Download OpenAPI specification:Download
A CapitalRx API key consists of 2 parts, a public and a private access key. The public access key is used as part of your request to identify who is making the request, and is not necessarily secret. The private access key is secret and is used to generate the HMAC signature to authenticate requests.
API Keys expire 365 days from the date of creation, and any one identity can only have two (2) active API key pairs at any given moment, to allow for seamless key rotation.
Public Access Keys start with CRX and are always all caps.
Private Access Keys are random strings 58 characters long.
Example Public Access Key:
Example Private Access Key:
The following headers are required or your request will be rejected, even if it contains a valid signature.
All requests should have a Content-Type of application/json and contain a request
body with valid json. Even a request that supplies no information should send an
empty object {}
Requests are signed with an HMAC-SHA256 signature using the private access key. The canonical request needs to be hashed using this algorithm, and the resulting HMAC placed into the X-CRX-SIGNATURE header of the request.
The canonical request is defined as these 4 elements concatenated together:
An example of a canonical request would be:
POST https://adjudication-sts.staging-cap-rx.com/claim/list
1709242510POST/claim/list{}
Below is a Python3 example of an authenticated API call to list claims visible to the user calling the endpoint. Your user must have the appropriate permissions granted to call the endpoint, and if allowed to make the call, must have access to some data in order to not get an empty response.
List Claims:
import hmac
import requests
import time
from requests.auth import AuthBase
class CapitalRxApiAuth(AuthBase):
def __init__(self, access_key, secret_key):
self.access_key = access_key
self.secret_key = secret_key
def __call__(self, request):
timestamp = str(int(time.time()))
canonical_request = timestamp + request.method + request.path_url + (request.body.decode("UTF-8") or '')
signature = hmac.new(self.secret_key.encode("UTF-8"), canonical_request.encode("UTF-8"), 'sha256').hexdigest()
request.headers.update({
'X-CRX-TIMESTAMP': timestamp,
'X-CRX-ACCESS-KEY': self.access_key,
'X-CRX-SIGNATURE': signature,
})
return request
ACCESS_KEY = ""
SECRET_KEY = ""
auth = CapitalRxApiAuth(ACCESS_KEY, SECRET_KEY)
api_url = "https://adjudication-sts.staging-cap-rx.com/claim/list" # or any other endpoint you want to hit.
payload = {}
r = requests.post(
url=api_url,
auth=auth,
json=payload,
headers={
"Content-Type": "application/json",
"User-Agent": "apiexample/1.0",
},
)
print(r.content)
List Drug (search):
import requests
import json
r = requests.post(
url="https://advantage-api.cap-rx.com/drug/list",
json={
"search": "ibuprofen",
"page_number": 2,
},
headers={
"Content-Type": "application/json",
"User-Agent": "apiexample/1.0",
},
)
print(json.dumps(r.json(), indent=2))
Requests are only valid within 5 minutes of the timestamp in the X-CRX-TIMESTAMP header. If more than 5 minutes has elapsed since the request was signed, it will be rejected as expired.
The User-Agent header is required. If not present in the request, it can appear as a failure to authenticate, despite a valid signature being included.
Create an Accumulation Configuration.
rn | string or null |
parser_name required | string |
description | string or null |
config | any or null |
bucket_pattern required | string Regex pattern for matching on the bucket. Example: '^example-bucket$ |
key_pattern required | string Regex pattern for matching on the key. Example: '^ |
plan_ids required | Array of integers or null <int32> |
status_report_output_dir | string or null Directory to upload output status report of load. Example: 'vendor/output/' |
client_ids | Array of strings or null |
status | string Enum: "active" "inactive" |
event_handler_type required | string Enum: "lambda" "batch" |
event_handler_is_enabled required | boolean |
event_handler_effective_date required | string or null <ArrowDateTime> |
event_handler_termination_date required | string or null <ArrowDateTime> |
{- "rn": "string",
- "parser_name": "string",
- "description": "string",
- "config": null,
- "bucket_pattern": "string",
- "key_pattern": "string",
- "plan_ids": [
- 0
], - "status_report_output_dir": "string",
- "client_ids": [
- "string"
], - "status": "active",
- "event_handler_type": "lambda",
- "event_handler_is_enabled": true,
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string"
}
{- "rn": "string",
- "parser_mapping_id": 0,
- "parser_name": "string",
- "description": "string",
- "config": null,
- "bucket_pattern": "string",
- "key_pattern": "string",
- "plan_ids": [
- 0
], - "status_report_output_dir": "string",
- "client_ids": [
- "string"
], - "status": "active",
- "event_handler_type": "lambda",
- "event_handler_is_enabled": true,
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string"
}
Get an Accumulation Configuration.
parser_mapping_id | integer <int32> |
{- "parser_mapping_id": 0
}
{- "rn": "string",
- "parser_mapping_id": 0,
- "parser_name": "string",
- "description": "string",
- "config": null,
- "bucket_pattern": "string",
- "key_pattern": "string",
- "plan_ids": [
- 0
], - "status_report_output_dir": "string",
- "client_ids": [
- "string"
], - "status": "active",
- "event_handler_type": "lambda",
- "event_handler_is_enabled": true,
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string"
}
List Accumulation Configurations.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
parser_mapping_id | integer or null <int32> |
parser_name | string or null |
bucket_pattern | string or null |
key_pattern | string or null |
plan_ids | Array of integers or null <int32> |
client_ids | Array of strings or null |
status | string Enum: "active" "inactive" |
description | string or null |
event_handler_type | string or null |
event_handler_is_enabled | boolean or null |
event_handler_effective_date | string or null <ArrowDateTime> |
event_handler_termination_date | string or null <ArrowDateTime> |
Array of objects or null (OrderBySchema_1744676532.8612218) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "parser_mapping_id": 0,
- "parser_name": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "plan_ids": [
- 0
], - "client_ids": [
- "string"
], - "status": "active",
- "description": "string",
- "event_handler_type": "string",
- "event_handler_is_enabled": true,
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string",
- "order_by": [
- {
- "parser_mapping_id": "string",
- "parser_name": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "plan_ids": "string",
- "client_ids": "string",
- "description": "string",
- "event_handler_type": "string",
- "event_handler_is_enabled": "string",
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string",
- "status_report_output_dir": "string",
- "status": "string"
}
]
}
{- "results": [
- {
- "accumulation_configuration": {
- "rn": "string",
- "parser_mapping_id": 0,
- "parser_name": "string",
- "description": "string",
- "config": null,
- "bucket_pattern": "string",
- "key_pattern": "string",
- "plan_ids": [
- 0
], - "status_report_output_dir": "string",
- "client_ids": [
- "string"
], - "status": "active",
- "event_handler_type": "lambda",
- "event_handler_is_enabled": true,
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string"
}
}
], - "result_count": "string"
}
Manually initiates the load of an accumulations file.
parser_mapping_id | integer or null <int32> The id of the accumulation configuration used as a base for the load, which may be overridden by other fields |
inbound_bucket required | string S3 bucket of the accumulations file to be loaded |
inbound_key required | string S3 key of the accumulations file to be loaded |
commit_data required | boolean Whether the results of the file load will be committed to the database. When false, reports are generated without commiting changes. |
override_report_status_folder | string When present, overrides the status_report_output_dir of the base accumulation configuration for this load. |
override_parser_mapping | string When present, overrides the parser of the base accumulation configuration for this load. |
override_parser_config | any or null When present, overrides the config object passed to the parser when processing this load. |
override_plans_mapping | Array of integers <int32> [ items <int32 > ] When present, overrides the file_plan_mapping_id of the base accumulation configuration for this load. |
override_event_handler_type | string Enum: "batch" "lambda" When present, overrides the event_handler_type of the base accumulation configuration for this load. |
manual_note | string or null A user-provided note describing details of the load. |
{- "parser_mapping_id": 0,
- "inbound_bucket": "string",
- "inbound_key": "string",
- "commit_data": true,
- "override_report_status_folder": "string",
- "override_parser_mapping": "string",
- "override_parser_config": null,
- "override_plans_mapping": [
- 0
], - "override_event_handler_type": "batch",
- "manual_note": "string"
}
{- "message": "string"
}
Update an Accumulation Configuration.
rn | string or null |
parser_mapping_id | integer <int32> |
parser_name | string |
description | string or null |
config | any or null |
bucket_pattern | string Regex pattern for matching on the bucket. Example: '^example-bucket$ |
key_pattern | string Regex pattern for matching on the key. Example: '^ |
plan_ids | Array of integers or null <int32> |
status_report_output_dir | string or null Directory to upload output status report of load. Example: 'vendor/output/' |
client_ids | Array of strings or null |
status | string Enum: "active" "inactive" |
event_handler_type | string Enum: "lambda" "batch" |
event_handler_is_enabled | boolean |
event_handler_effective_date | string or null <ArrowDateTime> |
event_handler_termination_date | string or null <ArrowDateTime> |
{- "rn": "string",
- "parser_mapping_id": 0,
- "parser_name": "string",
- "description": "string",
- "config": null,
- "bucket_pattern": "string",
- "key_pattern": "string",
- "plan_ids": [
- 0
], - "status_report_output_dir": "string",
- "client_ids": [
- "string"
], - "status": "active",
- "event_handler_type": "lambda",
- "event_handler_is_enabled": true,
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string"
}
{- "rn": "string",
- "parser_mapping_id": 0,
- "parser_name": "string",
- "description": "string",
- "config": null,
- "bucket_pattern": "string",
- "key_pattern": "string",
- "plan_ids": [
- 0
], - "status_report_output_dir": "string",
- "client_ids": [
- "string"
], - "status": "active",
- "event_handler_type": "lambda",
- "event_handler_is_enabled": true,
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string"
}
filename required | string |
{- "filename": "string"
}
{- "bucket": "string",
- "key": "string",
- "post": {
- "url": "string",
- "fields": null
}
}
Get an Accumulation Transaction Datum.
id required | integer or null <int32> |
{- "id": 0
}
{- "result_count": "string",
- "results": [
- {
- "accumulation_transaction_data": {
- "id": 0,
- "created_at": "string",
- "status": "string",
- "status_detail": "string",
- "transaction_id": "string",
- "data": "string",
- "source_bucket": "string",
- "source_key": "string",
- "processor": "string",
- "processed_at": [
- "string"
], - "processed_at_count": 0,
- "processed_at_max": "string",
- "override_client_id": "string",
- "override_external_member_id": "string",
- "override_person_code": "string",
- "override_external_account_id": "string",
- "override_external_group_id": "string",
- "edited_by": "string",
- "edited_at": "string",
- "rn": "string",
- "accumulation_transaction_record_id": 0,
- "accumulation_transaction_created_at": "string",
- "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "date_of_service": "string",
- "accumulation_type": "string",
- "last_processed_at": "string",
- "accumulated_amount": 0
}
}
]
}
List Accumulation Transaction Data.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer <int32> |
created_at | string <ArrowDateTime> |
status | string |
status_detail | string |
transaction_id | string |
data | string |
source_bucket | string |
source_key | string |
processor | string |
processed_at | string <ArrowDateTime> |
override_client_id | string |
override_external_member_id | string |
override_person_code | string |
override_external_account_id | string |
override_external_group_id | string |
edited_by | string |
edited_at | string <ArrowDateTime> |
accumulation_transaction_record_id | integer <int32> |
accumulation_transaction_created_at | string <ArrowDateTime> |
client_id | string |
external_member_id | string |
person_code | string |
accumulation_type | string |
accumulation_amount | string |
date_of_service | string <ArrowDateTime> |
Array of objects or null (OrderBySchema_1744676532.8717809) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "created_at": "string",
- "status": "string",
- "status_detail": "string",
- "transaction_id": "string",
- "data": "string",
- "source_bucket": "string",
- "source_key": "string",
- "processor": "string",
- "processed_at": "string",
- "override_client_id": "string",
- "override_external_member_id": "string",
- "override_person_code": "string",
- "override_external_account_id": "string",
- "override_external_group_id": "string",
- "edited_by": "string",
- "edited_at": "string",
- "accumulation_transaction_record_id": 0,
- "accumulation_transaction_created_at": "string",
- "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "accumulation_type": "string",
- "accumulation_amount": "string",
- "date_of_service": "string",
- "order_by": [
- {
- "id": "string",
- "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "processor": "string",
- "accumulation_type": "string",
- "accumulated_amount": "string",
- "created_at": "string",
- "status": "string",
- "status_detail": "string",
- "transaction_id": "string",
- "source_bucket": "string",
- "source_key": "string",
- "processed_at": "string",
- "override_client_id": "string",
- "override_external_member_id": "string",
- "override_person_code": "string",
- "override_external_account_id": "string",
- "override_external_group_id": "string",
- "edited_by": "string",
- "edited_at": "string",
- "date_of_service": "string"
}
]
}
{- "result_count": "string",
- "results": [
- {
- "accumulation_transaction_data": {
- "id": 0,
- "created_at": "string",
- "status": "string",
- "status_detail": "string",
- "transaction_id": "string",
- "data": "string",
- "source_bucket": "string",
- "source_key": "string",
- "processor": "string",
- "processed_at": [
- "string"
], - "processed_at_count": 0,
- "processed_at_max": "string",
- "override_client_id": "string",
- "override_external_member_id": "string",
- "override_person_code": "string",
- "override_external_account_id": "string",
- "override_external_group_id": "string",
- "edited_by": "string",
- "edited_at": "string",
- "rn": "string",
- "accumulation_transaction_record_id": 0,
- "accumulation_transaction_created_at": "string",
- "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "date_of_service": "string",
- "accumulation_type": "string",
- "last_processed_at": "string",
- "accumulated_amount": "string"
}
}
]
}
required | Array of objects or null (ProcessorSchema_1744676532.875044) |
{- "processors": [
- {
- "processor": "string",
- "data_ids": [
- 0
], - "bucket": "string",
- "source_key": "string"
}
]
}
{- "message": "string"
}
Update an Accumulation Transaction Datum.
id required | integer or null <int32> |
created_at | string or null <ArrowDateTime> |
status | string or null |
status_detail | string or null |
transaction_id | string or null |
data | string or null |
source_bucket | string or null |
source_key | string or null |
processor | string or null |
processed_at | Array of strings or null |
processed_at_count | integer or null <int32> |
processed_at_max | string or null |
override_client_id | string or null |
override_external_member_id | string or null |
override_person_code | string or null |
override_external_account_id | string or null |
override_external_group_id | string or null |
edited_by | string or null |
edited_at | string or null <ArrowDateTime> |
rn | string or null |
accumulation_transaction_record_id | integer or null <int32> |
accumulation_transaction_created_at | string or null <ArrowDateTime> |
client_id | string or null |
external_member_id | string or null |
person_code | string or null |
date_of_service | string or null <ArrowDateTime> |
accumulation_type | string or null |
last_processed_at | string or null <ArrowDateTime> |
accumulated_amount | number or null |
{- "id": 0,
- "created_at": "string",
- "status": "string",
- "status_detail": "string",
- "transaction_id": "string",
- "data": "string",
- "source_bucket": "string",
- "source_key": "string",
- "processor": "string",
- "processed_at": [
- "string"
], - "processed_at_count": 0,
- "processed_at_max": "string",
- "override_client_id": "string",
- "override_external_member_id": "string",
- "override_person_code": "string",
- "override_external_account_id": "string",
- "override_external_group_id": "string",
- "edited_by": "string",
- "edited_at": "string",
- "rn": "string",
- "accumulation_transaction_record_id": 0,
- "accumulation_transaction_created_at": "string",
- "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "date_of_service": "string",
- "accumulation_type": "string",
- "last_processed_at": "string",
- "accumulated_amount": 0
}
{- "id": 0,
- "created_at": "string",
- "status": "string",
- "status_detail": "string",
- "transaction_id": "string",
- "data": "string",
- "source_bucket": "string",
- "source_key": "string",
- "processor": "string",
- "processed_at": [
- "string"
], - "processed_at_count": 0,
- "processed_at_max": "string",
- "override_client_id": "string",
- "override_external_member_id": "string",
- "override_person_code": "string",
- "override_external_account_id": "string",
- "override_external_group_id": "string",
- "edited_by": "string",
- "edited_at": "string",
- "rn": "string",
- "accumulation_transaction_record_id": 0,
- "accumulation_transaction_created_at": "string",
- "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "date_of_service": "string",
- "accumulation_type": "string",
- "last_processed_at": "string",
- "accumulated_amount": 0
}
Create an Accumulation Transaction Record.
transmission_id | integer or null <int32> |
client_id | string or null |
external_member_id required | string |
person_code required | string |
date_of_service | string <ArrowDateTime> |
accumulation_types required | Array of strings |
accumulated_amount required | number or null |
{- "transmission_id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "date_of_service": "string",
- "accumulation_types": [
- "string"
], - "accumulated_amount": 0
}
{- "inserted_ids": [
- 0
]
}
transmission_id | integer or null <int32> |
client_id | string or null |
external_member_id required | string |
person_code required | string |
date_of_service | string <ArrowDateTime> |
accumulation_types required | Array of strings |
accumulated_amount required | number or null |
external_account_id required | string or null |
external_group_id required | string or null |
{- "transmission_id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "date_of_service": "string",
- "accumulation_types": [
- "string"
], - "accumulated_amount": 0,
- "external_account_id": "string",
- "external_group_id": "string"
}
{- "inserted_ids": [
- 0
]
}
List Accumulation Transaction Records.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer <int32> |
client_id required | string |
external_member_id required | string |
person_code | string |
accumulation_transaction_data_id | integer or null <int32> |
external_group_id | string or null |
external_account_id | string or null |
accumulation_type | string or null |
created_at | string <ArrowDateTime> |
maximum_created_at | string <ArrowDateTime> |
minimum_created_at | string <ArrowDateTime> |
date_of_service | string <ArrowDateTime> |
Array of objects or null (OrderBySchema_1744676532.8819535) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "accumulation_transaction_data_id": 0,
- "external_group_id": "string",
- "external_account_id": "string",
- "accumulation_type": "string",
- "created_at": "string",
- "maximum_created_at": "string",
- "minimum_created_at": "string",
- "date_of_service": "string",
- "order_by": [
- {
- "created_at": "string",
- "date_of_service": "string",
- "accumulation_type": "string",
- "accumulated_amount": "string",
- "external_group_id": "string",
- "external_account_id": "string"
}
]
}
{- "result_count": "string",
- "results": [
- {
- "accumulation_transaction_record": {
- "id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "created_at": "string",
- "date_of_service": "string",
- "accumulation_type": "string",
- "accumulated_amount": 0,
- "rn": "string",
- "external_group_id": "string",
- "external_account_id": "string",
- "is_adjustment": true,
- "adjustment_reason": "string"
}
}
]
}
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer <int32> |
client_id required | string |
external_member_id required | string |
person_code | string |
accumulation_transaction_data_id | integer or null <int32> |
external_group_id required | string or null |
external_account_id required | string or null |
accumulation_type | string or null |
created_at | string <ArrowDateTime> |
maximum_created_at | string <ArrowDateTime> |
minimum_created_at | string <ArrowDateTime> |
date_of_service | string <ArrowDateTime> |
Array of objects or null (OrderBySchema_1744676532.8819535) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "accumulation_transaction_data_id": 0,
- "external_group_id": "string",
- "external_account_id": "string",
- "accumulation_type": "string",
- "created_at": "string",
- "maximum_created_at": "string",
- "minimum_created_at": "string",
- "date_of_service": "string",
- "order_by": [
- {
- "created_at": "string",
- "date_of_service": "string",
- "accumulation_type": "string",
- "accumulated_amount": "string",
- "external_group_id": "string",
- "external_account_id": "string"
}
]
}
{- "result_count": "string",
- "results": [
- {
- "accumulation_transaction_record": {
- "id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "created_at": "string",
- "date_of_service": "string",
- "accumulation_type": "string",
- "accumulated_amount": 0,
- "rn": "string",
- "external_group_id": "string",
- "external_account_id": "string",
- "is_adjustment": true,
- "adjustment_reason": "string"
}
}
]
}
Get an Accumulation Parser Module.
id | integer or null <int32> |
name | string or null |
{- "id": 0,
- "name": "string"
}
{- "id": 0,
- "name": "string",
- "description": "string",
- "created_at": "string",
- "rn": "string",
- "supported_fields": null,
- "supported_attributes": null,
- "supported_functions": null,
- "supported_operators": null,
- "config_template": null
}
List Accumulation Parser Modules.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer or null <int32> |
name | string or null |
description | string or null |
Array of objects or null (OrderBySchema_1744676532.8889425) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "name": "string",
- "description": "string",
- "order_by": [
- {
- "id": 0,
- "name": "string",
- "description": "string"
}
]
}
{- "results": [
- {
- "accumulation_parser_module": {
- "id": 0,
- "name": "string",
- "description": "string",
- "created_at": "string",
- "rn": "string",
- "supported_fields": null,
- "supported_attributes": null,
- "supported_functions": null,
- "supported_operators": null,
- "config_template": null
}
}
], - "result_count": "string"
}
Get an Accumulation Reconciliation Execution.
id | integer or null <int32> |
{- "id": 0
}
{- "id": 0,
- "client_ids": [
- "string"
], - "status": "string",
- "created_at": "string",
- "start_time": "string",
- "end_time": "string",
- "run_time": "string",
- "balance_files": null,
- "oob_report_files": null,
- "status_files": null,
- "status_data": null,
- "error_message": "string"
}
List Accumulation Reconciliation Executions.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
status | string or null |
client_ids | Array of strings or null The client IDs used for the accumulations reconciliation |
Array of objects or null (OrderBySchema_1744676532.8930342) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "status": "string",
- "client_ids": [
- "string"
], - "order_by": [
- {
- "id": "string",
- "status": "string",
- "created_at": "string",
- "start_time": "string",
- "run_time": "string"
}
]
}
{- "results": [
- {
- "execution": {
- "id": 0,
- "client_ids": [
- "string"
], - "status": "string",
- "created_at": "string",
- "start_time": "string",
- "end_time": "string",
- "run_time": "string",
- "balance_files": null,
- "oob_report_files": null,
- "status_files": null,
- "status_data": null,
- "error_message": "string"
}
}
], - "result_count": "string"
}
file_name required | string |
{- "file_name": "string"
}
{- "file_name": "string",
- "bucket": "string",
- "key": "string",
- "post": {
- "url": "string",
- "fields": null
}
}
bucket required | string |
key required | string |
file_name required | string |
{- "bucket": "string",
- "key": "string",
- "file_name": "string"
}
{- "message": "string"
}
List all AI endpoints for this service.
:return: List of AI endpoints, their descriptions and schemas.
{ }
{- "endpoints": [
- {
- "endpoint": "string",
- "description": "string",
- "methods": [
- "string"
], - "input_schema": { },
- "output_schema": {
- "property1": { },
- "property2": { }
}
}
]
}
Get the SQLAlchemy code for the given model names in the given database.
:return: The SQLAlchemy code for the given models
model_names required | Array of strings List of SQLAlchemy models. |
{- "model_names": [
- "string"
]
}
{- "model_codes": [
- "string"
]
}
List the SQLAlchemy models for the given database.
:return: List of model names
{ }
{- "model_names": [
- "string"
]
}
Query the database with the given SQLAlchemy 2.0 query.
:return: The query results
query required | string SQLAlchemy 2.0 query in |
{- "query": "string"
}
{- "results": [
- { }
]
}
Create a Claim Adjustment.
type required | string Enum: "encounter" "pde" |
claim_id required | integer <int32> |
adjustments required | any |
{- "type": "encounter",
- "claim_id": 0,
- "adjustments": null
}
{- "id": 0,
- "type": "encounter",
- "claim_id": 0,
- "adjustments": null
}
type required | string Enum: "encounter" "pde" |
ids required | Array of numbers Claim adjustmet IDs |
{- "type": "encounter",
- "ids": [
- 0
]
}
{- "message": "string"
}
Get a Claim Adjustment.
id required | integer <int32> |
type required | string Enum: "encounter" "pde" |
{- "id": 0,
- "type": "encounter"
}
{- "id": 0,
- "type": "encounter",
- "claim_id": 0,
- "adjustments": null
}
List Claim Adjustments.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer <int32> |
type | string Enum: "encounter" "pde" |
claim_id | integer <int32> |
adjustments | string |
Array of objects or null (ClaimAdjustmentsOrderBySchema_1744676532.9065568) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "type": "encounter",
- "claim_id": 0,
- "adjustments": "string",
- "order_by": [
- {
- "id": "string",
- "type": "encounter",
- "claim_id": "string",
- "adjustments": "string"
}
]
}
{- "results": [
- {
- "claim_adjustment": {
- "id": 0,
- "type": "encounter",
- "claim_id": 0,
- "adjustments": null
}
}
], - "result_count": "string"
}
Update a Claim Adjustment.
id required | integer <int32> |
type required | string Enum: "encounter" "pde" |
claim_id | integer <int32> |
adjustments required | any |
{- "id": 0,
- "type": "encounter",
- "claim_id": 0,
- "adjustments": null
}
{- "id": 0,
- "type": "encounter",
- "claim_id": 0,
- "adjustments": null
}
original_name required | string |
{- "original_name": "string"
}
{- "bucket": "string",
- "key": "string",
- "post": {
- "url": "string",
- "fields": null
}
}
Get a Claim.
id required | integer <int32> |
client_id | string or null |
external_account_id | string or null |
external_group_id | string or null |
external_member_id | string or null |
person_code | string or null |
include_raw_request_parsed | boolean or null |
include_raw_response_parsed | boolean or null |
{- "id": 0,
- "client_id": "string",
- "external_account_id": "string",
- "external_group_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "include_raw_request_parsed": true,
- "include_raw_response_parsed": true
}
{- "id": 0,
- "rn": "string",
- "reversal_id": 0,
- "reverses_id": 0,
- "original_claim_id": 0,
- "client_id": "string",
- "external_account_id": "string",
- "external_group_id": "string",
- "provider_agreement_id": 0,
- "coverage_strategy_id": "string",
- "date_of_service": "string",
- "claim_submission_date": "string",
- "claim_payment_cycle_end_date": "string",
- "claim_reimbursement_cycle_end_date": "string",
- "claim_status": "string",
- "claim_count": 0,
- "received_at": "string",
- "source": "string",
- "external_member_id": "string",
- "person_code": "string",
- "first_name": "string",
- "last_name": "string",
- "coverage_strategy_type": "string",
- "plan_benefit_id": 0,
- "formulary_id": 0,
- "network_id": 0,
- "benefit_network": "string",
- "gpi": "string",
- "pharmacy_nabp": "string",
- "pharmacy_name": "string",
- "pharmacy_channel": "string",
- "version_release_number": "string",
- "request_transaction_code": "string",
- "bin_number": "string",
- "processor_control_number": "string",
- "transaction_count": "string",
- "service_provider_id_qualifier": "string",
- "service_provider_id": "string",
- "software_vendor_certification_id": "string",
- "submitted_cardholder_id": "string",
- "cardholder_first_name": "string",
- "cardholder_last_name": "string",
- "plan_id": "string",
- "eligibility_clarification_code": "string",
- "group_id": "string",
- "submitted_person_code": "string",
- "patient_relationship_code": "string",
- "medigap_id": "string",
- "medicaid_indicator": "string",
- "provider_accept_assignment_indicator": "string",
- "cms_part_d_defined_qualified_facility": "string",
- "medicaid_id_number": "string",
- "patient_id_qualifier": "string",
- "patient_id": "string",
- "date_of_birth": "string",
- "patient_gender_code": "string",
- "patient_first_name": "string",
- "patient_last_name": "string",
- "patient_street_address": "string",
- "patient_street_address_line_1": "string",
- "patient_street_address_line_2": "string",
- "patient_city_address": "string",
- "patient_state_province_address": "string",
- "patient_zip_postal_code": "string",
- "patient_country_code": "string",
- "patient_telephone_number": "string",
- "place_of_service": "string",
- "employer_id": "string",
- "pregnancy_indicator": "string",
- "patient_email_address": "user@example.com",
- "patient_residence": "string",
- "prescription_service_reference_number_qualifier": "string",
- "prescription_service_reference_number": "string",
- "product_service_id_qualifier": "string",
- "ndc": "string",
- "associated_prescription_service_reference_number": "string",
- "associated_prescription_service_date": "string",
- "procedure_modifier_code_1": "string",
- "procedure_modifier_code_2": "string",
- "procedure_modifier_code_3": "string",
- "procedure_modifier_code_4": "string",
- "procedure_modifier_code_5": "string",
- "procedure_modifier_code_6": "string",
- "procedure_modifier_code_7": "string",
- "procedure_modifier_code_8": "string",
- "procedure_modifier_code_9": "string",
- "procedure_modifier_code_10": "string",
- "quantity_dispensed": "string",
- "fill_number": 0,
- "days_supply": 0,
- "compound_code": "string",
- "daw": "string",
- "date_prescription_written": "string",
- "number_of_refills_authorized": 0,
- "prescription_origin_code": "string",
- "submission_clarification_code_1": "string",
- "submission_clarification_code_2": "string",
- "submission_clarification_code_3": "string",
- "submission_clarification_code_4": "string",
- "submission_clarification_code_5": "string",
- "submission_clarification_code_pde": "string",
- "submission_type_code_1": "string",
- "submission_type_code_2": "string",
- "submission_type_code_3": "string",
- "submission_type_code_4": "string",
- "submission_type_code_5": "string",
- "quantity_prescribed": "string",
- "multiple_prescription_service_order_group_id": "string",
- "multiple_prescription_service_order_group_reason_code": "string",
- "total_prescribed_quantity_remaining": "string",
- "other_coverage_code": "string",
- "special_packaging_indicator": "string",
- "originally_prescribed_product_service_id_qualifier": "string",
- "originally_prescribed_product_service_code": "string",
- "originally_prescribed_quantity": "string",
- "scheduled_prescription_id_number": "string",
- "unit_of_measure": "string",
- "level_of_service": "string",
- "prior_authorization_type_code": "string",
- "prior_authorization_id_submitted": "string",
- "dispensing_status": "string",
- "quantity_intended_to_be_dispensed": "string",
- "days_supply_intended_to_be_dispensed": 0,
- "delay_reason_code": "string",
- "patient_assignment_indicator": "string",
- "route_of_administration": "string",
- "compound_type": "string",
- "preparation_environment_type": "string",
- "preparation_environment_event_code": "string",
- "pharmacy_service_type": "string",
- "associated_prescription_service_reference_number_qualifier": "string",
- "associated_prescription_service_fill_number": 0,
- "original_manufacturer_product_id_qualifier": "string",
- "original_manufacturer_product_id": "string",
- "ltpac_dispense_frequency": "string",
- "ltpac_billing_methodology": "string",
- "number_of_ltpac_dispensing_events": 0,
- "do_not_dispense_before_date": "string",
- "ingredient_cost_submitted": "string",
- "dispensing_fee_submitted": "string",
- "patient_pay_amount_reported": "string",
- "incentive_amount_submitted": "string",
- "other_amount_claimed_submitted_qualifier_1": "string",
- "other_amount_claimed_submitted_1": "string",
- "other_amount_claimed_submitted_qualifier_2": "string",
- "other_amount_claimed_submitted_2": "string",
- "other_amount_claimed_submitted_qualifier_3": "string",
- "other_amount_claimed_submitted_3": "string",
- "regulatory_fee_type_code_submitted_1": "string",
- "regulatory_fee_amount_submitted_1": "string",
- "regulatory_fee_type_code_submitted_2": "string",
- "regulatory_fee_amount_submitted_2": "string",
- "regulatory_fee_type_code_submitted_3": "string",
- "regulatory_fee_amount_submitted_3": "string",
- "percentage_tax_amount_submitted": "string",
- "percentage_tax_rate_submitted": "string",
- "percentage_tax_basis_submitted": "string",
- "usual_and_customary_charge": "string",
- "gross_amount_due": "string",
- "basis_of_cost_determination": "string",
- "provider_id_qualifier": "string",
- "provider_id": "string",
- "provider_first_name": "string",
- "provider_last_name": "string",
- "prescriber_id_qualifier": "string",
- "prescriber_id": "string",
- "prescriber_last_name": "string",
- "prescriber_telephone_number": "string",
- "prescriber_telephone_number_extension": "string",
- "primary_care_provider_id_qualifier": "string",
- "primary_care_provider_id": "string",
- "primary_care_provider_last_name": "string",
- "prescriber_first_name": "string",
- "prescriber_street_address": "string",
- "prescriber_street_address_line_1": "string",
- "prescriber_street_address_line_2": "string",
- "prescriber_city_address": "string",
- "prescriber_state_province_address": "string",
- "prescriber_zip_postal_code": "string",
- "prescriber_country_code": "string",
- "prescriber_dea_number": "string",
- "prescriber_place_of_service": "string",
- "compound_prices": null,
- "compound_dosage_form_description_code": "string",
- "compound_dispensing_unit_form_indicator": "string",
- "compound_ingredient_component_count": 0,
- "compound_product_id_qualifier_1": "string",
- "compound_product_id_1": "string",
- "compound_ingredient_quantity_1": "string",
- "compound_product_id_qualifier_2": "string",
- "compound_product_id_2": "string",
- "compound_ingredient_quantity_2": "string",
- "compound_product_id_qualifier_3": "string",
- "compound_product_id_3": "string",
- "compound_ingredient_quantity_3": "string",
- "compound_product_id_qualifier_4": "string",
- "compound_product_id_4": "string",
- "compound_ingredient_quantity_4": "string",
- "compound_product_id_qualifier_5": "string",
- "compound_product_id_5": "string",
- "compound_ingredient_quantity_5": "string",
- "compound_product_id_qualifier_6": "string",
- "compound_product_id_6": "string",
- "compound_ingredient_quantity_6": "string",
- "compound_product_id_qualifier_7": "string",
- "compound_product_id_7": "string",
- "compound_ingredient_quantity_7": "string",
- "compound_product_id_qualifier_8": "string",
- "compound_product_id_8": "string",
- "compound_ingredient_quantity_8": "string",
- "compound_product_id_qualifier_9": "string",
- "compound_product_id_9": "string",
- "compound_ingredient_quantity_9": "string",
- "compound_product_id_qualifier_10": "string",
- "compound_product_id_10": "string",
- "compound_ingredient_quantity_10": "string",
- "compound_product_id_qualifier_11": "string",
- "compound_product_id_11": "string",
- "compound_ingredient_quantity_11": "string",
- "compound_product_id_qualifier_12": "string",
- "compound_product_id_12": "string",
- "compound_ingredient_quantity_12": "string",
- "compound_product_id_qualifier_13": "string",
- "compound_product_id_13": "string",
- "compound_ingredient_quantity_13": "string",
- "compound_product_id_qualifier_14": "string",
- "compound_product_id_14": "string",
- "compound_ingredient_quantity_14": "string",
- "compound_product_id_qualifier_15": "string",
- "compound_product_id_15": "string",
- "compound_ingredient_quantity_15": "string",
- "compound_product_id_qualifier_16": "string",
- "compound_product_id_16": "string",
- "compound_ingredient_quantity_16": "string",
- "compound_product_id_qualifier_17": "string",
- "compound_product_id_17": "string",
- "compound_ingredient_quantity_17": "string",
- "compound_product_id_qualifier_18": "string",
- "compound_product_id_18": "string",
- "compound_ingredient_quantity_18": "string",
- "compound_product_id_qualifier_19": "string",
- "compound_product_id_19": "string",
- "compound_ingredient_quantity_19": "string",
- "compound_product_id_qualifier_20": "string",
- "compound_product_id_20": "string",
- "compound_ingredient_quantity_20": "string",
- "compound_product_id_qualifier_21": "string",
- "compound_product_id_21": "string",
- "compound_ingredient_quantity_21": "string",
- "compound_product_id_qualifier_22": "string",
- "compound_product_id_22": "string",
- "compound_ingredient_quantity_22": "string",
- "compound_product_id_qualifier_23": "string",
- "compound_product_id_23": "string",
- "compound_ingredient_quantity_23": "string",
- "compound_product_id_qualifier_24": "string",
- "compound_product_id_24": "string",
- "compound_ingredient_quantity_24": "string",
- "compound_product_id_qualifier_25": "string",
- "compound_product_id_25": "string",
- "compound_ingredient_quantity_25": "string",
- "diagnosis_code_qualifier_1": "string",
- "diagnosis_code_1": "string",
- "diagnosis_code_qualifier_2": "string",
- "diagnosis_code_2": "string",
- "diagnosis_code_qualifier_3": "string",
- "diagnosis_code_3": "string",
- "diagnosis_code_qualifier_4": "string",
- "diagnosis_code_4": "string",
- "diagnosis_code_qualifier_5": "string",
- "diagnosis_code_5": "string",
- "header_response_status": "string",
- "response_transaction_code": "string",
- "response_message": "string",
- "response_group_id": "string",
- "response_plan_id": "string",
- "response_cob": null,
- "network_reimbursement_id": "string",
- "external_provider_agreement_id": "string",
- "payer_health_plan_id_qualifier": "string",
- "payer_health_plan_id": "string",
- "payer_health_plan_id_qualifier_1": "string",
- "payer_health_plan_id_1": "string",
- "payer_health_plan_id_qualifier_2": "string",
- "payer_health_plan_id_2": "string",
- "payer_health_plan_id_qualifier_3": "string",
- "payer_health_plan_id_3": "string",
- "transaction_response_status": "string",
- "authorization_number": "string",
- "reconciliation_id": "string",
- "reject_code_1": "string",
- "reject_code_2": "string",
- "reject_code_3": "string",
- "reject_code_4": "string",
- "reject_code_5": "string",
- "approved_message_code_1": "string",
- "approved_message_code_2": "string",
- "approved_message_code_3": "string",
- "approved_message_code_4": "string",
- "approved_message_code_5": "string",
- "additional_message_count": 0,
