RuleGeneralOptionsByDrugNDCSpecifics
The Rule General Option resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulegeneraloptionsbydrugndcspecifics |
Gets a collection of General Option rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulegeneraloptionsbydrugndcspecifics/{id} |
Gets an general options rule for the specified group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rulegeneraloptionsbydrugndcspecifics |
No documentation available. |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/rulegeneraloptionsbydrugndcspecifics/{id} |
No documentation available. |
NetworkAccessFeeReversals
The Network Access Fee Reversal resource for the authenticated user
API | Description |
---|---|
GET api/networkaccessfeereversals |
Gets a collection of network access fee reversal values based on the company associated with the authenticated user |
GET api/networkaccessfeereversals/{id} |
Gets a network access fee reversal value |
HeadquarterGlobalPlanLists
The Headquarter Global Plan List resource for the authenticated user
API | Description |
---|---|
GET api/pharmacyheadquarters/{headquarterid}/headquarterglobalplanlists |
Gets a collection of global plan name value pairs tied to a headquarter based on the company associated with the authenticated user |
GET api/pharmacyheadquarters/{headquarterid}/headquarterglobalplanlists/{id} |
Gets a global plan name value pair tied to a pharmacy headquarter |
MemberClaims
The Member Claim resource to be used to retrieve a member's claims
API | Description |
---|---|
GET api/memberclaims/{memberid}?from={from}&to={to} |
Retrieves a list of member claims for a specified member within an optional date range. |
GET api/memberclaims/{memberid}/{id} |
Retrieves a member claim. |
GroupMembers
The Group Member resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/members?lastName={lastName}&groupPlanNo={groupPlanNo}&firstName={firstName}&page={page}&pagesize={pagesize} |
Gets a collection of members based on the search paramaters and the group and plan (optional) associated with the authenticated user |
GET api/groups/{groupid}/membersetup?lastName={lastName}&page={page}&pagesize={pagesize} |
Gets a collection of members based on the provided identifier and the company associated with the authenticated user |
POST api/groups/{groupid}/membersetup |
Adds a new member to the group and plan based on the information sent in the posted model |
AgeLimits
The Age Limit resource for the authenticated user
API | Description |
---|---|
GET api/globalcompanyagelimits?page={page}&pagesize={pagesize} |
Gets a collection of global Company Age Limits |
GET api/formularies/{formularyid}/formularycompanyagelimits?page={page}&pagesize={pagesize} |
Gets a collection of Age Limits tied to a formulary |
GET api/globalcompanyagelimits/{id} |
Gets a global age limit --an age limit defined at the global/company level-- by id |
GET api/formularies/{formularyid}/formularycompanyagelimits/{id} |
Gets a Company Age Limit by formulary identifier and company age limit identifier |
POST api/globalcompanyagelimits |
Posts a new Global Company Age Limit |
POST api/formularies/{formularyid}/formularycompanyagelimits |
Posts a new Formulary Company Age Limit |
PATCH api/globalcompanyagelimits/{id} |
Patches an existing Global Company Age Limit object |
PATCH api/formularies/{formularyid}/formularycompanyagelimits/{id} |
Patches an existing Formulary Company Age Limit object |
DELETE api/globalcompanyagelimits/{id} |
Deletes a global age limit by ID |
DELETE api/formularies/{formularyid}/formularycompanyagelimits/{id} |
Deletes a Company Age Limit by formulary identifier and company age limit identifier |
PharmacyProfiles
API | Description |
---|---|
GET api/pharmacyprofiles |
Gets a collection of pharmacy profiles |
GET api/pharmacyprofiles/{id} |
Gets a pharmacy profile resource |
ManualClaimEntry
The Manual Claim Entry resource to be used to create manual claims.
API | Description |
---|---|
POST api/groups/{groupid}/membermanualclaim |
Processes a manual claim for a member. This involves validating various claim details and, if valid, processing the claim. |
POST api/groups/{groupid}/pharmacymanualclaim |
Adds a Pharmacy Manual Claim |
POST api/groups/{groupid}/testmanualclaim |
Adds a Test Manual Claim |
CompanyDiagnosisCodeLimitDxCodes
PriceCheck
API | Description |
---|---|
POST api/PriceCheck |
No documentation available. |
RuleRejectCodes
The Rule Reject Code resource for authenticated user
API | Description |
---|---|
GET api/rulerejectcodes |
Gets a list of Rule Reject Codes |
Formularies
The Formulary resource for the authenticated user
API | Description |
---|---|
GET api/formularies?activeOnly={activeOnly} |
Gets a collection of Formulary resources for a Company. |
GET api/formularies/{id} |
Gets a formulary by id |
DrugProfileGPIs
API | Description |
---|---|
GET api/drugprofiles/{drugprofileid}/drugprofilegpis?page={page}&pagesize={pagesize} |
Retrieves a paginated list of global drug profile GPIs for a given drug profile ID. |
GET api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilegpis?page={page}&pagesize={pagesize} |
Retrieves a paginated list of drug profile GPIs for a specific group and drug profile ID. |
GET api/drugprofiles/{drugprofileid}/drugprofilegpis/{id} |
Retrieves a single global drug profile GPI by ID for a given drug profile. |
GET api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilegpis/{id} |
Retrieves a single drug profile GPI for a specific group and drug profile. |
PATCH api/drugprofiles/{drugprofileid}/drugprofilegpis/{id} |
This endpoint allows modification of a global drug profile GPI. |
PATCH api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilegpis/{id} |
This endpoint allows modification of a group's drug profile GPI. |
POST api/drugprofiles/{drugprofileid}/drugprofilegpis |
Creates a new global drug profile GPI. |
POST api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilegpis |
Creates a new drug profile GPI associated with a specified group. |
POST api/drugprofiles/{drugprofileid}/drugprofilegpis/batch |
Creates multiple global drug profile GPI records by providing a list of non-empty GenericProductIdentifiers. Returns a 204 No Content response upon successful creation. |
POST api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilegpis/batch |
Creates multiple drug profile GPI records for a specific group by providing a list of non-empty GenericProductIdentifiers. Returns a 204 No Content response upon successful creation. |
POST api/drugprofiles/{drugprofileid}/drugprofilegpis/batch/delete?deleteAll={deleteAll} |
Deletes multiple global drug profile GPI records. If deleteAll=true, all GPIs are deleted for the specified drug profile. If deleteAll=false, only the provided GenericProductIdentifiers are deleted. Returns 204 No Content on success. |
POST api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilegpis/batch/delete?deleteAll={deleteAll} |
Deletes multiple drug profile GPI records at the group level. If deleteAll=true, all GPIs are deleted for the specified drug profile. If deleteAll=false, only the provided GenericProductIdentifiers are deleted. Returns 204 No Content on success. |
DELETE api/drugprofiles/{drugprofileid}/drugprofilegpis/{id} |
Deletes a single global drug profile GPI by ID for a given drug profile. |
DELETE api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilegpis/{id} |
Deletes a single drug profile GPI for a specific group and drug profile. |
CompanyStepMedicationMultiSourceCodes
PortalDrugSearch
Controller responsible for providing drug search functionality.
API | Description |
---|---|
GET api/portaldrugsearch?drugName={drugName} |
Searches for drugs by name and retrieves matching results for autocomplete functionality. |
QuantityLimits
The Quantity Limit resource for the authenticated user
API | Description |
---|---|
GET api/globalcompanyquantitylimits?page={page}&pagesize={pagesize} |
Gets a collection of global Company Quantity Limits |
GET api/formularies/{formularyid}/formularycompanyquantitylimits?page={page}&pagesize={pagesize} |
Gets a collection of quantity limits tied to the specified formulary |
GET api/globalcompanyquantitylimits/{id} |
Gets a global quantity limit by id |
GET api/formularies/{formularyid}/formularycompanyquantitylimits/{id} |
Gets a Company Quantity Limit by formulary identifier and company quantity limit identifier |
POST api/globalcompanyquantitylimits |
Posts a new Global Company Quantity Limit |
POST api/formularies/{formularyid}/formularycompanyquantitylimits |
Posts a new Formulary Company Quantity Limit |
PATCH api/globalcompanyquantitylimits/{id} |
Patches an existing Global Company Quantity Limit object |
PATCH api/formularies/{formularyid}/formularycompanyquantitylimits/{id} |
Patches an existing Formulary Company Quantity Limit object |
DELETE api/globalcompanyquantitylimits/{id} |
Deletes a global quantity limit by ID |
DELETE api/formularies/{formularyid}/formularycompanyquantitylimits/{id} |
Deletes a Company Quantity Limit by formulary identifier and company quantity limit identifier |
RuleAlternateProcessors
The Rule Alternate Processor resource for authenticated users
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulealternateprocessors |
Gets a collection of Rule Alternate Processors for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulealternateprocessors/{id} |
Gets a Rule Alternate Processor for the specified rule and alternate processor identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulealternateprocessors |
Posts a new alternate processor to a rule |
DELETE api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulealternateprocessors/{id} |
Deletes an alternate processor for a rule by id |
DataQProviders
The DataQ Provider resource for the authenticated user
API | Description |
---|---|
GET api/DataQProviders?npi={npi}&name={name}&statecode={statecode}&city={city}&page={page}&pagesize={pagesize} |
Gets a collection of providers from DataQ |
DiagnosisCodeLimits
The Diagnosis Code resource for the authenticated user
API | Description |
---|---|
GET api/globalcompanydiagnosiscodelimits?page={page}&pagesize={pagesize} |
Gets a collection of global Company Diagnosis Code Limits |
GET api/globalcompanydiagnosiscodelimits/{id} |
Gets a global diagnosis code limit by id |
GET api/formularies/{formularyid}/formularycompanydiagnosiscodelimits?page={page}&pagesize={pagesize} |
Gets a collection of diagnosis code limits tied to the specified formulary |
GET api/formularies/{formularyid}/formularycompanydiagnosiscodelimits/{id} |
Gets a Company Diagnosis Code Limit by formulary identifier and company diagnosis code limit identifier |
POST api/globalcompanydiagnosiscodelimits |
Posts a new Global Company Diagnosis Code Limit |
POST api/formularies/{formularyid}/formularycompanydiagnosiscodelimits |
Posts a new Formulary Company Diagnosis Code Limit |
PATCH api/globalcompanydiagnosiscodelimits/{id} |
Patches an existing Global Company Diagnosis Code Limit object |
PATCH api/formularies/{formularyid}/formularycompanydiagnosiscodelimits/{id} |
Patches an existing Formulary Company Diagnosis Code Limit object |
DELETE api/globalcompanydiagnosiscodelimits/{id} |
Deletes a global Company Diagnosis Code Limit by ID |
DELETE api/formularies/{formularyid}/formularycompanydiagnosiscodelimits/{id} |
Deletes a Company Diagnosis Code Limit by formulary identifier and company diagnosis code limit identifier |
PharmacyWholesalers
API | Description |
---|---|
GET api/pharmacywholesalers |
Gets a collection of pharmacy wholesalers |
GET api/pharmacywholesalers/{id} |
Gets a pharmacy wholesaler resource |
PharmacyLocations
The Pharmacy Location resource for the authenticated user
API | Description |
---|---|
GET api/PharmacyLocations?page={page}&pagesize={pagesize}&pharmacyHeadquarterNo={pharmacyHeadquarterNo}&name={name}&city={city}&npi={npi}&ncpdp={ncpdp}&state={state}&activeOnly={activeOnly}&lastModifiedAfter={lastModifiedAfter} |
Gets all pharmacy locations for this company matching the optional filters provided |
GET api/PharmacyLocations/{id} |
Gets a single Pharmacy Location by id |
POST api/PharmacyLocations?dataQProviderID={dataQProviderID} |
Posts a new PharmacyLocation to an existing group plan. |
PATCH api/PharmacyLocations?id={id} |
Patches an existing Pharmacy Location record |
ProductCoverageExclusions
The Product Coverage Exclusion resource for the authenticated user
API | Description |
---|---|
GET api/formularies/{formularyid}/formularyproductcoverageexclusions?page={page}&pagesize={pagesize} |
Gets a collection of product exclusions tied to the specified formulary |
GET api/formularies/{formularyid}/formularyproductcoverageexclusions/{id} |
Gets a Company Product Exclusion by formulary identifier and company product exclusion identifier |
POST api/formularies/{formularyid}/formularyproductcoverageexclusions |
Posts a new Product Coverage Exclusion |
PATCH api/formularies/{formularyid}/formularyproductcoverageexclusions/{id} |
Patches an existing Product Coverage Exclusion object |
DELETE api/formularies/{formularyid}/formularyproductcoverageexclusions/{id} |
Deletes a Product Coverage Exclusion by formulary identifier and product coverage exclusion identifier |
MemberPriceCheckClaims
The Member Price Check Claim resource to be used to retrieve a member's price check claims
API | Description |
---|---|
GET api/memberpricecheckclaims/{id}?from={from}&to={to} |
Gets a list of Member Test (price check) claims by member and date range |
NetworkPlanTemplates
The Network Plan Template resource for the authenticated user
API | Description |
---|---|
GET api/networkplantemplates |
Gets a collection of global Network Plan Templates |
GET api/networkplantemplates/{id} |
Gets a Network Plan Template for the specified plan template identifier |
POST api/networkplantemplates |
Posts a new global network plan template |
POST api/networkplantemplates/{id}/copyplan |
Creates a copy of an existing network plan template. |
PATCH api/networkplantemplates/{id} |
Patches an existing network plan template |
PortalStoreLocations
Provides store location data based on network and member location.
