POST api/groupplantemplates/{groupplantemplateid}/rulestandardformularyndcspecifics/{id}/override?groupplanid={groupplanid}
Overrides a standard formulary ndc specific template rule
Request Information
URI Parameters
Name | Description | Type | Additional information |
---|---|---|---|
groupplantemplateid |
Group Plan Template identifier |
integer |
Required |
groupplanid |
Group Plan identifier |
integer |
Required |
id |
Template Rule identifier |
integer |
Required |
Body Parameters
The json formatted rule standard formulary ndc specific model object supplied in the request body that is to be added
RuleStandardFormularyNDCSpecificModelName | Description | Type | Additional information |
---|---|---|---|
RuleActionTypeUrl |
Gets or sets the link to the rule action type resource |
string |
None. |
RuleActionTypeNo |
Gets or sets the identifier to the rule action type |
integer |
None. |
AlternatePricingGroupUrl |
Gets or sets the link to the alternate pricing group used by this rule |
string |
None. |
AlternatePricingGroupNo |
Gets or sets the identifier to the alternate pricing group |
integer |
None. |
EndProcessing |
Gets or sets whether more benefit rules are processed if all criteria has been met |
boolean |
None. |
DAWEnforceRule |
Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW |
boolean |
None. |
ACIOverride |
Gets or sets the ACI Override price |
decimal number |
None. |
ShortCycle |
Gets or sets whether the rule applies to claims identified as short cycle |
boolean |
None. |
NewStartDrug |
Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days) |
boolean |
None. |
NewStartDrugByDrugName |
Gets or sets whether the new start drug is based on the drug name (10 digit GPI) |
boolean |
None. |
NewDrug |
Gets or sets whether the rule is applied for drugs recently added to the catalog |
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. |
OnPlan |
Gets or sets whether the rule applies when the drug is on the plan |
boolean |
None. |
InCompound |
Gets or sets whether the rule applies to compounds being priced using ingredients |
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. |
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. |
Pharmacies |
Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all |
Collection of RulePharmacyModel |
None. |
Prescribers |
Gets or sets prescribers for which the rule applies; if the list is empty it applies to all |
Collection of RulePrescriberModel |
None. |
Facilities |
Gets or sets the Facilities for which the rule applies |
Collection of RuleFacilityBranchModel |
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. |
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. |
NDCs |
Gets or sets the list of NDCs associated with the rule criteria. These values can be posted/added at individual rule controllers, but should be patched at the RuleDrug endpoint - api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruledrugs/{id}. |
Collection of RuleDrugModel |
None. |
PricingGroups |
Gets or sets the list of pricing groups associated with the drug criteria |
Collection of RulePricingGroupModel |
None. |
FormularyTiers |
Gets or sets the list of formulary tiers associated with the drug criteria |
Collection of RuleFormularyTierModel |
None. |
isSpecialty |
Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs |
boolean |
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. |
PriorFillsGPIChars |
Gets or sets the Prior Fills GPI Chars |
string |
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. |
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. |
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. |
Request Formats