- "additional_message_information_qualifier_1": "string",
- "additional_message_information_1": "string",
- "additional_message_information_continuity_1": "string",
- "additional_message_information_qualifier_2": "string",
- "additional_message_information_2": "string",
- "additional_message_information_continuity_2": "string",
- "additional_message_information_qualifier_3": "string",
- "additional_message_information_3": "string",
- "additional_message_information_continuity_3": "string",
- "additional_message_information_qualifier_4": "string",
- "additional_message_information_4": "string",
- "additional_message_information_continuity_4": "string",
- "additional_message_information_qualifier_5": "string",
- "additional_message_information_5": "string",
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- "result_of_service_code_1": "string",
- "result_of_service_code_2": "string",
- "result_of_service_code_3": "string",
- "result_of_service_code_4": "string",
- "result_of_service_code_5": "string",
- "result_of_service_code_6": "string",
- "result_of_service_code_7": "string",
- "result_of_service_code_8": "string",
- "result_of_service_code_9": "string",
- "specialty_list_dispensing_fee": "string",
- "specialty_list_id": 0,
- "specialty_list_name": "string",
- "dmr_pay_to_city_address": "string",
- "dmr_pay_to_country_code": "string",
- "dmr_pay_to_name": "string",
- "dmr_pay_to_state_province_address": "string",
- "dmr_pay_to_street_address_line_1": "string",
- "dmr_pay_to_street_address_line_2": "string",
- "dmr_pay_to_tax_id": "string",
- "dmr_pay_to_vendor_id": "string",
- "dmr_pay_to_zip_postal_code": "string",
- "tax_id_number": "string",
- "reasons_for_rejection": [
- "string"
], - "reasons_for_adjudication": [
- "string"
], - "patient_pay_reduction_due_to_point_of_service_rebate": 0,
- "plan_pay_reduction_due_to_point_of_service_rebate": 0,
- "point_of_service_rebate_amount": 0,
- "low_income_subsidy_level": "string",
- "senior_savings_model_cost_share_reduction_gap": 0,
- "senior_savings_model_cost_share_reduction_non_gap": 0,
- "senior_savings_model_indicator": "string",
- "inflation_reduction_act_subsidy_amount": 0,
- "inflation_reduction_act_covered_vaccine": "string",
- "inflation_reduction_act_covered_insulin": "string",
- "other_true_out_of_pocket_amount_indicator": "string",
- "medicare_amounts_id": 0,
- "low_income_subsidy_amounts_id": 0,
- "medicare_medicaid_dsnp_co_administered_plan": "string",
- "dsnp_fee_for_service_or_capitation": 0,
- "dsnp_medicaid_cost_share_reduction_amount_part_d": 0,
- "dsnp_medicaid_cost_share_reduction_amount_part_b": 0,
- "dsnp_medicaid_cost_share_covered_excluded_reduction_amount": 0,
- "is_340b": true,
- "medicare_administrative_claim": "string",
- "controlled_substance_code": "string",
- "desi_code": "string",
- "reprocessing_id": 0,
- "reprocessing_type": "string",
- "reprocessing_patient_pay_difference": "string",
- "reprocessing_pharmacy_pay_amount": "string",
- "reprocessing_plan_pay_amount": "string",
- "reprocessing_goes_to_835": true,
- "reprocessing_goes_to_invoice": true,
- "reprocessing_is_member_recoupment": true,
- "nx_other_payers_total_amount": "string",
- "reprocessing_nx_amount_applied_to_patient_pay": "string",
- "reprocessing_excess_nx_amount_total": "string",
- "reprocessing_patient_pay_net_nx": "string",
- "reprocessing_member_refund_amount": "string",
- "reprocessing_member_recoupment_amount": "string",
- "reprocessing_is_recoup_ltc_pharmacy": true,
- "notes": "string",
- "first_claim_id": 0,
- "next_claim_id": 0,
- "include_raw_request_parsed": true,
- "include_raw_response_parsed": true,
- "manufacturer_discount_amount": 0,
- "is_manufacturer_discount_drug": true,
- "claim_number": "string",
- "claim_sequence_number": "string",
- "medicare_prescription_payment_plan_indicator": "string",
- "medicare_prescription_payment_plan_original_claim_id": 0,
- "pharmacy_transaction_fee": 0,
- "vbid_cost_share_reduction_amount_part_d": 0,
- "vbid_model_indicator": "string",
- "pricing_level_ids": [
- 0
], - "brand_name_code": "string",
- "drug_descriptor_id": "string",
- "dosage": "string",
- "dosage_form": "string",
- "dosage_form_packaging": "string",
- "drug_name": "string",
- "drug_type": "string",
- "group_name": "string",
- "provider_phone": "string",
- "most_expensive_compound_ingredient_ndc": "string",
- "multi_source": "string",
- "name_type_code": "string",
- "rx_otc_indicator_code": "string",
- "strength": "string",
- "strength_unit_of_measure": "string",
- "pde_record_id": "string",
- "pde_claim_control_number": "string",
- "pde_plan_benefit_package_id": "string",
- "medicare_prescription_payment_plan_claim_id": 0,
- "medicare_prescription_payment_plan_claim_amount": 0,
- "claim_gpi": "string",
- "drug_lists": null,
- "identity": "string"
}
claim_number required | string or null Unique number generated when claim is submitted for given clientid, external_member_id , person_code, date_of_service, service_provider_id, prescription_service_reference_number and fill_number |
claim_sequence_number required | string or null Sequence number assigned for a given claim_number and the operation resulting in claim with paid or rejected status |
{- "claim_number": "string",
- "claim_sequence_number": "string"
}
{- "id": 0,
- "rn": "string",
- "reversal_id": 0,
- "reverses_id": 0,
- "original_claim_id": 0,
- "client_id": "string",
- "external_account_id": "string",
- "external_group_id": "string",
- "provider_agreement_id": 0,
- "coverage_strategy_id": "string",
- "date_of_service": "string",
- "claim_submission_date": "string",
- "claim_payment_cycle_end_date": "string",
- "claim_reimbursement_cycle_end_date": "string",
- "claim_status": "string",
- "claim_count": 0,
- "received_at": "string",
- "source": "string",
- "external_member_id": "string",
- "person_code": "string",
- "first_name": "string",
- "last_name": "string",
- "coverage_strategy_type": "string",
- "plan_benefit_id": 0,
- "formulary_id": 0,
- "network_id": 0,
- "benefit_network": "string",
- "gpi": "string",
- "pharmacy_nabp": "string",
- "pharmacy_name": "string",
- "pharmacy_channel": "string",
- "version_release_number": "string",
- "request_transaction_code": "string",
- "bin_number": "string",
- "processor_control_number": "string",
- "transaction_count": "string",
- "service_provider_id_qualifier": "string",
- "service_provider_id": "string",
- "software_vendor_certification_id": "string",
- "submitted_cardholder_id": "string",
- "cardholder_first_name": "string",
- "cardholder_last_name": "string",
- "plan_id": "string",
- "eligibility_clarification_code": "string",
- "group_id": "string",
- "submitted_person_code": "string",
- "patient_relationship_code": "string",
- "medigap_id": "string",
- "medicaid_indicator": "string",
- "provider_accept_assignment_indicator": "string",
- "cms_part_d_defined_qualified_facility": "string",
- "medicaid_id_number": "string",
- "patient_id_qualifier": "string",
- "patient_id": "string",
- "date_of_birth": "string",
- "patient_gender_code": "string",
- "patient_first_name": "string",
- "patient_last_name": "string",
- "patient_street_address": "string",
- "patient_street_address_line_1": "string",
- "patient_street_address_line_2": "string",
- "patient_city_address": "string",
- "patient_state_province_address": "string",
- "patient_zip_postal_code": "string",
- "patient_country_code": "string",
- "patient_telephone_number": "string",
- "place_of_service": "string",
- "employer_id": "string",
- "pregnancy_indicator": "string",
- "patient_email_address": "user@example.com",
- "patient_residence": "string",
- "prescription_service_reference_number_qualifier": "string",
- "prescription_service_reference_number": "string",
- "product_service_id_qualifier": "string",
- "ndc": "string",
- "associated_prescription_service_reference_number": "string",
- "associated_prescription_service_date": "string",
- "procedure_modifier_code_1": "string",
- "procedure_modifier_code_2": "string",
- "procedure_modifier_code_3": "string",
- "procedure_modifier_code_4": "string",
- "procedure_modifier_code_5": "string",
- "procedure_modifier_code_6": "string",
- "procedure_modifier_code_7": "string",
- "procedure_modifier_code_8": "string",
- "procedure_modifier_code_9": "string",
- "procedure_modifier_code_10": "string",
- "quantity_dispensed": "string",
- "fill_number": 0,
- "days_supply": 0,
- "compound_code": "string",
- "daw": "string",
- "date_prescription_written": "string",
- "number_of_refills_authorized": 0,
- "prescription_origin_code": "string",
- "submission_clarification_code_1": "string",
- "submission_clarification_code_2": "string",
- "submission_clarification_code_3": "string",
- "submission_clarification_code_4": "string",
- "submission_clarification_code_5": "string",
- "submission_clarification_code_pde": "string",
- "submission_type_code_1": "string",
- "submission_type_code_2": "string",
- "submission_type_code_3": "string",
- "submission_type_code_4": "string",
- "submission_type_code_5": "string",
- "quantity_prescribed": "string",
- "multiple_prescription_service_order_group_id": "string",
- "multiple_prescription_service_order_group_reason_code": "string",
- "total_prescribed_quantity_remaining": "string",
- "other_coverage_code": "string",
- "special_packaging_indicator": "string",
- "originally_prescribed_product_service_id_qualifier": "string",
- "originally_prescribed_product_service_code": "string",
- "originally_prescribed_quantity": "string",
- "scheduled_prescription_id_number": "string",
- "unit_of_measure": "string",
- "level_of_service": "string",
- "prior_authorization_type_code": "string",
- "prior_authorization_id_submitted": "string",
- "dispensing_status": "string",
- "quantity_intended_to_be_dispensed": "string",
- "days_supply_intended_to_be_dispensed": 0,
- "delay_reason_code": "string",
- "patient_assignment_indicator": "string",
- "route_of_administration": "string",
- "compound_type": "string",
- "preparation_environment_type": "string",
- "preparation_environment_event_code": "string",
- "pharmacy_service_type": "string",
- "associated_prescription_service_reference_number_qualifier": "string",
- "associated_prescription_service_fill_number": 0,
- "original_manufacturer_product_id_qualifier": "string",
- "original_manufacturer_product_id": "string",
- "ltpac_dispense_frequency": "string",
- "ltpac_billing_methodology": "string",
- "number_of_ltpac_dispensing_events": 0,
- "do_not_dispense_before_date": "string",
- "ingredient_cost_submitted": "string",
- "dispensing_fee_submitted": "string",
- "patient_pay_amount_reported": "string",
- "incentive_amount_submitted": "string",
- "other_amount_claimed_submitted_qualifier_1": "string",
- "other_amount_claimed_submitted_1": "string",
- "other_amount_claimed_submitted_qualifier_2": "string",
- "other_amount_claimed_submitted_2": "string",
- "other_amount_claimed_submitted_qualifier_3": "string",
- "other_amount_claimed_submitted_3": "string",
- "regulatory_fee_type_code_submitted_1": "string",
- "regulatory_fee_amount_submitted_1": "string",
- "regulatory_fee_type_code_submitted_2": "string",
- "regulatory_fee_amount_submitted_2": "string",
- "regulatory_fee_type_code_submitted_3": "string",
- "regulatory_fee_amount_submitted_3": "string",
- "percentage_tax_amount_submitted": "string",
- "percentage_tax_rate_submitted": "string",
- "percentage_tax_basis_submitted": "string",
- "usual_and_customary_charge": "string",
- "gross_amount_due": "string",
- "basis_of_cost_determination": "string",
- "provider_id_qualifier": "string",
- "provider_id": "string",
- "provider_first_name": "string",
- "provider_last_name": "string",
- "prescriber_id_qualifier": "string",
- "prescriber_id": "string",
- "prescriber_last_name": "string",
- "prescriber_telephone_number": "string",
- "prescriber_telephone_number_extension": "string",
- "primary_care_provider_id_qualifier": "string",
- "primary_care_provider_id": "string",
- "primary_care_provider_last_name": "string",
- "prescriber_first_name": "string",
- "prescriber_street_address": "string",
- "prescriber_street_address_line_1": "string",
- "prescriber_street_address_line_2": "string",
- "prescriber_city_address": "string",
- "prescriber_state_province_address": "string",
- "prescriber_zip_postal_code": "string",
- "prescriber_country_code": "string",
- "prescriber_dea_number": "string",
- "prescriber_place_of_service": "string",
- "compound_prices": null,
- "compound_dosage_form_description_code": "string",
- "compound_dispensing_unit_form_indicator": "string",
- "compound_ingredient_component_count": 0,
- "compound_product_id_qualifier_1": "string",
- "compound_product_id_1": "string",
- "compound_ingredient_quantity_1": "string",
- "compound_product_id_qualifier_2": "string",
- "compound_product_id_2": "string",
- "compound_ingredient_quantity_2": "string",
- "compound_product_id_qualifier_3": "string",
- "compound_product_id_3": "string",
- "compound_ingredient_quantity_3": "string",
- "compound_product_id_qualifier_4": "string",
- "compound_product_id_4": "string",
- "compound_ingredient_quantity_4": "string",
- "compound_product_id_qualifier_5": "string",
- "compound_product_id_5": "string",
- "compound_ingredient_quantity_5": "string",
- "compound_product_id_qualifier_6": "string",
- "compound_product_id_6": "string",
- "compound_ingredient_quantity_6": "string",
- "compound_product_id_qualifier_7": "string",
- "compound_product_id_7": "string",
- "compound_ingredient_quantity_7": "string",
- "compound_product_id_qualifier_8": "string",
- "compound_product_id_8": "string",
- "compound_ingredient_quantity_8": "string",
- "compound_product_id_qualifier_9": "string",
- "compound_product_id_9": "string",
- "compound_ingredient_quantity_9": "string",
- "compound_product_id_qualifier_10": "string",
- "compound_product_id_10": "string",
- "compound_ingredient_quantity_10": "string",
- "compound_product_id_qualifier_11": "string",
- "compound_product_id_11": "string",
- "compound_ingredient_quantity_11": "string",
- "compound_product_id_qualifier_12": "string",
- "compound_product_id_12": "string",
- "compound_ingredient_quantity_12": "string",
- "compound_product_id_qualifier_13": "string",
- "compound_product_id_13": "string",
- "compound_ingredient_quantity_13": "string",
- "compound_product_id_qualifier_14": "string",
- "compound_product_id_14": "string",
- "compound_ingredient_quantity_14": "string",
- "compound_product_id_qualifier_15": "string",
- "compound_product_id_15": "string",
- "compound_ingredient_quantity_15": "string",
- "compound_product_id_qualifier_16": "string",
- "compound_product_id_16": "string",
- "compound_ingredient_quantity_16": "string",
- "compound_product_id_qualifier_17": "string",
- "compound_product_id_17": "string",
- "compound_ingredient_quantity_17": "string",
- "compound_product_id_qualifier_18": "string",
- "compound_product_id_18": "string",
- "compound_ingredient_quantity_18": "string",
- "compound_product_id_qualifier_19": "string",
- "compound_product_id_19": "string",
- "compound_ingredient_quantity_19": "string",
- "compound_product_id_qualifier_20": "string",
- "compound_product_id_20": "string",
- "compound_ingredient_quantity_20": "string",
- "compound_product_id_qualifier_21": "string",
- "compound_product_id_21": "string",
- "compound_ingredient_quantity_21": "string",
- "compound_product_id_qualifier_22": "string",
- "compound_product_id_22": "string",
- "compound_ingredient_quantity_22": "string",
- "compound_product_id_qualifier_23": "string",
- "compound_product_id_23": "string",
- "compound_ingredient_quantity_23": "string",
- "compound_product_id_qualifier_24": "string",
- "compound_product_id_24": "string",
- "compound_ingredient_quantity_24": "string",
- "compound_product_id_qualifier_25": "string",
- "compound_product_id_25": "string",
- "compound_ingredient_quantity_25": "string",
- "diagnosis_code_qualifier_1": "string",
- "diagnosis_code_1": "string",
- "diagnosis_code_qualifier_2": "string",
- "diagnosis_code_2": "string",
- "diagnosis_code_qualifier_3": "string",
- "diagnosis_code_3": "string",
- "diagnosis_code_qualifier_4": "string",
- "diagnosis_code_4": "string",
- "diagnosis_code_qualifier_5": "string",
- "diagnosis_code_5": "string",
- "header_response_status": "string",
- "response_transaction_code": "string",
- "response_message": "string",
- "response_group_id": "string",
- "response_plan_id": "string",
- "response_cob": null,
- "network_reimbursement_id": "string",
- "external_provider_agreement_id": "string",
- "payer_health_plan_id_qualifier": "string",
- "payer_health_plan_id": "string",
- "payer_health_plan_id_qualifier_1": "string",
- "payer_health_plan_id_1": "string",
- "payer_health_plan_id_qualifier_2": "string",
- "payer_health_plan_id_2": "string",
- "payer_health_plan_id_qualifier_3": "string",
- "payer_health_plan_id_3": "string",
- "transaction_response_status": "string",
- "authorization_number": "string",
- "reconciliation_id": "string",
- "reject_code_1": "string",
- "reject_code_2": "string",
- "reject_code_3": "string",
- "reject_code_4": "string",
- "reject_code_5": "string",
- "approved_message_code_1": "string",
- "approved_message_code_2": "string",
- "approved_message_code_3": "string",
- "approved_message_code_4": "string",
- "approved_message_code_5": "string",
- "additional_message_count": 0,
- "additional_message_information_qualifier_1": "string",
- "additional_message_information_1": "string",
- "additional_message_information_continuity_1": "string",
- "additional_message_information_qualifier_2": "string",
- "additional_message_information_2": "string",
- "additional_message_information_continuity_2": "string",
- "additional_message_information_qualifier_3": "string",
- "additional_message_information_3": "string",
- "additional_message_information_continuity_3": "string",
- "additional_message_information_qualifier_4": "string",
- "additional_message_information_4": "string",
- "additional_message_information_continuity_4": "string",
- "additional_message_information_qualifier_5": "string",
- "additional_message_information_5": "string",
- "additional_message_information_continuity_5": "string",
- "additional_message_information_qualifier_6": "string",
- "additional_message_information_6": "string",
- "additional_message_information_continuity_6": "string",
- "additional_message_information_qualifier_7": "string",
- "additional_message_information_7": "string",
- "additional_message_information_continuity_7": "string",
- "additional_message_information_qualifier_8": "string",
- "additional_message_information_8": "string",
- "additional_message_information_continuity_8": "string",
- "additional_message_information_qualifier_9": "string",
- "additional_message_information_9": "string",
- "additional_message_information_continuity_9": "string",
- "additional_message_information_qualifier_10": "string",
- "additional_message_information_10": "string",
- "additional_message_information_continuity_10": "string",
- "additional_message_information_qualifier_11": "string",
- "additional_message_information_11": "string",
- "additional_message_information_continuity_11": "string",
- "additional_message_information_qualifier_12": "string",
- "additional_message_information_12": "string",
- "additional_message_information_continuity_12": "string",
- "additional_message_information_qualifier_13": "string",
- "additional_message_information_13": "string",
- "additional_message_information_continuity_13": "string",
- "additional_message_information_qualifier_14": "string",
- "additional_message_information_14": "string",
- "additional_message_information_continuity_14": "string",
- "additional_message_information_qualifier_15": "string",
- "additional_message_information_15": "string",
- "additional_message_information_continuity_15": "string",
- "additional_message_information_qualifier_16": "string",
- "additional_message_information_16": "string",
- "additional_message_information_continuity_16": "string",
- "additional_message_information_qualifier_17": "string",
- "additional_message_information_17": "string",
- "additional_message_information_continuity_17": "string",
- "additional_message_information_qualifier_18": "string",
- "additional_message_information_18": "string",
- "additional_message_information_continuity_18": "string",
- "additional_message_information_qualifier_19": "string",
- "additional_message_information_19": "string",
- "additional_message_information_continuity_19": "string",
- "additional_message_information_qualifier_20": "string",
- "additional_message_information_20": "string",
- "additional_message_information_continuity_20": "string",
- "internal_control_number": "string",
- "adjudicated_program_type": "string",
- "next_available_fill_date": "string",
- "formulary_alternative_product_count": 0,
- "formulary_alternative_plan_benefit_tier_1": "string",
- "formulary_alternative_reason_code_1": "string",
- "formulary_alternative_id_qualifier_1": "string",
- "formulary_alternative_id_1": "string",
- "formulary_alternative_incentive_1": "string",
- "formulary_alternative_cost_share_incentive_1": "string",
- "formulary_alternative_description_1": "string",
- "formulary_alternative_plan_benefit_tier_2": "string",
- "formulary_alternative_reason_code_2": "string",
- "formulary_alternative_id_qualifier_2": "string",
- "formulary_alternative_id_2": "string",
- "formulary_alternative_incentive_2": "string",
- "formulary_alternative_cost_share_incentive_2": "string",
- "formulary_alternative_description_2": "string",
- "formulary_alternative_plan_benefit_tier_3": "string",
- "formulary_alternative_reason_code_3": "string",
- "formulary_alternative_id_qualifier_3": "string",
- "formulary_alternative_id_3": "string",
- "formulary_alternative_incentive_3": "string",
- "formulary_alternative_cost_share_incentive_3": 0,
- "formulary_alternative_description_3": "string",
- "plan_benefit_override_indicator": "string",
- "plan_benefit_override_value_1": "string",
- "plan_benefit_override_value_2": "string",
- "plan_benefit_override_value_3": "string",
- "plan_benefit_override_value_4": "string",
- "plan_benefit_override_value_5": "string",
- "plan_benefit_override_value_6": "string",
- "plan_benefit_override_value_7": "string",
- "plan_benefit_override_value_8": "string",
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- "provider_phone": "string",
- "most_expensive_compound_ingredient_ndc": "string",
- "multi_source": "string",
- "name_type_code": "string",
- "rx_otc_indicator_code": "string",
- "strength": "string",
- "strength_unit_of_measure": "string",
- "pde_record_id": "string",
- "pde_claim_control_number": "string",
- "pde_plan_benefit_package_id": "string",
- "medicare_prescription_payment_plan_claim_id": 0,
- "medicare_prescription_payment_plan_claim_amount": 0,
- "claim_gpi": "string",
- "drug_lists": null,
- "identity": "string"
}
List Claims.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
Array of objects or null (OrderBySchema_1744676532.942683) | |
id | integer or null <int32> The internal ID of a claim. Cannot be set during create nor subsequently changed. |
client_id | string or null |
external_member_id | string or null |
person_code | string or null |
external_account_id | string or null |
external_group_id | string or null |
submitted_carholder_id | string or null |
first_name | string or null |
last_name | string or null |
full_text_search | string or null The full text search for claims by product_service_description, date of service, and pharmacy name |
claim_status | string or null |
date_type | string or null |
prescription_service_reference_number | string or null A field on NCPDP D.0 that is also referred to as the 'prescription number' or 'Rx number'. This number is assigned by the pharmacy to represent a specific prescription, inclusive of all refills for that prescription (via fill number). Rx numbers are ONLY unique to pharmacies, and are NOT globally unique. |
pharmacy_nabp | string or null |
prescriber_id | string or null |
ndc | string or null |
service_provider_id | string or null A field in NCPDP D.0 which in our system is ALWAYS the NPI of the pharmacy for paid or accepted claims (rejected claims may submit other values, causing us to reject the claim). NPI is the national provider identifier, essentially every entity in healthcare has an NPI, which includes pharmacies, doctors, hospitals, and pharmacists themselves. |
start_date | string or null <ArrowDateTime> |
end_date | string or null <ArrowDateTime> |
minimum_claim_submission_date | string or null <ArrowDateTime> |
maximum_claim_submission_date | string or null <ArrowDateTime> |
is_340b | boolean or null Return claims matching the given is_340b value. |
reject_codes | string or null A string of reject codes, with multiple reject codes separated by commas. |
paid_claims_only | boolean or null Boolean to show paid claims only, ignoring reversed and rejected. Defaults to false. |
claim_sources | Array of strings or null or null Enum: "admin" "app" "batch-test" "historical" "migrated" "pharmacy" "switch" "test" "vendor" "web" |
get_dependent_claims | boolean or null Boolean to return dependent claims. |
month | integer or null <int32> Month to filter by as integer |
year | integer or null <int32> Year to filter by as integer |
year_to_date | boolean or null Should filter by year to date. |
gpi | string or null Drug gpi to search. |
gpi_operator | string or null Search field using =, STARTSWITH, CONTAINS |
drug_name | string or null |
excluded_gpi_list | Array of strings or null or null |
client_ids | Array of strings or null or null |
add_pharmacy_data | boolean or null Boolean to return pharmacy details from ncpdp_providers |
only_fields | Array of strings or null or null |
formulary_tier | string or null A string of formulary tiers, with multiple tiers separated by commas. |
first_claim_id | integer or null <int32> |
basis_of_cost_determination | string or null |
custom_filters | Array of strings or null or null |
medicare_prescription_payment_plan_indicator | string or null |
coverage_strategy_type | string or null |
claim_number | string or null |
claim_sequence_number | string or null |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "order_by": [
- {
- "id": "string",
- "client_id": "string",
- "external_group_id": "string",
- "date_of_service": "string",
- "claim_submission_date": "string",
- "claim_status": "string",
- "received_at": "string",
- "source": "string",
- "external_member_id": "string",
- "person_code": "string",
- "first_name": "string",
- "last_name": "string",
- "plan_benefit_id": "string",
- "formulary_id": "string",
- "network_id": "string",
- "service_provider_id": "string",
- "cardholder_first_name": "string",
- "cardholder_last_name": "string",
- "plan_id": "string",
- "group_id": "string",
- "date_of_birth": "string",
- "patient_first_name": "string",
- "patient_last_name": "string",
- "prescription_service_reference_number": "string",
- "ndc": "string",
- "quantity_dispensed": "string",
- "fill_number": "string",
- "days_supply": "string",
- "compound_code": "string",
- "daw": "string",
- "prior_authorization_type_code": "string",
- "prior_authorization_id_submitted": "string",
- "pharmacy_service_type": "string",
- "ingredient_cost_submitted": "string",
- "dispensing_fee_submitted": "string",
- "patient_pay_amount_reported": "string",
- "incentive_amount_submitted": "string",
- "other_amount_claimed_submitted_1": "string",
- "other_amount_claimed_submitted_2": "string",
- "other_amount_claimed_submitted_3": "string",
- "regulatory_fee_type_code_submitted_1": "string",
- "regulatory_fee_amount_submitted_1": "string",
- "regulatory_fee_type_code_submitted_2": "string",
- "regulatory_fee_amount_submitted_2": "string",
- "regulatory_fee_type_code_submitted_3": "string",
- "regulatory_fee_amount_submitted_3": "string",
- "percentage_tax_amount_submitted": "string",
- "percentage_tax_rate_submitted": "string",
- "percentage_tax_basis_submitted": "string",
- "usual_and_customary_charge": "string",
- "gross_amount_due": "string",
- "basis_of_cost_determination": "string",
- "provider_id": "string",
- "provider_last_name": "string",
- "prescriber_id": "string",
- "prescriber_last_name": "string",
- "header_response_status": "string",
- "response_transaction_code": "string",
- "transaction_response_status": "string",
- "reject_code_1": "string",
- "reject_code_2": "string",
- "reject_code_3": "string",
- "reject_code_4": "string",
- "reject_code_5": "string",
- "next_available_fill_date": "string",
- "ingredient_cost_charged_to_plan": "string",
- "dispensing_fee_charged_to_plan": "string",
- "product_service_classification": "string",
- "product_service_description": "string",
- "total_amount_paid": "string",
- "patient_pay_amount": "string",
- "patient_pay_component_amount_1": "string",
- "patient_pay_component_amount_2": "string",
- "patient_pay_component_amount_3": "string",
- "plan_pay_amount": "string",
- "amount_applied_to_periodic_deductible": "string",
- "amount_applied_to_periodic_maximum_benefit": "string",
- "amount_applied_to_periodic_maximum_out_of_pocket": "string",
- "amount_applied_to_periodic_maximum_fertility": "string",
- "amount_exceeding_periodic_fertility_maximum": "string",
- "amount_attributed_to_product_selection_brand_drug": "string",
- "amount_attributed_to_percentage_tax": "string",
- "amount_exceeding_periodic_benefit_maximum": "string",
- "amount_of_copay": "string",
- "amount_of_coinsurance": "string",
- "amount_attributed_to_product_selection_non_preferred": "string",
- "amount_attributed_to_health_plan_assistance": "string",
- "amount_attributed_to_provider_network_selection": "string",
- "amount_attributed_to_product_selection_brand_non_preferred": "string",
- "amount_attributed_to_coverage_gap": "string",
- "amount_attributed_to_processor_fee": "string",
- "amount_attributed_to_grace_period": "string",
- "amount_attributed_to_catastrophic_benefit": "string",
- "amount_attributed_to_regulatory_fee": "string",
- "ingredient_cost_paid": "string",
- "dispensing_fee_paid": "string",
- "percentage_tax_exempt_indicator": "string",
- "regulatory_fee_amount_paid_1": "string",
- "regulatory_fee_amount_paid_2": "string",
- "regulatory_fee_amount_paid_3": "string",
- "percentage_tax_amount_paid": "string",
- "percentage_tax_rate_paid": "string",
- "other_amount_paid_qualifier_1": "string",
- "other_amount_paid_1": "string",
- "other_amount_paid_qualifier_2": "string",
- "other_amount_paid_2": "string",
- "other_amount_paid_qualifier_3": "string",
- "other_amount_paid_3": "string",
- "other_payer_amount_recognized": "string",
- "basis_of_reimbursement_determination": "string",
- "basis_of_calculation_dispensing_fee": "string",
- "basis_of_calculation_copay": "string",
- "basis_of_calculation_coinsurance": "string",
- "basis_of_calculation_regulatory_fee": "string",
- "basis_of_calculation_percentage_tax": "string",
- "basis_of_days_supply_determination": "string",
- "accumulated_deductible_amount": "string",
- "remaining_deductible_amount": "string",
- "remaining_benefit_amount": "string",
- "patient_percentage_tax_amount": "string",
- "patient_regulatory_fee_amount": "string",
- "estimated_generic_savings": "string",
- "reason_for_service_code_1": "string",
- "previous_date_of_fill_1": "string",
- "quantity_of_previous_fill_1": "string",
- "reason_for_service_code_2": "string",
- "previous_date_of_fill_2": "string",
- "quantity_of_previous_fill_2": "string",
- "reason_for_service_code_3": "string",
- "previous_date_of_fill_3": "string",
- "quantity_of_previous_fill_3": "string",
- "direct_member_reimbursement_indicator": "string",
- "drug_name": "string",
- "pharmacy_name": "string",
- "reprocessing_id": "string",
- "original_claim_id": "string",
- "first_claim_id": "string",
- "claim_number": "string",
- "claim_sequence_number": "string"
}
], - "id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "external_account_id": "string",
- "external_group_id": "string",
- "submitted_carholder_id": "string",
- "first_name": "string",
- "last_name": "string",
- "full_text_search": "string",
- "claim_status": "string",
- "date_type": "string",
- "prescription_service_reference_number": "string",
- "pharmacy_nabp": "string",
- "prescriber_id": "string",
- "ndc": "string",
- "service_provider_id": "string",
- "start_date": "string",
- "end_date": "string",
- "minimum_claim_submission_date": "string",
- "maximum_claim_submission_date": "string",
- "is_340b": true,
- "reject_codes": "string",
- "paid_claims_only": true,
- "claim_sources": [
- "admin"
], - "get_dependent_claims": true,
- "month": 0,
- "year": 0,
- "year_to_date": true,
- "gpi": "string",
- "gpi_operator": "string",
- "drug_name": "string",
- "excluded_gpi_list": [
- "string"
], - "client_ids": [
- "string"
], - "add_pharmacy_data": true,
- "only_fields": [
- "string"
], - "formulary_tier": "string",
- "first_claim_id": 0,
- "basis_of_cost_determination": "string",
- "custom_filters": [
- "string"
], - "medicare_prescription_payment_plan_indicator": "string",
- "coverage_strategy_type": "string",
- "claim_number": "string",
- "claim_sequence_number": "string"
}
{- "results": [
- {
- "claim": {
- "id": 0,
- "rn": "string",
- "reversal_id": 0,
- "reverses_id": 0,
- "original_claim_id": 0,
- "client_id": "string",
- "external_account_id": "string",
- "external_group_id": "string",
- "provider_agreement_id": 0,
- "coverage_strategy_id": "string",
- "date_of_service": "string",
- "claim_submission_date": "string",
- "claim_payment_cycle_end_date": "string",
- "claim_reimbursement_cycle_end_date": "string",
- "claim_status": "string",
- "claim_count": 0,
- "received_at": "string",
- "source": "string",
- "external_member_id": "string",
- "person_code": "string",
- "first_name": "string",
- "last_name": "string",
- "coverage_strategy_type": "string",
- "plan_benefit_id": 0,
- "formulary_id": 0,
- "network_id": 0,
- "benefit_network": "string",
- "gpi": "string",
- "pharmacy_nabp": "string",
- "pharmacy_name": "string",
- "pharmacy_channel": "string",
- "version_release_number": "string",
- "request_transaction_code": "string",
- "bin_number": "string",
- "processor_control_number": "string",
- "transaction_count": "string",
- "service_provider_id_qualifier": "string",
- "service_provider_id": "string",
- "software_vendor_certification_id": "string",
- "submitted_cardholder_id": "string",
- "cardholder_first_name": "string",
- "cardholder_last_name": "string",
- "plan_id": "string",
- "eligibility_clarification_code": "string",
- "group_id": "string",
- "submitted_person_code": "string",
- "patient_relationship_code": "string",
- "medigap_id": "string",
- "medicaid_indicator": "string",
- "provider_accept_assignment_indicator": "string",
- "cms_part_d_defined_qualified_facility": "string",
- "medicaid_id_number": "string",
- "patient_id_qualifier": "string",
- "patient_id": "string",
- "date_of_birth": "string",
- "patient_gender_code": "string",
- "patient_first_name": "string",
- "patient_last_name": "string",
- "patient_street_address": "string",
- "patient_street_address_line_1": "string",
- "patient_street_address_line_2": "string",
- "patient_city_address": "string",
- "patient_state_province_address": "string",
- "patient_zip_postal_code": "string",
- "patient_country_code": "string",
- "patient_telephone_number": "string",
- "place_of_service": "string",
- "employer_id": "string",
- "pregnancy_indicator": "string",
- "patient_email_address": "user@example.com",
- "patient_residence": "string",
- "prescription_service_reference_number_qualifier": "string",
- "prescription_service_reference_number": "string",
- "product_service_id_qualifier": "string",
- "ndc": "string",
- "associated_prescription_service_reference_number": "string",
- "associated_prescription_service_date": "string",
- "procedure_modifier_code_1": "string",
- "procedure_modifier_code_2": "string",
- "procedure_modifier_code_3": "string",
- "procedure_modifier_code_4": "string",
- "procedure_modifier_code_5": "string",
- "procedure_modifier_code_6": "string",
- "procedure_modifier_code_7": "string",
- "procedure_modifier_code_8": "string",
- "procedure_modifier_code_9": "string",
- "procedure_modifier_code_10": "string",
- "quantity_dispensed": "string",
- "fill_number": 0,
- "days_supply": 0,
- "compound_code": "string",
- "daw": "string",
- "date_prescription_written": "string",
- "number_of_refills_authorized": 0,
- "prescription_origin_code": "string",
- "submission_clarification_code_1": "string",
- "submission_clarification_code_2": "string",
- "submission_clarification_code_3": "string",
- "submission_clarification_code_4": "string",
- "submission_clarification_code_5": "string",
- "submission_clarification_code_pde": "string",
- "submission_type_code_1": "string",
- "submission_type_code_2": "string",
- "submission_type_code_3": "string",
- "submission_type_code_4": "string",
- "submission_type_code_5": "string",
- "quantity_prescribed": "string",
- "multiple_prescription_service_order_group_id": "string",
- "multiple_prescription_service_order_group_reason_code": "string",
- "total_prescribed_quantity_remaining": "string",
- "other_coverage_code": "string",
- "special_packaging_indicator": "string",
- "originally_prescribed_product_service_id_qualifier": "string",
- "originally_prescribed_product_service_code": "string",
- "originally_prescribed_quantity": "string",
- "scheduled_prescription_id_number": "string",
- "unit_of_measure": "string",
- "level_of_service": "string",
- "prior_authorization_type_code": "string",
- "prior_authorization_id_submitted": "string",
- "dispensing_status": "string",
- "quantity_intended_to_be_dispensed": "string",
- "days_supply_intended_to_be_dispensed": 0,
- "delay_reason_code": "string",
- "patient_assignment_indicator": "string",
- "route_of_administration": "string",
- "compound_type": "string",
- "preparation_environment_type": "string",
- "preparation_environment_event_code": "string",
- "pharmacy_service_type": "string",
- "associated_prescription_service_reference_number_qualifier": "string",
- "associated_prescription_service_fill_number": 0,
- "original_manufacturer_product_id_qualifier": "string",
- "original_manufacturer_product_id": "string",
- "ltpac_dispense_frequency": "string",
- "ltpac_billing_methodology": "string",
- "number_of_ltpac_dispensing_events": 0,
- "do_not_dispense_before_date": "string",
- "ingredient_cost_submitted": "string",
- "dispensing_fee_submitted": "string",
- "patient_pay_amount_reported": "string",
- "incentive_amount_submitted": "string",
- "other_amount_claimed_submitted_qualifier_1": "string",
- "other_amount_claimed_submitted_1": "string",
- "other_amount_claimed_submitted_qualifier_2": "string",
- "other_amount_claimed_submitted_2": "string",
- "other_amount_claimed_submitted_qualifier_3": "string",
- "other_amount_claimed_submitted_3": "string",
- "regulatory_fee_type_code_submitted_1": "string",
- "regulatory_fee_amount_submitted_1": "string",
- "regulatory_fee_type_code_submitted_2": "string",
- "regulatory_fee_amount_submitted_2": "string",
- "regulatory_fee_type_code_submitted_3": "string",
- "regulatory_fee_amount_submitted_3": "string",
- "percentage_tax_amount_submitted": "string",
- "percentage_tax_rate_submitted": "string",
- "percentage_tax_basis_submitted": "string",
- "usual_and_customary_charge": "string",
- "gross_amount_due": "string",
- "basis_of_cost_determination": "string",
- "provider_id_qualifier": "string",
- "provider_id": "string",
- "provider_first_name": "string",
- "provider_last_name": "string",
- "prescriber_id_qualifier": "string",
- "prescriber_id": "string",
- "prescriber_last_name": "string",
- "prescriber_telephone_number": "string",
- "prescriber_telephone_number_extension": "string",
- "primary_care_provider_id_qualifier": "string",
- "primary_care_provider_id": "string",
- "primary_care_provider_last_name": "string",
- "prescriber_first_name": "string",
- "prescriber_street_address": "string",
- "prescriber_street_address_line_1": "string",
- "prescriber_street_address_line_2": "string",
- "prescriber_city_address": "string",
- "prescriber_state_province_address": "string",
- "prescriber_zip_postal_code": "string",
- "prescriber_country_code": "string",
- "prescriber_dea_number": "string",
- "prescriber_place_of_service": "string",
- "compound_prices": null,
- "compound_dosage_form_description_code": "string",
- "compound_dispensing_unit_form_indicator": "string",
- "compound_ingredient_component_count": 0,
- "compound_product_id_qualifier_1": "string",
- "compound_product_id_1": "string",