API | Description |
---|---|
GET api/portalstorelocations/{networkID}?memberid={memberid}&zipCode={zipCode}&page={page}&pageSize={pageSize} |
Gets store locations by network and member's location details. |
GET api/portalstorelocations/{networkID}/{id} |
No documentation available. |
CompanyStepMedicationStepDrugs
RuleStandardFormularyNDCSpecifics
The Rule Standard Formulary NDC Specific Controller resource for the authenticated user
CmppNetworkLogo
The CMPP Network Logo resource for the authenticated user
API | Description |
---|---|
GET api/cmppnetworklogo/{id}?width={width}&height={height}&crop={crop}&hexColor={hexColor}&placeholderForMissingLogo={placeholderForMissingLogo} |
Gets a logo image for a network if it exists with ability to specify new dimensions. If network does not have a logo, an optional placeholder image can be returned or a 404 status code. |
PlanTierCopays
The Plan Tier Copay resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/formularies/{formularyid}/plantiercopays?page={page}&pagesize={pagesize} |
Gets a collection of Plan Tier Copays by formulary identifier, group identifier, and group plan identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/formularies/{formularyid}/plantiercopays/{id} |
Gets a Plan Tier Copay by formulary identifier, group identifier, group plan identifier and plan tier copay id |
PriorAuthorizationPersistPharmacy
The Prior Authorization Persist Pharmacy resource for the authenticated user
API | Description |
---|---|
POST api/groups/{groupid}/priorauthpersistents/{id}/priorauthorizationpersistpharmacies |
Posts a new Persistent Prior Authorization Pharmacy to an existing group |
GET api/groups/{groupid}/priorauthpersistents/{id}/priorauthorizationpersistpharmacies |
Gets a Persistent Prior Authorization Pharmacy object by Persistent Prior Authorization Identifier |
GET api/groups/{groupid}/priorauthpersistents/{id}/priorauthorizationpersistpharmacies/{priorAuthorizationPersistPharmacyId} |
Gets a Persistent Prior Authorization Pharmacy object by Persistent Prior Authorization Identifier and Persistent Prior Authorization Pharmacy Identifier |
DELETE api/groups/{groupid}/priorauthpersistents/{id}/priorauthorizationpersistpharmacy/{priorAuthorizationPersistPharmacyId} |
Deletes a Persistent Prior Authorization Pharmacy by ID |
DAWCodes
The DAW Code resource for authenticated user
API | Description |
---|---|
GET api/dawcodes |
Gets a list of DAW Codes |
RuleGeneralOptions
The Rule General Option resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulegeneraloptions |
Gets a collection of General Option rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulegeneraloptions/{id} |
Gets an general options rule for the specified group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rulegeneraloptions |
No documentation available. |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/rulegeneraloptions/{id} |
No documentation available. |
UnassignedPharmacies
The Unassigned Pharmacies resource for the authenticated user
API | Description |
---|---|
GET api/unassignedpharmacies?page={page}&pagesize={pagesize}&dateAddedStart={dateAddedStart}&dateAddedEnd={dateAddedEnd}&name={name}&primaryTypeCode={primaryTypeCode}&state={state}&relationshipCode={relationshipCode}&taxonomyCode={taxonomyCode} |
Gets all unassigned pharmacies for this company matching the optional filters provided |
POST api/pharmacyheadquarters/{headquarterID}/unassignedpharmacies |
Posts a collection of DataQProviderIDs to an existing pharmacy headquarter. |
DrugProfileRouteOfAdministrations
API | Description |
---|---|
GET api/drugprofiles/{drugprofileid}/drugprofilerouteofadministrations?page={page}&pagesize={pagesize} |
Retrieves a paginated list of global drug profile RouteOfAdministrations for a given drug profile ID. |
GET api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilerouteofadministrations?page={page}&pagesize={pagesize} |
Retrieves a paginated list of drug profile RouteOfAdministrations for a specific group and drug profile ID. |
GET api/drugprofiles/{drugprofileid}/drugprofilerouteofadministrations/{id} |
Retrieves a single global drug profile RouteOfAdministration by ID for a given drug profile. |
GET api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilerouteofadministrations/{id} |
Retrieves a single drug profile RouteOfAdministration for a specific group and drug profile. |
PATCH api/drugprofiles/{drugprofileid}/drugprofilerouteofadministrations/{id} |
This endpoint allows modification of a global drug profile RouteOfAdministration. |
PATCH api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilerouteofadministrations/{id} |
This endpoint allows modification of a group's drug profile RouteOfAdministration. |
POST api/drugprofiles/{drugprofileid}/drugprofilerouteofadministrations |
Creates a new global drug profile RouteOfAdministration. |
POST api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilerouteofadministrations |
Creates a new drug profile RouteOfAdministration associated with a specified group. |
DELETE api/drugprofiles/{drugprofileid}/drugprofilerouteofadministrations/{id} |
Deletes a single global drug profile RouteOfAdministration by ID for a given drug profile. |
DELETE api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilerouteofadministrations/{id} |
Deletes a single drug profile RouteOfAdministration for a specific group and drug profile. |
DrugProfileDDIDs
API | Description |
---|---|
GET api/drugprofiles/{drugprofileid}/drugprofileddids?page={page}&pagesize={pagesize} |
Retrieves a paginated list of global drug profile DDIDs for a given drug profile ID. |
GET api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofileddids?page={page}&pagesize={pagesize} |
Retrieves a paginated list of drug profile DDIDs for a specific group and drug profile ID. |
GET api/drugprofiles/{drugprofileid}/drugprofileddids/{id} |
Retrieves a single global drug profile DDID by ID for a given drug profile. |
GET api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofileddids/{id} |
Retrieves a single drug profile DDID for a specific group and drug profile. |
PATCH api/drugprofiles/{drugprofileid}/drugprofileddids/{id} |
This endpoint allows modification of a global drug profile DDID. |
PATCH api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofileddids/{id} |
This endpoint allows modification of a group's drug profile DDID. |
POST api/drugprofiles/{drugprofileid}/drugprofileddids |
Creates a new global drug profile DDID. |
POST api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofileddids |
Creates a new drug profile DDID associated with a specified group. |
DELETE api/drugprofiles/{drugprofileid}/drugprofileddids/{id} |
Deletes a single global drug profile DDID by ID for a given drug profile. |
DELETE api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofileddids/{id} |
Deletes a single drug profile DDID for a specific group and drug profile. |
Networks
The Network resource for the authenticated user
API | Description |
---|---|
GET api/networks |
Gets a collection of networks based on the company associated with the authenticated user |
GET api/networks/{id} |
Gets a network |
POST api/networks |
Adds a new network |
PATCH api/networks/{id} |
Patches an existing network |
PlanStepMedicationStepDrugs
The Plan Step Medication Step Drugs resource for the authenticated user
API | Description |
---|---|
GET api/groupplans/{groupplanid}/formularies/{formularyid}/planstepmedicationstepdrugs?page={page}&pagesize={pagesize} |
Gets a collection of plan step medication step drugs by group plan identifier |
GET api/groupplans/{groupplanid}/formularies/{formularyid}/planstepmedicationstepdrugs/{id} |
Gets a plan step medication step drug by formulary identifier and group plan identifier and plan step medication step drug id |
GET api/groupplans/{groupplanid}/planonlystepmedicationstepdrugs?page={page}&pagesize={pagesize} |
Gets a collection of plan only step medication step drugs |
GET api/groupplans/{groupplanid}/planonlystepmedicationstepdrugs/{id} |
Gets a plan only step medication step drug by formulary identifier and group plan identifier and plan step medication step drug id |
SpecialDrugPricings
The Special Drug Pricing resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/specialdrugpricings |
Gets a collection of special drug pricing resources |
GET api/groups/{groupid}/groupplans/{groupplanid}/specialdrugpricings/{id} |
Gets a special drug pricing resource |
GET api/groupplantemplates/{groupplantemplateid}/specialdrugpricings/{id} |
No documentation available. |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/specialdrugpricings/{id} |
Patches an existing special drug pricing |
POST api/groups/{groupid}/groupplans/{groupplanid}/specialdrugpricings |
Posts a new special drug pricing |
PortalNetworkLogo
API | Description |
---|---|
GET api/portalnetworklogo/{id}?width={width}&height={height}&crop={crop}&hexColor={hexColor}&placeholderForMissingLogo={placeholderForMissingLogo} |
Gets a logo image for a network if it exists with ability to specify new dimensions. If network does not have a logo, an optional placeholder image can be returned or a 404 status code. |
HeadquarterPharmacyLocationDeltas
API | Description |
---|---|
GET api/headquarterpharmacylocationdeltas?lastModifiedAfter={lastModifiedAfter}&initialHeadquarterPharmacyLocationsDeltaID={initialHeadquarterPharmacyLocationsDeltaID}&page={page}&pagesize={pagesize} |
Retrieves a paginated list of historical change records from the pharmacy headquarter location delta table. This endpoint allows filtering the records based on their last modification date or a specific initial sequence number. The initialHeadquarterPharmacyLocationsDeltaID, if provided, takes precedence over the lastModifiedAfter parameter. This method was created to allow synchronizing or tracking changes to pharmacy headquarter locations. Once a change record is retrieved, the application can use the sequence number to retrieve the details of the changed record on the HeadquarterPharmacyLocations endpoint, using the PharmacyLocationSeqNo as the ID parameter |
GET api/headquarterpharmacylocationdeltas/{id} |
Retrieves the details of a specific pharmacy headquarter location delta by its sequence number. This endpoint is particularly used for obtaining information about changes or updates at a specific pharmacy headquarter location identified by the sequence number. |
PharmacyClasses
API | Description |
---|---|
GET api/pharmacyclasses |
Gets a collection of pharmacy classes |
GET api/pharmacyclasses/{id} |
Gets a pharmacy class resource |
PortalPriceCheck
Controller to perform price checks, designed with customer portals in mind as the consuming clients
API | Description |
---|---|
GET api/portalpricecheck/{ndc}?quantity={quantity}&dayssupply={dayssupply}&memberid={memberid}&zipCode={zipCode}&page={page}&pageSize={pageSize} |
Gets price check information for a specified drug (NDC) and member. By default, networks within 20 miles of the member’s address are returned, or, if provided, the specified zip code is used as the search location. |
GET api/portalpricecheck/bypharmacyHQ/{ndc}?quantity={quantity}&dayssupply={dayssupply}&memberid={memberid}&zipCode={zipCode}&page={page}&pageSize={pageSize} |
Gets price check information for a specified drug (NDC) and member. By default, networks within 20 miles of the member’s address are returned, or, if provided, the specified zip code is used as the search location. |
GET api/portalpricecheck/bypharmacylocation/{ndc}?quantity={quantity}&dayssupply={dayssupply}&memberid={memberid}&zipCode={zipCode}&page={page}&pageSize={pageSize}&distanceRadius={distanceRadius} |
Retrieves price check information for a specified drug (NDC) and member. By default, pharmacies within a 20-mile radius of the member's geocoded address are returned, or, if provided, the specified zip code is used as the search location. Supports pagination and returns pharmacy pricing details sorted by distance. |
FacilityBranches
The Facility Branch resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/facilitybranches |
