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

Gets a collection of special drug benefit rules for a given group plan

Request Information

URI Parameters

NameDescriptionTypeAdditional information
groupid

Group identifier

 integer

Required
groupplanid

Group Plan identifier

 integer

Required
showTemplates

Show templates

 boolean

Default value is False

Body Parameters

None.

Response Information

Resource Description

A list of special drug benefit rules

Collection of RuleBenefitSpecialDrugModel
NameDescriptionTypeAdditional information
EndProcessing

Gets or sets whether more benefit rules are processed if all criteria has been met

 boolean

None.
SpecialCoinsuranceUrl

Gets or sets the link to the coinsurance resource for the rule

 string

None.
SpecialCoinsuranceNo

Gets or sets the identifier for the coinsurance

 integer

None.
SpecialOutOfPocketCoinsuranceUrl

Gets or sets the link to the out of pocket coinsurance resource for the rule

 string

None.
SpecialOutOfPocketCoinsuranceNo

Gets or sets the identifier for the out of pocket coinsurance

 integer

None.
SpecialPlanBenefitLimitMonthUrl

Gets or sets the link to the monthly plan benefit limit resource for the rule

 string

None.
SpecialPlanBenefitLimitMonthNo

Gets or sets the monthly plan benefit limit identifier

 integer

None.
SpecialPlanBenefitLimitPeriodUrl

Gets or sets the link to the periodic plan benefit limit resource for the rule

 string

None.
SpecialPlanBenefitLimitPeriodNo

Gets or sets the periodic plan benefit limit identifier

 integer

None.
SpecialPlanBenefitLimitLifeUrl

Gets or sets the link to the lifetime plan benefit limit resource for the rule

 string

None.
SpecialPlanBenefitLimitLifeNo

Gets or sets the lifetime plan benefit limit identifier

 integer

None.
SpecialPlanBenefitLimitRxOnlyMonthUrl

Gets or sets the link to the Rx only monthly plan benefit limit resource

 string

None.
SpecialPlanBenefitLimitRxOnlyMonthNo

Gets or sets the Rx only monthly plan benefit limit identifier

 integer

None.
SpecialPlanBenefitLimitRxOnlyPeriodUrl

Gets or sets the link to the Rx only periodic plan benefit limit resource

 string

None.
SpecialPlanBenefitLimitRxOnlyPeriodNo

Gets or sets the Rx only periodic plan benefit limit identifier

 integer

None.
SpecialPlanBenefitLimitRxOnlyLifeUrl

Gets or sets the link to the Rx only lifetime plan benefit limit resource

 string

None.
SpecialPlanBenefitLimitRxOnlyLifeNo

Gets or sets the Rx only lifetime plan benefit limit identifier

 integer

None.
SpecialMaxPlanPaidAmount

Gets or sets whether the max amount that can be applied as the plan responsibility for special drugs (takes priority over the patient pay limit). Amounts in excess of the cap will be added to the copay.

 decimal number

None.
SpecialMaxPatientPayAmt

Gets or sets whether the max amount that can be applied as the patient responsibility for special drugs

 decimal number

None.
SpecialMaxPatientPayAmtIncludeDrugSelPenalty

Gets or sets whether the drug selection penalties are included in the limit(only applies if an amount is defined)

 boolean

None.
SpecialMaxPatientPayAmtIncludeMemberClaimFee

Gets or sets whether the member claim fees are included in the limit(only applies if an amount is defined)

 boolean

None.
SpecialExemptFromDeductible

Gets or sets whether the rule marks claim as exempt from the deductible

 boolean

None.
SpecialExemptFromOutOfPocketLimit

Gets or sets whether the rule marks claim as exempt from max out of pocket limits

 boolean

None.
SpecialApplyCoinsuranceAsDeductible

Gets or sets whether the rule applies coinsurance/copay amounts as the deductible amount(even if exempt from deductible)

 boolean

None.
SpecialDeductibleSplit

Gets or sets whether the percent of the deductible to be paid by the plan

 decimal number

None.
SpecialIncentiveSplit

Gets or sets whether the percent of the incentive that was added to the drug cost to be paid by the plan (This is not the plan incentive)

 decimal number

None.
SpecialPlanIncentiveUrl

Gets or sets the link back to the incentive resource for special drugs for the rule