- "compound_ingredient_quantity_1": "string",
- "compound_product_id_qualifier_2": "string",
- "compound_product_id_2": "string",
- "compound_ingredient_quantity_2": "string",
- "compound_product_id_qualifier_3": "string",
- "compound_product_id_3": "string",
- "compound_ingredient_quantity_3": "string",
- "compound_product_id_qualifier_4": "string",
- "compound_product_id_4": "string",
- "compound_ingredient_quantity_4": "string",
- "compound_product_id_qualifier_5": "string",
- "compound_product_id_5": "string",
- "compound_ingredient_quantity_5": "string",
- "compound_product_id_qualifier_6": "string",
- "compound_product_id_6": "string",
- "compound_ingredient_quantity_6": "string",
- "compound_product_id_qualifier_7": "string",
- "compound_product_id_7": "string",
- "compound_ingredient_quantity_7": "string",
- "compound_product_id_qualifier_8": "string",
- "compound_product_id_8": "string",
- "compound_ingredient_quantity_8": "string",
- "compound_product_id_qualifier_9": "string",
- "compound_product_id_9": "string",
- "compound_ingredient_quantity_9": "string",
- "compound_product_id_qualifier_10": "string",
- "compound_product_id_10": "string",
- "compound_ingredient_quantity_10": "string",
- "compound_product_id_qualifier_11": "string",
- "compound_product_id_11": "string",
- "compound_ingredient_quantity_11": "string",
- "compound_product_id_qualifier_12": "string",
- "compound_product_id_12": "string",
- "compound_ingredient_quantity_12": "string",
- "compound_product_id_qualifier_13": "string",
- "compound_product_id_13": "string",
- "compound_ingredient_quantity_13": "string",
- "compound_product_id_qualifier_14": "string",
- "compound_product_id_14": "string",
- "compound_ingredient_quantity_14": "string",
- "compound_product_id_qualifier_15": "string",
- "compound_product_id_15": "string",
- "compound_ingredient_quantity_15": "string",
- "compound_product_id_qualifier_16": "string",
- "compound_product_id_16": "string",
- "compound_ingredient_quantity_16": "string",
- "compound_product_id_qualifier_17": "string",
- "compound_product_id_17": "string",
- "compound_ingredient_quantity_17": "string",
- "compound_product_id_qualifier_18": "string",
- "compound_product_id_18": "string",
- "compound_ingredient_quantity_18": "string",
- "compound_product_id_qualifier_19": "string",
- "compound_product_id_19": "string",
- "compound_ingredient_quantity_19": "string",
- "compound_product_id_qualifier_20": "string",
- "compound_product_id_20": "string",
- "compound_ingredient_quantity_20": "string",
- "compound_product_id_qualifier_21": "string",
- "compound_product_id_21": "string",
- "compound_ingredient_quantity_21": "string",
- "compound_product_id_qualifier_22": "string",
- "compound_product_id_22": "string",
- "compound_ingredient_quantity_22": "string",
- "compound_product_id_qualifier_23": "string",
- "compound_product_id_23": "string",
- "compound_ingredient_quantity_23": "string",
- "compound_product_id_qualifier_24": "string",
- "compound_product_id_24": "string",
- "compound_ingredient_quantity_24": "string",
- "compound_product_id_qualifier_25": "string",
- "compound_product_id_25": "string",
- "compound_ingredient_quantity_25": "string",
- "diagnosis_code_qualifier_1": "string",
- "diagnosis_code_1": "string",
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- "other_payer_patient_responsibility_amount_6": "string",
- "other_payer_patient_responsibility_amount_7": "string",
- "other_payer_patient_responsibility_amount_8": "string",
- "other_payer_patient_responsibility_amount_9": "string",
- "other_payer_patient_responsibility_amount_count": 0,
- "other_payer_patient_responsibility_amount_qualifier_1": "string",
- "other_payer_patient_responsibility_amount_qualifier_2": "string",
- "other_payer_patient_responsibility_amount_qualifier_3": "string",
- "other_payer_patient_responsibility_amount_qualifier_4": "string",
- "other_payer_patient_responsibility_amount_qualifier_5": "string",
- "other_payer_patient_responsibility_amount_qualifier_6": "string",
- "other_payer_patient_responsibility_amount_qualifier_7": "string",
- "other_payer_patient_responsibility_amount_qualifier_8": "string",
- "other_payer_patient_responsibility_amount_qualifier_9": "string",
- "other_payer_reject_code_1": "string",
- "other_payer_reject_code_2": "string",
- "other_payer_reject_code_3": "string",
- "other_payer_reject_code_4": "string",
- "other_payer_reject_code_5": "string",
- "other_payer_reject_count": 0,
- "pay_amount_level_1": "string",
- "pay_amount_level_2": "string",
- "pay_amount_level_3": "string",
- "prescriber_npi": "string",
- "professional_service_code_1": "string",
- "professional_service_code_2": "string",
- "professional_service_code_3": "string",
- "professional_service_code_4": "string",
- "professional_service_code_5": "string",
- "professional_service_code_6": "string",
- "professional_service_code_7": "string",
- "professional_service_code_8": "string",
- "professional_service_code_9": "string",
- "remaining_category_deductible_1_amount": "string",
- "remaining_overall_deductible_amount": "string",
- "request_reason_for_service_code_1": "string",
- "request_reason_for_service_code_2": "string",
- "request_reason_for_service_code_3": "string",
- "request_reason_for_service_code_4": "string",
- "request_reason_for_service_code_5": "string",
- "request_reason_for_service_code_6": "string",
- "request_reason_for_service_code_7": "string",
- "request_reason_for_service_code_8": "string",
- "request_reason_for_service_code_9": "string",
- "result_of_service_code_1": "string",
- "result_of_service_code_2": "string",
- "result_of_service_code_3": "string",
- "result_of_service_code_4": "string",
- "result_of_service_code_5": "string",
- "result_of_service_code_6": "string",
- "result_of_service_code_7": "string",
- "result_of_service_code_8": "string",
- "result_of_service_code_9": "string",
- "specialty_list_dispensing_fee": "string",
- "specialty_list_id": 0,
- "specialty_list_name": "string",
- "dmr_pay_to_city_address": "string",
- "dmr_pay_to_country_code": "string",
- "dmr_pay_to_name": "string",
- "dmr_pay_to_state_province_address": "string",
- "dmr_pay_to_street_address_line_1": "string",
- "dmr_pay_to_street_address_line_2": "string",
- "dmr_pay_to_tax_id": "string",
- "dmr_pay_to_vendor_id": "string",
- "dmr_pay_to_zip_postal_code": "string",
- "tax_id_number": "string",
- "reasons_for_rejection": [
- "string"
], - "reasons_for_adjudication": [
- "string"
], - "patient_pay_reduction_due_to_point_of_service_rebate": 0,
- "plan_pay_reduction_due_to_point_of_service_rebate": 0,
- "point_of_service_rebate_amount": 0,
- "low_income_subsidy_level": "string",
- "senior_savings_model_cost_share_reduction_gap": 0,
- "senior_savings_model_cost_share_reduction_non_gap": 0,
- "senior_savings_model_indicator": "string",
- "inflation_reduction_act_subsidy_amount": 0,
- "inflation_reduction_act_covered_vaccine": "string",
- "inflation_reduction_act_covered_insulin": "string",
- "other_true_out_of_pocket_amount_indicator": "string",
- "medicare_amounts_id": 0,
- "low_income_subsidy_amounts_id": 0,
- "medicare_medicaid_dsnp_co_administered_plan": "string",
- "dsnp_fee_for_service_or_capitation": 0,
- "dsnp_medicaid_cost_share_reduction_amount_part_d": 0,
- "dsnp_medicaid_cost_share_reduction_amount_part_b": 0,
- "dsnp_medicaid_cost_share_covered_excluded_reduction_amount": 0,
- "is_340b": true,
- "medicare_administrative_claim": "string",
- "controlled_substance_code": "string",
- "desi_code": "string",
- "reprocessing_id": 0,
- "reprocessing_type": "string",
- "reprocessing_patient_pay_difference": "string",
- "reprocessing_pharmacy_pay_amount": "string",
- "reprocessing_plan_pay_amount": "string",
- "reprocessing_goes_to_835": true,
- "reprocessing_goes_to_invoice": true,
- "reprocessing_is_member_recoupment": true,
- "nx_other_payers_total_amount": "string",
- "reprocessing_nx_amount_applied_to_patient_pay": "string",
- "reprocessing_excess_nx_amount_total": "string",
- "reprocessing_patient_pay_net_nx": "string",
- "reprocessing_member_refund_amount": "string",
- "reprocessing_member_recoupment_amount": "string",
- "reprocessing_is_recoup_ltc_pharmacy": true,
- "notes": "string",
- "first_claim_id": 0,
- "next_claim_id": 0,
- "include_raw_request_parsed": true,
- "include_raw_response_parsed": true,
- "manufacturer_discount_amount": 0,
- "is_manufacturer_discount_drug": true,
- "claim_number": "string",
- "claim_sequence_number": "string",
- "medicare_prescription_payment_plan_indicator": "string",
- "medicare_prescription_payment_plan_original_claim_id": 0,
- "pharmacy_transaction_fee": 0,
- "vbid_cost_share_reduction_amount_part_d": 0,
- "vbid_model_indicator": "string",
- "pricing_level_ids": [
- 0
], - "brand_name_code": "string",
- "drug_descriptor_id": "string",
- "dosage": "string",
- "dosage_form": "string",
- "dosage_form_packaging": "string",
- "drug_name": "string",
- "drug_type": "string",
- "group_name": "string",
- "provider_phone": "string",
- "most_expensive_compound_ingredient_ndc": "string",
- "multi_source": "string",
- "name_type_code": "string",
- "rx_otc_indicator_code": "string",
- "strength": "string",
- "strength_unit_of_measure": "string",
- "pde_record_id": "string",
- "pde_claim_control_number": "string",
- "pde_plan_benefit_package_id": "string",
- "medicare_prescription_payment_plan_claim_id": 0,
- "medicare_prescription_payment_plan_claim_amount": 0,
- "claim_gpi": "string",
- "drug_lists": null,
- "identity": "string"
}
}
], - "result_count": "string"
}
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
required | Array of objects (MemberIdentifierSchema_1744676532.9537404) |
claim_statuses required | Array of strings or null or null Enum: "P" "R" |
claim_sources | Array of strings or null or null |
start_date_of_service | string or null <ArrowDateTime> Date of service to filter (inclusive >=) |
end_date_of_service | string or null <ArrowDateTime> Date of service to filter (inclusive <=) |
month | integer or null <int32> Month to filter by as integer |
year | integer or null <int32> Year to filter by as integer |
year_to_date | boolean or null Should filter by year to date. |
add_pharmacy_data | boolean or null Boolean to return pharmacy details from ncpdp_providers |
only_fields | Array of strings or null or null |
custom_filters | Array of strings or null or null |
full_text_search | string or null The full text search for claims by product_service_description, date of service, and pharmacy name |
reject_codes | Array of strings or null or null |
Array of objects or null (OrderBySchema_1744676532.942683) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "member_list": [
- {
- "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "external_group_id": "string",
- "external_account_id": "string"
}
], - "claim_statuses": [
- "P"
], - "claim_sources": [
- "string"
], - "start_date_of_service": "string",
- "end_date_of_service": "string",
- "month": 0,
- "year": 0,
- "year_to_date": true,
- "add_pharmacy_data": true,
- "only_fields": [
- "string"
], - "custom_filters": [
- "string"
], - "full_text_search": "string",
- "reject_codes": [
- "string"
], - "order_by": [
- {
- "id": "string",
- "client_id": "string",
- "external_group_id": "string",
- "date_of_service": "string",
- "claim_submission_date": "string",
- "claim_status": "string",
- "received_at": "string",
- "source": "string",
- "external_member_id": "string",
- "person_code": "string",
- "first_name": "string",
- "last_name": "string",
- "plan_benefit_id": "string",
- "formulary_id": "string",
- "network_id": "string",
- "service_provider_id": "string",
- "cardholder_first_name": "string",
- "cardholder_last_name": "string",
- "plan_id": "string",
- "group_id": "string",
- "date_of_birth": "string",
- "patient_first_name": "string",
- "patient_last_name": "string",
- "prescription_service_reference_number": "string",
- "ndc": "string",
- "quantity_dispensed": "string",
- "fill_number": "string",
- "days_supply": "string",
- "compound_code": "string",
- "daw": "string",
- "prior_authorization_type_code": "string",
- "prior_authorization_id_submitted": "string",
- "pharmacy_service_type": "string",
- "ingredient_cost_submitted": "string",
- "dispensing_fee_submitted": "string",
- "patient_pay_amount_reported": "string",
- "incentive_amount_submitted": "string",
- "other_amount_claimed_submitted_1": "string",
- "other_amount_claimed_submitted_2": "string",
- "other_amount_claimed_submitted_3": "string",
- "regulatory_fee_type_code_submitted_1": "string",
- "regulatory_fee_amount_submitted_1": "string",
- "regulatory_fee_type_code_submitted_2": "string",
- "regulatory_fee_amount_submitted_2": "string",
- "regulatory_fee_type_code_submitted_3": "string",
- "regulatory_fee_amount_submitted_3": "string",
- "percentage_tax_amount_submitted": "string",
- "percentage_tax_rate_submitted": "string",
- "percentage_tax_basis_submitted": "string",
- "usual_and_customary_charge": "string",
- "gross_amount_due": "string",
- "basis_of_cost_determination": "string",
- "provider_id": "string",
- "provider_last_name": "string",
- "prescriber_id": "string",
- "prescriber_last_name": "string",
- "header_response_status": "string",
- "response_transaction_code": "string",
- "transaction_response_status": "string",
- "reject_code_1": "string",
- "reject_code_2": "string",
- "reject_code_3": "string",
- "reject_code_4": "string",
- "reject_code_5": "string",
- "next_available_fill_date": "string",
- "ingredient_cost_charged_to_plan": "string",
- "dispensing_fee_charged_to_plan": "string",
- "product_service_classification": "string",
- "product_service_description": "string",
- "total_amount_paid": "string",
- "patient_pay_amount": "string",
- "patient_pay_component_amount_1": "string",
- "patient_pay_component_amount_2": "string",
- "patient_pay_component_amount_3": "string",
- "plan_pay_amount": "string",
- "amount_applied_to_periodic_deductible": "string",
- "amount_applied_to_periodic_maximum_benefit": "string",
- "amount_applied_to_periodic_maximum_out_of_pocket": "string",
- "amount_applied_to_periodic_maximum_fertility": "string",
- "amount_exceeding_periodic_fertility_maximum": "string",
- "amount_attributed_to_product_selection_brand_drug": "string",
- "amount_attributed_to_percentage_tax": "string",
- "amount_exceeding_periodic_benefit_maximum": "string",
- "amount_of_copay": "string",
- "amount_of_coinsurance": "string",
- "amount_attributed_to_product_selection_non_preferred": "string",
- "amount_attributed_to_health_plan_assistance": "string",
- "amount_attributed_to_provider_network_selection": "string",
- "amount_attributed_to_product_selection_brand_non_preferred": "string",
- "amount_attributed_to_coverage_gap": "string",
- "amount_attributed_to_processor_fee": "string",
- "amount_attributed_to_grace_period": "string",
- "amount_attributed_to_catastrophic_benefit": "string",
- "amount_attributed_to_regulatory_fee": "string",
- "ingredient_cost_paid": "string",
- "dispensing_fee_paid": "string",
- "percentage_tax_exempt_indicator": "string",
- "regulatory_fee_amount_paid_1": "string",
- "regulatory_fee_amount_paid_2": "string",
- "regulatory_fee_amount_paid_3": "string",
- "percentage_tax_amount_paid": "string",
- "percentage_tax_rate_paid": "string",
- "other_amount_paid_qualifier_1": "string",
- "other_amount_paid_1": "string",
- "other_amount_paid_qualifier_2": "string",
- "other_amount_paid_2": "string",
- "other_amount_paid_qualifier_3": "string",
- "other_amount_paid_3": "string",
- "other_payer_amount_recognized": "string",
- "basis_of_reimbursement_determination": "string",
- "basis_of_calculation_dispensing_fee": "string",
- "basis_of_calculation_copay": "string",
- "basis_of_calculation_coinsurance": "string",
- "basis_of_calculation_regulatory_fee": "string",
- "basis_of_calculation_percentage_tax": "string",
- "basis_of_days_supply_determination": "string",
- "accumulated_deductible_amount": "string",
- "remaining_deductible_amount": "string",
- "remaining_benefit_amount": "string",
- "patient_percentage_tax_amount": "string",
- "patient_regulatory_fee_amount": "string",
- "estimated_generic_savings": "string",
- "reason_for_service_code_1": "string",
- "previous_date_of_fill_1": "string",
- "quantity_of_previous_fill_1": "string",
- "reason_for_service_code_2": "string",
- "previous_date_of_fill_2": "string",
- "quantity_of_previous_fill_2": "string",
- "reason_for_service_code_3": "string",
- "previous_date_of_fill_3": "string",
- "quantity_of_previous_fill_3": "string",
- "direct_member_reimbursement_indicator": "string",
- "drug_name": "string",
- "pharmacy_name": "string",
- "reprocessing_id": "string",
- "original_claim_id": "string",
- "first_claim_id": "string",
- "claim_number": "string",
- "claim_sequence_number": "string"
}
]
}
{- "results": [
- {
- "claim": {
- "id": 0,
- "rn": "string",
- "reversal_id": 0,
- "reverses_id": 0,
- "original_claim_id": 0,
- "client_id": "string",
- "external_account_id": "string",
- "external_group_id": "string",
- "provider_agreement_id": 0,
- "coverage_strategy_id": "string",
- "date_of_service": "string",
- "claim_submission_date": "string",
- "claim_payment_cycle_end_date": "string",
- "claim_reimbursement_cycle_end_date": "string",
- "claim_status": "string",
- "claim_count": 0,
- "received_at": "string",
- "source": "string",
- "external_member_id": "string",
- "person_code": "string",
- "first_name": "string",
- "last_name": "string",
- "coverage_strategy_type": "string",
- "plan_benefit_id": 0,
- "formulary_id": 0,
- "network_id": 0,
- "benefit_network": "string",
- "gpi": "string",
- "pharmacy_nabp": "string",
- "pharmacy_name": "string",
- "pharmacy_channel": "string",
- "version_release_number": "string",
- "request_transaction_code": "string",
- "bin_number": "string",
- "processor_control_number": "string",
- "transaction_count": "string",
- "service_provider_id_qualifier": "string",
- "service_provider_id": "string",
- "software_vendor_certification_id": "string",
- "submitted_cardholder_id": "string",
- "cardholder_first_name": "string",
- "cardholder_last_name": "string",
- "plan_id": "string",
- "eligibility_clarification_code": "string",
- "group_id": "string",
- "submitted_person_code": "string",
- "patient_relationship_code": "string",
- "medigap_id": "string",
- "medicaid_indicator": "string",
- "provider_accept_assignment_indicator": "string",
- "cms_part_d_defined_qualified_facility": "string",
- "medicaid_id_number": "string",
- "patient_id_qualifier": "string",
- "patient_id": "string",
- "date_of_birth": "string",
- "patient_gender_code": "string",
- "patient_first_name": "string",
- "patient_last_name": "string",
- "patient_street_address": "string",
- "patient_street_address_line_1": "string",
- "patient_street_address_line_2": "string",
- "patient_city_address": "string",
- "patient_state_province_address": "string",
- "patient_zip_postal_code": "string",
- "patient_country_code": "string",
- "patient_telephone_number": "string",
- "place_of_service": "string",
- "employer_id": "string",
- "pregnancy_indicator": "string",
- "patient_email_address": "user@example.com",
- "patient_residence": "string",
- "prescription_service_reference_number_qualifier": "string",
- "prescription_service_reference_number": "string",
- "product_service_id_qualifier": "string",
- "ndc": "string",
- "associated_prescription_service_reference_number": "string",
- "associated_prescription_service_date": "string",
- "procedure_modifier_code_1": "string",
- "procedure_modifier_code_2": "string",
- "procedure_modifier_code_3": "string",
- "procedure_modifier_code_4": "string",
- "procedure_modifier_code_5": "string",
- "procedure_modifier_code_6": "string",
- "procedure_modifier_code_7": "string",
- "procedure_modifier_code_8": "string",
- "procedure_modifier_code_9": "string",
- "procedure_modifier_code_10": "string",
- "quantity_dispensed": "string",
- "fill_number": 0,
- "days_supply": 0,
- "compound_code": "string",
- "daw": "string",
- "date_prescription_written": "string",
- "number_of_refills_authorized": 0,
- "prescription_origin_code": "string",
- "submission_clarification_code_1": "string",
- "submission_clarification_code_2": "string",
- "submission_clarification_code_3": "string",
- "submission_clarification_code_4": "string",
- "submission_clarification_code_5": "string",
- "submission_clarification_code_pde": "string",
- "submission_type_code_1": "string",
- "submission_type_code_2": "string",
- "submission_type_code_3": "string",
- "submission_type_code_4": "string",
- "submission_type_code_5": "string",
- "quantity_prescribed": "string",
- "multiple_prescription_service_order_group_id": "string",
- "multiple_prescription_service_order_group_reason_code": "string",
- "total_prescribed_quantity_remaining": "string",
- "other_coverage_code": "string",
- "special_packaging_indicator": "string",
- "originally_prescribed_product_service_id_qualifier": "string",
- "originally_prescribed_product_service_code": "string",
- "originally_prescribed_quantity": "string",
- "scheduled_prescription_id_number": "string",
- "unit_of_measure": "string",
- "level_of_service": "string",
- "prior_authorization_type_code": "string",
- "prior_authorization_id_submitted": "string",
- "dispensing_status": "string",
- "quantity_intended_to_be_dispensed": "string",
- "days_supply_intended_to_be_dispensed": 0,
- "delay_reason_code": "string",
- "patient_assignment_indicator": "string",
- "route_of_administration": "string",
- "compound_type": "string",
- "preparation_environment_type": "string",
- "preparation_environment_event_code": "string",
- "pharmacy_service_type": "string",
- "associated_prescription_service_reference_number_qualifier": "string",
- "associated_prescription_service_fill_number": 0,
- "original_manufacturer_product_id_qualifier": "string",
- "original_manufacturer_product_id": "string",
- "ltpac_dispense_frequency": "string",
- "ltpac_billing_methodology": "string",
- "number_of_ltpac_dispensing_events": 0,
- "do_not_dispense_before_date": "string",
- "ingredient_cost_submitted": "string",
- "dispensing_fee_submitted": "string",
- "patient_pay_amount_reported": "string",
- "incentive_amount_submitted": "string",
- "other_amount_claimed_submitted_qualifier_1": "string",
- "other_amount_claimed_submitted_1": "string",
- "other_amount_claimed_submitted_qualifier_2": "string",
- "other_amount_claimed_submitted_2": "string",
- "other_amount_claimed_submitted_qualifier_3": "string",
- "other_amount_claimed_submitted_3": "string",
- "regulatory_fee_type_code_submitted_1": "string",
- "regulatory_fee_amount_submitted_1": "string",
- "regulatory_fee_type_code_submitted_2": "string",
- "regulatory_fee_amount_submitted_2": "string",
- "regulatory_fee_type_code_submitted_3": "string",
- "regulatory_fee_amount_submitted_3": "string",
- "percentage_tax_amount_submitted": "string",
- "percentage_tax_rate_submitted": "string",
- "percentage_tax_basis_submitted": "string",
- "usual_and_customary_charge": "string",
- "gross_amount_due": "string",
- "basis_of_cost_determination": "string",
- "provider_id_qualifier": "string",
- "provider_id": "string",
- "provider_first_name": "string",
- "provider_last_name": "string",
- "prescriber_id_qualifier": "string",
- "prescriber_id": "string",
- "prescriber_last_name": "string",
- "prescriber_telephone_number": "string",
- "prescriber_telephone_number_extension": "string",
- "primary_care_provider_id_qualifier": "string",
- "primary_care_provider_id": "string",
- "primary_care_provider_last_name": "string",
- "prescriber_first_name": "string",
- "prescriber_street_address": "string",
- "prescriber_street_address_line_1": "string",
- "prescriber_street_address_line_2": "string",
- "prescriber_city_address": "string",
- "prescriber_state_province_address": "string",
- "prescriber_zip_postal_code": "string",
- "prescriber_country_code": "string",
- "prescriber_dea_number": "string",
- "prescriber_place_of_service": "string",
- "compound_prices": null,
- "compound_dosage_form_description_code": "string",
- "compound_dispensing_unit_form_indicator": "string",
- "compound_ingredient_component_count": 0,
- "compound_product_id_qualifier_1": "string",
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- "accumulated_part_b_out_of_pocket_out_of_network": "string",
- "amount_applied_to_part_b_deductible_out_of_network": "string",
- "amount_applied_to_part_b_out_of_pocket_out_of_network": "string",
- "amount_exceeding_periodic_category_deductible_1": 0,
- "amount_exceeding_periodic_overall_deductible": "string",
- "birth_date": "string",
- "coordination_of_benefits_other_payments_count": 0,
- "dispensing_fee_charged_level_1": "string",
- "dispensing_fee_charged_level_2": "string",
- "dispensing_fee_charged_level_3": "string",
- "ingredient_cost_charged_level_1": "string",
- "ingredient_cost_charged_level_2": "string",
- "ingredient_cost_charged_level_3": "string",
- "mac_list_dispensing_fee": "string",
- "pricing_category_mac_list_unit_price_adjustment_percentage": 0,
- "mac_list_id": 0,
- "mac_list_name": "string",
- "other_payer_amount_paid_1": "string",
- "other_payer_amount_paid_2": "string",
- "other_payer_amount_paid_3": "string",
- "other_payer_amount_paid_4": "string",
- "other_payer_amount_paid_5": "string",
- "other_payer_amount_paid_6": "string",
- "other_payer_amount_paid_7": "string",
- "other_payer_amount_paid_8": "string",
- "other_payer_amount_paid_9": "string",
- "other_payer_amount_paid_count": 0,
- "other_payer_amount_paid_qualifier_1": "string",
- "other_payer_amount_paid_qualifier_2": "string",
- "other_payer_amount_paid_qualifier_3": "string",
- "other_payer_amount_paid_qualifier_4": "string",
- "other_payer_amount_paid_qualifier_5": "string",
- "other_payer_amount_paid_qualifier_6": "string",
- "other_payer_amount_paid_qualifier_7": "string",
- "other_payer_amount_paid_qualifier_8": "string",
- "other_payer_amount_paid_qualifier_9": "string",
- "other_payer_coverage_type_1": "string",
- "other_payer_coverage_type_2": "string",
- "other_payer_coverage_type_3": "string",
- "other_payer_coverage_type_4": "string",
- "other_payer_coverage_type_5": "string",
- "other_payer_coverage_type_6": "string",
- "other_payer_coverage_type_7": "string",
- "other_payer_coverage_type_8": "string",
- "other_payer_coverage_type_9": "string",
- "other_payer_id_1": "string",
- "other_payer_id_2": "string",
- "other_payer_id_3": "string",
- "other_payer_id_4": "string",
- "other_payer_id_5": "string",
- "other_payer_id_6": "string",
- "other_payer_id_7": "string",
- "other_payer_id_8": "string",
- "other_payer_id_9": "string",
- "other_payer_id_qualifier_1": "string",
- "other_payer_id_qualifier_2": "string",
- "other_payer_id_qualifier_3": "string",
- "other_payer_id_qualifier_4": "string",
- "other_payer_id_qualifier_5": "string",
- "other_payer_id_qualifier_6": "string",
- "other_payer_id_qualifier_7": "string",
- "other_payer_id_qualifier_8": "string",
- "other_payer_id_qualifier_9": "string",
- "other_payer_patient_responsibility_amount_1": "string",
- "other_payer_patient_responsibility_amount_2": "string",
- "other_payer_patient_responsibility_amount_3": "string",
- "other_payer_patient_responsibility_amount_4": "string",
- "other_payer_patient_responsibility_amount_5": "string",
- "other_payer_patient_responsibility_amount_6": "string",
- "other_payer_patient_responsibility_amount_7": "string",
- "other_payer_patient_responsibility_amount_8": "string",
- "other_payer_patient_responsibility_amount_9": "string",
- "other_payer_patient_responsibility_amount_count": 0,
- "other_payer_patient_responsibility_amount_qualifier_1": "string",
- "other_payer_patient_responsibility_amount_qualifier_2": "string",
- "other_payer_patient_responsibility_amount_qualifier_3": "string",
- "other_payer_patient_responsibility_amount_qualifier_4": "string",
- "other_payer_patient_responsibility_amount_qualifier_5": "string",
- "other_payer_patient_responsibility_amount_qualifier_6": "string",
- "other_payer_patient_responsibility_amount_qualifier_7": "string",
- "other_payer_patient_responsibility_amount_qualifier_8": "string",
- "other_payer_patient_responsibility_amount_qualifier_9": "string",
- "other_payer_reject_code_1": "string",
- "other_payer_reject_code_2": "string",
- "other_payer_reject_code_3": "string",
- "other_payer_reject_code_4": "string",
- "other_payer_reject_code_5": "string",
- "other_payer_reject_count": 0,
- "pay_amount_level_1": "string",
- "pay_amount_level_2": "string",
- "pay_amount_level_3": "string",
- "prescriber_npi": "string",
- "professional_service_code_1": "string",
- "professional_service_code_2": "string",
- "professional_service_code_3": "string",
- "professional_service_code_4": "string",
- "professional_service_code_5": "string",
- "professional_service_code_6": "string",
- "professional_service_code_7": "string",
- "professional_service_code_8": "string",
- "professional_service_code_9": "string",
- "remaining_category_deductible_1_amount": "string",
- "remaining_overall_deductible_amount": "string",
- "request_reason_for_service_code_1": "string",
- "request_reason_for_service_code_2": "string",
- "request_reason_for_service_code_3": "string",
- "request_reason_for_service_code_4": "string",
- "request_reason_for_service_code_5": "string",
- "request_reason_for_service_code_6": "string",
- "request_reason_for_service_code_7": "string",
- "request_reason_for_service_code_8": "string",
- "request_reason_for_service_code_9": "string",
- "result_of_service_code_1": "string",
- "result_of_service_code_2": "string",
- "result_of_service_code_3": "string",
- "result_of_service_code_4": "string",
- "result_of_service_code_5": "string",
- "result_of_service_code_6": "string",
- "result_of_service_code_7": "string",
- "result_of_service_code_8": "string",
- "result_of_service_code_9": "string",
- "specialty_list_dispensing_fee": "string",
- "specialty_list_id": 0,
- "specialty_list_name": "string",
- "dmr_pay_to_city_address": "string",
- "dmr_pay_to_country_code": "string",
- "dmr_pay_to_name": "string",
- "dmr_pay_to_state_province_address": "string",
- "dmr_pay_to_street_address_line_1": "string",
- "dmr_pay_to_street_address_line_2": "string",
- "dmr_pay_to_tax_id": "string",
- "dmr_pay_to_vendor_id": "string",
- "dmr_pay_to_zip_postal_code": "string",
- "tax_id_number": "string",
- "reasons_for_rejection": [
- "string"
], - "reasons_for_adjudication": [
- "string"
], - "patient_pay_reduction_due_to_point_of_service_rebate": 0,
- "plan_pay_reduction_due_to_point_of_service_rebate": 0,
- "point_of_service_rebate_amount": 0,
- "low_income_subsidy_level": "string",
- "senior_savings_model_cost_share_reduction_gap": 0,
- "senior_savings_model_cost_share_reduction_non_gap": 0,
- "senior_savings_model_indicator": "string",
- "inflation_reduction_act_subsidy_amount": 0,
- "inflation_reduction_act_covered_vaccine": "string",
- "inflation_reduction_act_covered_insulin": "string",
- "other_true_out_of_pocket_amount_indicator": "string",
- "medicare_amounts_id": 0,
- "low_income_subsidy_amounts_id": 0,
- "medicare_medicaid_dsnp_co_administered_plan": "string",
- "dsnp_fee_for_service_or_capitation": 0,
- "dsnp_medicaid_cost_share_reduction_amount_part_d": 0,
- "dsnp_medicaid_cost_share_reduction_amount_part_b": 0,
- "dsnp_medicaid_cost_share_covered_excluded_reduction_amount": 0,
- "is_340b": true,
- "medicare_administrative_claim": "string",
- "controlled_substance_code": "string",
- "desi_code": "string",
- "reprocessing_id": 0,
- "reprocessing_type": "string",
- "reprocessing_patient_pay_difference": "string",
- "reprocessing_pharmacy_pay_amount": "string",
- "reprocessing_plan_pay_amount": "string",
- "reprocessing_goes_to_835": true,
- "reprocessing_goes_to_invoice": true,
- "reprocessing_is_member_recoupment": true,
- "nx_other_payers_total_amount": "string",
- "reprocessing_nx_amount_applied_to_patient_pay": "string",
- "reprocessing_excess_nx_amount_total": "string",
- "reprocessing_patient_pay_net_nx": "string",
- "reprocessing_member_refund_amount": "string",
- "reprocessing_member_recoupment_amount": "string",
- "reprocessing_is_recoup_ltc_pharmacy": true,
- "notes": "string",
- "first_claim_id": 0,
- "next_claim_id": 0,
- "include_raw_request_parsed": true,
- "include_raw_response_parsed": true,
- "manufacturer_discount_amount": 0,
- "is_manufacturer_discount_drug": true,
- "claim_number": "string",
- "claim_sequence_number": "string",
- "medicare_prescription_payment_plan_indicator": "string",
- "medicare_prescription_payment_plan_original_claim_id": 0,
- "pharmacy_transaction_fee": 0,
- "vbid_cost_share_reduction_amount_part_d": 0,
- "vbid_model_indicator": "string",
- "pricing_level_ids": [
- 0
], - "brand_name_code": "string",
- "drug_descriptor_id": "string",
- "dosage": "string",
- "dosage_form": "string",
- "dosage_form_packaging": "string",
- "drug_name": "string",
- "drug_type": "string",
- "group_name": "string",
- "provider_phone": "string",
- "most_expensive_compound_ingredient_ndc": "string",
- "multi_source": "string",
- "name_type_code": "string",
- "rx_otc_indicator_code": "string",
- "strength": "string",
- "strength_unit_of_measure": "string",
- "pde_record_id": "string",
- "pde_claim_control_number": "string",
- "pde_plan_benefit_package_id": "string",
- "medicare_prescription_payment_plan_claim_id": 0,
- "medicare_prescription_payment_plan_claim_amount": 0,
- "claim_gpi": "string",
- "drug_lists": null,
- "identity": "string"
}
}
], - "result_count": "string"
}
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
Array of objects or null (OrderBySchema_1744676532.942683) | |
id | integer or null <int32> The internal ID of a claim. Cannot be set during create nor subsequently changed. |
client_id | string or null |
external_member_id | string or null |
person_code | string or null |
external_account_id required | string or null |
external_group_id required | string or null |
submitted_carholder_id | string or null |
first_name | string or null |
last_name | string or null |
full_text_search | string or null The full text search for claims by product_service_description, date of service, and pharmacy name |
claim_status | string or null |
date_type | string or null |
prescription_service_reference_number | string or null A field on NCPDP D.0 that is also referred to as the 'prescription number' or 'Rx number'. This number is assigned by the pharmacy to represent a specific prescription, inclusive of all refills for that prescription (via fill number). Rx numbers are ONLY unique to pharmacies, and are NOT globally unique. |
pharmacy_nabp | string or null |
prescriber_id | string or null |
ndc | string or null |
service_provider_id | string or null A field in NCPDP D.0 which in our system is ALWAYS the NPI of the pharmacy for paid or accepted claims (rejected claims may submit other values, causing us to reject the claim). NPI is the national provider identifier, essentially every entity in healthcare has an NPI, which includes pharmacies, doctors, hospitals, and pharmacists themselves. |
start_date | string or null <ArrowDateTime> |
end_date | string or null <ArrowDateTime> |
minimum_claim_submission_date | string or null <ArrowDateTime> |
maximum_claim_submission_date | string or null <ArrowDateTime> |
is_340b | boolean or null Return claims matching the given is_340b value. |
reject_codes | string or null A string of reject codes, with multiple reject codes separated by commas. |
paid_claims_only | boolean or null Boolean to show paid claims only, ignoring reversed and rejected. Defaults to false. |
claim_sources | Array of strings or null or null Enum: "admin" "app" "batch-test" "historical" "migrated" "pharmacy" "switch" "test" "vendor" "web" |
get_dependent_claims | boolean or null Boolean to return dependent claims. |
month | integer or null <int32> Month to filter by as integer |
year | integer or null <int32> Year to filter by as integer |
year_to_date | boolean or null Should filter by year to date. |
gpi | string or null Drug gpi to search. |
gpi_operator | string or null Search field using =, STARTSWITH, CONTAINS |
drug_name | string or null |
excluded_gpi_list | Array of strings or null or null |
client_ids | Array of strings or null or null |
add_pharmacy_data | boolean or null Boolean to return pharmacy details from ncpdp_providers |
only_fields | Array of strings or null or null |
formulary_tier | string or null A string of formulary tiers, with multiple tiers separated by commas. |
first_claim_id | integer or null <int32> |
basis_of_cost_determination | string or null |
custom_filters | Array of strings or null or null |
medicare_prescription_payment_plan_indicator | string or null |
coverage_strategy_type | string or null |
claim_number | string or null |
claim_sequence_number | string or null |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "order_by": [
- {
- "id": "string",
- "client_id": "string",
- "external_group_id": "string",
- "date_of_service": "string",
- "claim_submission_date": "string",
- "claim_status": "string",
- "received_at": "string",
- "source": "string",
- "external_member_id": "string",
- "person_code": "string",
- "first_name": "string",
- "last_name": "string",
- "plan_benefit_id": "string",
- "formulary_id": "string",
- "network_id": "string",
- "service_provider_id": "string",
- "cardholder_first_name": "string",
- "cardholder_last_name": "string",
- "plan_id": "string",
- "group_id": "string",
- "date_of_birth": "string",
- "patient_first_name": "string",
- "patient_last_name": "string",
- "prescription_service_reference_number": "string",
- "ndc": "string",
- "quantity_dispensed": "string",
- "fill_number": "string",
- "days_supply": "string",
- "compound_code": "string",
- "daw": "string",
- "prior_authorization_type_code": "string",
- "prior_authorization_id_submitted": "string",
- "pharmacy_service_type": "string",
- "ingredient_cost_submitted": "string",
- "dispensing_fee_submitted": "string",
- "patient_pay_amount_reported": "string",
- "incentive_amount_submitted": "string",
- "other_amount_claimed_submitted_1": "string",
- "other_amount_claimed_submitted_2": "string",
- "other_amount_claimed_submitted_3": "string",
- "regulatory_fee_type_code_submitted_1": "string",
- "regulatory_fee_amount_submitted_1": "string",
- "regulatory_fee_type_code_submitted_2": "string",
- "regulatory_fee_amount_submitted_2": "string",
- "regulatory_fee_type_code_submitted_3": "string",
- "regulatory_fee_amount_submitted_3": "string",
- "percentage_tax_amount_submitted": "string",
- "percentage_tax_rate_submitted": "string",
- "percentage_tax_basis_submitted": "string",
- "usual_and_customary_charge": "string",
- "gross_amount_due": "string",
- "basis_of_cost_determination": "string",
- "provider_id": "string",
- "provider_last_name": "string",
- "prescriber_id": "string",
- "prescriber_last_name": "string",
- "header_response_status": "string",
- "response_transaction_code": "string",
- "transaction_response_status": "string",
- "reject_code_1": "string",
- "reject_code_2": "string",
- "reject_code_3": "string",
- "reject_code_4": "string",
- "reject_code_5": "string",
- "next_available_fill_date": "string",
- "ingredient_cost_charged_to_plan": "string",
- "dispensing_fee_charged_to_plan": "string",
- "product_service_classification": "string",
- "product_service_description": "string",
- "total_amount_paid": "string",
- "patient_pay_amount": "string",
- "patient_pay_component_amount_1": "string",
- "patient_pay_component_amount_2": "string",
- "patient_pay_component_amount_3": "string",
- "plan_pay_amount": "string",
- "amount_applied_to_periodic_deductible": "string",
- "amount_applied_to_periodic_maximum_benefit": "string",
- "amount_applied_to_periodic_maximum_out_of_pocket": "string",
- "amount_applied_to_periodic_maximum_fertility": "string",
- "amount_exceeding_periodic_fertility_maximum": "string",
- "amount_attributed_to_product_selection_brand_drug": "string",
- "amount_attributed_to_percentage_tax": "string",
- "amount_exceeding_periodic_benefit_maximum": "string",
- "amount_of_copay": "string",
- "amount_of_coinsurance": "string",
- "amount_attributed_to_product_selection_non_preferred": "string",
- "amount_attributed_to_health_plan_assistance": "string",
- "amount_attributed_to_provider_network_selection": "string",
- "amount_attributed_to_product_selection_brand_non_preferred": "string",
- "amount_attributed_to_coverage_gap": "string",
- "amount_attributed_to_processor_fee": "string",
- "amount_attributed_to_grace_period": "string",
- "amount_attributed_to_catastrophic_benefit": "string",