Gets a collection of facility branches for a group |
GET api/groups/{groupid}/facilitybranches/{id} |
Gets a facility branch resource |
POST api/groups/{groupid}/facilitybranches |
Creates a new facility tied to the specified PharmacyBranch |
BenefitPeriods
The Benefit Period resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/plancontracts/{plancontractid}/benefitperiods |
Gets a collection of benefit period resources for a Plan Contract |
GET api/groups/{groupid}/groupplans/{groupplanid}/plancontracts/{plancontractid}/benefitperiods/{id} |
Gets a benefit period resource |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/plancontracts/{plancontractid}/benefitperiods/{id} |
Patches an existing benefit period |
POST api/groups/{groupid}/groupplans/{groupplanid}/plancontracts/{plancontractid}/benefitperiods |
Posts a new benefit period to the plan. |
CoveragePriorAuthorizations
The Coverage Prior Authorization resource for the authenticated user
API | Description |
---|---|
GET api/formularies/{formularyid}/formularypriorauthorizations?page={page}&pagesize={pagesize} |
Gets a collection of prior authorizations tied to the specified formulary |
GET api/formularies/{formularyid}/formularypriorauthorizations/{id} |
Gets a Company Prior Authorization by formulary identifier and company prior authorization identifier |
POST api/formularies/{formularyid}/formularypriorauthorizations |
Posts a new Coverage Prior Authorization |
PATCH api/formularies/{formularyid}/formularypriorauthorizations/{id} |
Patches an existing Coverage Prior Authorization object |
DELETE api/formularies/{formularyid}/formularypriorauthorizations/{id} |
Deletes a Coverage Prior Authorization object by formulary identifier and coverage prior authorization identifier |
VariableCopayCouponDrugs
The Variable Copay Coupon Drug resource for the authenticated user
API | Description |
---|---|
GET api/variablecopaycoupons/{variablecopaycouponid}/VariableCopayCouponDrugs |
Gets a collection of drugs for a Variable Copay Coupon |
GET api/variablecopaycoupons/{variablecopaycouponid}/VariableCopayCouponDrugs/{id} |
Gets a Variable Copay Coupon Drug resource |
POST api/variablecopaycoupons/{variablecopaycouponid}/VariableCopayCouponDrugs |
Posts a new variableCopayCouponDrug object to the specified variableCopayCoupon record |
PATCH api/variablecopaycoupons/{variableCopayCouponid}/VariableCopayCouponDrugs/{id} |
Patches an existing variable copay coupon drug |
PlanQuantityLimits
The Quantity Limit resource for the authenticated user
API | Description |
---|---|
GET api/groupplans/{groupplanid}/formularies/{formularyid}/planquantitylimits?page={page}&pagesize={pagesize} |
Gets a collection of Plan Quantity Limits by formulary identifier and group plan identifier |
GET api/groupplans/{groupplanid}/formularies/{formularyid}/planquantitylimits/{id} |
Gets a Plan Quantity Limit by formulary identifier and group plan identifier and plan quantity limit id |
GET api/groupplans/{groupplanid}/planonlyquantitylimits?page={page}&pagesize={pagesize} |
Gets a collection of Plan Only Quantity Limits |
GET api/groupplans/{groupplanid}/planonlyquantitylimits/{id} |
Gets a Plan Only Quantity Limit by group plan identifier and plan quantity limit id |
POST api/groupplans/{groupplanid}/formularies/{formularyid}/planquantitylimits/optin-all |
Opt-in of all Quantity Limits for all plans tied to a formulary |
POST api/groupplans/{groupplanid}/formularies/{formularyid}/planquantitylimits/optout-all |
Opt-out of all Quantity Limits for all plans tied to a formulary |
HeadquarterPlanLists
The Headquarter Plan list resource for the authenticated user
API | Description |
---|---|
GET api/pharmacyheadquarters/{headquarterid}/headquarterplanlists |
Gets a collection of headquarter plan name value pairs based on the company associated with the authenticated user |
GET api/pharmacyheadquarters/{headquarterid}/headquarterplanlists/{id} |
Gets a headquarter plan name value pair |
VariableCopayCoupons
The Variable Copay Coupon resource for the authenticated user
API | Description |
---|---|
GET api/variablecopaycoupons |
Gets a collection of VariableCopayCoupon/Copay resources for a Group Plan |
GET api/variablecopaycoupons/{id} |
Gets a Variable Copay Coupon resource |
POST api/variablecopaycoupons |
Posts a new variableCopayCoupon to an existing group plan |
PATCH api/variablecopaycoupons/{id} |
Patches an existing variableCopayCoupon record |
PayablesCenters
The Payables Center resource for the authenticated user
API | Description |
---|---|
GET api/payablescenters?pharmacyHeadquarterNo={pharmacyHeadquarterNo}&name={name} |
Gets a collection of payables center resources for a Group Plan |
GET api/payablescenters/{id} |
Gets payables center resource |
POST api/payablescenters |
Posts a new payables center to an existing group |
PlanAgeLimits
The Age Limit resource for the authenticated user
API | Description |
---|---|
GET api/groupplans/{groupplanid}/formularies/{formularyid}/planagelimits?page={page}&pagesize={pagesize} |
Gets a collection of Plan Age Limits by formulary identifier and group plan identifier |
GET api/groupplans/{groupplanid}/formularies/{formularyid}/planagelimits/{id} |
Gets a Plan Age Limit by formulary identifier and group plan identifier and plan age limit id |
GET api/groupplans/{groupplanid}/planonlyagelimits?page={page}&pagesize={pagesize} |
Gets a collection of Plan Only Age Limits |
GET api/groupplans/{groupplanid}/planonlyagelimits/{id} |
Gets a Plan Only Age Limit by group plan identifier and plan age limit id |
POST api/groupplans/{groupplanid}/formularies/{formularyid}/planagelimits/optin-all |
Opt-in of all Age Limits for all plans tied to a formulary |
POST api/groupplans/{groupplanid}/formularies/{formularyid}/planagelimits/optout-all |
Opt-out of all Age Limits for all plans tied to a formulary |
CmppFormularyProducts
The CMPP Formulary Product resource for the authenticated user
API | Description |
---|---|
GET api/cmppformulary/{formularyID}/cmppformularyproduct?tier={tier}&nameStartsWith={nameStartsWith}&page={page}&pagesize={pagesize} |
Gets a paged result of formulary products for a given formulary id for authorized location |
DrugProfileDosageForms
API | Description |
---|---|
GET api/drugprofiles/{drugprofileid}/drugprofiledosageforms?page={page}&pagesize={pagesize} |
Retrieves a paginated list of global drug profile Dosage Forms for a given drug profile ID. |
GET api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofiledosageforms?page={page}&pagesize={pagesize} |
Retrieves a paginated list of drug profile Dosage Forms for a specific group and drug profile ID. |
GET api/drugprofiles/{drugprofileid}/drugprofiledosageforms/{id} |
Retrieves a single global drug profile DosageForm by ID for a given drug profile. |
GET api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofiledosageforms/{id} |
Retrieves a single drug profile DosageForm for a specific group and drug profile. |
PATCH api/drugprofiles/{drugprofileid}/drugprofiledosageforms/{id} |
This endpoint allows modification of a global drug profile DosageForm. |
PATCH api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofiledosageforms/{id} |
This endpoint allows modification of a group's drug profile DosageForm. |
POST api/drugprofiles/{drugprofileid}/drugprofiledosageforms |
Creates a new global drug profile DosageForm. |
POST api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofiledosageforms |
Creates a new drug profile DosageForm associated with a specified group. |
DELETE api/drugprofiles/{drugprofileid}/drugprofiledosageforms/{id} |
Deletes a single global drug profile DosageForm by ID for a given drug profile. |
DELETE api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofiledosageforms/{id} |
Deletes a single drug profile DosageForm for a specific group and drug profile. |
RouteOfAdministrations
The Route Of Administration resource for authenticated user
API | Description |
---|---|
GET api/routeofadministrations |
Retrieves all routes of administration. |
RuleGeneralOptionsByDrugs
The Rule General Option resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulegeneraloptionsbydrugs |
Gets a collection of General Option rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulegeneraloptionsbydrugs/{id} |
Gets an general options rule for the specified group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rulegeneraloptionsbydrugs |
No documentation available. |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/rulegeneraloptionsbydrugs/{id} |
No documentation available. |
UnitPriceOverridePriceCodes
API | Description |
---|---|
GET api/unitpriceoverrides/{unitpriceoverrideid}/unitpriceoverridepricecodes |
Retrieves a collection of unit price override price codes for a specified unit price override |
GET api/unitpriceoverrides/{unitpriceoverrideid}/unitpriceoverridepricecodes/{id} |
Retrieves an unit price override price code resource |
POST api/unitpriceoverrides/{unitpriceoverrideid}/unitpriceoverridepricecodes |
Posts a new unit price override price code object to the specified unit price override record |
PATCH api/unitpriceoverrides/{unitpriceoverrideid}/unitpriceoverridepricecodes/{id} |
Patches an existing unit price override price code |
RuleFormularyTiers
The Rule Formulary Tiers resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruleformularytiers |
Gets a collection of rule formulary tiers for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruleformularytiers/{id} |
Gets a rule formulary tier for the specified rule and formulary tier identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruleformularytiers |
Adds an existing formulary tier to an existing rule |
FacilityARTypes
The Facility AR Type resource for the authenticated user
API | Description |
---|---|
GET api/facilitybranches/{facilitybranchid}/facilityARTypes |
Gets a collection of AR Types for a Facility Branch |
GET api/facilitybranches/{facilitybranchid}/facilityARTypes/{id} |
Gets an AR Type resource by ID |
GET api/groups/{groupid}/facilitybranches/{facilitybranchid}/facilityARTypes |
Gets a collection of AR Types for a Facility Branch |
POST api/groups/{groupid}/facilitybranches/{facilitybranchid}/facilityARTypes |
Adds a facility AR Type to the specified facility branch |
PATCH api/groups/{groupid}/facilitybranches/{facilitybranchid}/facilityARTypes/{id} |
Patches an existing facility AR Type resource |
RuleDiagnosisCodes
The Rule Diagnosis Code resource for authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulediagnosiscodes |
Gets a collection of Rule Diagnosis Codes for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulediagnosiscodes/{id} |
Gets a Rule Diagnosis Code for the specified rule and diagnosis code identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulediagnosiscodes |
Posts a new diagnosis code to a rule |
DELETE api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulediagnosiscodes/{id} |
Deletes a diagnosis code for a rule by id |
NetworkPharmacyHeadquarterDeltas
API | Description |
---|---|
GET api/networkpharmacyheadquarterdeltas?lastModifiedAfter={lastModifiedAfter}&initialNetworkPharmacyHeadquarterDeltaID={initialNetworkPharmacyHeadquarterDeltaID}&page={page}&pagesize={pagesize} |
Retrieves a paginated list of Network Pharmacy Headquarter Delta records. This endpoint allows filtering by last modification date or a specific initial sequence number (the initialNetworkPharmacyHeadquarterDeltaID). Either lastModifiedAfter or initialNetworkPharmacyHeadquarterDeltaID must be provided. |
GET api/networkpharmacyheadquarterdeltas/{id} |
This is used to get the details of a specific change (delta) to a network pharmacy headquarter. |
CmppFormularies
The CMPP Formulary resource for the authenticated user
API | Description |
---|---|
GET api/cmppformulary |
Gets a list of formularies for authorized location |
GET api/cmppformulary/{id} |
Gets a formulary by ID |
PlanStepMedicationMultiSourceCode
The Plan Step Medication Multi Source Code resource for the authenticated user
API | Description |
---|---|
