2025-04-11
service_provider: د. محمد عبدالرحمن القحطاني
service_provider_license: SML75481
facility_name: مستشفى بقشان
facility_license: MOH992249
primary_diagnosis_code: N18.6
primary_diagnosis_description: End stage renal disease / المرحلة الأخيرة من مرض الكلى
secondary_diagnosis_codes: []
submitted_date: 2025-04-03 21:00:00
payment_date: 2025-04-29 21:00:00
saudi_id_number: 1648419841
insurance_card_number: IC543676519
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.465546
updated_at: 2025-09-03 14:42:14.465548
procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 3468.992973135906}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025709397
claim_type: PHARMACY
status: PAID
priority: HIGH
service_date: 2025-04-06
service_provider: د. ليلى محمد الجبير
service_provider_license: SML24171
facility_name: مستشفى الأمير محمد بن عبدالعزيز
facility_license: MOH390592
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-06-09 21:00:00
payment_date: 2025-07-09 21:00:00
saudi_id_number: 2089684705
insurance_card_number: IC137797269
authorization_number: AUTH814353
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.465939
updated_at: 2025-09-03 14:42:14.465941
secondary_diagnosis_codes:
  [{"code": "E11.9", "description": "Type 2 diabetes mellitus without complications", "description_ar": "\u062f\u0627\u0621 \u0627\u0644\u0633\u0643\u0631\u064a \u0645\u0646 \u0627\u0644\u0646\u0648\u0639 \u0627\u0644\u062b\u0627\u0646\u064a \u0628\u062f\u0648\u0646 \u0645\u0636\u0627\u0639\u0641\u0627\u062a"}]

procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 81.26718306052877}, {"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 216.63469737375652}, {"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 235.7498197218667}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025745521
claim_type: MEDICAL
status: PAID
priority: HIGH
service_date: 2025-08-02
service_provider: د. دانا محمد الفهد
service_provider_license: SML65433
facility_name: مستشفى الملك سعود
facility_license: MOH556506
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
secondary_diagnosis_codes: []
submitted_date: 2025-05-03 21:00:00
payment_date: 2025-05-30 21:00:00
saudi_id_number: 2559520886
insurance_card_number: IC639487793
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.466377
updated_at: 2025-09-03 14:42:14.466379
procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 130.8399894597599}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}]


claim_number: CLM2025151985
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-03-09
service_provider: د. سعد محمد العتيبي
service_provider_license: SML62202
facility_name: مستشفى الملك فيصل التخصصي ومركز الأبحاث
facility_license: MOH575456
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-03-17 21:00:00
payment_date: 2025-04-16 21:00:00
saudi_id_number: 1598884299
insurance_card_number: IC881225134
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.466780
updated_at: 2025-09-03 14:42:14.466782
secondary_diagnosis_codes:
  [{"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "E11.9", "description": "Type 2 diabetes mellitus without complications", "description_ar": "\u062f\u0627\u0621 \u0627\u0644\u0633\u0643\u0631\u064a \u0645\u0646 \u0627\u0644\u0646\u0648\u0639 \u0627\u0644\u062b\u0627\u0646\u064a \u0628\u062f\u0648\u0646 \u0645\u0636\u0627\u0639\u0641\u0627\u062a"}]

procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 3987.305202761589}, {"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 5131.634906032653}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025369151
claim_type: MEDICAL
status: PAID
priority: HIGH
service_date: 2025-04-22
service_provider: د. طارق حسام الدين الأنصاري
service_provider_license: SML95795
facility_name: مستشفى الملك خالد الجامعي
facility_license: MOH844501
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
submitted_date: 2025-09-11 21:00:00
payment_date: 2025-10-05 21:00:00
saudi_id_number: 2536826477
insurance_card_number: IC306339620
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.467184
updated_at: 2025-09-03 14:42:14.467186
secondary_diagnosis_codes:
  [{"code": "E11.9", "description": "Type 2 diabetes mellitus without complications", "description_ar": "\u062f\u0627\u0621 \u0627\u0644\u0633\u0643\u0631\u064a \u0645\u0646 \u0627\u0644\u0646\u0648\u0639 \u0627\u0644\u062b\u0627\u0646\u064a \u0628\u062f\u0648\u0646 \u0645\u0636\u0627\u0639\u0641\u0627\u062a"}]

procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 4549.972444470965}, {"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 82.48045533056398}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}]


claim_number: CLM2025295853
claim_type: OUTPATIENT
status: PAID
priority: LOW
service_date: 2025-05-03
service_provider: د. رنا سعود الأحمد
service_provider_license: SML86480
facility_name: مستشفى سعد التخصصي
facility_license: MOH227959
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-04-26 21:00:00
payment_date: 2025-05-21 21:00:00
saudi_id_number: 2086288211
insurance_card_number: IC667967858
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.467569
updated_at: 2025-09-03 14:42:14.467572
secondary_diagnosis_codes:
  [{"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}]

procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 95.24912465574172}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025497942
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-08-26
service_provider: د. خالد يوسف الشهري
service_provider_license: SML45891
facility_name: مستشفى الأمير محمد بن عبدالعزيز
facility_license: MOH114208
primary_diagnosis_code: M25.50
primary_diagnosis_description: Pain in unspecified joint / ألم في المفصل غير المحدد
secondary_diagnosis_codes: []
submitted_date: 2025-06-26 21:00:00
payment_date: 2025-07-03 21:00:00
saudi_id_number: 2716602901
insurance_card_number: IC150127149
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.467976
updated_at: 2025-09-03 14:42:14.467978
procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 283.2277582081863}, {"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 86.24098434712805}, {"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 84.49465936102035}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025608523
claim_type: DIAGNOSTIC
status: PAID
priority: LOW
service_date: 2025-04-05
service_provider: د. رنا سعود الأحمد
service_provider_license: SML85395
facility_name: مستشفى الموسى التخصصي
facility_license: MOH407835
primary_diagnosis_code: M25.50
primary_diagnosis_description: Pain in unspecified joint / ألم في المفصل غير المحدد
secondary_diagnosis_codes: []
submitted_date: 2025-04-16 21:00:00
payment_date: 2025-05-03 21:00:00
saudi_id_number: 1601321120
insurance_card_number: IC296898043
authorization_number: AUTH389442
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.468353
updated_at: 2025-09-03 14:42:14.468355
procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 345.2609865079364}, {"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 135.0724484635905}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "LAB_RESULT", "name": "\u0646\u062a\u0627\u0626\u062c \u0627\u0644\u0645\u062e\u062a\u0628\u0631.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025764347
claim_type: OUTPATIENT
status: PAID
priority: HIGH
service_date: 2025-07-27
service_provider: د. يوسف علي البقمي
service_provider_license: SML34242
facility_name: مستشفى الأهلي
facility_license: MOH748408
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-06-05 21:00:00
payment_date: 2025-06-21 21:00:00
saudi_id_number: 1720267477
insurance_card_number: IC593233462
authorization_number: AUTH192641
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.468762
updated_at: 2025-09-03 14:42:14.468765
secondary_diagnosis_codes:
  [{"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}, {"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}]

procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 5266.881828728129}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}]


claim_number: CLM2025696862
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-07-26
service_provider: د. ماجد فواز العسيري
service_provider_license: SML14781
facility_name: مستشفى سعد التخصصي
facility_license: MOH110164
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-07-07 21:00:00
payment_date: 2025-07-26 21:00:00
saudi_id_number: 1041732351
insurance_card_number: IC153695367
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.469159
updated_at: 2025-09-03 14:42:14.469162
secondary_diagnosis_codes:
  [{"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}, {"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}, {"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}]

procedure_codes:
  [{"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1336.210274953109}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025797676
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-05-14
service_provider: د. نورا سعد الغامدي
service_provider_license: SML87728
facility_name: مستشفى المملكة
facility_license: MOH314341
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-04-25 21:00:00
payment_date: 2025-05-16 21:00:00
saudi_id_number: 2967247498
insurance_card_number: IC569324878
authorization_number: AUTH941598
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.469554
updated_at: 2025-09-03 14:42:14.469556
secondary_diagnosis_codes:
  [{"code": "E78.5", "description": "Hyperlipidemia", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0627\u0644\u062f\u0647\u0648\u0646 \u0641\u064a \u0627\u0644\u062f\u0645"}]

procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 269.7378074326182}, {"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 278.4093327748954}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025486820
claim_type: PHARMACY
status: PAID
priority: NORMAL
service_date: 2025-05-02
service_provider: د. خالد يوسف الشهري
service_provider_license: SML88543
facility_name: مستشفى الأمير سلطان العسكري
facility_license: MOH420304
primary_diagnosis_code: Z51.11
primary_diagnosis_description: Encounter for antineoplastic chemotherapy / مواجهة للعلاج الكيميائي المضاد للأورام
secondary_diagnosis_codes: []
submitted_date: 2025-05-30 21:00:00
payment_date: 2025-06-26 21:00:00
saudi_id_number: 2092856959
insurance_card_number: IC974007346
authorization_number: AUTH712200
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.469952
updated_at: 2025-09-03 14:42:14.469954
procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 327.90324341243326}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}]


claim_number: CLM2025952384
claim_type: DIAGNOSTIC
status: PAID
priority: NORMAL
service_date: 2025-06-28
service_provider: د. يوسف علي البقمي
service_provider_license: SML28215
facility_name: مستشفى الملك خالد الجامعي
facility_license: MOH493221
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-06-29 21:00:00
payment_date: 2025-07-13 21:00:00
saudi_id_number: 1549780441
insurance_card_number: IC287939063
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.470349
updated_at: 2025-09-03 14:42:14.470351
procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 102.80956955839352}, {"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 174.03190463454098}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "LAB_RESULT", "name": "\u0646\u062a\u0627\u0626\u062c \u0627\u0644\u0645\u062e\u062a\u0628\u0631.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025962497
claim_type: OUTPATIENT
status: PAID
priority: EMERGENCY
service_date: 2025-07-31
service_provider: د. عمر فهد الخالدي
service_provider_license: SML78632
facility_name: مستشفى الملك فهد للحرس الوطني
facility_license: MOH203951
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-06-15 21:00:00
payment_date: 2025-07-21 21:00:00
saudi_id_number: 2050598133
insurance_card_number: IC243250050
authorization_number: AUTH187298
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.470770
updated_at: 2025-09-03 14:42:14.470772
secondary_diagnosis_codes:
  [{"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}, {"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}]

procedure_codes:
  [{"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1128.6646040059336}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025283600
claim_type: PHARMACY
status: PAID
priority: HIGH
service_date: 2025-08-27
service_provider: د. سعد محمد العتيبي
service_provider_license: SML92197
facility_name: مستشفى الأمير سلطان العسكري
facility_license: MOH479988
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
submitted_date: 2025-07-11 21:00:00
payment_date: 2025-08-14 21:00:00
saudi_id_number: 1071671200
insurance_card_number: IC547591009
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.471213
updated_at: 2025-09-03 14:42:14.471216
secondary_diagnosis_codes:
  [{"code": "E78.5", "description": "Hyperlipidemia", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0627\u0644\u062f\u0647\u0648\u0646 \u0641\u064a \u0627\u0644\u062f\u0645"}]

procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 151.49227360533436}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 5581.526518534042}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}]


claim_number: CLM2025625038
claim_type: DIAGNOSTIC
status: PAID
priority: NORMAL
service_date: 2025-06-14
service_provider: د. عائشة حسن الحربي
service_provider_license: SML21285
facility_name: مستشفى الملك خالد الجامعي
facility_license: MOH403538
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
secondary_diagnosis_codes: []
submitted_date: 2025-06-20 21:00:00
payment_date: 2025-07-18 21:00:00
saudi_id_number: 2568285138
insurance_card_number: IC739332488
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.471649
updated_at: 2025-09-03 14:42:14.471652
procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 7059.401764299987}, {"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 120.53380368491185}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 6466.882180480558}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "LAB_RESULT", "name": "\u0646\u062a\u0627\u0626\u062c \u0627\u0644\u0645\u062e\u062a\u0628\u0631.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025942668
claim_type: PHARMACY
status: DENIED
priority: NORMAL
service_date: 2025-07-06
service_provider: د. فاطمة علي الزهراني
service_provider_license: SML56357
facility_name: مستشفى الدكتور سليمان الحبيب
facility_license: MOH328581
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-04-12 21:00:00
processed_date: 2025-04-22 21:00:00
saudi_id_number: 2471528507
insurance_card_number: IC245703120
denial_reason: خدمة مستثناة
denial_code: D001
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.472221
updated_at: 2025-09-03 14:42:14.472225
secondary_diagnosis_codes:
  [{"code": "N18.6", "description": "End stage renal disease", "description_ar": "\u0627\u0644\u0645\u0631\u062d\u0644\u0629 \u0627\u0644\u0623\u062e\u064a\u0631\u0629 \u0645\u0646 \u0645\u0631\u0636 \u0627\u0644\u0643\u0644\u0649"}]

procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 116.82203559421016}, {"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 127.3038059227082}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025533279
claim_type: PHARMACY
status: DENIED
priority: NORMAL
service_date: 2025-06-11
service_provider: د. فيصل عبدالله السديري
service_provider_license: SML10379
facility_name: مستشفى الملك خالد الجامعي
facility_license: MOH295863
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-08-22 21:00:00
processed_date: 2025-09-04 21:00:00
saudi_id_number: 2521973759
insurance_card_number: IC866845540
denial_reason: مطلوب تصريح مسبق
denial_code: D008
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.472691
updated_at: 2025-09-03 14:42:14.472694
secondary_diagnosis_codes:
  [{"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}, {"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}]

procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 114.36999797598108}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025918809
claim_type: OUTPATIENT
status: PAID
priority: HIGH
service_date: 2025-08-04
service_provider: د. ليلى محمد الجبير
service_provider_license: SML45962
facility_name: مستشفى الموسى التخصصي
facility_license: MOH504457
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-07-20 21:00:00
payment_date: 2025-08-15 21:00:00
saudi_id_number: 1539604238
insurance_card_number: IC233521610
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.473220
updated_at: 2025-09-03 14:42:14.473223
procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 58.37739159217104}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025719635
claim_type: OUTPATIENT
status: PAID
priority: LOW
service_date: 2025-07-04
service_provider: د. طارق حسام الدين الأنصاري
service_provider_license: SML82105
facility_name: مستشفى الملك فيصل التخصصي ومركز الأبحاث
facility_license: MOH891049
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-06-30 21:00:00
payment_date: 2025-07-15 21:00:00
saudi_id_number: 2311318631
insurance_card_number: IC457665587
authorization_number: AUTH948838
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.473635
updated_at: 2025-09-03 14:42:14.473638
secondary_diagnosis_codes:
  [{"code": "J45.9", "description": "Asthma, unspecified", "description_ar": "\u0627\u0644\u0631\u0628\u0648 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "N18.6", "description": "End stage renal disease", "description_ar": "\u0627\u0644\u0645\u0631\u062d\u0644\u0629 \u0627\u0644\u0623\u062e\u064a\u0631\u0629 \u0645\u0646 \u0645\u0631\u0636 \u0627\u0644\u0643\u0644\u0649"}]

procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 7669.605892121608}, {"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 94.281074871418}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025734140
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-08-19
service_provider: د. أحمد محمد العبدالله
service_provider_license: SML20635
facility_name: المستشفى السعودي الألماني
facility_license: MOH557197
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
submitted_date: 2025-05-11 21:00:00
payment_date: 2025-06-21 21:00:00
saudi_id_number: 2186566952
insurance_card_number: IC679601888
authorization_number: AUTH990440
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.474030
updated_at: 2025-09-03 14:42:14.474032
secondary_diagnosis_codes:
  [{"code": "F32.9", "description": "Major depressive disorder", "description_ar": "\u0627\u0636\u0637\u0631\u0627\u0628 \u0627\u0644\u0627\u0643\u062a\u0626\u0627\u0628 \u0627\u0644\u0634\u062f\u064a\u062f"}]

procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 275.3554034676999}, {"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 333.66178180329416}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 5742.503580281174}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025760549
claim_type: OUTPATIENT
status: PAID
priority: LOW
service_date: 2025-06-09
service_provider: د. هند عبدالعزيز الراشد
service_provider_license: SML43607
facility_name: مستشفى الملك فهد للحرس الوطني
facility_license: MOH887404
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
submitted_date: 2025-08-06 21:00:00
payment_date: 2025-08-21 21:00:00
saudi_id_number: 2753701949
insurance_card_number: IC292744255
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.474420
updated_at: 2025-09-03 14:42:14.474422
secondary_diagnosis_codes:
  [{"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}, {"code": "E78.5", "description": "Hyperlipidemia", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0627\u0644\u062f\u0647\u0648\u0646 \u0641\u064a \u0627\u0644\u062f\u0645"}, {"code": "J45.9", "description": "Asthma, unspecified", "description_ar": "\u0627\u0644\u0631\u0628\u0648 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}]

procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 79.03273637542954}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025191662
claim_type: PHARMACY
status: PAID
priority: HIGH
service_date: 2025-05-09
service_provider: د. مريم أحمد الدوسري
service_provider_license: SML36324
facility_name: مستشفى سعد التخصصي
facility_license: MOH415548
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
secondary_diagnosis_codes: []
submitted_date: 2025-09-06 21:00:00
payment_date: 2025-10-07 21:00:00
saudi_id_number: 2253261104
insurance_card_number: IC789419499
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.474803
updated_at: 2025-09-03 14:42:14.474806
procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 379.3620734247055}, {"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 261.9276645741026}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025928166
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-05-20
service_provider: د. مريم أحمد الدوسري
service_provider_license: SML24139
facility_name: مستشفى الملك فهد الطبي
facility_license: MOH608055
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-07-12 21:00:00
payment_date: 2025-08-22 21:00:00
saudi_id_number: 1992134208
insurance_card_number: IC246729626
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.475187
updated_at: 2025-09-03 14:42:14.475189
secondary_diagnosis_codes:
  [{"code": "J45.9", "description": "Asthma, unspecified", "description_ar": "\u0627\u0644\u0631\u0628\u0648 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}]

procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 92.8378430858873}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 6081.968169930264}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025409978
claim_type: EMERGENCY
status: PAID
priority: LOW
service_date: 2025-08-28
service_provider: د. عائشة حسن الحربي
service_provider_license: SML31539
facility_name: المستشفى السعودي الألماني
facility_license: MOH404895
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
secondary_diagnosis_codes: []
submitted_date: 2025-04-21 21:00:00
payment_date: 2025-05-24 21:00:00
saudi_id_number: 1982508634
insurance_card_number: IC748841438
authorization_number: AUTH721223
notes: مطالبة تأمينية لـ emergency - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.475571
updated_at: 2025-09-03 14:42:14.475573
procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 147.67244715621214}, {"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 54.03195705104079}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "DISCHARGE_SUMMARY", "name": "\u0645\u0644\u062e\u0635 \u0627\u0644\u062e\u0631\u0648\u062c.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025903762
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-06-30
service_provider: د. دانا محمد الفهد
service_provider_license: SML19374
facility_name: المستشفى السعودي الألماني
facility_license: MOH578252
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
secondary_diagnosis_codes: []
submitted_date: 2025-08-16 21:00:00
payment_date: 2025-09-19 21:00:00
saudi_id_number: 2628974035
insurance_card_number: IC612399058
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.475972
updated_at: 2025-09-03 14:42:14.475974
procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 372.8711342218378}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025602485
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-06-16
service_provider: د. رنا سعود الأحمد
service_provider_license: SML16157
facility_name: مستشفى الولادة والأطفال
facility_license: MOH571087
primary_diagnosis_code: M25.50
primary_diagnosis_description: Pain in unspecified joint / ألم في المفصل غير المحدد
submitted_date: 2025-08-27 21:00:00
payment_date: 2025-09-15 21:00:00
saudi_id_number: 1460321930
insurance_card_number: IC483225020
authorization_number: AUTH801532
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.476377
updated_at: 2025-09-03 14:42:14.476379
secondary_diagnosis_codes:
  [{"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}, {"code": "N18.6", "description": "End stage renal disease", "description_ar": "\u0627\u0644\u0645\u0631\u062d\u0644\u0629 \u0627\u0644\u0623\u062e\u064a\u0631\u0629 \u0645\u0646 \u0645\u0631\u0636 \u0627\u0644\u0643\u0644\u0649"}]

procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 222.64871237884853}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025248568
claim_type: OUTPATIENT
status: DENIED
priority: NORMAL
service_date: 2025-05-23
service_provider: د. عائشة حسن الحربي
service_provider_license: SML43265
facility_name: مستشفى الحبيب
facility_license: MOH191696
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-05-26 21:00:00
processed_date: 2025-06-04 21:00:00
saudi_id_number: 1282198565
insurance_card_number: IC736915980
denial_reason: تجاوز الحد الأقصى السنوي
denial_code: D009
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.476756
updated_at: 2025-09-03 14:42:14.476758
secondary_diagnosis_codes:
  [{"code": "N18.6", "description": "End stage renal disease", "description_ar": "\u0627\u0644\u0645\u0631\u062d\u0644\u0629 \u0627\u0644\u0623\u062e\u064a\u0631\u0629 \u0645\u0646 \u0645\u0631\u0636 \u0627\u0644\u0643\u0644\u0649"}]

procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 132.78599406542185}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025394270
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-03-15
service_provider: د. ماجد فواز العسيري
service_provider_license: SML90283
facility_name: مستشفى الموسى التخصصي
facility_license: MOH238573
primary_diagnosis_code: M25.50
primary_diagnosis_description: Pain in unspecified joint / ألم في المفصل غير المحدد
submitted_date: 2025-08-11 21:00:00
payment_date: 2025-08-21 21:00:00
saudi_id_number: 1063751699
insurance_card_number: IC993875840
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.477103
updated_at: 2025-09-03 14:42:14.477106
secondary_diagnosis_codes:
  [{"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}, {"code": "J45.9", "description": "Asthma, unspecified", "description_ar": "\u0627\u0644\u0631\u0628\u0648 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}]

procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 6816.227841073569}, {"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 51.81075215937058}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025232531
claim_type: PHARMACY
status: PAID
priority: NORMAL
service_date: 2025-06-06
service_provider: د. محمد عبدالرحمن القحطاني
service_provider_license: SML36135
facility_name: مستشفى الأهلي
facility_license: MOH720042
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-05-18 21:00:00
payment_date: 2025-06-03 21:00:00
saudi_id_number: 1824893813
insurance_card_number: IC575313070
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.477524
updated_at: 2025-09-03 14:42:14.477526
secondary_diagnosis_codes:
  [{"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}]

procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 114.73262974801682}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025518497
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-05-05
service_provider: د. محمد عبدالرحمن القحطاني
service_provider_license: SML87646
facility_name: مستشفى دلة
facility_license: MOH104285
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
submitted_date: 2025-05-01 21:00:00
payment_date: 2025-06-07 21:00:00
saudi_id_number: 1132132721
insurance_card_number: IC143558033
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.477908
updated_at: 2025-09-03 14:42:14.477910
secondary_diagnosis_codes:
  [{"code": "F32.9", "description": "Major depressive disorder", "description_ar": "\u0627\u0636\u0637\u0631\u0627\u0628 \u0627\u0644\u0627\u0643\u062a\u0626\u0627\u0628 \u0627\u0644\u0634\u062f\u064a\u062f"}, {"code": "E78.5", "description": "Hyperlipidemia", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0627\u0644\u062f\u0647\u0648\u0646 \u0641\u064a \u0627\u0644\u062f\u0645"}]

procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 7270.000032065265}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025448169
claim_type: SURGICAL
status: PAID
priority: URGENT
service_date: 2025-04-08
service_provider: د. أحمد محمد العبدالله
service_provider_license: SML49402
facility_name: مستشفى بقشان
facility_license: MOH329779
primary_diagnosis_code: M25.50
primary_diagnosis_description: Pain in unspecified joint / ألم في المفصل غير المحدد
secondary_diagnosis_codes: []
submitted_date: 2025-04-30 21:00:00
payment_date: 2025-05-30 21:00:00
saudi_id_number: 2848822629
insurance_card_number: IC423992790
authorization_number: AUTH722091
notes: مطالبة تأمينية لـ surgical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.478327
updated_at: 2025-09-03 14:42:14.478329
procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 97.4475550580292}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "OPERATIVE_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0627\u0644\u0639\u0645\u0644\u064a\u0629.pdf"}, {"type": "AUTHORIZATION", "name": "\u062a\u0635\u0631\u064a\u062d \u0645\u0633\u0628\u0642.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025377145
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-03-30
service_provider: د. هند عبدالعزيز الراشد
service_provider_license: SML40365
facility_name: مستشفى سعد التخصصي
facility_license: MOH757530
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
secondary_diagnosis_codes: []
submitted_date: 2025-07-04 21:00:00
payment_date: 2025-07-28 21:00:00
saudi_id_number: 1944997246
insurance_card_number: IC686597888
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.478721
updated_at: 2025-09-03 14:42:14.478724
procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 5962.5316590607135}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025182805
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-04-04
service_provider: د. عمر فهد الخالدي
service_provider_license: SML91916
facility_name: مستشفى الملك سعود
facility_license: MOH324907
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
submitted_date: 2025-05-17 21:00:00
payment_date: 2025-06-16 21:00:00
saudi_id_number: 2912848658
insurance_card_number: IC461568887
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.479123
updated_at: 2025-09-03 14:42:14.479126
secondary_diagnosis_codes:
  [{"code": "F32.9", "description": "Major depressive disorder", "description_ar": "\u0627\u0636\u0637\u0631\u0627\u0628 \u0627\u0644\u0627\u0643\u062a\u0626\u0627\u0628 \u0627\u0644\u0634\u062f\u064a\u062f"}, {"code": "N18.6", "description": "End stage renal disease", "description_ar": "\u0627\u0644\u0645\u0631\u062d\u0644\u0629 \u0627\u0644\u0623\u062e\u064a\u0631\u0629 \u0645\u0646 \u0645\u0631\u0636 \u0627\u0644\u0643\u0644\u0649"}, {"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}]

procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 91.50991937808755}, {"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1387.5935432689162}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025794887
claim_type: EMERGENCY
status: DENIED
priority: HIGH
service_date: 2025-07-23
service_provider: د. فاطمة علي الزهراني
service_provider_license: SML31978
facility_name: مستشفى الملك فيصل التخصصي ومركز الأبحاث
facility_license: MOH190476
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
secondary_diagnosis_codes: []
submitted_date: 2025-06-19 21:00:00
processed_date: 2025-07-01 21:00:00
saudi_id_number: 1942173522
insurance_card_number: IC670343009
denial_reason: تجاوز الحد الأقصى السنوي
denial_code: D009
notes: مطالبة تأمينية لـ emergency - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.479532
updated_at: 2025-09-03 14:42:14.479535
procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 108.95339535464696}, {"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 247.38758493456726}, {"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1019.0699573774557}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "DISCHARGE_SUMMARY", "name": "\u0645\u0644\u062e\u0635 \u0627\u0644\u062e\u0631\u0648\u062c.pdf"}]


claim_number: CLM2025567233
claim_type: PHARMACY
status: PAID
priority: HIGH
service_date: 2025-03-08
service_provider: د. إيمان عبدالمحسن الشمري
service_provider_license: SML65791
facility_name: مستشفى الموسى التخصصي
facility_license: MOH655616
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-08-19 21:00:00
payment_date: 2025-09-18 21:00:00
saudi_id_number: 2900766527
insurance_card_number: IC564835214
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.479894
updated_at: 2025-09-03 14:42:14.479897
secondary_diagnosis_codes:
  [{"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}]

procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 97.70628868533024}, {"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 267.0795980404763}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}]


claim_number: CLM2025641073
claim_type: OUTPATIENT
status: PAID
priority: HIGH
service_date: 2025-08-25
service_provider: د. إيمان عبدالمحسن الشمري
service_provider_license: SML81424
facility_name: مستشفى الملك فيصل التخصصي ومركز الأبحاث
facility_license: MOH964052
primary_diagnosis_code: M25.50
primary_diagnosis_description: Pain in unspecified joint / ألم في المفصل غير المحدد
submitted_date: 2025-03-16 21:00:00
payment_date: 2025-04-09 21:00:00
saudi_id_number: 1264899294
insurance_card_number: IC351305445
authorization_number: AUTH533452
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.480298
updated_at: 2025-09-03 14:42:14.480301
secondary_diagnosis_codes:
  [{"code": "J45.9", "description": "Asthma, unspecified", "description_ar": "\u0627\u0644\u0631\u0628\u0648 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "E11.9", "description": "Type 2 diabetes mellitus without complications", "description_ar": "\u062f\u0627\u0621 \u0627\u0644\u0633\u0643\u0631\u064a \u0645\u0646 \u0627\u0644\u0646\u0648\u0639 \u0627\u0644\u062b\u0627\u0646\u064a \u0628\u062f\u0648\u0646 \u0645\u0636\u0627\u0639\u0641\u0627\u062a"}, {"code": "N18.6", "description": "End stage renal disease", "description_ar": "\u0627\u0644\u0645\u0631\u062d\u0644\u0629 \u0627\u0644\u0623\u062e\u064a\u0631\u0629 \u0645\u0646 \u0645\u0631\u0636 \u0627\u0644\u0643\u0644\u0649"}]

procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 5685.146726714172}]

attachments:
[cell repeats an earlier one in this file: 477 characters]


claim_number: CLM2025419081
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-08-02
service_provider: د. فيصل عبدالله السديري
service_provider_license: SML94117
facility_name: مستشفى الموسى التخصصي
facility_license: MOH443396
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-09-07 21:00:00
payment_date: 2025-09-26 21:00:00
saudi_id_number: 2929555802
insurance_card_number: IC371375469
authorization_number: AUTH561226
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.480695
updated_at: 2025-09-03 14:42:14.480697
procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 248.72696196317898}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025900787
claim_type: DIAGNOSTIC
status: DENIED
priority: URGENT
service_date: 2025-06-11
service_provider: د. خالد يوسف الشهري
service_provider_license: SML72212
facility_name: مستشفى الملك فهد الطبي
facility_license: MOH925497
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
submitted_date: 2025-06-26 21:00:00
processed_date: 2025-07-12 21:00:00
saudi_id_number: 2294942305
insurance_card_number: IC510997728
authorization_number: AUTH782893
denial_reason: معلومات ناقصة
denial_code: D006
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.481112
updated_at: 2025-09-03 14:42:14.481115
secondary_diagnosis_codes:
  [{"code": "J45.9", "description": "Asthma, unspecified", "description_ar": "\u0627\u0644\u0631\u0628\u0648 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}]

procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 146.38487707933112}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "LAB_RESULT", "name": "\u0646\u062a\u0627\u0626\u062c \u0627\u0644\u0645\u062e\u062a\u0628\u0631.pdf"}]


claim_number: CLM2025258972
claim_type: PHARMACY
status: PAID
priority: URGENT
service_date: 2025-08-18
service_provider: د. سعد محمد العتيبي
service_provider_license: SML31621
facility_name: مستشفى الملك خالد الجامعي
facility_license: MOH381022
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-07-08 21:00:00
payment_date: 2025-08-06 21:00:00
saudi_id_number: 2548448355
insurance_card_number: IC383092864
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.481469
updated_at: 2025-09-03 14:42:14.481471
secondary_diagnosis_codes:
  [{"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}]

procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 5518.602894630536}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025697467
claim_type: OUTPATIENT
status: DENIED
priority: URGENT
service_date: 2025-04-06
service_provider: د. رنا سعود الأحمد
service_provider_license: SML10976
facility_name: مستشفى الحبيب
facility_license: MOH786415
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
submitted_date: 2025-07-14 21:00:00
processed_date: 2025-08-02 21:00:00
saudi_id_number: 1385073571
insurance_card_number: IC715225793
denial_reason: خدمة تجميلية غير ضرورية طبياً
denial_code: D002
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.481869
updated_at: 2025-09-03 14:42:14.481871
secondary_diagnosis_codes:
  [{"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}]

procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 108.65610763090464}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 7121.254710913996}, {"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 184.80734035982525}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025259312
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-03-25
service_provider: د. طارق حسام الدين الأنصاري
service_provider_license: SML51536
facility_name: مستشفى الملك سعود
facility_license: MOH809911
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
submitted_date: 2025-08-16 21:00:00
payment_date: 2025-08-29 21:00:00
saudi_id_number: 2259917401
insurance_card_number: IC552005064
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.482227
updated_at: 2025-09-03 14:42:14.482229
secondary_diagnosis_codes:
  [{"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}]

procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 95.3550794946461}, {"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 104.01306036556042}, {"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 174.96150442311807}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025500740
claim_type: OUTPATIENT
status: PAID
priority: LOW
service_date: 2025-04-08
service_provider: د. سعد محمد العتيبي
service_provider_license: SML35067
facility_name: مستشفى الولادة والأطفال
facility_license: MOH485698
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
secondary_diagnosis_codes: []
submitted_date: 2025-07-05 21:00:00
payment_date: 2025-08-02 21:00:00
saudi_id_number: 2935632032
insurance_card_number: IC239679515
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.482626
updated_at: 2025-09-03 14:42:14.482629
procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 237.31398967720386}, {"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 3056.2444383123984}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025950613
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-07-26
service_provider: د. فيصل عبدالله السديري
service_provider_license: SML32003
facility_name: مستشفى الأمير سلطان العسكري
facility_license: MOH405278
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
submitted_date: 2025-09-01 21:00:00
payment_date: 2025-09-26 21:00:00
saudi_id_number: 1839231664
insurance_card_number: IC714170872
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.483039
updated_at: 2025-09-03 14:42:14.483041
secondary_diagnosis_codes:
  [{"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}, {"code": "E11.9", "description": "Type 2 diabetes mellitus without complications", "description_ar": "\u062f\u0627\u0621 \u0627\u0644\u0633\u0643\u0631\u064a \u0645\u0646 \u0627\u0644\u0646\u0648\u0639 \u0627\u0644\u062b\u0627\u0646\u064a \u0628\u062f\u0648\u0646 \u0645\u0636\u0627\u0639\u0641\u0627\u062a"}]

procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 278.85528687707887}, {"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 282.1185914159444}]

attachments:
[cell repeats an earlier one in this file: 474 characters]


claim_number: CLM2025935944
claim_type: INPATIENT
status: PAID
priority: NORMAL
service_date: 2025-08-19
service_provider: د. عبدالله سليمان المطيري
service_provider_license: SML38326
facility_name: مستشفى الموسى التخصصي
facility_license: MOH187413
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
secondary_diagnosis_codes: []
submitted_date: 2025-04-09 21:00:00
payment_date: 2025-04-30 21:00:00
saudi_id_number: 1302829437
insurance_card_number: IC498241282
notes: مطالبة تأمينية لـ inpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.483509
updated_at: 2025-09-03 14:42:14.483511
procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 3689.7137026056357}, {"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 153.50298136272656}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025314800
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-08-26
service_provider: د. أحمد محمد العبدالله
service_provider_license: SML88451
facility_name: مستشفى الملك سعود
facility_license: MOH297269
primary_diagnosis_code: N18.6
primary_diagnosis_description: End stage renal disease / المرحلة الأخيرة من مرض الكلى
submitted_date: 2025-09-04 21:00:00
payment_date: 2025-10-07 21:00:00
saudi_id_number: 2052198814
insurance_card_number: IC657018254
authorization_number: AUTH950767
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.483900
updated_at: 2025-09-03 14:42:14.483902
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 310 characters]

procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 193.15240599200726}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025935530
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-04-18
service_provider: د. دانا محمد الفهد
service_provider_license: SML86169
facility_name: مستشفى الموسى التخصصي
facility_license: MOH832313
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
secondary_diagnosis_codes: []
submitted_date: 2025-04-29 21:00:00
payment_date: 2025-05-13 21:00:00
saudi_id_number: 1689662829
insurance_card_number: IC752280054
authorization_number: AUTH313736
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.484316
updated_at: 2025-09-03 14:42:14.484318
procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 313.67610205828544}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025857547
claim_type: OUTPATIENT
status: DENIED
priority: LOW
service_date: 2025-08-17
service_provider: د. عمر فهد الخالدي
service_provider_license: SML18630
facility_name: مستشفى الملك سعود
facility_license: MOH274428
primary_diagnosis_code: F32.9
primary_diagnosis_description: Major depressive disorder / اضطراب الاكتئاب الشديد
submitted_date: 2025-07-22 21:00:00
processed_date: 2025-08-01 21:00:00
saudi_id_number: 2920727866
insurance_card_number: IC973889597
authorization_number: AUTH223371
denial_reason: خدمة مستثناة
denial_code: D005
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.484724
updated_at: 2025-09-03 14:42:14.484727
secondary_diagnosis_codes:
  [{"code": "E78.5", "description": "Hyperlipidemia", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0627\u0644\u062f\u0647\u0648\u0646 \u0641\u064a \u0627\u0644\u062f\u0645"}, {"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}, {"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}]

procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 224.72740274828624}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 5660.482562308465}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 6529.348987098518}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025420213
claim_type: PHARMACY
status: PAID
priority: NORMAL
service_date: 2025-06-07
service_provider: د. عبدالله سليمان المطيري
service_provider_license: SML48825
facility_name: مستشفى الأمير سلطان العسكري
facility_license: MOH907613
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
secondary_diagnosis_codes: []
submitted_date: 2025-03-20 21:00:00
payment_date: 2025-04-11 21:00:00
saudi_id_number: 2076427387
insurance_card_number: IC326604200
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.485106
updated_at: 2025-09-03 14:42:14.485108
procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 3977.7010843476805}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025762905
claim_type: MEDICAL
status: DENIED
priority: LOW
service_date: 2025-03-18
service_provider: د. هند عبدالعزيز الراشد
service_provider_license: SML86754
facility_name: مستشفى الملك عبدالعزيز الجامعي
facility_license: MOH114507
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-04-16 21:00:00
processed_date: 2025-04-29 21:00:00
saudi_id_number: 1887744374
insurance_card_number: IC500583585
denial_reason: خدمة مستثناة
denial_code: D005
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.485503
updated_at: 2025-09-03 14:42:14.485506
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 310 characters]

procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 130.67093781789603}, {"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1125.7289657801682}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025688312
claim_type: OUTPATIENT
status: PAID
priority: LOW
service_date: 2025-07-04
service_provider: د. سارة عبدالرحمن الفيصل
service_provider_license: SML86457
facility_name: مستشفى الملك سعود
facility_license: MOH243531
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-07-31 21:00:00
payment_date: 2025-08-17 21:00:00
saudi_id_number: 1052195209
insurance_card_number: IC814080438
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.485872
updated_at: 2025-09-03 14:42:14.485874
secondary_diagnosis_codes:
  [{"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}, {"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}]

procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 334.387662670892}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025996937
claim_type: DIAGNOSTIC
status: PAID
priority: NORMAL
service_date: 2025-05-24
service_provider: د. فاطمة علي الزهراني
service_provider_license: SML53896
facility_name: مستشفى الملك عبدالعزيز الجامعي
facility_license: MOH831058
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-06-24 21:00:00
payment_date: 2025-07-14 21:00:00
saudi_id_number: 1860490948
insurance_card_number: IC457199362
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.486279
updated_at: 2025-09-03 14:42:14.486281
secondary_diagnosis_codes:
  [{"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}, {"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}]

procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 293.3799777081441}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 7645.681409603442}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 7460.735842871664}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "LAB_RESULT", "name": "\u0646\u062a\u0627\u0626\u062c \u0627\u0644\u0645\u062e\u062a\u0628\u0631.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025201220
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-03-31
service_provider: د. فيصل عبدالله السديري
service_provider_license: SML97125
facility_name: مستشفى الملك عبدالعزيز الجامعي
facility_license: MOH169953
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-06-29 21:00:00
payment_date: 2025-07-21 21:00:00
saudi_id_number: 2682919302
insurance_card_number: IC124695151
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.486689
updated_at: 2025-09-03 14:42:14.486691
secondary_diagnosis_codes:
  [{"code": "J45.9", "description": "Asthma, unspecified", "description_ar": "\u0627\u0644\u0631\u0628\u0648 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}]

procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 266.4621243925733}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 5317.014398257368}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025442669
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-06-30
service_provider: د. أحمد محمد العبدالله
service_provider_license: SML88472
facility_name: مستشفى الملك خالد الجامعي
facility_license: MOH137552
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-08-14 21:00:00
payment_date: 2025-10-20 21:00:00
saudi_id_number: 1562595852
insurance_card_number: IC653438677
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.487092
updated_at: 2025-09-03 14:42:14.487095
secondary_diagnosis_codes:
  [{"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}, {"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}]

procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 289.3240981061723}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025902383
claim_type: DIAGNOSTIC
status: PAID
priority: NORMAL
service_date: 2025-04-11
service_provider: د. ليلى محمد الجبير
service_provider_license: SML16945
facility_name: مستشفى دلة
facility_license: MOH419656
primary_diagnosis_code: F32.9
primary_diagnosis_description: Major depressive disorder / اضطراب الاكتئاب الشديد
secondary_diagnosis_codes: []
submitted_date: 2025-04-21 21:00:00
payment_date: 2025-05-26 21:00:00
saudi_id_number: 2545561148
insurance_card_number: IC941802057
authorization_number: AUTH993248
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.487492
updated_at: 2025-09-03 14:42:14.487495
procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 121.12922253109676}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "LAB_RESULT", "name": "\u0646\u062a\u0627\u0626\u062c \u0627\u0644\u0645\u062e\u062a\u0628\u0631.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025987601
claim_type: EMERGENCY
status: PAID
priority: NORMAL
service_date: 2025-03-17
service_provider: د. أحمد محمد العبدالله
service_provider_license: SML59412
facility_name: مستشفى الملك فهد للحرس الوطني
facility_license: MOH198574
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-03-25 21:00:00
payment_date: 2025-04-08 21:00:00
saudi_id_number: 1332484311
insurance_card_number: IC518169113
authorization_number: AUTH633092
notes: مطالبة تأمينية لـ emergency - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.487903
updated_at: 2025-09-03 14:42:14.487905
secondary_diagnosis_codes:
  [{"code": "F32.9", "description": "Major depressive disorder", "description_ar": "\u0627\u0636\u0637\u0631\u0627\u0628 \u0627\u0644\u0627\u0643\u062a\u0626\u0627\u0628 \u0627\u0644\u0634\u062f\u064a\u062f"}]

procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 5090.673067786476}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "DISCHARGE_SUMMARY", "name": "\u0645\u0644\u062e\u0635 \u0627\u0644\u062e\u0631\u0648\u062c.pdf"}]


claim_number: CLM2025291402
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-06-23
service_provider: د. أحمد محمد العبدالله
service_provider_license: SML66005
facility_name: مستشفى الملك فهد الطبي
facility_license: MOH714327
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-06-22 21:00:00
payment_date: 2025-07-12 21:00:00
saudi_id_number: 2109280238
insurance_card_number: IC109011243
authorization_number: AUTH656489
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.488309
updated_at: 2025-09-03 14:42:14.488312
secondary_diagnosis_codes:
  [{"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}]

procedure_codes:
  [{"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1028.6283937410822}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025179633
claim_type: DENTAL
status: PAID
priority: LOW
service_date: 2025-04-01
service_provider: د. عمر فهد الخالدي
service_provider_license: SML55395
facility_name: مستشفى الملك عبدالعزيز الجامعي
facility_license: MOH799466
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-03-27 21:00:00
payment_date: 2025-04-11 21:00:00
saudi_id_number: 2377149044
insurance_card_number: IC489602671
authorization_number: AUTH248164
notes: مطالبة تأمينية لـ dental - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.488709
updated_at: 2025-09-03 14:42:14.488711
secondary_diagnosis_codes:
  [{"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}]

procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 145.92161261326078}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025944560
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-08-23
service_provider: د. ليلى محمد الجبير
service_provider_license: SML19816
facility_name: مركز الأورام الطبي
facility_license: MOH606582
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
submitted_date: 2025-08-01 21:00:00
payment_date: 2025-08-21 21:00:00
saudi_id_number: 1300419388
insurance_card_number: IC731378512
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.489107
updated_at: 2025-09-03 14:42:14.489109
secondary_diagnosis_codes:
  [{"code": "F32.9", "description": "Major depressive disorder", "description_ar": "\u0627\u0636\u0637\u0631\u0627\u0628 \u0627\u0644\u0627\u0643\u062a\u0626\u0627\u0628 \u0627\u0644\u0634\u062f\u064a\u062f"}, {"code": "E78.5", "description": "Hyperlipidemia", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0627\u0644\u062f\u0647\u0648\u0646 \u0641\u064a \u0627\u0644\u062f\u0645"}, {"code": "E11.9", "description": "Type 2 diabetes mellitus without complications", "description_ar": "\u062f\u0627\u0621 \u0627\u0644\u0633\u0643\u0631\u064a \u0645\u0646 \u0627\u0644\u0646\u0648\u0639 \u0627\u0644\u062b\u0627\u0646\u064a \u0628\u062f\u0648\u0646 \u0645\u0636\u0627\u0639\u0641\u0627\u062a"}]

procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 123.9236476893734}]

attachments:
[cell repeats an earlier one in this file: 474 characters]


claim_number: CLM2025254148
claim_type: DIAGNOSTIC
status: PAID
priority: NORMAL
service_date: 2025-08-07
service_provider: د. عبدالله سليمان المطيري
service_provider_license: SML99358
facility_name: مستشفى الأهلي
facility_license: MOH434156
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-08-18 21:00:00
payment_date: 2025-09-08 21:00:00
saudi_id_number: 1890501841
insurance_card_number: IC488679666
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.489509
updated_at: 2025-09-03 14:42:14.489511
procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 107.16651842719396}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "LAB_RESULT", "name": "\u0646\u062a\u0627\u0626\u062c \u0627\u0644\u0645\u062e\u062a\u0628\u0631.pdf"}]


claim_number: CLM2025734095
claim_type: PHARMACY
status: PAID
priority: NORMAL
service_date: 2025-03-25
service_provider: د. ليلى محمد الجبير
service_provider_license: SML35692
facility_name: مستشفى الأهلي
facility_license: MOH307354
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
submitted_date: 2025-03-26 21:00:00
payment_date: 2025-04-24 21:00:00
saudi_id_number: 1363360744
insurance_card_number: IC463827956
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.489919
updated_at: 2025-09-03 14:42:14.489921
secondary_diagnosis_codes:
  [{"code": "E78.5", "description": "Hyperlipidemia", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0627\u0644\u062f\u0647\u0648\u0646 \u0641\u064a \u0627\u0644\u062f\u0645"}]

procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 57.82038866621659}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 6510.297012838696}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025832377
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-03-17
service_provider: د. عائشة حسن الحربي
service_provider_license: SML94530
facility_name: مركز الأورام الطبي
facility_license: MOH273602
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
secondary_diagnosis_codes: []
submitted_date: 2025-06-09 21:00:00
payment_date: 2025-07-12 21:00:00
saudi_id_number: 2847056735
insurance_card_number: IC791873791
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.490339
updated_at: 2025-09-03 14:42:14.490341
procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 140.42042363632814}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025834650
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-07-08
service_provider: د. عائشة حسن الحربي
service_provider_license: SML95205
facility_name: مستشفى الملك خالد الجامعي
facility_license: MOH671009
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-08-31 21:00:00
payment_date: 2025-09-18 21:00:00
saudi_id_number: 2005374678
insurance_card_number: IC856490353
authorization_number: AUTH101111
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.490746
updated_at: 2025-09-03 14:42:14.490749
procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 164.35305639511037}, {"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 3510.392248748659}]

attachments:
[cell repeats an earlier one in this file: 474 characters]


claim_number: CLM2025980542
claim_type: MEDICAL
status: PAID
priority: EMERGENCY
service_date: 2025-03-17
service_provider: د. فيصل عبدالله السديري
service_provider_license: SML58044
facility_name: مستشفى الحبيب
facility_license: MOH434559
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-05-22 21:00:00
payment_date: 2025-06-19 21:00:00
saudi_id_number: 1634942400
insurance_card_number: IC936514873
authorization_number: AUTH994642
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.491149
updated_at: 2025-09-03 14:42:14.491151
procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 285.1787776312926}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025409126
claim_type: MEDICAL
status: PAID
priority: LOW
service_date: 2025-08-03
service_provider: د. هند عبدالعزيز الراشد
service_provider_license: SML91075
facility_name: مستشفى العيون التخصصي
facility_license: MOH817843
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
secondary_diagnosis_codes: []
submitted_date: 2025-03-23 21:00:00
payment_date: 2025-04-23 21:00:00
saudi_id_number: 2947528359
insurance_card_number: IC643253897
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.491550
updated_at: 2025-09-03 14:42:14.491553
procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 74.93473305207885}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025962287
claim_type: MEDICAL
status: PAID
priority: HIGH
service_date: 2025-03-27
service_provider: د. سارة عبدالرحمن الفيصل
service_provider_license: SML80146
facility_name: مستشفى الملك خالد الجامعي
facility_license: MOH950874
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-03-07 21:00:00
payment_date: 2025-03-28 21:00:00
saudi_id_number: 1956353802
insurance_card_number: IC202028553
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.492215
updated_at: 2025-09-03 14:42:14.492218
secondary_diagnosis_codes:
  [{"code": "E11.9", "description": "Type 2 diabetes mellitus without complications", "description_ar": "\u062f\u0627\u0621 \u0627\u0644\u0633\u0643\u0631\u064a \u0645\u0646 \u0627\u0644\u0646\u0648\u0639 \u0627\u0644\u062b\u0627\u0646\u064a \u0628\u062f\u0648\u0646 \u0645\u0636\u0627\u0639\u0641\u0627\u062a"}]

procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 204.46576445007315}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025583665
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-03-30
service_provider: د. سارة عبدالرحمن الفيصل
service_provider_license: SML99652
facility_name: مستشفى الملك فهد للحرس الوطني
facility_license: MOH934982
primary_diagnosis_code: Z51.11
primary_diagnosis_description: Encounter for antineoplastic chemotherapy / مواجهة للعلاج الكيميائي المضاد للأورام
submitted_date: 2025-07-16 21:00:00
payment_date: 2025-08-08 21:00:00
saudi_id_number: 1109404643
insurance_card_number: IC567917194
authorization_number: AUTH593537
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.492636
updated_at: 2025-09-03 14:42:14.492639
secondary_diagnosis_codes:
  [{"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}, {"code": "N18.6", "description": "End stage renal disease", "description_ar": "\u0627\u0644\u0645\u0631\u062d\u0644\u0629 \u0627\u0644\u0623\u062e\u064a\u0631\u0629 \u0645\u0646 \u0645\u0631\u0636 \u0627\u0644\u0643\u0644\u0649"}, {"code": "E11.9", "description": "Type 2 diabetes mellitus without complications", "description_ar": "\u062f\u0627\u0621 \u0627\u0644\u0633\u0643\u0631\u064a \u0645\u0646 \u0627\u0644\u0646\u0648\u0639 \u0627\u0644\u062b\u0627\u0646\u064a \u0628\u062f\u0648\u0646 \u0645\u0636\u0627\u0639\u0641\u0627\u062a"}]

procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 163.7067838385639}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025287240
claim_type: DIAGNOSTIC
status: PAID
priority: NORMAL
service_date: 2025-08-12
service_provider: د. هند عبدالعزيز الراشد
service_provider_license: SML74805
facility_name: مستشفى العيون التخصصي
facility_license: MOH282872
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
secondary_diagnosis_codes: []
submitted_date: 2025-06-20 21:00:00
payment_date: 2025-07-15 21:00:00
saudi_id_number: 2979410327
insurance_card_number: IC197264727
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.493049
updated_at: 2025-09-03 14:42:14.493051
procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 179.30101644556203}, {"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 165.88224714248685}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "LAB_RESULT", "name": "\u0646\u062a\u0627\u0626\u062c \u0627\u0644\u0645\u062e\u062a\u0628\u0631.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025337737
claim_type: DIAGNOSTIC
status: PAID
priority: NORMAL
service_date: 2025-05-30
service_provider: د. عائشة حسن الحربي
service_provider_license: SML10344
facility_name: مستشفى سعد التخصصي
facility_license: MOH666243
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
submitted_date: 2025-05-13 21:00:00
payment_date: 2025-05-28 21:00:00
saudi_id_number: 2572796568
insurance_card_number: IC568960706
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.493458
updated_at: 2025-09-03 14:42:14.493461
secondary_diagnosis_codes:
  [{"code": "F32.9", "description": "Major depressive disorder", "description_ar": "\u0627\u0636\u0637\u0631\u0627\u0628 \u0627\u0644\u0627\u0643\u062a\u0626\u0627\u0628 \u0627\u0644\u0634\u062f\u064a\u062f"}]

procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 365.02287216928346}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "LAB_RESULT", "name": "\u0646\u062a\u0627\u0626\u062c \u0627\u0644\u0645\u062e\u062a\u0628\u0631.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025476212
claim_type: DIAGNOSTIC
status: PAID
priority: NORMAL
service_date: 2025-07-27
service_provider: د. هند عبدالعزيز الراشد
service_provider_license: SML80108
facility_name: مستشفى المملكة
facility_license: MOH617751
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-05-16 21:00:00
payment_date: 2025-06-05 21:00:00
saudi_id_number: 2037784665
insurance_card_number: IC888312326
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.493889
updated_at: 2025-09-03 14:42:14.493891
secondary_diagnosis_codes:
  [{"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}, {"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}, {"code": "E11.9", "description": "Type 2 diabetes mellitus without complications", "description_ar": "\u062f\u0627\u0621 \u0627\u0644\u0633\u0643\u0631\u064a \u0645\u0646 \u0627\u0644\u0646\u0648\u0639 \u0627\u0644\u062b\u0627\u0646\u064a \u0628\u062f\u0648\u0646 \u0645\u0636\u0627\u0639\u0641\u0627\u062a"}]

procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 4792.304509193572}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "LAB_RESULT", "name": "\u0646\u062a\u0627\u0626\u062c \u0627\u0644\u0645\u062e\u062a\u0628\u0631.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025772332
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-07-10
service_provider: د. عائشة حسن الحربي
service_provider_license: SML14669
facility_name: مستشفى الأمير محمد بن عبدالعزيز
facility_license: MOH277308
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-05-01 21:00:00
payment_date: 2025-06-02 21:00:00
saudi_id_number: 1784227399
insurance_card_number: IC655809471
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.494312
updated_at: 2025-09-03 14:42:14.494314
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 185 characters]

procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 7814.758596261894}]

attachments:
[cell repeats an earlier one in this file: 477 characters]


claim_number: CLM2025349241
claim_type: DIAGNOSTIC
status: PAID
priority: NORMAL
service_date: 2025-05-02
service_provider: د. رنا سعود الأحمد
service_provider_license: SML40705
facility_name: مستشفى الملك عبدالعزيز الجامعي
facility_license: MOH727905
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-03-31 21:00:00
payment_date: 2025-04-24 21:00:00
saudi_id_number: 1523412037
insurance_card_number: IC321754442
authorization_number: AUTH860489
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.494730
updated_at: 2025-09-03 14:42:14.494732
secondary_diagnosis_codes:
  [{"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}, {"code": "F32.9", "description": "Major depressive disorder", "description_ar": "\u0627\u0636\u0637\u0631\u0627\u0628 \u0627\u0644\u0627\u0643\u062a\u0626\u0627\u0628 \u0627\u0644\u0634\u062f\u064a\u062f"}]

procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 54.865573241119804}, {"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 127.1576046435813}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "LAB_RESULT", "name": "\u0646\u062a\u0627\u0626\u062c \u0627\u0644\u0645\u062e\u062a\u0628\u0631.pdf"}]


claim_number: CLM2025882263
claim_type: MEDICAL
status: PAID
priority: LOW
service_date: 2025-05-16
service_provider: د. إيمان عبدالمحسن الشمري
service_provider_license: SML38921
facility_name: مستشفى الأهلي
facility_license: MOH946415
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-07-21 21:00:00
payment_date: 2025-08-26 21:00:00
saudi_id_number: 2809942906
insurance_card_number: IC392870417
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.495138
updated_at: 2025-09-03 14:42:14.495141
procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 3980.7558134536384}, {"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 163.38955149838065}, {"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 146.03212488204397}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025427788
claim_type: MEDICAL
status: PAID
priority: LOW
service_date: 2025-04-28
service_provider: د. أحمد محمد العبدالله
service_provider_license: SML59933
facility_name: مستشفى الموسى التخصصي
facility_license: MOH817738
primary_diagnosis_code: N18.6
primary_diagnosis_description: End stage renal disease / المرحلة الأخيرة من مرض الكلى
submitted_date: 2025-06-19 21:00:00
payment_date: 2025-07-07 21:00:00
saudi_id_number: 2926925056
insurance_card_number: IC718620848
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.495539
updated_at: 2025-09-03 14:42:14.495541
secondary_diagnosis_codes:
  [{"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}]

procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 5020.030422510913}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025580104
claim_type: PHARMACY
status: PAID
priority: LOW
service_date: 2025-05-08
service_provider: د. محمد عبدالرحمن القحطاني
service_provider_license: SML63394
facility_name: مستشفى الملك فهد الطبي
facility_license: MOH585804
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
secondary_diagnosis_codes: []
submitted_date: 2025-08-27 21:00:00
payment_date: 2025-09-30 21:00:00
saudi_id_number: 2749767004
insurance_card_number: IC706786014
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.495953
updated_at: 2025-09-03 14:42:14.495955
procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 263.63649019869194}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025903937
claim_type: PHARMACY
status: PAID
priority: NORMAL
service_date: 2025-09-01
service_provider: د. ماجد فواز العسيري
service_provider_license: SML42713
facility_name: مستشفى بقشان
facility_license: MOH296440
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
secondary_diagnosis_codes: []
submitted_date: 2025-04-04 21:00:00
payment_date: 2025-04-12 21:00:00
saudi_id_number: 1335537263
insurance_card_number: IC238212935
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.496365
updated_at: 2025-09-03 14:42:14.496368
procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 254.68787169322866}]

attachments:
[cell repeats an earlier one in this file: 374 characters]


claim_number: CLM2025166863
claim_type: MEDICAL
status: DENIED
priority: LOW
service_date: 2025-07-01
service_provider: د. إيمان عبدالمحسن الشمري
service_provider_license: SML10871
facility_name: مركز الأورام الطبي
facility_license: MOH840574
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-04-28 21:00:00
processed_date: 2025-05-04 21:00:00
saudi_id_number: 2146100220
insurance_card_number: IC395510203
denial_reason: خدمة تجميلية غير ضرورية طبياً
denial_code: D003
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.496766
updated_at: 2025-09-03 14:42:14.496768
procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 53.616925287968286}, {"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 4014.7949835926684}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025471962
claim_type: EMERGENCY
status: PAID
priority: HIGH
service_date: 2025-06-02
service_provider: د. فاطمة علي الزهراني
service_provider_license: SML82894
facility_name: مركز الأورام الطبي
facility_license: MOH839844
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-04-24 21:00:00
payment_date: 2025-05-11 21:00:00
saudi_id_number: 2188702639
insurance_card_number: IC611018500
authorization_number: AUTH906601
notes: مطالبة تأمينية لـ emergency - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.497124
updated_at: 2025-09-03 14:42:14.497127
secondary_diagnosis_codes:
  [{"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}]

procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 208.65190182089523}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "DISCHARGE_SUMMARY", "name": "\u0645\u0644\u062e\u0635 \u0627\u0644\u062e\u0631\u0648\u062c.pdf"}]


claim_number: CLM2025675374
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-07-15
service_provider: د. خالد يوسف الشهري
service_provider_license: SML61086
facility_name: مستشفى الدكتور سليمان الحبيب
facility_license: MOH745903
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-03-18 21:00:00
payment_date: 2025-04-09 21:00:00
saudi_id_number: 1167926354
insurance_card_number: IC195607383
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.497528
updated_at: 2025-09-03 14:42:14.497530
secondary_diagnosis_codes:
  [{"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}]

procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 96.68675552226898}, {"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 380.3666136029421}, {"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1431.9680869870306}]

attachments:
[cell repeats an earlier one in this file: 381 characters]


claim_number: CLM2025952002
claim_type: EMERGENCY
status: DENIED
priority: NORMAL
service_date: 2025-04-30
service_provider: د. ماجد فواز العسيري
service_provider_license: SML14929
facility_name: مستشفى الأهلي
facility_license: MOH781199
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
secondary_diagnosis_codes: []
submitted_date: 2025-04-20 21:00:00
processed_date: 2025-05-06 21:00:00
saudi_id_number: 1670727486
insurance_card_number: IC420009932
denial_reason: تكرار في المطالبة
denial_code: D005
notes: مطالبة تأمينية لـ emergency - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.497941
updated_at: 2025-09-03 14:42:14.497943
procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 151.7314033446736}, {"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 111.11591834974644}]

attachments:
[cell repeats an earlier one in this file: 391 characters]


claim_number: CLM2025392399
claim_type: EMERGENCY
status: PAID
priority: NORMAL
service_date: 2025-05-31
service_provider: د. ماجد فواز العسيري
service_provider_license: SML78757
facility_name: مستشفى الموسى التخصصي
facility_license: MOH719334
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-03-30 21:00:00
payment_date: 2025-04-24 21:00:00
saudi_id_number: 1083449222
insurance_card_number: IC581423284
notes: مطالبة تأمينية لـ emergency - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.498339
updated_at: 2025-09-03 14:42:14.498342
secondary_diagnosis_codes:
  [{"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}]

procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 299.9366948341993}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 5337.575945188992}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "DISCHARGE_SUMMARY", "name": "\u0645\u0644\u062e\u0635 \u0627\u0644\u062e\u0631\u0648\u062c.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025654197
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-05-01
service_provider: د. عمر فهد الخالدي
service_provider_license: SML97913
facility_name: مستشفى دلة
facility_license: MOH224914
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-05-18 21:00:00
payment_date: 2025-06-06 21:00:00
saudi_id_number: 1073184587
insurance_card_number: IC517897837
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.498743
updated_at: 2025-09-03 14:42:14.498745
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 239 characters]

procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 90.4030647540033}, {"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 136.85578156200742}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025159984
claim_type: OUTPATIENT
status: PAID
priority: URGENT
service_date: 2025-06-17
service_provider: د. ليلى محمد الجبير
service_provider_license: SML62838
facility_name: مستشفى دلة
facility_license: MOH192645
primary_diagnosis_code: M25.50
primary_diagnosis_description: Pain in unspecified joint / ألم في المفصل غير المحدد
secondary_diagnosis_codes: []
submitted_date: 2025-07-03 21:00:00
payment_date: 2025-07-23 21:00:00
saudi_id_number: 2643944777
insurance_card_number: IC380253608
authorization_number: AUTH438397
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.499151
updated_at: 2025-09-03 14:42:14.499154
procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 226.51504475824885}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025122126
claim_type: MEDICAL
status: PAID
priority: HIGH
service_date: 2025-06-18
service_provider: د. إيمان عبدالمحسن الشمري
service_provider_license: SML43654
facility_name: مستشفى الدكتور سليمان الحبيب
facility_license: MOH700986
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-06-28 21:00:00
payment_date: 2025-07-24 21:00:00
saudi_id_number: 1603148056
insurance_card_number: IC217249973
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.499553
updated_at: 2025-09-03 14:42:14.499556
secondary_diagnosis_codes:
  [{"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}]

procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 3677.468974036566}, {"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 192.43499611112412}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025330953
claim_type: DIAGNOSTIC
status: PAID
priority: HIGH
service_date: 2025-03-08
service_provider: د. ليلى محمد الجبير
service_provider_license: SML90121
facility_name: مستشفى المملكة
facility_license: MOH135064
primary_diagnosis_code: Z51.11
primary_diagnosis_description: Encounter for antineoplastic chemotherapy / مواجهة للعلاج الكيميائي المضاد للأورام
submitted_date: 2025-06-22 21:00:00
payment_date: 2025-07-01 21:00:00
saudi_id_number: 2499263107
insurance_card_number: IC187308563
authorization_number: AUTH515422
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.499962
updated_at: 2025-09-03 14:42:14.499964
secondary_diagnosis_codes:
  [{"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}]

procedure_codes:
  [{"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1198.4562438580638}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "LAB_RESULT", "name": "\u0646\u062a\u0627\u0626\u062c \u0627\u0644\u0645\u062e\u062a\u0628\u0631.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025438410
claim_type: PHARMACY
status: DENIED
priority: NORMAL
service_date: 2025-05-17
service_provider: د. رنا سعود الأحمد
service_provider_license: SML43887
facility_name: مستشفى الحبيب
facility_license: MOH835263
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-04-09 21:00:00
processed_date: 2025-04-21 21:00:00
saudi_id_number: 2978055728
insurance_card_number: IC156933032
denial_reason: تكرار في المطالبة
denial_code: D003
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.500375
updated_at: 2025-09-03 14:42:14.500377
procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 148.9864864371434}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025164303
claim_type: MEDICAL
status: PAID
priority: LOW
service_date: 2025-08-15
service_provider: د. عائشة حسن الحربي
service_provider_license: SML99283
facility_name: مستشفى الملك فيصل التخصصي ومركز الأبحاث
facility_license: MOH859739
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
submitted_date: 2025-09-01 21:00:00
payment_date: 2025-09-20 21:00:00
saudi_id_number: 1548929018
insurance_card_number: IC367377043
authorization_number: AUTH899541
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.500738
updated_at: 2025-09-03 14:42:14.500740
secondary_diagnosis_codes:
  [{"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}, {"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}]

procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 58.20308892202272}, {"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 196.52377454321095}]

attachments:
[cell repeats an earlier one in this file: 379 characters]


claim_number: CLM2025754171
claim_type: EMERGENCY
status: PAID
priority: NORMAL
service_date: 2025-04-11
service_provider: د. أحمد محمد العبدالله
service_provider_license: SML68743
facility_name: مستشفى الموسى التخصصي
facility_license: MOH685854
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
secondary_diagnosis_codes: []
submitted_date: 2025-03-16 21:00:00
payment_date: 2025-04-10 21:00:00
saudi_id_number: 1041072979
insurance_card_number: IC666724529
notes: مطالبة تأمينية لـ emergency - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.501137
updated_at: 2025-09-03 14:42:14.501140
procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 105.85688836184269}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "DISCHARGE_SUMMARY", "name": "\u0645\u0644\u062e\u0635 \u0627\u0644\u062e\u0631\u0648\u062c.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025735003
claim_type: DIAGNOSTIC
status: DENIED
priority: HIGH
service_date: 2025-04-13
service_provider: د. مريم أحمد الدوسري
service_provider_license: SML61625
facility_name: مستشفى الأمير سلطان العسكري
facility_license: MOH543388
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-06-05 21:00:00
processed_date: 2025-06-21 21:00:00
saudi_id_number: 1855524903
insurance_card_number: IC792666223
authorization_number: AUTH545333
denial_reason: مقدم خدمة خارج الشبكة
denial_code: D006
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.501566
updated_at: 2025-09-03 14:42:14.501569
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 185 characters]

procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 60.429219604831495}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "LAB_RESULT", "name": "\u0646\u062a\u0627\u0626\u062c \u0627\u0644\u0645\u062e\u062a\u0628\u0631.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025230583
claim_type: MEDICAL
status: DENIED
priority: NORMAL
service_date: 2025-03-19
service_provider: د. مريم أحمد الدوسري
service_provider_license: SML34699
facility_name: مستشفى الملك فهد الطبي
facility_license: MOH978397
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
submitted_date: 2025-04-29 21:00:00
processed_date: 2025-05-10 21:00:00
saudi_id_number: 1059497685
insurance_card_number: IC395592376
denial_reason: مطلوب تقرير طبي إضافي
denial_code: D001
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.501922
updated_at: 2025-09-03 14:42:14.501924
secondary_diagnosis_codes:
  [{"code": "F32.9", "description": "Major depressive disorder", "description_ar": "\u0627\u0636\u0637\u0631\u0627\u0628 \u0627\u0644\u0627\u0643\u062a\u0626\u0627\u0628 \u0627\u0644\u0634\u062f\u064a\u062f"}, {"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "J45.9", "description": "Asthma, unspecified", "description_ar": "\u0627\u0644\u0631\u0628\u0648 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}]

procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 4467.313540255455}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025248469
claim_type: INPATIENT
status: DENIED
priority: NORMAL
service_date: 2025-06-15
service_provider: د. عمر فهد الخالدي
service_provider_license: SML93179
facility_name: مستشفى الحبيب
facility_license: MOH281609
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-06-06 21:00:00
processed_date: 2025-06-19 21:00:00
saudi_id_number: 2626587442
insurance_card_number: IC170059284
authorization_number: AUTH301658
denial_reason: مطلوب تصريح مسبق
denial_code: D009
notes: مطالبة تأمينية لـ inpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.502292
updated_at: 2025-09-03 14:42:14.502294
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 310 characters]

procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 54.79419244075151}, {"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 131.86337994617637}, {"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 114.48859831820958}]

attachments:
[cell repeats an earlier one in this file: 379 characters]


claim_number: CLM2025392179
claim_type: MEDICAL
status: PAID
priority: HIGH
service_date: 2025-03-22
service_provider: د. نورا سعد الغامدي
service_provider_license: SML60748
facility_name: مستشفى دلة
facility_license: MOH288362
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-06-12 21:00:00
payment_date: 2025-06-28 21:00:00
saudi_id_number: 2067915125
insurance_card_number: IC256586631
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.502679
updated_at: 2025-09-03 14:42:14.502682
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 231 characters]

procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 5431.469888920454}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025398477
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-05-29
service_provider: د. ماجد فواز العسيري
service_provider_license: SML79838
facility_name: مركز الأورام الطبي
facility_license: MOH918066
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
secondary_diagnosis_codes: []
submitted_date: 2025-08-06 21:00:00
payment_date: 2025-09-02 21:00:00
saudi_id_number: 2380638709
insurance_card_number: IC927418318
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.503083
updated_at: 2025-09-03 14:42:14.503086
procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 3173.12643160202}, {"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 253.79127783073164}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025298321
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-04-15
service_provider: د. نورا سعد الغامدي
service_provider_license: SML85454
facility_name: مستشفى المملكة
facility_license: MOH553617
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
submitted_date: 2025-07-11 21:00:00
payment_date: 2025-08-02 21:00:00
saudi_id_number: 1686996604
insurance_card_number: IC356214214
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.503489
updated_at: 2025-09-03 14:42:14.503492
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 310 characters]

procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 278.0704221622314}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025978520
claim_type: SURGICAL
status: PAID
priority: HIGH
service_date: 2025-06-28
service_provider: د. دانا محمد الفهد
service_provider_license: SML88488
facility_name: مستشفى الولادة والأطفال
facility_license: MOH321221
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-08-06 21:00:00
payment_date: 2025-09-05 21:00:00
saudi_id_number: 1635123462
insurance_card_number: IC983148167
notes: مطالبة تأمينية لـ surgical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.503903
updated_at: 2025-09-03 14:42:14.503905
procedure_codes:
  [{"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1030.0875814512838}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "OPERATIVE_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0627\u0644\u0639\u0645\u0644\u064a\u0629.pdf"}, {"type": "AUTHORIZATION", "name": "\u062a\u0635\u0631\u064a\u062d \u0645\u0633\u0628\u0642.pdf"}]


claim_number: CLM2025144987
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-05-28
service_provider: د. سعد محمد العتيبي
service_provider_license: SML70843
facility_name: مستشفى سعد التخصصي
facility_license: MOH847536
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-05-29 21:00:00
payment_date: 2025-06-07 21:00:00
saudi_id_number: 1885794218
insurance_card_number: IC689402507
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.504309
updated_at: 2025-09-03 14:42:14.504311
procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 271.67245271058175}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025965202
claim_type: EMERGENCY
status: PAID
priority: NORMAL
service_date: 2025-08-25
service_provider: د. خالد يوسف الشهري
service_provider_license: SML92658
facility_name: المستشفى السعودي الألماني
facility_license: MOH984475
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
secondary_diagnosis_codes: []
submitted_date: 2025-06-16 21:00:00
payment_date: 2025-07-09 21:00:00
saudi_id_number: 1227092529
insurance_card_number: IC228284237
authorization_number: AUTH637020
notes: مطالبة تأمينية لـ emergency - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.504713
updated_at: 2025-09-03 14:42:14.504716
procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 214.16895900554647}]

attachments:
[cell repeats an earlier one in this file: 391 characters]


claim_number: CLM2025405353
claim_type: DIAGNOSTIC
status: PAID
priority: NORMAL
service_date: 2025-08-18
service_provider: د. رنا سعود الأحمد
service_provider_license: SML97931
facility_name: مستشفى دلة
facility_license: MOH716902
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-06-12 21:00:00
payment_date: 2025-07-11 21:00:00
saudi_id_number: 1176426715
insurance_card_number: IC546509461
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.505128
updated_at: 2025-09-03 14:42:14.505130
secondary_diagnosis_codes:
  [{"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}, {"code": "F32.9", "description": "Major depressive disorder", "description_ar": "\u0627\u0636\u0637\u0631\u0627\u0628 \u0627\u0644\u0627\u0643\u062a\u0626\u0627\u0628 \u0627\u0644\u0634\u062f\u064a\u062f"}]

procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 6374.660161773185}, {"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 5309.156636401829}, {"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 83.02257844528062}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "LAB_RESULT", "name": "\u0646\u062a\u0627\u0626\u062c \u0627\u0644\u0645\u062e\u062a\u0628\u0631.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025664194
claim_type: DIAGNOSTIC
status: PAID
priority: NORMAL
service_date: 2025-03-09
service_provider: د. أحمد محمد العبدالله
service_provider_license: SML26883
facility_name: مستشفى الحبيب
facility_license: MOH140960
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
submitted_date: 2025-05-10 21:00:00
payment_date: 2025-06-02 21:00:00
saudi_id_number: 1104487426
insurance_card_number: IC964492551
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.505537
updated_at: 2025-09-03 14:42:14.505539
secondary_diagnosis_codes:
  [{"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}, {"code": "E11.9", "description": "Type 2 diabetes mellitus without complications", "description_ar": "\u062f\u0627\u0621 \u0627\u0644\u0633\u0643\u0631\u064a \u0645\u0646 \u0627\u0644\u0646\u0648\u0639 \u0627\u0644\u062b\u0627\u0646\u064a \u0628\u062f\u0648\u0646 \u0645\u0636\u0627\u0639\u0641\u0627\u062a"}]

procedure_codes:
  [{"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1368.254085886434}]

attachments:
[cell repeats an earlier one in this file: 396 characters]


claim_number: CLM2025592041
claim_type: PHARMACY
status: PAID
priority: EMERGENCY
service_date: 2025-04-01
service_provider: د. يوسف علي البقمي
service_provider_license: SML39407
facility_name: مستشفى الموسى التخصصي
facility_license: MOH134409
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-04-05 21:00:00
payment_date: 2025-04-26 21:00:00
saudi_id_number: 1971742159
insurance_card_number: IC110640738
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.505945
updated_at: 2025-09-03 14:42:14.505948
secondary_diagnosis_codes:
  [{"code": "J45.9", "description": "Asthma, unspecified", "description_ar": "\u0627\u0644\u0631\u0628\u0648 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}]

procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 3644.286890278944}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025351121
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-08-26
service_provider: د. عبدالله سليمان المطيري
service_provider_license: SML91478
facility_name: مستشفى الملك عبدالعزيز الجامعي
facility_license: MOH996076
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-07-14 21:00:00
payment_date: 2025-07-27 21:00:00
saudi_id_number: 1838085830
insurance_card_number: IC548151650
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.506357
updated_at: 2025-09-03 14:42:14.506359
procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 141.8263783392939}, {"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 156.1826464115424}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025822483
claim_type: MEDICAL
status: PAID
priority: HIGH
service_date: 2025-07-31
service_provider: د. إيمان عبدالمحسن الشمري
service_provider_license: SML87804
facility_name: مستشفى الملك خالد الجامعي
facility_license: MOH236840
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
secondary_diagnosis_codes: []
submitted_date: 2025-05-28 21:00:00
payment_date: 2025-06-16 21:00:00
saudi_id_number: 2126652318
insurance_card_number: IC219878130
authorization_number: AUTH189537
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.506773
updated_at: 2025-09-03 14:42:14.506775
procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 389.7897121970741}]