 string

None.
SpecialPlanIncentiveNo

Gets or sets the plan incentive identifier for special drugs

 integer

None.
SpecialPeriodDeductibleUrl

Gets or sets the link to the periodic deductible resource for the rule

 string

None.
SpecialPeriodDeductibleNo

Gets or sets the periodic deductible identifier

 integer

None.
SpecialPeriodMaxOutOfPocketUrl

Gets or sets the link to the periodic max out of pocket resource for the rule

 string

None.
SpecialPeriodMaxOutOfPocketNo

Gets or sets the periodic max out of pocket identifier

 integer

None.
SpecialMonthlyDeductibleUrl

Gets or sets the link to the monthly deductible resource for the rule

 string

None.
SpecialMonthlyDeductibleNo

Gets or sets the monthly deductible identifier

 integer

None.
SpecialMonthlyMaxOutOfPocketUrl

Gets or sets the link to the monthly max out of pocket resource

 string

None.
SpecialMonthlyMaxOutOfPocketNo

Gets or sets the monthly max out of pocket identifier

 integer

None.
PharmacyPriceMin

Gets or sets the minimum pharmacy price in order for the rule to apply

 decimal number

None.
PharmacyPriceMax

Gets or sets the minimum pharmacy price in order for the rule to apply

 decimal number

None.
PharmacyPricePreTax

Gets or sets the option for whether the pharmacy price range is the pre-tax amount

 boolean

None.
PharmacyPriceCentsMin

Gets or sets the minimum cents portion of the pharmacy price in order for the rule to apply

 decimal number

None.
PharmacyPriceCentsMax

Gets or sets the maximum cents portion of the pharmacy price in order for the rule to apply

 decimal number

None.
PharmacyPriceCentsPreTax

Gets or sets the option for whether the cents portion of the pharmacy price range is the pre-tax amount

 boolean

None.
FirstFillByRx

Gets or sets whether the rule applies to first fills

 boolean

None.
RefillExpired

Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)

 boolean

None.
DiagnosisCodes

Gets or sets the DiagnosisCodes for which the rule applies

 Collection of RuleDiagnosisCodeModel

None.
Members

Gets or sets members for which the rule applies; if the list is empty it applies to all

 Collection of RuleMemberModel

None.
MemberListIsExclusion

Gets or sets a value indicating whether the member list is treated as an exclusion list. If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule. If the list is empty, it applies to all pharmacies regardless of this value.

 boolean

None.
MemberProfileListIsExclusion

Gets or sets a value indicating whether the member profile list is treated as an exclusion list. If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule. If the list is empty, it applies to all pharmacies regardless of this value.

 boolean

None.
Networks

Gets or sets networks for which the rule applies; if the list is empty it applies to all

 Collection of RuleNetworkModel

None.
Headquarters

Gets or sets headquarters for which the rule applies; if the list is empty it applies to all

 Collection of RulePharmacyHeadquarterModel

None.
PharmacyHeadquarterListIsExclusion

Gets or sets a value indicating whether the headquarter list is treated as an exclusion list. If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule. If the list is empty, it applies to all pharmacies regardless of this value.

 boolean

None.
Pharmacies

Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all

 Collection of RulePharmacyModel

None.
PharmacyListIsExclusion

Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list. If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule. If the list is empty, it applies to all pharmacies regardless of this value.

 boolean

None.
PharmacyProfileListIsExclusion

Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list. If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule. If the list is empty, it applies to all pharmacy profiles regardless of this value.

 boolean

None.
Prescribers

Gets or sets prescribers for which the rule applies; if the list is empty it applies to all

 Collection of RulePrescriberModel

None.
PrescriberListIsExclusion

Gets or sets a value indicating whether the prescriber list is treated as an exclusion list. If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule. If the list is empty, it applies to all pharmacies regardless of this value.

