> ## Documentation Index
> Fetch the complete documentation index at: https://docs.usecobalt.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Get Claim by ID

> Returns a single claim with its line items, payments, and billing details by its Cobalt claim ID, for example the data.id from a claim webhook.

### Example Request

```bash theme={null}
curl -X GET https://api.usecobalt.com/v1/claims/a1b2c3d4e5f6789012345678abcdef90 \
-H 'client_id: ci_live_198908HJDKJSH98789OHKJL' \
-H 'client_secret: cs_live_9827hofdsklOYYHJLJh' \
-H 'access_token: 493JKLHIU98789hLKH9HHJH'
```

### Example Response

```json theme={null}
{
    "success": true,
    "claim": {
        "id": "a1b2c3d4e5f6789012345678abcdef90",
        "emr_claim_id": "100234",
        "emr_appointment_id": "500100",
        "service_date": "2025-08-01",
        "claim_date": "2025-08-08",
        "claim_status": "48CL",
        "claim_status_description": "Closed (48-hour rule)",
        "claim_type": "0",
        "void_flag": false,
        "emr_patient_id": "40210",
        "patient_name": "DOE, JANE, M",
        "emr_provider_id": "10052",
        "provider_name": "Smith, Robert",
        "total_charge": "350.00",
        "total_payment": "280.00",
        "net_payment": "280.00",
        "balance": "20.00",
        "net_adjustment": "50.00",
        "patient_responsibility": "20.00",
        "icd_codes": ["M54.5", "Z96.641"],
        "line_items": [
            {
                "id": "f1e2d3c4b5a6789012345678",
                "line_number": 1,
                "cpt_code": "99213",
                "description": "Office visit, established patient",
                "modifiers": ["25"],
                "units": 1,
                "billed_amount": 150.00,
                "allowed_amount": 120.00,
                "icd_pointers": ["1", "2"],
                "place_of_service": "11",
                "service_date_start": "2025-08-01",
                "service_date_end": "2025-08-01",
                "rendering_provider_npi": "1234567890"
            }
        ],
        "payments": [
            {
                "id": "d4c3b2a1f6e5789012345678",
                "emr_payment_id": "55001",
                "check_number": "EFT-20250825-001",
                "payment_date": "2025-08-25",
                "amount": 280.00,
                "payment_type": "Insurance",
                "payer_name": "Blue Cross Blue Shield",
                "adjustment": 50.00,
                "coinsurance": 20.00,
                "allowed": 280.00,
                "era_claim_status": "Processed as Primary"
            }
        ],
        "synced_at": "2025-08-31T04:40:00.002Z",
        "created_at": "2025-08-31T04:40:00.002Z",
        "updated_at": "2025-08-31T04:40:00.002Z"
    }
}
```