- "amount_attributed_to_regulatory_fee": "string",
- "ingredient_cost_paid": "string",
- "dispensing_fee_paid": "string",
- "percentage_tax_exempt_indicator": "string",
- "regulatory_fee_amount_paid_1": "string",
- "regulatory_fee_amount_paid_2": "string",
- "regulatory_fee_amount_paid_3": "string",
- "percentage_tax_amount_paid": "string",
- "percentage_tax_rate_paid": "string",
- "other_amount_paid_qualifier_1": "string",
- "other_amount_paid_1": "string",
- "other_amount_paid_qualifier_2": "string",
- "other_amount_paid_2": "string",
- "other_amount_paid_qualifier_3": "string",
- "other_amount_paid_3": "string",
- "other_payer_amount_recognized": "string",
- "basis_of_reimbursement_determination": "string",
- "basis_of_calculation_dispensing_fee": "string",
- "basis_of_calculation_copay": "string",
- "basis_of_calculation_coinsurance": "string",
- "basis_of_calculation_regulatory_fee": "string",
- "basis_of_calculation_percentage_tax": "string",
- "basis_of_days_supply_determination": "string",
- "accumulated_deductible_amount": "string",
- "remaining_deductible_amount": "string",
- "remaining_benefit_amount": "string",
- "patient_percentage_tax_amount": "string",
- "patient_regulatory_fee_amount": "string",
- "estimated_generic_savings": "string",
- "reason_for_service_code_1": "string",
- "previous_date_of_fill_1": "string",
- "quantity_of_previous_fill_1": "string",
- "reason_for_service_code_2": "string",
- "previous_date_of_fill_2": "string",
- "quantity_of_previous_fill_2": "string",
- "reason_for_service_code_3": "string",
- "previous_date_of_fill_3": "string",
- "quantity_of_previous_fill_3": "string",
- "direct_member_reimbursement_indicator": "string",
- "drug_name": "string",
- "pharmacy_name": "string",
- "reprocessing_id": "string",
- "original_claim_id": "string",
- "first_claim_id": "string",
- "claim_number": "string",
- "claim_sequence_number": "string"
}
], - "id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "external_account_id": "string",
- "external_group_id": "string",
- "submitted_carholder_id": "string",
- "first_name": "string",
- "last_name": "string",
- "full_text_search": "string",
- "claim_status": "string",
- "date_type": "string",
- "prescription_service_reference_number": "string",
- "pharmacy_nabp": "string",
- "prescriber_id": "string",
- "ndc": "string",
- "service_provider_id": "string",
- "start_date": "string",
- "end_date": "string",
- "minimum_claim_submission_date": "string",
- "maximum_claim_submission_date": "string",
- "is_340b": true,
- "reject_codes": "string",
- "paid_claims_only": true,
- "claim_sources": [
- "admin"
], - "get_dependent_claims": true,
- "month": 0,
- "year": 0,
- "year_to_date": true,
- "gpi": "string",
- "gpi_operator": "string",
- "drug_name": "string",
- "excluded_gpi_list": [
- "string"
], - "client_ids": [
- "string"
], - "add_pharmacy_data": true,
- "only_fields": [
- "string"
], - "formulary_tier": "string",
- "first_claim_id": 0,
- "basis_of_cost_determination": "string",
- "custom_filters": [
- "string"
], - "medicare_prescription_payment_plan_indicator": "string",
- "coverage_strategy_type": "string",
- "claim_number": "string",
- "claim_sequence_number": "string"
}
{- "results": [
- {
- "claim": {
- "id": 0,
- "rn": "string",
- "reversal_id": 0,
- "reverses_id": 0,
- "original_claim_id": 0,
- "client_id": "string",
- "external_account_id": "string",
- "external_group_id": "string",
- "provider_agreement_id": 0,
- "coverage_strategy_id": "string",
- "date_of_service": "string",
- "claim_submission_date": "string",
- "claim_payment_cycle_end_date": "string",
- "claim_reimbursement_cycle_end_date": "string",
- "claim_status": "string",
- "claim_count": 0,
- "received_at": "string",
- "source": "string",
- "external_member_id": "string",
- "person_code": "string",
- "first_name": "string",
- "last_name": "string",
- "coverage_strategy_type": "string",
- "plan_benefit_id": 0,
- "formulary_id": 0,
- "network_id": 0,
- "benefit_network": "string",
- "gpi": "string",
- "pharmacy_nabp": "string",
- "pharmacy_name": "string",
- "pharmacy_channel": "string",
- "version_release_number": "string",
- "request_transaction_code": "string",
- "bin_number": "string",
- "processor_control_number": "string",
- "transaction_count": "string",
- "service_provider_id_qualifier": "string",
- "service_provider_id": "string",
- "software_vendor_certification_id": "string",
- "submitted_cardholder_id": "string",
- "cardholder_first_name": "string",
- "cardholder_last_name": "string",
- "plan_id": "string",
- "eligibility_clarification_code": "string",
- "group_id": "string",
- "submitted_person_code": "string",
- "patient_relationship_code": "string",
- "medigap_id": "string",
- "medicaid_indicator": "string",
- "provider_accept_assignment_indicator": "string",
- "cms_part_d_defined_qualified_facility": "string",
- "medicaid_id_number": "string",
- "patient_id_qualifier": "string",
- "patient_id": "string",
- "date_of_birth": "string",
- "patient_gender_code": "string",
- "patient_first_name": "string",
- "patient_last_name": "string",
- "patient_street_address": "string",
- "patient_street_address_line_1": "string",
- "patient_street_address_line_2": "string",
- "patient_city_address": "string",
- "patient_state_province_address": "string",
- "patient_zip_postal_code": "string",
- "patient_country_code": "string",
- "patient_telephone_number": "string",
- "place_of_service": "string",
- "employer_id": "string",
- "pregnancy_indicator": "string",
- "patient_email_address": "user@example.com",
- "patient_residence": "string",
- "prescription_service_reference_number_qualifier": "string",
- "prescription_service_reference_number": "string",
- "product_service_id_qualifier": "string",
- "ndc": "string",
- "associated_prescription_service_reference_number": "string",
- "associated_prescription_service_date": "string",
- "procedure_modifier_code_1": "string",
- "procedure_modifier_code_2": "string",
- "procedure_modifier_code_3": "string",
- "procedure_modifier_code_4": "string",
- "procedure_modifier_code_5": "string",
- "procedure_modifier_code_6": "string",
- "procedure_modifier_code_7": "string",
- "procedure_modifier_code_8": "string",
- "procedure_modifier_code_9": "string",
- "procedure_modifier_code_10": "string",
- "quantity_dispensed": "string",
- "fill_number": 0,
- "days_supply": 0,
- "compound_code": "string",
- "daw": "string",
- "date_prescription_written": "string",
- "number_of_refills_authorized": 0,
- "prescription_origin_code": "string",
- "submission_clarification_code_1": "string",
- "submission_clarification_code_2": "string",
- "submission_clarification_code_3": "string",
- "submission_clarification_code_4": "string",
- "submission_clarification_code_5": "string",
- "submission_clarification_code_pde": "string",
- "submission_type_code_1": "string",
- "submission_type_code_2": "string",
- "submission_type_code_3": "string",
- "submission_type_code_4": "string",
- "submission_type_code_5": "string",
- "quantity_prescribed": "string",
- "multiple_prescription_service_order_group_id": "string",
- "multiple_prescription_service_order_group_reason_code": "string",
- "total_prescribed_quantity_remaining": "string",
- "other_coverage_code": "string",
- "special_packaging_indicator": "string",
- "originally_prescribed_product_service_id_qualifier": "string",
- "originally_prescribed_product_service_code": "string",
- "originally_prescribed_quantity": "string",
- "scheduled_prescription_id_number": "string",
- "unit_of_measure": "string",
- "level_of_service": "string",
- "prior_authorization_type_code": "string",
- "prior_authorization_id_submitted": "string",
- "dispensing_status": "string",
- "quantity_intended_to_be_dispensed": "string",
- "days_supply_intended_to_be_dispensed": 0,
- "delay_reason_code": "string",
- "patient_assignment_indicator": "string",
- "route_of_administration": "string",
- "compound_type": "string",
- "preparation_environment_type": "string",
- "preparation_environment_event_code": "string",
- "pharmacy_service_type": "string",
- "associated_prescription_service_reference_number_qualifier": "string",
- "associated_prescription_service_fill_number": 0,
- "original_manufacturer_product_id_qualifier": "string",
- "original_manufacturer_product_id": "string",
- "ltpac_dispense_frequency": "string",
- "ltpac_billing_methodology": "string",
- "number_of_ltpac_dispensing_events": 0,
- "do_not_dispense_before_date": "string",
- "ingredient_cost_submitted": "string",
- "dispensing_fee_submitted": "string",
- "patient_pay_amount_reported": "string",
- "incentive_amount_submitted": "string",
- "other_amount_claimed_submitted_qualifier_1": "string",
- "other_amount_claimed_submitted_1": "string",
- "other_amount_claimed_submitted_qualifier_2": "string",
- "other_amount_claimed_submitted_2": "string",
- "other_amount_claimed_submitted_qualifier_3": "string",
- "other_amount_claimed_submitted_3": "string",
- "regulatory_fee_type_code_submitted_1": "string",
- "regulatory_fee_amount_submitted_1": "string",
- "regulatory_fee_type_code_submitted_2": "string",
- "regulatory_fee_amount_submitted_2": "string",
- "regulatory_fee_type_code_submitted_3": "string",
- "regulatory_fee_amount_submitted_3": "string",
- "percentage_tax_amount_submitted": "string",
- "percentage_tax_rate_submitted": "string",
- "percentage_tax_basis_submitted": "string",
- "usual_and_customary_charge": "string",
- "gross_amount_due": "string",
- "basis_of_cost_determination": "string",
- "provider_id_qualifier": "string",
- "provider_id": "string",
- "provider_first_name": "string",
- "provider_last_name": "string",
- "prescriber_id_qualifier": "string",
- "prescriber_id": "string",
- "prescriber_last_name": "string",
- "prescriber_telephone_number": "string",
- "prescriber_telephone_number_extension": "string",
- "primary_care_provider_id_qualifier": "string",
- "primary_care_provider_id": "string",
- "primary_care_provider_last_name": "string",
- "prescriber_first_name": "string",
- "prescriber_street_address": "string",
- "prescriber_street_address_line_1": "string",
- "prescriber_street_address_line_2": "string",
- "prescriber_city_address": "string",
- "prescriber_state_province_address": "string",
- "prescriber_zip_postal_code": "string",
- "prescriber_country_code": "string",
- "prescriber_dea_number": "string",
- "prescriber_place_of_service": "string",
- "compound_prices": null,
- "compound_dosage_form_description_code": "string",
- "compound_dispensing_unit_form_indicator": "string",
- "compound_ingredient_component_count": 0,
- "compound_product_id_qualifier_1": "string",
- "compound_product_id_1": "string",
- "compound_ingredient_quantity_1": "string",
- "compound_product_id_qualifier_2": "string",
- "compound_product_id_2": "string",
- "compound_ingredient_quantity_2": "string",
- "compound_product_id_qualifier_3": "string",
- "compound_product_id_3": "string",
- "compound_ingredient_quantity_3": "string",
- "compound_product_id_qualifier_4": "string",
- "compound_product_id_4": "string",
- "compound_ingredient_quantity_4": "string",
- "compound_product_id_qualifier_5": "string",
- "compound_product_id_5": "string",
- "compound_ingredient_quantity_5": "string",
- "compound_product_id_qualifier_6": "string",
- "compound_product_id_6": "string",
- "compound_ingredient_quantity_6": "string",
- "compound_product_id_qualifier_7": "string",
- "compound_product_id_7": "string",
- "compound_ingredient_quantity_7": "string",
- "compound_product_id_qualifier_8": "string",
- "compound_product_id_8": "string",
- "compound_ingredient_quantity_8": "string",
- "compound_product_id_qualifier_9": "string",
- "compound_product_id_9": "string",
- "compound_ingredient_quantity_9": "string",
- "compound_product_id_qualifier_10": "string",
- "compound_product_id_10": "string",
- "compound_ingredient_quantity_10": "string",
- "compound_product_id_qualifier_11": "string",
- "compound_product_id_11": "string",
- "compound_ingredient_quantity_11": "string",
- "compound_product_id_qualifier_12": "string",
- "compound_product_id_12": "string",
- "compound_ingredient_quantity_12": "string",
- "compound_product_id_qualifier_13": "string",
- "compound_product_id_13": "string",
- "compound_ingredient_quantity_13": "string",
- "compound_product_id_qualifier_14": "string",
- "compound_product_id_14": "string",
- "compound_ingredient_quantity_14": "string",
- "compound_product_id_qualifier_15": "string",
- "compound_product_id_15": "string",
- "compound_ingredient_quantity_15": "string",
- "compound_product_id_qualifier_16": "string",
- "compound_product_id_16": "string",
- "compound_ingredient_quantity_16": "string",
- "compound_product_id_qualifier_17": "string",
- "compound_product_id_17": "string",
- "compound_ingredient_quantity_17": "string",
- "compound_product_id_qualifier_18": "string",
- "compound_product_id_18": "string",
- "compound_ingredient_quantity_18": "string",
- "compound_product_id_qualifier_19": "string",
- "compound_product_id_19": "string",
- "compound_ingredient_quantity_19": "string",
- "compound_product_id_qualifier_20": "string",
- "compound_product_id_20": "string",
- "compound_ingredient_quantity_20": "string",
- "compound_product_id_qualifier_21": "string",
- "compound_product_id_21": "string",
- "compound_ingredient_quantity_21": "string",
- "compound_product_id_qualifier_22": "string",
- "compound_product_id_22": "string",
- "compound_ingredient_quantity_22": "string",
- "compound_product_id_qualifier_23": "string",
- "compound_product_id_23": "string",
- "compound_ingredient_quantity_23": "string",
- "compound_product_id_qualifier_24": "string",
- "compound_product_id_24": "string",
- "compound_ingredient_quantity_24": "string",
- "compound_product_id_qualifier_25": "string",
- "compound_product_id_25": "string",
- "compound_ingredient_quantity_25": "string",
- "diagnosis_code_qualifier_1": "string",
- "diagnosis_code_1": "string",
- "diagnosis_code_qualifier_2": "string",
- "diagnosis_code_2": "string",
- "diagnosis_code_qualifier_3": "string",
- "diagnosis_code_3": "string",
- "diagnosis_code_qualifier_4": "string",
- "diagnosis_code_4": "string",
- "diagnosis_code_qualifier_5": "string",
- "diagnosis_code_5": "string",
- "header_response_status": "string",
- "response_transaction_code": "string",
- "response_message": "string",
- "response_group_id": "string",
- "response_plan_id": "string",
- "response_cob": null,
- "network_reimbursement_id": "string",
- "external_provider_agreement_id": "string",
- "payer_health_plan_id_qualifier": "string",
- "payer_health_plan_id": "string",
- "payer_health_plan_id_qualifier_1": "string",
- "payer_health_plan_id_1": "string",
- "payer_health_plan_id_qualifier_2": "string",
- "payer_health_plan_id_2": "string",
- "payer_health_plan_id_qualifier_3": "string",
- "payer_health_plan_id_3": "string",
- "transaction_response_status": "string",
- "authorization_number": "string",
- "reconciliation_id": "string",
- "reject_code_1": "string",
- "reject_code_2": "string",
- "reject_code_3": "string",
- "reject_code_4": "string",
- "reject_code_5": "string",
- "approved_message_code_1": "string",
- "approved_message_code_2": "string",
- "approved_message_code_3": "string",
- "approved_message_code_4": "string",
- "approved_message_code_5": "string",
- "additional_message_count": 0,
- "additional_message_information_qualifier_1": "string",
- "additional_message_information_1": "string",
- "additional_message_information_continuity_1": "string",
- "additional_message_information_qualifier_2": "string",
- "additional_message_information_2": "string",
- "additional_message_information_continuity_2": "string",
- "additional_message_information_qualifier_3": "string",
- "additional_message_information_3": "string",
- "additional_message_information_continuity_3": "string",
- "additional_message_information_qualifier_4": "string",
- "additional_message_information_4": "string",
- "additional_message_information_continuity_4": "string",
- "additional_message_information_qualifier_5": "string",
- "additional_message_information_5": "string",
- "additional_message_information_continuity_5": "string",
- "additional_message_information_qualifier_6": "string",
- "additional_message_information_6": "string",
- "additional_message_information_continuity_6": "string",
- "additional_message_information_qualifier_7": "string",
- "additional_message_information_7": "string",
- "additional_message_information_continuity_7": "string",
- "additional_message_information_qualifier_8": "string",
- "additional_message_information_8": "string",
- "additional_message_information_continuity_8": "string",
- "additional_message_information_qualifier_9": "string",
- "additional_message_information_9": "string",
- "additional_message_information_continuity_9": "string",
- "additional_message_information_qualifier_10": "string",
- "additional_message_information_10": "string",
- "additional_message_information_continuity_10": "string",
- "additional_message_information_qualifier_11": "string",
- "additional_message_information_11": "string",
- "additional_message_information_continuity_11": "string",
- "additional_message_information_qualifier_12": "string",
- "additional_message_information_12": "string",
- "additional_message_information_continuity_12": "string",
- "additional_message_information_qualifier_13": "string",
- "additional_message_information_13": "string",
- "additional_message_information_continuity_13": "string",
- "additional_message_information_qualifier_14": "string",
- "additional_message_information_14": "string",
- "additional_message_information_continuity_14": "string",
- "additional_message_information_qualifier_15": "string",
- "additional_message_information_15": "string",
- "additional_message_information_continuity_15": "string",
- "additional_message_information_qualifier_16": "string",
- "additional_message_information_16": "string",
- "additional_message_information_continuity_16": "string",
- "additional_message_information_qualifier_17": "string",
- "additional_message_information_17": "string",
- "additional_message_information_continuity_17": "string",
- "additional_message_information_qualifier_18": "string",
- "additional_message_information_18": "string",
- "additional_message_information_continuity_18": "string",
- "additional_message_information_qualifier_19": "string",
- "additional_message_information_19": "string",
- "additional_message_information_continuity_19": "string",
- "additional_message_information_qualifier_20": "string",
- "additional_message_information_20": "string",
- "additional_message_information_continuity_20": "string",
- "internal_control_number": "string",
- "adjudicated_program_type": "string",
- "next_available_fill_date": "string",
- "formulary_alternative_product_count": 0,
- "formulary_alternative_plan_benefit_tier_1": "string",
- "formulary_alternative_reason_code_1": "string",
- "formulary_alternative_id_qualifier_1": "string",
- "formulary_alternative_id_1": "string",
- "formulary_alternative_incentive_1": "string",
- "formulary_alternative_cost_share_incentive_1": "string",
- "formulary_alternative_description_1": "string",
- "formulary_alternative_plan_benefit_tier_2": "string",
- "formulary_alternative_reason_code_2": "string",
- "formulary_alternative_id_qualifier_2": "string",
- "formulary_alternative_id_2": "string",
- "formulary_alternative_incentive_2": "string",
- "formulary_alternative_cost_share_incentive_2": "string",
- "formulary_alternative_description_2": "string",
- "formulary_alternative_plan_benefit_tier_3": "string",
- "formulary_alternative_reason_code_3": "string",
- "formulary_alternative_id_qualifier_3": "string",
- "formulary_alternative_id_3": "string",
- "formulary_alternative_incentive_3": "string",
- "formulary_alternative_cost_share_incentive_3": 0,
- "formulary_alternative_description_3": "string",
- "plan_benefit_override_indicator": "string",
- "plan_benefit_override_value_1": "string",
- "plan_benefit_override_value_2": "string",
- "plan_benefit_override_value_3": "string",
- "plan_benefit_override_value_4": "string",
- "plan_benefit_override_value_5": "string",
- "plan_benefit_override_value_6": "string",
- "plan_benefit_override_value_7": "string",
- "plan_benefit_override_value_8": "string",
- "plan_benefit_override_value_9": "string",
- "maximum_age_qualifier": "string",
- "maximum_age": 0,
- "minimum_age_qualifier": "string",
- "minimum_age": 0,
- "minimum_amount_qualifier": "string",
- "minimum_amount": "string",
- "maximum_amount_qualifier": "string",
- "maximum_amount": "string",
- "maximum_amount_time_period": "string",
- "maximum_amount_time_period_end_date": "string",
- "maximum_amount_time_period_start_date": "string",
- "maximum_amount_time_period_units": "string",
- "remaining_amount_qualifier": "string",
- "remaining_amount": "string",
- "benefit_type_opportunity_count": 0,
- "benefit_type_opportunity_1": "string",
- "benefit_type_opportunity_2": "string",
- "benefit_type_opportunity_3": "string",
- "direct_member_reimbursement_indicator": "string",
- "ingredient_cost_charged_to_plan": "string",
- "dispensing_fee_charged_to_plan": "string",
- "product_service_classification": "string",
- "product_service_specialty_indication": "string",
- "product_service_description": "string",
- "mac_price_per_unit": "string",
- "specialty_price_per_unit": "string",
- "awp_per_unit": "string",
- "total_awp": "string",
- "wac_per_unit": "string",
- "total_wac": "string",
- "total_amount_paid": "string",
- "patient_pay_amount": "string",
- "patient_pay_component_qualifier_1": "string",
- "patient_pay_component_amount_1": "string",
- "patient_pay_component_qualifier_2": "string",
- "patient_pay_component_amount_2": "string",
- "patient_pay_component_qualifier_3": "string",
- "patient_pay_component_amount_3": "string",
- "plan_pay_amount": "string",
- "amount_exceeding_periodic_deductible": "string",
- "remaining_out_of_pocket_maximum_amount": "string",
- "amount_exceeding_periodic_maximum_out_of_pocket": "string",
- "remaining_category_out_of_pocket_maximum_amount_1": "string",
- "amount_exceeding_periodic_maximum_category_out_of_pocket_1": "string",
- "amount_applied_to_periodic_deductible": "string",
- "amount_applied_to_periodic_overall_deductible": "string",
- "amount_applied_to_periodic_category_deductible_1": "string",
- "amount_applied_to_periodic_maximum_benefit": "string",
- "amount_applied_to_periodic_maximum_out_of_pocket": "string",
- "amount_applied_to_periodic_maximum_category_out_of_pocket_1": "string",
- "amount_applied_to_periodic_maximum_fertility": "string",
- "amount_exceeding_periodic_fertility_maximum": "string",
- "amount_attributed_to_product_selection_brand_drug": "string",
- "amount_attributed_to_percentage_tax": "string",
- "amount_exceeding_periodic_benefit_maximum": "string",
- "amount_applied_to_cob_plan_maximum": "string",
- "remaining_cob_plan_maximum_amount": "string",
- "amount_exceeding_cob_plan_maximum": "string",
- "amount_of_coinsurance_exceeding_cob_plan_maximum": "string",
- "amount_of_manufacturer_assistance": "string",
- "anti_accumulation_indicator": "string",
- "amount_of_copay": "string",
- "amount_of_coinsurance": "string",
- "amount_attributed_to_product_selection_non_preferred": "string",
- "amount_attributed_to_health_plan_assistance": "string",
- "amount_attributed_to_provider_network_selection": "string",
- "amount_attributed_to_product_selection_brand_non_preferred": "string",
- "amount_attributed_to_coverage_gap": "string",
- "amount_attributed_to_processor_fee": "string",
- "amount_attributed_to_grace_period": "string",
- "amount_attributed_to_catastrophic_benefit": "string",
- "amount_attributed_to_regulatory_fee": "string",
- "ingredient_cost_paid": "string",
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- "percentage_tax_exempt_indicator": "string",
- "regulatory_fee_amount_paid": "string",
- "regulatory_fee_type_code_1": "string",
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- "percentage_tax_amount_paid": "string",
- "percentage_tax_rate_paid": "string",
- "percentage_tax_basis_paid": "string",
- "incentive_amount_paid": "string",
- "professional_service_fee_paid": "string",
- "other_amount_paid_qualifier_1": "string",
- "other_amount_paid_1": 0,
- "other_amount_paid_qualifier_2": "string",
- "other_amount_paid_2": 0,
- "other_amount_paid_qualifier_3": "string",
- "other_amount_paid_3": 0,
- "other_payer_amount_recognized": "string",
- "basis_of_reimbursement_determination": "string",
- "benefit_stage_qualifier_1": "string",
- "benefit_stage_qualifier_2": "string",
- "benefit_stage_qualifier_3": "string",
- "benefit_stage_qualifier_4": "string",
- "benefit_stage_amount_1": "string",
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- "benefit_stage_amount_3": "string",
- "benefit_stage_amount_4": "string",
- "basis_of_calculation_dispensing_fee": "string",
- "basis_of_calculation_copay": "string",
- "basis_of_calculation_coinsurance": "string",
- "basis_of_calculation_regulatory_fee": "string",
- "basis_of_calculation_percentage_tax": "string",
- "basis_of_days_supply_determination": "string",
- "accumulated_deductible_amount": "string",
- "remaining_deductible_amount": "string",
- "remaining_benefit_amount": "string",
- "spending_account_amount_remaining": "string",
- "patient_percentage_tax_amount": "string",
- "patient_regulatory_fee_amount": "string",
- "estimated_generic_savings": "string",
- "ingredient_cost_contracted_reimbursable_amount": "string",
- "dispensing_fee_contracted_reimbursable_amount": "string",
- "reason_for_service_code_1": "string",
- "clinical_significance_code_1": "string",
- "other_pharmacy_indicator_1": "string",
- "previous_date_of_fill_1": "string",
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- "database_indicator_1": "string",
- "other_prescriber_indicator_1": "string",
- "dur_free_text_message_1": "string",
- "dur_additional_text_1": "string",
- "reason_for_service_code_2": "string",
- "clinical_significance_code_2": "string",
- "other_pharmacy_indicator_2": "string",
- "previous_date_of_fill_2": "string",
- "quantity_of_previous_fill_2": "string",
- "database_indicator_2": "string",
- "other_prescriber_indicator_2": "string",
- "dur_free_text_message_2": "string",
- "dur_additional_text_2": "string",
- "reason_for_service_code_3": "string",
- "reason_for_service_code_4": "string",
- "reason_for_service_code_5": "string",
- "reason_for_service_code_6": "string",
- "reason_for_service_code_7": "string",
- "reason_for_service_code_8": "string",
- "reason_for_service_code_9": "string",
- "clinical_significance_code_3": "string",
- "other_pharmacy_indicator_3": "string",
- "previous_date_of_fill_3": "string",
- "quantity_of_previous_fill_3": "string",
- "database_indicator_3": "string",
- "other_prescriber_indicator_3": "string",
- "dur_free_text_message_3": "string",
- "dur_additional_text_3": "string",
- "dur_pps_level_of_effort_1": "string",
- "dur_pps_level_of_effort_2": "string",
- "dur_pps_level_of_effort_3": "string",
- "dur_pps_level_of_effort_4": "string",
- "dur_pps_level_of_effort_5": "string",
- "dur_pps_level_of_effort_6": "string",
- "dur_pps_level_of_effort_7": "string",
- "dur_pps_level_of_effort_8": "string",
- "dur_pps_level_of_effort_9": "string",
- "aws_region": "string",
- "log_group_name": "string",
- "log_stream_name": "string",
- "aws_request_id": "string",
- "log_key": "string",
- "raw_request": "string",
- "raw_response": "string",
- "raw_request_parsed": null,
- "raw_response_parsed": null,
- "relationship_code": "string",
- "overrides": [
- 0
], - "prior_authorizations": [
- 0
], - "tags": [
- 0
], - "finance_835_record_id": 0,
- "finished_at": "string",
- "formulary_name": "string",
- "formulary_tier": "string",
- "nadac_per_unit": 0,
- "nadac_plus_ndc": "string",
- "nadac_plus_per_unit": 0,
- "relationship_id": "string",
- "ncpdp_relationship_id": "string",
- "affiliation_relationship_id": "string",
- "parent_organization_id": "string",
- "remit_and_reconciliation_id": "string",
- "payment_center_id": "string",
- "rx_cap_flag": "string",
- "rx_cap_plus_flag": "string",
- "total_mac_list": 0,
- "total_nadac": 0,
- "total_nadac_plus": 0,
- "total_specialty_list": 0,
- "external_invoice_id": 0,
- "pde_id": 0,
- "pde_status": "string",
- "pde_cms_calculated_gap_discount": 0,
- "pde_plan_benefit_package_id_of_record": "string",
- "pde_alternate_service_provider_id_qualifier": "string",
- "pde_alternate_service_provider_id": "string",
- "pde_original_submitting_contract": "string",
- "pde_plan_to_plan_contract_of_record": "string",
- "pde_corrected_medicare_beneficiary_identifier": "string",
- "pde_error_count": 0,
- "pde_error_1": "string",
- "pde_error_2": "string",
- "pde_error_3": "string",
- "pde_error_4": "string",
- "pde_error_5": "string",
- "pde_error_6": "string",
- "pde_error_7": "string",
- "pde_error_8": "string",
- "pde_error_9": "string",
- "pde_error_10": "string",
- "pde_exclusion_reason_code": "string",
- "pde_adjustment_deletion_code": "string",
- "programs": [
- "string"
], - "plan_additional_covered_amount": 0,
- "nsde_drug_application_type": "string",
- "drug_application_type": "string",
- "non_standard_format_code": "string",
- "drug_status_code": "string",
- "part_b": "string",
- "part_d": "string",
- "contract_number": "string",
- "plan_benefit_package_id": "string",
- "clinical_rules": [
- { }
], - "pharmacy_quality_alliance": [
- { }
], - "formulary_attributes": { },
- "callback_overrides": [
- { }
], - "performance": { },
- "adjustments": [
- null
], - "plan_type": "string",
- "medicare_beneficiary_identifier": "string",
- "gross_covered_drug_cost_before_adjudication": "string",
- "reported_gap_discount": "string",
- "beginning_benefit_phase": "string",
- "ending_benefit_phase": "string",
- "formulary_code": "string",
- "true_out_of_pocket_before_adjudication": "string",
- "gross_drug_cost_above": "string",
- "gross_drug_cost_below": "string",
- "total_claim_covered_plan_pay": "string",
- "total_claim_non_covered_plan_pay": "string",
- "amount_applied_to_low_income_subsidy": "string",
- "amount_applied_to_low_income_subsidy_deductible": "string",
- "amount_applied_to_part_b_deductible": "string",
- "amount_applied_to_part_b_maximum_out_of_pocket": "string",
- "adjustment_reason_code": "string",
- "adjustment_reason_code_qualifier": "string",
- "estimated_rebate_at_point_of_service": "string",
- "other_true_out_of_pocket_amount": "string",
- "part_d_model_indicator": "string",
- "pricing_exception_code": "string",
- "pricing_custom_id": 0,
- "patient_liability_reduction_due_to_other_payer_amount": "string",
- "patient_liability_reduction_due_to_the_employer_amount": "string",
- "accumulated_category_deductible_1_amount": "string",
- "accumulations_applied": null,
- "alternate_benefit_cost_share": null,
- "amount_applied_to_deductible_phase": "string",
- "amount_applied_to_gross_covered_drug_cost": "string",
- "amount_applied_to_initial_coverage_phase": "string",
- "amount_applied_to_true_out_of_pocket": "string",
- "accumulated_deductible_phase_amount": "string",
- "accumulated_gross_covered_drug_cost_amount": "string",
- "accumulated_true_out_of_pocket_amount": "string",
- "accumulated_part_b_deductible_amount": "string",
- "accumulated_part_b_maximum_out_of_pocket_amount": "string",
- "accumulated_part_b_deductible_out_of_network_amount": "string",
- "accumulated_part_b_out_of_pocket_out_of_network": "string",
- "amount_applied_to_part_b_deductible_out_of_network": "string",
- "amount_applied_to_part_b_out_of_pocket_out_of_network": "string",
- "amount_exceeding_periodic_category_deductible_1": 0,
- "amount_exceeding_periodic_overall_deductible": "string",
- "birth_date": "string",
- "coordination_of_benefits_other_payments_count": 0,
- "dispensing_fee_charged_level_1": "string",
- "dispensing_fee_charged_level_2": "string",
- "dispensing_fee_charged_level_3": "string",
- "ingredient_cost_charged_level_1": "string",
- "ingredient_cost_charged_level_2": "string",
- "ingredient_cost_charged_level_3": "string",
- "mac_list_dispensing_fee": "string",
- "pricing_category_mac_list_unit_price_adjustment_percentage": 0,
- "mac_list_id": 0,
- "mac_list_name": "string",
- "other_payer_amount_paid_1": "string",
- "other_payer_amount_paid_2": "string",
- "other_payer_amount_paid_3": "string",
- "other_payer_amount_paid_4": "string",
- "other_payer_amount_paid_5": "string",
- "other_payer_amount_paid_6": "string",
- "other_payer_amount_paid_7": "string",
- "other_payer_amount_paid_8": "string",
- "other_payer_amount_paid_9": "string",
- "other_payer_amount_paid_count": 0,
- "other_payer_amount_paid_qualifier_1": "string",
- "other_payer_amount_paid_qualifier_2": "string",
- "other_payer_amount_paid_qualifier_3": "string",
- "other_payer_amount_paid_qualifier_4": "string",
- "other_payer_amount_paid_qualifier_5": "string",
- "other_payer_amount_paid_qualifier_6": "string",
- "other_payer_amount_paid_qualifier_7": "string",
- "other_payer_amount_paid_qualifier_8": "string",
- "other_payer_amount_paid_qualifier_9": "string",
- "other_payer_coverage_type_1": "string",
- "other_payer_coverage_type_2": "string",
- "other_payer_coverage_type_3": "string",
- "other_payer_coverage_type_4": "string",
- "other_payer_coverage_type_5": "string",
- "other_payer_coverage_type_6": "string",
- "other_payer_coverage_type_7": "string",
- "other_payer_coverage_type_8": "string",
- "other_payer_coverage_type_9": "string",
- "other_payer_id_1": "string",
- "other_payer_id_2": "string",
- "other_payer_id_3": "string",
- "other_payer_id_4": "string",
- "other_payer_id_5": "string",
- "other_payer_id_6": "string",
- "other_payer_id_7": "string",
- "other_payer_id_8": "string",
- "other_payer_id_9": "string",
- "other_payer_id_qualifier_1": "string",
- "other_payer_id_qualifier_2": "string",
- "other_payer_id_qualifier_3": "string",
- "other_payer_id_qualifier_4": "string",
- "other_payer_id_qualifier_5": "string",
- "other_payer_id_qualifier_6": "string",
- "other_payer_id_qualifier_7": "string",
- "other_payer_id_qualifier_8": "string",
- "other_payer_id_qualifier_9": "string",
- "other_payer_patient_responsibility_amount_1": "string",
- "other_payer_patient_responsibility_amount_2": "string",
- "other_payer_patient_responsibility_amount_3": "string",
- "other_payer_patient_responsibility_amount_4": "string",
- "other_payer_patient_responsibility_amount_5": "string",
- "other_payer_patient_responsibility_amount_6": "string",
- "other_payer_patient_responsibility_amount_7": "string",
- "other_payer_patient_responsibility_amount_8": "string",
- "other_payer_patient_responsibility_amount_9": "string",
- "other_payer_patient_responsibility_amount_count": 0,
- "other_payer_patient_responsibility_amount_qualifier_1": "string",
- "other_payer_patient_responsibility_amount_qualifier_2": "string",
- "other_payer_patient_responsibility_amount_qualifier_3": "string",
- "other_payer_patient_responsibility_amount_qualifier_4": "string",
- "other_payer_patient_responsibility_amount_qualifier_5": "string",
- "other_payer_patient_responsibility_amount_qualifier_6": "string",
- "other_payer_patient_responsibility_amount_qualifier_7": "string",
- "other_payer_patient_responsibility_amount_qualifier_8": "string",
- "other_payer_patient_responsibility_amount_qualifier_9": "string",
- "other_payer_reject_code_1": "string",
- "other_payer_reject_code_2": "string",
- "other_payer_reject_code_3": "string",
- "other_payer_reject_code_4": "string",
- "other_payer_reject_code_5": "string",
- "other_payer_reject_count": 0,
- "pay_amount_level_1": "string",
- "pay_amount_level_2": "string",
- "pay_amount_level_3": "string",
- "prescriber_npi": "string",
- "professional_service_code_1": "string",
- "professional_service_code_2": "string",
- "professional_service_code_3": "string",
- "professional_service_code_4": "string",
- "professional_service_code_5": "string",
- "professional_service_code_6": "string",
- "professional_service_code_7": "string",
- "professional_service_code_8": "string",
- "professional_service_code_9": "string",
- "remaining_category_deductible_1_amount": "string",
- "remaining_overall_deductible_amount": "string",
- "request_reason_for_service_code_1": "string",
- "request_reason_for_service_code_2": "string",
- "request_reason_for_service_code_3": "string",
- "request_reason_for_service_code_4": "string",
- "request_reason_for_service_code_5": "string",
- "request_reason_for_service_code_6": "string",
- "request_reason_for_service_code_7": "string",
- "request_reason_for_service_code_8": "string",
- "request_reason_for_service_code_9": "string",
- "result_of_service_code_1": "string",
- "result_of_service_code_2": "string",
- "result_of_service_code_3": "string",
- "result_of_service_code_4": "string",
- "result_of_service_code_5": "string",
- "result_of_service_code_6": "string",
- "result_of_service_code_7": "string",
- "result_of_service_code_8": "string",
- "result_of_service_code_9": "string",
- "specialty_list_dispensing_fee": "string",
- "specialty_list_id": 0,
- "specialty_list_name": "string",
- "dmr_pay_to_city_address": "string",
- "dmr_pay_to_country_code": "string",
- "dmr_pay_to_name": "string",
- "dmr_pay_to_state_province_address": "string",
- "dmr_pay_to_street_address_line_1": "string",
- "dmr_pay_to_street_address_line_2": "string",
- "dmr_pay_to_tax_id": "string",
- "dmr_pay_to_vendor_id": "string",
- "dmr_pay_to_zip_postal_code": "string",
- "tax_id_number": "string",
- "reasons_for_rejection": [
- "string"
], - "reasons_for_adjudication": [
- "string"
], - "patient_pay_reduction_due_to_point_of_service_rebate": 0,
- "plan_pay_reduction_due_to_point_of_service_rebate": 0,
- "point_of_service_rebate_amount": 0,
- "low_income_subsidy_level": "string",
- "senior_savings_model_cost_share_reduction_gap": 0,
- "senior_savings_model_cost_share_reduction_non_gap": 0,
- "senior_savings_model_indicator": "string",
- "inflation_reduction_act_subsidy_amount": 0,
- "inflation_reduction_act_covered_vaccine": "string",
- "inflation_reduction_act_covered_insulin": "string",
- "other_true_out_of_pocket_amount_indicator": "string",
- "medicare_amounts_id": 0,
- "low_income_subsidy_amounts_id": 0,
- "medicare_medicaid_dsnp_co_administered_plan": "string",
- "dsnp_fee_for_service_or_capitation": 0,
- "dsnp_medicaid_cost_share_reduction_amount_part_d": 0,
- "dsnp_medicaid_cost_share_reduction_amount_part_b": 0,
- "dsnp_medicaid_cost_share_covered_excluded_reduction_amount": 0,
- "is_340b": true,
- "medicare_administrative_claim": "string",
- "controlled_substance_code": "string",
- "desi_code": "string",
- "reprocessing_id": 0,
- "reprocessing_type": "string",
- "reprocessing_patient_pay_difference": "string",
- "reprocessing_pharmacy_pay_amount": "string",
- "reprocessing_plan_pay_amount": "string",
- "reprocessing_goes_to_835": true,
- "reprocessing_goes_to_invoice": true,
- "reprocessing_is_member_recoupment": true,
- "nx_other_payers_total_amount": "string",
- "reprocessing_nx_amount_applied_to_patient_pay": "string",
- "reprocessing_excess_nx_amount_total": "string",
- "reprocessing_patient_pay_net_nx": "string",
- "reprocessing_member_refund_amount": "string",
- "reprocessing_member_recoupment_amount": "string",
- "reprocessing_is_recoup_ltc_pharmacy": true,
- "notes": "string",
- "first_claim_id": 0,
- "next_claim_id": 0,
- "include_raw_request_parsed": true,
- "include_raw_response_parsed": true,
- "manufacturer_discount_amount": 0,
- "is_manufacturer_discount_drug": true,
- "claim_number": "string",
- "claim_sequence_number": "string",
- "medicare_prescription_payment_plan_indicator": "string",
- "medicare_prescription_payment_plan_original_claim_id": 0,
- "pharmacy_transaction_fee": 0,
- "vbid_cost_share_reduction_amount_part_d": 0,
- "vbid_model_indicator": "string",
- "pricing_level_ids": [
- 0
], - "brand_name_code": "string",
- "drug_descriptor_id": "string",
- "dosage": "string",
- "dosage_form": "string",
- "dosage_form_packaging": "string",
- "drug_name": "string",
- "drug_type": "string",
- "group_name": "string",
- "provider_phone": "string",
- "most_expensive_compound_ingredient_ndc": "string",
- "multi_source": "string",
- "name_type_code": "string",
- "rx_otc_indicator_code": "string",
- "strength": "string",
- "strength_unit_of_measure": "string",
- "pde_record_id": "string",
- "pde_claim_control_number": "string",
- "pde_plan_benefit_package_id": "string",
- "medicare_prescription_payment_plan_claim_id": 0,
- "medicare_prescription_payment_plan_claim_amount": 0,
- "claim_gpi": "string",
- "drug_lists": null,
- "identity": "string"
}
}
], - "result_count": "string"
}
Update a Claim.