 boolean

None.
Facilities

Gets or sets the Facilities for which the rule applies

 Collection of RuleFacilityBranchModel

None.
ExemptFromDeductible

Gets or sets the Exempt from Deductible indicator

 boolean

None.
ExemptFromOutOfPocketLimit

Gets or sets the Exempt from Out of Pocket Limit indicator

 boolean

None.
ApplyCoinsuranceAsDeductible

Gets or sets the Apply Coinsurance as Deductible indicator

 boolean

None.
QuantityMin

Gets or sets the minimum quantity in order for the rule to apply

 decimal number

None.
QuantityMax

Gets or sets the maximum quantity in order for the rule to apply

 decimal number

None.
CompoundDrugs

Gets whether the special drug criteria applies to compound drugs

 boolean

None.
UnknownDrugs

Gets whether the special drug criteria applies to unknown drugs

 boolean

None.
UndefinedDrugs

Gets whether the special drug criteria applies to undefined drugs

 boolean

None.
CompoundLevelOfEffort

Gets level of effort values applicable to the special drug criteria

 Collection of LevelOfEffortModel

None.
GroupPlanNo

Gets or sets the group plan id associated with the rule

 integer

None.
Description

Gets or sets the description

 string

None.
Priority

Gets or sets the priority

 integer

None.
ReferenceCode

Gets or sets the reference code

 string

None.
Message

Gets or sets the message

 string

None.
ChangeNote

Gets the latest change note or sets a change note to be saved on a patch

 string

None.
EffectiveStartDate

Gets or sets the effective start date

 date

None.
EffectiveEndDate

Gets or sets the effective end date

 date

None.
Active

Gets or sets whether the rule is active

 boolean

None.
DaysSupplyMin

Gets or sets the minimum days supply in order for the rule to apply

 integer

None.
DaysSupplyMax

Gets or sets the maximum days supply in order for the rule to apply

 integer

None.
MemberAgeMin

Gets or sets the minimum age of the member in order for the rule to apply

 integer

None.
MemberAgeMax

Gets or sets the maximum age of the member in order for the rule to apply

 integer

None.
MemberAgeUnits

Gets or sets the age units.

 string

None.
DependentRelationshipCodes

Gets or sets the dependent relationship code as a delimited list for which the rule applies.

 Collection of RelationshipModel

None.
ServiceCategory

Gets or sets the service category

 string

None.
MemberGender

Gets or sets the gender (if necessary) for which the rule applies

 string

None.
PharmacyTypes

Gets or sets the list of acceptable pharmacy types

 Collection of RulePharmacyTypeModel

None.
SubmissionClarificationCodeCriteriaType

Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)

 string

None.
SubmissionClarificationCodes

Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)

 Collection of RuleSubmissionClarificationCodeModel

None.
PharmacyServiceTypeCriteriaType

Gets or sets the pharmacy service criteria type

 string

None.
PharmacyServiceType

Gets or sets the pharmacy service value. Uses standarded NCPDP values.

 string

None.
PatientResidenceCriteriaType

Gets or sets the patient residence criteria type

 string

None.
PatientResidence

Gets or sets the patient residence value. Uses standarded NCPDP values.

 string

None.
PlaceOfServiceCriteriaType

Gets or sets the place of service criteria type

 string

None.
PlaceOfService

Gets or sets the place of service value. Uses standarded NCPDP values.

 string

None.
BenefitCodeUrl

Gets or sets the Benefit Code Url

 string

None.
BenefitCodeNo

Gets or sets the Benefit Code number

 integer

None.
PriorFillsMin

Gets or sets the Prior Fills Minumum

 integer

None.
PriorFillsMax

Gets or sets the Prior Fills Maximum

 integer

None.
PriorFillsDaysInterval

Gets or sets the Prior Fills Interval Days

 integer

None.
PriorFillsGraceDays

Gets or sets the Prior Fills Grace Days

 integer

None.
PriorFillsStartDate

Gets or sets the Prior Fills Start Date

 date

None.
PriorFillsDaysSupplyMin

Gets or sets the Prior Fills Days Supply Minimum

 integer

None.
PriorFillsDaysSupplyMax

Gets or sets the Prior Fills Days Supply Maximum

 integer

None.
PriorFillsDrugProfileUrl

Gets or sets the Prior Fills Drug Profile Url

 string

None.
PriorFillsDrugProfileNo

Gets or sets the Prior Fill Drug Profile number

 integer

None.
PriorFillsPharmacyProfileUrl

Gets or sets the Prior Fills Pharmacy Profile Url

 string

None.
PriorFillsPharmacyProfileNo

Gets or sets the Prior Fills Pharmacy Profile number

 integer

None.
PriorFillsGPIChars

Gets or sets the Prior Fills GPI Chars

 string

None.
PriorFillsLimitToCurrentPeriod

Gets or sets the Prior Fills Limit to Current Period

 boolean

None.
PriorFillsByRxNumber

Gets or sets the Prior Fills Limit to Submitted Rx Number

 boolean

None.
PriorFillsByNDC

Gets or sets the Prior Fills Limit to Submitted NDC

 boolean

None.
DiagnosisCodeCriteriaType

Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)

