curl --request POST \
  --url https://api.example.com/api/v2/clearinghouse/patient-cost \
  --header 'Content-Type: application/json' \
  --data '
{
  "eligibilityResponses": [
    {
      "inNetwork": true,
      "meta": {
        "senderId": "<string>",
        "submitterId": "<string>",
        "billerId": "<string>",
        "traceId": "<string>",
        "outboundTraceId": "<string>"
      },
      "controlNumber": "<string>",
      "reassociationKey": "<string>",
      "tradingPartnerServiceId": "<string>",
      "provider": {
        "providerName": "<string>",
        "providerFirstName": "<string>",
        "providerOrgName": "<string>",
        "middleName": "<string>",
        "suffix": "<string>",
        "npi": "<string>",
        "referenceIdentification": "<string>",
        "ssn": "<string>",
        "federalTaxpayersIdNumber": "<string>",
        "payorIdentification": "<string>",
        "pharmacyProcessorNumber": "<string>",
        "serviceProviderNumber": "<string>",
        "servicesPlanID": "<string>",
        "address": {
          "address1": "<string>",
          "address2": "<string>",
          "city": "<string>",
          "postalCode": "<string>",
          "countryCode": "<string>",
          "countrySubDivisionCode": "<string>"
        },
        "employersId": "<string>",
        "aaaErrors": [
          {
            "field": "<string>",
            "description": "<string>",
            "location": "<string>",
            "possibleResolutions": "<string>"
          }
        ]
      },
      "subscriber": {
        "healthCareDiagnosisCodes": [
          {
            "diagnosisTypeCode": "<string>",
            "diagnosisCode": "<string>"
          }
        ],
        "memberId": "<string>",
        "firstName": "<string>",
        "lastName": "<string>",
        "middleName": "<string>",
        "suffix": "<string>",
        "uniqueHealthIdentifier": "<string>",
        "dateOfBirth": "<string>",
        "description": "<string>",
        "dateTimePeriod": "<string>",
        "startDateTimePeriod": "<string>",
        "endDateTimePeriod": "<string>",
        "ssn": "<string>",
        "groupNumber": "<string>",
        "planNumber": "<string>",
        "planNetworkIdNumber": "<string>",
        "groupDescription": "<string>",
        "planDescription": "<string>",
        "planNetworkDescription": "<string>",
        "birthSequenceNumber": "<string>",
        "address": {
          "address1": "<string>",
          "address2": "<string>",
          "city": "<string>",
          "postalCode": "<string>",
          "countryCode": "<string>",
          "countrySubDivisionCode": "<string>"
        },
        "responseProvider": {
          "providerName": "<string>",
          "providerFirstName": "<string>",
          "providerOrgName": "<string>",
          "middleName": "<string>",
          "suffix": "<string>",
          "npi": "<string>",
          "referenceIdentification": "<string>",
          "ssn": "<string>",
          "federalTaxpayersIdNumber": "<string>",
          "payorIdentification": "<string>",
          "pharmacyProcessorNumber": "<string>",
          "serviceProviderNumber": "<string>",
          "servicesPlanID": "<string>",
          "address": {
            "address1": "<string>",
            "address2": "<string>",
            "city": "<string>",
            "postalCode": "<string>",
            "countryCode": "<string>",
            "countrySubDivisionCode": "<string>"
          },
          "employersId": "<string>",
          "aaaErrors": [
            {
              "field": "<string>",
              "description": "<string>",
              "location": "<string>",
              "possibleResolutions": "<string>"
            }
          ]
        },
        "aaaErrors": [
          {
            "field": "<string>",
            "description": "<string>",
            "location": "<string>",
            "possibleResolutions": "<string>"
          }
        ]
      },
      "subscriberTraceNumbers": [
        {
          "traceTypeCode": "<string>",
          "traceType": "<string>",
          "referenceIdentification": "<string>",
          "originatingCompanyIdentifier": "<string>",
          "secondaryReferenceIdentification": "<string>"
        }
      ],
      "payer": {
        "firstName": "<string>",
        "lastName": "<string>",
        "name": "<string>",