id required | integer <int32> |
is_340b | boolean or null |
external_account_id | string or null |
external_group_id | string or null |
{- "id": 0,
- "is_340b": true,
- "external_account_id": "string",
- "external_group_id": "string"
}
{- "id": 0,
- "rn": "string",
- "reversal_id": 0,
- "reverses_id": 0,
- "original_claim_id": 0,
- "client_id": "string",
- "external_account_id": "string",
- "external_group_id": "string",
- "provider_agreement_id": 0,
- "coverage_strategy_id": "string",
- "date_of_service": "string",
- "claim_submission_date": "string",
- "claim_payment_cycle_end_date": "string",
- "claim_reimbursement_cycle_end_date": "string",
- "claim_status": "string",
- "claim_count": 0,
- "received_at": "string",
- "source": "string",
- "external_member_id": "string",
- "person_code": "string",
- "first_name": "string",
- "last_name": "string",
- "coverage_strategy_type": "string",
- "plan_benefit_id": 0,
- "formulary_id": 0,
- "network_id": 0,
- "benefit_network": "string",
- "gpi": "string",
- "pharmacy_nabp": "string",
- "pharmacy_name": "string",
- "pharmacy_channel": "string",
- "version_release_number": "string",
- "request_transaction_code": "string",
- "bin_number": "string",
- "processor_control_number": "string",
- "transaction_count": "string",
- "service_provider_id_qualifier": "string",
- "service_provider_id": "string",
- "software_vendor_certification_id": "string",
- "submitted_cardholder_id": "string",
- "cardholder_first_name": "string",
- "cardholder_last_name": "string",
- "plan_id": "string",
- "eligibility_clarification_code": "string",
- "group_id": "string",
- "submitted_person_code": "string",
- "patient_relationship_code": "string",
- "medigap_id": "string",
- "medicaid_indicator": "string",
- "provider_accept_assignment_indicator": "string",
- "cms_part_d_defined_qualified_facility": "string",
- "medicaid_id_number": "string",
- "patient_id_qualifier": "string",
- "patient_id": "string",
- "date_of_birth": "string",
- "patient_gender_code": "string",
- "patient_first_name": "string",
- "patient_last_name": "string",
- "patient_street_address": "string",
- "patient_street_address_line_1": "string",
- "patient_street_address_line_2": "string",
- "patient_city_address": "string",
- "patient_state_province_address": "string",
- "patient_zip_postal_code": "string",
- "patient_country_code": "string",
- "patient_telephone_number": "string",
- "place_of_service": "string",
- "employer_id": "string",
- "pregnancy_indicator": "string",
- "patient_email_address": "user@example.com",
- "patient_residence": "string",
- "prescription_service_reference_number_qualifier": "string",
- "prescription_service_reference_number": "string",
- "product_service_id_qualifier": "string",
- "ndc": "string",
- "associated_prescription_service_reference_number": "string",
- "associated_prescription_service_date": "string",
- "procedure_modifier_code_1": "string",
- "procedure_modifier_code_2": "string",
- "procedure_modifier_code_3": "string",
- "procedure_modifier_code_4": "string",
- "procedure_modifier_code_5": "string",
- "procedure_modifier_code_6": "string",
- "procedure_modifier_code_7": "string",
- "procedure_modifier_code_8": "string",
- "procedure_modifier_code_9": "string",
- "procedure_modifier_code_10": "string",
- "quantity_dispensed": "string",
- "fill_number": 0,
- "days_supply": 0,
- "compound_code": "string",
- "daw": "string",
- "date_prescription_written": "string",
- "number_of_refills_authorized": 0,
- "prescription_origin_code": "string",
- "submission_clarification_code_1": "string",
- "submission_clarification_code_2": "string",
- "submission_clarification_code_3": "string",
- "submission_clarification_code_4": "string",
- "submission_clarification_code_5": "string",
- "submission_clarification_code_pde": "string",
- "submission_type_code_1": "string",
- "submission_type_code_2": "string",
- "submission_type_code_3": "string",
- "submission_type_code_4": "string",
- "submission_type_code_5": "string",
- "quantity_prescribed": "string",
- "multiple_prescription_service_order_group_id": "string",
- "multiple_prescription_service_order_group_reason_code": "string",
- "total_prescribed_quantity_remaining": "string",
- "other_coverage_code": "string",
- "special_packaging_indicator": "string",
- "originally_prescribed_product_service_id_qualifier": "string",
- "originally_prescribed_product_service_code": "string",
- "originally_prescribed_quantity": "string",
- "scheduled_prescription_id_number": "string",
- "unit_of_measure": "string",
- "level_of_service": "string",
- "prior_authorization_type_code": "string",
- "prior_authorization_id_submitted": "string",
- "dispensing_status": "string",
- "quantity_intended_to_be_dispensed": "string",
- "days_supply_intended_to_be_dispensed": 0,
- "delay_reason_code": "string",
- "patient_assignment_indicator": "string",
- "route_of_administration": "string",
- "compound_type": "string",
- "preparation_environment_type": "string",
- "preparation_environment_event_code": "string",
- "pharmacy_service_type": "string",
- "associated_prescription_service_reference_number_qualifier": "string",
- "associated_prescription_service_fill_number": 0,
- "original_manufacturer_product_id_qualifier": "string",
- "original_manufacturer_product_id": "string",
- "ltpac_dispense_frequency": "string",
- "ltpac_billing_methodology": "string",
- "number_of_ltpac_dispensing_events": 0,
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- "non_standard_format_code": "string",
- "drug_status_code": "string",
- "part_b": "string",
- "part_d": "string",
- "contract_number": "string",
- "plan_benefit_package_id": "string",
- "clinical_rules": [
- { }
], - "pharmacy_quality_alliance": [
- { }
], - "formulary_attributes": { },
- "callback_overrides": [
- { }
], - "performance": { },
- "adjustments": [
- null
], - "plan_type": "string",
- "medicare_beneficiary_identifier": "string",
- "gross_covered_drug_cost_before_adjudication": "string",
- "reported_gap_discount": "string",
- "beginning_benefit_phase": "string",
- "ending_benefit_phase": "string",
- "formulary_code": "string",
- "true_out_of_pocket_before_adjudication": "string",
- "gross_drug_cost_above": "string",
- "gross_drug_cost_below": "string",
- "total_claim_covered_plan_pay": "string",
- "total_claim_non_covered_plan_pay": "string",
- "amount_applied_to_low_income_subsidy": "string",
- "amount_applied_to_low_income_subsidy_deductible": "string",
- "amount_applied_to_part_b_deductible": "string",
- "amount_applied_to_part_b_maximum_out_of_pocket": "string",
- "adjustment_reason_code": "string",
- "adjustment_reason_code_qualifier": "string",
- "estimated_rebate_at_point_of_service": "string",
- "other_true_out_of_pocket_amount": "string",
- "part_d_model_indicator": "string",
- "pricing_exception_code": "string",
- "pricing_custom_id": 0,
- "patient_liability_reduction_due_to_other_payer_amount": "string",
- "patient_liability_reduction_due_to_the_employer_amount": "string",
- "accumulated_category_deductible_1_amount": "string",
- "accumulations_applied": null,
- "alternate_benefit_cost_share": null,
- "amount_applied_to_deductible_phase": "string",
- "amount_applied_to_gross_covered_drug_cost": "string",
- "amount_applied_to_initial_coverage_phase": "string",
- "amount_applied_to_true_out_of_pocket": "string",
- "accumulated_deductible_phase_amount": "string",
- "accumulated_gross_covered_drug_cost_amount": "string",
- "accumulated_true_out_of_pocket_amount": "string",
- "accumulated_part_b_deductible_amount": "string",
- "accumulated_part_b_maximum_out_of_pocket_amount": "string",
- "accumulated_part_b_deductible_out_of_network_amount": "string",
- "accumulated_part_b_out_of_pocket_out_of_network": "string",
- "amount_applied_to_part_b_deductible_out_of_network": "string",
- "amount_applied_to_part_b_out_of_pocket_out_of_network": "string",
- "amount_exceeding_periodic_category_deductible_1": 0,
- "amount_exceeding_periodic_overall_deductible": "string",
- "birth_date": "string",
- "coordination_of_benefits_other_payments_count": 0,
- "dispensing_fee_charged_level_1": "string",
- "dispensing_fee_charged_level_2": "string",
- "dispensing_fee_charged_level_3": "string",
- "ingredient_cost_charged_level_1": "string",
- "ingredient_cost_charged_level_2": "string",
- "ingredient_cost_charged_level_3": "string",
- "mac_list_dispensing_fee": "string",
- "pricing_category_mac_list_unit_price_adjustment_percentage": 0,
- "mac_list_id": 0,
- "mac_list_name": "string",
- "other_payer_amount_paid_1": "string",
- "other_payer_amount_paid_2": "string",
- "other_payer_amount_paid_3": "string",
- "other_payer_amount_paid_4": "string",
- "other_payer_amount_paid_5": "string",
- "other_payer_amount_paid_6": "string",
- "other_payer_amount_paid_7": "string",
- "other_payer_amount_paid_8": "string",
- "other_payer_amount_paid_9": "string",
- "other_payer_amount_paid_count": 0,
- "other_payer_amount_paid_qualifier_1": "string",
- "other_payer_amount_paid_qualifier_2": "string",
- "other_payer_amount_paid_qualifier_3": "string",
- "other_payer_amount_paid_qualifier_4": "string",
- "other_payer_amount_paid_qualifier_5": "string",
- "other_payer_amount_paid_qualifier_6": "string",
- "other_payer_amount_paid_qualifier_7": "string",
- "other_payer_amount_paid_qualifier_8": "string",
- "other_payer_amount_paid_qualifier_9": "string",
- "other_payer_coverage_type_1": "string",
- "other_payer_coverage_type_2": "string",
- "other_payer_coverage_type_3": "string",
- "other_payer_coverage_type_4": "string",
- "other_payer_coverage_type_5": "string",
- "other_payer_coverage_type_6": "string",
- "other_payer_coverage_type_7": "string",
- "other_payer_coverage_type_8": "string",
- "other_payer_coverage_type_9": "string",
- "other_payer_id_1": "string",
- "other_payer_id_2": "string",
- "other_payer_id_3": "string",
- "other_payer_id_4": "string",
- "other_payer_id_5": "string",
- "other_payer_id_6": "string",
- "other_payer_id_7": "string",
- "other_payer_id_8": "string",
- "other_payer_id_9": "string",
- "other_payer_id_qualifier_1": "string",
- "other_payer_id_qualifier_2": "string",
- "other_payer_id_qualifier_3": "string",
- "other_payer_id_qualifier_4": "string",
- "other_payer_id_qualifier_5": "string",
- "other_payer_id_qualifier_6": "string",
- "other_payer_id_qualifier_7": "string",
- "other_payer_id_qualifier_8": "string",
- "other_payer_id_qualifier_9": "string",
- "other_payer_patient_responsibility_amount_1": "string",
- "other_payer_patient_responsibility_amount_2": "string",
- "other_payer_patient_responsibility_amount_3": "string",
- "other_payer_patient_responsibility_amount_4": "string",
- "other_payer_patient_responsibility_amount_5": "string",
- "other_payer_patient_responsibility_amount_6": "string",
- "other_payer_patient_responsibility_amount_7": "string",
- "other_payer_patient_responsibility_amount_8": "string",
- "other_payer_patient_responsibility_amount_9": "string",
- "other_payer_patient_responsibility_amount_count": 0,
- "other_payer_patient_responsibility_amount_qualifier_1": "string",
- "other_payer_patient_responsibility_amount_qualifier_2": "string",
- "other_payer_patient_responsibility_amount_qualifier_3": "string",
- "other_payer_patient_responsibility_amount_qualifier_4": "string",
- "other_payer_patient_responsibility_amount_qualifier_5": "string",
- "other_payer_patient_responsibility_amount_qualifier_6": "string",
- "other_payer_patient_responsibility_amount_qualifier_7": "string",
- "other_payer_patient_responsibility_amount_qualifier_8": "string",
- "other_payer_patient_responsibility_amount_qualifier_9": "string",
- "other_payer_reject_code_1": "string",
- "other_payer_reject_code_2": "string",
- "other_payer_reject_code_3": "string",
- "other_payer_reject_code_4": "string",
- "other_payer_reject_code_5": "string",
- "other_payer_reject_count": 0,
- "pay_amount_level_1": "string",
- "pay_amount_level_2": "string",
- "pay_amount_level_3": "string",
- "prescriber_npi": "string",
- "professional_service_code_1": "string",
- "professional_service_code_2": "string",
- "professional_service_code_3": "string",
- "professional_service_code_4": "string",
- "professional_service_code_5": "string",
- "professional_service_code_6": "string",
- "professional_service_code_7": "string",
- "professional_service_code_8": "string",
- "professional_service_code_9": "string",
- "remaining_category_deductible_1_amount": "string",
- "remaining_overall_deductible_amount": "string",
- "request_reason_for_service_code_1": "string",
- "request_reason_for_service_code_2": "string",
- "request_reason_for_service_code_3": "string",
- "request_reason_for_service_code_4": "string",
- "request_reason_for_service_code_5": "string",
- "request_reason_for_service_code_6": "string",
- "request_reason_for_service_code_7": "string",
- "request_reason_for_service_code_8": "string",
- "request_reason_for_service_code_9": "string",
- "result_of_service_code_1": "string",
- "result_of_service_code_2": "string",
- "result_of_service_code_3": "string",
- "result_of_service_code_4": "string",
- "result_of_service_code_5": "string",
- "result_of_service_code_6": "string",
- "result_of_service_code_7": "string",
- "result_of_service_code_8": "string",
- "result_of_service_code_9": "string",
- "specialty_list_dispensing_fee": "string",
- "specialty_list_id": 0,
- "specialty_list_name": "string",
- "dmr_pay_to_city_address": "string",
- "dmr_pay_to_country_code": "string",
- "dmr_pay_to_name": "string",
- "dmr_pay_to_state_province_address": "string",
- "dmr_pay_to_street_address_line_1": "string",
- "dmr_pay_to_street_address_line_2": "string",
- "dmr_pay_to_tax_id": "string",
- "dmr_pay_to_vendor_id": "string",
- "dmr_pay_to_zip_postal_code": "string",
- "tax_id_number": "string",
- "reasons_for_rejection": [
- "string"
], - "reasons_for_adjudication": [
- "string"
], - "patient_pay_reduction_due_to_point_of_service_rebate": 0,
- "plan_pay_reduction_due_to_point_of_service_rebate": 0,
- "point_of_service_rebate_amount": 0,
- "low_income_subsidy_level": "string",
- "senior_savings_model_cost_share_reduction_gap": 0,
- "senior_savings_model_cost_share_reduction_non_gap": 0,
- "senior_savings_model_indicator": "string",
- "inflation_reduction_act_subsidy_amount": 0,
- "inflation_reduction_act_covered_vaccine": "string",
- "inflation_reduction_act_covered_insulin": "string",
- "other_true_out_of_pocket_amount_indicator": "string",
- "medicare_amounts_id": 0,
- "low_income_subsidy_amounts_id": 0,
- "medicare_medicaid_dsnp_co_administered_plan": "string",
- "dsnp_fee_for_service_or_capitation": 0,
- "dsnp_medicaid_cost_share_reduction_amount_part_d": 0,
- "dsnp_medicaid_cost_share_reduction_amount_part_b": 0,
- "dsnp_medicaid_cost_share_covered_excluded_reduction_amount": 0,
- "is_340b": true,
- "medicare_administrative_claim": "string",
- "controlled_substance_code": "string",
- "desi_code": "string",
- "reprocessing_id": 0,
- "reprocessing_type": "string",
- "reprocessing_patient_pay_difference": "string",
- "reprocessing_pharmacy_pay_amount": "string",
- "reprocessing_plan_pay_amount": "string",
- "reprocessing_goes_to_835": true,
- "reprocessing_goes_to_invoice": true,
- "reprocessing_is_member_recoupment": true,
- "nx_other_payers_total_amount": "string",
- "reprocessing_nx_amount_applied_to_patient_pay": "string",
- "reprocessing_excess_nx_amount_total": "string",
- "reprocessing_patient_pay_net_nx": "string",
- "reprocessing_member_refund_amount": "string",
- "reprocessing_member_recoupment_amount": "string",
- "reprocessing_is_recoup_ltc_pharmacy": true,
- "notes": "string",
- "first_claim_id": 0,
- "next_claim_id": 0,
- "include_raw_request_parsed": true,
- "include_raw_response_parsed": true,
- "manufacturer_discount_amount": 0,
- "is_manufacturer_discount_drug": true,
- "claim_number": "string",
- "claim_sequence_number": "string",
- "medicare_prescription_payment_plan_indicator": "string",
- "medicare_prescription_payment_plan_original_claim_id": 0,
- "pharmacy_transaction_fee": 0,
- "vbid_cost_share_reduction_amount_part_d": 0,
- "vbid_model_indicator": "string",
- "pricing_level_ids": [
- 0
], - "brand_name_code": "string",
- "drug_descriptor_id": "string",
- "dosage": "string",
- "dosage_form": "string",
- "dosage_form_packaging": "string",
- "drug_name": "string",
- "drug_type": "string",
- "group_name": "string",
- "provider_phone": "string",
- "most_expensive_compound_ingredient_ndc": "string",
- "multi_source": "string",
- "name_type_code": "string",
- "rx_otc_indicator_code": "string",
- "strength": "string",
- "strength_unit_of_measure": "string",
- "pde_record_id": "string",
- "pde_claim_control_number": "string",
- "pde_plan_benefit_package_id": "string",
- "medicare_prescription_payment_plan_claim_id": 0,
- "medicare_prescription_payment_plan_claim_amount": 0,
- "claim_gpi": "string",
- "drug_lists": null,
- "identity": "string"
}
id required | integer <int32> |
is_340b | boolean or null |
external_account_id required | string or null |
external_group_id required | string or null |
{- "id": 0,
- "is_340b": true,
- "external_account_id": "string",
- "external_group_id": "string"
}
{- "id": 0,
- "rn": "string",
- "reversal_id": 0,
- "reverses_id": 0,
- "original_claim_id": 0,
- "client_id": "string",
- "external_account_id": "string",
- "external_group_id": "string",
- "provider_agreement_id": 0,
- "coverage_strategy_id": "string",
- "date_of_service": "string",
- "claim_submission_date": "string",
- "claim_payment_cycle_end_date": "string",
- "claim_reimbursement_cycle_end_date": "string",
- "claim_status": "string",
- "claim_count": 0,
- "received_at": "string",
- "source": "string",
- "external_member_id": "string",
- "person_code": "string",
- "first_name": "string",
- "last_name": "string",
- "coverage_strategy_type": "string",
- "plan_benefit_id": 0,
- "formulary_id": 0,
- "network_id": 0,
- "benefit_network": "string",
- "gpi": "string",
- "pharmacy_nabp": "string",
- "pharmacy_name": "string",
- "pharmacy_channel": "string",
- "version_release_number": "string",
- "request_transaction_code": "string",
- "bin_number": "string",
- "processor_control_number": "string",
- "transaction_count": "string",
- "service_provider_id_qualifier": "string",
- "service_provider_id": "string",
- "software_vendor_certification_id": "string",
- "submitted_cardholder_id": "string",
- "cardholder_first_name": "string",
- "cardholder_last_name": "string",
- "plan_id": "string",
- "eligibility_clarification_code": "string",
- "group_id": "string",
- "submitted_person_code": "string",
- "patient_relationship_code": "string",
- "medigap_id": "string",
- "medicaid_indicator": "string",
- "provider_accept_assignment_indicator": "string",
- "cms_part_d_defined_qualified_facility": "string",
- "medicaid_id_number": "string",
- "patient_id_qualifier": "string",
- "patient_id": "string",
- "date_of_birth": "string",
- "patient_gender_code": "string",
- "patient_first_name": "string",
- "patient_last_name": "string",
- "patient_street_address": "string",
- "patient_street_address_line_1": "string",
- "patient_street_address_line_2": "string",
- "patient_city_address": "string",
- "patient_state_province_address": "string",
- "patient_zip_postal_code": "string",
- "patient_country_code": "string",
- "patient_telephone_number": "string",
- "place_of_service": "string",
- "employer_id": "string",
- "pregnancy_indicator": "string",
- "patient_email_address": "user@example.com",
- "patient_residence": "string",
- "prescription_service_reference_number_qualifier": "string",
- "prescription_service_reference_number": "string",
- "product_service_id_qualifier": "string",
- "ndc": "string",
- "associated_prescription_service_reference_number": "string",
- "associated_prescription_service_date": "string",
- "procedure_modifier_code_1": "string",
- "procedure_modifier_code_2": "string",
- "procedure_modifier_code_3": "string",
- "procedure_modifier_code_4": "string",
- "procedure_modifier_code_5": "string",
- "procedure_modifier_code_6": "string",
- "procedure_modifier_code_7": "string",
- "procedure_modifier_code_8": "string",
- "procedure_modifier_code_9": "string",
- "procedure_modifier_code_10": "string",
- "quantity_dispensed": "string",
- "fill_number": 0,
- "days_supply": 0,
- "compound_code": "string",
- "daw": "string",
- "date_prescription_written": "string",
- "number_of_refills_authorized": 0,
- "prescription_origin_code": "string",
- "submission_clarification_code_1": "string",
- "submission_clarification_code_2": "string",
- "submission_clarification_code_3": "string",
- "submission_clarification_code_4": "string",
- "submission_clarification_code_5": "string",
- "submission_clarification_code_pde": "string",
- "submission_type_code_1": "string",
- "submission_type_code_2": "string",
- "submission_type_code_3": "string",
- "submission_type_code_4": "string",
- "submission_type_code_5": "string",
- "quantity_prescribed": "string",
- "multiple_prescription_service_order_group_id": "string",
- "multiple_prescription_service_order_group_reason_code": "string",
- "total_prescribed_quantity_remaining": "string",
- "other_coverage_code": "string",
- "special_packaging_indicator": "string",
- "originally_prescribed_product_service_id_qualifier": "string",
- "originally_prescribed_product_service_code": "string",
- "originally_prescribed_quantity": "string",
- "scheduled_prescription_id_number": "string",
- "unit_of_measure": "string",
- "level_of_service": "string",
- "prior_authorization_type_code": "string",
- "prior_authorization_id_submitted": "string",
- "dispensing_status": "string",
- "quantity_intended_to_be_dispensed": "string",
- "days_supply_intended_to_be_dispensed": 0,
- "delay_reason_code": "string",
- "patient_assignment_indicator": "string",
- "route_of_administration": "string",
- "compound_type": "string",
- "preparation_environment_type": "string",
- "preparation_environment_event_code": "string",
- "pharmacy_service_type": "string",
- "associated_prescription_service_reference_number_qualifier": "string",
- "associated_prescription_service_fill_number": 0,
- "original_manufacturer_product_id_qualifier": "string",
- "original_manufacturer_product_id": "string",
- "ltpac_dispense_frequency": "string",
- "ltpac_billing_methodology": "string",
- "number_of_ltpac_dispensing_events": 0,
- "do_not_dispense_before_date": "string",
- "ingredient_cost_submitted": "string",
- "dispensing_fee_submitted": "string",
- "patient_pay_amount_reported": "string",
- "incentive_amount_submitted": "string",
- "other_amount_claimed_submitted_qualifier_1": "string",
- "other_amount_claimed_submitted_1": "string",
- "other_amount_claimed_submitted_qualifier_2": "string",
- "other_amount_claimed_submitted_2": "string",
- "other_amount_claimed_submitted_qualifier_3": "string",
- "other_amount_claimed_submitted_3": "string",
- "regulatory_fee_type_code_submitted_1": "string",
- "regulatory_fee_amount_submitted_1": "string",
- "regulatory_fee_type_code_submitted_2": "string",
- "regulatory_fee_amount_submitted_2": "string",
- "regulatory_fee_type_code_submitted_3": "string",
- "regulatory_fee_amount_submitted_3": "string",
- "percentage_tax_amount_submitted": "string",
- "percentage_tax_rate_submitted": "string",
- "percentage_tax_basis_submitted": "string",
- "usual_and_customary_charge": "string",
- "gross_amount_due": "string",
- "basis_of_cost_determination": "string",
- "provider_id_qualifier": "string",
- "provider_id": "string",
- "provider_first_name": "string",
- "provider_last_name": "string",
- "prescriber_id_qualifier": "string",
- "prescriber_id": "string",
- "prescriber_last_name": "string",
- "prescriber_telephone_number": "string",
- "prescriber_telephone_number_extension": "string",
- "primary_care_provider_id_qualifier": "string",
- "primary_care_provider_id": "string",
- "primary_care_provider_last_name": "string",
- "prescriber_first_name": "string",
- "prescriber_street_address": "string",
- "prescriber_street_address_line_1": "string",
- "prescriber_street_address_line_2": "string",
- "prescriber_city_address": "string",
- "prescriber_state_province_address": "string",
- "prescriber_zip_postal_code": "string",
- "prescriber_country_code": "string",
- "prescriber_dea_number": "string",
- "prescriber_place_of_service": "string",
- "compound_prices": null,
- "compound_dosage_form_description_code": "string",
- "compound_dispensing_unit_form_indicator": "string",
- "compound_ingredient_component_count": 0,
- "compound_product_id_qualifier_1": "string",
- "compound_product_id_1": "string",
- "compound_ingredient_quantity_1": "string",
- "compound_product_id_qualifier_2": "string",
- "compound_product_id_2": "string",
- "compound_ingredient_quantity_2": "string",
- "compound_product_id_qualifier_3": "string",
- "compound_product_id_3": "string",
- "compound_ingredient_quantity_3": "string",
- "compound_product_id_qualifier_4": "string",
- "compound_product_id_4": "string",
- "compound_ingredient_quantity_4": "string",
- "compound_product_id_qualifier_5": "string",
- "compound_product_id_5": "string",
- "compound_ingredient_quantity_5": "string",
- "compound_product_id_qualifier_6": "string",
- "compound_product_id_6": "string",
- "compound_ingredient_quantity_6": "string",
- "compound_product_id_qualifier_7": "string",
- "compound_product_id_7": "string",
- "compound_ingredient_quantity_7": "string",
- "compound_product_id_qualifier_8": "string",
- "compound_product_id_8": "string",
- "compound_ingredient_quantity_8": "string",
- "compound_product_id_qualifier_9": "string",
- "compound_product_id_9": "string",
- "compound_ingredient_quantity_9": "string",
- "compound_product_id_qualifier_10": "string",
- "compound_product_id_10": "string",
- "compound_ingredient_quantity_10": "string",
- "compound_product_id_qualifier_11": "string",
- "compound_product_id_11": "string",
- "compound_ingredient_quantity_11": "string",
- "compound_product_id_qualifier_12": "string",
- "compound_product_id_12": "string",
- "compound_ingredient_quantity_12": "string",
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- "other_payer_amount_paid_qualifier_4": "string",
- "other_payer_amount_paid_qualifier_5": "string",
- "other_payer_amount_paid_qualifier_6": "string",
- "other_payer_amount_paid_qualifier_7": "string",
- "other_payer_amount_paid_qualifier_8": "string",
- "other_payer_amount_paid_qualifier_9": "string",
- "other_payer_coverage_type_1": "string",
- "other_payer_coverage_type_2": "string",
- "other_payer_coverage_type_3": "string",
- "other_payer_coverage_type_4": "string",
- "other_payer_coverage_type_5": "string",
- "other_payer_coverage_type_6": "string",
- "other_payer_coverage_type_7": "string",
- "other_payer_coverage_type_8": "string",
- "other_payer_coverage_type_9": "string",
- "other_payer_id_1": "string",
- "other_payer_id_2": "string",
- "other_payer_id_3": "string",
- "other_payer_id_4": "string",
- "other_payer_id_5": "string",
- "other_payer_id_6": "string",
- "other_payer_id_7": "string",
- "other_payer_id_8": "string",
- "other_payer_id_9": "string",
- "other_payer_id_qualifier_1": "string",
- "other_payer_id_qualifier_2": "string",
- "other_payer_id_qualifier_3": "string",
- "other_payer_id_qualifier_4": "string",
- "other_payer_id_qualifier_5": "string",
- "other_payer_id_qualifier_6": "string",
- "other_payer_id_qualifier_7": "string",
- "other_payer_id_qualifier_8": "string",
- "other_payer_id_qualifier_9": "string",
- "other_payer_patient_responsibility_amount_1": "string",
- "other_payer_patient_responsibility_amount_2": "string",
- "other_payer_patient_responsibility_amount_3": "string",
- "other_payer_patient_responsibility_amount_4": "string",
- "other_payer_patient_responsibility_amount_5": "string",
- "other_payer_patient_responsibility_amount_6": "string",
- "other_payer_patient_responsibility_amount_7": "string",
- "other_payer_patient_responsibility_amount_8": "string",
- "other_payer_patient_responsibility_amount_9": "string",
- "other_payer_patient_responsibility_amount_count": 0,
- "other_payer_patient_responsibility_amount_qualifier_1": "string",
- "other_payer_patient_responsibility_amount_qualifier_2": "string",
- "other_payer_patient_responsibility_amount_qualifier_3": "string",
- "other_payer_patient_responsibility_amount_qualifier_4": "string",
- "other_payer_patient_responsibility_amount_qualifier_5": "string",
- "other_payer_patient_responsibility_amount_qualifier_6": "string",
- "other_payer_patient_responsibility_amount_qualifier_7": "string",
- "other_payer_patient_responsibility_amount_qualifier_8": "string",
- "other_payer_patient_responsibility_amount_qualifier_9": "string",
- "other_payer_reject_code_1": "string",
- "other_payer_reject_code_2": "string",
- "other_payer_reject_code_3": "string",
- "other_payer_reject_code_4": "string",
- "other_payer_reject_code_5": "string",
- "other_payer_reject_count": 0,
- "pay_amount_level_1": "string",
- "pay_amount_level_2": "string",
- "pay_amount_level_3": "string",
- "prescriber_npi": "string",
- "professional_service_code_1": "string",
- "professional_service_code_2": "string",
- "professional_service_code_3": "string",
- "professional_service_code_4": "string",
- "professional_service_code_5": "string",
- "professional_service_code_6": "string",
- "professional_service_code_7": "string",
- "professional_service_code_8": "string",
- "professional_service_code_9": "string",
- "remaining_category_deductible_1_amount": "string",
- "remaining_overall_deductible_amount": "string",
- "request_reason_for_service_code_1": "string",
- "request_reason_for_service_code_2": "string",
- "request_reason_for_service_code_3": "string",
- "request_reason_for_service_code_4": "string",
- "request_reason_for_service_code_5": "string",
- "request_reason_for_service_code_6": "string",
- "request_reason_for_service_code_7": "string",
- "request_reason_for_service_code_8": "string",
- "request_reason_for_service_code_9": "string",
- "result_of_service_code_1": "string",
- "result_of_service_code_2": "string",
- "result_of_service_code_3": "string",
- "result_of_service_code_4": "string",
- "result_of_service_code_5": "string",
- "result_of_service_code_6": "string",
- "result_of_service_code_7": "string",
- "result_of_service_code_8": "string",
- "result_of_service_code_9": "string",
- "specialty_list_dispensing_fee": "string",
- "specialty_list_id": 0,
- "specialty_list_name": "string",
- "dmr_pay_to_city_address": "string",
- "dmr_pay_to_country_code": "string",
- "dmr_pay_to_name": "string",
- "dmr_pay_to_state_province_address": "string",
- "dmr_pay_to_street_address_line_1": "string",
- "dmr_pay_to_street_address_line_2": "string",
- "dmr_pay_to_tax_id": "string",
- "dmr_pay_to_vendor_id": "string",
- "dmr_pay_to_zip_postal_code": "string",
- "tax_id_number": "string",
- "reasons_for_rejection": [
- "string"
], - "reasons_for_adjudication": [
- "string"
], - "patient_pay_reduction_due_to_point_of_service_rebate": 0,
- "plan_pay_reduction_due_to_point_of_service_rebate": 0,
- "point_of_service_rebate_amount": 0,
- "low_income_subsidy_level": "string",
- "senior_savings_model_cost_share_reduction_gap": 0,
- "senior_savings_model_cost_share_reduction_non_gap": 0,
- "senior_savings_model_indicator": "string",
- "inflation_reduction_act_subsidy_amount": 0,
- "inflation_reduction_act_covered_vaccine": "string",
- "inflation_reduction_act_covered_insulin": "string",
- "other_true_out_of_pocket_amount_indicator": "string",
- "medicare_amounts_id": 0,
- "low_income_subsidy_amounts_id": 0,
- "medicare_medicaid_dsnp_co_administered_plan": "string",
- "dsnp_fee_for_service_or_capitation": 0,
- "dsnp_medicaid_cost_share_reduction_amount_part_d": 0,
- "dsnp_medicaid_cost_share_reduction_amount_part_b": 0,
- "dsnp_medicaid_cost_share_covered_excluded_reduction_amount": 0,
- "is_340b": true,
- "medicare_administrative_claim": "string",
- "controlled_substance_code": "string",
- "desi_code": "string",
- "reprocessing_id": 0,
- "reprocessing_type": "string",
- "reprocessing_patient_pay_difference": "string",
- "reprocessing_pharmacy_pay_amount": "string",
- "reprocessing_plan_pay_amount": "string",
- "reprocessing_goes_to_835": true,
- "reprocessing_goes_to_invoice": true,
- "reprocessing_is_member_recoupment": true,
- "nx_other_payers_total_amount": "string",
- "reprocessing_nx_amount_applied_to_patient_pay": "string",
- "reprocessing_excess_nx_amount_total": "string",
- "reprocessing_patient_pay_net_nx": "string",
- "reprocessing_member_refund_amount": "string",
- "reprocessing_member_recoupment_amount": "string",
- "reprocessing_is_recoup_ltc_pharmacy": true,
- "notes": "string",
- "first_claim_id": 0,
- "next_claim_id": 0,
- "include_raw_request_parsed": true,
- "include_raw_response_parsed": true,
- "manufacturer_discount_amount": 0,
- "is_manufacturer_discount_drug": true,
- "claim_number": "string",
- "claim_sequence_number": "string",
- "medicare_prescription_payment_plan_indicator": "string",
- "medicare_prescription_payment_plan_original_claim_id": 0,
- "pharmacy_transaction_fee": 0,
- "vbid_cost_share_reduction_amount_part_d": 0,
- "vbid_model_indicator": "string",
- "pricing_level_ids": [
- 0
], - "brand_name_code": "string",
- "drug_descriptor_id": "string",
- "dosage": "string",
- "dosage_form": "string",
- "dosage_form_packaging": "string",
- "drug_name": "string",
- "drug_type": "string",
- "group_name": "string",
- "provider_phone": "string",
- "most_expensive_compound_ingredient_ndc": "string",
- "multi_source": "string",
- "name_type_code": "string",
- "rx_otc_indicator_code": "string",
- "strength": "string",
- "strength_unit_of_measure": "string",
- "pde_record_id": "string",
- "pde_claim_control_number": "string",
- "pde_plan_benefit_package_id": "string",
- "medicare_prescription_payment_plan_claim_id": 0,
- "medicare_prescription_payment_plan_claim_amount": 0,
- "claim_gpi": "string",
- "drug_lists": null,
- "identity": "string"
}
Get a Claim Reprocessing.
id required | integer <int32> |
{- "id": 0
}
{- "id": 0,
- "created_at": "string",
- "identity": "string",
- "description": "string",
- "data_source": "string",
- "bucket": "string",
- "key": "string",
- "original_name": "string",
- "data": "string",
- "type": "string",
- "kind": "string",
- "status": "string",
- "status_bucket": "string",
- "status_key": "string",
- "rn": "string",
- "reprocessing_type": "string",
- "reprocessing_kind": "string",
- "total_rows": 0,
- "rows_processed": 0,
- "display_status": "string",
- "updated_at": "string"
}
List Claim Reprocessings.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
Array of objects or null (OrderBySchema_1744676532.9998288) | |
created_at | string or null <ArrowDateTime> |
original_name | string or null |
type | string or null |
status | string or null |
id | string or null |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "order_by": [
- {
- "created_at": "string",
- "key": "string",
- "type": "string",
- "kind": "string",
- "id": "string"
}
], - "created_at": "string",
- "original_name": "string",
- "type": "string",
- "status": "string",
- "id": "string"
}
{- "results": [
- {
- "claim_reprocessing": {
- "id": 0,
- "created_at": "string",
- "identity": "string",
- "description": "string",
- "data_source": "string",
- "bucket": "string",
- "key": "string",
- "original_name": "string",
- "data": "string",
- "type": "string",
- "kind": "string",
- "status": "string",
- "status_bucket": "string",
- "status_key": "string",
- "rn": "string",
- "reprocessing_type": "string",
- "reprocessing_kind": "string",
- "total_rows": 0,
- "rows_processed": 0,
- "display_status": "string",
- "updated_at": "string"
}
}
], - "result_count": "string"
}
Reprocesses claims as a test.
id required | integer <int32> |
reprocessing_type | string |
{- "id": 0,
- "reprocessing_type": "string"
}
{- "message": "string"
}
original_name | string or null |
reprocessing_type | string |
{- "original_name": "string",
- "reprocessing_type": "string"
}
{- "id": 0,
- "created_at": "string",
- "identity": "string",
- "description": "string",
- "data_source": "string",
- "bucket": "string",
- "key": "string",
- "original_name": "string",
- "data": "string",
- "type": "string",
- "kind": "string",
- "status": "string",
- "status_bucket": "string",
- "status_key": "string",
- "rn": "string",
- "reprocessing_type": "string",
- "reprocessing_kind": "string",
- "total_rows": 0,
- "rows_processed": 0,
- "display_status": "string",
- "updated_at": "string",
- "post": {
- "url": "string",
- "fields": null
}
}
For given client_id/report_type/report_period/report_year/sheet, return presigned URL for corresponding JSON.
By using "url" key of returned JSON, user get temporary access to JSON stored on S3.
client_id required | string |
report_period required | string |
report_year required | string |
report_type required | string |
sheet required | string |
{- "client_id": "string",
- "report_period": "string",
- "report_year": "string",
- "report_type": "string",
- "sheet": "string"
}
{- "url": "string"
}
client_id required | string |
override | boolean or null |
report_period required | string |
report_year required | string |
report_type required | string |
{- "client_id": "string",
- "override": true,
- "report_period": "string",
- "report_year": "string",
- "report_type": "string"
}
{- "message": "string"
}
client_id required | string |
report_period required | string |
report_year required | string |
report_type required | string |
{- "client_id": "string",
- "report_period": "string",
- "report_year": "string",
- "report_type": "string"
}
{- "url": "string"
}
List Reportings.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
client_id required | string The client ID for desired reports |
Array of objects or null (OrderBySchema_1744676533.009218) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "client_id": "string",
- "order_by": [
- {
- "client_id": "string",
- "report_type": "string",
- "report_date": "string",
- "updated_at": "string",
- "status": "string"
}
]
}
{- "results": [
- {
- "client_utilization_report": {
- "rn": "string",
- "created_at": "string",
- "updated_at": "string",
- "client_id": "string",
- "report_type": "string",
- "report_date": "string",
- "status": "string",
- "failure_reason": "string",
- "bucket": "string",
- "key": "string"
}
}
], - "result_count": "string"
}
Get a Continuation Of Therapy.
id required | integer <int32> The internal ID of the continuation of therapy. Cannot be set during create nor subsequently changed. |
{- "id": 0
}
{- "id": 0,
- "plan_benefit_id": 0,
- "rn": "string",
- "continuation_types": [
- "string"
], - "intent": "string",
- "drug_type": "string",
- "drug_use": "string",
- "only_applies_to_categories": [
- "string"
], - "only_applies_to_tags": [
- 0
], - "does_not_apply_to_tags": [
- 0
], - "only_applies_to_carve_out": [
- "string"
], - "does_not_apply_to_carve_out": [
- "string"
], - "utilizer_type": [
- "string"
], - "use_continuation_of_therapy_effective_date": true,
- "use_new_enrollee_effective_date": true,
- "lookback_days": 0,
- "existing_utilizer_cutoff_date": "string",
- "network_types": [
- "string"
], - "duration": 0,
- "number_of_fills": 0,
- "cumulative_days_supply": 0,
- "effective_date": "string",
- "termination_date": "string",
- "continuation_of_therapy_id": 0
}
Update a Continuation Of Therapy.
id required | integer <int32> The continuation of therapy ID to update |
plan_benefit_id | integer or null <int32> The internal ID of the associated plan benefit. Should not be changed. |
rn | string or null |
continuation_types | Array of strings or null |
intent | string or null |
drug_type | string or null |
drug_use | string or null |
only_applies_to_categories | Array of strings or null |
only_applies_to_tags | Array of integers or null <int32> |
does_not_apply_to_tags | Array of integers or null <int32> |
only_applies_to_carve_out | Array of strings or null |
does_not_apply_to_carve_out | Array of strings or null |
utilizer_type | Array of strings or null |
use_continuation_of_therapy_effective_date | boolean or null |
use_new_enrollee_effective_date | boolean or null |
lookback_days | integer or null <int32> |
existing_utilizer_cutoff_date | string or null <ArrowDateTime> |
network_types | Array of strings or null |
duration | integer or null <int32> |
number_of_fills | integer or null <int32> |
cumulative_days_supply | integer or null <int32> |
effective_date | string <ArrowDateTime> |
termination_date | string <ArrowDateTime> |
continuation_of_therapy_id | integer or null <int32> |
{- "id": 0,
- "plan_benefit_id": 0,
- "rn": "string",
- "continuation_types": [
- "string"
], - "intent": "string",
- "drug_type": "string",
- "drug_use": "string",
- "only_applies_to_categories": [
- "string"
], - "only_applies_to_tags": [
- 0
], - "does_not_apply_to_tags": [
- 0
], - "only_applies_to_carve_out": [
- "string"
], - "does_not_apply_to_carve_out": [
- "string"
], - "utilizer_type": [
- "string"
], - "use_continuation_of_therapy_effective_date": true,
- "use_new_enrollee_effective_date": true,
- "lookback_days": 0,
- "existing_utilizer_cutoff_date": "string",
- "network_types": [
- "string"
], - "duration": 0,
- "number_of_fills": 0,
- "cumulative_days_supply": 0,
- "effective_date": "string",
- "termination_date": "string",
- "continuation_of_therapy_id": 0
}
{- "id": 0,
- "plan_benefit_id": 0,
- "rn": "string",
- "continuation_types": [
- "string"
], - "intent": "string",
- "drug_type": "string",
- "drug_use": "string",
- "only_applies_to_categories": [
- "string"
], - "only_applies_to_tags": [
- 0
], - "does_not_apply_to_tags": [
- 0
], - "only_applies_to_carve_out": [
- "string"
], - "does_not_apply_to_carve_out": [
- "string"
], - "utilizer_type": [
- "string"
], - "use_continuation_of_therapy_effective_date": true,
- "use_new_enrollee_effective_date": true,
- "lookback_days": 0,
- "existing_utilizer_cutoff_date": "string",
- "network_types": [
- "string"
], - "duration": 0,
- "number_of_fills": 0,
- "cumulative_days_supply": 0,
- "effective_date": "string",
- "termination_date": "string",
- "continuation_of_therapy_id": 0
}
Create a Continuation Of Therapy.
plan_benefit_id | integer or null <int32> The internal ID of the associated plan benefit. Should not be changed. |
rn | string or null |
continuation_types | Array of strings or null |
intent | string or null |
drug_type | string or null |
drug_use | string or null |
only_applies_to_categories | Array of strings or null |
only_applies_to_tags | Array of integers or null <int32> |
does_not_apply_to_tags | Array of integers or null <int32> |
only_applies_to_carve_out | Array of strings or null |
does_not_apply_to_carve_out | Array of strings or null |
utilizer_type | Array of strings or null |
use_continuation_of_therapy_effective_date | boolean or null |
use_new_enrollee_effective_date | boolean or null |
lookback_days | integer or null <int32> |
existing_utilizer_cutoff_date | string or null <ArrowDateTime> |
network_types | Array of strings or null |
duration | integer or null <int32> |
number_of_fills | integer or null <int32> |
cumulative_days_supply | integer or null <int32> |
effective_date | string <ArrowDateTime> |
termination_date | string <ArrowDateTime> |
continuation_of_therapy_id | integer or null <int32> |
{- "plan_benefit_id": 0,
- "rn": "string",
- "continuation_types": [
- "string"
], - "intent": "string",
- "drug_type": "string",
- "drug_use": "string",
- "only_applies_to_categories": [
- "string"
], - "only_applies_to_tags": [
- 0
], - "does_not_apply_to_tags": [
- 0
], - "only_applies_to_carve_out": [
- "string"
], - "does_not_apply_to_carve_out": [
- "string"
], - "utilizer_type": [
- "string"
], - "use_continuation_of_therapy_effective_date": true,
- "use_new_enrollee_effective_date": true,
- "lookback_days": 0,
- "existing_utilizer_cutoff_date": "string",
- "network_types": [
- "string"
], - "duration": 0,
- "number_of_fills": 0,
- "cumulative_days_supply": 0,
- "effective_date": "string",
- "termination_date": "string",
- "continuation_of_therapy_id": 0
}
{- "id": 0,
- "plan_benefit_id": 0,
- "rn": "string",
- "continuation_types": [
- "string"
], - "intent": "string",
- "drug_type": "string",
- "drug_use": "string",
- "only_applies_to_categories": [
- "string"
], - "only_applies_to_tags": [
- 0
], - "does_not_apply_to_tags": [
- 0
], - "only_applies_to_carve_out": [
- "string"
], - "does_not_apply_to_carve_out": [
- "string"
], - "utilizer_type": [
- "string"
], - "use_continuation_of_therapy_effective_date": true,
- "use_new_enrollee_effective_date": true,
- "lookback_days": 0,
- "existing_utilizer_cutoff_date": "string",
- "network_types": [
- "string"
], - "duration": 0,
- "number_of_fills": 0,
- "cumulative_days_supply": 0,
- "effective_date": "string",
- "termination_date": "string",
- "continuation_of_therapy_id": 0
}
List Continuation Of Therapies.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
plan_benefit_id required | integer <int32> The internal ID of the associated plan benefit. Should not be changed. |
Array of objects or null (OrderBySchema_1744676533.0174143) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "plan_benefit_id": 0,
- "order_by": [
- {
- "id": "string",
- "continuation_types": "string",
- "intent": "string",
- "termination_date": "string"
}
]
}
{- "results": [
- {
- "continuation_of_therapy": {
- "id": 0,
- "plan_benefit_id": 0,
- "rn": "string",
- "continuation_types": [
- "string"
], - "intent": "string",
- "drug_type": "string",
- "drug_use": "string",
- "only_applies_to_categories": [
- "string"
], - "only_applies_to_tags": [
- 0
], - "does_not_apply_to_tags": [
- 0
], - "only_applies_to_carve_out": [
- "string"
], - "does_not_apply_to_carve_out": [
- "string"
], - "utilizer_type": [
- "string"
], - "use_continuation_of_therapy_effective_date": true,
- "use_new_enrollee_effective_date": true,
- "lookback_days": 0,
- "existing_utilizer_cutoff_date": "string",
- "network_types": [
- "string"
], - "duration": 0,
- "number_of_fills": 0,
- "cumulative_days_supply": 0,
- "effective_date": "string",
- "termination_date": "string",
- "continuation_of_therapy_id": 0
}
}
], - "result_count": "string"
}
Get a Continuation Of Therapy Draft.
id required | integer <int32> The ID of the group that was just updated. |
{- "id": 0
}
{- "id": 0,
- "plan_benefit_id": 0,
- "rn": "string",
- "continuation_types": [
- "string"
], - "intent": "string",
- "drug_type": "string",
- "drug_use": "string",
- "only_applies_to_categories": [
- "string"
], - "only_applies_to_tags": [
- 0
], - "does_not_apply_to_tags": [
- 0
], - "only_applies_to_carve_out": [
- "string"
], - "does_not_apply_to_carve_out": [
- "string"
], - "utilizer_type": [
- "string"
], - "use_continuation_of_therapy_effective_date": true,
- "use_new_enrollee_effective_date": true,
- "lookback_days": 0,
- "existing_utilizer_cutoff_date": "string",
- "network_types": [
- "string"
], - "duration": 0,
- "number_of_fills": 0,
- "cumulative_days_supply": 0,
- "effective_date": "string",
- "termination_date": "string",
- "continuation_of_therapy_id": 0
}
Update a Continuation Of Therapy Draft.