 string

None.
DAWCodes

Gets or sets the acceptable DAW code values that apply to the rule

 Collection of DAWCodeModel

None.
ContractCodes

Gets or sets the list of contract codes associated with the general criteria

 Collection of RuleContractCodeModel

None.
ARCodes

Gets or sets the list of AR codes associated with the general criteria

 Collection of RuleARCodeModel

None.
CoverageLevels

Gets or sets the coverage levels associated with the general criteria

 Collection of RuleCoverageLevelModel

None.
EmployeeStatuses

Gets or sets the list of employee statuses associated with the general criteria

 Collection of RuleEmployeeStatusModel

None.
OtherStatuses

Gets or sets the list of other statuses associated with the general criteria

 Collection of RuleOtherStatusModel

None.
MemberStates

Gets or sets the list of US States associated with the general criteria

 Collection of RuleMemberStateModel

None.
PharmacyStates

Gets or sets the list of US States associated with the general criteria

 Collection of RuleStateModel

None.
isTemplate

Gets or sets whether the rule is a template

 boolean

None.
IsOverridden

Gets or sets the flag if this rule is overridden

 boolean

None.
OverridingRuleURL

Gets or sets the rule template thats being overridden

 string

None.
Enabled

Gets or sets the rule template is enabled

 boolean

None.
Url

Gets or sets the link representing a link back to the resource

 string

None.
ID

Gets or sets the identifier for the resource

 integer

None.