        "middleName": "<string>",
        "suffix": "<string>",
        "federalTaxpayersIdNumber": "<string>",
        "naic": "<string>",
        "npi": "<string>",
        "centersForMedicareAndMedicaidPlanId": "<string>",
        "payorIdentification": "<string>",
        "contactInformation": {
          "name": "<string>",
          "contacts": [
            {
              "communicationNumber": "<string>"
            }
          ]
        },
        "etin": "<string>",
        "employersId": "<string>",
        "aaaErrors": [
          {
            "field": "<string>",
            "description": "<string>",
            "location": "<string>",
            "possibleResolutions": "<string>"
          }
        ]
      },
      "planInformation": {
        "stateLicenseNumber": "<string>",
        "medicareProviderNumber": "<string>",
        "medicaidProviderNumber": "<string>",
        "facilityIdNumber": "<string>",
        "personalIdentificationNumber": "<string>",
        "planNumber": "<string>",
        "planDescription": "<string>",
        "policyNumber": "<string>",
        "memberId": "<string>",
        "caseNumber": "<string>",
        "familyUnitNumber": "<string>",
        "groupNumber": "<string>",
        "groupDescription": "<string>",
        "referralNumber": "<string>",
        "alternativeListId": "<string>",
        "classOfContractCode": "<string>",
        "coverageListId": "<string>",
        "contractNumber": "<string>",
        "medicalRecordIdentificationNumber": "<string>",
        "electronicDevicePin": "<string>",
        "submitterIdentificationNumber": "<string>",
        "patientAccountNumber": "<string>",
        "hicNumber": "<string>",
        "drugFormularyNumber": "<string>",
        "priorAuthorizationNumber": "<string>",
        "idCardSerialNumber": "<string>",
        "idCardNumber": "<string>",
        "centersForMedicareAndMedicaidServicesNPI": "<string>",
        "issueNumber": "<string>",
        "insurancePolicyNumber": "<string>",
        "userIdentification": "<string>",
        "medicalAssistanceCategory": "<string>",
        "eligibilityCategory": "<string>",
        "planNetworkIdNumber": "<string>",
        "planNetworkIdDescription": "<string>",
        "facilityNetworkIdentificationNumber": "<string>",
        "medicaidRecipientIdNumber": "<string>",
        "priorIdNumber": "<string>",
        "socialSecurityNumber": "<string>",
        "federalTaxpayersIdentificationNumber": "<string>",
        "agencyClaimNumber": "<string>"
      },
      "planDateInformation": {
        "discharge": "<string>",
        "issue": "<string>",
        "effectiveDateOfChange": "<string>",
        "plan": "<string>",
        "eligibility": "<string>",
        "added": "<string>",
        "cobraBegin": "<string>",
        "cobraEnd": "<string>",
        "premiumPaidToDateBegin": "<string>",
        "premiumPaidToDateEnd": "<string>",
        "planBegin": "<string>",
        "planEnd": "<string>",
        "eligibilityBegin": "<string>",
        "eligibilityEnd": "<string>",
        "enrollment": "<string>",
        "admission": "<string>",
        "dateOfDeath": "<string>",
        "certification": "<string>",
        "service": "<string>",
        "policyEffective": "<string>",
        "policyExpiration": "<string>",
        "dateOfLastUpdate": "<string>",
        "status": "<string>",
        "periodStart": "<string>",
        "periodEnd": "<string>",
        "completion": "<string>",
        "coordinationOfBenefits": "<string>",
        "benefit": "<string>",
        "primaryCareProvider": "<string>",
        "latestVisitOrConsultation": "<string>",
        "benefitBegin": "<string>",
        "benefitEnd": "<string>"
      },
      "errors": [
        {
          "field": "<string>",
          "description": "<string>",
          "location": "<string>",
          "possibleResolutions": "<string>"
        }
      ],
      "warnings": [
        {
          "code": "<string>",
          "description": "<string>"
        }
      ],
      "status": "<string>",
      "transactionSetAcknowledgement": "<string>",
      "implementationTransactionSetSyntaxError": "<string>",
      "x12": "<string>",
      "planStatus": [
        {
          "statusCode": "<string>",
          "status": "<string>",
          "planDetails": "<string>",
          "serviceTypeCodes": []
        }
