RuleGeneralOptionsByDrugNDCSpecifics

The Rule General Option resource for the authenticated user

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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.

APIDescription
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

APIDescription
GET api/globalcompanydiagnosiscodelimits/{companydiagnosiscodelimitid}/companydiagnosiscodelimitdxcodes

Gets a collection of global dx codes that apply to a diagnosis code limit

GET api/globalcompanydiagnosiscodelimits/{companydiagnosiscodelimitid}/companydiagnosiscodelimitdxcodes/{id}

Gets a global Company Diagnosis Code Limit Dx Code by diagnosis code limit ID and the ID of the dx code

GET api/formularies/{formularyid}/formularycompanydiagnosiscodelimits/{formularycompanydiagnosiscodelimitid}/companydiagnosiscodelimitdxcodes/{id}

Gets a single Company Diagnosis Code Limit Dx Code by formulary, diagnosis code limit ID and ID of the dx code.

POST api/globalcompanydiagnosiscodelimits/{companydiagnosiscodelimitid}/companydiagnosiscodelimitdxcodes

Posts a new Company Diagnosis Code Limit Dx Code The id of the company diagnosis code limit for which dx codes will be added

POST api/formularies/{formularyid}/formularycompanydiagnosiscodelimits/{companydiagnosiscodelimitid}/companydiagnosiscodelimitdxcodes?formularycompanydiagnosiscodelimitid={formularycompanydiagnosiscodelimitid}

Posts a new Formulary Diagnosis Code Limit Dx Code The id of the formulary for which dx codes will be returnedThe id of the company diagnosis code limit for which dx codes will be added

DELETE api/globalcompanydiagnosiscodelimits/{companydiagnosiscodelimitid}/companydiagnosiscodelimitdxcodes/{id}

Deletes a Company Diagnosis Code Limit Dx Code by ID

DELETE api/formularies/{formularyid}/formularycompanydiagnosiscodelimits/{companydiagnosiscodelimitid}/companydiagnosiscodelimitdxcodes/{id}?formularycompanydiagnosiscodelimitid={formularycompanydiagnosiscodelimitid}

Deletes a single Company Diagnosis Code Limit Dx Code by formulary, diagnosis code limit ID and ID of the dx code.

GET api/formularies/{formularyid}/formularycompanydiagnosiscodelimits/{formularycompanydiagnosiscodelimitid}/companydiagnosiscodelimitdxcodes

Gets a collection of dx codes that apply to a diagnosis code limit on a formulary

PriceCheck

APIDescription
POST api/PriceCheck

No documentation available.

RuleRejectCodes

The Rule Reject Code resource for authenticated user

APIDescription
GET api/rulerejectcodes

Gets a list of Rule Reject Codes

Formularies

The Formulary resource for the authenticated user

APIDescription
GET api/formularies?activeOnly={activeOnly}

Gets a collection of Formulary resources for a Company.

GET api/formularies/{id}

Gets a formulary by id

DrugProfileGPIs

APIDescription
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

APIDescription
GET api/formularies/{formularyid}/formularycompanystepmedications/{formularycompanystepmedicationid}/companystepmedicationmultisourcecodes

Gets a collection of multi source codes that apply to a formulary step medication's step drug.

GET api/globalcompanystepmedications/{companystepmedicationid}/companystepmedicationmultisourcecodes

Gets a collection of global multi source codes that apply to a step medication's step drug

GET api/formularies/{formularyid}/formularycompanystepmedications/{formularycompanystepmedicationid}/companystepmedicationmultisourcecodes/{id}

Gets a formulary-level Company Step Medication MultiSourceCode by formulary ID, step medication ID and the ID of the multisource code

GET api/globalcompanystepmedications/{companystepmedicationid}/companystepmedicationmultisourcecodes/{id}

Gets a global Company Step Medication MultiSourceCode by step medication ID and the ID of the multisource code

POST api/companystepmedications/{companystepmedicationid}/companystepmedicationmultisourcecodes

Posts a new Company Step Medication Multi Source Code The id of the step medication for which multi source codes will be returned

DELETE api/companystepmedications/{companystepmedicationid}/companystepmedicationmultisourcecodes/{id}

Deletes a Company Step Medication Multi Source Code by ID

PortalDrugSearch

Controller responsible for providing drug search functionality.