Response Formats

application/json, text/json, application/json-patch+json

Sample: 
[
  {
    "url": "sample string 41",
    "id": 42,
    "endProcessing": true,
    "specialCoinsuranceUrl": "sample string 1",
    "specialCoinsuranceNo": 1,
    "specialOutOfPocketCoinsuranceUrl": "sample string 2",
    "specialOutOfPocketCoinsuranceNo": 1,
    "specialPlanBenefitLimitMonthUrl": "sample string 3",
    "specialPlanBenefitLimitMonthNo": 1,
    "specialPlanBenefitLimitPeriodUrl": "sample string 4",
    "specialPlanBenefitLimitPeriodNo": 1,
    "specialPlanBenefitLimitLifeUrl": "sample string 5",
    "specialPlanBenefitLimitLifeNo": 1,
    "specialPlanBenefitLimitRxOnlyMonthUrl": "sample string 6",
    "specialPlanBenefitLimitRxOnlyMonthNo": 1,
    "specialPlanBenefitLimitRxOnlyPeriodUrl": "sample string 7",
    "specialPlanBenefitLimitRxOnlyPeriodNo": 1,
    "specialPlanBenefitLimitRxOnlyLifeUrl": "sample string 8",
    "specialPlanBenefitLimitRxOnlyLifeNo": 1,
    "specialMaxPlanPaidAmount": 1.0,
    "specialMaxPatientPayAmt": 1.0,
    "specialMaxPatientPayAmtIncludeDrugSelPenalty": true,
    "specialMaxPatientPayAmtIncludeMemberClaimFee": true,
    "specialExemptFromDeductible": true,
    "specialExemptFromOutOfPocketLimit": true,
    "specialApplyCoinsuranceAsDeductible": true,
    "specialDeductibleSplit": 1.0,
    "specialIncentiveSplit": 1.0,
    "specialPlanIncentiveUrl": "sample string 9",
    "specialPlanIncentiveNo": 1,
    "specialPeriodDeductibleUrl": "sample string 10",
    "specialPeriodDeductibleNo": 1,
    "specialPeriodMaxOutOfPocketUrl": "sample string 11",
    "specialPeriodMaxOutOfPocketNo": 1,
    "specialMonthlyDeductibleUrl": "sample string 12",
    "specialMonthlyDeductibleNo": 1,
    "specialMonthlyMaxOutOfPocketUrl": "sample string 13",
    "specialMonthlyMaxOutOfPocketNo": 1,
    "pharmacyPriceMin": 1.0,
    "pharmacyPriceMax": 1.0,
    "pharmacyPricePreTax": true,
    "pharmacyPriceCentsMin": 1.0,
    "pharmacyPriceCentsMax": 1.0,
    "pharmacyPriceCentsPreTax": true,
    "firstFillByRx": true,
    "refillExpired": true,
    "diagnosisCodes": [
      {
        "url": "sample string 5",
        "id": 6,
        "ruleNo": 1,
        "diagnosisCode": "sample string 2",
        "description": "sample string 3"
      },
      {
        "url": "sample string 5",
        "id": 6,
        "ruleNo": 1,
        "diagnosisCode": "sample string 2",
        "description": "sample string 3"
      }
    ],
    "members": [
      {
        "url": "sample string 9",
        "id": 10,
        "ruleNo": 1,
        "lastName": "sample string 2",
        "firstName": "sample string 3",
        "middleName": "sample string 4",
        "dateOfBirth": "2026-05-07T07:23:49.9421531-05:00",
        "ssn": "sample string 5",
        "memberSeqNo": 6,
        "locationName": "sample string 8"
      },
      {
        "url": "sample string 9",
        "id": 10,
        "ruleNo": 1,
        "lastName": "sample string 2",
        "firstName": "sample string 3",
        "middleName": "sample string 4",
        "dateOfBirth": "2026-05-07T07:23:49.9421531-05:00",
        "ssn": "sample string 5",
        "memberSeqNo": 6,
        "locationName": "sample string 8"
      }
    ],
    "memberListIsExclusion": true,
    "memberProfileListIsExclusion": true,
    "networks": [
      {
        "url": "sample string 5",
        "id": 6,
        "ruleNo": 1,
        "description": "sample string 2",
        "networkNo": 4
      },
      {
        "url": "sample string 5",
        "id": 6,
        "ruleNo": 1,
        "description": "sample string 2",
        "networkNo": 4
      }
    ],
    "headquarters": [
      {
        "url": "sample string 5",
        "id": 6,
        "ruleNo": 1,
        "description": "sample string 2",
        "pharmacyHeadquarterNo": 4
      },
      {
        "url": "sample string 5",
        "id": 6,
        "ruleNo": 1,
        "description": "sample string 2",
        "pharmacyHeadquarterNo": 4
      }
    ],
    "pharmacyHeadquarterListIsExclusion": true,
    "pharmacies": [
      {
        "url": "sample string 4",
        "id": 5,
        "ruleNo": 1,
        "npi": "sample string 2",
        "pharmacyName": "sample string 3",
        "effectiveStartDate": "2026-05-07T07:23:49.9421531-05:00",
        "effectiveEndDate": "2026-05-07T07:23:49.9421531-05:00"
      },
      {
        "url": "sample string 4",
        "id": 5,
        "ruleNo": 1,
        "npi": "sample string 2",
        "pharmacyName": "sample string 3",
        "effectiveStartDate": "2026-05-07T07:23:49.9421531-05:00",
        "effectiveEndDate": "2026-05-07T07:23:49.9421531-05:00"
      }
    ],
    "pharmacyListIsExclusion": true,
    "pharmacyProfileListIsExclusion": true,
    "prescribers": [
      {
        "url": "sample string 4",
        "id": 5,
        "ruleNo": 1,
        "npi": "sample string 2",
        "prescriberName": "sample string 3",
        "effectiveStartDate": "2026-05-07T07:23:49.9421531-05:00",
        "effectiveEndDate": "2026-05-07T07:23:49.9421531-05:00"
      },
      {
        "url": "sample string 4",
        "id": 5,
        "ruleNo": 1,
        "npi": "sample string 2",