id required | integer <int32> The ID of the group that was just updated. |
plan_benefit_id | integer or null <int32> The internal ID of the associated plan benefit. Should not be changed. |
rn | string or null |
continuation_types | Array of strings or null |
intent | string or null |
drug_type | string or null |
drug_use | string or null |
only_applies_to_categories | Array of strings or null |
only_applies_to_tags | Array of integers or null <int32> |
does_not_apply_to_tags | Array of integers or null <int32> |
only_applies_to_carve_out | Array of strings or null |
does_not_apply_to_carve_out | Array of strings or null |
utilizer_type | Array of strings or null |
use_continuation_of_therapy_effective_date | boolean or null |
use_new_enrollee_effective_date | boolean or null |
lookback_days | integer or null <int32> |
existing_utilizer_cutoff_date | string or null <ArrowDateTime> |
network_types | Array of strings or null |
duration | integer or null <int32> |
number_of_fills | integer or null <int32> |
cumulative_days_supply | integer or null <int32> |
effective_date | string <ArrowDateTime> |
termination_date | string <ArrowDateTime> |
continuation_of_therapy_id | integer or null <int32> |
{- "id": 0,
- "plan_benefit_id": 0,
- "rn": "string",
- "continuation_types": [
- "string"
], - "intent": "string",
- "drug_type": "string",
- "drug_use": "string",
- "only_applies_to_categories": [
- "string"
], - "only_applies_to_tags": [
- 0
], - "does_not_apply_to_tags": [
- 0
], - "only_applies_to_carve_out": [
- "string"
], - "does_not_apply_to_carve_out": [
- "string"
], - "utilizer_type": [
- "string"
], - "use_continuation_of_therapy_effective_date": true,
- "use_new_enrollee_effective_date": true,
- "lookback_days": 0,
- "existing_utilizer_cutoff_date": "string",
- "network_types": [
- "string"
], - "duration": 0,
- "number_of_fills": 0,
- "cumulative_days_supply": 0,
- "effective_date": "string",
- "termination_date": "string",
- "continuation_of_therapy_id": 0
}
{- "id": 0,
- "plan_benefit_id": 0,
- "rn": "string",
- "continuation_types": [
- "string"
], - "intent": "string",
- "drug_type": "string",
- "drug_use": "string",
- "only_applies_to_categories": [
- "string"
], - "only_applies_to_tags": [
- 0
], - "does_not_apply_to_tags": [
- 0
], - "only_applies_to_carve_out": [
- "string"
], - "does_not_apply_to_carve_out": [
- "string"
], - "utilizer_type": [
- "string"
], - "use_continuation_of_therapy_effective_date": true,
- "use_new_enrollee_effective_date": true,
- "lookback_days": 0,
- "existing_utilizer_cutoff_date": "string",
- "network_types": [
- "string"
], - "duration": 0,
- "number_of_fills": 0,
- "cumulative_days_supply": 0,
- "effective_date": "string",
- "termination_date": "string",
- "continuation_of_therapy_id": 0
}
Create a Continuation Of Therapy Draft.
plan_benefit_id | integer or null <int32> The internal ID of the associated plan benefit. Should not be changed. |
rn | string or null |
continuation_types | Array of strings or null |
intent | string or null |
drug_type | string or null |
drug_use | string or null |
only_applies_to_categories | Array of strings or null |
only_applies_to_tags | Array of integers or null <int32> |
does_not_apply_to_tags | Array of integers or null <int32> |
only_applies_to_carve_out | Array of strings or null |
does_not_apply_to_carve_out | Array of strings or null |
utilizer_type | Array of strings or null |
use_continuation_of_therapy_effective_date | boolean or null |
use_new_enrollee_effective_date | boolean or null |
lookback_days | integer or null <int32> |
existing_utilizer_cutoff_date | string or null <ArrowDateTime> |
network_types | Array of strings or null |
duration | integer or null <int32> |
number_of_fills | integer or null <int32> |
cumulative_days_supply | integer or null <int32> |
effective_date | string <ArrowDateTime> |
termination_date | string <ArrowDateTime> |
continuation_of_therapy_id | integer or null <int32> |
{- "plan_benefit_id": 0,
- "rn": "string",
- "continuation_types": [
- "string"
], - "intent": "string",
- "drug_type": "string",
- "drug_use": "string",
- "only_applies_to_categories": [
- "string"
], - "only_applies_to_tags": [
- 0
], - "does_not_apply_to_tags": [
- 0
], - "only_applies_to_carve_out": [
- "string"
], - "does_not_apply_to_carve_out": [
- "string"
], - "utilizer_type": [
- "string"
], - "use_continuation_of_therapy_effective_date": true,
- "use_new_enrollee_effective_date": true,
- "lookback_days": 0,
- "existing_utilizer_cutoff_date": "string",
- "network_types": [
- "string"
], - "duration": 0,
- "number_of_fills": 0,
- "cumulative_days_supply": 0,
- "effective_date": "string",
- "termination_date": "string",
- "continuation_of_therapy_id": 0
}
{- "id": 0,
- "plan_benefit_id": 0,
- "rn": "string",
- "continuation_types": [
- "string"
], - "intent": "string",
- "drug_type": "string",
- "drug_use": "string",
- "only_applies_to_categories": [
- "string"
], - "only_applies_to_tags": [
- 0
], - "does_not_apply_to_tags": [
- 0
], - "only_applies_to_carve_out": [
- "string"
], - "does_not_apply_to_carve_out": [
- "string"
], - "utilizer_type": [
- "string"
], - "use_continuation_of_therapy_effective_date": true,
- "use_new_enrollee_effective_date": true,
- "lookback_days": 0,
- "existing_utilizer_cutoff_date": "string",
- "network_types": [
- "string"
], - "duration": 0,
- "number_of_fills": 0,
- "cumulative_days_supply": 0,
- "effective_date": "string",
- "termination_date": "string",
- "continuation_of_therapy_id": 0
}
List Continuation Of Therapy Drafts.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
plan_benefit_id required | integer <int32> The internal ID of the associated plan benefit. Should not be changed. |
Array of objects or null (OrderBySchema_1744676533.0174143) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "plan_benefit_id": 0,
- "order_by": [
- {
- "id": "string",
- "continuation_types": "string",
- "intent": "string",
- "termination_date": "string"
}
]
}
{- "results": [
- {
- "continuation_of_therapy": {
- "id": 0,
- "plan_benefit_id": 0,
- "rn": "string",
- "continuation_types": [
- "string"
], - "intent": "string",
- "drug_type": "string",
- "drug_use": "string",
- "only_applies_to_categories": [
- "string"
], - "only_applies_to_tags": [
- 0
], - "does_not_apply_to_tags": [
- 0
], - "only_applies_to_carve_out": [
- "string"
], - "does_not_apply_to_carve_out": [
- "string"
], - "utilizer_type": [
- "string"
], - "use_continuation_of_therapy_effective_date": true,
- "use_new_enrollee_effective_date": true,
- "lookback_days": 0,
- "existing_utilizer_cutoff_date": "string",
- "network_types": [
- "string"
], - "duration": 0,
- "number_of_fills": 0,
- "cumulative_days_supply": 0,
- "effective_date": "string",
- "termination_date": "string",
- "continuation_of_therapy_id": 0
}
}
], - "result_count": "string"
}
Create a Data Report.
rn | string or null |
module_name required | string |
consumes required | string |
output_bucket required | string |
output_key required | string |
description | string or null |
exchange_type | string or null |
plan_ids required | Array of numbers or null |
plan_filters | any or null |
cron_schedule | string or null |
sftp_delivery_target_id required | integer or null <int32> |
ftps_delivery_target_id required | integer or null <int32> |
email_delivery_target_id required | integer or null <int32> |
s3_delivery_target_id required | integer or null <int32> |
effective_date | string or null <ArrowDateTime> |
termination_date | string or null <ArrowDateTime> |
min_data_date | string or null <ArrowDateTime> |
max_data_date | string or null <ArrowDateTime> |
allow_consumption | boolean |
allow_delivery | boolean |
override_output_key | boolean |
inclusive_start_date | string or null <ArrowDateTime> |
exclusive_end_date | string or null <ArrowDateTime> |
config | any or null |
claims_file | file xlsx file upload containing claim_id column. |
status | string or null |
{- "rn": "string",
- "module_name": "string",
- "consumes": "string",
- "output_bucket": "string",
- "output_key": "string",
- "description": "string",
- "exchange_type": "string",
- "plan_ids": [
- 0
], - "plan_filters": null,
- "cron_schedule": "string",
- "sftp_delivery_target_id": 0,
- "ftps_delivery_target_id": 0,
- "email_delivery_target_id": 0,
- "s3_delivery_target_id": 0,
- "effective_date": "string",
- "termination_date": "string",
- "min_data_date": "string",
- "max_data_date": "string",
- "allow_consumption": true,
- "allow_delivery": true,
- "override_output_key": true,
- "inclusive_start_date": "string",
- "exclusive_end_date": "string",
- "config": null,
- "claims_file": null,
- "status": "string"
}
{- "id": 0,
- "rn": "string",
- "module_name": "string",
- "consumes": "string",
- "output_bucket": "string",
- "output_key": "string",
- "description": "string",
- "exchange_type": "string",
- "plan_ids": [
- 0
], - "plan_filters": null,
- "cron_schedule": "string",
- "sftp_delivery_target_id": 0,
- "ftps_delivery_target_id": 0,
- "email_delivery_target_id": 0,
- "s3_delivery_target_id": 0,
- "effective_date": "string",
- "termination_date": "string",
- "min_data_date": "string",
- "max_data_date": "string",
- "allow_consumption": true,
- "allow_delivery": true,
- "override_output_key": true,
- "inclusive_start_date": "string",
- "exclusive_end_date": "string",
- "config": null,
- "claims_file": null,
- "status": "string"
}
Get a Data Report.
id | integer <int32> |
{- "id": 0
}
{- "id": 0,
- "rn": "string",
- "module_name": "string",
- "consumes": "string",
- "output_bucket": "string",
- "output_key": "string",
- "description": "string",
- "exchange_type": "string",
- "plan_ids": [
- 0
], - "plan_filters": null,
- "cron_schedule": "string",
- "sftp_delivery_target_id": 0,
- "ftps_delivery_target_id": 0,
- "email_delivery_target_id": 0,
- "s3_delivery_target_id": 0,
- "effective_date": "string",
- "termination_date": "string",
- "min_data_date": "string",
- "max_data_date": "string",
- "allow_consumption": true,
- "allow_delivery": true,
- "override_output_key": true,
- "inclusive_start_date": "string",
- "exclusive_end_date": "string",
- "config": null,
- "claims_file": null,
- "status": "string"
}
List Data Reports.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer or null <int32> |
client_ids | Array of strings or null or null |
module_name | string or null |
description | string or null |
config | any |
has_delivery_target | boolean |
has_cron_schedule | boolean |
output_key | string or null |
exchange_type | string |
effective_date | string or null <ArrowDateTime> |
termination_date | string or null <ArrowDateTime> |
status | string Enum: "active" "inactive" |
full_text_search | string or null |
Array of objects or null (OrderBySchema_1744676533.0319076) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "client_ids": [
- "string"
], - "module_name": "string",
- "description": "string",
- "config": null,
- "has_delivery_target": true,
- "has_cron_schedule": true,
- "output_key": "string",
- "exchange_type": "string",
- "effective_date": "string",
- "termination_date": "string",
- "status": "active",
- "full_text_search": "string",
- "order_by": [
- {
- "id": "string",
- "module_name": "string",
- "output_key": "string",
- "description": "string",
- "plan_ids": "string",
- "effective_date": "string",
- "termination_date": "string",
- "exchange_type": "string"
}
]
}
{- "results": [
- {
- "data_report": {
- "id": 0,
- "rn": "string",
- "module_name": "string",
- "consumes": "string",
- "output_bucket": "string",
- "output_key": "string",
- "description": "string",
- "exchange_type": "string",
- "plan_ids": [
- 0
], - "plan_filters": null,
- "cron_schedule": "string",
- "sftp_delivery_target_id": 0,
- "ftps_delivery_target_id": 0,
- "email_delivery_target_id": 0,
- "s3_delivery_target_id": 0,
- "effective_date": "string",
- "termination_date": "string",
- "min_data_date": "string",
- "max_data_date": "string",
- "allow_consumption": true,
- "allow_delivery": true,
- "override_output_key": true,
- "inclusive_start_date": "string",
- "exclusive_end_date": "string",
- "config": null,
- "claims_file": null,
- "status": "string"
}
}
], - "result_count": "string"
}
id required | integer <int32> |
allow_consumption required | boolean |
allow_delivery required | boolean |
override_output_key required | boolean |
output_key | string |
inclusive_start_date | string or null <ArrowDateTime> |
exclusive_end_date | string or null <ArrowDateTime> |
claims_file | file xlsx file upload containing claim_id column. |
{- "id": 0,
- "allow_consumption": true,
- "allow_delivery": true,
- "override_output_key": true,
- "output_key": "string",
- "inclusive_start_date": "string",
- "exclusive_end_date": "string",
- "claims_file": null
}
{- "report_execution_id": 0,
- "message": "string"
}
Update a Data Report.
id | integer <int32> |
rn | string or null |
module_name | string |
consumes | string |
output_bucket | string |
output_key | string |
description | string or null |
exchange_type | string or null |
plan_ids | Array of numbers or null |
plan_filters | any or null |
cron_schedule | string or null |
sftp_delivery_target_id | integer or null <int32> |
ftps_delivery_target_id | integer or null <int32> |
email_delivery_target_id | integer or null <int32> |
s3_delivery_target_id | integer or null <int32> |
effective_date | string or null <ArrowDateTime> |
termination_date | string or null <ArrowDateTime> |
min_data_date | string or null <ArrowDateTime> |
max_data_date | string or null <ArrowDateTime> |
allow_consumption | boolean |
allow_delivery | boolean |
override_output_key | boolean |
inclusive_start_date | string or null <ArrowDateTime> |
exclusive_end_date | string or null <ArrowDateTime> |
config | any or null |
claims_file | file xlsx file upload containing claim_id column. |
status | string or null |
{- "id": 0,
- "rn": "string",
- "module_name": "string",
- "consumes": "string",
- "output_bucket": "string",
- "output_key": "string",
- "description": "string",
- "exchange_type": "string",
- "plan_ids": [
- 0
], - "plan_filters": null,
- "cron_schedule": "string",
- "sftp_delivery_target_id": 0,
- "ftps_delivery_target_id": 0,
- "email_delivery_target_id": 0,
- "s3_delivery_target_id": 0,
- "effective_date": "string",
- "termination_date": "string",
- "min_data_date": "string",
- "max_data_date": "string",
- "allow_consumption": true,
- "allow_delivery": true,
- "override_output_key": true,
- "inclusive_start_date": "string",
- "exclusive_end_date": "string",
- "config": null,
- "claims_file": null,
- "status": "string"
}
{- "id": 0,
- "rn": "string",
- "module_name": "string",
- "consumes": "string",
- "output_bucket": "string",
- "output_key": "string",
- "description": "string",
- "exchange_type": "string",
- "plan_ids": [
- 0
], - "plan_filters": null,
- "cron_schedule": "string",
- "sftp_delivery_target_id": 0,
- "ftps_delivery_target_id": 0,
- "email_delivery_target_id": 0,
- "s3_delivery_target_id": 0,
- "effective_date": "string",
- "termination_date": "string",
- "min_data_date": "string",
- "max_data_date": "string",
- "allow_consumption": true,
- "allow_delivery": true,
- "override_output_key": true,
- "inclusive_start_date": "string",
- "exclusive_end_date": "string",
- "config": null,
- "claims_file": null,
- "status": "string"
}
List Data Report Consumed Dates.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
data_report_id required | integer <int32> |
Array of objects (OrderBySchema_1744676533.0383189) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "data_report_id": 0,
- "order_by": [
- {
- "data_report_id": "string",
- "end_date": "string",
- "start_date": "string",
- "created_at": "string"
}
]
}
{- "results": [
- {
- "data_report_consumed_dates": {
- "data_report_id": 0,
- "start_date": "string",
- "end_date": "string",
- "created_at": "string"
}
}
], - "result_count": "string"
}
List Data Report Consumed Id Sequences.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
data_report_id required | integer <int32> |
Array of objects (OrderBySchema_1744676533.041721) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "data_report_id": 0,
- "order_by": [
- {
- "data_report_id": "string",
- "minimum_id": "string",
- "maximum_id": "string",
- "created_at": "string"
}
]
}
{- "results": [
- {
- "data_report_consumed_id_sequence": {
- "data_report_id": 0,
- "minimum_id": 0,
- "maximum_id": 0,
- "created_at": "string"
}
}
], - "result_count": "string"
}
Get a Data Report Execution.
id | integer <int32> |
{- "id": 0
}
{- "id": 0,
- "rn": "string",
- "data_report_id": 0,
- "client_id": "string",
- "output_key": "string",
- "created_at": "string",
- "updated_at": "string",
- "report_started_at": "string",
- "report_ended_at": "string",
- "status": "string",
- "message": "string",
- "error_message": "string",
- "event": null,
- "config": null,
- "report_consumes": "string",
- "min_consumed_id": 0,
- "max_consumed_id": 0,
- "min_consumed_date": "string",
- "max_consumed_date": "string",
- "raw_sql": "string",
- "total_seconds_runtime": 0,
- "total_rows_count": 0,
- "total_files_uploaded": 0,
- "output_files": null,
- "type": "manual",
- "created_by": "string",
- "review_status": "in_review",
- "review_message": "string",
- "reviewed_by": "string",
- "reviewed_at": "string"
}
List Data Report Executions.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer <int32> |
data_report_id | integer <int32> |
exchange_type | string |
config | any |
has_delivery_target | boolean |
has_cron_schedule | boolean |
created_at | string <ArrowDateTime> |
updated_at | string <ArrowDateTime> |
data_report_output_key | string |
status | string |
review_status | string Enum: "in_review" "resolved" "open" |
type | string Enum: "manual" "scheduled" |
plan_ids | Array of integers or null <int32> |
Array of objects or null (DataReportExecutionOrderBySchema_1744676533.0471015) | |
created_by | string or null |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "data_report_id": 0,
- "exchange_type": "string",
- "config": null,
- "has_delivery_target": true,
- "has_cron_schedule": true,
- "created_at": "string",
- "updated_at": "string",
- "data_report_output_key": "string",
- "status": "string",
- "review_status": "in_review",
- "type": "manual",
- "plan_ids": [
- 0
], - "order_by": [
- {
- "id": "string",
- "data_report_id": "string",
- "created_at": "string",
- "updated_at": "string",
- "output_key": "string",
- "status": "string",
- "type": "string"
}
], - "created_by": "string"
}
{- "results": [
- {
- "data_report_execution": {
- "id": 0,
- "rn": "string",
- "data_report_id": 0,
- "output_key": "string",
- "module_name": "string",
- "description": "string",
- "created_at": "string",
- "updated_at": "string",
- "report_started_at": "string",
- "report_ended_at": "string",
- "status": "string",
- "review_status": "in_review",
- "report_consumes": "string",
- "total_seconds_runtime": 0,
- "total_rows_count": 0,
- "total_files_uploaded": 0,
- "type": "manual",
- "created_by": "string"
}
}
], - "result_count": "string"
}
Update a Data Report Execution.
id required | integer <int32> |
review_status | string Enum: "in_review" "resolved" "open" |
review_message | string or null |
{- "id": 0,
- "review_status": "in_review",
- "review_message": "string"
}
{- "id": 0,
- "rn": "string",
- "data_report_id": 0,
- "client_id": "string",
- "output_key": "string",
- "created_at": "string",
- "updated_at": "string",
- "report_started_at": "string",
- "report_ended_at": "string",
- "status": "string",
- "message": "string",
- "error_message": "string",
- "event": null,
- "config": null,
- "report_consumes": "string",
- "min_consumed_id": 0,
- "max_consumed_id": 0,
- "min_consumed_date": "string",
- "max_consumed_date": "string",
- "raw_sql": "string",
- "total_seconds_runtime": 0,
- "total_rows_count": 0,
- "total_files_uploaded": 0,
- "output_files": null,
- "type": "manual",
- "created_by": "string",
- "review_status": "in_review",
- "review_message": "string",
- "reviewed_by": "string",
- "reviewed_at": "string"
}
data_report_execution_id required | integer <int32> |
bucket required | string |
key required | string |
{- "data_report_execution_id": 0,
- "bucket": "string",
- "key": "string"
}
{- "url": "string"
}
Get a Data Report Module.
id | integer or null <int32> |
name | string or null |
{- "id": 0,
- "name": "string"
}
{- "id": 0,
- "name": "string",
- "description": "string",
- "consumes": "dates",
- "supported_options": [
- "string"
], - "supported_attributes": null,
- "supported_fields": null,
- "supported_functions": null,
- "supported_report_info": null,
- "supported_operators": null
}
List Data Report Modules.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer or null <int32> |
name | string or null |
description | string or null |
consumes | string or null Enum: "dates" "ids" |
supported_options | Array of strings or null |
Array of objects or null (OrderBySchema_1744676533.0540586) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "name": "string",
- "description": "string",
- "consumes": "dates",
- "supported_options": [
- "string"
], - "order_by": [
- {
- "id": 0,
- "name": "string",
- "description": "string",
- "consumes": "string",
- "status": "dates"
}
]
}
{- "results": [
- {
- "data_report_module": {
- "id": 0,
- "name": "string",
- "description": "string",
- "consumes": "dates",
- "supported_options": [
- "string"
], - "supported_attributes": null,
- "supported_fields": null,
- "supported_functions": null,
- "supported_report_info": null,
- "supported_operators": null
}
}
], - "result_count": 0
}
rn | string or null |
source_bucket required | string S3 bucket containing file to be delivered. Sample: sftp-cap-rx-com |
source_key required | string S3 key for file to be delivered. Sample: vendor/outbound/some_file.txt |
protocol required | string Enum: "email" "ftps" "sftp" "s3" |
target_id required | integer <int32> ID of target to send file. This field is used together with protocol to find proper delivery target |
encrypted required | boolean True if file already encrypted to ignore target settings. Otherwise False to encrypt or not based on target configuration |
{- "rn": "string",
- "source_bucket": "string",
- "source_key": "string",
- "protocol": "email",
- "target_id": 0,
- "encrypted": true
}
{- "message": "string"
}
ndc required | string |
service_provider_id required | string |
days_supply required | number |
quantity_dispensed required | number |
group_number | string or null |
{- "ndc": "string",
- "service_provider_id": "string",
- "days_supply": 0,
- "quantity_dispensed": 0,
- "group_number": "string"
}
{- "patient_pay_amount": 0
}
gender required | string Enum: "M" "F" Must be 'M' or 'F' |
first_name required | string |
last_name required | string |
date_of_birth required | string <ArrowDateTime> |
external_member_id | string or null |
group_number | string or null |
{- "gender": "M",
- "first_name": "string",
- "last_name": "string",
- "date_of_birth": "string",
- "external_member_id": "string",
- "group_number": "string"
}
{- "member": {
- "id": 0,
- "rn": "string",
- "external_member_id": "string",
- "client_id": "string",
- "person_code": "string",
- "group_id": 0,
- "test_member": false,
- "created_at": "string",
- "updated_at": "string",
- "start_date": "string",
- "end_date": "string",
- "relationship_code": "string",
- "sex": "string",
- "effective_date": "string",
- "termination_date": "string",
- "first_name": "string",
- "last_name": "string",
- "address_line_1": "string",
- "address_line_2": "string",
- "address_line_3": "string",
- "city": "string",
- "state": "string",
- "zip_code": "string",
- "country": "string",
- "location": "string",
- "birth_date": "string",
- "death_date": "string",
- "multiple_birth_code": 0,
- "phone_number": "string",
- "social_security_number": "string",
- "ppo_name": "string",
- "coverage_type": "string",
- "language_code": "string",
- "email": "string",
- "coverage_status": "string",
- "handicap_indicator": "string",
- "miscellaneous_id": "string",
- "is_allocated": true,
- "identity": "string",
- "medicare_indicator": "string",
- "medicare_beneficiary_identifier": "string",
- "low_income_subsidy_level": "string",
- "low_income_subsidy_level_effective_date": "string",
- "low_income_subsidy_level_termination_date": "string",
- "hospice_flag": "string",
- "hospice_flag_effective_date": "string",
- "hospice_flag_termination_date": "string",
- "end_stage_renal_disease_flag": "string",
- "end_stage_renal_disease_flag_effective_date": "string",
- "end_stage_renal_disease_flag_termination_date": "string",
- "transplant_patient_flag": "string",
- "transplant_patient_flag_effective_date": "string",
- "transplant_patient_flag_termination_date": "string",
- "cancer_flag": "string",
- "cancer_flag_effective_date": "string",
- "cancer_flag_termination_date": "string",
- "beneficiary_identifier": "string",
- "action_type": "string",
- "other_payer_member_identification_number": "string",
- "other_payer_group_number": "string",
- "other_payer_bin_number": "string",
- "other_payer_processor_control_number": "string",
- "other_payer_effective_date": "string",
- "other_payer_termination_date": "string",
- "new_enrollee_effective_date": "string",
- "udf_1": "string",
- "udf_1_name": "string",
- "udf_2": "string",
- "udf_2_name": "string",
- "udf_3": "string",
- "udf_3_name": "string",
- "udf_4": "string",
- "udf_4_name": "string",
- "udf_5": "string",
- "udf_5_name": "string",
- "udf_6": "string",
- "udf_6_name": "string",
- "udf_7": "string",
- "udf_7_name": "string",
- "udf_8": "string",
- "udf_8_name": "string",
- "udf_9": "string",
- "udf_9_name": "string",
- "udf_10": "string",
- "udf_10_name": "string",
- "udf_11": "string",
- "udf_11_name": "string",
- "udf_12": "string",
- "udf_12_name": "string",
- "udf_13": "string",
- "udf_13_name": "string",
- "udf_14": "string",
- "udf_14_name": "string",
- "udf_15": "string",
- "udf_15_name": "string",
- "file_lock_start_date": "string",
- "file_lock_end_date": "string",
- "legal_representative_first_name": "string",
- "legal_representative_last_name": "string",
- "legal_representative_address_line_1": "string",
- "legal_representative_address_line_2": "string",
- "legal_representative_city": "string",
- "legal_representative_state": "string",
- "legal_representative_zip_code": "string",
- "legal_representative_country": "string",
- "large_print": true,
- "spans": [
- { }
], - "protected_member_address": "string",
- "phone_number_qualifier": "string",
- "written_language": "string",
- "verbal_language": "string",
- "alternate_written_communication_mode": "string",
- "disenrollment_reason": "string",
- "line_of_business": "string",
- "program": "string",
- "service_area_state": "string",
- "service_area_county": "string",
- "marketplace_metal_level": "string",
- "hios_id_naic": "string",
- "medicaid_id": "string",
- "encounter_member_id": "string",
- "encounter_member_id_qualifier": "string",
- "medicaid_dual_status_code": "string",
- "medicaid_dual_status_code_effective_date": "string",
- "medicaid_dual_status_code_termination_date": "string",
- "is_medical_member": true,
- "medical_group_id": "string"
}, - "plan": {
- "id": 0,
- "rn": "string",
- "name": "string",
- "client_id": "string",
- "bin_number": "string",
- "processor_control_number": "string",
- "claim_payment_cycle": "semi_monthly",
- "address_line_1": "string",
- "address_line_2": "string",
- "city": "string",
- "state": "string",
- "zip_code": "string",
- "group_number": "string",
- "effective_date": "string",
- "created_at": "string",
- "updated_at": "string",
- "status": "string",
- "groups_status": "string",
- "eligibility_status": "string",
- "member_documents_status": "string",
- "absence_method": "do_nothing",
- "absence_boundary": "plan",
- "absence_method_terminate_date_option": "file_date",
- "absence_method_group": "do_nothing",
- "absence_method_group_terminate_date_option": "file_date",
- "eligibility_reject_failure_threshold": 0,
- "eligibility_change_failure_threshold": 0,
- "accumulation_load_failure_threshold": 0,
- "external_member_id_format": "string",
- "person_code_length": 0,
- "customer_service_phone_number": "string",
- "help_desk_phone": "string",
- "plan_additional_covered_type": "string",
- "plan_additional_covered_standard_deductible": "string",
- "plan_additional_covered_standard_plan_max": "string",
- "plan_additional_covered_standard_category_plan_max": "string",
- "plan_additional_covered_percentage_amount": 0,
- "plan_additional_covered_dollar_amount": 0,
- "pricing_status": "string",
- "pharmacy_service_fee_enabled": true,
- "strategic_partner_fee": 0,
- "plan_type": "string",
- "has_automatic_enrollment": true,
- "automatic_enrollment_type": "string",
- "routing_configuration": "string",
- "print_system": "string",
- "custom_accumulation_types": null,
- "is_address_required": true,
- "termination_date": "string",
- "external_member_id_pattern": "string",
- "external_member_id_length": 0,
- "bin_number_medicare_prescription_payment_plan": "string",
- "processor_control_number_medicare_prescription_payment_plan": "string",
- "group_number_medicare_prescription_payment_plan": "string",
- "medicare_prescription_payment_plan_allowed_payment_methods": "string",
- "medicare_prescription_payment_plan_invoice_print_window": "string",
- "payment_vendor_account_id": "string"
}
}
id | integer <int32> |
rn | string or null <SanitizedString> |
documents required | Array of integers <int32> [ items <int32 > ] |
coverage_strategy_id | string or null <SanitizedString> |
plan_id | integer or null <int32> |
destination | string Enum: "member_portal" "enrollment" |
order | integer <int32> |
{- "id": 0,
- "rn": "string",
- "documents": [
- 0
], - "coverage_strategy_id": "string",
- "plan_id": 0,
- "destination": "member_portal",
- "order": 0
}
{- "message": "string"
}
Create a Document.
id | integer <int32> |
rn | string or null <SanitizedString> |
file_name required | string <SanitizedString> |
name required | string <SanitizedString> |
description required | string <SanitizedString> |
created_at | string or null <SanitizedString> |
updated_at | string or null <SanitizedString> |
bucket | string <SanitizedString> |
prefix | string <SanitizedString> |
key | string <SanitizedString> |
object or null | |
destination | string or null |
order | integer <int32> |
{- "id": 0,
- "rn": "string",
- "file_name": "string",
- "name": "string",
- "description": "string",
- "created_at": "string",
- "updated_at": "string",
- "bucket": "string",
- "prefix": "string",
- "key": "string",
- "post": {
- "url": "string",
- "fields": null
}, - "destination": "string",
- "order": 0
}
{- "id": 0,
- "rn": "string",
- "file_name": "string",
- "name": "string",
- "description": "string",
- "created_at": "string",
- "updated_at": "string",
- "bucket": "string",
- "prefix": "string",
- "key": "string",
- "post": {
- "url": "string",
- "fields": null
}, - "destination": "string",
- "order": 0
}
id | integer <int32> |
rn | string or null <SanitizedString> |
documents required | Array of integers <int32> [ items <int32 > ] |
coverage_strategy_id | string or null <SanitizedString> |
plan_id | integer or null <int32> |
destination | string Enum: "member_portal" "enrollment" |
order | integer <int32> |
{- "id": 0,
- "rn": "string",
- "documents": [
- 0
], - "coverage_strategy_id": "string",
- "plan_id": 0,
- "destination": "member_portal",
- "order": 0
}
{- "message": "string"
}
List Documents.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The number of results per page. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer <int32> |
plan_id | integer or null <int32> |
coverage_strategy_id | string or null <SanitizedString> |
client_id | string or null <SanitizedString> |
destination | string or null Enum: "member_portal" "enrollment" |
Array of objects or null (OrderBySchema_1744676533.0705843) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "plan_id": 0,
- "coverage_strategy_id": "string",
- "client_id": "string",
- "destination": "member_portal",
- "order_by": [
- {
- "file_name": "string",
- "name": "string",
- "destination": "string",
- "created_at": "string",
- "updated_at": "string"
}
]
}
{- "results": [
- {
- "document": {
- "id": 0,
- "rn": "string",
- "file_name": "string",
- "name": "string",
- "description": "string",
- "created_at": "string",
- "updated_at": "string",
- "bucket": "string",
- "prefix": "string",
- "key": "string",
- "post": {
- "url": "string",
- "fields": null
}, - "destination": "string",
- "order": 0
}
}
], - "result_count": "string"
}
Update a Document.
id required | integer <int32> |
name | string <SanitizedString> |
description | string <SanitizedString> |
file_name | string <SanitizedString> |
{- "id": 0,
- "name": "string",
- "description": "string",
- "file_name": "string"
}
{- "id": 0,
- "rn": "string",
- "file_name": "string",
- "name": "string",
- "description": "string",
- "created_at": "string",
- "updated_at": "string",
- "bucket": "string",
- "prefix": "string",
- "key": "string",
- "post": {
- "url": "string",
- "fields": null
}, - "destination": "string",
- "order": 0
}
id required | integer <int32> |
user_target | string or null Enum: "download" "view" The desired end user action |
{- "id": 0,
- "user_target": "download"
}
{- "url": "string"
}
{- "id": 0
}
{- "id": 0,
- "rn": "string",
- "file_name": "string",
- "name": "string",
- "description": "string",
- "created_at": "string",
- "updated_at": "string",
- "bucket": "string",
- "prefix": "string",
- "key": "string",
- "post": {
- "url": "string",
- "fields": null
}, - "destination": "string",
- "order": 0
}
document_id required | integer <int32> |
plan_id required | integer <int32> |
destination required | string Enum: "enrollment" "member_portal" |
new_order required | integer <int32> |
{- "document_id": 0,
- "plan_id": 0,
- "destination": "enrollment",
- "new_order": 0
}
{ }
coverage_strategy_id required | string or null Final plan benefit code |
date_of_service required | string or null <ArrowDateTime> Date of service |
client_id | string or null The client ID is an external-facing identifier used on eligibility feeds and other information to tie the data to this specific plan. |
drug_descriptor_id | string or null The Drug Descriptor Identifier from Medi-Span |
ndc | string or null NDC of the product |
benefit_reset_date | string or null <ArrowDateTime> Group accumulations/benefit reset date |
package_size | number Size of mddb generic product pack |
{- "coverage_strategy_id": "string",
- "date_of_service": "string",
- "client_id": "string",
- "drug_descriptor_id": "string",
- "ndc": "string",
- "benefit_reset_date": "string",
- "package_size": 0
}
{- "ndc": "string",
- "coverage_status": "string",
- "awp_price": 0,
- "is_on_formulary": true,
- "package_size": 0,
- "tee_code": "string",
- "formulary_attributes": { }
}
Create a Drug Management Program Lockin.
client_id required | string |
external_member_id required | string The external member ID of the member. |
external_lockin_id | integer or null <int32> |
exempt_gpis | Array of strings or null |
person_code required | string The person code of the member. |
drug_management_program_lockin_id | integer or null <int32> |
start_date | string or null <ArrowDateTime> |
end_date | string or null <ArrowDateTime> |
effective_date | string or null <ArrowDateTime> |
termination_date | string or null <ArrowDateTime> |
pharmacy_lockin_level | string or null |
prescriber_npi | string or null |
prescriber_lockin_level | string or null |
pharmacy_nabp | integer or null <int32> NABP Pharmacy ID |
allowed_gpis | Array of strings or null |
disallowed_gpis | Array of strings or null |
custom_drug_limits | Array of any or null |
external_group_id | string or null |
external_account_id | string or null |
{- "client_id": "string",
- "external_member_id": "string",
- "external_lockin_id": 0,
- "exempt_gpis": [
- "string"
], - "person_code": "string",
- "drug_management_program_lockin_id": 0,
- "start_date": "string",
- "end_date": "string",
- "effective_date": "string",
- "termination_date": "string",
- "pharmacy_lockin_level": "string",
- "prescriber_npi": "string",
- "prescriber_lockin_level": "string",
- "pharmacy_nabp": 0,
- "allowed_gpis": [
- "string"
], - "disallowed_gpis": [
- "string"
], - "custom_drug_limits": [
- null
], - "external_group_id": "string",
- "external_account_id": "string"
}
{- "id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "external_lockin_id": 0,
- "exempt_gpis": [
- "string"
], - "person_code": "string",
- "drug_management_program_lockin_id": 0,
- "start_date": "string",
- "end_date": "string",
- "effective_date": "string",
- "termination_date": "string",
- "pharmacy_lockin_level": "string",
- "prescriber_npi": "string",
- "prescriber_lockin_level": "string",
- "pharmacy_nabp": 0,
- "allowed_gpis": [
- "string"
], - "disallowed_gpis": [
- "string"
], - "custom_drug_limits": [
- null
], - "external_group_id": "string",
- "external_account_id": "string"
}
client_id required | string |
external_member_id required | string The external member ID of the member. |
external_lockin_id | integer or null <int32> |
exempt_gpis | Array of strings or null |
person_code required | string The person code of the member. |
drug_management_program_lockin_id | integer or null <int32> |
start_date | string or null <ArrowDateTime> |
end_date | string or null <ArrowDateTime> |
effective_date | string or null <ArrowDateTime> |
termination_date | string or null <ArrowDateTime> |
pharmacy_lockin_level | string or null |
prescriber_npi | string or null |
prescriber_lockin_level | string or null |
pharmacy_nabp | integer or null <int32> NABP Pharmacy ID |
allowed_gpis | Array of strings or null |
disallowed_gpis | Array of strings or null |
custom_drug_limits | Array of any or null |
external_group_id required | string or null |
external_account_id required | string or null |
{- "client_id": "string",
- "external_member_id": "string",
- "external_lockin_id": 0,
- "exempt_gpis": [
- "string"
], - "person_code": "string",
- "drug_management_program_lockin_id": 0,
- "start_date": "string",
- "end_date": "string",
- "effective_date": "string",
- "termination_date": "string",
- "pharmacy_lockin_level": "string",
- "prescriber_npi": "string",
- "prescriber_lockin_level": "string",
- "pharmacy_nabp": 0,
- "allowed_gpis": [
- "string"
], - "disallowed_gpis": [
- "string"
], - "custom_drug_limits": [
- null
], - "external_group_id": "string",
- "external_account_id": "string"
}
{- "id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "external_lockin_id": 0,
- "exempt_gpis": [
- "string"
], - "person_code": "string",
- "drug_management_program_lockin_id": 0,
- "start_date": "string",
- "end_date": "string",
- "effective_date": "string",
- "termination_date": "string",
- "pharmacy_lockin_level": "string",
- "prescriber_npi": "string",
- "prescriber_lockin_level": "string",
- "pharmacy_nabp": 0,
- "allowed_gpis": [
- "string"
], - "disallowed_gpis": [
- "string"
], - "custom_drug_limits": [
- null
], - "external_group_id": "string",
- "external_account_id": "string"
}
Get a Drug Management Program Lockin.
id required | integer <int32> |
client_id | string |
external_member_id | string The external member ID of the member. |
external_lockin_id | integer or null <int32> |
exempt_gpis | Array of strings or null |
person_code | string The person code of the member. |
drug_management_program_lockin_id | integer or null <int32> |
start_date | string or null <ArrowDateTime> |
end_date | string or null <ArrowDateTime> |
effective_date | string or null <ArrowDateTime> |
termination_date | string or null <ArrowDateTime> |
pharmacy_lockin_level | string or null |
prescriber_npi | string or null |
prescriber_lockin_level | string or null |
pharmacy_nabp | integer or null <int32> NABP Pharmacy ID |
allowed_gpis | Array of strings or null |
disallowed_gpis | Array of strings or null |
custom_drug_limits | Array of any or null |
external_group_id | string or null |
external_account_id | string or null |
{- "id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "external_lockin_id": 0,
- "exempt_gpis": [
- "string"
], - "person_code": "string",
- "drug_management_program_lockin_id": 0,
- "start_date": "string",
- "end_date": "string",
- "effective_date": "string",
- "termination_date": "string",
- "pharmacy_lockin_level": "string",
- "prescriber_npi": "string",
- "prescriber_lockin_level": "string",
- "pharmacy_nabp": 0,
- "allowed_gpis": [
- "string"
], - "disallowed_gpis": [
- "string"
], - "custom_drug_limits": [
- null
], - "external_group_id": "string",
- "external_account_id": "string"
}
{- "id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "external_lockin_id": 0,
- "exempt_gpis": [
- "string"
], - "person_code": "string",
- "drug_management_program_lockin_id": 0,
- "start_date": "string",
- "end_date": "string",
- "effective_date": "string",
- "termination_date": "string",
- "pharmacy_lockin_level": "string",
- "prescriber_npi": "string",
- "prescriber_lockin_level": "string",
- "pharmacy_nabp": 0,
- "allowed_gpis": [
- "string"
], - "disallowed_gpis": [
- "string"
], - "custom_drug_limits": [
- null
], - "external_group_id": "string",
- "external_account_id": "string"
}
List Drug Management Program Lockins.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
client_id required | string |
external_member_id required | string |
person_code required | string |
only_current | boolean or null |
Array of objects or null (OrderBySchema_1744676533.0870073) | |
external_group_id | string or null |
external_account_id | string or null |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "only_current": true,
- "order_by": [
- {
- "id": "string",
- "effective_date": "string",
- "termination_date": "string",
- "external_group_id": "string",
- "external_account_id": "string"
}
], - "external_group_id": "string",
- "external_account_id": "string"
}
{- "results": [
- {
- "lock_in": {
- "id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "external_lockin_id": 0,
- "exempt_gpis": [
- "string"
], - "person_code": "string",
- "drug_management_program_lockin_id": 0,
- "start_date": "string",
- "end_date": "string",
- "effective_date": "string",
- "termination_date": "string",
- "pharmacy_lockin_level": "string",
- "prescriber_npi": "string",
- "prescriber_lockin_level": "string",
- "pharmacy_nabp": 0,
- "allowed_gpis": [
- "string"
], - "disallowed_gpis": [
- "string"
], - "custom_drug_limits": [
- null
], - "external_group_id": "string",
- "external_account_id": "string"
}
}
], - "result_count": "string"
}
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
client_id required | string |
external_member_id required | string |
person_code required | string |
only_current | boolean or null |
Array of objects or null (OrderBySchema_1744676533.0870073) | |
external_group_id required | string or null |
external_account_id required | string or null |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "client_id": "string",
- "external_member_id": "string",
- "person_code": "string",
- "only_current": true,
- "order_by": [
- {
- "id": "string",
- "effective_date": "string",
- "termination_date": "string",
- "external_group_id": "string",
- "external_account_id": "string"
}
], - "external_group_id": "string",
- "external_account_id": "string"
}
{- "results": [
- {
- "lock_in": {
- "id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "external_lockin_id": 0,
- "exempt_gpis": [
- "string"
], - "person_code": "string",
- "drug_management_program_lockin_id": 0,
- "start_date": "string",
- "end_date": "string",
- "effective_date": "string",
- "termination_date": "string",
- "pharmacy_lockin_level": "string",
- "prescriber_npi": "string",
- "prescriber_lockin_level": "string",
- "pharmacy_nabp": 0,
- "allowed_gpis": [
- "string"
], - "disallowed_gpis": [
- "string"
], - "custom_drug_limits": [
- null
], - "external_group_id": "string",
- "external_account_id": "string"
}
}
], - "result_count": "string"
}
Update a Drug Management Program Lockin.