      ],
      "dependents": [
        {
          "healthCareDiagnosisCodes": [
            {
              "diagnosisTypeCode": "<string>",
              "diagnosisCode": "<string>"
            }
          ],
          "memberId": "<string>",
          "firstName": "<string>",
          "lastName": "<string>",
          "middleName": "<string>",
          "suffix": "<string>",
          "uniqueHealthIdentifier": "<string>",
          "dateOfBirth": "<string>",
          "description": "<string>",
          "dateTimePeriod": "<string>",
          "startDateTimePeriod": "<string>",
          "endDateTimePeriod": "<string>",
          "ssn": "<string>",
          "groupNumber": "<string>",
          "planNumber": "<string>",
          "planNetworkIdNumber": "<string>",
          "groupDescription": "<string>",
          "planDescription": "<string>",
          "planNetworkDescription": "<string>",
          "birthSequenceNumber": "<string>",
          "address": {
            "address1": "<string>",
            "address2": "<string>",
            "city": "<string>",
            "postalCode": "<string>",
            "countryCode": "<string>",
            "countrySubDivisionCode": "<string>"
          },
          "responseProvider": {
            "providerName": "<string>",
            "providerFirstName": "<string>",
            "providerOrgName": "<string>",
            "middleName": "<string>",
            "suffix": "<string>",
            "npi": "<string>",
            "referenceIdentification": "<string>",
            "ssn": "<string>",
            "federalTaxpayersIdNumber": "<string>",
            "payorIdentification": "<string>",
            "pharmacyProcessorNumber": "<string>",
            "serviceProviderNumber": "<string>",
            "servicesPlanID": "<string>",
            "address": {
              "address1": "<string>",
              "address2": "<string>",
              "city": "<string>",
              "postalCode": "<string>",
              "countryCode": "<string>",
              "countrySubDivisionCode": "<string>"
            },
            "employersId": "<string>",
            "aaaErrors": [
              {
                "field": "<string>",
                "description": "<string>",
                "location": "<string>",
                "possibleResolutions": "<string>"
              }
            ]
          },
          "aaaErrors": [
            {
              "field": "<string>",
              "description": "<string>",
              "location": "<string>",
              "possibleResolutions": "<string>"
            }
          ]
        }
      ],
      "benefitsInformation": [
        {
          "serviceTypeCodes": [],
          "serviceTypes": [],
          "planCoverage": "<string>",
          "benefitAmount": "<string>",
          "benefitPercent": "<string>",
          "benefitQuantity": "<string>",
          "headerLoopIdentifierCode": "<string>",
          "trailerLoopIdentifierCode": "<string>",
          "compositeMedicalProcedureIdentifier": {
            "productOrServiceIdQualifierCode": "<string>",
            "productOrServiceIdQualifier": "<string>",
            "procedureCode": "<string>",
            "procedureModifiers": [
              "<string>"
            ],
            "productOrServiceID": "<string>",
            "diagnosisCodePointer": [
              "<string>"
            ]
          },
          "benefitsAdditionalInformation": {
            "planNumber": "<string>",
            "policyNumber": "<string>",
            "memberId": "<string>",
            "familyUnitNumber": "<string>",
            "groupNumber": "<string>",
            "groupDescription": "<string>",
            "planDescription": "<string>",
            "planNetworkDescription": "<string>",
            "referralNumber": "<string>",
            "alternativeListId": "<string>",
            "coverageListId": "<string>",
            "hicNumber": "<string>",
            "drugFormularyNumber": "<string>",
            "priorAuthorizationNumber": "<string>",
            "insurancePolicyNumber": "<string>",
            "medicalAssistanceCategory": "<string>",
            "planNetworkIdNumber": "<string>",
            "medicaidRecepientIdNumber": "<string>"
          },
          "benefitsServiceDelivery": [
            {
              "quantity": "<string>",
              "sampleSelectionModulus": "<string>",