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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.

APIDescription
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

APIDescription
GET api/formularies/{formularyid}/formularycompanystepmedications/{formularycompanystepmedicationid}/companystepmedicationstepdrugs

Gets a collection of step drugs that apply to a step medication on a formulary

GET api/globalcompanystepmedications/{companystepmedicationid}/companystepmedicationstepdrugs

Gets a collection of global step drugs that apply to a step medication

GET api/formularies/{formularyid}/formularycompanystepmedications/{formularycompanystepmedicationid}/companystepmedicationstepdrugs/{id}

Gets a single Company Step Medication Step Drug/Product by formulary, step medication ID and ID of the step drug.

GET api/globalcompanystepmedications/{companystepmedicationid}/companystepmedicationstepdrugs/{id}

Gets a global Company Step Medication Step Drug by step medication ID and the ID of the step drug

POST api/companystepmedications/{companystepmedicationid}/companystepmedicationstepdrugs

Posts a new Company Step Medication Step Drug The id of the company step medication for which step drugs will be added

DELETE api/companystepmedications/{companystepmedicationid}/companystepmedicationstepdrugs/{id}

Deletes a Company Step Medication Step Drug by ID

RuleStandardFormularyNDCSpecifics

The Rule Standard Formulary NDC Specific Controller resource for the authenticated user

APIDescription
GET api/groupplantemplates/{groupplantemplateid}/rulestandardformularyndcspecifics

Gets a collection of Standard Formulary NDC specific rule templates for a given group plan template

GET api/groupplantemplates/{groupplantemplateid}/rulestandardformularyndcspecifics/{id}

Gets an standard formulary rule ndc specific templates for the specified group plan template and template rule identifier

POST api/groupplantemplates/{groupplantemplateid}/rulestandardformularyndcspecifics/{id}/override?groupplanid={groupplanid}

Overrides a standard formulary ndc specific template rule

POST api/groupplantemplates/{groupplantemplateid}/rulestandardformularyndcspecifics/{id}/reset?groupplanid={groupplanid}

Resets a standard formulary ndc specific template rule

POST api/groupplantemplates/{groupplantemplateid}/rulestandardformularyndcspecifics/{id}/disableInheritingPlan?groupplanid={groupplanid}

Disables a standard formulary ndc specific template inheriting plan

POST api/groupplantemplates/{groupplantemplateid}/rulestandardformularyndcspecifics/{id}/enableInheritingPlan?groupplanid={groupplanid}

Enables a standard formulary ndc specific template inheriting plan

GET api/groups/{groupid}/groupplans/{groupplanid}/rulestandardformularyndcspecifics?showTemplates={showTemplates}

Gets a collection of NDC specific standard formulary rules for a given group plan

GET api/groups/{groupid}/groupplans/{groupplanid}/rulestandardformularyndcspecifics/{id}

Gets an NDC specific standard formulary rule for a given group plan and rule identifier

POST api/groups/{groupid}/groupplans/{groupplanid}/rulestandardformularyndcspecifics

Adds a new ndc specific standard formulary rule

PATCH api/groups/{groupid}/groupplans/{groupplanid}/rulestandardformularyndcspecifics/{id}

Patches an existing ndc specific standard formulary rule

The CMPP Network Logo resource for the authenticated user

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
GET api/dawcodes

Gets a list of DAW Codes

RuleGeneralOptions

The Rule General Option resource for the authenticated user

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
GET api/routeofadministrations

Retrieves all routes of administration.