GET api/groupplans/{groupplanid}/formularies/{formularyid}/planstepmedicationmultisourcecodes?page={page}&pagesize={pagesize} |
Gets a collection of plan step medication multi source codes by formulary identifier and group plan identifier |
GET api/groupplans/{groupplanid}/formularies/{formularyid}/planstepmedicationmultisourcecodes/{id} |
Gets a plan step medication multi source code by formulary identifier and group plan identifier and plan step medication multi source code id |
GET api/groupplans/{groupplanid}/planonlystepmedicationmultisourcecodes?page={page}&pagesize={pagesize} |
Gets a collection of plan only step medication multi source codes |
GET api/groupplans/{groupplanid}/planonlystepmedicationmultisourcecodes/{id} |
Gets a plan only step medication multi source code by formulary identifier and group plan identifier and plan only step medication multisource code id |
PlanStepMedications
The Plan Step Medication resource for the authenticated user
PlanTemplatePricingGroups
The Plan Template Pricing Group resource for the authenticated user
API | Description |
---|---|
GET api/groupplans/{groupplanid}/PlanTemplatePricingGroups |
Gets a collection of Plan Template Pricing Groups for a Group Plan |
GET api/groupplans/{groupplanid}/PlanTemplatePricingGroups/{id} |
Gets a Plan Template Pricing Group |
PATCH api/groupplans/{groupplanid}/PlanTemplatePricingGroups/{id} |
Patches an existing Plan Template Pricing Group |
POST api/groupplans/{groupplanid}/PlanTemplatePricingGroups |
Posts a new plan templat epricing group |
AppliedNetworks
The Applied Networks resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/appliednetworks |
Gets a collection of Applied Networks for a Group Plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/appliednetworks/{id} |
Gets an Applied Network |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/appliednetworks/{id} |
Patches an existing applied network |
POST api/groups/{groupid}/groupplans/{groupplanid}/appliednetworks |
Posts a new applied network to the plan. |
PharmacyHeadquarters
The Pharmacy Headquarter resource for the authenticated user
API | Description |
---|---|
GET api/pharmacyheadquarters?nameFilter={nameFilter} |
Gets a collection of Pharmacy Headquarters for the company of the authenticated user. |
GET api/pharmacyheadquarters/{id} |
Gets a Pharmacy Headquarter. |
PATCH api/pharmacyheadquarters/{id} |
Patches an existing Pharmacy Headquarter. |
POST api/pharmacyheadquarters |
Posts a new Pharmacy Headquarter model to a company. |
RuleDrugProfiles
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruledrugprofiles |
Gets a collection of Rule Drug Profiles for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruledrugprofiles/{id} |
Gets a Rule Drug Profile for the specified rule and drug profile identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruledrugprofiles |
Posts a new drug profile to a rule |
DELETE api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruledrugprofiles/{id} |
Deletes a drug profile for a rule by id |
RuleFacilityBranches
The Rule Facility Branch resource for authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulefacilitybranches |
Gets a collection of Rule Facility Branches for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulefacilitybranches/{id} |
Gets a Rule Facility Branch for the specified rule and diagnosis code identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulefacilitybranches |
Posts a new facility branch to the plan. |
DELETE api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulefacilitybranches/{id} |
Deletes a facility branch for a rule by id |
StepMedications
The Step Medication resource for the authenticated user
API | Description |
---|---|
GET api/globalcompanystepmedications?page={page}&pagesize={pagesize} |
Gets a collection of global Company Step Medications |
GET api/formularies/{formularyid}/formularycompanystepmedications?page={page}&pagesize={pagesize} |
Gets a collection of step medications tied to the specified formulary |
GET api/globalcompanystepmedications/{id} |
Gets a global step medication by id |
GET api/formularies/{formularyid}/formularycompanystepmedications/{id} |
Gets a Company Step Medication by formulary identifier and company step medication identifier |
POST api/globalcompanystepmedications |
Posts a new Global Company Step Medication |
POST api/formularies/{formularyid}/formularycompanystepmedications |
Posts a new Formulary Company Step Medication |
PATCH api/globalcompanystepmedications/{id} |
Patches an existing Global Company Step Medication object |
PATCH api/formularies/{formularyid}/formularycompanystepmedications/{id} |
Patches an existing Formulary Company Step Medication object |
DELETE api/globalcompanystepmedications/{id} |
Deletes a global Company Step Medication Step Drug by ID |
DELETE api/formularies/{formularyid}/formularycompanystepmedications/{id} |
Deletes a Company Step Medication by formulary identifier and company step medication identifier |
Members
The Member resource for the authenticated user
API | Description |
---|---|
GET api/members?lastName={lastName}&firstName={firstName}&cardholderID={cardholderID}&personCode={personCode}&arCode={arCode}&page={page}&pagesize={pagesize} |
Retrieves a paginated list of members associated with the authenticated user's company, based on the provided search parameters. **Search Criteria:** - **Required:** Either lastName or cardholderID must be provided. - **Optional:** Additional parameters like firstName, personCode, and arCode can refine the search. **Pagination:** - Use the page and pagesize parameters to control the pagination of the results. - The pagesize has a default value of 50 and a maximum allowed value of 100. **Response Codes:** - **200 OK:** Successfully retrieved the list of members. - **400 Bad Request:** Invalid request parameters (e.g., neither lastName nor cardholderID provided, or pagesize exceeds the maximum allowed). - **404 Not Found:** No members found matching the search criteria, or the authenticated user's company is invalid. - **500 Internal Server Error:** An unexpected error occurred on the server. |
GET api/members/{id} |
No documentation available. |
PATCH api/members/{id} |
Patches an existing member |
GroupPlans
The Group Plan resource for the authenticated user
API | Description |
---|---|
POST api/groups/{groupid}/groupplans/{id}/copyplan |
Creates a copy of an existing group plan using the specified template and settings. |
GET api/groups/{groupid}/groupplans |
Gets a collection of Plans for a group by the group identifier |
GET api/groups/{groupid}/groupplans/{id} |
Gets a Plan for the specified group and plan identifier |
POST api/groups/{groupid}/groupplans |
Posts a new group plan to an existing group |
PATCH api/groups/{groupid}/groupplans/{id} |
Patches an existing group plan |
OtherStatuses
API | Description |
---|---|
GET api/groups/{groupid}/otherstatuses?otherStatusNumber={otherStatusNumber} |
Retrieves a collection of other statuses for a specified group and status type (other status #). |
GET api/groups/{groupid}/otherstatuses/{id} |
Retrieves an other status by its identifier. |
PatientPlans
The Patient Plan resource for the authenticated user
API | Description |
---|---|
GET api/members/{memberid}/patientplans |
Gets a collection of PatientPlan resources for a member |
GET api/members/{memberid}/patientplans/{id} |
Gets a patient plan resource |
POST api/members/{memberid}/patientplans |
Adds a new patient plan (AR status history) record to an existing member |
PATCH api/members/{memberid}/patientplans/{id} |
Patches an existing patient plan (AR status history) record |
DiagnosisCodes
The Diagnosis Code resource for the authenticated user
API | Description |
---|---|
GET api/diagnosiscodes/{description} |
Gets a diagnosis code resource |
PharmacyHeadquarterCodes
The Pharmacy Headquarter Code resource for the authenticated user
API | Description |
---|---|
GET api/pharmacyheadquarters/{headquarterID}/codes |
Gets a collection of Pharmacy Headquarter Codes associated with the Pharmacy Headquarter Identifier. |
GET api/pharmacyheadquarters/{headquarterID}/codes/{id} |
Gets a Pharmacy Headquarter Code. |
POST api/pharmacyheadquarters/{headquarterID}/codes |
Posts a new Relationship Code to a Pharmacy Headquarter. |
DELETE api/pharmacyheadquarters/{headquarterID}/codes/{id} |
Deletes a Pharmacy Headquarter Code. |
PlanGenderLimits
The Gender Limit resource for the authenticated user
API | Description |
---|---|
GET api/groupplans/{groupplanid}/formularies/{formularyid}/plangenderlimits?page={page}&pagesize={pagesize} |
Gets a collection of Plan Gender Limits by formulary identifier and group plan identifier |
GET api/groupplans/{groupplanid}/formularies/{formularyid}/plangenderlimits/{id} |
Gets a Plan Gender Limit by formulary identifier and group plan identifier and plan gender limit id |
GET api/groupplans/{groupplanid}/planonlygenderlimits?page={page}&pagesize={pagesize} |
Gets a collection of Plan Only Gender Limits |
GET api/groupplans/{groupplanid}/planonlygenderlimits/{id} |
Gets a Plan Only Gender Limit by group plan identifier and plan gender limit id |
POST api/groupplans/{groupplanid}/formularies/{formularyid}/plangenderlimits/optin-all |
Opt-in of all Gender Limits for all plans tied to a formulary |
POST api/groupplans/{groupplanid}/formularies/{formularyid}/plangenderlimits/optout-all |
Opt-out of all Gender Limits for all plans tied to a formulary |
DrugProfileNDCs
API | Description |
---|---|
GET api/drugprofiles/{drugprofileid}/drugprofilendcs?page={page}&pagesize={pagesize} |
Retrieves a paginated list of global drug profile NDCs for a given drug profile ID. |
GET api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilendcs?page={page}&pagesize={pagesize} |
Retrieves a paginated list of drug profile NDCs for a specific group and drug profile ID. |
GET api/drugprofiles/{drugprofileid}/drugprofilendcs/{id} |
Retrieves a single global drug profile NDC by ID for a given drug profile. |
GET api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilendcs/{id} |
Retrieves a single drug profile NDC for a specific group and drug profile. |
PATCH api/drugprofiles/{drugprofileid}/drugprofilendcs/{id} |
This endpoint allows modification of a global drug profile NDC. |
PATCH api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilendcs/{id} |
This endpoint allows modification of a group's drug profile NDC. |
POST api/drugprofiles/{drugprofileid}/drugprofilendcs |
Creates a new global drug profile NDC. |
POST api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilendcs |
Creates a new drug profile NDC associated with a specified group. |
DELETE api/drugprofiles/{drugprofileid}/drugprofilendcs/{id} |
Deletes a single global drug profile NDC by ID for a given drug profile. |
DELETE api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilendcs/{id} |
Deletes a single drug profile NDC for a specific group and drug profile. |
UnitPriceOverrides
API | Description |
---|---|
GET api/globalunitpriceoverrides |
Retrieves a collection of global unit price overrides |
GET api/globalunitpriceoverrides/{id} |
Retrieves an global unit price override |
POST api/globalunitpriceoverrides |
Posts a new global unit price override object |
PATCH api/globalunitpriceoverrides/{id} |
Patches an existing global unit price override |
GET api/groups/{groupid}/unitpriceoverrides |
Retrieves a collection of unit price overrides by group |
GET api/groups/{groupid}/unitpriceoverrides/{id} |
Retrieves an unit price override |
POST api/groups/{groupid}/unitpriceoverrides |
Posts a new unit price override |
PATCH api/groups/{groupid}/unitpriceoverrides/{id} |
Patches an existing unit price override |
PlanProductExclusion
The Plan Product Exclusion resource for the authenticated user
PortalDrugSelect
Handles drug selection by ID or name. This is the second step in the portal price check API workflow where users retrieve detailed drug information, such as available forms, strengths, and packages, after identifying a drug through the Drug Search endpoint.