        "prescriberName": "sample string 3",
        "effectiveStartDate": "2026-05-07T07:23:49.9421531-05:00",
        "effectiveEndDate": "2026-05-07T07:23:49.9421531-05:00"
      }
    ],
    "prescriberListIsExclusion": true,
    "facilities": [
      {
        "url": "sample string 6",
        "id": 7,
        "ruleNo": 1,
        "facilityName": "sample string 2",
        "pharmacyBranch": "sample string 3",
        "facilityBranchSeqNo": 4
      },
      {
        "url": "sample string 6",
        "id": 7,
        "ruleNo": 1,
        "facilityName": "sample string 2",
        "pharmacyBranch": "sample string 3",
        "facilityBranchSeqNo": 4
      }
    ],
    "exemptFromDeductible": true,
    "exemptFromOutOfPocketLimit": true,
    "applyCoinsuranceAsDeductible": true,
    "quantityMin": 1.0,
    "quantityMax": 1.0,
    "compoundDrugs": true,
    "unknownDrugs": true,
    "undefinedDrugs": true,
    "compoundLevelOfEffort": [
      {
        "displayName": "sample string 1"
      },
      {
        "displayName": "sample string 1"
      }
    ],
    "groupPlanNo": 20,
    "description": "sample string 21",
    "priority": 1,
    "referenceCode": "sample string 22",
    "message": "sample string 23",
    "changeNote": "sample string 24",
    "effectiveStartDate": "2026-05-07T07:23:49.9421531-05:00",
    "effectiveEndDate": "2026-05-07T07:23:49.9421531-05:00",
    "active": true,
    "daysSupplyMin": 1,
    "daysSupplyMax": 1,
    "memberAgeMin": 1,
    "memberAgeMax": 1,
    "memberAgeUnits": "sample string 25",
    "dependentRelationshipCodes": [
      {
        "displayName": "sample string 1"
      },
      {
        "displayName": "sample string 1"
      }
    ],
    "serviceCategory": "sample string 26",
    "memberGender": "sample string 27",
    "pharmacyTypes": [
      {
        "url": "sample string 6",
        "id": 7,
        "ruleNo": 1,
        "description": "sample string 2",
        "pharmacyTypeCode": "sample string 3"
      },
      {
        "url": "sample string 6",
        "id": 7,
        "ruleNo": 1,
        "description": "sample string 2",
        "pharmacyTypeCode": "sample string 3"
      }
    ],
    "submissionClarificationCodeCriteriaType": "sample string 28",
    "submissionClarificationCodes": [
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "submissionClarificationCode": "sample string 2"
      },
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "submissionClarificationCode": "sample string 2"
      }
    ],
    "pharmacyServiceTypeCriteriaType": "sample string 29",
    "pharmacyServiceType": "sample string 30",
    "patientResidenceCriteriaType": "sample string 31",
    "patientResidence": "sample string 32",
    "placeOfServiceCriteriaType": "sample string 33",
    "placeOfService": "sample string 34",
    "benefitCodeUrl": "sample string 35",
    "benefitCodeNo": 1,
    "priorFillsMin": 1,
    "priorFillsMax": 1,
    "priorFillsDaysInterval": 1,
    "priorFillsGraceDays": 1,
    "priorFillsStartDate": "2026-05-07T07:23:49.9421531-05:00",
    "priorFillsDaysSupplyMin": 1,
    "priorFillsDaysSupplyMax": 1,
    "priorFillsDrugProfileUrl": "sample string 36",
    "priorFillsDrugProfileNo": 1,
    "priorFillsPharmacyProfileUrl": "sample string 37",
    "priorFillsPharmacyProfileNo": 1,
    "priorFillsGPIChars": "sample string 38",
    "priorFillsLimitToCurrentPeriod": true,
    "priorFillsByRxNumber": true,
    "priorFillsByNDC": true,
    "diagnosisCodeCriteriaType": "sample string 39",
    "dawCodes": [
      {
        "displayName": "sample string 1"
      },
      {
        "displayName": "sample string 1"
      }
    ],
    "contractCodes": [
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "contractCode": "sample string 2"
      },
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "contractCode": "sample string 2"
      }
    ],
    "arCodes": [
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "arShortCode": "sample string 2"
      },
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "arShortCode": "sample string 2"
      }
    ],
    "coverageLevels": [
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "coverageLevelCode": "sample string 2"
      },
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "coverageLevelCode": "sample string 2"
      }
    ],
    "employeeStatuses": [
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "employeeStatus": "sample string 2"
      },
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "employeeStatus": "sample string 2"
      }
    ],
    "otherStatuses": [
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "otherStatus": "sample string 2"
      },
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "otherStatus": "sample string 2"
      }
    ],
    "memberStates": [
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "stateCode": "sample string 2"
      },
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "stateCode": "sample string 2"
      }
    ],
    "pharmacyStates": [
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "stateCode": "sample string 2"
      },
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "stateCode": "sample string 2"
      }
    ],