attachments:
[cell repeats an earlier one in this file: 379 characters]


claim_number: CLM2025361845
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-05-21
service_provider: د. سعد محمد العتيبي
service_provider_license: SML76121
facility_name: مستشفى الدكتور سليمان الحبيب
facility_license: MOH733543
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
submitted_date: 2025-07-03 21:00:00
payment_date: 2025-07-28 21:00:00
saudi_id_number: 2264129221
insurance_card_number: IC892640528
authorization_number: AUTH279799
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.507173
updated_at: 2025-09-03 14:42:14.507175
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 231 characters]

procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 141.44210193935083}, {"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 101.38025980742312}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025688756
claim_type: PHARMACY
status: PAID
priority: LOW
service_date: 2025-03-07
service_provider: د. ليلى محمد الجبير
service_provider_license: SML73740
facility_name: مستشفى الأمير محمد بن عبدالعزيز
facility_license: MOH823056
primary_diagnosis_code: Z51.11
primary_diagnosis_description: Encounter for antineoplastic chemotherapy / مواجهة للعلاج الكيميائي المضاد للأورام
secondary_diagnosis_codes: []
submitted_date: 2025-05-28 21:00:00
payment_date: 2025-06-30 21:00:00
saudi_id_number: 1935475857
insurance_card_number: IC579588016
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.507578
updated_at: 2025-09-03 14:42:14.507581
procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 86.81464441165474}, {"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 282.22234456995636}]

attachments:
[cell repeats an earlier one in this file: 467 characters]


claim_number: CLM2025383084
claim_type: PHARMACY
status: PAID
priority: LOW
service_date: 2025-08-21
service_provider: د. طارق حسام الدين الأنصاري
service_provider_license: SML26836
facility_name: مستشفى الملك خالد الجامعي
facility_license: MOH236773
primary_diagnosis_code: M25.50
primary_diagnosis_description: Pain in unspecified joint / ألم في المفصل غير المحدد
secondary_diagnosis_codes: []
submitted_date: 2025-03-25 21:00:00
payment_date: 2025-04-10 21:00:00
saudi_id_number: 2965773984
insurance_card_number: IC320150020
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.507994
updated_at: 2025-09-03 14:42:14.507996
procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 106.29725593718094}]

attachments:
[cell repeats an earlier one in this file: 374 characters]


claim_number: CLM2025399672
claim_type: MEDICAL
status: PAID
priority: LOW
service_date: 2025-05-16
service_provider: د. فاطمة علي الزهراني
service_provider_license: SML54835
facility_name: مستشفى الملك فهد الطبي
facility_license: MOH820215
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
submitted_date: 2025-06-15 21:00:00
payment_date: 2025-07-18 21:00:00
saudi_id_number: 1134374121
insurance_card_number: IC350084087
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.508408
updated_at: 2025-09-03 14:42:14.508410
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 231 characters]

procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 3856.0075050416626}, {"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 146.79544574600354}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025759721
claim_type: DIAGNOSTIC
status: PAID
priority: HIGH
service_date: 2025-07-06
service_provider: د. رنا سعود الأحمد
service_provider_license: SML99335
facility_name: مستشفى الملك فهد للحرس الوطني
facility_license: MOH739600
primary_diagnosis_code: N18.6
primary_diagnosis_description: End stage renal disease / المرحلة الأخيرة من مرض الكلى
secondary_diagnosis_codes: []
submitted_date: 2025-07-03 21:00:00
payment_date: 2025-08-31 21:00:00
saudi_id_number: 2836005045
insurance_card_number: IC857496905
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.508833
updated_at: 2025-09-03 14:42:14.508835
procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 81.3150292956384}]

attachments:
[cell repeats an earlier one in this file: 489 characters]


claim_number: CLM2025822098
claim_type: OUTPATIENT
status: DENIED
priority: NORMAL
service_date: 2025-04-12
service_provider: د. فيصل عبدالله السديري
service_provider_license: SML73431
facility_name: مستشفى الملك عبدالعزيز الجامعي
facility_license: MOH944004
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-06-10 21:00:00
processed_date: 2025-06-23 21:00:00
saudi_id_number: 1851451870
insurance_card_number: IC168676897
denial_reason: مطلوب تصريح مسبق
denial_code: D003
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.509238
updated_at: 2025-09-03 14:42:14.509241
secondary_diagnosis_codes:
  [{"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}, {"code": "N18.6", "description": "End stage renal disease", "description_ar": "\u0627\u0644\u0645\u0631\u062d\u0644\u0629 \u0627\u0644\u0623\u062e\u064a\u0631\u0629 \u0645\u0646 \u0645\u0631\u0636 \u0627\u0644\u0643\u0644\u0649"}]

procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 124.99686743703353}, {"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 90.07061578704405}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025331544
claim_type: PREVENTIVE
status: PAID
priority: NORMAL
service_date: 2025-07-29
service_provider: د. دانا محمد الفهد
service_provider_license: SML88207
facility_name: مستشفى الولادة والأطفال
facility_license: MOH545041
primary_diagnosis_code: N18.6
primary_diagnosis_description: End stage renal disease / المرحلة الأخيرة من مرض الكلى
secondary_diagnosis_codes: []
submitted_date: 2025-09-05 21:00:00
payment_date: 2025-09-26 21:00:00
saudi_id_number: 1965934813
insurance_card_number: IC853213998
authorization_number: AUTH732606
notes: مطالبة تأمينية لـ preventive - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.509592
updated_at: 2025-09-03 14:42:14.509595
procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 339.0284444532342}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025243163
claim_type: INPATIENT
status: PAID
priority: NORMAL
service_date: 2025-03-23
service_provider: د. دانا محمد الفهد
service_provider_license: SML44135
facility_name: مستشفى الأمير محمد بن عبدالعزيز
facility_license: MOH880450
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
submitted_date: 2025-08-26 21:00:00
payment_date: 2025-09-26 21:00:00
saudi_id_number: 2077489025
insurance_card_number: IC894217660
notes: مطالبة تأمينية لـ inpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.509990
updated_at: 2025-09-03 14:42:14.509993
secondary_diagnosis_codes:
  [{"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}, {"code": "E11.9", "description": "Type 2 diabetes mellitus without complications", "description_ar": "\u062f\u0627\u0621 \u0627\u0644\u0633\u0643\u0631\u064a \u0645\u0646 \u0627\u0644\u0646\u0648\u0639 \u0627\u0644\u062b\u0627\u0646\u064a \u0628\u062f\u0648\u0646 \u0645\u0636\u0627\u0639\u0641\u0627\u062a"}, {"code": "N18.6", "description": "End stage renal disease", "description_ar": "\u0627\u0644\u0645\u0631\u062d\u0644\u0629 \u0627\u0644\u0623\u062e\u064a\u0631\u0629 \u0645\u0646 \u0645\u0631\u0636 \u0627\u0644\u0643\u0644\u0649"}]

procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 127.58911272307222}]

attachments:
[cell repeats an earlier one in this file: 379 characters]


claim_number: CLM2025777105
claim_type: MEDICAL
status: PAID
priority: LOW
service_date: 2025-03-23
service_provider: د. دانا محمد الفهد
service_provider_license: SML58999
facility_name: مستشفى دلة
facility_license: MOH290009
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
secondary_diagnosis_codes: []
submitted_date: 2025-03-31 21:00:00
payment_date: 2025-04-22 21:00:00
saudi_id_number: 2023424874
insurance_card_number: IC226895089
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.510404
updated_at: 2025-09-03 14:42:14.510406
procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 70.35649738304721}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 6389.284355253336}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025766207
claim_type: OUTPATIENT
status: PAID
priority: LOW
service_date: 2025-05-07
service_provider: د. طارق حسام الدين الأنصاري
service_provider_license: SML47841
facility_name: مستشفى الولادة والأطفال
facility_license: MOH994905
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
submitted_date: 2025-08-06 21:00:00
payment_date: 2025-09-07 21:00:00
saudi_id_number: 2902209118
insurance_card_number: IC244622311
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.510825
updated_at: 2025-09-03 14:42:14.510828
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 207 characters]

procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 252.88222627337325}, {"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 301.0195818649793}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025301116
claim_type: MEDICAL
status: PAID
priority: HIGH
service_date: 2025-05-17
service_provider: د. سعد محمد العتيبي
service_provider_license: SML22246
facility_name: مستشفى الأهلي
facility_license: MOH384324
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-06-24 21:00:00
payment_date: 2025-07-05 21:00:00
saudi_id_number: 1357903351
insurance_card_number: IC887266056
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.511236
updated_at: 2025-09-03 14:42:14.511238
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 165 characters]

procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 138.6190017258661}, {"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 337.82500620182446}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025709833
claim_type: DIAGNOSTIC
status: PAID
priority: NORMAL
service_date: 2025-04-17
service_provider: د. عائشة حسن الحربي
service_provider_license: SML10113
facility_name: مستشفى الملك فهد للحرس الوطني
facility_license: MOH733625
primary_diagnosis_code: M25.50
primary_diagnosis_description: Pain in unspecified joint / ألم في المفصل غير المحدد
submitted_date: 2025-04-28 21:00:00
payment_date: 2025-06-13 21:00:00
saudi_id_number: 1481109357
insurance_card_number: IC359328748
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.511647
updated_at: 2025-09-03 14:42:14.511650
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 207 characters]

procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 328.1937415954616}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "LAB_RESULT", "name": "\u0646\u062a\u0627\u0626\u062c \u0627\u0644\u0645\u062e\u062a\u0628\u0631.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025267531
claim_type: INPATIENT
status: PAID
priority: NORMAL
service_date: 2025-08-08
service_provider: د. أحمد محمد العبدالله
service_provider_license: SML60857
facility_name: مستشفى سعد التخصصي
facility_license: MOH390655
primary_diagnosis_code: N18.6
primary_diagnosis_description: End stage renal disease / المرحلة الأخيرة من مرض الكلى
secondary_diagnosis_codes: []
submitted_date: 2025-08-08 21:00:00
payment_date: 2025-08-31 21:00:00
saudi_id_number: 1171583025
insurance_card_number: IC237800874
notes: مطالبة تأمينية لـ inpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.512063
updated_at: 2025-09-03 14:42:14.512066
procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 178.73715711440826}, {"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 188.1200177809643}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025696474
claim_type: PHARMACY
status: PAID
priority: NORMAL
service_date: 2025-06-22
service_provider: د. عائشة حسن الحربي
service_provider_license: SML73825
facility_name: مستشفى سعد التخصصي
facility_license: MOH718778
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
secondary_diagnosis_codes: []
submitted_date: 2025-05-13 21:00:00
payment_date: 2025-06-05 21:00:00
saudi_id_number: 1545649432
insurance_card_number: IC664104867
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.512469
updated_at: 2025-09-03 14:42:14.512472
procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 214.24442500347175}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025160213
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-07-28
service_provider: د. محمد عبدالرحمن القحطاني
service_provider_license: SML14181
facility_name: مستشفى الملك سعود
facility_license: MOH614420
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-04-24 21:00:00
payment_date: 2025-05-19 21:00:00
saudi_id_number: 2853123075
insurance_card_number: IC575214793
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.512886
updated_at: 2025-09-03 14:42:14.512888
procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 7407.7828129131685}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025973458
claim_type: MEDICAL
status: PAID
priority: URGENT
service_date: 2025-04-01
service_provider: د. سعد محمد العتيبي
service_provider_license: SML56681
facility_name: مستشفى العيون التخصصي
facility_license: MOH466360
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-07-21 21:00:00
payment_date: 2025-08-11 21:00:00
saudi_id_number: 1517220748
insurance_card_number: IC964277178
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.513292
updated_at: 2025-09-03 14:42:14.513295
secondary_diagnosis_codes:
  [{"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}, {"code": "F32.9", "description": "Major depressive disorder", "description_ar": "\u0627\u0636\u0637\u0631\u0627\u0628 \u0627\u0644\u0627\u0643\u062a\u0626\u0627\u0628 \u0627\u0644\u0634\u062f\u064a\u062f"}]

procedure_codes:
  [{"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1233.6695918385258}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 7254.761779593879}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025660478
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-08-23
service_provider: د. سارة عبدالرحمن الفيصل
service_provider_license: SML93785
facility_name: مستشفى الولادة والأطفال
facility_license: MOH904359
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
secondary_diagnosis_codes: []
submitted_date: 2025-05-31 21:00:00
payment_date: 2025-06-16 21:00:00
saudi_id_number: 2679624918
insurance_card_number: IC407887360
authorization_number: AUTH875545
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.513704
updated_at: 2025-09-03 14:42:14.513706
procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 133.8499009073277}]

attachments:
[cell repeats an earlier one in this file: 381 characters]


claim_number: CLM2025591099
claim_type: PHARMACY
status: PAID
priority: HIGH
service_date: 2025-04-04
service_provider: د. سارة عبدالرحمن الفيصل
service_provider_license: SML32570
facility_name: مستشفى الملك فيصل التخصصي ومركز الأبحاث
facility_license: MOH382319
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
submitted_date: 2025-07-05 21:00:00
payment_date: 2025-07-18 21:00:00
saudi_id_number: 1319443101
insurance_card_number: IC364523374
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.514107
updated_at: 2025-09-03 14:42:14.514110
secondary_diagnosis_codes:
  [{"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}, {"code": "E78.5", "description": "Hyperlipidemia", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0627\u0644\u062f\u0647\u0648\u0646 \u0641\u064a \u0627\u0644\u062f\u0645"}]

procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 135.44821633779532}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025206128
claim_type: MEDICAL
status: PAID
priority: HIGH
service_date: 2025-07-20
service_provider: د. يوسف علي البقمي
service_provider_license: SML55311
facility_name: مستشفى الولادة والأطفال
facility_license: MOH583426
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-06-23 21:00:00
payment_date: 2025-07-30 21:00:00
saudi_id_number: 1580812265
insurance_card_number: IC960451333
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.514509
updated_at: 2025-09-03 14:42:14.514512
secondary_diagnosis_codes:
  [{"code": "E11.9", "description": "Type 2 diabetes mellitus without complications", "description_ar": "\u062f\u0627\u0621 \u0627\u0644\u0633\u0643\u0631\u064a \u0645\u0646 \u0627\u0644\u0646\u0648\u0639 \u0627\u0644\u062b\u0627\u0646\u064a \u0628\u062f\u0648\u0646 \u0645\u0636\u0627\u0639\u0641\u0627\u062a"}, {"code": "N18.6", "description": "End stage renal disease", "description_ar": "\u0627\u0644\u0645\u0631\u062d\u0644\u0629 \u0627\u0644\u0623\u062e\u064a\u0631\u0629 \u0645\u0646 \u0645\u0631\u0636 \u0627\u0644\u0643\u0644\u0649"}]

procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 181.39977926276805}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025595543
claim_type: INPATIENT
status: PAID
priority: NORMAL
service_date: 2025-03-19
service_provider: د. هند عبدالعزيز الراشد
service_provider_license: SML23249
facility_name: مستشفى الملك سعود
facility_license: MOH237718
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-08-03 21:00:00
payment_date: 2025-08-30 21:00:00
saudi_id_number: 2275525416
insurance_card_number: IC300180849
notes: مطالبة تأمينية لـ inpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.514919
updated_at: 2025-09-03 14:42:14.514921
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 310 characters]

procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 163.73945996684972}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025279484
claim_type: PHARMACY
status: PAID
priority: NORMAL
service_date: 2025-06-30
service_provider: د. رنا سعود الأحمد
service_provider_license: SML35973
facility_name: مستشفى المملكة
facility_license: MOH737609
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-06-02 21:00:00
payment_date: 2025-07-02 21:00:00
saudi_id_number: 1410800516
insurance_card_number: IC322144229
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.515329
updated_at: 2025-09-03 14:42:14.515331
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 185 characters]

procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 146.57000764217045}]

attachments:
[cell repeats an earlier one in this file: 374 characters]


claim_number: CLM2025185718
claim_type: PHARMACY
status: PAID
priority: NORMAL
service_date: 2025-04-16
service_provider: د. عمر فهد الخالدي
service_provider_license: SML89473
facility_name: مستشفى الأمير سلطان العسكري
facility_license: MOH101204
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
submitted_date: 2025-05-16 21:00:00
payment_date: 2025-06-16 21:00:00
saudi_id_number: 1370224033
insurance_card_number: IC997707364
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.515734
updated_at: 2025-09-03 14:42:14.515736
secondary_diagnosis_codes:
  [{"code": "J45.9", "description": "Asthma, unspecified", "description_ar": "\u0627\u0644\u0631\u0628\u0648 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "E78.5", "description": "Hyperlipidemia", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0627\u0644\u062f\u0647\u0648\u0646 \u0641\u064a \u0627\u0644\u062f\u0645"}]

procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 220.5262907053842}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025790393
claim_type: DIAGNOSTIC
status: PAID
priority: NORMAL
service_date: 2025-04-07
service_provider: د. مريم أحمد الدوسري
service_provider_license: SML14108
facility_name: مستشفى الملك فهد للحرس الوطني
facility_license: MOH427300
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-04-25 21:00:00
payment_date: 2025-05-27 21:00:00
saudi_id_number: 1809613124
insurance_card_number: IC398794770
authorization_number: AUTH664597
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.516150
updated_at: 2025-09-03 14:42:14.516153
secondary_diagnosis_codes:
  [{"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}, {"code": "J45.9", "description": "Asthma, unspecified", "description_ar": "\u0627\u0644\u0631\u0628\u0648 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}]

procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 81.83222388063348}, {"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 106.56352498875573}, {"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 78.26498560615119}]

attachments:
[cell repeats an earlier one in this file: 396 characters]


claim_number: CLM2025418906
claim_type: OUTPATIENT
status: PAID
priority: HIGH
service_date: 2025-04-22
service_provider: د. فيصل عبدالله السديري
service_provider_license: SML33867
facility_name: مستشفى الموسى التخصصي
facility_license: MOH661393
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
submitted_date: 2025-03-23 21:00:00
payment_date: 2025-04-11 21:00:00
saudi_id_number: 2991387009
insurance_card_number: IC335071624
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.516571
updated_at: 2025-09-03 14:42:14.516573
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 310 characters]

procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 7254.775893120575}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025178880
claim_type: MEDICAL
status: DENIED
priority: EMERGENCY
service_date: 2025-03-25
service_provider: د. عبدالله سليمان المطيري
service_provider_license: SML91548
facility_name: مستشفى الدكتور سليمان الحبيب
facility_license: MOH604004
primary_diagnosis_code: F32.9
primary_diagnosis_description: Major depressive disorder / اضطراب الاكتئاب الشديد
submitted_date: 2025-04-01 21:00:00
processed_date: 2025-04-18 21:00:00
saudi_id_number: 1310491977
insurance_card_number: IC643272392
denial_reason: انتهاء صلاحية البوليصة
denial_code: D010
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.516987
updated_at: 2025-09-03 14:42:14.516989
secondary_diagnosis_codes:
  [{"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}]

procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 249.5126728619364}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025830876
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-07-09
service_provider: د. إيمان عبدالمحسن الشمري
service_provider_license: SML38077
facility_name: مستشفى المملكة
facility_license: MOH926271
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
secondary_diagnosis_codes: []
submitted_date: 2025-04-15 21:00:00
payment_date: 2025-05-05 21:00:00
saudi_id_number: 2122080940
insurance_card_number: IC865226857
authorization_number: AUTH977563
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.517350
updated_at: 2025-09-03 14:42:14.517352
procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 128.24500484411254}, {"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 59.734404951489246}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025741977
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-07-21
service_provider: د. نورا سعد الغامدي
service_provider_license: SML99966
facility_name: المستشفى السعودي الألماني
facility_license: MOH164682
primary_diagnosis_code: N18.6
primary_diagnosis_description: End stage renal disease / المرحلة الأخيرة من مرض الكلى
submitted_date: 2025-05-22 21:00:00
payment_date: 2025-06-28 21:00:00
saudi_id_number: 1351666982
insurance_card_number: IC203338438
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.517755
updated_at: 2025-09-03 14:42:14.517757
secondary_diagnosis_codes:
  [{"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}, {"code": "J45.9", "description": "Asthma, unspecified", "description_ar": "\u0627\u0644\u0631\u0628\u0648 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}]

procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 259.6430922327029}]

attachments:
[cell repeats an earlier one in this file: 477 characters]


claim_number: CLM2025692056
claim_type: OUTPATIENT
status: PAID
priority: HIGH
service_date: 2025-08-28
service_provider: د. ماجد فواز العسيري
service_provider_license: SML78821
facility_name: مستشفى الملك فهد للحرس الوطني
facility_license: MOH250760
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
submitted_date: 2025-07-20 21:00:00
payment_date: 2025-08-15 21:00:00
saudi_id_number: 1692215297
insurance_card_number: IC883104453
authorization_number: AUTH829185
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.518165
updated_at: 2025-09-03 14:42:14.518168
secondary_diagnosis_codes:
  [{"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}]

procedure_codes:
  [{"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1400.7839986883073}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025896195
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-06-18
service_provider: د. عائشة حسن الحربي
service_provider_license: SML57492
facility_name: مستشفى الملك فهد الطبي
facility_license: MOH849110
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
submitted_date: 2025-08-21 21:00:00
payment_date: 2025-08-27 21:00:00
saudi_id_number: 2775409920
insurance_card_number: IC979011990
authorization_number: AUTH298023
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.518569
updated_at: 2025-09-03 14:42:14.518572
secondary_diagnosis_codes:
  [{"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}, {"code": "F32.9", "description": "Major depressive disorder", "description_ar": "\u0627\u0636\u0637\u0631\u0627\u0628 \u0627\u0644\u0627\u0643\u062a\u0626\u0627\u0628 \u0627\u0644\u0634\u062f\u064a\u062f"}]

procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 284.1113765482528}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025700906
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-03-15
service_provider: د. فيصل عبدالله السديري
service_provider_license: SML79337
facility_name: مستشفى الأمير محمد بن عبدالعزيز
facility_license: MOH178297
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-07-19 21:00:00
payment_date: 2025-08-21 21:00:00
saudi_id_number: 1463005411
insurance_card_number: IC752139771
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.518975
updated_at: 2025-09-03 14:42:14.518977
secondary_diagnosis_codes:
  [{"code": "E78.5", "description": "Hyperlipidemia", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0627\u0644\u062f\u0647\u0648\u0646 \u0641\u064a \u0627\u0644\u062f\u0645"}, {"code": "F32.9", "description": "Major depressive disorder", "description_ar": "\u0627\u0636\u0637\u0631\u0627\u0628 \u0627\u0644\u0627\u0643\u062a\u0626\u0627\u0628 \u0627\u0644\u0634\u062f\u064a\u062f"}, {"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}]

procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 239.3902544682103}]

attachments:
[cell repeats an earlier one in this file: 477 characters]


claim_number: CLM2025795275
claim_type: OUTPATIENT
status: DENIED
priority: NORMAL
service_date: 2025-08-28
service_provider: د. فاطمة علي الزهراني
service_provider_license: SML92228
facility_name: مستشفى الولادة والأطفال
facility_license: MOH421213
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
secondary_diagnosis_codes: []
submitted_date: 2025-04-22 21:00:00
processed_date: 2025-05-01 21:00:00
saudi_id_number: 2378059428
insurance_card_number: IC479961730
authorization_number: AUTH405341
denial_reason: تكرار في المطالبة
denial_code: D002
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.519399
updated_at: 2025-09-03 14:42:14.519401
procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 296.73380408628077}]

attachments:
[cell repeats an earlier one in this file: 381 characters]


claim_number: CLM2025223536
claim_type: EMERGENCY
status: PAID
priority: HIGH
service_date: 2025-06-26
service_provider: د. أحمد محمد العبدالله
service_provider_license: SML81575
facility_name: مستشفى الموسى التخصصي
facility_license: MOH891470
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
secondary_diagnosis_codes: []
submitted_date: 2025-06-17 21:00:00
payment_date: 2025-07-07 21:00:00
saudi_id_number: 2805350891
insurance_card_number: IC526347825
authorization_number: AUTH358620
notes: مطالبة تأمينية لـ emergency - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.519773
updated_at: 2025-09-03 14:42:14.519775
procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 5901.456815470623}]

attachments:
[cell repeats an earlier one in this file: 391 characters]


claim_number: CLM2025997390
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-05-15
service_provider: د. نورا سعد الغامدي
service_provider_license: SML57483
facility_name: مستشفى الملك سعود
facility_license: MOH742241
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
secondary_diagnosis_codes: []
submitted_date: 2025-05-31 21:00:00
payment_date: 2025-07-01 21:00:00
saudi_id_number: 1682847626
insurance_card_number: IC763817257
authorization_number: AUTH535230
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.520179
updated_at: 2025-09-03 14:42:14.520181
procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 114.00195863981202}, {"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 215.99665353158736}]

attachments:
[cell repeats an earlier one in this file: 477 characters]


claim_number: CLM2025202909
claim_type: OUTPATIENT
status: PAID
priority: LOW
service_date: 2025-06-17
service_provider: د. ليلى محمد الجبير
service_provider_license: SML63926
facility_name: مستشفى الملك سعود
facility_license: MOH773904
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
submitted_date: 2025-06-29 21:00:00
payment_date: 2025-07-11 21:00:00
saudi_id_number: 2625546450
insurance_card_number: IC642443702
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.520592
updated_at: 2025-09-03 14:42:14.520595
secondary_diagnosis_codes:
  [{"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}, {"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}]

procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 112.67752290904045}]

attachments:
[cell repeats an earlier one in this file: 379 characters]


claim_number: CLM2025837822
claim_type: MEDICAL
status: PAID
priority: LOW
service_date: 2025-05-12
service_provider: د. عبدالله سليمان المطيري
service_provider_license: SML71453
facility_name: مستشفى الموسى التخصصي
facility_license: MOH130139
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
submitted_date: 2025-04-19 21:00:00
payment_date: 2025-05-10 21:00:00
saudi_id_number: 2946871941
insurance_card_number: IC109085111
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.521000
updated_at: 2025-09-03 14:42:14.521002
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 231 characters]

procedure_codes:
  [{"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 966.4883633795678}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025865230
claim_type: EMERGENCY
status: PAID
priority: NORMAL
service_date: 2025-03-11
service_provider: د. سارة عبدالرحمن الفيصل
service_provider_license: SML33708
facility_name: المستشفى السعودي الألماني
facility_license: MOH806431
primary_diagnosis_code: F32.9
primary_diagnosis_description: Major depressive disorder / اضطراب الاكتئاب الشديد
submitted_date: 2025-07-31 21:00:00
payment_date: 2025-08-21 21:00:00
saudi_id_number: 2094627293
insurance_card_number: IC479604595
authorization_number: AUTH563739
notes: مطالبة تأمينية لـ emergency - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.521413
updated_at: 2025-09-03 14:42:14.521415
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 310 characters]

procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 118.44568697515597}]

attachments:
[cell repeats an earlier one in this file: 391 characters]


claim_number: CLM2025517125
claim_type: EMERGENCY
status: PAID
priority: URGENT
service_date: 2025-06-16
service_provider: د. سعد محمد العتيبي
service_provider_license: SML39828
facility_name: مستشفى دلة
facility_license: MOH459039
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
submitted_date: 2025-04-13 21:00:00
payment_date: 2025-04-30 21:00:00
saudi_id_number: 2365546037
insurance_card_number: IC382752761
authorization_number: AUTH475714
notes: مطالبة تأمينية لـ emergency - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.521819
updated_at: 2025-09-03 14:42:14.521821
secondary_diagnosis_codes:
  [{"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "E78.5", "description": "Hyperlipidemia", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0627\u0644\u062f\u0647\u0648\u0646 \u0641\u064a \u0627\u0644\u062f\u0645"}]

procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 111.7662350876096}]

attachments:
[cell repeats an earlier one in this file: 391 characters]


claim_number: CLM2025951650
claim_type: INPATIENT
status: PAID
priority: LOW
service_date: 2025-04-07
service_provider: د. إيمان عبدالمحسن الشمري
service_provider_license: SML55344
facility_name: المستشفى السعودي الألماني
facility_license: MOH511428
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-07-20 21:00:00
payment_date: 2025-08-29 21:00:00
saudi_id_number: 1755183679
insurance_card_number: IC488089337
notes: مطالبة تأمينية لـ inpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.522252
updated_at: 2025-09-03 14:42:14.522255
procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 59.494289414352295}, {"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 5692.31244304422}]

attachments:
[cell repeats an earlier one in this file: 379 characters]


claim_number: CLM2025192488
claim_type: MEDICAL
status: DENIED
priority: HIGH
service_date: 2025-06-26
service_provider: د. يوسف علي البقمي
service_provider_license: SML16615
facility_name: مستشفى سعد التخصصي
facility_license: MOH327037
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-04-18 21:00:00
processed_date: 2025-05-06 21:00:00
saudi_id_number: 2754026716
insurance_card_number: IC203626766
denial_reason: خدمة تجميلية غير ضرورية طبياً
denial_code: D008
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.522697
updated_at: 2025-09-03 14:42:14.522700
secondary_diagnosis_codes:
  [{"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}, {"code": "N18.6", "description": "End stage renal disease", "description_ar": "\u0627\u0644\u0645\u0631\u062d\u0644\u0629 \u0627\u0644\u0623\u062e\u064a\u0631\u0629 \u0645\u0646 \u0645\u0631\u0636 \u0627\u0644\u0643\u0644\u0649"}]

procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 126.74619031787341}]

attachments:
[cell repeats an earlier one in this file: 474 characters]


claim_number: CLM2025305042
claim_type: DIAGNOSTIC
status: DENIED
priority: NORMAL
service_date: 2025-05-15
service_provider: د. فيصل عبدالله السديري
service_provider_license: SML82811
facility_name: مستشفى الحبيب
facility_license: MOH174942
primary_diagnosis_code: F32.9
primary_diagnosis_description: Major depressive disorder / اضطراب الاكتئاب الشديد
submitted_date: 2025-08-26 21:00:00
processed_date: 2025-09-07 21:00:00
saudi_id_number: 2218548994
insurance_card_number: IC536012102
authorization_number: AUTH128171
denial_reason: خدمة غير مغطاة بالبوليصة
denial_code: D006
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.523063
updated_at: 2025-09-03 14:42:14.523065
secondary_diagnosis_codes:
  [{"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}, {"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}]

procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 246.89199640121117}, {"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 175.3044983318282}]

attachments:
[cell repeats an earlier one in this file: 489 characters]


claim_number: CLM2025661461
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-08-09
service_provider: د. فاطمة علي الزهراني
service_provider_license: SML91506
facility_name: مستشفى بقشان
facility_license: MOH505776
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
secondary_diagnosis_codes: []
submitted_date: 2025-06-01 21:00:00
payment_date: 2025-07-10 21:00:00
saudi_id_number: 2440823511
insurance_card_number: IC589061275
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.523431
updated_at: 2025-09-03 14:42:14.523433
procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 131.5154803160044}, {"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1070.6691404085886}]

attachments:
[cell repeats an earlier one in this file: 381 characters]


claim_number: CLM2025824845
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-06-23
service_provider: د. عائشة حسن الحربي
service_provider_license: SML16568
facility_name: مستشفى الملك خالد الجامعي
facility_license: MOH372945
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-08-06 21:00:00
payment_date: 2025-08-15 21:00:00
saudi_id_number: 1834487923
insurance_card_number: IC753019307
authorization_number: AUTH883123
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.523844
updated_at: 2025-09-03 14:42:14.523847
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 185 characters]

procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 80.6178036218629}]

attachments:
[cell repeats an earlier one in this file: 379 characters]


claim_number: CLM2025684779
claim_type: OUTPATIENT
status: PAID
priority: URGENT
service_date: 2025-07-01
service_provider: د. طارق حسام الدين الأنصاري
service_provider_license: SML61699
facility_name: مستشفى الحبيب
facility_license: MOH652077
primary_diagnosis_code: N18.6
primary_diagnosis_description: End stage renal disease / المرحلة الأخيرة من مرض الكلى
submitted_date: 2025-06-06 21:00:00
payment_date: 2025-06-30 21:00:00
saudi_id_number: 1588796262
insurance_card_number: IC274379704
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.524246
updated_at: 2025-09-03 14:42:14.524249
secondary_diagnosis_codes:
  [{"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}, {"code": "J45.9", "description": "Asthma, unspecified", "description_ar": "\u0627\u0644\u0631\u0628\u0648 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}]

procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 5381.845921206899}, {"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 63.68187306089054}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025374271
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-08-08
service_provider: د. رنا سعود الأحمد
service_provider_license: SML11413
facility_name: مستشفى الحبيب
facility_license: MOH236589
primary_diagnosis_code: M25.50
primary_diagnosis_description: Pain in unspecified joint / ألم في المفصل غير المحدد
submitted_date: 2025-07-22 21:00:00
payment_date: 2025-08-11 21:00:00
saudi_id_number: 1442147979
insurance_card_number: IC316072144
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.524657
updated_at: 2025-09-03 14:42:14.524660
secondary_diagnosis_codes:
  [{"code": "J45.9", "description": "Asthma, unspecified", "description_ar": "\u0627\u0644\u0631\u0628\u0648 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "E78.5", "description": "Hyperlipidemia", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0627\u0644\u062f\u0647\u0648\u0646 \u0641\u064a \u0627\u0644\u062f\u0645"}]

procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 3106.435122061058}]

attachments:
[cell repeats an earlier one in this file: 472 characters]


claim_number: CLM2025936798
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-03-27
service_provider: د. ماجد فواز العسيري
service_provider_license: SML95861
facility_name: مستشفى الحبيب
facility_license: MOH598740
primary_diagnosis_code: M25.50
primary_diagnosis_description: Pain in unspecified joint / ألم في المفصل غير المحدد
submitted_date: 2025-06-22 21:00:00
payment_date: 2025-07-14 21:00:00
saudi_id_number: 2366373998
insurance_card_number: IC153902259
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.525068
updated_at: 2025-09-03 14:42:14.525070
secondary_diagnosis_codes:
  [{"code": "E11.9", "description": "Type 2 diabetes mellitus without complications", "description_ar": "\u062f\u0627\u0621 \u0627\u0644\u0633\u0643\u0631\u064a \u0645\u0646 \u0627\u0644\u0646\u0648\u0639 \u0627\u0644\u062b\u0627\u0646\u064a \u0628\u062f\u0648\u0646 \u0645\u0636\u0627\u0639\u0641\u0627\u062a"}, {"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}]

procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 274.7037191091247}]

attachments:
[cell repeats an earlier one in this file: 477 characters]


claim_number: CLM2025325317
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-05-24
service_provider: د. نورا سعد الغامدي
service_provider_license: SML11160
facility_name: مستشفى العيون التخصصي
facility_license: MOH997303
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-04-09 21:00:00
payment_date: 2025-04-29 21:00:00
saudi_id_number: 1367129878
insurance_card_number: IC156153033
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.525472
updated_at: 2025-09-03 14:42:14.525474
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 210 characters]

procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 5361.915058702514}, {"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 232.30370132894518}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025544223
claim_type: DIAGNOSTIC
status: PAID
priority: HIGH
service_date: 2025-07-28
service_provider: د. هند عبدالعزيز الراشد
service_provider_license: SML48624
facility_name: مستشفى بقشان
facility_license: MOH952030
primary_diagnosis_code: N18.6
primary_diagnosis_description: End stage renal disease / المرحلة الأخيرة من مرض الكلى
submitted_date: 2025-03-25 21:00:00
payment_date: 2025-04-10 21:00:00
saudi_id_number: 1431564569
insurance_card_number: IC508283477
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.525882
updated_at: 2025-09-03 14:42:14.525884
secondary_diagnosis_codes:
  [{"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}, {"code": "E78.5", "description": "Hyperlipidemia", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0627\u0644\u062f\u0647\u0648\u0646 \u0641\u064a \u0627\u0644\u062f\u0645"}, {"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}]

procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 180.10781433723156}]

attachments:
[cell repeats an earlier one in this file: 396 characters]


claim_number: CLM2025328373
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-04-03
service_provider: د. نورا سعد الغامدي
service_provider_license: SML51708
facility_name: مستشفى الملك فيصل التخصصي ومركز الأبحاث
facility_license: MOH129596
primary_diagnosis_code: M25.50
primary_diagnosis_description: Pain in unspecified joint / ألم في المفصل غير المحدد
submitted_date: 2025-08-29 21:00:00
payment_date: 2025-09-16 21:00:00
saudi_id_number: 2470111750
insurance_card_number: IC951419537
authorization_number: AUTH706510
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.526294
updated_at: 2025-09-03 14:42:14.526296
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 207 characters]

procedure_codes:
  [{"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1054.3410590059589}, {"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 83.98462613302048}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025947713
claim_type: DIAGNOSTIC
status: PAID
priority: HIGH
service_date: 2025-07-10
service_provider: د. عبدالله سليمان المطيري
service_provider_license: SML61659
facility_name: مستشفى الأهلي
facility_license: MOH757770
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
secondary_diagnosis_codes: []
submitted_date: 2025-06-23 21:00:00
payment_date: 2025-07-08 21:00:00
saudi_id_number: 1272614893
insurance_card_number: IC408846160
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.526698
updated_at: 2025-09-03 14:42:14.526700
procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 7855.9124220553995}]

attachments:
[cell repeats an earlier one in this file: 396 characters]