              "numOfPeriods": "<string>"
            }
          ],
          "additionalInformation": [
            {
              "description": "<string>"
            }
          ],
          "eligibilityAdditionalInformationList": [
            {
              "codeListQualifier": "<string>",
              "industryCode": "<string>",
              "industry": "<string>",
              "injuredBodyPartName": "<string>"
            }
          ],
          "benefitsRelatedEntities": [
            {
              "entityName": "<string>",
              "entityFirstname": "<string>",
              "entityMiddlename": "<string>",
              "entitySuffix": "<string>",
              "entityIdentificationValue": "<string>",
              "address": {
                "address1": "<string>",
                "address2": "<string>",
                "city": "<string>",
                "postalCode": "<string>",
                "countryCode": "<string>",
                "countrySubDivisionCode": "<string>"
              },
              "contactInformation": {
                "name": "<string>",
                "contacts": [
                  {
                    "communicationNumber": "<string>"
                  }
                ]
              },
              "providerInformation": {
                "referenceIdentification": "<string>"
              }
            }
          ],
          "benefitsDateInformation": {
            "discharges": [
              {
                "date": "<string>",
                "startDate": "<string>",
                "endDate": "<string>"
              }
            ],
            "issue": "<string>",
            "effectiveDateOfChange": "<string>",
            "periodStart": "<string>",
            "periodEnd": "<string>",
            "completion": "<string>",
            "coordinationOfBenefits": "<string>",
            "plan": "<string>",
            "benefit": "<string>",
            "primaryCareProvider": "<string>",
            "latestVisitOrConsultation": "<string>",
            "eligibility": "<string>",
            "added": "<string>",
            "cobraBegin": "<string>",
            "cobraEnd": "<string>",
            "premiumPaidtoDateBegin": "<string>",
            "premiumPaidToDateEnd": "<string>",
            "planBegin": "<string>",
            "planEnd": "<string>",
            "benefitBegin": "<string>",
            "benefitEnd": "<string>",
            "eligibilityBegin": "<string>",
            "eligibilityEnd": "<string>",
            "enrollment": "<string>",
            "admissions": [
              {
                "date": "<string>",
                "startDate": "<string>",
                "endDate": "<string>"
              }
            ],
            "dateOfDeath": "<string>",
            "certification": "<string>",
            "service": "<string>",
            "policyEffective": "<string>",
            "policyExpiration": "<string>",
            "dateOfLastUpdate": "<string>",
            "status": "<string>",
            "discharge": "<string>",
            "admission": "<string>"
          },
          "benefitsRelatedEntity": {
            "entityName": "<string>",
            "entityFirstname": "<string>",
            "entityMiddlename": "<string>",
            "entitySuffix": "<string>",
            "entityIdentificationValue": "<string>",
            "address": {
              "address1": "<string>",
              "address2": "<string>",
              "city": "<string>",
              "postalCode": "<string>",
              "countryCode": "<string>",
              "countrySubDivisionCode": "<string>"
            },
            "contactInformation": {
              "name": "<string>",
              "contacts": [
                {
                  "communicationNumber": "<string>"
                }
              ]
            },
            "providerInformation": {
              "referenceIdentification": "<string>"
            }
          },
          "eligibilityAdditionalInformation": {
            "codeListQualifier": "<string>",
            "industryCode": "<string>",
            "industry": "<string>",
            "injuredBodyPartName": "<string>"
          }
        }
      ]
    }
  ],
  "lineItems": [
    {
      "id": "<string>",
      "cptCode": "<string>",
      "serviceDate": "<string>",
      "serviceAmount": 123
    }
  ]
}
'