application/json, text/json, application/json-patch+json
{ "url": "sample string 24", "id": 25, "ruleActionTypeUrl": "sample string 1", "ruleActionTypeNo": 2, "alternatePricingGroupUrl": "sample string 4", "alternatePricingGroupNo": 1, "endProcessing": true, "dawEnforceRule": true, "aciOverride": 1.0, "shortCycle": true, "newStartDrug": true, "newStartDrugByDrugName": true, "newDrug": true, "firstFillByRx": true, "refillExpired": true, "onPlan": true, "inCompound": 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": "2025-05-30T21:33:06.5922922-05:00", "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": "2025-05-30T21:33:06.5922922-05:00", "ssn": "sample string 5", "memberSeqNo": 6, "locationName": "sample string 8" } ], "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 } ], "pharmacies": [ { "url": "sample string 4", "id": 5, "ruleNo": 1, "npi": "sample string 2", "pharmacyName": "sample string 3" }, { "url": "sample string 4", "id": 5, "ruleNo": 1, "npi": "sample string 2", "pharmacyName": "sample string 3" } ], "prescribers": [ { "url": "sample string 4", "id": 5, "ruleNo": 1, "npi": "sample string 2", "prescriberName": "sample string 3", "effectiveStartDate": "2025-05-30T21:33:06.5922922-05:00", "effectiveEndDate": "2025-05-30T21:33:06.5922922-05:00" }, { "url": "sample string 4", "id": 5, "ruleNo": 1, "npi": "sample string 2", "prescriberName": "sample string 3", "effectiveStartDate": "2025-05-30T21:33:06.5922922-05:00", "effectiveEndDate": "2025-05-30T21:33:06.5922922-05:00" } ], "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 } ], "quantityMin": 1.0, "quantityMax": 1.0, "pricingGroups": [ { "url": "sample string 6", "id": 7, "ruleNo": 1, "name": "sample string 2", "description": "sample string 3", "planPricingGroupNo": 5 }, { "url": "sample string 6", "id": 7, "ruleNo": 1, "name": "sample string 2", "description": "sample string 3", "planPricingGroupNo": 5 } ], "formularyTiers": [ { "url": "sample string 6", "id": 7, "ruleNo": 1, "name": "sample string 2", "description": "sample string 3", "tier": 1, "formularyTierNo": 4 }, { "url": "sample string 6", "id": 7, "ruleNo": 1, "name": "sample string 2", "description": "sample string 3", "tier": 1, "formularyTierNo": 4 } ], "isSpecialty": true, "groupPlanNo": 6, "description": "sample string 7", "priority": 1, "referenceCode": "sample string 8", "message": "sample string 9", "changeNote": "sample string 10", "effectiveStartDate": "2025-05-30T21:33:06.5922922-05:00", "effectiveEndDate": "2025-05-30T21:33:06.5922922-05:00", "active": true, "daysSupplyMin": 1, "daysSupplyMax": 1, "memberAgeMin": 1, "memberAgeMax": 1, "memberAgeUnits": "sample string 11", "dependentRelationshipCodes": [ { "displayName": "sample string 1" }, { "displayName": "sample string 1" } ], "serviceCategory": "sample string 12", "memberGender": "sample string 13", "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 14", "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 15", "pharmacyServiceType": "sample string 16", "patientResidenceCriteriaType": "sample string 17", "patientResidence": "sample string 18", "placeOfServiceCriteriaType": "sample string 19", "placeOfService": "sample string 20", "benefitCodeUrl": "sample string 21", "benefitCodeNo": 1, "priorFillsGPIChars": "sample string 22", "diagnosisCodeCriteriaType": "sample string 23", "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" } ], "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, "ndCs": [ { "url": "sample string 3", "id": 4, "ruleNo": 1, "ndc": "sample string 2" }, { "url": "sample string 3", "id": 4, "ruleNo": 1, "ndc": "sample string 2" } ] }
application/x-www-form-urlencoded
Sample not available.