id required | integer <int32> The ID of the lockin to update. |
client_id | string |
external_member_id | string The external member ID of the member. |
external_lockin_id | integer or null <int32> |
exempt_gpis | Array of strings or null |
person_code | string The person code of the member. |
drug_management_program_lockin_id | integer or null <int32> |
start_date | string or null <ArrowDateTime> |
end_date | string or null <ArrowDateTime> |
effective_date | string or null <ArrowDateTime> |
termination_date | string or null <ArrowDateTime> |
pharmacy_lockin_level | string or null |
prescriber_npi | string or null |
prescriber_lockin_level | string or null |
pharmacy_nabp | integer or null <int32> NABP Pharmacy ID |
allowed_gpis | Array of strings or null |
disallowed_gpis | Array of strings or null |
custom_drug_limits | Array of any or null |
external_group_id | string or null |
external_account_id | string or null |
{- "id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "external_lockin_id": 0,
- "exempt_gpis": [
- "string"
], - "person_code": "string",
- "drug_management_program_lockin_id": 0,
- "start_date": "string",
- "end_date": "string",
- "effective_date": "string",
- "termination_date": "string",
- "pharmacy_lockin_level": "string",
- "prescriber_npi": "string",
- "prescriber_lockin_level": "string",
- "pharmacy_nabp": 0,
- "allowed_gpis": [
- "string"
], - "disallowed_gpis": [
- "string"
], - "custom_drug_limits": [
- null
], - "external_group_id": "string",
- "external_account_id": "string"
}
{- "id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "external_lockin_id": 0,
- "exempt_gpis": [
- "string"
], - "person_code": "string",
- "drug_management_program_lockin_id": 0,
- "start_date": "string",
- "end_date": "string",
- "effective_date": "string",
- "termination_date": "string",
- "pharmacy_lockin_level": "string",
- "prescriber_npi": "string",
- "prescriber_lockin_level": "string",
- "pharmacy_nabp": 0,
- "allowed_gpis": [
- "string"
], - "disallowed_gpis": [
- "string"
], - "custom_drug_limits": [
- null
], - "external_group_id": "string",
- "external_account_id": "string"
}
id required | integer <int32> The ID of the lockin to update. |
client_id | string |
external_member_id | string The external member ID of the member. |
external_lockin_id | integer or null <int32> |
exempt_gpis | Array of strings or null |
person_code | string The person code of the member. |
drug_management_program_lockin_id | integer or null <int32> |
start_date | string or null <ArrowDateTime> |
end_date | string or null <ArrowDateTime> |
effective_date | string or null <ArrowDateTime> |
termination_date | string or null <ArrowDateTime> |
pharmacy_lockin_level | string or null |
prescriber_npi | string or null |
prescriber_lockin_level | string or null |
pharmacy_nabp | integer or null <int32> NABP Pharmacy ID |
allowed_gpis | Array of strings or null |
disallowed_gpis | Array of strings or null |
custom_drug_limits | Array of any or null |
external_group_id required | string or null |
external_account_id required | string or null |
{- "id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "external_lockin_id": 0,
- "exempt_gpis": [
- "string"
], - "person_code": "string",
- "drug_management_program_lockin_id": 0,
- "start_date": "string",
- "end_date": "string",
- "effective_date": "string",
- "termination_date": "string",
- "pharmacy_lockin_level": "string",
- "prescriber_npi": "string",
- "prescriber_lockin_level": "string",
- "pharmacy_nabp": 0,
- "allowed_gpis": [
- "string"
], - "disallowed_gpis": [
- "string"
], - "custom_drug_limits": [
- null
], - "external_group_id": "string",
- "external_account_id": "string"
}
{- "id": 0,
- "client_id": "string",
- "external_member_id": "string",
- "external_lockin_id": 0,
- "exempt_gpis": [
- "string"
], - "person_code": "string",
- "drug_management_program_lockin_id": 0,
- "start_date": "string",
- "end_date": "string",
- "effective_date": "string",
- "termination_date": "string",
- "pharmacy_lockin_level": "string",
- "prescriber_npi": "string",
- "prescriber_lockin_level": "string",
- "pharmacy_nabp": 0,
- "allowed_gpis": [
- "string"
], - "disallowed_gpis": [
- "string"
], - "custom_drug_limits": [
- null
], - "external_group_id": "string",
- "external_account_id": "string"
}
List Drug Lists.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
external_drug_list_ids | Array of strings or null |
id | integer <int32> |
name | string or null Name of the drug list |
drug_identifier | string or null Search the list that contains a drug_record with the provided identifier |
ids | Array of integers or null <int32> |
excluded_drug_list_ids | Array of integers or null <int32> |
Array of objects or null (OrderBySchema_1744676533.0984926) | |
plan_benefit_id | integer <int32> |
external_drug_list_id | string or null |
plan_benefit_attachable_drug_lists_only | boolean or null |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "external_drug_list_ids": [
- "string"
], - "id": 0,
- "name": "string",
- "drug_identifier": "string",
- "ids": [
- 0
], - "excluded_drug_list_ids": [
- 0
], - "order_by": [
- {
- "id": "string",
- "name": "string",
- "created_at": "string",
- "external_drug_list_id": "string",
- "type": "string"
}
], - "plan_benefit_id": 0,
- "external_drug_list_id": "string",
- "plan_benefit_attachable_drug_lists_only": true
}
{- "results": [
- {
- "drug_list": {
- "id": 0,
- "external_drug_list_id": "string",
- "type": "string",
- "client_ids": [
- "string"
], - "name": "string",
- "notes": "string",
- "created_at": "string",
- "rn": "string"
}
}
], - "result_count": "string"
}
drug_list_id | integer <int32> |
attributes | Array of strings |
drug_list_record_id | integer or null <int32> |
attribute_keys | Array of strings |
attribute_values | Array of strings |
Array of objects or null (OrderBySchema_1744676533.1011195) |
{- "drug_list_id": 0,
- "attributes": [
- "string"
], - "drug_list_record_id": 0,
- "attribute_keys": [
- "string"
], - "attribute_values": [
- "string"
], - "order_by": [
- {
- "effective_date": "string",
- "termination_date": "string",
- "start_date": "string",
- "end_date": "string",
- "updated_by": "string",
- "identifier_type": "string"
}
]
}
{- "attributes": [
- "string"
]
}
List Drug List Records.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
drug_list_id | integer <int32> |
attributes | Array of strings or null |
show_latest_versions_only | boolean or null |
Array of objects or null (OrderBySchema_1744676533.1011195) | |
identifier | string |
identifier_type | string |
minimum_effective_date | string or null <ArrowDateTime> |
maximum_effective_date | string or null <ArrowDateTime> |
minimum_termination_date | string or null <ArrowDateTime> |
maximum_termination_date | string or null <ArrowDateTime> |
minimum_start_date | string or null <ArrowDateTime> |
maximum_start_date | string or null <ArrowDateTime> |
minimum_end_date | string or null <ArrowDateTime> |
maximum_end_date | string or null <ArrowDateTime> |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "drug_list_id": 0,
- "attributes": [
- "string"
], - "show_latest_versions_only": true,
- "order_by": [
- {
- "effective_date": "string",
- "termination_date": "string",
- "start_date": "string",
- "end_date": "string",
- "updated_by": "string",
- "identifier_type": "string"
}
], - "identifier": "string",
- "identifier_type": "string",
- "minimum_effective_date": "string",
- "maximum_effective_date": "string",
- "minimum_termination_date": "string",
- "maximum_termination_date": "string",
- "minimum_start_date": "string",
- "maximum_start_date": "string",
- "minimum_end_date": "string",
- "maximum_end_date": "string"
}
{- "results": [
- {
- "drug_list_record": {
- "id": 0,
- "drug_list_id": 0,
- "drug_list_file_id": 0,
- "identifier": "string",
- "identifier_type": "string",
- "effective_date": "string",
- "termination_date": "string",
- "start_date": "string",
- "end_date": "string",
- "multi_source": [
- "string"
], - "attributes": null,
- "notes": "string",
- "created_at": "string",
- "created_by": "string",
- "updated_at": "string",
- "updated_by": "string",
- "rn": "string"
}
}
], - "result_count": "string"
}
drug_list_id | integer <int32> |
attributes | Array of strings |
drug_list_record_id required | integer or null <int32> |
attribute_keys | Array of strings |
attribute_values | Array of strings |
Array of objects or null (OrderBySchema_1744676533.1011195) |
{- "drug_list_id": 0,
- "attributes": [
- "string"
], - "drug_list_record_id": 0,
- "attribute_keys": [
- "string"
], - "attribute_values": [
- "string"
], - "order_by": [
- {
- "effective_date": "string",
- "termination_date": "string",
- "start_date": "string",
- "end_date": "string",
- "updated_by": "string",
- "identifier_type": "string"
}
]
}
{- "result_count": "string",
- "results": [
- {
- "key": "string",
- "value": "string"
}
]
}
Create an Email Delivery Target.
rn | string or null |
action | string or null |
description | string or null |
from_address required | string |
to_addresses required | Array of strings |
reply_to required | string or null |
subject required | string or null |
body_plain required | string or null |
body_html required | string or null |
encryption_setting_id | integer or null <int32> |
effective_date | string or null <ArrowDateTime> |
termination_date | string or null <ArrowDateTime> |
{- "rn": "string",
- "action": "string",
- "description": "string",
- "from_address": "string",
- "to_addresses": [
- "string"
], - "reply_to": "string",
- "subject": "string",
- "body_plain": "string",
- "body_html": "string",
- "encryption_setting_id": 0,
- "effective_date": "string",
- "termination_date": "string"
}
{- "id": 0,
- "rn": "string",
- "action": "string",
- "description": "string",
- "from_address": "string",
- "to_addresses": [
- "string"
], - "reply_to": "string",
- "subject": "string",
- "body_plain": "string",
- "body_html": "string",
- "encryption_setting_id": 0,
- "effective_date": "string",
- "termination_date": "string"
}
Get an Email Delivery Target.
id | integer <int32> |
{- "id": 0
}
{- "id": 0,
- "rn": "string",
- "action": "string",
- "description": "string",
- "from_address": "string",
- "to_addresses": [
- "string"
], - "reply_to": "string",
- "subject": "string",
- "body_plain": "string",
- "body_html": "string",
- "encryption_setting_id": 0,
- "effective_date": "string",
- "termination_date": "string"
}
List Email Delivery Targets.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer or null <int32> |
description | string or null |
subject | string or null |
from_address | string or null |
to_addresses | string or null |
reply_to | string or null |
effective_date | string or null <ArrowDateTime> |
Array of objects or null (OrderBySchema_1744676533.10982) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "description": "string",
- "subject": "string",
- "from_address": "string",
- "to_addresses": "string",
- "reply_to": "string",
- "effective_date": "string",
- "order_by": [
- {
- "id": "string",
- "from_address": "string",
- "subject": "string",
- "description": "string",
- "reply_to": "string",
- "effective_date": "string"
}
]
}
{- "results": [
- {
- "email_delivery_target": {
- "id": 0,
- "rn": "string",
- "action": "string",
- "description": "string",
- "from_address": "string",
- "to_addresses": [
- "string"
], - "reply_to": "string",
- "subject": "string",
- "body_plain": "string",
- "body_html": "string",
- "encryption_setting_id": 0,
- "effective_date": "string",
- "termination_date": "string"
}
}
], - "result_count": "string"
}
Update an Email Delivery Target.
id | integer <int32> |
rn | string or null |
action | string or null |
description | string or null |
from_address | string |
to_addresses | Array of strings |
reply_to | string or null |
subject | string or null |
body_plain | string or null |
body_html | string or null |
encryption_setting_id | integer or null <int32> |
effective_date | string or null <ArrowDateTime> |
termination_date | string or null <ArrowDateTime> |
{- "id": 0,
- "rn": "string",
- "action": "string",
- "description": "string",
- "from_address": "string",
- "to_addresses": [
- "string"
], - "reply_to": "string",
- "subject": "string",
- "body_plain": "string",
- "body_html": "string",
- "encryption_setting_id": 0,
- "effective_date": "string",
- "termination_date": "string"
}
{- "id": 0,
- "rn": "string",
- "action": "string",
- "description": "string",
- "from_address": "string",
- "to_addresses": [
- "string"
], - "reply_to": "string",
- "subject": "string",
- "body_plain": "string",
- "body_html": "string",
- "encryption_setting_id": 0,
- "effective_date": "string",
- "termination_date": "string"
}
Create an Eligibility Configuration.
rn | string or null |
parser_name required | string |
description | string or null |
config | any or null |
client_thresholds | any or null |
eligibility_created_failure_threshold | integer or null <int32> |
eligibility_tba_failure_threshold | integer or null <int32> |
eligibility_updated_failure_threshold | integer or null <int32> |
bucket_pattern required | string |
key_pattern required | string |
plan_ids required | Array of integers or null <int32> |
client_ids | Array of strings or null |
status | string Enum: "active" "inactive" |
event_handler_type required | string Enum: "batch" "lambda" |
event_handler_is_enabled required | boolean |
event_handler_effective_date required | string or null <ArrowDateTime> |
event_handler_termination_date required | string or null <ArrowDateTime> |
event_handler_is_group_eligibility | boolean In conjunction with |
event_handler_is_member_flags_eligibility | boolean In conjunction with |
{- "rn": "string",
- "parser_name": "string",
- "description": "string",
- "config": null,
- "client_thresholds": null,
- "eligibility_created_failure_threshold": 0,
- "eligibility_tba_failure_threshold": 0,
- "eligibility_updated_failure_threshold": 0,
- "bucket_pattern": "string",
- "key_pattern": "string",
- "plan_ids": [
- 0
], - "client_ids": [
- "string"
], - "status": "active",
- "event_handler_type": "batch",
- "event_handler_is_enabled": true,
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string",
- "event_handler_is_group_eligibility": true,
- "event_handler_is_member_flags_eligibility": true
}
{- "rn": "string",
- "parser_mapping_id": 0,
- "parser_name": "string",
- "description": "string",
- "config": null,
- "client_thresholds": null,
- "eligibility_created_failure_threshold": 0,
- "eligibility_tba_failure_threshold": 0,
- "eligibility_updated_failure_threshold": 0,
- "bucket_pattern": "string",
- "key_pattern": "string",
- "plan_ids": [
- 0
], - "client_ids": [
- "string"
], - "status": "active",
- "event_handler_type": "batch",
- "event_handler_is_enabled": true,
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string",
- "event_handler_is_group_eligibility": true,
- "event_handler_is_member_flags_eligibility": true
}
Get an Eligibility Configuration.
parser_mapping_id | integer <int32> |
{- "parser_mapping_id": 0
}
{- "rn": "string",
- "parser_mapping_id": 0,
- "parser_name": "string",
- "description": "string",
- "config": null,
- "client_thresholds": null,
- "eligibility_created_failure_threshold": 0,
- "eligibility_tba_failure_threshold": 0,
- "eligibility_updated_failure_threshold": 0,
- "bucket_pattern": "string",
- "key_pattern": "string",
- "plan_ids": [
- 0
], - "client_ids": [
- "string"
], - "status": "active",
- "event_handler_type": "batch",
- "event_handler_is_enabled": true,
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string",
- "event_handler_is_group_eligibility": true,
- "event_handler_is_member_flags_eligibility": true
}
List Eligibility Configurations.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
parser_mapping_id | integer or null <int32> |
parser_name | string or null |
bucket_pattern | string or null |
key_pattern | string or null |
plan_ids | Array of integers or null <int32> |
client_ids | Array of strings or null |
status | string Enum: "active" "inactive" |
description | string or null |
event_handler_type | string or null |
event_handler_is_enabled | boolean or null |
event_handler_effective_date | string or null <ArrowDateTime> |
event_handler_termination_date | string or null <ArrowDateTime> |
Array of objects or null (OrderBySchema_1744676533.1169858) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "parser_mapping_id": 0,
- "parser_name": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "plan_ids": [
- 0
], - "client_ids": [
- "string"
], - "status": "active",
- "description": "string",
- "event_handler_type": "string",
- "event_handler_is_enabled": true,
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string",
- "order_by": [
- {
- "parser_mapping_id": "string",
- "parser_name": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "plan_ids": "string",
- "client_ids": "string",
- "description": "string",
- "event_handler_type": "string",
- "event_handler_is_enabled": "string",
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string"
}
]
}
{- "results": [
- {
- "eligibility_configuration": {
- "rn": "string",
- "parser_mapping_id": 0,
- "parser_name": "string",
- "description": "string",
- "config": null,
- "client_thresholds": null,
- "eligibility_created_failure_threshold": 0,
- "eligibility_tba_failure_threshold": 0,
- "eligibility_updated_failure_threshold": 0,
- "bucket_pattern": "string",
- "key_pattern": "string",
- "plan_ids": [
- 0
], - "client_ids": [
- "string"
], - "status": "active",
- "event_handler_type": "batch",
- "event_handler_is_enabled": true,
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string",
- "event_handler_is_group_eligibility": true,
- "event_handler_is_member_flags_eligibility": true
}
}
], - "result_count": "string"
}
parser_mapping_id | integer or null <int32> |
rn | string or null |
inbound_bucket required | string |
inbound_key required | string |
commit_data required | boolean |
is_group_eligibility | boolean In conjunction with |
is_member_flags_eligibility | boolean In conjunction with |
override_report_status_folder | string |
override_parser_mapping | string |
override_parser_config | any or null |
override_plans_mapping | Array of integers <int32> [ items <int32 > ] |
override_event_handler_type | string Enum: "lambda" "batch" |
{- "parser_mapping_id": 0,
- "rn": "string",
- "inbound_bucket": "string",
- "inbound_key": "string",
- "commit_data": true,
- "is_group_eligibility": true,
- "is_member_flags_eligibility": true,
- "override_report_status_folder": "string",
- "override_parser_mapping": "string",
- "override_parser_config": null,
- "override_plans_mapping": [
- 0
], - "override_event_handler_type": "lambda"
}
{- "message": "string"
}
Update an Eligibility Configuration.
rn | string or null |
parser_mapping_id | integer <int32> |
parser_name | string |
description | string or null |
config | any or null |
client_thresholds | any or null |
eligibility_created_failure_threshold | integer or null <int32> |
eligibility_tba_failure_threshold | integer or null <int32> |
eligibility_updated_failure_threshold | integer or null <int32> |
bucket_pattern | string |
key_pattern | string |
plan_ids | Array of integers or null <int32> |
client_ids | Array of strings or null |
status | string Enum: "active" "inactive" |
event_handler_type required | string Enum: "batch" "lambda" |
event_handler_is_enabled | boolean |
event_handler_effective_date | string or null <ArrowDateTime> |
event_handler_termination_date | string or null <ArrowDateTime> |
event_handler_is_group_eligibility | boolean In conjunction with |
event_handler_is_member_flags_eligibility | boolean In conjunction with |
{- "rn": "string",
- "parser_mapping_id": 0,
- "parser_name": "string",
- "description": "string",
- "config": null,
- "client_thresholds": null,
- "eligibility_created_failure_threshold": 0,
- "eligibility_tba_failure_threshold": 0,
- "eligibility_updated_failure_threshold": 0,
- "bucket_pattern": "string",
- "key_pattern": "string",
- "plan_ids": [
- 0
], - "client_ids": [
- "string"
], - "status": "active",
- "event_handler_type": "batch",
- "event_handler_is_enabled": true,
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string",
- "event_handler_is_group_eligibility": true,
- "event_handler_is_member_flags_eligibility": true
}
{- "rn": "string",
- "parser_mapping_id": 0,
- "parser_name": "string",
- "description": "string",
- "config": null,
- "client_thresholds": null,
- "eligibility_created_failure_threshold": 0,
- "eligibility_tba_failure_threshold": 0,
- "eligibility_updated_failure_threshold": 0,
- "bucket_pattern": "string",
- "key_pattern": "string",
- "plan_ids": [
- 0
], - "client_ids": [
- "string"
], - "status": "active",
- "event_handler_type": "batch",
- "event_handler_is_enabled": true,
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string",
- "event_handler_is_group_eligibility": true,
- "event_handler_is_member_flags_eligibility": true
}
Get an Eligibility Status.
id | integer or null <int32> |
{- "id": 0
}
{- "id": 0,
- "updated_at": "string",
- "bucket": "string",
- "key": "string",
- "status": "string",
- "status_key_txt": "string",
- "status_key_csv": "string",
- "file_eligibility_parser_mapping_id": 0,
- "file_plan_mapping_id": 0,
- "parser": "string",
- "client_ids": [
- "string"
], - "data": null,
- "config": "string",
- "event": "string",
- "error_message": "string",
- "rn": "string",
- "review_status": "in_review",
- "review_message": "string",
- "reviewed_by": "string",
- "reviewed_at": "string"
}
List Eligibility Statuses.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
parser_mapping_id | integer or null <int32> |
search | string or null |
status | string or null |
Array of objects or null (OrderBySchema_1744676533.1245234) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "parser_mapping_id": 0,
- "search": "string",
- "status": "string",
- "order_by": [
- {
- "id": "string",
- "bucket": "string",
- "status": "string",
- "key": "string",
- "updated_at": "string"
}
]
}
{- "results": [
- {
- "status": {
- "id": 0,
- "updated_at": "string",
- "bucket": "string",
- "key": "string",
- "status": "string",
- "status_key_txt": "string",
- "status_key_csv": "string",
- "file_eligibility_parser_mapping_id": 0,
- "file_plan_mapping_id": 0,
- "parser": "string",
- "client_ids": [
- "string"
], - "data": null,
- "config": "string",
- "event": "string",
- "error_message": "string",
- "rn": "string",
- "review_status": "in_review",
- "review_message": "string",
- "reviewed_by": "string",
- "reviewed_at": "string"
}
}
], - "result_count": "string"
}
Update an Eligibility Status.
id required | integer or null <int32> |
review_status | string Enum: "in_review" "resolved" "open" |
review_message | string or null |
{- "id": 0,
- "review_status": "in_review",
- "review_message": "string"
}
{- "id": 0,
- "updated_at": "string",
- "bucket": "string",
- "key": "string",
- "status": "string",
- "status_key_txt": "string",
- "status_key_csv": "string",
- "file_eligibility_parser_mapping_id": 0,
- "file_plan_mapping_id": 0,
- "parser": "string",
- "client_ids": [
- "string"
], - "data": null,
- "config": "string",
- "event": "string",
- "error_message": "string",
- "rn": "string",
- "review_status": "in_review",
- "review_message": "string",
- "reviewed_by": "string",
- "reviewed_at": "string"
}
Get an Accumulation Status.
id | integer or null <int32> |
{- "id": 0
}
{- "id": 0,
- "updated_at": "string",
- "bucket": "string",
- "key": "string",
- "status": "string",
- "status_key_txt": "string",
- "status_key_csv": "string",
- "file_accumulation_parser_mapping_id": 0,
- "file_plan_mapping_id": 0,
- "parser": "string",
- "client_ids": [
- "string"
], - "data": null,
- "config": "string",
- "event": "string",
- "error_message": "string",
- "rn": "string",
- "review_status": "in_review",
- "review_message": "string",
- "reviewed_by": "string",
- "reviewed_at": "string",
- "created_at": "string",
- "created_by": "string",
- "trigger_type": "string",
- "manual_note": "string"
}
List Accumulation Statuses.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
parser_mapping_id | integer or null <int32> |
search | string or null |
status | string or null |
Array of objects or null (OrderBySchema_1744676533.1300118) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "parser_mapping_id": 0,
- "search": "string",
- "status": "string",
- "order_by": [
- {
- "id": "string",
- "bucket": "string",
- "status": "string",
- "key": "string",
- "updated_at": "string"
}
]
}
{- "results": [
- {
- "status": {
- "id": 0,
- "updated_at": "string",
- "bucket": "string",
- "key": "string",
- "status": "string",
- "status_key_txt": "string",
- "status_key_csv": "string",
- "file_accumulation_parser_mapping_id": 0,
- "file_plan_mapping_id": 0,
- "parser": "string",
- "client_ids": [
- "string"
], - "data": null,
- "config": "string",
- "event": "string",
- "error_message": "string",
- "rn": "string",
- "review_status": "in_review",
- "review_message": "string",
- "reviewed_by": "string",
- "reviewed_at": "string",
- "created_at": "string",
- "created_by": "string",
- "trigger_type": "string",
- "manual_note": "string"
}
}
], - "result_count": "string"
}
Updates the Accumulation Status to reflect manual reviews.
id required | integer or null <int32> |
review_status | string Enum: "in_review" "resolved" "open" The condition of the status with regards to the review process |
review_message | string or null A message from the reviewer |
{- "id": 0,
- "review_status": "in_review",
- "review_message": "string"
}
{- "id": 0,
- "updated_at": "string",
- "bucket": "string",
- "key": "string",
- "status": "string",
- "status_key_txt": "string",
- "status_key_csv": "string",
- "file_accumulation_parser_mapping_id": 0,
- "file_plan_mapping_id": 0,
- "parser": "string",
- "client_ids": [
- "string"
], - "data": null,
- "config": "string",
- "event": "string",
- "error_message": "string",
- "rn": "string",
- "review_status": "in_review",
- "review_message": "string",
- "reviewed_by": "string",
- "reviewed_at": "string",
- "created_at": "string",
- "created_by": "string",
- "trigger_type": "string",
- "manual_note": "string"
}
Get an Encounter File.
id | integer or null <int32> |
{- "id": 0
}
{- "id": 0,
- "batch_number": "string",
- "created_at": "string",
- "updated_at": "string",
- "status": "string",
- "output_bucket": "string",
- "output_key": "string",
- "rx_fa_response_bucket": "string",
- "rx_fa_response_key": "string",
- "rx_fa_status": null,
- "rx_ta_response_bucket": "string",
- "rx_ta_response_key": "string",
- "rx_ca_response_bucket": "string",
- "rx_ca_response_key": "string",
- "deleted_by": "string",
- "deleted_at": "string"
}
List Encounter Files.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer or null <int32> |
batch_number | string or null |
created_at | string or null <ArrowDateTime> |
updated_at | string or null <ArrowDateTime> |
status | string or null |
output_bucket | string or null |
output_key | string or null |
rx_fa_response_bucket | string or null |
rx_fa_response_key | string or null |
rx_fa_status | any |
rx_ta_response_bucket | string or null |
rx_ta_response_key | string or null |
rx_ca_response_bucket | string or null |
rx_ca_response_key | string or null |
deleted_by | string or null |
deleted_at | string or null <ArrowDateTime> |
hide_deleted_files | boolean or null |
Array of objects or null (OrderBySchema_1744676533.1377997) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "batch_number": "string",
- "created_at": "string",
- "updated_at": "string",
- "status": "string",
- "output_bucket": "string",
- "output_key": "string",
- "rx_fa_response_bucket": "string",
- "rx_fa_response_key": "string",
- "rx_fa_status": null,
- "rx_ta_response_bucket": "string",
- "rx_ta_response_key": "string",
- "rx_ca_response_bucket": "string",
- "rx_ca_response_key": "string",
- "deleted_by": "string",
- "deleted_at": "string",
- "hide_deleted_files": true,
- "order_by": [
- {
- "id": 0,
- "batch_number": "string",
- "created_at": "string",
- "updated_at": "string",
- "status": "string",
- "output_bucket": "string",
- "output_key": "string",
- "rx_fa_response_bucket": "string",
- "rx_fa_response_key": "string",
- "rx_ta_response_bucket": "string",
- "rx_ta_response_key": "string",
- "rx_ca_response_bucket": "string",
- "rx_ca_response_key": "string",
- "deleted_by": "string",
- "deleted_at": "string"
}
]
}
{- "result_count": "string",
- "results": [
- {
- "encounter_file": {
- "id": 0,
- "batch_number": "string",
- "created_at": "string",
- "updated_at": "string",
- "status": "string",
- "output_bucket": "string",
- "output_key": "string",
- "rx_fa_response_bucket": "string",
- "rx_fa_response_key": "string",
- "rx_fa_status": null,
- "rx_ta_response_bucket": "string",
- "rx_ta_response_key": "string",
- "rx_ca_response_bucket": "string",
- "rx_ca_response_key": "string",
- "deleted_by": "string",
- "deleted_at": "string"
}
}
]
}
Get an Encounter File Record.
id | integer or null <int32> |
{- "id": 0
}
{- "id": 0,
- "encounter_file_id": 0,
- "claim_id": 0,
- "line_number": 0,
- "created_at": "string",
- "updated_at": "string",
- "rx_ta_status": null,
- "rx_ca_status": null,
- "status": "string",
- "batch_number": "string",
- "output_bucket": "string",
- "output_key": "string",
- "rx_fa_response_bucket": "string",
- "rx_fa_response_key": "string",
- "rx_fa_status": null,
- "rx_ta_response_bucket": "string",
- "rx_ta_response_key": "string",
- "rx_ca_response_bucket": "string",
- "rx_ca_response_key": "string",
- "deleted_by": "string",
- "deleted_at": "string",
- "encounter_file_created_at": "string",
- "encounter_file_updated_at": "string",
- "encounter_file_status": "string"
}
List Encounter File Records.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer or null <int32> |
encounter_file_id | integer or null <int32> |
claim_id | integer or null <int32> |
line_number | integer or null <int32> |
created_at | string or null <ArrowDateTime> |
updated_at | string or null <ArrowDateTime> |
rx_ta_status | any |
rx_ca_status | any |
status | string or null |
Array of objects or null (OrderBySchema_1744676533.142759) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "encounter_file_id": 0,
- "claim_id": 0,
- "line_number": 0,
- "created_at": "string",
- "updated_at": "string",
- "rx_ta_status": null,
- "rx_ca_status": null,
- "status": "string",
- "order_by": [
- {
- "id": 0,
- "encounter_file_id": 0,
- "claim_id": 0,
- "line_number": 0,
- "created_at": "string",
- "updated_at": "string",
- "status": "string"
}
]
}
{- "result_count": "string",
- "results": [
- {
- "encounter_file_record": {
- "id": 0,
- "encounter_file_id": 0,
- "claim_id": 0,
- "line_number": 0,
- "created_at": "string",
- "updated_at": "string",
- "rx_ta_status": null,
- "rx_ca_status": null,
- "status": "string"
}
}
]
}
Get an Encounter File Record Detail.
id | integer or null <int32> |
{- "id": 0
}
{- "id": 0,
- "encounter_file_record_id": 0,
- "record_type": "string",
- "submitter_id": "string",
- "batch_number": "string",
- "status": "string",
- "field_number": "string",
- "field_name": "string",
- "value_submitted": "string",
- "reject_number": "string",
- "error_description": "string",
- "error_type": "string",
- "created_at": "string",
- "updated_at": "string",
- "encounter_file_id": 0,
- "claim_id": 0,
- "line_number": 0,
- "rx_ta_status": null,
- "rx_ca_status": null,
- "output_bucket": "string",
- "output_key": "string",
- "rx_fa_response_bucket": "string",
- "rx_fa_response_key": "string",
- "rx_fa_status": null,
- "rx_ta_response_bucket": "string",
- "rx_ta_response_key": "string",
- "rx_ca_response_bucket": "string",
- "rx_ca_response_key": "string",
- "deleted_by": "string",
- "deleted_at": "string",
- "encounter_file_record_created_at": "string",
- "encounter_file_record_updated_at": "string",
- "encounter_file_record_status": "string",
- "encounter_file_created_at": "string",
- "encounter_file_updated_at": "string",
- "encounter_file_status": "string"
}
List Encounter File Record Details.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer or null <int32> |
encounter_file_id | integer or null <int32> |
encounter_file_batch_number | string or null |
encounter_file_record_id | integer or null <int32> |
encounter_file_record_status | string or null |
record_type | string or null |
submitter_id | string or null |
status | string or null |
field_number | string or null |
field_name | string or null |
value_submitted | string or null |
reject_number | string or null |
error_description | string or null |
error_type | string or null |
created_at | string or null <ArrowDateTime> |
updated_at | string or null <ArrowDateTime> |
Array of objects or null (OrderBySchema_1744676533.1473544) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "encounter_file_id": 0,
- "encounter_file_batch_number": "string",
- "encounter_file_record_id": 0,
- "encounter_file_record_status": "string",
- "record_type": "string",
- "submitter_id": "string",
- "status": "string",
- "field_number": "string",
- "field_name": "string",
- "value_submitted": "string",
- "reject_number": "string",
- "error_description": "string",
- "error_type": "string",
- "created_at": "string",
- "updated_at": "string",
- "order_by": [
- {
- "id": 0,
- "encounter_file_id": 0,
- "encounter_file_record_id": 0,
- "record_type": "string",
- "submitter_id": "string",
- "batch_number": "string",
- "status": "string",
- "field_number": "string",
- "field_name": "string",
- "value_submitted": "string",
- "reject_number": "string",
- "error_description": "string",
- "error_type": "string",
- "created_at": "string",
- "updated_at": "string"
}
]
}
{- "result_count": "string",
- "results": [
- {
- "encounter_file_record_detail": {
- "id": 0,
- "encounter_file_record_id": 0,
- "record_type": "string",
- "submitter_id": "string",
- "batch_number": "string",
- "status": "string",
- "field_number": "string",
- "field_name": "string",
- "value_submitted": "string",
- "reject_number": "string",
- "error_description": "string",
- "error_type": "string",
- "created_at": "string",
- "updated_at": "string",
- "encounter_file_id": 0,
- "claim_id": 0,
- "line_number": 0,
- "rx_ta_status": null,
- "rx_ca_status": null,
- "output_bucket": "string",
- "output_key": "string",
- "rx_fa_response_bucket": "string",
- "rx_fa_response_key": "string",
- "rx_fa_status": null,
- "rx_ta_response_bucket": "string",
- "rx_ta_response_key": "string",
- "rx_ca_response_bucket": "string",
- "rx_ca_response_key": "string",
- "deleted_by": "string",
- "deleted_at": "string",
- "encounter_file_batch_number": "string",
- "encounter_file_status": "string",
- "encounter_file_created_at": "string",
- "encounter_file_updated_at": "string",
- "encounter_file_deleted_by": "string",
- "encounter_file_deleted_at": "string",
- "encounter_file_record_status": "string",
- "encounter_file_record_created_at": "string",
- "encounter_file_record_updated_at": "string",
- "encounter_file_record_detail_id": 0,
- "encounter_file_record_detail_batch_number": "string",
- "encounter_file_record_detail_status": "string",
- "encounter_file_record_detail_created_at": "string",
- "encounter_file_record_detail_updated_at": "string"
}
}
]
}
Create an Encryption Setting.
type | string or null |
vendor_name | string or null |
bucket_pattern | string or null |
key_pattern | string or null |
public_key | string or null |
private_key | string or null |
passphrase | string or null |
signature_public_key | string or null |
signature_private_key | string or null |
signature_passphrase | string or null |
description | string or null |
rn | string or null |
event_handler_effective_date | string or null <ArrowDateTime> |
event_handler_termination_date | string or null <ArrowDateTime> |
{- "type": "string",
- "vendor_name": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "public_key": "string",
- "private_key": "string",
- "passphrase": "string",
- "signature_public_key": "string",
- "signature_private_key": "string",
- "signature_passphrase": "string",
- "description": "string",
- "rn": "string",
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string"
}
{- "id": 0,
- "type": "string",
- "vendor_name": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "public_key": "string",
- "private_key": "string",
- "passphrase": "string",
- "signature_public_key": "string",
- "signature_private_key": "string",
- "signature_passphrase": "string",
- "description": "string",
- "rn": "string",
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string"
}
encryption_setting_id required | integer <int32> |
actions | Array of strings or null or null List of actions, currently keygen-generate and signature-keygen-generate |
{- "encryption_setting_id": 0,
- "actions": [
- "string"
]
}
{- "message": "string"
}
Get an Encryption Setting.
id | integer or null <int32> |
{- "id": 0
}
{- "id": 0,
- "type": "string",
- "vendor_name": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "public_key": "string",
- "private_key": "string",
- "passphrase": "string",
- "signature_public_key": "string",
- "signature_private_key": "string",
- "signature_passphrase": "string",
- "description": "string",
- "rn": "string",
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string"
}
List Encryption Settings.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer or null <int32> |
type | string or null |
vendor_name | string or null |
description | string or null |
rn | string or null |
Array of objects or null (OrderBySchema_1744676533.1534333) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "type": "string",
- "vendor_name": "string",
- "description": "string",
- "rn": "string",
- "order_by": [
- {
- "id": "string",
- "type": "string",
- "public_key": "string",
- "description": "string",
- "vendor_name": "string"
}
]
}
{- "results": [
- {
- "encryption_settings": {
- "id": 0,
- "type": "string",
- "vendor_name": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "public_key": "string",
- "private_key": "string",
- "passphrase": "string",
- "signature_public_key": "string",
- "signature_private_key": "string",
- "signature_passphrase": "string",
- "description": "string",
- "rn": "string",
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string"
}
}
], - "result_count": "string"
}
encryption_setting_id required | integer <int32> |
bucket | string or null |
key | string or null |
{- "encryption_setting_id": 0,
- "bucket": "string",
- "key": "string"
}
{- "message": "string"
}
Update an Encryption Setting.
id required | integer or null <int32> |
type | string or null |
vendor_name | string or null |
bucket_pattern | string or null |
key_pattern | string or null |
public_key | string or null |
private_key | string or null |
passphrase | string or null |
signature_public_key | string or null |
signature_private_key | string or null |
signature_passphrase | string or null |
description | string or null |
rn | string or null |
event_handler_effective_date | string or null <ArrowDateTime> |
event_handler_termination_date | string or null <ArrowDateTime> |
{- "id": 0,
- "type": "string",
- "vendor_name": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "public_key": "string",
- "private_key": "string",
- "passphrase": "string",
- "signature_public_key": "string",
- "signature_private_key": "string",
- "signature_passphrase": "string",
- "description": "string",
- "rn": "string",
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string"
}
{- "id": 0,
- "type": "string",
- "vendor_name": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "public_key": "string",
- "private_key": "string",
- "passphrase": "string",
- "signature_public_key": "string",
- "signature_private_key": "string",
- "signature_passphrase": "string",
- "description": "string",
- "rn": "string",
- "event_handler_effective_date": "string",
- "event_handler_termination_date": "string"
}
List Exchange Healths.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
time_frame | string |
date_from | string or null <ArrowDateTime> |
date_to | string or null <ArrowDateTime> |
client_ids | Array of strings |
eligibility_status | Array of strings |
data_reports_status | Array of strings |
accumulations_status | Array of strings |
Array of objects or null (ExchangeHealthOrderBySchema_1744676533.1586616) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "time_frame": "string",
- "date_from": "string",
- "date_to": "string",
- "client_ids": [
- "string"
], - "eligibility_status": [
- "string"
], - "data_reports_status": [
- "string"
], - "accumulations_status": [
- "string"
], - "order_by": [
- {
- "exchange_type": "string",
- "status": "string",
- "review_status": "string",
- "updated_at": "string",
- "execution_id": "string",
- "description": "string"
}
]
}
{- "results": [
- {
- "exchange_status": {
- "updated_at": "string",
- "exchange_type": "string",
- "description": "string",
- "status": "string",
- "review_status": "in_review",
- "report_id": 0,
- "execution_id": 0,
- "client_ids": [
- "string"
]
}
}
], - "result_count": "string",
- "metadata": null
}
Create an Expected File Event.
rn | string or null |
description required | string or null |
bucket_pattern required | string |
key_pattern required | string |
status | string |
cron_pattern required | string or null |
lookback_time | string or null |
created_at | string or null <ArrowDateTime> |
effective_date | string or null <ArrowDateTime> |
termination_date | string or null <ArrowDateTime> |
email_delivery_target_ids | Array of integers <int32> [ items <int32 > ] |
{- "rn": "string",
- "description": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "status": "string",
- "cron_pattern": "string",
- "lookback_time": "string",
- "created_at": "string",
- "effective_date": "string",
- "termination_date": "string",
- "email_delivery_target_ids": [
- 0
]
}
{- "id": 0,
- "rn": "string",
- "description": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "status": "string",
- "cron_pattern": "string",
- "lookback_time": "string",
- "created_at": "string",
- "effective_date": "string",
- "termination_date": "string",
- "email_delivery_target_ids": [
- 0
]
}
Get an Expected File Event.
id | integer <int32> |
{- "id": 0
}
{- "id": 0,
- "rn": "string",
- "description": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "cron_pattern": "string",
- "lookback_time": "string",
- "created_at": "string",
- "effective_date": "string",
- "termination_date": "string",
- "updated_at": "string",
- "email_delivery_target_ids": [
- 0
], - "status": "string"
}
List Expected File Events.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer <int32> |
description | string |
bucket_pattern | string |
key_pattern | string |
cron_pattern | string or null |
created_at | string <ArrowDateTime> |
effective_date | string <ArrowDateTime> |
termination_date | string <ArrowDateTime> |
Array of objects or null (OrderBySchema_1744676533.165295) | |
status | string Enum: "active" "inactive" |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "description": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "cron_pattern": "string",
- "created_at": "string",
- "effective_date": "string",
- "termination_date": "string",
- "order_by": [
- {
- "id": "string",
- "description": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "cron_pattern": "string",
- "status": "string",
- "created_at": "string",
- "effective_date": "string",
- "termination_date": "string"
}
], - "status": "active"
}
{- "results": [
- {
- "expected_file_event": {
- "id": 0,
- "rn": "string",
- "description": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "status": "string",
- "cron_pattern": "string",
- "lookback_time": "string",
- "created_at": "string",
- "effective_date": "string",
- "termination_date": "string",
- "email_delivery_target_ids": [
- 0
]
}
}
], - "result_count": "string"
}
Update an Expected File Event.