API | Description |
---|---|
GET api/portaldrugselect/drugID?ndc={ndc}&page={page}&pageSize={pageSize} |
Retrieves detailed drug information by National Drug Code (NDC). Use this endpoint after selecting an NDC from the Drug Search endpoint to explore specific drug details, including available forms, strengths, and packages. |
GET api/portaldrugselect/drugname?drugName={drugName}&page={page}&pageSize={pageSize} |
Retrieves detailed drug information by drug name. Use this endpoint to find drug details if a full drug name is known but the NDC is not available. |
MemberOtherClaims
The Member Other Claim resource to be used to retrieve a member's other claims
API | Description |
---|---|
GET api/memberotherclaims/{memberid}?from={from}&to={to} |
Gets a list of member other claims by member and date range |
GET api/memberotherclaims/{memberid}/{id} |
Gets a member other claim by ID |
POST api/memberotherclaims |
Adds a a member other claim to the patient based on the information sent in the posted model |
DELETE api/memberotherclaims/{memberid}/{id} |
Deletes a member other claim by ID |
FormularyTiers
The Formulary Tier resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/formularytiers |
Gets a collection of FormularyTier resources for a Group Plan. |
GET api/groups/{groupid}/groupplans/{groupplanid}/formularytiers/{id} |
Gets a formulary tier resource tied to a given group plan |
GET api/formularies/{formularyid}/formularytiers/{id} |
Gets a formulary tier resource by formulary tier id and formulary id |
GET api/formularies/{formularyid}/formularytiers |
Gets a formulary tier resource tied to a given formulary |
DrugProfiles
API | Description |
---|---|
GET api/drugprofiles?name={name}&page={page}&pagesize={pagesize} |
Retrieves a paginated list of global drug profiles. |
GET api/groups/{groupid}/drugprofiles?name={name}&page={page}&pagesize={pagesize} |
Retrieves a paginated list of drug profiles for a specific group. |
GET api/drugprofiles/{id} |
Retrieves a single global drug profile by ID. |
GET api/groups/{groupid}/drugprofiles/{id} |
Retrieves a single drug profile by ID for a specific group. |
PATCH api/drugprofiles/{id} |
This endpoint allows modification of a global drug profile . |
PATCH api/groups/{groupid}/drugprofiles/{id} |
This endpoint allows modification of a group's drug profile . |
POST api/drugprofiles |
Creates a new global drug profile . |
POST api/groups/{groupid}/drugprofiles |
Creates a new drug profile associated with a specified group. |
NetworkPlans
The Global Network Plan resource for the authenticated user
API | Description |
---|---|
GET api/networkplans |
Gets a collection of global Network Plans for a company |
GET api/networkplans/{id} |
Gets a global Network Plan for the specified network plan identifier |
POST api/networkplans |
No documentation available. |
POST api/networkplans/{id}/copyplan |
Creates a copy of an existing network plan |
PATCH api/networkplans/{id} |
Patches an existing network plan |
MemberOtherStatuses
API | Description |
---|---|
GET api/groups/{groupid}/members/{memberid}/memberotherstatuses?otherStatusNumber={otherStatusNumber} |
Gets a collection of MemberOtherStatuses. |
GET api/groups/{groupid}/members/{memberid}/memberotherstatuses/{id}?otherStatusNumber={otherStatusNumber} |
Gets a MemberOtherStatus by ID. |
PATCH api/groups/{groupid}/members/{memberid}/memberotherstatuses/{id}?otherStatusNumber={otherStatusNumber} |
Patches an existing MemberOtherStatus. |
POST api/groups/{groupid}/members/{memberid}/memberotherstatuses |
Posts a new MemberOtherStatus. |
DELETE api/groups/{groupid}/members/{memberid}/memberotherstatuses/{id}?otherStatusNumber={otherStatusNumber} |
Deletes a MemberOtherStatus. |
AlternateProcessorVendors
API | Description |
---|---|
GET api/alternateprocessorvendors |
No documentation available. |
GET api/alternateprocessorvendors/{id} |
No documentation available. |
AlternateProcessors
API | Description |
---|---|
GET api/alternateprocessors |
No documentation available. |
GET api/alternateprocessors/{id} |
No documentation available. |
PATCH api/alternateprocessors/{id} |
This endpoint allows modification of a global alternate processor . |
POST api/alternateprocessors |
No documentation available. |
PlanIncentives
The Plan Incentive resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/planincentives |
A collection of plan incentives for a group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/planincentives/{id} |
Gets a plan incentive |
POST api/groups/{groupid}/groupplans/{groupplanid}/planincentives |
Posts a new plan incentive to an existing group plan |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/planincentives/{id} |
Patches an existing plan incentive record |
GroupPlanTemplates
The Group Plan Template resource for the authenticated user
API | Description |
---|---|
POST api/groupplantemplates/{id}/copyplan |
Creates a copy of an existing group plan template. |
GET api/groupplantemplates |
Gets a collection of global Plan Templates |
GET api/groupplantemplates/{id} |
Gets a Plan Template for the specified plan template identifier |
POST api/groupplantemplates |
Posts a new global group plan template |
PATCH api/groupplantemplates/{id} |
Patches an existing plan template |
GenderLimits
The Gender Limit resource for the authenticated user
API | Description |
---|---|
GET api/globalcompanygenderlimits?page={page}&pagesize={pagesize} |
Gets a collection of global Company Gender Limits |
GET api/formularies/{formularyid}/formularycompanygenderlimits?page={page}&pagesize={pagesize} |
Gets a collection of gender limits tied to the specified formulary |
GET api/globalcompanygenderlimits/{id} |
Gets a global gender limit by id |
GET api/formularies/{formularyid}/formularycompanygenderlimits/{id} |
Gets a Company Gender Limit by formulary identifier and company gender limit identifier |
POST api/globalcompanygenderlimits |
Posts a new Global Company Gender Limit |
POST api/formularies/{formularyid}/formularycompanygenderlimits |
Posts a new Formulary Company Gender Limit |
PATCH api/globalcompanygenderlimits/{id} |
Patches an existing Global Company Gender Limit object |
PATCH api/formularies/{formularyid}/formularycompanygenderlimits/{id} |
Patches an existing Formulary Company Gender Limit object |
DELETE api/globalcompanygenderlimits/{id} |
Deletes a global gender limit by ID |
DELETE api/formularies/{formularyid}/formularycompanygenderlimits/{id} |
Deletes a Company Gender Limit by formulary identifier and company gender limit identifier |
EligibilityImportSettings
The Eligibility Import Settings resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/facilitybranches/{facilitybranchid}/eligibilityimportsettings |
Gets Eligibility Import Settings resources for a group and facility |
PATCH api/groups/{groupid}/facilitybranches/{facilitybranchid}/eligibilityimportsettings |
Patches Eligibility Import Settings |
DosageForms
The Dosage Forms resource for authenticated user
API | Description |
---|---|
GET api/dosageforms |
Retrieves all dosage forms. |
PlanFormulary
The Plan Formulary resource for the authenticated user
API | Description |
---|---|
POST api/groupplans/{groupplanid}/planformulary |
Posts a new Plan Formulary to an existing group |
PATCH api/groupplans/{groupplanid}/planformulary/{planformularyid} |
Patches an existing Plan Formulary object |
GET api/groupplans/{groupplanid}/planformulary |
Gets a list of Plan Formulary objects by Group Plan Identifier |
GET api/groupplans/{groupplanid}/planformulary/{planformularyid} |
Gets a Plan Formulary object by Group Plan Identifier and Plan Formulary Identifier |
DELETE api/groupplans/{groupplanid}/planformulary/{planformularyid} |
Deletes a Plan Formulary by ID |
ClaimAdjustment
The Claim Adjustment resource for the authenticated user
API | Description |
---|---|
GET api/claimadjustment?claimNo={claimNo} |
Gets a collection of claim adjustments for the company |
GET api/claimadjustment/{id} |
Gets a claim adjustment for the company |
POST api/claimadjustment/{claimNo} |
Creates a new claim adjustment for a specified claim. |
PlanFormularyProducts
The Plan Formulary Product resource for the authenticated user
Accounts
API | Description |
---|---|
GET api/account/{clientid}/{nonce} |
No documentation available. |
POST api/account |
No documentation available. |
MemberDirectory
The Member resource for the authenticated user
API | Description |
---|---|
GET api/MemberDirectory?lastName={lastName}&firstName={firstName}&cardholderID={cardholderID}&personCode={personCode}&arCode={arCode}&contractCode={contractCode}&page={page}&pagesize={pagesize} |
Retrieves a paginated list of members. |
PlanContractARTypeAlternates
The Plan Contract AR Type resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/planContracts/{plancontractid}/plancontractartypealternates |
Gets a collection of alternate plan contract AR Types for a Plan Contract |
GET api/groups/{groupid}/groupplans/{groupplanid}/planContracts/{plancontractid}/plancontractartypealternates/{id} |
Gets an alternate plan contract AR Type resource |
POST api/groups/{groupid}/groupplans/{groupplanid}/planContracts/{plancontractid}/plancontractartypealternates |
Creates a new cross reference relationship between an alternate plan contract and an AR type. |
DELETE api/groups/{groupid}/groupplans/{groupplanid}/planContracts/{plancontractid}/plancontractartypealternates/{id} |
Deletes an alternate Plan Contract - AR Type junction record, removing the association between a contract code and an AR type. |
HeadquarterPharmacyLocations
The Headquarter Pharmacy Location resource for the authenticated user
API | Description |
---|---|
GET api/HeadquarterPharmacyLocations?pharmacyheadquarterid={pharmacyheadquarterid}&page={page}&pagesize={pagesize}&lastModifiedAfter={lastModifiedAfter} |
Gets a collection of pharmacy locations associated with a pharmacy headquarter, paged. |
GET api/HeadquarterPharmacyLocations/{id} |
Retrieves details of a single pharmacy location associated with a pharmacy headquarter using its unique identifier. This endpoint can be used in combination with the HeadquarterPharmacyLocationDeltas endpoint to keep a local copy of the pharmacy location data in sync with the server. |
NetworkPharmacyHeadquarters
The Network Pharmacy Headquarter resource for the authenticated user
API | Description |
---|---|
GET api/networks/{networkid}/networkpharmacyheadquarters?page={page}&pagesize={pagesize}&lastModifiedAfter={lastModifiedAfter} |
Gets a collection of network pharmacy headquarter resources for a network |
GET api/networks/{networkid}/networkpharmacyheadquarters/{id} |
Gets a network pharmacy headquarter resource |
POST api/networks/{networkid}/networkpharmacyheadquarters |
Posts a new network pharmacy headquarter object to the specified network record |
PATCH api/networks/{networkid}/networkpharmacyheadquarters/{id} |
Patches an existing network pharmacy headquarter |
DELETE api/networks/{networkid}/networkpharmacyheadquarters/{id} |
Deletes a network pharmacy headquarter |
Dependents
API | Description |
---|---|
GET api/groups/{groupid}/members/{memberid}/dependents |
Gets a collection of Dependents for a specified group and member. This method retrieves all dependents associated with the given group and member ID. |
GET api/groups/{groupid}/members/{memberid}/dependents/{id} |
Gets a Dependent by ID for a specified group and member. This method retrieves a specific dependent based on the given group ID, member ID, and dependent ID. |
PATCH api/groups/{groupid}/members/{memberid}/dependents/{id} |
Patches an existing Dependent. Unlike other endpoints, this controller/endpoint allows you to patch the dependent's child objects, such as phone and address. Other endpoints require you to use the child object's endpoint directly for updates. |
POST api/groups/{groupid}/members/{memberid}/dependents |
Adds a new dependent for the specified group and member. |
PlanPriorAuthorizations
The Plan Prior Authorization resource for the authenticated user
RuleStandardFormularies
The Rule Standard Formularies resource for the authenticated user
DataQRelationships
The DataQ Relationship resource for the authenticated user
API | Description |
---|---|
GET api/dataQRelationships?name={name}&code={code}&page={page}&pagesize={pagesize} |
Gets a collection of entities from dataQ |
PlanContractARTypes