Response Information
Resource Description
RuleName | Description | Type | Additional information |
---|---|---|---|
PlanID | globally unique identifier |
None. |
|
RuleTypeID | globally unique identifier |
None. |
|
ByNDC | boolean |
None. |
|
NewStartDrug | boolean |
None. |
|
NewStartDrugByDrugName | boolean |
None. |
|
Description | string |
None. |
|
Priority | integer |
None. |
|
RuleActionTypeID | globally unique identifier |
None. |
|
AlternatePricingGroupID | globally unique identifier |
None. |
|
Message | string |
None. |
|
OnPlan | boolean |
None. |
|
OnFormulary | boolean |
None. |
|
InCompound | boolean |
None. |
|
CompoundDrugs | boolean |
None. |
|
UnknownDrugs | boolean |
None. |
|
UndefinedDrugs | boolean |
None. |
|
MemberGender | string |
None. |
|
LevelOfEffort | string |
None. |
|
EndProcessing | boolean |
None. |
|
Active | boolean |
None. |
|
EffectiveStartDate | date |
None. |
|
EffectiveEndDate | date |
None. |
|
QuantityMin | decimal number |
None. |
|
QuantityMax | decimal number |
None. |
|
DaysSupplyMin | integer |
None. |
|
DaysSupplyMax | integer |
None. |
|
ShortCycle | boolean |
None. |
|
SubmissionClarificationCodeCriteriaType | string |
None. |
|
PharmacyServiceType | string |
None. |
|
PharmacyServiceTypeCriteriaType | string |
None. |
|
PatientResidence | string |
None. |
|
PatientResidenceCriteriaType | string |
None. |
|
PlaceOfService | string |
None. |
|
PlaceOfServiceCriteriaType | string |
None. |
|
ServiceCategory | string |
None. |
|
NewDrug | boolean |
None. |
|
IsTemplate | boolean |
None. |
|
StepTherapy | boolean |
None. |
|
EnforcePlanFormulary | boolean |
None. |
|
ReferenceCode | string |
None. |
|
RxExpired | boolean |
None. |
|
ClaimTagItemID1 | globally unique identifier |
None. |
|
ClaimTagItemID2 | globally unique identifier |
None. |
|
ClaimTagItemID3 | globally unique identifier |
None. |
|
DAWCode | string |
None. |
|
DependentRelationshipCode | string |
None. |
|
MemberAgeMin | integer |
None. |
|
MemberAgeMax | integer |
None. |
|
MemberAgeUnits | string |
None. |
|
RxFirstFill | boolean |
None. |
|
OverridingRuleID | globally unique identifier |
None. |
|
OverridingRuleActive | boolean |
None. |
|
PharmacyPriceMin | decimal number |
None. |
|
PharmacyPriceMax | decimal number |
None. |
|
DrugSelectionPenaltyUsed | boolean |
None. |
|
SeqNo | integer |
None. |
|
BenefitCodeID | globally unique identifier |
None. |
|
PharmacyPriceCentsMin | decimal number |
None. |
|
PharmacyPriceCentsMax | decimal number |
None. |
|
PharmacyPriceCentsPreTax | boolean |
None. |
|
PharmacyPricePreTax | boolean |
None. |
|
PharmacyRelationshipCodeCriteriaType | string |
None. |
|
GenericCostExceedsBrand | boolean |
None. |
|
ScheduleID | globally unique identifier |
None. |
|
ScheduleException | boolean |
None. |
|
PriorFillsMin | integer |
None. |
|
PriorFillsMax | integer |
None. |
|
PriorFillsDaysInterval | integer |
None. |
|
PriorFillsGraceDays | integer |
None. |
|
PriorFillsDrugProfileID | globally unique identifier |
None. |
|
PriorFillsPharmacyProfileID | globally unique identifier |
None. |
|
PriorFillsByRxNumber | boolean |
None. |
|
PriorFillsGPIChars | string |
None. |
|
PriorFillsByNDC | boolean |
None. |
|
PriorFillsBysSpecialDrugType | boolean |
None. |
|