id | integer <int32> |
rn | string or null |
description | string or null |
bucket_pattern | string |
key_pattern | string |
status | string |
cron_pattern | string or null |
lookback_time | string or null |
created_at | string or null <ArrowDateTime> |
effective_date | string or null <ArrowDateTime> |
termination_date | string or null <ArrowDateTime> |
email_delivery_target_ids | Array of integers <int32> [ items <int32 > ] |
{- "id": 0,
- "rn": "string",
- "description": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "status": "string",
- "cron_pattern": "string",
- "lookback_time": "string",
- "created_at": "string",
- "effective_date": "string",
- "termination_date": "string",
- "email_delivery_target_ids": [
- 0
]
}
{- "id": 0,
- "rn": "string",
- "description": "string",
- "bucket_pattern": "string",
- "key_pattern": "string",
- "status": "string",
- "cron_pattern": "string",
- "lookback_time": "string",
- "created_at": "string",
- "effective_date": "string",
- "termination_date": "string",
- "email_delivery_target_ids": [
- 0
]
}
List Fdbs.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
drug_name | string or null Drug name or part thereof. |
ndc | string or null NDC. Partial allowed. |
Array of objects or null (OrderBySchema_1744676533.1685915) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "drug_name": "string",
- "ndc": "string",
- "order_by": [
- {
- "drug_name": "string",
- "ndc": "string",
- "fdb_ndc.bn": "string",
- "fdb_ndc.gcn_seqno": "string",
- "fdb_ndc.daddnc": "string",
- "fdb_ndc.obsdtec": "string"
}
]
}
{- "results": [
- {
- "ndc": "string",
- "date": "string",
- "fdb_ndc": {
- "ndc": "string",
- "start_date": "string",
- "end_date": "string",
- "dupdc": "string",
- "termination_date": "string",
- "lblrid": "string",
- "gcn_seqno": "string",
- "ps": 0,
- "df": "string",
- "ad": "string",
- "ln": "string",
- "bn": "string",
- "pndc": "string",
- "repndc": "string",
- "ndcfi": "string",
- "daddnc": "string",
- "desi": "string",
- "desdtec": "string",
- "desi2": "string",
- "des2dtec": "string",
- "dea": "string",
- "cl": "string",
- "gpi": "string",
- "hosp": "string",
- "innov": "string",
- "ipi": "string",
- "mini": "string",
- "maint": "string",
- "obc": "string",
- "obsdtec": "string",
- "ppi": "string",
- "stpk": "string",
- "repack": "string",
- "top200": "string",
- "ud": "string",
- "csp": "string",
- "ndl_gdge": "string",
- "ndl_length": "string",
- "syr_cpcty": "string",
- "shlf_pck": "string",
- "shipper": "string",
- "hcfa_fda": "string",
- "hcfa_unit": "string",
- "hcfa_pa": "string",
- "hcfa_appc": "string",
- "hcfa_mrkc": "string",
- "hcfa_trmc": "string",
- "hcfa_typ": "string",
- "hcfa_desc1": "string",
- "hcfa_desi1": "string",
- "uu": "string",
- "pd": "string",
- "ln25": "string",
- "ln25i": "string",
- "gpidc": "string",
- "bbdc": "string",
- "home": "string",
- "inpcki": "string",
- "outpcki": "string",
- "obc_exp": "string",
- "ps_equiv": "string",
- "plblr": "string",
- "top50gen": "string",
- "obc3": "string",
- "gmi": "string",
- "gni": "string",
- "gsi": "string",
- "gti": "string",
- "ndcgi1": "string",
- "hcfa_dc": "string",
- "ln60": "string",
- "id": 0
}, - "fdb_gcn_seqno_link": {
- "gcn_seqno": "string",
- "start_date": "string",
- "end_date": "string",
- "effective_date": "string",
- "termination_date": "string",
- "gcn": "string",
- "id": 0
}
}
], - "result_count": "string"
}
Get an FDB.
ndc | string or null |
date | string or null |
object or null | |
object or null |
{- "ndc": "string",
- "date": "string",
- "fdb_ndc": {
- "ndc": "string",
- "start_date": "string",
- "end_date": "string",
- "dupdc": "string",
- "termination_date": "string",
- "lblrid": "string",
- "gcn_seqno": "string",
- "ps": 0,
- "df": "string",
- "ad": "string",
- "ln": "string",
- "bn": "string",
- "pndc": "string",
- "repndc": "string",
- "ndcfi": "string",
- "daddnc": "string",
- "desi": "string",
- "desdtec": "string",
- "desi2": "string",
- "des2dtec": "string",
- "dea": "string",
- "cl": "string",
- "gpi": "string",
- "hosp": "string",
- "innov": "string",
- "ipi": "string",
- "mini": "string",
- "maint": "string",
- "obc": "string",
- "obsdtec": "string",
- "ppi": "string",
- "stpk": "string",
- "repack": "string",
- "top200": "string",
- "ud": "string",
- "csp": "string",
- "ndl_gdge": "string",
- "ndl_length": "string",
- "syr_cpcty": "string",
- "shlf_pck": "string",
- "shipper": "string",
- "hcfa_fda": "string",
- "hcfa_unit": "string",
- "hcfa_pa": "string",
- "hcfa_appc": "string",
- "hcfa_mrkc": "string",
- "hcfa_trmc": "string",
- "hcfa_typ": "string",
- "hcfa_desc1": "string",
- "hcfa_desi1": "string",
- "uu": "string",
- "pd": "string",
- "ln25": "string",
- "ln25i": "string",
- "gpidc": "string",
- "bbdc": "string",
- "home": "string",
- "inpcki": "string",
- "outpcki": "string",
- "obc_exp": "string",
- "ps_equiv": "string",
- "plblr": "string",
- "top50gen": "string",
- "obc3": "string",
- "gmi": "string",
- "gni": "string",
- "gsi": "string",
- "gti": "string",
- "ndcgi1": "string",
- "hcfa_dc": "string",
- "ln60": "string",
- "id": 0
}, - "fdb_gcn_seqno_link": {
- "gcn_seqno": "string",
- "start_date": "string",
- "end_date": "string",
- "effective_date": "string",
- "termination_date": "string",
- "gcn": "string",
- "id": 0
}
}
{- "ndc": "string",
- "date": "string",
- "fdb_ndc": {
- "ndc": "string",
- "start_date": "string",
- "end_date": "string",
- "dupdc": "string",
- "termination_date": "string",
- "lblrid": "string",
- "gcn_seqno": "string",
- "ps": 0,
- "df": "string",
- "ad": "string",
- "ln": "string",
- "bn": "string",
- "pndc": "string",
- "repndc": "string",
- "ndcfi": "string",
- "daddnc": "string",
- "desi": "string",
- "desdtec": "string",
- "desi2": "string",
- "des2dtec": "string",
- "dea": "string",
- "cl": "string",
- "gpi": "string",
- "hosp": "string",
- "innov": "string",
- "ipi": "string",
- "mini": "string",
- "maint": "string",
- "obc": "string",
- "obsdtec": "string",
- "ppi": "string",
- "stpk": "string",
- "repack": "string",
- "top200": "string",
- "ud": "string",
- "csp": "string",
- "ndl_gdge": "string",
- "ndl_length": "string",
- "syr_cpcty": "string",
- "shlf_pck": "string",
- "shipper": "string",
- "hcfa_fda": "string",
- "hcfa_unit": "string",
- "hcfa_pa": "string",
- "hcfa_appc": "string",
- "hcfa_mrkc": "string",
- "hcfa_trmc": "string",
- "hcfa_typ": "string",
- "hcfa_desc1": "string",
- "hcfa_desi1": "string",
- "uu": "string",
- "pd": "string",
- "ln25": "string",
- "ln25i": "string",
- "gpidc": "string",
- "bbdc": "string",
- "home": "string",
- "inpcki": "string",
- "outpcki": "string",
- "obc_exp": "string",
- "ps_equiv": "string",
- "plblr": "string",
- "top50gen": "string",
- "obc3": "string",
- "gmi": "string",
- "gni": "string",
- "gsi": "string",
- "gti": "string",
- "ndcgi1": "string",
- "hcfa_dc": "string",
- "ln60": "string",
- "id": 0
}, - "fdb_gcn_seqno_link": {
- "gcn_seqno": "string",
- "start_date": "string",
- "end_date": "string",
- "effective_date": "string",
- "termination_date": "string",
- "gcn": "string",
- "id": 0
}
}
Get a File Delivery Status.
id | number or null |
{- "id": 0
}
{- "id": 0,
- "rn": "string",
- "status": "string",
- "bucket": "string",
- "key": "string",
- "protocol": "string",
- "target_id": 0,
- "encrypted": "string",
- "destination": "string",
- "output_path": "string",
- "source_app": "string",
- "source_record": { },
- "log_message": "string",
- "error_message": "string",
- "created_at": "string"
}
List File Delivery Statuses.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
search | string or null Search. |
status | string or null Status. |
Array of objects or null (OrderBySchema_1744676533.1750207) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "search": "string",
- "status": "string",
- "order_by": [
- {
- "id": "string",
- "bucket": "string",
- "key": "string",
- "created_at": "string",
- "output_path": "string",
- "status": "string",
- "source_app": "string"
}
]
}
{- "results": [
- {
- "status": {
- "id": 0,
- "rn": "string",
- "status": "string",
- "bucket": "string",
- "key": "string",
- "protocol": "string",
- "target_id": 0,
- "encrypted": "string",
- "destination": "string",
- "output_path": "string",
- "source_app": "string",
- "source_record": { },
- "log_message": "string",
- "error_message": "string",
- "created_at": "string"
}
}
], - "result_count": "string"
}
Create a File Forwarding Email Delivery Target.
rn | string |
email_delivery_target_id required | integer <int32> |
bucket_pattern required | string |
key_pattern required | string |
{- "rn": "string",
- "email_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
{- "id": 0,
- "rn": "string",
- "email_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
Get a File Forwarding Email Delivery Target.
id | integer <int32> |
{- "id": 0
}
{- "id": 0,
- "rn": "string",
- "email_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
List File Forwarding Email Delivery Targets.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer <int32> |
email_delivery_target_id | integer <int32> |
bucket_pattern | string |
key_pattern | string |
Array of objects or null (FileForwardingEmailDeliveryTargetOrderBySchema_1744676533.1800828) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "email_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string",
- "order_by": [
- {
- "id": "string",
- "email_delivery_target_id": "string",
- "bucket_pattern": "string",
- "key_pattern": "string"
}
]
}
{- "results": [
- {
- "file_forwarding_email_delivery_target": {
- "id": 0,
- "rn": "string",
- "email_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
}
], - "result_count": "string"
}
Update a File Forwarding Email Delivery Target.
id | integer <int32> |
rn | string |
email_delivery_target_id | integer <int32> |
bucket_pattern | string |
key_pattern | string |
{- "id": 0,
- "rn": "string",
- "email_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
{- "id": 0,
- "rn": "string",
- "email_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
Create a File Forwarding S3 Delivery Target.
s3_delivery_target_id required | integer <int32> |
bucket_pattern required | string |
key_pattern required | string |
{- "s3_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
{- "id": 0,
- "s3_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
Get a File Forwarding S3 Delivery Target.
id required | integer <int32> |
{- "id": 0
}
{- "id": 0,
- "s3_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
List File Forwarding S3 Delivery Targets.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer <int32> |
s3_delivery_target_id | integer <int32> |
bucket_pattern | string |
key_pattern | string |
Array of objects or null (FileForwardingS3DeliveryTargetOrderBySchema_1744676533.1861486) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "s3_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string",
- "order_by": [
- {
- "id": "string",
- "s3_delivery_target_id": "string",
- "bucket_pattern": "string",
- "key_pattern": "string"
}
]
}
{- "results": [
- {
- "file_forwarding_s3_delivery_target": {
- "id": 0,
- "s3_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
}
], - "result_count": "string"
}
Update a File Forwarding S3 Delivery Target.
id required | integer <int32> |
s3_delivery_target_id | integer <int32> |
bucket_pattern required | string |
key_pattern required | string |
{- "id": 0,
- "s3_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
{- "id": 0,
- "s3_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
Create a File Forwarding Sftp Delivery Target.
rn | string |
sftp_delivery_target_id required | integer <int32> |
bucket_pattern required | string |
key_pattern required | string |
{- "rn": "string",
- "sftp_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
{- "id": 0,
- "rn": "string",
- "sftp_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
Get a File Forwarding Sftp Delivery Target.
id | integer <int32> |
{- "id": 0
}
{- "id": 0,
- "rn": "string",
- "sftp_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
List File Forwarding Sftp Delivery Targets.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer <int32> |
sftp_delivery_target_id | integer <int32> |
bucket_pattern | string |
key_pattern | string |
Array of objects or null (FileForwardingSFTPDeliveryTargetOrderBySchema_1744676533.1918452) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "sftp_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string",
- "order_by": [
- {
- "id": "string",
- "sftp_delivery_target_id": "string",
- "bucket_pattern": "string",
- "key_pattern": "string"
}
]
}
{- "results": [
- {
- "file_forwarding_sftp_delivery_target": {
- "id": 0,
- "rn": "string",
- "sftp_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
}
], - "result_count": "string"
}
Update a File Forwarding Sftp Delivery Target.
id | integer <int32> |
rn | string |
sftp_delivery_target_id | integer <int32> |
bucket_pattern | string |
key_pattern | string |
{- "id": 0,
- "rn": "string",
- "sftp_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
{- "id": 0,
- "rn": "string",
- "sftp_delivery_target_id": 0,
- "bucket_pattern": "string",
- "key_pattern": "string"
}
Get a Financial Informational Reporting Transaction.
id required | integer <int32> |
{- "id": 0
}
{- "id": 0,
- "received_at": "string",
- "finished_at": "string",
- "source": "string",
- "raw_request": "string",
- "raw_response": "string",
- "status": "string",
- "bin_number": "string",
- "request_transaction_code": "string",
- "response_transaction_code": "string",
- "version_release_number": "string",
- "processor_control_number": "string",
- "transaction_count": "string",
- "accumulator_year": 0,
- "transaction_identifier": "string",
- "software_vendor_certification_id": "string",
- "cardholder_id": "string",
- "cms_part_d_contract_id": "string",
- "medicare_part_d_plan_benefit_package": 0,
- "group_id": "string",
- "medicare_beneficiary_identifier": "string",
- "contract_number": "string",
- "plan_benefit_package_id": "string",
- "date_of_birth": "string",
- "patient_gender_code": "string",
- "person_code": "string",
- "datetime": "string",
- "header_response_status": "string",
- "message": "string",
- "transaction_response_status": "string",
- "authorization_number": "string",
- "reject_code_1": "string",
- "reject_code_2": "string",
- "reject_code_3": "string",
- "reject_code_4": "string",
- "reject_code_5": "string",
- "reject_count": "string",
- "additional_message_information": "string",
- "additional_message_count": 0,
- "request_accumulator_month_count": 0,
- "request_accumulator_month_1": 0,
- "request_accumulator_month_2": 0,
- "request_accumulator_month_3": 0,
- "request_accumulator_month_4": 0,
- "request_accumulator_month_5": 0,
- "request_accumulator_month_6": 0,
- "request_accumulator_month_7": 0,
- "request_accumulator_month_8": 0,
- "request_accumulator_month_9": 0,
- "request_accumulator_month_10": 0,
- "request_accumulator_month_11": 0,
- "request_accumulator_month_12": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_1": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_2": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_3": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_4": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_5": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_6": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_7": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_8": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_9": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_10": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_11": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_12": 0,
- "request_accumulated_gross_covered_drug_cost_amount_1": 0,
- "request_accumulated_gross_covered_drug_cost_amount_2": 0,
- "request_accumulated_gross_covered_drug_cost_amount_3": 0,
- "request_accumulated_gross_covered_drug_cost_amount_4": 0,
- "request_accumulated_gross_covered_drug_cost_amount_5": 0,
- "request_accumulated_gross_covered_drug_cost_amount_6": 0,
- "request_accumulated_gross_covered_drug_cost_amount_7": 0,
- "request_accumulated_gross_covered_drug_cost_amount_8": 0,
- "request_accumulated_gross_covered_drug_cost_amount_9": 0,
- "request_accumulated_gross_covered_drug_cost_amount_10": 0,
- "request_accumulated_gross_covered_drug_cost_amount_11": 0,
- "request_accumulated_gross_covered_drug_cost_amount_12": 0,
- "response_accumulator_month_count": 0,
- "response_accumulator_month_1": 0,
- "response_accumulator_month_2": 0,
- "response_accumulator_month_3": 0,
- "response_accumulator_month_4": 0,
- "response_accumulator_month_5": 0,
- "response_accumulator_month_6": 0,
- "response_accumulator_month_7": 0,
- "response_accumulator_month_8": 0,
- "response_accumulator_month_9": 0,
- "response_accumulator_month_10": 0,
- "response_accumulator_month_11": 0,
- "response_accumulator_month_12": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_1": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_2": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_3": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_4": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_5": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_6": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_7": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_8": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_9": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_10": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_11": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_12": 0,
- "response_accumulated_gross_covered_drug_cost_amount_1": 0,
- "response_accumulated_gross_covered_drug_cost_amount_2": 0,
- "response_accumulated_gross_covered_drug_cost_amount_3": 0,
- "response_accumulated_gross_covered_drug_cost_amount_4": 0,
- "response_accumulated_gross_covered_drug_cost_amount_5": 0,
- "response_accumulated_gross_covered_drug_cost_amount_6": 0,
- "response_accumulated_gross_covered_drug_cost_amount_7": 0,
- "response_accumulated_gross_covered_drug_cost_amount_8": 0,
- "response_accumulated_gross_covered_drug_cost_amount_9": 0,
- "response_accumulated_gross_covered_drug_cost_amount_10": 0,
- "response_accumulated_gross_covered_drug_cost_amount_11": 0,
- "response_accumulated_gross_covered_drug_cost_amount_12": 0,
- "external_account_id": "string",
- "external_group_id": "string",
- "external_member_id": "string",
- "client_id": "string",
- "coverage_strategy_id": "string",
- "plan_benefit_id": 0,
- "member_effective_date": "string",
- "member_termination_date": "string",
- "member_start_date": "string",
- "member_end_date": "string",
- "true_out_of_pocket_before_adjudication": 0,
- "gross_covered_drug_cost_before_adjudication": 0,
- "additional_message_information_qualifier_1": "string",
- "additional_message_information_continuity_1": "string",
- "additional_message_information_1": "string",
- "additional_message_information_qualifier_2": "string",
- "additional_message_information_continuity_2": "string",
- "additional_message_information_2": "string",
- "additional_message_information_qualifier_3": "string",
- "additional_message_information_continuity_3": "string",
- "additional_message_information_3": "string",
- "additional_message_information_qualifier_4": "string",
- "additional_message_information_continuity_4": "string",
- "additional_message_information_4": "string",
- "additional_message_information_qualifier_5": "string",
- "additional_message_information_continuity_5": "string",
- "additional_message_information_5": "string",
- "aws_region": "string",
- "log_group_name": "string",
- "log_stream_name": "string",
- "aws_request_id": "string",
- "rn": "string"
}
List Financial Informational Reporting Transactions.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
Array of objects or null (OrderBySchema_1744676533.2002726) | |
id | integer <int32> |
transaction_identifier | string or null |
accumulator_year | integer or null <int32> |
medicare_beneficiary_identifier | string or null |
client_id | string or null |
cardholder_id | string or null |
status | string or null |
external_member_id | string or null |
source | string |
transaction_response_status | string or null |
received_at | string or null <ArrowDateTime> |
response_transaction_code | string or null |
reject_code | string or null |
received_start_date | string or null <ArrowDateTime> |
received_end_date | string or null <ArrowDateTime> |
processor_control_number | string or null |
bin_number | string or null |
external_account_id | string or null |
external_group_id | string or null |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "order_by": [
- {
- "id": "string",
- "transaction_identifier": "string",
- "received_at": "string",
- "accumulator_year": "string",
- "response_transaction_code": "string",
- "status": "string",
- "external_member_id": "string",
- "client_id": "string",
- "bin_number": "string",
- "processor_control_number": "string",
- "reject_codes": "string"
}
], - "id": 0,
- "transaction_identifier": "string",
- "accumulator_year": 0,
- "medicare_beneficiary_identifier": "string",
- "client_id": "string",
- "cardholder_id": "string",
- "status": "string",
- "external_member_id": "string",
- "source": "string",
- "transaction_response_status": "string",
- "received_at": "string",
- "response_transaction_code": "string",
- "reject_code": "string",
- "received_start_date": "string",
- "received_end_date": "string",
- "processor_control_number": "string",
- "bin_number": "string",
- "external_account_id": "string",
- "external_group_id": "string"
}
{- "results": [
- {
- "financial_informational_reporting_transaction": {
- "id": 0,
- "received_at": "string",
- "finished_at": "string",
- "source": "string",
- "raw_request": "string",
- "raw_response": "string",
- "status": "string",
- "bin_number": "string",
- "request_transaction_code": "string",
- "response_transaction_code": "string",
- "version_release_number": "string",
- "processor_control_number": "string",
- "transaction_count": "string",
- "accumulator_year": 0,
- "transaction_identifier": "string",
- "software_vendor_certification_id": "string",
- "cardholder_id": "string",
- "cms_part_d_contract_id": "string",
- "medicare_part_d_plan_benefit_package": 0,
- "group_id": "string",
- "medicare_beneficiary_identifier": "string",
- "contract_number": "string",
- "plan_benefit_package_id": "string",
- "date_of_birth": "string",
- "patient_gender_code": "string",
- "person_code": "string",
- "datetime": "string",
- "header_response_status": "string",
- "message": "string",
- "transaction_response_status": "string",
- "authorization_number": "string",
- "reject_code_1": "string",
- "reject_code_2": "string",
- "reject_code_3": "string",
- "reject_code_4": "string",
- "reject_code_5": "string",
- "reject_count": "string",
- "additional_message_information": "string",
- "additional_message_count": 0,
- "request_accumulator_month_count": 0,
- "request_accumulator_month_1": 0,
- "request_accumulator_month_2": 0,
- "request_accumulator_month_3": 0,
- "request_accumulator_month_4": 0,
- "request_accumulator_month_5": 0,
- "request_accumulator_month_6": 0,
- "request_accumulator_month_7": 0,
- "request_accumulator_month_8": 0,
- "request_accumulator_month_9": 0,
- "request_accumulator_month_10": 0,
- "request_accumulator_month_11": 0,
- "request_accumulator_month_12": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_1": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_2": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_3": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_4": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_5": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_6": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_7": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_8": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_9": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_10": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_11": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_12": 0,
- "request_accumulated_gross_covered_drug_cost_amount_1": 0,
- "request_accumulated_gross_covered_drug_cost_amount_2": 0,
- "request_accumulated_gross_covered_drug_cost_amount_3": 0,
- "request_accumulated_gross_covered_drug_cost_amount_4": 0,
- "request_accumulated_gross_covered_drug_cost_amount_5": 0,
- "request_accumulated_gross_covered_drug_cost_amount_6": 0,
- "request_accumulated_gross_covered_drug_cost_amount_7": 0,
- "request_accumulated_gross_covered_drug_cost_amount_8": 0,
- "request_accumulated_gross_covered_drug_cost_amount_9": 0,
- "request_accumulated_gross_covered_drug_cost_amount_10": 0,
- "request_accumulated_gross_covered_drug_cost_amount_11": 0,
- "request_accumulated_gross_covered_drug_cost_amount_12": 0,
- "response_accumulator_month_count": 0,
- "response_accumulator_month_1": 0,
- "response_accumulator_month_2": 0,
- "response_accumulator_month_3": 0,
- "response_accumulator_month_4": 0,
- "response_accumulator_month_5": 0,
- "response_accumulator_month_6": 0,
- "response_accumulator_month_7": 0,
- "response_accumulator_month_8": 0,
- "response_accumulator_month_9": 0,
- "response_accumulator_month_10": 0,
- "response_accumulator_month_11": 0,
- "response_accumulator_month_12": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_1": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_2": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_3": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_4": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_5": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_6": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_7": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_8": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_9": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_10": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_11": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_12": 0,
- "response_accumulated_gross_covered_drug_cost_amount_1": 0,
- "response_accumulated_gross_covered_drug_cost_amount_2": 0,
- "response_accumulated_gross_covered_drug_cost_amount_3": 0,
- "response_accumulated_gross_covered_drug_cost_amount_4": 0,
- "response_accumulated_gross_covered_drug_cost_amount_5": 0,
- "response_accumulated_gross_covered_drug_cost_amount_6": 0,
- "response_accumulated_gross_covered_drug_cost_amount_7": 0,
- "response_accumulated_gross_covered_drug_cost_amount_8": 0,
- "response_accumulated_gross_covered_drug_cost_amount_9": 0,
- "response_accumulated_gross_covered_drug_cost_amount_10": 0,
- "response_accumulated_gross_covered_drug_cost_amount_11": 0,
- "response_accumulated_gross_covered_drug_cost_amount_12": 0,
- "external_account_id": "string",
- "external_group_id": "string",
- "external_member_id": "string",
- "client_id": "string",
- "coverage_strategy_id": "string",
- "plan_benefit_id": 0,
- "member_effective_date": "string",
- "member_termination_date": "string",
- "member_start_date": "string",
- "member_end_date": "string",
- "true_out_of_pocket_before_adjudication": 0,
- "gross_covered_drug_cost_before_adjudication": 0,
- "additional_message_information_qualifier_1": "string",
- "additional_message_information_continuity_1": "string",
- "additional_message_information_1": "string",
- "additional_message_information_qualifier_2": "string",
- "additional_message_information_continuity_2": "string",
- "additional_message_information_2": "string",
- "additional_message_information_qualifier_3": "string",
- "additional_message_information_continuity_3": "string",
- "additional_message_information_3": "string",
- "additional_message_information_qualifier_4": "string",
- "additional_message_information_continuity_4": "string",
- "additional_message_information_4": "string",
- "additional_message_information_qualifier_5": "string",
- "additional_message_information_continuity_5": "string",
- "additional_message_information_5": "string",
- "aws_region": "string",
- "log_group_name": "string",
- "log_stream_name": "string",
- "aws_request_id": "string",
- "rn": "string"
}
}
], - "result_count": "string"
}
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
Array of objects or null (OrderBySchema_1744676533.2002726) | |
id | integer <int32> |
transaction_identifier | string or null |
accumulator_year | integer or null <int32> |
medicare_beneficiary_identifier | string or null |
client_id | string or null |
cardholder_id | string or null |
status | string or null |
external_member_id | string or null |
source | string |
transaction_response_status | string or null |
received_at | string or null <ArrowDateTime> |
response_transaction_code | string or null |
reject_code | string or null |
received_start_date | string or null <ArrowDateTime> |
received_end_date | string or null <ArrowDateTime> |
processor_control_number | string or null |
bin_number | string or null |
external_account_id required | string or null |
external_group_id required | string or null |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "order_by": [
- {
- "id": "string",
- "transaction_identifier": "string",
- "received_at": "string",
- "accumulator_year": "string",
- "response_transaction_code": "string",
- "status": "string",
- "external_member_id": "string",
- "client_id": "string",
- "bin_number": "string",
- "processor_control_number": "string",
- "reject_codes": "string"
}
], - "id": 0,
- "transaction_identifier": "string",
- "accumulator_year": 0,
- "medicare_beneficiary_identifier": "string",
- "client_id": "string",
- "cardholder_id": "string",
- "status": "string",
- "external_member_id": "string",
- "source": "string",
- "transaction_response_status": "string",
- "received_at": "string",
- "response_transaction_code": "string",
- "reject_code": "string",
- "received_start_date": "string",
- "received_end_date": "string",
- "processor_control_number": "string",
- "bin_number": "string",
- "external_account_id": "string",
- "external_group_id": "string"
}
{- "results": [
- {
- "financial_informational_reporting_transaction": {
- "id": 0,
- "received_at": "string",
- "finished_at": "string",
- "source": "string",
- "raw_request": "string",
- "raw_response": "string",
- "status": "string",
- "bin_number": "string",
- "request_transaction_code": "string",
- "response_transaction_code": "string",
- "version_release_number": "string",
- "processor_control_number": "string",
- "transaction_count": "string",
- "accumulator_year": 0,
- "transaction_identifier": "string",
- "software_vendor_certification_id": "string",
- "cardholder_id": "string",
- "cms_part_d_contract_id": "string",
- "medicare_part_d_plan_benefit_package": 0,
- "group_id": "string",
- "medicare_beneficiary_identifier": "string",
- "contract_number": "string",
- "plan_benefit_package_id": "string",
- "date_of_birth": "string",
- "patient_gender_code": "string",
- "person_code": "string",
- "datetime": "string",
- "header_response_status": "string",
- "message": "string",
- "transaction_response_status": "string",
- "authorization_number": "string",
- "reject_code_1": "string",
- "reject_code_2": "string",
- "reject_code_3": "string",
- "reject_code_4": "string",
- "reject_code_5": "string",
- "reject_count": "string",
- "additional_message_information": "string",
- "additional_message_count": 0,
- "request_accumulator_month_count": 0,
- "request_accumulator_month_1": 0,
- "request_accumulator_month_2": 0,
- "request_accumulator_month_3": 0,
- "request_accumulator_month_4": 0,
- "request_accumulator_month_5": 0,
- "request_accumulator_month_6": 0,
- "request_accumulator_month_7": 0,
- "request_accumulator_month_8": 0,
- "request_accumulator_month_9": 0,
- "request_accumulator_month_10": 0,
- "request_accumulator_month_11": 0,
- "request_accumulator_month_12": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_1": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_2": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_3": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_4": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_5": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_6": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_7": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_8": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_9": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_10": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_11": 0,
- "request_accumulated_patient_true_out_of_pocket_amount_12": 0,
- "request_accumulated_gross_covered_drug_cost_amount_1": 0,
- "request_accumulated_gross_covered_drug_cost_amount_2": 0,
- "request_accumulated_gross_covered_drug_cost_amount_3": 0,
- "request_accumulated_gross_covered_drug_cost_amount_4": 0,
- "request_accumulated_gross_covered_drug_cost_amount_5": 0,
- "request_accumulated_gross_covered_drug_cost_amount_6": 0,
- "request_accumulated_gross_covered_drug_cost_amount_7": 0,
- "request_accumulated_gross_covered_drug_cost_amount_8": 0,
- "request_accumulated_gross_covered_drug_cost_amount_9": 0,
- "request_accumulated_gross_covered_drug_cost_amount_10": 0,
- "request_accumulated_gross_covered_drug_cost_amount_11": 0,
- "request_accumulated_gross_covered_drug_cost_amount_12": 0,
- "response_accumulator_month_count": 0,
- "response_accumulator_month_1": 0,
- "response_accumulator_month_2": 0,
- "response_accumulator_month_3": 0,
- "response_accumulator_month_4": 0,
- "response_accumulator_month_5": 0,
- "response_accumulator_month_6": 0,
- "response_accumulator_month_7": 0,
- "response_accumulator_month_8": 0,
- "response_accumulator_month_9": 0,
- "response_accumulator_month_10": 0,
- "response_accumulator_month_11": 0,
- "response_accumulator_month_12": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_1": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_2": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_3": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_4": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_5": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_6": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_7": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_8": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_9": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_10": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_11": 0,
- "response_accumulated_patient_true_out_of_pocket_amount_12": 0,
- "response_accumulated_gross_covered_drug_cost_amount_1": 0,
- "response_accumulated_gross_covered_drug_cost_amount_2": 0,
- "response_accumulated_gross_covered_drug_cost_amount_3": 0,
- "response_accumulated_gross_covered_drug_cost_amount_4": 0,
- "response_accumulated_gross_covered_drug_cost_amount_5": 0,
- "response_accumulated_gross_covered_drug_cost_amount_6": 0,
- "response_accumulated_gross_covered_drug_cost_amount_7": 0,
- "response_accumulated_gross_covered_drug_cost_amount_8": 0,
- "response_accumulated_gross_covered_drug_cost_amount_9": 0,
- "response_accumulated_gross_covered_drug_cost_amount_10": 0,
- "response_accumulated_gross_covered_drug_cost_amount_11": 0,
- "response_accumulated_gross_covered_drug_cost_amount_12": 0,
- "external_account_id": "string",
- "external_group_id": "string",
- "external_member_id": "string",
- "client_id": "string",
- "coverage_strategy_id": "string",
- "plan_benefit_id": 0,
- "member_effective_date": "string",
- "member_termination_date": "string",
- "member_start_date": "string",
- "member_end_date": "string",
- "true_out_of_pocket_before_adjudication": 0,
- "gross_covered_drug_cost_before_adjudication": 0,
- "additional_message_information_qualifier_1": "string",
- "additional_message_information_continuity_1": "string",
- "additional_message_information_1": "string",
- "additional_message_information_qualifier_2": "string",
- "additional_message_information_continuity_2": "string",
- "additional_message_information_2": "string",
- "additional_message_information_qualifier_3": "string",
- "additional_message_information_continuity_3": "string",
- "additional_message_information_3": "string",
- "additional_message_information_qualifier_4": "string",
- "additional_message_information_continuity_4": "string",
- "additional_message_information_4": "string",
- "additional_message_information_qualifier_5": "string",
- "additional_message_information_continuity_5": "string",
- "additional_message_information_5": "string",
- "aws_region": "string",
- "log_group_name": "string",
- "log_stream_name": "string",
- "aws_request_id": "string",
- "rn": "string"
}
}
], - "result_count": "string"
}
Create a Fixed Width Spec.
rn | string or null |
name required | string or null |
description | string or null |
definitions | any or null |
created_at | string or null <ArrowDateTime> |
updated_at | string or null <ArrowDateTime> |
effective_date | string or null <ArrowDateTime> |
termination_date | string or null <ArrowDateTime> |
{- "rn": "string",
- "name": "string",
- "description": "string",
- "definitions": null,
- "created_at": "string",
- "updated_at": "string",
- "effective_date": "string",
- "termination_date": "string"
}
{- "id": 0,
- "rn": "string",
- "name": "string",
- "description": "string",
- "definitions": null,
- "created_at": "string",
- "updated_at": "string",
- "effective_date": "string",
- "termination_date": "string"
}
Get a Fixed Width Spec.
id | integer <int32> |
{- "id": 0
}
{- "id": 0,
- "rn": "string",
- "name": "string",
- "description": "string",
- "definitions": null,
- "created_at": "string",
- "updated_at": "string",
- "effective_date": "string",
- "termination_date": "string"
}
fixed_width_file required | file fixed-width file |
{- "fixed_width_file": null
}
{- "id": 0,
- "rn": "string",
- "name": "string",
- "description": "string",
- "definitions": null,
- "created_at": "string",
- "updated_at": "string",
- "effective_date": "string",
- "termination_date": "string"
}
id required | integer or null <int32> |
rn | string or null |
input_bucket required | string |
input_key required | string |
output_bucket required | string |
output_key required | string |
delimiter | string |
{- "id": 0,
- "rn": "string",
- "input_bucket": "string",
- "input_key": "string",
- "output_bucket": "string",
- "output_key": "string",
- "delimiter": "string"
}
{- "id": 0,
- "rn": "string",
- "name": "string",
- "description": "string",
- "definitions": null,
- "created_at": "string",
- "updated_at": "string",
- "effective_date": "string",
- "termination_date": "string"
}
List Fixed Width Specs.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer <int32> |
name | string or null |
description | string or null |
created_at | string or null <ArrowDateTime> |
updated_at | string or null <ArrowDateTime> |
effective_date | string or null <ArrowDateTime> |
termination_date | string or null <ArrowDateTime> |
Array of objects or null (OrderBySchema_1744676533.2133024) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "name": "string",
- "description": "string",
- "created_at": "string",
- "updated_at": "string",
- "effective_date": "string",
- "termination_date": "string",
- "order_by": [
- {
- "id": "string",
- "name": "string",
- "created_at": "string",
- "updated_at": "string",
- "effective_date": "string",
- "termination_date": "string",
- "description": "string"
}
]
}
{- "results": [
- {
- "fixed_width_spec": {
- "id": 0,
- "rn": "string",
- "name": "string",
- "description": "string",
- "definitions": null,
- "created_at": "string",
- "updated_at": "string",
- "effective_date": "string",
- "termination_date": "string"
}
}
], - "result_count": "string"
}
Update a Fixed Width Spec.
id | integer <int32> |
rn | string or null |
name | string or null |
description | string or null |
definitions | any or null |
created_at | string or null <ArrowDateTime> |
updated_at | string or null <ArrowDateTime> |
effective_date | string or null <ArrowDateTime> |
termination_date | string or null <ArrowDateTime> |
{- "id": 0,
- "rn": "string",
- "name": "string",
- "description": "string",
- "definitions": null,
- "created_at": "string",
- "updated_at": "string",
- "effective_date": "string",
- "termination_date": "string"
}
{- "id": 0,
- "rn": "string",
- "name": "string",
- "description": "string",
- "definitions": null,
- "created_at": "string",
- "updated_at": "string",
- "effective_date": "string",
- "termination_date": "string"
}
Create a Formulary.
rn | string or null |
name required | string or null Formulary name. |
lookup_tool_url | string or null Formulary Lookup Tool URL. |
type | string or null Formulary type. |
created_at | string or null When the formulary was created. |
updated_at | string or null When the formulary was updated. |
formulary_file_id | integer or null <int32> The internal ID of the latest Formulary File for this Formulary. |
identifier | string or null Unique identifier for the formulary, aka external_formulary_id. |
internal_formulary | boolean or null Internal formularies are designed to work with the internal formulary tool. |
internal_lookup_url | string or null Internal formulary lookup URL. |
step_therapy_id | integer or null <int32> Step Therapy ID. |
external_id | string or null External ID allows you to do such things like cross-walk a formulary to a different system. |
{- "rn": "string",
- "name": "string",
- "lookup_tool_url": "string",
- "type": "string",
- "created_at": "string",
- "updated_at": "string",
- "formulary_file_id": 0,
- "identifier": "string",
- "internal_formulary": true,
- "internal_lookup_url": "string",
- "step_therapy_id": 0,
- "external_id": "string"
}
{- "id": 0,
- "rn": "string",
- "name": "string",
- "lookup_tool_url": "string",
- "type": "string",
- "created_at": "string",
- "updated_at": "string",
- "formulary_file_id": 0,
- "identifier": "string",
- "internal_formulary": true,
- "internal_lookup_url": "string",
- "step_therapy_id": 0,
- "external_id": "string"
}
Get a Formulary.
id | integer or null <int32> The internal ID of the formulary. Cannot be set during create nor subsequently changed. |
{- "id": 0
}
{- "id": 0,
- "rn": "string",
- "name": "string",
- "lookup_tool_url": "string",
- "type": "string",
- "created_at": "string",
- "updated_at": "string",
- "formulary_file_id": 0,
- "identifier": "string",
- "internal_formulary": true,
- "internal_lookup_url": "string",
- "step_therapy_id": 0,
- "external_id": "string"
}
List Formularies.
page_number | integer or null <int32> The page of results you would like to get. For the first page, pass |
results_per_page | integer or null <int32> The maximum number of results per page. Cannot be set higher than 1000. |
expected_fields | Array of strings or null or null The desired list of fields to be returned. |
id | integer or null <int32> |
name | string or null |
Array of objects or null (OrderBySchema_1744676533.2206879) |
{- "page_number": 0,
- "results_per_page": 0,
- "expected_fields": [
- "string"
], - "id": 0,
- "name": "string",
- "order_by": [
- {
- "id": "string",
- "name": "string",
- "type": "string",
- "created_at": "string",
- "internal_formulary": "string",
- "identifier": "string",
- "external_id": "string"
}
]
}
{- "results": [
- {
- "formulary": {
- "id": 0,
- "rn": "string",
- "name": "string",
- "lookup_tool_url": "string",
- "type": "string",
- "created_at": "string",
- "updated_at": "string",
- "formulary_file_id": 0,
- "identifier": "string",
- "internal_formulary": true,
- "internal_lookup_url": "string",
- "step_therapy_id": 0,
- "external_id": "string"
}
}
], - "result_count": "string"
}
Update a Formulary.
id required | integer or null <int32> The internal ID of the formulary. Cannot be set during create nor subsequently changed. |
name | string or null Formulary name. |
lookup_tool_url | string or null Formulary Lookup Tool URL. |
type | string or null Formulary type. |
updated_at | string or null When the formulary was updated. |
identifier | string or null Unique identifier for the formulary, aka external_formulary_id. |
internal_formulary | boolean or null Internal formularies are designed to work with the internal formulary tool. |
internal_lookup_url | string or null Internal formulary lookup URL. |
step_therapy_id | integer or null <int32> Step Therapy ID. |
external_id | string or null External ID allows you to do such things like cross-walk a formulary to a different system. |
{- "id": 0,
- "name": "string",
- "lookup_tool_url": "string",
- "type": "string",
- "updated_at": "string",
- "identifier": "string",
- "internal_formulary": true,
- "internal_lookup_url": "string",
- "step_therapy_id": 0,
- "external_id": "string"
}
{- "id": 0,
- "rn": "string",
- "name": "string",
- "lookup_tool_url": "string",
- "type": "string",
- "created_at": "string",
- "updated_at": "string",
- "formulary_file_id": 0,
- "identifier": "string",
- "internal_formulary": true,
- "internal_lookup_url": "string",
- "step_therapy_id": 0,
- "external_id": "string"
}
formulary_id required | integer or null <int32> Formulary id used to grab in network representative ndc. |
ndc required | string or null |
gpi | string or null |
ndc_selection_method | string or null Enum: "highest_utilization" "average_unit_price" "highest_unit_price" Method to use to find representative ndc. Defaults to highest_unit_price. |
ndc_selection_method_used | string or null Enum: "highest_utilization" "average_unit_price" "highest_unit_price_nadac" "highest_unit_price_mddb" Method used to find representative ndc. If highest_utilization is submitted and no utilization is found. Will fallback to average_unit_price by AWP |
{- "formulary_id": 0,
- "ndc": "string",
- "gpi": "string",
- "ndc_selection_method": "highest_utilization",
- "ndc_selection_method_used": "highest_utilization"
}