sample_id string | pdfClaimId string | split string | prompt string | target_json string | images list | messages list | image_count int64 | image_001 image | image_002 image | image_003 image | image_004 image | image_005 image | image_006 image | image_007 image | image_008 image |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
cms-1500_e9c517a7dec4 | e9c517a7dec4 | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"PATHLINK OF GEORGIA LLC","facility":"CLAYTON COUNTY JAIL","invoiceNumber":"6I5H5E6K-1-1","taxId":"921353241","patients":[{"firstName":"DERONTAE","lastName":"WILSON","middleName":null,"hospitalAdmitDate":"2026-02-19T00:00:00.000Z","hospitalReleaseDate":"2026-02-20T00:00:00.000Z","dob":"1994-11-07T00:00:00.000... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_0bf9b13df1c4 | 0bf9b13df1c4 | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"PATHLINK OF GEORGIA LLC","facility":"CLAYTON COUNTY JAIL","invoiceNumber":"5W3I24V5-1-1","taxId":"921353241","patients":[{"firstName":"CHRISTOPHER","lastName":"CONSTABLE","middleName":"D","hospitalAdmitDate":"2026-02-06T00:00:00.000Z","hospitalReleaseDate":"2026-02-06T00:00:00.000Z","dob":"1993-04-06T00:00:0... | [
"image_001",
"image_002"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": "image_002",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extrac... | 2 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | ||
cms-1500_2099def9a2e2 | 2099def9a2e2 | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"NORTH METROPOLITAN RADIOLOGY","facility":"GWINNETT SHERIFF","invoiceNumber":"ZE3T0ZD","taxId":"581245030","patients":[{"firstName":"ALEX","lastName":"FLORES SIERRA","middleName":null,"hospitalAdmitDate":"2025-08-31T00:00:00.000Z","hospitalReleaseDate":"2025-08-31T00:00:00.000Z","dob":"1994-11-22T00:00:00.000... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_93e27c011e9e | 93e27c011e9e | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"AGA PROFESSIONAL SERVICES","facility":"GA STATE PAT GWT INSTNL","invoiceNumber":"57377558APS981949","taxId":"453694469","patients":[{"firstName":"DAVID","lastName":"LOPEZ","middleName":null,"hospitalAdmitDate":"2025-07-22T00:00:00.000Z","hospitalReleaseDate":"2025-07-22T00:00:00.000Z","dob":"1983-03-07T00:00... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_b9eb1696660b | b9eb1696660b | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"NORTH ATLANTA ANESTHESIA PROF","facility":"GWINNETT COUNTY DETENTION CENTER","invoiceNumber":"4F5L3M4U-1-1","taxId":"882051065","patients":[{"firstName":"RENE","lastName":"ALVAREZ","middleName":"A","hospitalAdmitDate":"2025-10-24T00:00:00.000Z","hospitalReleaseDate":"2025-10-24T00:00:00.000Z","dob":"1958-10-... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_45ec1760558b | 45ec1760558b | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"ONESOURCE SPORTS NEURO REHAB DETE","facility":"CLAYTON COUNTY-FIRSTCLASS HEALTHCAR","invoiceNumber":"260318757076","taxId":"454309052","patients":[{"firstName":"HUBERT","lastName":"BOLES","middleName":null,"hospitalAdmitDate":"2026-03-02T00:00:00.000Z","hospitalReleaseDate":"2026-03-02T00:00:00.000Z","dob":"... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_27b13d750091 | 27b13d750091 | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"INPHYNET PRIMARY CARE PHYSICI PO BOX 636017 CINCINNATI, OH 45263-6017","facility":"HENRY COUNTY SHERIFF'S OFFICE","invoiceNumber":"416174173/11","taxId":"65-0203499","patients":[{"firstName":"JOSEPH","lastName":"BARTLETT","middleName":"D","hospitalAdmitDate":"2026-02-26T00:00:00.000Z","hospitalReleaseDate":"... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_5e53720ee396 | 5e53720ee396 | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"NORTH METROPOLITAN RADIOLOGY ASSO","facility":"GWINNETT SHERIFF","invoiceNumber":"ZDQ8D6D","taxId":"581245030","patients":[{"firstName":"KIERA","lastName":"MURRY","middleName":null,"hospitalAdmitDate":"2025-03-28T00:00:00.000Z","hospitalReleaseDate":"2025-03-28T00:00:00.000Z","dob":"1992-08-11T00:00:00.000Z"... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_52b2e5166882 | 52b2e5166882 | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"N ATLANTA PROF SERVICES","facility":"GA STATE PAT GWT INSTNL","invoiceNumber":"31676551N19124278","taxId":"205106086","patients":[{"firstName":"EUGENE","lastName":"BASS","middleName":null,"hospitalAdmitDate":"2025-07-10T00:00:00.000Z","hospitalReleaseDate":"2025-07-10T00:00:00.000Z","dob":"1963-10-07T00:00:0... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_8b696bc66ee2 | 8b696bc66ee2 | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"NORTH METROPOLITAN RADIOLOGY","facility":"GWINNETT SHERIFF","invoiceNumber":"ZDW7CM8","taxId":"581245030","patients":[{"firstName":"RUSSELL","lastName":"CHEEVES","middleName":null,"hospitalAdmitDate":"2025-08-15T00:00:00.000Z","hospitalReleaseDate":"2025-08-15T00:00:00.000Z","dob":"1981-12-01T00:00:00.000Z",... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_e9188275d9a5 | e9188275d9a5 | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"NORTHSIDE RADIOLOGY ASSOCIATES","facility":"DOUGHERTY COUNTY JAIL ATTN-MAJOR CATES","invoiceNumber":"NRAA1718443","taxId":"582244832","patients":[{"firstName":"LISA","lastName":"NUNLEY","middleName":"M","hospitalAdmitDate":"2026-03-09T00:00:00.000Z","hospitalReleaseDate":"2026-03-09T00:00:00.000Z","dob":"198... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_23220b8fb6c0 | 23220b8fb6c0 | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"ONESOURCE SPORTS NEURO REHAB DETE","facility":"CLAYTON COUNTY-FIRSTCLASS HEALTHCAR","invoiceNumber":"251118751819","taxId":"454309052","patients":[{"firstName":"REJONTA","lastName":"MURPHY","middleName":null,"hospitalAdmitDate":"2026-02-09T00:00:00.000Z","hospitalReleaseDate":"2026-02-09T00:00:00.000Z","dob"... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_014cb621c933 | 014cb621c933 | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"MIDTOWN INFECTIOUS DISEASE SPEC 1900 10TH AVE SUITE 110 COLUMBUS, GA 31901-3608","facility":"MUSCOGEE COUNTY JAIL","invoiceNumber":"20363048C","taxId":"463012520","patients":[{"firstName":"DENNY","lastName":"WILKINS","middleName":"R","hospitalAdmitDate":"2026-01-12T00:00:00.000Z","hospitalReleaseDate":"2026-... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_87218cb2e760 | 87218cb2e760 | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"SOUTHERN REGIONAL PHYSICIANS MANAGEM","facility":null,"invoiceNumber":"70698364Z11228","taxId":"300891469","patients":[{"firstName":"TERESA","lastName":"HARDEMAN","middleName":null,"hospitalAdmitDate":"2025-12-22T00:00:00.000Z","hospitalReleaseDate":"2025-12-22T00:00:00.000Z","dob":"1966-06-09T00:00:00.000Z"... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_30191289f704 | 30191289f704 | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"ONESOURCE SPORTS NEURO REHAB DETE","facility":"HENRY COUNTY-FIRSTCLASS HEALTHCARE","invoiceNumber":"260318754768","taxId":"454309052","patients":[{"firstName":"CALVIN","lastName":"MURDOCK","middleName":null,"hospitalAdmitDate":"2026-03-11T00:00:00.000Z","hospitalReleaseDate":"2026-03-11T00:00:00.000Z","dob":... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_d415155a057c | d415155a057c | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"GWINNETT HOSPITAL SYSTEM G","facility":"GA STATE PAT GWT INSTNL","invoiceNumber":"30355769N16652982","taxId":"465634252","patients":[{"firstName":"RENE","lastName":"ALVAREZ","middleName":"ALAN","hospitalAdmitDate":"2025-10-28T00:00:00.000Z","hospitalReleaseDate":"2025-10-28T00:00:00.000Z","dob":"1958-10-24T0... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_b65f7b5fd19c | b65f7b5fd19c | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"N ATLANTA PROF SERVICES PO BOX 935257 ATLANTA, GA 311935257","facility":"GA STATE PAT GWT INSTNL ATTN MEDICAL 2900 UNIVERSITY PKWY NE LAWRENCEVILLE, GA 30043","invoiceNumber":"05358185N19275052","taxId":"205106086","patients":[{"firstName":"JONATHAN","lastName":"MITCHELL","middleName":"WHITNEY","hospitalAdmi... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_cdb42e01e5e4 | cdb42e01e5e4 | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"NORTH METROPOLITAN RADIOLOGY","facility":"GWINNETT SHERIFF","invoiceNumber":"ZE7Q2OG","taxId":"581245030","patients":[{"firstName":"CHRISTOPHER","lastName":"BEAUBRUN","middleName":null,"hospitalAdmitDate":"2025-10-24T00:00:00.000Z","hospitalReleaseDate":"2025-10-24T00:00:00.000Z","dob":"1989-11-02T00:00:00.0... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_6f6a49bf22f8 | 6f6a49bf22f8 | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"ONESOURCE SPORTS NEURO REHAB DETE","facility":"CLAYTON COUNTY-FIRSTCLASS HEALTHCAR","invoiceNumber":"251218758339","taxId":"454309052","patients":[{"firstName":"TERRY","lastName":"ROWE","middleName":null,"hospitalAdmitDate":"2026-03-02T00:00:00.000Z","hospitalReleaseDate":"2026-03-02T00:00:00.000Z","dob":"19... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_d79f717224cc | d79f717224cc | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"NORTH METROPOLITAN RADIOLOGY","facility":"GWINNETT SHERIFF","invoiceNumber":"ZDQRHVW","taxId":"581245030","patients":[{"firstName":"ALLEN","lastName":"JOHNSON","middleName":"J","hospitalAdmitDate":"2025-07-10T00:00:00.000Z","hospitalReleaseDate":"2025-07-10T00:00:00.000Z","dob":"1978-04-21T00:00:00.000Z","ph... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | |
cms-1500_726f2ae26723 | 726f2ae26723 | train | You are an expert medical claim parser.
Your task is to extract information from the provided document according to the required output format.
Here is the extraction guidance for cms-1500:
CMS-1500 form guardrails:
- 3. PATIENT'S BIRTH DATE and 24. A. DATE(S) OF SERVICE are box-based dates. Read the MM, DD, and YY/YY... | {"vendor":"NORTH METROPOLITAN RADIOLOGY","facility":"GWINNETT SHERIFF","invoiceNumber":"ZDYEZLJ","taxId":"581245030","patients":[{"firstName":"SHANNELLWARR","lastName":"GIBBS","middleName":null,"hospitalAdmitDate":"2025-08-27T00:00:00.000Z","hospitalReleaseDate":"2025-08-27T00:00:00.000Z","dob":"1978-01-28T00:00:00.000... | [
"image_001"
] | [
{
"content": [
{
"image": "image_001",
"text": null,
"type": "image"
},
{
"image": null,
"text": "You are an expert medical claim parser.\nYour task is to extract information from the provided document according to the required output format.\n\nHere is ... | 1 | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet | Not supported with pagination yet |
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