The Plan Contract AR Type resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/planContracts/{plancontractid}/plancontractartypes |
Gets a collection of plan contract AR Types for a Plan Contract |
GET api/groups/{groupid}/groupplans/{groupplanid}/planContracts/{plancontractid}/plancontractartypes/{id} |
Gets a plan contract AR Type resource |
POST api/groups/{groupid}/groupplans/{groupplanid}/planContracts/{plancontractid}/plancontractartypes |
Creates a new cross reference relationship between a plan contract and an AR type. |
DELETE api/groups/{groupid}/groupplans/{groupplanid}/planContracts/{plancontractid}/plancontractartypes/{id} |
Deletes a Plan Contract - AR Type junction record, removing the association between a contract code and an AR type. |
PlanAlternateProcessors
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/planalternateprocessors | |
GET api/groups/{groupid}/groupplans/{groupplanid}/planalternateprocessors/{id} |
No documentation available. |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/planalternateprocessors/{id} |
No documentation available. |
POST api/groups/{groupid}/groupplans/{groupplanid}/planalternateprocessors |
No documentation available. |
FormularyProducts
The Formulary Product resource for the authenticated user
API | Description |
---|---|
GET api/formularies/{formularyid}/formularyproducts?page={page}&pagesize={pagesize} |
Gets a collection of Formulary Product resources for a Formulary. |
GET api/formularies/{formularyid}/formularyproducts/{id} |
Gets a formulary product by id |
PharmacyLocator
API | Description |
---|---|
GET api/PharmacyLocator?zipCode={zipCode}&maxDistance={maxDistance}&bin={bin}&groupCode={groupCode} |
Retrieves a list of pharmacies within a specified distance from a given zip code. |
GET api/PharmacyLocator/paged?zipCode={zipCode}&page={page}&pagesize={pagesize}&maxDistance={maxDistance}&bin={bin}&groupCode={groupCode} |
Retrieves a list of pharmacies within a specified distance from a given zip code. |
POST api/PharmacyLocator?maxDistance={maxDistance}&bin={bin}&groupCode={groupCode} |
Retrieves a list of pharmacies within a specified distance from a given address. |
PlanIncentiveRates
The Plan Incentive Rate resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/planincentives/{planincentiveid}/planincentiverates |
Gets a collection of Plan Incentive Rate resources for a Group Plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/planincentives/{planincentiveid}/planincentiverates/{id} |
Gets a plan incentive rate resource |
POST api/groups/{groupid}/groupplans/{groupplanid}/planincentives/{planincentiveid}/planincentiverates |
Posts a new plan incentive rate object to the specified plan incentive record |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/planincentives/{planincentiveid}/planincentiverates/{id} |
Patches an existing plan incentive rate |
Company
The Company resource for the authenticated user
API | Description |
---|---|
GET api/company?showGroups={showGroups} |
Gets the company information for the authenticated user |
GroupSetup
A resource for creating a new group, facility, and plan with the minimum requirements
API | Description |
---|---|
POST api/groupsetup?createPlan={createPlan} |
Adds a new group, facility, and plan with the minimum requirements |
Groups
The Group resource for the authenticated user
API | Description |
---|---|
GET api/groups?showGroupPlans={showGroupPlans} |
Gets a collection of Groups based on the company associated with the authenticated user |
GET api/groups/{id}?showGroupPlans={showGroupPlans} |
Gets a a Group based on provided identifier of and the company associated with the authenticated user |
BenefitCodes
The Benefit Code resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/benefitcodes |
Gets a collection of benefit code resources |
GET api/groups/{groupid}/benefitcodes/{id} |
Gets a benefit code resource |
BillingGroups
The Billing Group resource for the authenticated user
API | Description |
---|---|
GET api/billinggroups |
Gets a collection of billing group resources |
GET api/billinggroups/{id} |
Gets a billing group resource |
PriceCodes
The Price Code resource for the authenticated user
API | Description |
---|---|
GET api/pricecodes |
Gets a collection of Price Codes |
GET api/pricecodes/{id} |
Gets a Price Code |
RuleActionTypes
The Rule Action Type resource for the authenticated user
API | Description |
---|---|
GET api/ruleactiontypes |
Gets a collection of Rule Action Types |
GET api/ruleactiontypes/{id} |
Gets a Rule Action Type |
Coinsurances
The Coinsurance resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/coinsurances |
Gets a collection of Coinsurance/Copay resources for a Group Plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/coinsurances/{id} |
Gets a coinsurance resource |
POST api/groups/{groupid}/groupplans/{groupplanid}/coinsurances |
Posts a new coinsurance to an existing group plan |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/coinsurances/{id} |
Patches an existing coinsurance record |
CoinsuranceRates
The Coinsurance Rate resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/coinsurances/{coinsuranceid}/coinsurancerates |
Gets a collection of Coinsurance/Copay resources for a Group Plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/coinsurances/{coinsuranceid}/coinsurancerates/{id} |
Gets a coinsurance resource |
POST api/groups/{groupid}/groupplans/{groupplanid}/coinsurances/{coinsuranceid}/coinsurancerates |
Posts a new coinsurance rate object to the specified coinsurance record |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/coinsurances/{coinsuranceid}/coinsurancerates/{id} |
Patches an existing plan pricing group drug |
PlanContracts
The Plan Contract resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/plancontracts |
Gets a collection of plan contracts for a Group Plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/plancontracts/{id} |
Gets a plan contract |
POST api/groups/{groupid}/groupplans/{groupplanid}/plancontracts |
Posts a plan contract |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/plancontracts/{id} |
Patches an plan contract |
Deductibles
The Deductible resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/deductibles |
Gets a collection of deductible resources for a Group Plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/deductibles/{id} |
Gets a deductible resource |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/deductibles/{id} |
Patches an existing plan pricing group |
POST api/groups/{groupid}/groupplans/{groupplanid}/deductibles |
Posts a new deductible |
MaxOutOfPockets
The Max Out Of Pocket resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/maxoutofpockets |
Gets a collection of max out of pocket resources for a Group Plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/maxoutofpockets/{id} |
Gets max out of pocket resource |
POST api/groups/{groupid}/groupplans/{groupplanid}/maxoutofpockets |
Posts a new max out of pocket to an existing group |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/maxoutofpockets/{id} |
Patches an existing max out of pocket |
PlanBenefitLimits
The Plan Benefit Limit resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/planbenefitlimits |
Gets a collection of plan benefit limit resources for a Group Plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/planbenefitlimits/{id} |
Gets a plan benefit limit resource |
POST api/groups/{groupid}/groupplans/{groupplanid}/planbenefitlimits |
Posts a plan benefit limit |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/planbenefitlimits/{id} |
Patches a plan benefit limit |
PenaltyBasises
The Drug Selection Penalty Basises Groups resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/penaltybasises |
Gets a collection of drug selection penalty basis resources |
GET api/groups/{groupid}/groupplans/{groupplanid}/penaltybasises/{id} |
Gets a drug selection penalty basis resource |
POST api/groups/{groupid}/groupplans/{groupplanid}/penaltybasises |
Posts a penalty basis record |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/penaltybasises/{id} |
Patches a penalty basis record |
PlanPricingGroups
The Plan Pricing Group resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/planpricinggroups |
Gets a collection of plan pricing groups for a Group Plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/planpricinggroups/{id} |
Gets a plan pricing group |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/planpricinggroups/{id} |
Patches an existing plan pricing group |
POST api/groups/{groupid}/groupplans/{groupplanid}/planpricinggroups |
Posts a new pricing group |
PerDiems
The Per Diem resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/perdiems?showRates={showRates} |
Gets a collection of per diem resources for a Group Plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/perdiems/{id}?showRates={showRates} |
Gets a per diem resource |
AppliedPharmacyHeadquarterExceptions
The Applied Pharmacy Headquarter Exception resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/appliedpharmacyheadquarterexceptions |
Gets a collection of Applied Pharmacy Headquarter Exceptions for a Group Plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/appliedpharmacyheadquarterexceptions/{id} |
Gets an Applied Pharmacy Headquarter Exception |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/appliedpharmacyheadquarterexceptions/{id} |
Patches an existing Applied Pharmacy Headquarter Exception. |
POST api/groups/{groupid}/groupplans/{groupplanid}/appliedpharmacyheadquarterexceptions |
Posts a new Applied Pharmacy Headquarter Exception. |
DELETE api/groups/{groupid}/groupplans/{groupplanid}/appliedpharmacyheadquarterexceptions/{id} |
Deletes an Applied Pharmacy Headquarter Exception |
RuleOverrides
The Rule Override resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleoverrides |
Gets a collection of standard override rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleoverrides/{id} |
Gets a standard override rule for the specified group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/ruleoverrides |
Adds a new override rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/ruleoverrides/{id} |
Patches an override rule |
RuleOverrideNDCSpecifics
The Rule Override NDC Specific Controller resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleoverridendcspecifics |
Gets a collection of NDC specific override rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleoverridendcspecifics/{id} |
Gets an NDC specific override rule for a given group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/ruleoverridendcspecifics |
Adds a new override rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/ruleoverridendcspecifics/{id} |
Patches an override ndc specific rule |
RuleOverrideSpecialDrugs
The Rule Override Special Drug resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleoverridespecialdrugs |
Gets a collection of special drug override rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleoverridespecialdrugs/{id} |
Gets a special drug override rule for a given group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/ruleoverridespecialdrugs |
Adds a new override rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/ruleoverridespecialdrugs/{id} |
Patches an override rule |
RuleDAWs
The Rule DAWs resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/ruledaws |
Gets a collection of standard DAW rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/ruledaws/{id} |
Gets a standard benefit rule for a given group plan and rule identifier |
RulePlanFormularies
The Rule Plan Formularies resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleplanformularies |
Gets a collection of standard plan formulary rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleplanformularies/{id} |
Gets a standard plan formulary rule for the specified group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/ruleplanformularies |
Adds a new plan formulary rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/ruleplanformularies/{id} |
Patches a plan formulary rule |
RulePlanFormularyNDCSpecifics
The Rule Plan Formulary NDC Specific resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleplanformularyndcspecifics |
Gets a collection of NDC specific plan formulary rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleplanformularyndcspecifics/{id} |