    "isTemplate": true
  },
  {
    "url": "sample string 41",
    "id": 42,
    "endProcessing": true,
    "specialCoinsuranceUrl": "sample string 1",
    "specialCoinsuranceNo": 1,
    "specialOutOfPocketCoinsuranceUrl": "sample string 2",
    "specialOutOfPocketCoinsuranceNo": 1,
    "specialPlanBenefitLimitMonthUrl": "sample string 3",
    "specialPlanBenefitLimitMonthNo": 1,
    "specialPlanBenefitLimitPeriodUrl": "sample string 4",
    "specialPlanBenefitLimitPeriodNo": 1,
    "specialPlanBenefitLimitLifeUrl": "sample string 5",
    "specialPlanBenefitLimitLifeNo": 1,
    "specialPlanBenefitLimitRxOnlyMonthUrl": "sample string 6",
    "specialPlanBenefitLimitRxOnlyMonthNo": 1,
    "specialPlanBenefitLimitRxOnlyPeriodUrl": "sample string 7",
    "specialPlanBenefitLimitRxOnlyPeriodNo": 1,
    "specialPlanBenefitLimitRxOnlyLifeUrl": "sample string 8",
    "specialPlanBenefitLimitRxOnlyLifeNo": 1,
    "specialMaxPlanPaidAmount": 1.0,
    "specialMaxPatientPayAmt": 1.0,
    "specialMaxPatientPayAmtIncludeDrugSelPenalty": true,
    "specialMaxPatientPayAmtIncludeMemberClaimFee": true,
    "specialExemptFromDeductible": true,
    "specialExemptFromOutOfPocketLimit": true,
    "specialApplyCoinsuranceAsDeductible": true,
    "specialDeductibleSplit": 1.0,
    "specialIncentiveSplit": 1.0,
    "specialPlanIncentiveUrl": "sample string 9",
    "specialPlanIncentiveNo": 1,
    "specialPeriodDeductibleUrl": "sample string 10",
    "specialPeriodDeductibleNo": 1,
    "specialPeriodMaxOutOfPocketUrl": "sample string 11",
    "specialPeriodMaxOutOfPocketNo": 1,
    "specialMonthlyDeductibleUrl": "sample string 12",
    "specialMonthlyDeductibleNo": 1,
    "specialMonthlyMaxOutOfPocketUrl": "sample string 13",
    "specialMonthlyMaxOutOfPocketNo": 1,
    "pharmacyPriceMin": 1.0,
    "pharmacyPriceMax": 1.0,
    "pharmacyPricePreTax": true,
    "pharmacyPriceCentsMin": 1.0,
    "pharmacyPriceCentsMax": 1.0,
    "pharmacyPriceCentsPreTax": true,
    "firstFillByRx": true,
    "refillExpired": true,
    "diagnosisCodes": [
      {
        "url": "sample string 5",
        "id": 6,
        "ruleNo": 1,
        "diagnosisCode": "sample string 2",
        "description": "sample string 3"
      },
      {
        "url": "sample string 5",
        "id": 6,
        "ruleNo": 1,
        "diagnosisCode": "sample string 2",
        "description": "sample string 3"
      }
    ],
    "members": [
      {
        "url": "sample string 9",
        "id": 10,
        "ruleNo": 1,
        "lastName": "sample string 2",
        "firstName": "sample string 3",
        "middleName": "sample string 4",
        "dateOfBirth": "2026-05-07T07:23:49.9421531-05:00",
        "ssn": "sample string 5",
        "memberSeqNo": 6,
        "locationName": "sample string 8"
      },
      {
        "url": "sample string 9",
        "id": 10,
        "ruleNo": 1,
        "lastName": "sample string 2",
        "firstName": "sample string 3",
        "middleName": "sample string 4",
        "dateOfBirth": "2026-05-07T07:23:49.9421531-05:00",
        "ssn": "sample string 5",
        "memberSeqNo": 6,
        "locationName": "sample string 8"
      }
    ],
    "memberListIsExclusion": true,
    "memberProfileListIsExclusion": true,
    "networks": [
      {
        "url": "sample string 5",
        "id": 6,
        "ruleNo": 1,
        "description": "sample string 2",
        "networkNo": 4
      },
      {
        "url": "sample string 5",
        "id": 6,
        "ruleNo": 1,
        "description": "sample string 2",
        "networkNo": 4
      }
    ],
    "headquarters": [
      {
        "url": "sample string 5",
        "id": 6,
        "ruleNo": 1,
        "description": "sample string 2",
        "pharmacyHeadquarterNo": 4
      },
      {
        "url": "sample string 5",
        "id": 6,
        "ruleNo": 1,
        "description": "sample string 2",
        "pharmacyHeadquarterNo": 4
      }
    ],
    "pharmacyHeadquarterListIsExclusion": true,
    "pharmacies": [
      {
        "url": "sample string 4",
        "id": 5,
        "ruleNo": 1,
        "npi": "sample string 2",
        "pharmacyName": "sample string 3",
        "effectiveStartDate": "2026-05-07T07:23:49.9421531-05:00",
        "effectiveEndDate": "2026-05-07T07:23:49.9421531-05:00"
      },
      {
        "url": "sample string 4",
        "id": 5,
        "ruleNo": 1,
        "npi": "sample string 2",
        "pharmacyName": "sample string 3",
        "effectiveStartDate": "2026-05-07T07:23:49.9421531-05:00",
        "effectiveEndDate": "2026-05-07T07:23:49.9421531-05:00"
      }
    ],
    "pharmacyListIsExclusion": true,
    "pharmacyProfileListIsExclusion": true,
    "prescribers": [
      {
        "url": "sample string 4",
        "id": 5,
        "ruleNo": 1,
        "npi": "sample string 2",
        "prescriberName": "sample string 3",
        "effectiveStartDate": "2026-05-07T07:23:49.9421531-05:00",
        "effectiveEndDate": "2026-05-07T07:23:49.9421531-05:00"
      },
      {
        "url": "sample string 4",
        "id": 5,
        "ruleNo": 1,
        "npi": "sample string 2",
        "prescriberName": "sample string 3",