RejectCode | string |
None. |
|
IsSpecialty | boolean |
None. |
|
PriorFillsStartDate | date |
None. |
|
OnCostcoJSONAWP | boolean |
None. |
|
OnCostcoJSONMAC | boolean |
None. |
|
VariableCopayCouponExists | boolean |
None. |
|
IsPrimaryClaim | boolean |
None. |
|
IsSecondaryClaimAsPrimary | boolean |
None. |
|
PriorFillsLimitToCurrentPeriod | boolean |
None. |
|
CreateIssueTrackerTicket | boolean |
None. |
|
IssueProfileID | globally unique identifier |
None. |
|
DiagnosisCodeCriteriaType | string |
None. |
|
FormularyNotCoveredException | boolean |
None. |
|
FormularyAgeLimitException | boolean |
None. |
|
FormularyGenderLimitException | boolean |
None. |
|
FormularyQtyLimitException | boolean |
None. |
|
FormularyStepMedException | boolean |
None. |
|
FormularyPriorAuthException | boolean |
None. |
|
ResponseTimeException | boolean |
None. |
|
PharmacyPriceAddProcFee | boolean |
None. |
|
PharmacyPriceCentsAddProcFee | boolean |
None. |
|
DAWEnforceRule | boolean |
None. |
|
OnCostcoJSONProcessorFee | boolean |
None. |
|
NDCListIsExclusion | boolean |
None. |
|
SubmissionClarificationCodeLimit | integer |
None. |
|
PriorFillsPharmacyPriceMin | decimal number |
None. |
|
PriorFillsPharmacyPriceMax | decimal number |
None. |
|
PharmacyHeadquarterListIsExclusion | boolean |
None. |
|
MemberListIsExclusion | boolean |
None. |
|
PriorFillsPricePerDaySupplyMin | decimal number |
None. |
|
PriorFillsPricePerDaySupplyMax | decimal number |
None. |
|
FormularyDiagnosisCodeLimitException | boolean |
None. |
|
OtherCoverageCodeCriteriaType | string |
None. |
|
PharmacyListIsExclusion | boolean |
None. |
|
PrescriberListIsExclusion | boolean |
None. |
|
PharmacyProfileListIsExclusion | boolean |
None. |
|
OtherPayerIDQualifierCriteriaType | string |
None. |
|
MemberProfileListIsExclusion | boolean |
None. |
|
CreatedOn | date |
None. |
|
CreatedBy | globally unique identifier |
None. |
|
ChangedOn | date |
None. |
|
ChangedBy | globally unique identifier |
None. |
|
ChangedAt | globally unique identifier |
None. |
|
ID | globally unique identifier |
None. |
|
IsNewRecord | boolean |
None. |
Response Formats
application/json, text/json, application/json-patch+json
{ "planID": "f1874cb3-66d1-4a84-819b-7e99a4df363a", "ruleTypeID": "29be849f-a16f-46b7-a3d1-0f6c2d66e568", "byNDC": true, "newStartDrug": true, "newStartDrugByDrugName": true, "description": "sample string 3", "priority": 1, "ruleActionTypeID": "62660f5e-a7bf-40af-9bc5-edad8e5d49e2", "alternatePricingGroupID": "85049711-445d-48ef-b670-9f9b169abf8b", "message": "sample string 5", "onPlan": true, "onFormulary": true, "inCompound": true, "compoundDrugs": true, "unknownDrugs": true, "undefinedDrugs": true, "memberGender": "sample string 6", "levelOfEffort": "sample string 7", "endProcessing": true, "active": true, "effectiveStartDate": "2025-05-30T21:33:06.594293-05:00", "effectiveEndDate": "2025-05-30T21:33:06.594293-05:00", "quantityMin": 1.0, "quantityMax": 1.0, "daysSupplyMin": 1, "daysSupplyMax": 1, "shortCycle": true, "submissionClarificationCodeCriteriaType": "sample string 8", "pharmacyServiceType": "sample string 9", "pharmacyServiceTypeCriteriaType": "sample string 10", "patientResidence": "sample string 11", "patientResidenceCriteriaType": "sample string 