claim_number: CLM2025635693
claim_type: MEDICAL
status: DENIED
priority: NORMAL
service_date: 2025-07-22
service_provider: د. فاطمة علي الزهراني
service_provider_license: SML58060
facility_name: مركز الأورام الطبي
facility_license: MOH797126
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
secondary_diagnosis_codes: []
submitted_date: 2025-06-07 21:00:00
processed_date: 2025-06-22 21:00:00
saudi_id_number: 1981654745
insurance_card_number: IC627506721
denial_reason: تجاوز الحد الأقصى السنوي
denial_code: D004
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.527093
updated_at: 2025-09-03 14:42:14.527095
procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 356.1272381039213}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025666020
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-07-08
service_provider: د. ماجد فواز العسيري
service_provider_license: SML65320
facility_name: مستشفى المملكة
facility_license: MOH717946
primary_diagnosis_code: M25.50
primary_diagnosis_description: Pain in unspecified joint / ألم في المفصل غير المحدد
secondary_diagnosis_codes: []
submitted_date: 2025-08-02 21:00:00
payment_date: 2025-09-01 21:00:00
saudi_id_number: 2057501751
insurance_card_number: IC311335241
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.527437
updated_at: 2025-09-03 14:42:14.527440
procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 4993.6380363119215}, {"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1286.8022419613858}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025993054
claim_type: OUTPATIENT
status: PAID
priority: HIGH
service_date: 2025-06-20
service_provider: د. يوسف علي البقمي
service_provider_license: SML96147
facility_name: مستشفى الملك عبدالعزيز الجامعي
facility_license: MOH497462
primary_diagnosis_code: Z51.11
primary_diagnosis_description: Encounter for antineoplastic chemotherapy / مواجهة للعلاج الكيميائي المضاد للأورام
submitted_date: 2025-07-31 21:00:00
payment_date: 2025-08-24 21:00:00
saudi_id_number: 2025400127
insurance_card_number: IC158447157
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.527854
updated_at: 2025-09-03 14:42:14.527857
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 165 characters]

procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 116.6181019006228}, {"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 3092.9503591046155}]

attachments:
[cell repeats an earlier one in this file: 474 characters]


claim_number: CLM2025186761
claim_type: PHARMACY
status: PAID
priority: HIGH
service_date: 2025-07-18
service_provider: د. يوسف علي البقمي
service_provider_license: SML64748
facility_name: مستشفى الموسى التخصصي
facility_license: MOH175346
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-08-28 21:00:00
payment_date: 2025-09-13 21:00:00
saudi_id_number: 2712471275
insurance_card_number: IC278794467
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.528266
updated_at: 2025-09-03 14:42:14.528268
procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 171.70323408524825}]

attachments:
[cell repeats an earlier one in this file: 374 characters]


claim_number: CLM2025851342
claim_type: MEDICAL
status: DENIED
priority: NORMAL
service_date: 2025-06-23
service_provider: د. خالد يوسف الشهري
service_provider_license: SML21305
facility_name: مستشفى بقشان
facility_license: MOH893660
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
submitted_date: 2025-08-13 21:00:00
processed_date: 2025-08-22 21:00:00
saudi_id_number: 2399123476
insurance_card_number: IC319328662
denial_reason: انتهاء صلاحية البوليصة
denial_code: D005
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.528689
updated_at: 2025-09-03 14:42:14.528691
secondary_diagnosis_codes:
  [{"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}]

procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 190.5195771767899}]

attachments:
[cell repeats an earlier one in this file: 472 characters]


claim_number: CLM2025309251
claim_type: PHARMACY
status: PAID
priority: NORMAL
service_date: 2025-04-01
service_provider: د. محمد عبدالرحمن القحطاني
service_provider_license: SML68214
facility_name: مستشفى الملك فهد للحرس الوطني
facility_license: MOH405484
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
submitted_date: 2025-05-30 21:00:00
payment_date: 2025-06-18 21:00:00
saudi_id_number: 1492471934
insurance_card_number: IC595441841
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.529052
updated_at: 2025-09-03 14:42:14.529054
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 185 characters]

procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 96.96432889867503}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025627483
claim_type: INPATIENT
status: PAID
priority: LOW
service_date: 2025-03-21
service_provider: د. إيمان عبدالمحسن الشمري
service_provider_license: SML43445
facility_name: مستشفى بقشان
facility_license: MOH524585
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-08-09 21:00:00
payment_date: 2025-09-02 21:00:00
saudi_id_number: 2624117764
insurance_card_number: IC223667236
authorization_number: AUTH118989
notes: مطالبة تأمينية لـ inpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.529462
updated_at: 2025-09-03 14:42:14.529464
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 231 characters]

procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 6730.598335137247}, {"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 139.28748560857198}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025206481
claim_type: MEDICAL
status: PAID
priority: LOW
service_date: 2025-08-10
service_provider: د. عبدالله سليمان المطيري
service_provider_license: SML22044
facility_name: مستشفى سعد التخصصي
facility_license: MOH361216
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
submitted_date: 2025-03-29 21:00:00
payment_date: 2025-04-09 21:00:00
saudi_id_number: 1672816185
insurance_card_number: IC944654503
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.529879
updated_at: 2025-09-03 14:42:14.529882
secondary_diagnosis_codes:
  [{"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}, {"code": "J45.9", "description": "Asthma, unspecified", "description_ar": "\u0627\u0644\u0631\u0628\u0648 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "N18.6", "description": "End stage renal disease", "description_ar": "\u0627\u0644\u0645\u0631\u062d\u0644\u0629 \u0627\u0644\u0623\u062e\u064a\u0631\u0629 \u0645\u0646 \u0645\u0631\u0636 \u0627\u0644\u0643\u0644\u0649"}]

procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 268.6244985189993}, {"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 396.6605970765511}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025841752
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-08-03
service_provider: د. طارق حسام الدين الأنصاري
service_provider_license: SML58997
facility_name: مستشفى الملك فهد الطبي
facility_license: MOH505572
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
secondary_diagnosis_codes: []
submitted_date: 2025-07-27 21:00:00
payment_date: 2025-08-21 21:00:00
saudi_id_number: 2386433744
insurance_card_number: IC409847759
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.530292
updated_at: 2025-09-03 14:42:14.530295
procedure_codes:
  [{"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1006.2565417081641}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025601792
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-05-16
service_provider: د. هند عبدالعزيز الراشد
service_provider_license: SML97580
facility_name: مستشفى الملك فهد الطبي
facility_license: MOH704579
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-04-06 21:00:00
payment_date: 2025-04-29 21:00:00
saudi_id_number: 1627796125
insurance_card_number: IC490464798
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.530718
updated_at: 2025-09-03 14:42:14.530720
secondary_diagnosis_codes:
  [{"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}]

procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 75.06509835633445}]

attachments:
[cell repeats an earlier one in this file: 379 characters]


claim_number: CLM2025613627
claim_type: MEDICAL
status: DENIED
priority: NORMAL
service_date: 2025-08-26
service_provider: د. سعد محمد العتيبي
service_provider_license: SML83022
facility_name: مستشفى الملك سعود
facility_license: MOH462451
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
secondary_diagnosis_codes: []
submitted_date: 2025-08-26 21:00:00
processed_date: 2025-08-30 21:00:00
saudi_id_number: 2214915814
insurance_card_number: IC299302379
denial_reason: مقدم خدمة خارج الشبكة
denial_code: D006
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.531135
updated_at: 2025-09-03 14:42:14.531137
procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 110.9374139348485}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025782486
claim_type: EMERGENCY
status: PAID
priority: NORMAL
service_date: 2025-07-26
service_provider: د. خالد يوسف الشهري
service_provider_license: SML11230
facility_name: مركز الأورام الطبي
facility_license: MOH113502
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
secondary_diagnosis_codes: []
submitted_date: 2025-05-30 21:00:00
payment_date: 2025-06-10 21:00:00
saudi_id_number: 2432840302
insurance_card_number: IC622939074
authorization_number: AUTH311161
notes: مطالبة تأمينية لـ emergency - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.531481
updated_at: 2025-09-03 14:42:14.531483
procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 204.78129148264802}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "DISCHARGE_SUMMARY", "name": "\u0645\u0644\u062e\u0635 \u0627\u0644\u062e\u0631\u0648\u062c.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025760773
claim_type: MEDICAL
status: DENIED
priority: NORMAL
service_date: 2025-07-05
service_provider: د. إيمان عبدالمحسن الشمري
service_provider_license: SML44670
facility_name: المستشفى السعودي الألماني
facility_license: MOH103540
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-03-13 21:00:00
processed_date: 2025-03-24 21:00:00
saudi_id_number: 2127097180
insurance_card_number: IC586842335
denial_reason: مطلوب تصريح مسبق
denial_code: D003
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.531893
updated_at: 2025-09-03 14:42:14.531895
procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 5405.699893065748}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025338981
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-08-30
service_provider: د. يوسف علي البقمي
service_provider_license: SML85235
facility_name: مستشفى العيون التخصصي
facility_license: MOH657324
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-06-23 21:00:00
payment_date: 2025-07-17 21:00:00
saudi_id_number: 1387256710
insurance_card_number: IC266102338
authorization_number: AUTH455014
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.532261
updated_at: 2025-09-03 14:42:14.532264
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 210 characters]

procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 170.19979886982702}]

attachments:
[cell repeats an earlier one in this file: 472 characters]


claim_number: CLM2025217349
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-03-17
service_provider: د. سارة عبدالرحمن الفيصل
service_provider_license: SML16592
facility_name: مستشفى الملك عبدالعزيز الجامعي
facility_license: MOH436259
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
secondary_diagnosis_codes: []
submitted_date: 2025-07-16 21:00:00
payment_date: 2025-08-04 21:00:00
saudi_id_number: 2963352249
insurance_card_number: IC299552438
authorization_number: AUTH658223
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.532660
updated_at: 2025-09-03 14:42:14.532663
procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 141.0388747513125}, {"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 248.25852925652248}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025548077
claim_type: OUTPATIENT
status: PAID
priority: LOW
service_date: 2025-03-19
service_provider: د. محمد عبدالرحمن القحطاني
service_provider_license: SML67234
facility_name: مستشفى العيون التخصصي
facility_license: MOH686320
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
secondary_diagnosis_codes: []
submitted_date: 2025-05-16 21:00:00
payment_date: 2025-06-09 21:00:00
saudi_id_number: 2010444094
insurance_card_number: IC232822751
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.533070
updated_at: 2025-09-03 14:42:14.533072
procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 91.79527566436718}, {"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 334.9392155627772}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025263224
claim_type: EMERGENCY
status: PAID
priority: NORMAL
service_date: 2025-03-22
service_provider: د. فيصل عبدالله السديري
service_provider_license: SML71438
facility_name: مستشفى دلة
facility_license: MOH175911
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-05-26 21:00:00
payment_date: 2025-06-19 21:00:00
saudi_id_number: 2302230448
insurance_card_number: IC789648729
authorization_number: AUTH717200
notes: مطالبة تأمينية لـ emergency - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.533493
updated_at: 2025-09-03 14:42:14.533495
secondary_diagnosis_codes:
  [{"code": "N18.6", "description": "End stage renal disease", "description_ar": "\u0627\u0644\u0645\u0631\u062d\u0644\u0629 \u0627\u0644\u0623\u062e\u064a\u0631\u0629 \u0645\u0646 \u0645\u0631\u0636 \u0627\u0644\u0643\u0644\u0649"}, {"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}]

procedure_codes:
  [{"code": "93000", "description": "Electrocardiogram", "description_ar": "\u062a\u062e\u0637\u064a\u0637 \u0627\u0644\u0642\u0644\u0628 \u0627\u0644\u0643\u0647\u0631\u0628\u0627\u0626\u064a", "cost": 123.70276146441779}, {"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 5230.010709742496}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "DISCHARGE_SUMMARY", "name": "\u0645\u0644\u062e\u0635 \u0627\u0644\u062e\u0631\u0648\u062c.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}]


claim_number: CLM2025476956
claim_type: OUTPATIENT
status: PAID
priority: HIGH
service_date: 2025-05-14
service_provider: د. فيصل عبدالله السديري
service_provider_license: SML40770
facility_name: مستشفى المملكة
facility_license: MOH820903
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
secondary_diagnosis_codes: []
submitted_date: 2025-03-30 21:00:00
payment_date: 2025-04-16 21:00:00
saudi_id_number: 1096123408
insurance_card_number: IC856140398
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.533903
updated_at: 2025-09-03 14:42:14.533905
procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 127.97331660380435}, {"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 3960.245835376867}, {"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 4822.979422219741}]

attachments:
[cell repeats an earlier one in this file: 477 characters]


claim_number: CLM2025139974
claim_type: MEDICAL
status: PAID
priority: LOW
service_date: 2025-03-23
service_provider: د. فاطمة علي الزهراني
service_provider_license: SML65164
facility_name: مستشفى الأمير سلطان العسكري
facility_license: MOH239509
primary_diagnosis_code: Z51.11
primary_diagnosis_description: Encounter for antineoplastic chemotherapy / مواجهة للعلاج الكيميائي المضاد للأورام
submitted_date: 2025-06-17 21:00:00
payment_date: 2025-07-04 21:00:00
saudi_id_number: 2440267834
insurance_card_number: IC219279916
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.534324
updated_at: 2025-09-03 14:42:14.534326
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 185 characters]

procedure_codes:
  [{"code": "80053", "description": "Comprehensive metabolic panel", "description_ar": "\u0641\u062d\u0635 \u0627\u0644\u0623\u064a\u0636 \u0627\u0644\u0634\u0627\u0645\u0644", "cost": 199.55833943063618}, {"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 3793.4399320772554}, {"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 282.10296948014155}]

attachments:
[cell repeats an earlier one in this file: 472 characters]


claim_number: CLM2025287741
claim_type: PHARMACY
status: PAID
priority: NORMAL
service_date: 2025-06-09
service_provider: د. إيمان عبدالمحسن الشمري
service_provider_license: SML89939
facility_name: مستشفى الملك خالد الجامعي
facility_license: MOH829273
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-05-01 21:00:00
payment_date: 2025-05-11 21:00:00
saudi_id_number: 2369658609
insurance_card_number: IC852544817
authorization_number: AUTH487001
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.534737
updated_at: 2025-09-03 14:42:14.534740
procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 343.0839375962794}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "OTHER", "name": "\u0645\u0633\u062a\u0646\u062f \u0625\u0636\u0627\u0641\u064a.pdf"}]


claim_number: CLM2025576243
claim_type: PHARMACY
status: PAID
priority: NORMAL
service_date: 2025-07-21
service_provider: د. طارق حسام الدين الأنصاري
service_provider_license: SML92644
facility_name: مستشفى العيون التخصصي
facility_license: MOH557341
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-08-28 21:00:00
payment_date: 2025-10-04 21:00:00
saudi_id_number: 1060060342
insurance_card_number: IC775776728
authorization_number: AUTH974112
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.535147
updated_at: 2025-09-03 14:42:14.535150
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 165 characters]

procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 6955.243641432051}]

attachments:
[cell repeats an earlier one in this file: 467 characters]


claim_number: CLM2025528040
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-05-17
service_provider: د. عبدالله سليمان المطيري
service_provider_license: SML85627
facility_name: مركز الأورام الطبي
facility_license: MOH622385
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
secondary_diagnosis_codes: []
submitted_date: 2025-06-08 21:00:00
payment_date: 2025-06-21 21:00:00
saudi_id_number: 1013014232
insurance_card_number: IC765299806
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.535555
updated_at: 2025-09-03 14:42:14.535557
procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 287.64593853025724}, {"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 85.58361922102472}]

attachments:
[cell repeats an earlier one in this file: 474 characters]


claim_number: CLM2025945001
claim_type: MEDICAL
status: PAID
priority: HIGH
service_date: 2025-05-08
service_provider: د. نورا سعد الغامدي
service_provider_license: SML24311
facility_name: مستشفى الملك فهد الطبي
facility_license: MOH993430
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-08-20 21:00:00
payment_date: 2025-09-07 21:00:00
saudi_id_number: 1797171549
insurance_card_number: IC346387311
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.535955
updated_at: 2025-09-03 14:42:14.535957
secondary_diagnosis_codes:
  [{"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}, {"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}]

procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 112.87724564720685}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025633995
claim_type: OUTPATIENT
status: PAID
priority: HIGH
service_date: 2025-07-15
service_provider: د. دانا محمد الفهد
service_provider_license: SML64064
facility_name: مستشفى الملك فهد للحرس الوطني
facility_license: MOH151017
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
secondary_diagnosis_codes: []
submitted_date: 2025-04-15 21:00:00
payment_date: 2025-05-07 21:00:00
saudi_id_number: 2402504624
insurance_card_number: IC788976854
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.536381
updated_at: 2025-09-03 14:42:14.536383
procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 288.71307618204276}, {"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 277.07243240972673}]

attachments:
[cell repeats an earlier one in this file: 477 characters]


claim_number: CLM2025887502
claim_type: PHARMACY
status: PAID
priority: HIGH
service_date: 2025-08-26
service_provider: د. عبدالله سليمان المطيري
service_provider_license: SML83736
facility_name: مستشفى الملك فهد الطبي
facility_license: MOH891017
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
submitted_date: 2025-08-07 21:00:00
payment_date: 2025-08-15 21:00:00
saudi_id_number: 2475325896
insurance_card_number: IC104874966
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.536798
updated_at: 2025-09-03 14:42:14.536801
secondary_diagnosis_codes:
  [{"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}]

procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 7188.459210744966}]

attachments:
[cell repeats an earlier one in this file: 467 characters]


claim_number: CLM2025945647
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-06-10
service_provider: د. فاطمة علي الزهراني
service_provider_license: SML16752
facility_name: مستشفى بقشان
facility_license: MOH353044
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-07-13 21:00:00
payment_date: 2025-08-01 21:00:00
saudi_id_number: 1026207599
insurance_card_number: IC830414355
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.537215
updated_at: 2025-09-03 14:42:14.537218
secondary_diagnosis_codes:
  [{"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}, {"code": "F32.9", "description": "Major depressive disorder", "description_ar": "\u0627\u0636\u0637\u0631\u0627\u0628 \u0627\u0644\u0627\u0643\u062a\u0626\u0627\u0628 \u0627\u0644\u0634\u062f\u064a\u062f"}]

procedure_codes:
  [{"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 77.38790967278234}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025640373
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-05-07
service_provider: د. طارق حسام الدين الأنصاري
service_provider_license: SML92511
facility_name: مستشفى الملك فهد للحرس الوطني
facility_license: MOH395550
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-03-24 21:00:00
payment_date: 2025-04-13 21:00:00
saudi_id_number: 1028979853
insurance_card_number: IC233317883
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.537623
updated_at: 2025-09-03 14:42:14.537626
secondary_diagnosis_codes:
  [{"code": "E78.5", "description": "Hyperlipidemia", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0627\u0644\u062f\u0647\u0648\u0646 \u0641\u064a \u0627\u0644\u062f\u0645"}, {"code": "E11.9", "description": "Type 2 diabetes mellitus without complications", "description_ar": "\u062f\u0627\u0621 \u0627\u0644\u0633\u0643\u0631\u064a \u0645\u0646 \u0627\u0644\u0646\u0648\u0639 \u0627\u0644\u062b\u0627\u0646\u064a \u0628\u062f\u0648\u0646 \u0645\u0636\u0627\u0639\u0641\u0627\u062a"}, {"code": "F32.9", "description": "Major depressive disorder", "description_ar": "\u0627\u0636\u0637\u0631\u0627\u0628 \u0627\u0644\u0627\u0643\u062a\u0626\u0627\u0628 \u0627\u0644\u0634\u062f\u064a\u062f"}]

procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 216.93341251632185}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 6080.027093332335}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 5309.841861691164}]

attachments:
[cell repeats an earlier one in this file: 474 characters]


claim_number: CLM2025816418
claim_type: DIAGNOSTIC
status: PAID
priority: NORMAL
service_date: 2025-05-22
service_provider: د. فاطمة علي الزهراني
service_provider_license: SML19845
facility_name: مستشفى الملك عبدالعزيز الجامعي
facility_license: MOH763426
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
submitted_date: 2025-05-02 21:00:00
payment_date: 2025-05-30 21:00:00
saudi_id_number: 2031418649
insurance_card_number: IC627899076
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.538035
updated_at: 2025-09-03 14:42:14.538037
secondary_diagnosis_codes:
  [{"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}]

procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 196.74106061150448}]

attachments:
[cell repeats an earlier one in this file: 396 characters]


claim_number: CLM2025176213
claim_type: PHARMACY
status: PAID
priority: HIGH
service_date: 2025-07-20
service_provider: د. فاطمة علي الزهراني
service_provider_license: SML55731
facility_name: مستشفى الموسى التخصصي
facility_license: MOH154579
primary_diagnosis_code: N18.6
primary_diagnosis_description: End stage renal disease / المرحلة الأخيرة من مرض الكلى
secondary_diagnosis_codes: []
submitted_date: 2025-03-23 21:00:00
payment_date: 2025-04-19 21:00:00
saudi_id_number: 1672465944
insurance_card_number: IC733072903
authorization_number: AUTH445679
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.538457
updated_at: 2025-09-03 14:42:14.538460
procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 3677.4712510494}]

attachments:
[cell repeats an earlier one in this file: 467 characters]


claim_number: CLM2025168510
claim_type: PHARMACY
status: PAID
priority: NORMAL
service_date: 2025-08-24
service_provider: د. ماجد فواز العسيري
service_provider_license: SML47917
facility_name: مستشفى الولادة والأطفال
facility_license: MOH934692
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
submitted_date: 2025-03-21 21:00:00
payment_date: 2025-03-26 21:00:00
saudi_id_number: 2123617817
insurance_card_number: IC695061810
authorization_number: AUTH648887
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.538880
updated_at: 2025-09-03 14:42:14.538882
secondary_diagnosis_codes:
  [{"code": "Z51.11", "description": "Encounter for antineoplastic chemotherapy", "description_ar": "\u0645\u0648\u0627\u062c\u0647\u0629 \u0644\u0644\u0639\u0644\u0627\u062c \u0627\u0644\u0643\u064a\u0645\u064a\u0627\u0626\u064a \u0627\u0644\u0645\u0636\u0627\u062f \u0644\u0644\u0623\u0648\u0631\u0627\u0645"}, {"code": "M79.3", "description": "Panniculitis, unspecified", "description_ar": "\u0627\u0644\u062a\u0647\u0627\u0628 \u0627\u0644\u0646\u0633\u064a\u062c \u0627\u0644\u0634\u062d\u0645\u064a"}, {"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}]

procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 202.83981852543027}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "PRESCRIPTION", "name": "\u0648\u0635\u0641\u0629 \u0637\u0628\u064a\u0629.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025718075
claim_type: PHARMACY
status: PAID
priority: NORMAL
service_date: 2025-04-03
service_provider: د. عائشة حسن الحربي
service_provider_license: SML34860
facility_name: مستشفى الملك عبدالعزيز الجامعي
facility_license: MOH368747
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-07-23 21:00:00
payment_date: 2025-08-09 21:00:00
saudi_id_number: 2789373011
insurance_card_number: IC881214618
notes: مطالبة تأمينية لـ pharmacy - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.539303
updated_at: 2025-09-03 14:42:14.539305
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 210 characters]

procedure_codes:
  [{"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 895.7365664045153}, {"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 106.41002710343385}]

attachments:
[cell repeats an earlier one in this file: 467 characters]


claim_number: CLM2025777499
claim_type: OUTPATIENT
status: PAID
priority: NORMAL
service_date: 2025-07-30
service_provider: د. عائشة حسن الحربي
service_provider_license: SML13849
facility_name: مستشفى بقشان
facility_license: MOH125891
primary_diagnosis_code: N18.6
primary_diagnosis_description: End stage renal disease / المرحلة الأخيرة من مرض الكلى
secondary_diagnosis_codes: []
submitted_date: 2025-05-25 21:00:00
payment_date: 2025-06-17 21:00:00
saudi_id_number: 2347331364
insurance_card_number: IC367991698
authorization_number: AUTH989274
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.539706
updated_at: 2025-09-03 14:42:14.539709
procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 258.30840409489366}]

attachments:
[cell repeats an earlier one in this file: 477 characters]


claim_number: CLM2025841449
claim_type: EMERGENCY
status: PAID
priority: HIGH
service_date: 2025-07-07
service_provider: د. دانا محمد الفهد
service_provider_license: SML14995
facility_name: مستشفى الملك خالد الجامعي
facility_license: MOH907063
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-08-30 21:00:00
payment_date: 2025-09-21 21:00:00
saudi_id_number: 1093398632
insurance_card_number: IC602392565
authorization_number: AUTH395213
notes: مطالبة تأمينية لـ emergency - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.540113
updated_at: 2025-09-03 14:42:14.540115
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 165 characters]

procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 375.6694979132669}]

attachments:
  [{"type": "MEDICAL_REPORT", "name": "\u062a\u0642\u0631\u064a\u0631 \u0637\u0628\u064a.pdf"}, {"type": "INVOICE", "name": "\u0641\u0627\u062a\u0648\u0631\u0629.pdf"}, {"type": "INSURANCE_CARD", "name": "\u0628\u0637\u0627\u0642\u0629 \u0627\u0644\u062a\u0623\u0645\u064a\u0646.pdf"}, {"type": "DISCHARGE_SUMMARY", "name": "\u0645\u0644\u062e\u0635 \u0627\u0644\u062e\u0631\u0648\u062c.pdf"}, {"type": "REFERRAL", "name": "\u062e\u0637\u0627\u0628 \u062a\u062d\u0648\u064a\u0644.pdf"}, {"type": "ID_COPY", "name": "\u0646\u0633\u062e\u0629 \u0627\u0644\u0647\u0648\u064a\u0629.pdf"}]


claim_number: CLM2025705325
claim_type: OUTPATIENT
status: PAID
priority: LOW
service_date: 2025-03-15
service_provider: د. فيصل عبدالله السديري
service_provider_license: SML32987
facility_name: مستشفى الحبيب
facility_license: MOH724111
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
submitted_date: 2025-08-03 21:00:00
payment_date: 2025-09-01 21:00:00
saudi_id_number: 1230225512
insurance_card_number: IC266004295
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.540520
updated_at: 2025-09-03 14:42:14.540522
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 185 characters]

procedure_codes:
  [{"code": "66984", "description": "Cataract surgery", "description_ar": "\u062c\u0631\u0627\u062d\u0629 \u0627\u0644\u0633\u0627\u062f", "cost": 4322.5209088046195}, {"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 245.23062119444415}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025677545
claim_type: OUTPATIENT
status: PAID
priority: HIGH
service_date: 2025-07-14
service_provider: د. سارة عبدالرحمن الفيصل
service_provider_license: SML26388
facility_name: مستشفى الملك سعود
facility_license: MOH811548
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-08-02 21:00:00
payment_date: 2025-08-24 21:00:00
saudi_id_number: 1693580070
insurance_card_number: IC798209232
notes: مطالبة تأمينية لـ outpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.540931
updated_at: 2025-09-03 15:30:57.909924
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 310 characters]

procedure_codes:
  [{"code": "71020", "description": "Chest X-ray", "description_ar": "\u0623\u0634\u0639\u0629 \u0633\u064a\u0646\u064a\u0629 \u0644\u0644\u0635\u062f\u0631", "cost": 144.59259393652718}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 7038.161576278765}, {"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 104.85784730724697}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025460616
claim_type: DIAGNOSTIC
status: PAID
priority: HIGH
service_date: 2025-07-08
service_provider: د. عبدالله سليمان المطيري
service_provider_license: SML44468
facility_name: المستشفى السعودي الألماني
facility_license: MOH199880
primary_diagnosis_code: M25.50
primary_diagnosis_description: Pain in unspecified joint / ألم في المفصل غير المحدد
submitted_date: 2025-05-07 21:00:00
payment_date: 2025-05-25 21:00:00
saudi_id_number: 2809000642
insurance_card_number: IC191577773
authorization_number: AUTH863042
notes: مطالبة تأمينية لـ diagnostic - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.541346
updated_at: 2025-09-03 14:42:14.541348
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 207 characters]

procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 7015.130722277678}, {"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 6151.2611718331855}]

attachments:
[cell repeats an earlier one in this file: 396 characters]


claim_number: CLM2025302240
claim_type: INPATIENT
status: DENIED
priority: NORMAL
service_date: 2025-06-19
service_provider: د. إيمان عبدالمحسن الشمري
service_provider_license: SML48581
facility_name: مستشفى سعد التخصصي
facility_license: MOH554431
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
secondary_diagnosis_codes: []
submitted_date: 2025-08-15 21:00:00
processed_date: 2025-08-18 21:00:00
saudi_id_number: 1915528119
insurance_card_number: IC807266617
denial_reason: انتهاء صلاحية البوليصة
denial_code: D002
notes: مطالبة تأمينية لـ inpatient - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.541757
updated_at: 2025-09-03 14:42:14.541759
procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 333.0580100626271}]

attachments:
[cell repeats an earlier one in this file: 474 characters]


claim_number: CLM2025164144
claim_type: MEDICAL
status: PAID
priority: URGENT
service_date: 2025-06-28
service_provider: د. أحمد محمد العبدالله
service_provider_license: SML56751
facility_name: مستشفى الأمير محمد بن عبدالعزيز
facility_license: MOH222451
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
secondary_diagnosis_codes: []
submitted_date: 2025-06-05 21:00:00
payment_date: 2025-07-04 21:00:00
saudi_id_number: 1416987691
insurance_card_number: IC521952132
authorization_number: AUTH918706
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.542108
updated_at: 2025-09-03 14:42:14.542111
procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 7732.4732404761235}, {"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 351.8540322927085}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025902028
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-07-25
service_provider: د. محمد عبدالرحمن القحطاني
service_provider_license: SML69229
facility_name: مستشفى سعد التخصصي
facility_license: MOH706624
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
secondary_diagnosis_codes: []
submitted_date: 2025-05-28 21:00:00
payment_date: 2025-06-25 21:00:00
saudi_id_number: 2879945112
insurance_card_number: IC919182950
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.542517
updated_at: 2025-09-03 14:42:14.542519
procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 211.1450656180881}]

attachments:
[cell repeats an earlier one in this file: 472 characters]


claim_number: CLM2025980615
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-06-10
service_provider: د. فيصل عبدالله السديري
service_provider_license: SML90260
facility_name: مستشفى الملك فهد للحرس الوطني
facility_license: MOH906033
primary_diagnosis_code: E78.5
primary_diagnosis_description: Hyperlipidemia / ارتفاع الدهون في الدم
submitted_date: 2025-05-06 21:00:00
payment_date: 2025-05-12 21:00:00
saudi_id_number: 1421468304
insurance_card_number: IC950434627
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.542921
updated_at: 2025-09-03 14:42:14.542923
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 195 characters]

procedure_codes:
  [{"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 938.7370992263827}, {"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 193.466118620371}, {"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1294.5908976189328}]

attachments:
[cell repeats an earlier one in this file: 477 characters]


claim_number: CLM2025370837
claim_type: EMERGENCY
status: PAID
priority: NORMAL
service_date: 2025-04-10
service_provider: د. خالد يوسف الشهري
service_provider_license: SML72720
facility_name: مستشفى الدكتور سليمان الحبيب
facility_license: MOH111644
primary_diagnosis_code: J45.9
primary_diagnosis_description: Asthma, unspecified / الربو غير المحدد
submitted_date: 2025-05-30 21:00:00
payment_date: 2025-07-03 21:00:00
saudi_id_number: 1784259659
insurance_card_number: IC302437284
notes: مطالبة تأمينية لـ emergency - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.543340
updated_at: 2025-09-03 14:42:14.543343
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 310 characters]

procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 280.87617900230254}]

attachments:
[cell repeats an earlier one in this file: 391 characters]


claim_number: CLM2025105557
claim_type: MEDICAL
status: PAID
priority: HIGH
service_date: 2025-07-23
service_provider: د. سعد محمد العتيبي
service_provider_license: SML68192
facility_name: مستشفى المملكة
facility_license: MOH998826
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-07-05 21:00:00
payment_date: 2025-07-20 21:00:00
saudi_id_number: 2370047230
insurance_card_number: IC572948423
authorization_number: AUTH246810
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.543773
updated_at: 2025-09-03 14:42:14.543776
secondary_diagnosis_codes:
  [{"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}, {"code": "K21.9", "description": "Gastro-esophageal reflux disease", "description_ar": "\u0645\u0631\u0636 \u0627\u0644\u0627\u0631\u062a\u062c\u0627\u0639 \u0627\u0644\u0645\u0639\u062f\u064a \u0627\u0644\u0645\u0631\u064a\u0626\u064a"}]

procedure_codes:
  [{"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 237.60060839539653}, {"code": "99213", "description": "Office visit - established patient", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645", "cost": 227.70119065401292}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025837294
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-05-06
service_provider: د. فيصل عبدالله السديري
service_provider_license: SML95779
facility_name: مستشفى الملك فهد الطبي
facility_license: MOH559690
primary_diagnosis_code: I10
primary_diagnosis_description: Essential hypertension / ارتفاع ضغط الدم الأساسي
secondary_diagnosis_codes: []
submitted_date: 2025-07-25 21:00:00
payment_date: 2025-08-16 21:00:00
saudi_id_number: 2424998819
insurance_card_number: IC443842180
authorization_number: AUTH975799
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.544181
updated_at: 2025-09-03 14:42:14.544184
procedure_codes:
  [{"code": "99214", "description": "Office visit - established patient, moderate complexity", "description_ar": "\u0632\u064a\u0627\u0631\u0629 \u0627\u0644\u0639\u064a\u0627\u062f\u0629 - \u0645\u0631\u064a\u0636 \u0645\u0646\u062a\u0638\u0645\u060c \u062a\u0639\u0642\u064a\u062f \u0645\u062a\u0648\u0633\u0637", "cost": 264.6871535888051}, {"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1332.660239649058}]

attachments:
[cell repeats an earlier one in this file: 477 characters]


claim_number: CLM2025622222
claim_type: MEDICAL
status: PAID
priority: NORMAL
service_date: 2025-05-29
service_provider: د. أحمد محمد العبدالله
service_provider_license: SML37681
facility_name: مستشفى الأمير سلطان العسكري
facility_license: MOH756291
primary_diagnosis_code: E11.9
primary_diagnosis_description: Type 2 diabetes mellitus without complications / داء السكري من النوع الثاني بدون مضاعفات
secondary_diagnosis_codes: []
submitted_date: 2025-08-25 21:00:00
payment_date: 2025-09-16 21:00:00
saudi_id_number: 1228742862
insurance_card_number: IC983156560
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.544594
updated_at: 2025-09-03 14:42:14.544597
procedure_codes:
  [{"code": "47562", "description": "Laparoscopic cholecystectomy", "description_ar": "\u0627\u0633\u062a\u0626\u0635\u0627\u0644 \u0627\u0644\u0645\u0631\u0627\u0631\u0629 \u0628\u0627\u0644\u0645\u0646\u0638\u0627\u0631", "cost": 6443.776722932471}, {"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 60.38960647885846}, {"code": "85025", "description": "Blood count; complete (CBC)", "description_ar": "\u062a\u0639\u062f\u0627\u062f \u0627\u0644\u062f\u0645 \u0627\u0644\u0643\u0627\u0645\u0644", "cost": 103.78147400250924}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


claim_number: CLM2025683437
claim_type: MEDICAL
status: PAID
priority: HIGH
service_date: 2025-07-09
service_provider: د. فاطمة علي الزهراني
service_provider_license: SML62118
facility_name: مستشفى الحبيب
facility_license: MOH590625
primary_diagnosis_code: M79.3
primary_diagnosis_description: Panniculitis, unspecified / التهاب النسيج الشحمي
submitted_date: 2025-06-01 21:00:00
payment_date: 2025-06-30 21:00:00
saudi_id_number: 1800781778
insurance_card_number: IC673392513
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.545015
updated_at: 2025-09-03 14:42:14.545017
secondary_diagnosis_codes:
[cell repeats an earlier one in this file: 203 characters]

procedure_codes:
  [{"code": "45378", "description": "Colonoscopy", "description_ar": "\u062a\u0646\u0638\u064a\u0631 \u0627\u0644\u0642\u0648\u0644\u0648\u0646", "cost": 1138.891964151107}]

attachments:
[cell repeats an earlier one in this file: 376 characters]


claim_number: CLM2025961084
claim_type: MEDICAL
status: PAID
priority: HIGH
service_date: 2025-08-08
service_provider: د. عائشة حسن الحربي
service_provider_license: SML49199
facility_name: مستشفى الحبيب
facility_license: MOH160015
primary_diagnosis_code: K21.9
primary_diagnosis_description: Gastro-esophageal reflux disease / مرض الارتجاع المعدي المريئي
submitted_date: 2025-03-20 21:00:00
payment_date: 2025-04-09 21:00:00
saudi_id_number: 2370682711
insurance_card_number: IC643121729
notes: مطالبة تأمينية لـ medical - تم إنشاؤها تلقائياً
created_at: 2025-09-03 14:42:14.545432
updated_at: 2025-09-03 14:42:14.545434
secondary_diagnosis_codes:
  [{"code": "I10", "description": "Essential hypertension", "description_ar": "\u0627\u0631\u062a\u0641\u0627\u0639 \u0636\u063a\u0637 \u0627\u0644\u062f\u0645 \u0627\u0644\u0623\u0633\u0627\u0633\u064a"}, {"code": "M25.50", "description": "Pain in unspecified joint", "description_ar": "\u0623\u0644\u0645 \u0641\u064a \u0627\u0644\u0645\u0641\u0635\u0644 \u063a\u064a\u0631 \u0627\u0644\u0645\u062d\u062f\u062f"}]

procedure_codes:
  [{"code": "76700", "description": "Abdominal ultrasound", "description_ar": "\u0627\u0644\u0645\u0648\u062c\u0627\u062a \u0641\u0648\u0642 \u0627\u0644\u0635\u0648\u062a\u064a\u0629 \u0644\u0644\u0628\u0637\u0646", "cost": 256.4496582454408}]

attachments:
[cell repeats an earlier one in this file: 283 characters]