## OpenAPI

````yaml GET /claims/{id}
openapi: 3.0.0
info:
  title: Cobalt API
  version: 1.0.1
  description: API for interacting with Cobalt's EHR integration services
servers:
  - url: https://api.usecobalt.com/v1
security:
  - ClientCredentials: []
    ClientSecret: []
    AccessToken: []
paths:
  /claims/{id}:
    get:
      summary: Get Claim
      description: >-
        Returns a single claim with its line items, payments, and billing
        details by its Cobalt claim ID, for example the `data.id` from a claim
        webhook.
      parameters:
        - in: path
          name: id
          required: true
          schema:
            type: string
          description: >-
            The Cobalt claim ID (the `id` returned by GET /claims or the
            `data.id` on a claim webhook).
      responses:
        '200':
          description: Successful response
          content:
            application/json:
              schema:
                type: object
                properties:
                  success:
                    type: boolean
                  claim:
                    type: object
                    properties:
                      id:
                        type: string
                        description: Unique claim identifier
                      emr_claim_id:
                        type: string
                        description: Claim ID from the EMR system
                      emr_appointment_id:
                        type: string
                        description: Associated appointment/encounter ID from the EMR
                      service_date:
                        type: string
                        format: date
                        description: Date of service (YYYY-MM-DD)
                      claim_date:
                        type: string
                        format: date
                        description: Date the claim was filed (YYYY-MM-DD)
                      claim_status:
                        type: string
                        description: Current status of the claim
                      claim_status_description:
                        type: string
                        description: Detailed description of the claim status
                      claim_type:
                        type: string
                        description: Type of claim (e.g., Professional, Institutional)
                      void_flag:
                        type: boolean
                        description: Whether this claim has been voided
                      emr_patient_id:
                        type: string
                        description: Patient ID from the EMR system
                      patient_name:
                        type: string
                        description: Full name of the patient
                      emr_provider_id:
                        type: string
                        description: Provider ID from the EMR system
                      provider_name:
                        type: string
                        description: Full name of the rendering provider
                      total_charge:
                        type: number
                        description: Total billed amount
                      total_payment:
                        type: number
                        description: Total payments received
                      net_payment:
                        type: number
                        description: Net payment amount
                      balance:
                        type: number
                        description: Outstanding balance
                      net_adjustment:
                        type: number
                        description: Total adjustments applied
                      patient_responsibility:
                        type: number
                        description: Amount owed by patient
                      insurances:
                        type: array
                        description: >-
                          Insurance policies associated with the claim, ordered
                          by sequence (primary, secondary, etc.)
                        items:
                          type: object
                          properties:
                            insurance_id:
                              type: string
                              description: EMR insurance ID
                            insurance_name:
                              type: string
                              description: Name of the insurance company
                            insurance_type:
                              type: string
                              description: Insurance type code
                            claim_indicator:
                              type: string
                              description: >-
                                Claim indicator code (P=Primary, S=Secondary,
                                I=Inactive, etc.)
                            claim_indicator_description:
                              type: string
                              description: >-
                                Human-readable claim indicator (e.g., 'Primary',
                                'Inactive/Secondary')
                            sequence_number:
                              type: string
                              description: >-
                                Order of insurance priority (1=primary,
                                2=secondary, etc.)
                            subscriber_name:
                              type: string
                              description: Name of the insurance subscriber
                            subscriber_number:
                              type: string
                              description: Subscriber/member ID number
                            subscriber_dob:
                              type: string
                              format: date
                              description: Subscriber date of birth
                            subscriber_relation:
                              type: string
                              description: Relationship of patient to subscriber (1=Self)
                            group_name:
                              type: string
                              description: Insurance group name
                            group_number:
                              type: string
                              description: Insurance group number
                            provider_number:
                              type: string
                              description: Provider number for this insurance
                            payment_source:
                              type: string
                              description: Payment source code
                            assign_benefits:
                              type: string
                              description: Whether benefits are assigned (Y/N)
                            insurance_address_1:
                              type: string
                            insurance_address_2:
                              type: string
                            insurance_city:
                              type: string
                            insurance_state:
                              type: string
                            insurance_zip:
                              type: string
                            medicaid_id:
                              type: string
                      balances:
                        type: object
                        description: Detailed balance breakdown for the claim
                        properties:
                          invoice_amount:
                            type: string
                            description: Original invoice/charge amount
                          total_payment:
                            type: string
                            description: Total payments received
                          net_payment:
                            type: string
                            description: Net payment amount
                          balance:
                            type: string
                            description: Outstanding balance
                          patient_balance:
                            type: string
                            description: Amount owed by patient
                          patient_payment:
                            type: string
                            description: Total patient payments received
                          patient_responsibility:
                            type: string
                            description: Total patient responsibility amount
                          on_plan:
                            type: string
                            description: Whether patient is on a payment plan
                      icd_codes:
                        type: array
                        description: ICD-10 diagnosis codes associated with the claim
                        items:
                          type: string
                      void_claim:
                        type: object
                        nullable: true
                        description: Void/copy claim references linking related claims
                        properties:
                          void_to_claim_id:
                            type: string
                            description: Claim ID this was voided to (-1 if none)
                          void_from_claim_id:
                            type: string
                            description: Claim ID this was voided from (-1 if none)
                          copy_to_claim_id:
                            type: string
                            description: Claim ID this was copied to (-1 if none)
                          copy_from_claim_id:
                            type: string
