| Name | Description | Type | Additional information |
|---|---|---|---|
| OriginalClaimNo |
Gets or sets Original Claim Number |
integer |
None. |
| TransactionResponseStatus |
Gets or sets the claim's transaction response status |
string |
None. |
| TransactionCode |
Gets or sets the claim's transaction code (e.g. B1 or B2) |
string |
None. |
| RxCPatientID |
Gets or sets the patient's RxClearinghouse ID |
integer |
None. |
| DateOfBirth | date |
None. |
|
| Bin |
Gets or sets the claim's Bin |
string |
None. |
| PCN |
Gets or sets the claim's PCN |
string |
None. |
| GroupID |
Gets or sets the claim's Group ID |
string |
None. |
| PrescriptionReferenceNumber |
Gets or sets the claim's Rx Number |
string |
None. |
| FillNumber |
Gets or sets the claim's Fill Number |
byte |
None. |
| DAWCode |
Gets or sets the claim's Dispense as Written code |
string |
None. |
| SubmissionClarificationCode |
Gets or sets the claim's Submission Clarification Code |
string |
None. |
| ClaimDate |
Gets or sets the claim's date received by processor |
date |
None. |
| Reversed |
Gets or sets the claim's Reversed status flag |
boolean |
None. |
| ReversedDate |
Gets or sets the claim's reversed date if it has been reversed |
date |
None. |
| DateOfService |
Gets or sets the claim's Date of Service |
date |
None. |
| DatePrescriptionWritten |
Gets or sets the claim's Date Prescription Written |
date |
None. |
| QuantityDispensed |
Gets or sets the claim's Quantity Dispensed |
decimal number |
None. |
| DaysSupply |
Gets or sets the claim's Days Supply |
integer |
None. |
| DrugName |
Gets or sets claim's drug name |
string |
None. |
| GenericName |
Gets or sets the drug's generic drug name |
string |
None. |
| StrengthDescription |
Gets or sets the drug's strength and description (e.g. 0.50 MG - TABS) |
string |
None. |
| DosageFormDescription |
Gets or sets the drug's dosage form description (e.g. Tablet) |
string |
None. |
| RouteOfAdministrationDescription |
Gets or sets the drug's route of adminisration (e.g. Oral) |
string |
None. |
| GenericProductIdentifier |
Gets or sets the drug's Generic Product Identifier (GPI) |
string |
None. |
| IsMultiSourced |
Gets or sets whether the drug on the claim is multi-sourced |
boolean |
None. |
| MultiSourceCode |
Gets or sets the drug's multi-source code |
string |
None. |
| DEAClassCode |
Gets or sets the drug's DEA class code |
string |
None. |
| IsRx |
Gets or sets whether the drug requires written prescription |
boolean |
None. |
| NDC |
Gets or sets the drug's NDC |
string |
None. |
| IngredientCostPaid |
Gets or sets the claim's ingredient cost paid according to plan |
decimal number |
None. |
| DispensingFeePaid |
Gets or sets the claim's dispensing fee paid according to plan |
decimal number |
None. |
| IncentiveAmountPaid |
Gets or sets the claim's incentive amount paid accourding to plan |
decimal number |
None. |
| ProfessionalServiceFeePaid |
Gets or sets the claim's professional service fee paid according to plan |
decimal number |
None. |
| FlatSalesTaxAmountPaid |
Gets or sets the claim's flat sales tax amount paid |
decimal number |
None. |
| PercentageSalesTaxAmountPaid |
Gets or sets the claim's percentage sales tax amount paid |
decimal number |
None. |
| PercentageSalesTaxRatePaid |
Gets or sets the claim's percentage sales tax rate |
decimal number |
None. |
| PharmacyPrice |
Gets or sets the claim's pharmcy price |
decimal number |
None. |
| AmountOfCoPay |
Gets or sets the claim's Copay according to plan |
decimal number |
None. |
| AmountOfCoInsurance |
Gets or sets the claim's Coinsurance according to plan |
decimal number |
None. |
| DrugSelectionPenalty |
Gets or sets the claim's drug selection penalty |
decimal number |
None. |
| AmountExceedingPeriodicBenefitMaximum |
Gets or sets the claim's amount that exceeded periodic benefit maximum according to plan |
decimal number |
None. |
| TotalAmountPaid |
Gets or sets the claim's total amount paid |
decimal number |
None. |
| PatientPayAmount |
Gets or sets the claim's patient pay amount |
decimal number |
None. |
| GrossAmountDue |
Gets or sets the gross amount due supplied in the claim |
decimal number |
None. |
| SecondaryPayer |
Gets or sets whether claim is secondary payer |
boolean |
None. |
| COBAmount |
Gets or sets the coordination of benefit amount |
decimal number |
None. |
| DeductibleDescription |
Gets or sets the claim's deductible description set by plan |
string |
None. |
| MOOPDescription |
Gets or sets the claims max out of pocket description set by plan |
string |
None. |
| PlanIncentiveDescription |
Gets or sets the plan incentive description set by plan |
string |
None. |
| BenefitCodeDescription |
Gets or sets the benefit code description set by plan |
string |
None. |
| PharmacyNPI |
Gets or sets the NPI of the pharmacy |
string |
None. |
| PharmacyLocationName |
Gets or sets the name of the pharmacy |
string |
None. |
| PrescriberID |
Gets or set the ID of the prescriber submitted in the claim |
string |
None. |
| PrescriberName |
Gets or sets the name of the prescriber |
string |
None. |
| AmountAppliedToPeriodicDeductible |
Gets or sets the amount applied to periodic deductible |
decimal number |
None. |
| PricingMethod |
Gets or sets the pricing method used when the claim was processed |
string |
None. |
| PricingMethodDetail |
Gets or sets the pricing method detail used when the claim was processed |
string |
None. |
| TherapeuticClass02 |
Gets or sets the Therapeutic class (level 2) |
string |
None. |
| TherapeuticClass04 |
Gets or sets the Therapeutic class (level 4) |
string |
None. |
| TherapeuticClass06 |
Gets or sets the Therapeutic class (level 6) |
string |
None. |
| TherapeuticClass08 |
Gets or sets the Therapeutic class (level 8) |
string |
None. |
| TherapeuticClass10 |
Gets or sets the Therapeutic class (level 10) |
string |
None. |
| TherapeuticClass12 |
Gets or sets the Therapeutic class (level 12) |
string |
None. |
| TherapeuticClass14 |
Gets or sets the Therapeutic class (level 14) |
string |
None. |
| BrandNameCode |
Gets or sets the brand name code of the drug (B/G/T) |
string |
None. |
| PlanPricingGroup |
Gets or sets the plan pricing group used for processing |
string |
None. |
| EnforcedRules |
Gets or sets a delimited (^) list of enforced rules |
string |
None. |
| PrimaryRules |
Gets or sets the list of rules that were examined during adjudication |
Collection of MemberClaimRuleModel |
None. |
| SecondaryRules |
Get or sets the secondary list of rules that were examined during adjudication (secondary rules may be plan specific if template level rules were applied earlier) |
Collection of MemberClaimRuleModel |
None. |
| AdditionalMessageInfo |
Gets or sets the list of additional messages that were supplied in the claim response |
Collection of MessageInfoModel |
None. |
| RejectInfo |
Gets or sets the list of reject messages and descriptions that were supplied in the claim response |
Collection of RejectInfoModel |
None. |
| IsManualClaim |
Gets or sets the value indicating whether this claim is a manual claim |
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. |