{
  "schemaVersion": 1,
  "generatedAt": "2026-09-08",
  "sourceKit": "appointment-capacity",
  "currency": "USD",
  "identities": [
    {
      "id": "encounters-from-bookings",
      "statement": "Every confirmed booking produces exactly one encounter and one claim; cancelled bookings produce none.",
      "bookings": 18,
      "confirmed": 16,
      "cancelled": 2,
      "encounters": 16
    },
    {
      "id": "charge-split",
      "statement": "Charge equals allowed plus contractual on every claim and in total.",
      "charged": "1180.00",
      "allowed": "876.00",
      "contractual": "304.00"
    },
    {
      "id": "allowed-split",
      "statement": "Allowed equals payer payment plus patient coinsurance.",
      "allowed": "876.00",
      "paid": "700.80",
      "patientResponsibility": "175.20"
    },
    {
      "id": "837-balance",
      "statement": "Each CLM02 equals the SV102 amounts beneath it, and the claim totals sum to the charge total.",
      "claims": 16,
      "serviceLines": 18,
      "chargeTotal": "1180.00"
    },
    {
      "id": "835-balance",
      "statement": "Each BPR02 equals the CLP04 amounts in its transaction set, and the three transaction sets sum to the payment total.",
      "transactionSets": 3,
      "paidTotal": "700.80",
      "byPayer": {
        "PYR-01": "272.00",
        "PYR-02": "208.00",
        "PYR-03": "220.80"
      }
    },
    {
      "id": "denial-is-not-a-patient-balance",
      "statement": "The denied claim is adjusted CO 97, a contractual group, so nothing becomes payable by the patient.",
      "claimId": "CLM-0011",
      "deniedAmount": "85.00",
      "patientResponsibility": "0.00"
    }
  ],
  "deliberateDefects": [
    {
      "file": "claim-837p-CLM-0006-service-line-total-mismatch.edi",
      "defect": "CLM02 reads 225.00 while the service lines sum to 205.00",
      "measuredDifference": "20.00",
      "structurallyValid": true
    }
  ]
}