                            description: Claim ID this was copied from (-1 if none)
                      submission_history:
                        type: object
                        nullable: true
                        description: Claim submission/creation history
                        properties:
                          created_by:
                            type: string
                            description: User who created the claim
                          entries:
                            type: array
                            description: Submission log entries
                          auto_claim_data:
                            type: object
                            description: Automated claim creation metadata
                      billing_activity_log:
                        type: array
                        nullable: true
                        description: >-
                          Chronological log of all billing actions (status
                          changes, provider assignments, insurance changes,
                          etc.)
                        items:
                          type: object
                          properties:
                            date:
                              type: string
                              description: Timestamp of the activity (YYYY-MM-DD HH:mm:ss)
                            action:
                              type: string
                              description: >-
                                Type of action (e.g., 'Modified', 'Created',
                                'add')
                            category:
                              type: string
                              description: >-
                                Category of the change (e.g., 'Claim Status',
                                'Insurance', 'Providers')
                            notes:
                              type: string
                              description: Detailed description of the change
                            user_name:
                              type: string
                              description: User who performed the action
                      billing_notes:
                        type: string
                        nullable: true
                        description: >-
                          Free-text billing notes including eligibility checks,
                          collection notes, and staff comments
                      line_items:
                        type: array
                        description: CPT/procedure line items for this claim
                        items:
                          type: object
                          properties:
                            id:
                              type: string
                              description: Unique line item identifier
                            line_number:
                              type: integer
                              description: Line number on the claim
                            cpt_code:
                              type: string
                              description: CPT/HCPCS procedure code
                            description:
                              type: string
                              description: Procedure description
                            modifiers:
                              type: array
                              items:
                                type: string
                              description: CPT modifier codes (e.g., '25', '59')
                            units:
                              type: integer
                              description: Number of units billed
                            billed_amount:
                              type: number
                              description: Total billed amount for this line
                            allowed_amount:
                              type: number
                              description: Insurance-allowed amount
                            billed_unit_fee:
                              type: number
                              description: Fee per unit
                            icd_pointers:
                              type: array
                              items:
                                type: string
                              description: >-
                                Pointers to ICD codes on the claim (e.g., ['1',
                                '2'])
                            place_of_service:
                              type: string
                              description: >-
                                CMS place of service code (e.g., '11' for
                                office)
                            type_of_service:
                              type: string
                              description: Type of service code
                            service_date_start:
                              type: string
                              format: date
                              description: Service start date
                            service_date_end:
                              type: string
                              format: date
                              description: Service end date
                            rendering_provider_npi:
                              type: string
                              description: NPI of the rendering provider
                            ordering_provider_npi:
                              type: string
                              description: NPI of the ordering provider
                            referring_provider_npi:
                              type: string
                              description: NPI of the referring provider
                      payments:
                        type: array
                        description: Payment and remittance records for this claim
                        items:
                          type: object
                          properties:
                            id:
                              type: string
                              description: Unique payment identifier
                            emr_payment_id:
                              type: string
                              description: Payment ID from the EMR
                            check_number:
                              type: string
                              description: Check or EFT reference number
                            payment_date:
                              type: string
                              format: date
                              description: Date payment was posted
                            amount:
                              type: number
                              description: Payment amount
                            payment_type:
                              type: string
                              description: Type of payment (e.g., 'Insurance', 'Patient')
                            payer_name:
                              type: string
                              description: Name of the payer
                            payer_type:
                              type: string
                              description: Type of payer
                            adjustment:
                              type: number
                              description: Adjustment amount
                            deductible:
                              type: number
                              description: Deductible amount applied
                            coinsurance:
                              type: number
                              description: Coinsurance amount
                            allowed:
                              type: number
                              description: Allowed amount from the payer
                            member_balance:
                              type: number
                              description: Member/patient balance from remittance
                            withheld:
                              type: number
                              description: Withheld amount
                            era_claim_status:
                              type: string
                              description: Claim status from the ERA/835 remittance
                            era_claim_status_code:
                              type: string
                              description: ERA claim status code
                            era_payer_name:
                              type: string
                              description: Payer name from the ERA
                            era_check_amount:
                              type: number
                              description: Total check amount from the ERA
                            era_adjustment_codes:
                              type: object
                              nullable: true
                              description: CARC/RARC adjustment reason codes from the ERA
                      synced_at:
                        type: string
                        format: date-time
                        description: When this claim was last synced from the EMR
                      created_at:
                        type: string
                        format: date-time
                        description: When this claim record was first created
                      updated_at:
                        type: string
                        format: date-time
                        description: When this claim record was last updated
        '404':
          description: Claim not found
components:
  securitySchemes:
    ClientCredentials:
      type: apiKey
      in: header
      name: client_id
    ClientSecret:
      type: apiKey
      in: header
      name: client_secret
    AccessToken:
      type: apiKey
      in: header
      name: access_token

````