RuleGeneralOptionsByDrugs

The Rule General Option resource for the authenticated user

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
GET api/groupplans/{groupplanid}/formularies/{formularyid}/planstepmedications?page={page}&pagesize={pagesize}

Gets a collection of plan step medications by formulary identifier and group plan identifier

GET api/groupplans/{groupplanid}/formularies/{formularyid}/planstepmedications/{id}

Gets a plan step medication by formulary identifier and group plan identifier and plan step medication id

GET api/groupplans/{groupplanid}/planonlystepmedications?page={page}&pagesize={pagesize}

Gets a collection of plan only step medications

GET api/groupplans/{groupplanid}/planonlystepmedications/{id}

Gets a plan only step medication by group plan identifier and plan only step medication id

POST api/groupplans/{groupplanid}/formularies/{formularyid}/planstepmedications/optin-all

Opt-in of all plan step medications for all plans tied to a formulary

POST api/groupplans/{groupplanid}/formularies/{formularyid}/planstepmedications/optout-all

Opt-out of all Plan Step Medications for all plans tied to a formulary

PlanTemplatePricingGroups

The Plan Template Pricing Group resource for the authenticated user

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
GET api/diagnosiscodes/{description}

Gets a diagnosis code resource

PharmacyHeadquarterCodes

The Pharmacy Headquarter Code resource for the authenticated user

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
GET api/groupplans/{groupplanid}/formularies/{formularyid}/planproductexclusions?page={page}&pagesize={pagesize}

Gets a collection of Plan Product Exclusions by formulary identifier and group plan identifier

GET api/groupplans/{groupplanid}/formularies/{formularyid}/planproductexclusions/{id}

Gets a Plan Product Exclusion by formulary identifier and group plan identifier and plan product exclusion id

GET api/groupplans/{groupplanid}/planonlyproductexclusions?page={page}&pagesize={pagesize}

Gets a collection of Plan Only Product Exclusions

GET api/groupplans/{groupplanid}/planonlyproductexclusions/{id}

Gets a Plan Only Product Exclusions by group plan identifier and plan product exclusion id

POST api/groupplans/{groupplanid}/formularies/{formularyid}/planproductexclusions/optin-all

Opt-in of all Product Exclusions for all plans tied to a formulary

POST api/groupplans/{groupplanid}/formularies/{formularyid}/planproductexclusions/optout-all

Opt-out of all Product Exclusions for all plans tied to a formulary

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.

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
GET api/alternateprocessorvendors

No documentation available.

GET api/alternateprocessorvendors/{id}

No documentation available.

AlternateProcessors

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
GET api/dosageforms

Retrieves all dosage forms.

PlanFormulary

The Plan Formulary resource for the authenticated user

APIDescription
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

APIDescription
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

APIDescription
GET api/groupplans/{groupplanid}/formularies/{formularyid}/planformularyproducts?page={page}&pagesize={pagesize}

Gets a collection of Plan Formulary Products by formulary identifier and group plan identifier

GET api/groupplans/{groupplanid}/formularies/{formularyid}/planformularyproducts/{id}

Gets a Plan Formulary Product by formulary identifier and group plan identifier and plan formulary product id

GET api/groupplans/{groupplanid}/planonlyformularyproducts?page={page}&pagesize={pagesize}

Gets a collection of Plan Only Formulary Products

GET api/groupplans/{groupplanid}/planonlyformularyproducts/{id}

Gets a Plan Only Formulary Products by group plan identifier and plan formulary product id

POST api/groupplans/{groupplanid}/formularies/{formularyid}/planformularyproducts/optin-all

Opt-in for all plan formulary products tied to a formulary

POST api/groupplans/{groupplanid}/formularies/{formularyid}/planformularyproducts/optout-all

Opt-out of all plan formulary products tied to a formulary

Accounts

APIDescription
GET api/account/{clientid}/{nonce}

No documentation available.

POST api/account

No documentation available.