Gets an NDC specific plan formulary rule for a given group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/ruleplanformularyndcspecifics |
Adds a new NDC specific plan formulary rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/ruleplanformularyndcspecifics/{id} |
Patches an plan formulary ndc specific rule |
RulePlanFormularySpecialDrugs
The Rule Plan Formulary Special Drug resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleplanformularyspecialdrugs |
Gets a collection of special drug plan formulary rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleplanformularyspecialdrugs/{id} |
Gets a special drug plan formulary rule for a given group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/ruleplanformularyspecialdrugs |
Adds a new special drug plan formulary rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/ruleplanformularyspecialdrugs/{id} |
Patches a special drug plan formulary rule |
RuleMemberFormularies
The Rule Member Formularies resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulememberformularies |
Gets a collection of standard member formulary rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulememberformularies/{id} |
Gets a standard member formulary rule for the specified group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rulememberformularies |
Adds a new member formulary rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/rulememberformularies/{id} |
Patches an existing member formulary rule |
RuleMemberFormularyNDCSpecifics
The Rule Members Formulary NDC Specific resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulememberformularyndcspecifics |
Gets a collection of NDC specific member formulary rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulememberformularyndcspecifics/{id} |
Gets an NDC specific member formulary rule for a given group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rulememberformularyndcspecifics |
Adds a new ndc specific member formulary rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/rulememberformularyndcspecifics/{id} |
Patches an existing ndc specific member formulary rule |
RulePrescriberFormularies
The Rule Prescriber Formularies resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleprescriberformularies |
Gets a collection of standard prescriber formulary rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleprescriberformularies/{id} |
Gets a standard prescriber formulary rule for the specified group plan and rule identifier |
RulePrescriberFormularyNDCSpecifics
The Rule Prescriber Formulary NDC Specific resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleprescriberformularyndcspecifics |
Gets a collection of NDC specific prescriber formulary rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleprescriberformularyndcspecifics/{id} |
Gets an NDC specific prescriber formulary rule for a given group plan and rule identifier |
RuleStepTherapies
The Rule Step Therapies resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulesteptherapies |
Gets a collection of standard step therapy rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulesteptherapies/{id} |
Gets a standard step therpay rule for a given group plan and rule identifier |
RuleStepTherapyNDCSpecifics
The Rule Step Therapy NDC Specific resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulesteptherapyndcspecifics |
Gets a collection of NDC specific step therapy rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulesteptherapyndcspecifics/{id} |
Gets an NDC specific step therpay rule for a given group plan and rule identifier |
RuleClaimLimits
The Rule Claim Limit resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleclaimlimits |
Gets a collection of standard claim limit rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleclaimlimits/{id} |
Gets a standard claim limit rule for a given group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/ruleclaimlimits |
Adds a new standard claim limit rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/ruleclaimlimits/{id} |
Patches a standard claim limit rule |
RuleClaimLimitNDCSpecifics
The Rule Claim Limit NDC Specific resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleclaimlimitndcspecifics |
Gets a collection of NDC specific claim limit rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleclaimlimitndcspecifics/{id} |
Gets an NDC specific claim limit rule for a given group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/ruleclaimlimitndcspecifics |
Adds a new NDC specific claim limit rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/ruleclaimlimitndcspecifics/{id} |
Patches an claim limit ndc specific rule |
RuleClaimLimitSpecialDrugs
The Rule Claim Limit Special Drug resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleclaimlimitspecialdrugs |
Gets a collection of special drug claim limit rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleclaimlimitspecialdrugs/{id} |
Gets a special drug claim limit rule for a given group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/ruleclaimlimitspecialdrugs |
Adds a new special drug claim limit rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/ruleclaimlimitspecialdrugs/{id} |
Patches a special drug claim limit rule |
RuleClaimLimitDefaults
The Rule Claim Limit Default resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleclaimlimitdefaults |
Gets a collection of claim limit default rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleclaimlimitdefaults/{id} |
Gets a claim limit rule for a given group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/ruleclaimlimitdefaults |
Adds a new claim limit default rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/ruleclaimlimitdefaults/{id} |
Patches a claim limit default rule |
RulePharmacyFormularies
The Rule Pharmacy Formularies resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulepharmacyformularies |
Gets a collection of standard pharmacy formulary rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulepharmacyformularies/{id} |
Gets a standard pharmacy formulary rule for a given group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rulepharmacyformularies |
Adds a new pharmacy formulary rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/rulepharmacyformularies/{id} |
Patches an existing pharmacy formulary rule |
RulePharmacyFormularyNDCSpecifics
The Rule Pharmacy Formulary NDC Specific resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulepharmacyformularyndcspecifics |
Gets a collection of NDC specific pharmacy formulary rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulepharmacyformularyndcspecifics/{id} |
Gets an NDC specific pharmacy formulary rule for a given group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rulepharmacyformularyndcspecifics |
Adds a new ndc specific pharmacy formulary rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/rulepharmacyformularyndcspecifics/{id} |
Patches an existing ndc specific pharmacy formulary rule |
RulePharmacyFormularySpecialDrugs
The Rule Pharmacy Formulary Special Drugs resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulepharmacyformularyspecialdrugs |
Gets a collection of special drug pharmacy formulary rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulepharmacyformularyspecialdrugs/{id} |
Gets a special drug pharmacy formulary rule for a given group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rulepharmacyformularyspecialdrugs |
Adds a new pharmacy formulary special drug rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/rulepharmacyformularyspecialdrugs/{id} |
Patches an existing pharmacy formulary special drug rule |
RuleOptions
The Rule Option resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleoptions |
Gets a collection of standard option rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleoptions/{id} |
Gets a standard option rule for the specified group plan and rule identifier |
RuleOptionNDCSpecifics
The Rule Options NDC Specific resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleoptionndcspecifics |
Gets a collection of NDC specific option rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleoptionndcspecifics/{id} |
Gets an NDC specific option rule for a given group plan and rule identifier |
RuleOptionSpecialDrugs
The Rule Options Special Drug resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleoptionspecialdrugs |
Gets a collection of special drug option rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/ruleoptionspecialdrugs/{id} |
Gets a special drug option rule for a given group plan and rule identifier |
RuleFinalFormularies
The Rule Final Formularies resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulefinalformularies |
Gets a collection of standard Final Formulary rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulefinalformularies/{id} |
Gets a Final Formulary Rule for the specified group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rulefinalformularies |
Adds a new final formulary rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/rulefinalformularies/{id} |
Patches a final formulary rule |
RuleFinalFormularyNDCSpecifics
The Rule Final Formularies NDC Specific resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulefinalformularyndcspecifics |
Gets a collection of NDC specific Final Formulary rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulefinalformularyndcspecifics/{id} |
Gets an NDC specific Final Formulary Rule for the specified group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rulefinalformularyndcspecifics |
Adds a new ndc specific final formulary rule |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/rulefinalformularyndcspecifics/{id} |
Patches an final formulary ndc specific rule |
RuleBenefits
The Rule Benefit resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulebenefits |
Gets a collection of standard benefit rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulebenefits/{id} |
Gets a standard benefit rule for a given group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rulebenefits |
No documentation available. |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/rulebenefits/{id} |
Patches an existing member formulary rule |
RuleBenefitNDCSpecifics
The Rule Benefit NDC Specific resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulebenefitndcspecifics |
Gets a collection of NDC specific benefit rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulebenefitndcspecifics/{id} |
Gets an NDC specific benefit rule for a given group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rulebenefitndcspecifics |
No documentation available. |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/rulebenefitndcspecifics/{id} |
Patches an existing NDC specific benefit rule |
RuleBenefitSpecialDrugs
The Rule Benefit Special Drug resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulebenefitspecialdrugs |
Gets a collection of special drug benefit rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulebenefitspecialdrugs/{id} |
Gets a special drug benefit rule for a given group plan and rule identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rulebenefitspecialdrugs |
No documentation available. |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/rulebenefitspecialdrugs/{id} |
Patches an existing special drug benefit rule |
RulePostPricings
The Rule Post Pricing resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulepostpricings |
Gets a collection of standard post pricing rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulepostpricings/{id} |
Gets a standard post pricing rule for the specified group plan and rule identifier |
RulePostPricingNDCSpecifics
The Rule Post Pricing NDC Specific resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulepostpricingndcspecifics |
Gets a collection of NDC specific post pricing rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulepostpricingndcspecifics/{id} |
Gets an NDC specific post pricing rule for a given group plan and rule identifier |
RulePostPricingSpecialDrugs
The Rule Post Pricing Special Drug resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rulepostpricingspecialdrugs |
Gets a collection of special drug post pricing rules for a given group plan |
GET api/groups/{groupid}/groupplans/{groupplanid}/rulepostpricingspecialdrugs/{id} |
Gets a special drug post pricing rule for a given group plan and rule identifier |