        "effectiveStartDate": "2026-05-07T07:23:49.9421531-05:00",
        "effectiveEndDate": "2026-05-07T07:23:49.9421531-05:00"
      }
    ],
    "prescriberListIsExclusion": true,
    "facilities": [
      {
        "url": "sample string 6",
        "id": 7,
        "ruleNo": 1,
        "facilityName": "sample string 2",
        "pharmacyBranch": "sample string 3",
        "facilityBranchSeqNo": 4
      },
      {
        "url": "sample string 6",
        "id": 7,
        "ruleNo": 1,
        "facilityName": "sample string 2",
        "pharmacyBranch": "sample string 3",
        "facilityBranchSeqNo": 4
      }
    ],
    "exemptFromDeductible": true,
    "exemptFromOutOfPocketLimit": true,
    "applyCoinsuranceAsDeductible": true,
    "quantityMin": 1.0,
    "quantityMax": 1.0,
    "compoundDrugs": true,
    "unknownDrugs": true,
    "undefinedDrugs": true,
    "compoundLevelOfEffort": [
      {
        "displayName": "sample string 1"
      },
      {
        "displayName": "sample string 1"
      }
    ],
    "groupPlanNo": 20,
    "description": "sample string 21",
    "priority": 1,
    "referenceCode": "sample string 22",
    "message": "sample string 23",
    "changeNote": "sample string 24",
    "effectiveStartDate": "2026-05-07T07:23:49.9421531-05:00",
    "effectiveEndDate": "2026-05-07T07:23:49.9421531-05:00",
    "active": true,
    "daysSupplyMin": 1,
    "daysSupplyMax": 1,
    "memberAgeMin": 1,
    "memberAgeMax": 1,
    "memberAgeUnits": "sample string 25",
    "dependentRelationshipCodes": [
      {
        "displayName": "sample string 1"
      },
      {
        "displayName": "sample string 1"
      }
    ],
    "serviceCategory": "sample string 26",
    "memberGender": "sample string 27",
    "pharmacyTypes": [
      {
        "url": "sample string 6",
        "id": 7,
        "ruleNo": 1,
        "description": "sample string 2",
        "pharmacyTypeCode": "sample string 3"
      },
      {
        "url": "sample string 6",
        "id": 7,
        "ruleNo": 1,
        "description": "sample string 2",
        "pharmacyTypeCode": "sample string 3"
      }
    ],
    "submissionClarificationCodeCriteriaType": "sample string 28",
    "submissionClarificationCodes": [
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "submissionClarificationCode": "sample string 2"
      },
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "submissionClarificationCode": "sample string 2"
      }
    ],
    "pharmacyServiceTypeCriteriaType": "sample string 29",
    "pharmacyServiceType": "sample string 30",
    "patientResidenceCriteriaType": "sample string 31",
    "patientResidence": "sample string 32",
    "placeOfServiceCriteriaType": "sample string 33",
    "placeOfService": "sample string 34",
    "benefitCodeUrl": "sample string 35",
    "benefitCodeNo": 1,
    "priorFillsMin": 1,
    "priorFillsMax": 1,
    "priorFillsDaysInterval": 1,
    "priorFillsGraceDays": 1,
    "priorFillsStartDate": "2026-05-07T07:23:49.9421531-05:00",
    "priorFillsDaysSupplyMin": 1,
    "priorFillsDaysSupplyMax": 1,
    "priorFillsDrugProfileUrl": "sample string 36",
    "priorFillsDrugProfileNo": 1,
    "priorFillsPharmacyProfileUrl": "sample string 37",
    "priorFillsPharmacyProfileNo": 1,
    "priorFillsGPIChars": "sample string 38",
    "priorFillsLimitToCurrentPeriod": true,
    "priorFillsByRxNumber": true,
    "priorFillsByNDC": true,
    "diagnosisCodeCriteriaType": "sample string 39",
    "dawCodes": [
      {
        "displayName": "sample string 1"
      },
      {
        "displayName": "sample string 1"
      }
    ],
    "contractCodes": [
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "contractCode": "sample string 2"
      },
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "contractCode": "sample string 2"
      }
    ],
    "arCodes": [
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "arShortCode": "sample string 2"
      },
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "arShortCode": "sample string 2"
      }
    ],
    "coverageLevels": [
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "coverageLevelCode": "sample string 2"
      },
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "coverageLevelCode": "sample string 2"
      }
    ],
    "employeeStatuses": [
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "employeeStatus": "sample string 2"
      },
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "employeeStatus": "sample string 2"
      }
    ],
    "otherStatuses": [
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "otherStatus": "sample string 2"
      },
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "otherStatus": "sample string 2"
      }
    ],
    "memberStates": [
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "stateCode": "sample string 2"
      },
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "stateCode": "sample string 2"
      }
    ],
    "pharmacyStates": [
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "stateCode": "sample string 2"
      },
      {
        "url": "sample string 3",
        "id": 4,
        "ruleNo": 1,
        "stateCode": "sample string 2"
      }
    ],
    "isTemplate": true
  }
]