12", "placeOfService": "sample string 13", "placeOfServiceCriteriaType": "sample string 14", "serviceCategory": "sample string 15", "newDrug": true, "isTemplate": true, "stepTherapy": true, "enforcePlanFormulary": true, "referenceCode": "sample string 16", "rxExpired": true, "claimTagItemID1": "94eb833b-dda8-44a5-9a46-ce02298caeb5", "claimTagItemID2": "83ab69b0-0547-4014-bc9b-8fd751ab16d9", "claimTagItemID3": "31bf808d-498a-46d0-8748-7516c36f9b78", "dawCode": "sample string 17", "dependentRelationshipCode": "sample string 18", "memberAgeMin": 1, "memberAgeMax": 1, "memberAgeUnits": "sample string 19", "rxFirstFill": true, "overridingRuleID": "cd6e6962-ecd3-47e8-9eac-afd56b01e699", "overridingRuleActive": true, "pharmacyPriceMin": 1.0, "pharmacyPriceMax": 1.0, "drugSelectionPenaltyUsed": true, "seqNo": 21, "benefitCodeID": "8ed8abf9-ebc8-4d1a-b1d1-4326ffbc9af1", "pharmacyPriceCentsMin": 1.0, "pharmacyPriceCentsMax": 1.0, "pharmacyPriceCentsPreTax": true, "pharmacyPricePreTax": true, "pharmacyRelationshipCodeCriteriaType": "sample string 22", "genericCostExceedsBrand": true, "scheduleID": "c8cd9a60-512f-45e7-b0b9-e8ce25a4ce60", "scheduleException": true, "priorFillsMin": 1, "priorFillsMax": 1, "priorFillsDaysInterval": 1, "priorFillsGraceDays": 1, "priorFillsDrugProfileID": "b4b62a5b-d801-4489-bfb0-64deb4630f11", "priorFillsPharmacyProfileID": "b17166b4-7405-49fd-aafa-414c8e6c56a0", "priorFillsByRxNumber": true, "priorFillsGPIChars": "sample string 23", "priorFillsByNDC": true, "priorFillsBysSpecialDrugType": true, "rejectCode": "sample string 24", "isSpecialty": true, "priorFillsStartDate": "2025-05-30T21:33:06.594293-05:00", "onCostcoJSONAWP": true, "onCostcoJSONMAC": true, "variableCopayCouponExists": true, "isPrimaryClaim": true, "isSecondaryClaimAsPrimary": true, "priorFillsLimitToCurrentPeriod": true, "createIssueTrackerTicket": true, "issueProfileID": "3fcc7040-61c8-4919-b478-99a8c48c1882", "diagnosisCodeCriteriaType": "sample string 25", "formularyNotCoveredException": true, "formularyAgeLimitException": true, "formularyGenderLimitException": true, "formularyQtyLimitException": true, "formularyStepMedException": true, "formularyPriorAuthException": true, "responseTimeException": true, "pharmacyPriceAddProcFee": true, "pharmacyPriceCentsAddProcFee": true, "dawEnforceRule": true, "onCostcoJSONProcessorFee": true, "ndcListIsExclusion": true, "submissionClarificationCodeLimit": 1, "priorFillsPharmacyPriceMin": 1.0, "priorFillsPharmacyPriceMax": 1.0, "pharmacyHeadquarterListIsExclusion": true, "memberListIsExclusion": true, "priorFillsPricePerDaySupplyMin": 1.0, "priorFillsPricePerDaySupplyMax": 1.0, "formularyDiagnosisCodeLimitException": true, "otherCoverageCodeCriteriaType": "sample string 26", "pharmacyListIsExclusion": true, "prescriberListIsExclusion": true, "pharmacyProfileListIsExclusion": true, "otherPayerIDQualifierCriteriaType": "sample string 27", "memberProfileListIsExclusion": true, "createdOn": "2025-05-30T21:33:06.594293-05:00", "createdBy": "81c6fcc8-8c8f-4a4f-923f-80234e09c633", "changedOn": "2025-05-30T21:33:06.594293-05:00", "changedBy": "5235aa42-534c-451e-945c-e0bddfc7dc06", "changedAt": "8471a661-f32f-4f53-b274-0db0e7ea67d8", "id": "d63ae876-2b08-4c04-9b4d-568fc89602fe", "isNewRecord": true }