PerDiemRates
The Per Diem Rate resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/perdiems/{perdiemid}/perdiemrates |
Gets a collection of per diem rates for a per diem resource |
GET api/groups/{groupid}/groupplans/{groupplanid}/perdiems/{perdiemid}/perdiemrates/{id} |
Gets a per diem rate |
PlanPricingGroupDrugs
The Plan Pricing Group Drug resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/planpricinggroups/{planpricinggroupid}/planpricinggroupdrugs |
Gets a collection of pricing group drugs for a plan pricing group |
GET api/groups/{groupid}/groupplans/{groupplanid}/planpricinggroups/{planpricinggroupid}/planpricinggroupdrugs/{id} |
Gets a plan pricing group drug |
POST api/groups/{groupid}/groupplans/{groupplanid}/planpricinggroups/{planpricinggroupid}/planpricinggroupdrugs |
Posts a new drug to an existing pricing group |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/planpricinggroups/{planpricinggroupid}/planpricinggroupdrugs/{id} |
Patches an existing plan pricing group drug |
DELETE api/groups/{groupid}/groupplans/{groupplanid}/planpricinggroups/{planpricinggroupid}/planpricinggroupdrugs/{id} |
Deletes a plan pricing group drug |
AppliedPharmacyHeadquarterInclusions
The Applied Pharmacy Headquarter Inclusion resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/appliedpharmacyheadquarterexceptions/{exceptionid}/appliedpharmacyheadquarterinclusions |
Gets a collection of pharmacy inclusions for an Applied Pharmacy Headquarter Exception |
GET api/groups/{groupid}/groupplans/{groupplanid}/appliedpharmacyheadquarterexceptions/{exceptionid}/appliedpharmacyheadquarterinclusions/{id} |
Gets an included pharmacy for an Applied Pharmacy Headquarter Exception |
POST api/groups/{groupid}/groupplans/{groupplanid}/appliedpharmacyheadquarterexceptions/{exceptionid}/appliedpharmacyheadquarterinclusions |
Posts a new included pharmacy for an Applied Pharmacy Headquarter Exception |
DELETE api/groups/{groupid}/groupplans/{groupplanid}/appliedpharmacyheadquarterexceptions/{exceptionid}/appliedpharmacyheadquarterinclusions/{id} |
Deletes an included pharmacy for an Applied Pharmacy Headquarter Exception |
OpenEnrollmentSubmissionClarificationCodes
The Open Enrollment Submission Clarification Code resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/plancontracts/{plancontractid}/openenrollmentsubmissionclarificationcodes |
Gets a collection of open enrollment submission clarification code resources for a Plan Contract |
GET api/groups/{groupid}/groupplans/{groupplanid}/plancontracts/{plancontractid}/openenrollmentsubmissionclarificationcodes/{id} |
Gets an open enrollment submission clarification code resource |
RuleDrugs
The Rule Drug resource for authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruledrugs |
Gets a collection of Rule Drugs for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruledrugs/{id} |
Gets a Rule Drug for the specified rule and drug identifier |
RulePharmacyTypes
The Rule Pharmacy Type resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulepharmacytypes |
Gets a collection of pharmacy types for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulepharmacytypes/{id} |
Gets a pharmacy type for the specified rule and pharmacy type identifier |
PharmacyType
The Pharmacy Type resource for the authenticated user
API | Description |
---|---|
GET api/pharmacytypes |
Gets a collection of all pharmacy types |
RuleMembers
The Rule Member resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulemembers |
Gets a collection of rule members for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulemembers/{id} |
Gets a rule member for the specified rule and member identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulemembers |
Adds a new member to an existing rule |
RuleNetworks
The Rule Network resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulenetworks |
Gets a collection of rule networks for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulenetworks/{id} |
Gets a rule network for the specified rule and member identifier |
RulePricingGroups
The Rule Pricing Group resource for authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulepricinggroups |
Gets a collection of Rule Pricing Groups for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulepricinggroups/{id} |
Gets a Rule Pricing Group for the specified rule and pricing group identifier |
RulePharmacyHeadquarters
The Rule Pharmacy Headquarter resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulepharmacyheadquarters |
Gets a collection of pharmacy headquarters for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulepharmacyheadquarters/{id} |
Gets a pharmacy headquarter for the specified rule and pharmacy headquarter identifier |
PATCH api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulepharmacyheadquarters/{id} |
No documentation available. |
RulePharmacies
The Rule Pharmacy resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulepharmacies |
Gets a collection of pharmacies for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulepharmacies/{id} |
Gets a pharmacy for the specified rule and pharmacy identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulepharmacies |
Adds a new pharmacy to an existing rule |
RulePrescribers
The Rule Prescriber resource for authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruleprescribers |
Gets a collection of Rule Prescribers for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruleprescribers/{id} |
Gets a Rule Prescriber for the specified rule and prescriber identifier |
RuleContractCodes
The Contract Code resource for authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulecontractcodes |
Gets a collection of Rule Contract Codes for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulecontractcodes/{id} |
Gets a Rule Contract Code for the specified rule and contract code identifier |
RuleARCodes
The Rule AR Code resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulearcodes |
Gets a collection of Rule AR Codes for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulearcodes/{id} |
Gets a Rule AR Code for the specified rule and AR code identifier |
RuleCoverageLevels
The Rule Coverage Level resource for authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulecoveragelevels |
Gets a collection of Rule Coverage Levels for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulecoveragelevels/{id} |
Gets a Rule Coverage Level for the specified rule and coverage level identifier |
RuleEmployeeStatuses
The Rule Employee Statuses resource for authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruleemployeestatuses |
Gets a collection of Rule Employee Statuses for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruleemployeestatuses/{id} |
Gets a Rule Employee Status for the specified rule and employee status form identifier |
RuleOtherStatuses
The Rule Other Statuses resource for authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruleotherstatuses |
Gets a collection of Rule Other Statuses for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruleotherstatuses/{id} |
Gets a Rule Other Status for the specified rule and other status form identifier |
RuleStates
The Rule States resource for authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulestates |
Gets a collection of Rule States for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulestates/{id} |
Gets a Rule State for the specified rule and ROA identifier |
RuleGPIs
The Rule GPIs resource for authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulegpis |
Gets a collection of Rule GPIs for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulegpis/{id} |
Gets a Rule GPI for the specified rule and GPI identifier |
RuleROAs
The Route of Administrations (ROA) resource for authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruleroas |
Gets a collection of Rule ROAs for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruleroas/{id} |
Gets a Rule ROA for the specified rule and ROA identifier |
RuleDosageForms
The Rule Dosage Forms resource for authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruledosageforms |
Gets a collection of Rule Dosage Forms for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruledosageforms/{id} |
Gets a Rule Dosage Forms for the specified rule and dosage form identifier |
RuleSubmissionClarificationCodes
The Submission Clarification Codes (SCC) resource for authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulesubmissionclarificationcodes |
Gets a collection of Rule SCCs for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulesubmissionclarificationcodes/{id} |
Gets a Rule SCC for the specified rule and SCC identifier |
POST api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulesubmissionclarificationcodes |
Deletes a submission clarification code by other claim by ID |
DELETE api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/rulesubmissionclarificationcodes/{id} |
Deletes a submission clarification code by other claim by ID |
RulePrerequisiteDrugs
The Rule Prerequisite Drugs resource for authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruleprerequisitedrugs |
Gets a collection of Rule Prerequisite Drugs for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruleprerequisitedrugs/{id} |
Gets a Rule Prerequisite Drug for the specified rule and prerequisite drug identifier |
RulePrerequisiteGPIs
The Rule Prerequisite GPIs resource for authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruleprerequisitegpis |
Gets a collection of Rule Prerequisite GPIs for a rule by rule identifier |
GET api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruleprerequisitegpis/{id} |
Gets a Rule Prerequisite GPI for the specified rule and prerequisite GPI identifier |
ServiceCategories
The Service Category resource for authenticated user
API | Description |
---|---|
GET api/servicecategories |
No documentation available. |
BrandNameCodes
The Brand Name Code resource for authenticated user
API | Description |
---|---|
GET api/brandnamecodes |
Gets all brand name codes |
DEASchedules
The DEA Schedule resource for authenticated user
API | Description |
---|---|
GET api/deaschedules |
Gets a list of DEA Schedules |
MultiSourceCodes
The Multi Source Code resource for authenticated user
API | Description |
---|---|
GET api/multisourcecodes |
No documentation available. |
Relationships
The Relationship resource for authenticated user
API | Description |
---|---|
GET api/relationships |
No documentation available. |
BenefitCheck
The Benefit Check resource for authenticated user
API | Description |
---|---|
GET api/benefitcheck?memberNo={memberNo}&benefitCodeNo={benefitCodeNo}&dateOfService={dateOfService}&excludeClaimsAfterDateOfService={excludeClaimsAfterDateOfService} |
Retrieves the claim amounts for specified intervals (Period, Month, and Lifetime), along with the Max Out of Pocket (MOOP) and deductible values set up on the plan for a given member. |
PriorAuths
The Prior Auths resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/priorauths?approvedStatus={approvedStatus}&memberNo={memberNo}&startDate={startDate}&endDate={endDate} |
Get a prior authorization model by group, group plan, and optionally memberNo, and dateOfService startDate and endDate |
GET api/groups/{groupid}/priorauths/{id} |
Gets a single prior authorization by its uniqueidentifier and group |
PATCH api/groups/{groupid}/priorauths/{id} |
Patches an existing prior auth |
PriorAuthPersistents
The Prior Authorization Persist resource for the authenticated user
API | Description |
---|---|
GET api/groups/{groupid}/priorauthpersistents?activeDate={activeDate}&memberNo={memberNo}&cardholderNo={cardholderNo}&NDC={NDC}&GPI={GPI}&rxNumber={rxNumber} |
Gets a collection of Persisted Prior Authorizations |
GET api/groups/{groupid}/priorauthpersistents/{id} |
Gets a Persistent Prior Authorization object by group and id |
POST api/groups/{groupid}/priorauthpersistents?priorAuthID={priorAuthID} |
Posts a new persistent PA to an existing group |
PATCH api/groups/{groupid}/priorauthpersistents/{id} |
Patches an existing persistent prior auth |
OverrideTypes
The Override Type resource for the authenticated user
API | Description |
---|---|
GET api/overridetypes |
Gets override type resources for the current user's company |
GET api/overridetypes/{id} |
Gets override type resource by id |