MemberDirectory

The Member resource for the authenticated user

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
GET api/groupplans/{groupplanid}/formularies/{formularyid}/planpriorauthorizations?page={page}&pagesize={pagesize}

Gets a collection of Plan Prior Authorizations by formulary identifier and group plan identifier

GET api/groupplans/{groupplanid}/formularies/{formularyid}/planpriorauthorizations/{id}

Gets a Plan Prior Authorization by formulary identifier and group plan identifier and plan prior authorization id

GET api/groupplans/{groupplanid}/planonlypriorauthorizations?page={page}&pagesize={pagesize}

Gets a collection of Plan Only Prior Authorizations

GET api/groupplans/{groupplanid}/planonlypriorauthorizations/{id}

Gets a Plan Only Prior Authorization by group plan identifier and plan prior authorization id

POST api/groupplans/{groupplanid}/formularies/{formularyid}/planpriorauthorizations/optin-all

Opt-in of all Prior Authorizations for all plans tied to a formulary

POST api/groupplans/{groupplanid}/formularies/{formularyid}/planpriorauthorizations/optout-all

Opt-out of all Prior Authorizations for all plans tied to a formulary

RuleStandardFormularies

The Rule Standard Formularies resource for the authenticated user

APIDescription
GET api/groupplantemplates/{groupplantemplateid}/rulestandardformularies

Gets a collection of Standard Formulary rule templates for a given group plan template

GET api/groupplantemplates/{groupplantemplateid}/rulestandardformularies/{id}

Gets an standard formulary rule templates for the specified group plan template and template rule identifier

POST api/groupplantemplates/{groupplantemplateid}/rulestandardformularies/{id}/override?groupplanid={groupplanid}

Overrides a standard formulary template rule

POST api/groupplantemplates/{groupplantemplateid}/rulestandardformularies/{id}/reset?groupplanid={groupplanid}

Resets a standard formulary template rule

POST api/groupplantemplates/{groupplantemplateid}/rulestandardformularies/{id}/disableInheritingPlan?groupplanid={groupplanid}

Disables a standard formulary template inheriting plan

POST api/groupplantemplates/{groupplantemplateid}/rulestandardformularies/{id}/enableInheritingPlan?groupplanid={groupplanid}

Enables a standard formulary template inheriting plan

GET api/groups/{groupid}/groupplans/{groupplanid}/rulestandardformularies?showTemplates={showTemplates}

Gets a collection of standard formulary rules for a given group plan

GET api/groups/{groupid}/groupplans/{groupplanid}/rulestandardformularies/{id}

Gets a standard formulary rule for the specified group plan and rule identifier

POST api/groups/{groupid}/groupplans/{groupplanid}/rulestandardformularies

Adds a new standard formulary rule

PATCH api/groups/{groupid}/groupplans/{groupplanid}/rulestandardformularies/{id}

Patches an existing standard formulary rule

DataQRelationships

The DataQ Relationship resource for the authenticated user

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
POST api/groupsetup?createPlan={createPlan}

Adds a new group, facility, and plan with the minimum requirements

Groups

The Group resource for the authenticated user

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
GET api/pharmacytypes

Gets a collection of all pharmacy types

RuleMembers

The Rule Member resource for the authenticated user

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
GET api/servicecategories

No documentation available.

BrandNameCodes

The Brand Name Code resource for authenticated user

APIDescription
GET api/brandnamecodes

Gets all brand name codes

DEASchedules

The DEA Schedule resource for authenticated user

APIDescription
GET api/deaschedules

Gets a list of DEA Schedules

MultiSourceCodes

The Multi Source Code resource for authenticated user

APIDescription
GET api/multisourcecodes

No documentation available.

Relationships

The Relationship resource for authenticated user

APIDescription
GET api/relationships

No documentation available.

BenefitCheck

The Benefit Check resource for authenticated user

APIDescription
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

APIDescription
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

APIDescription
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

APIDescription
GET api/overridetypes

Gets override type resources for the current user's company

GET api/overridetypes/{id}

Gets override type resource by id