| Name | Description | Type | Additional information |
|---|---|---|---|
| PriceCodesUrl |
Gets or sets the link to the Price Codes resource for the pricing group |
string |
None. |
| PlanPricingGroupDrugsUrl |
Gets or sets the link to the drugs for the pricing group |
string |
None. |
| GroupPlanNo |
Gets or sets the identifier for the Group Plan associated with this pricing group |
integer |
None. |
| Name |
Gets or sets the name of the pricing group |
string |
None. |
| Description |
Gets or sets the description of the pricing group |
string |
None. |
| PriceCodeNo |
Gets or sets the custom pricing price code identifier |
integer |
None. |
| PriceCode |
Gets or sets the custom pricing price code |
string |
None. |
| CustomPriceAdjustment |
Gets or sets the custom pricing adjustment. The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value) |
decimal number |
None. |
| CustomPriceRate |
Gets or sets the custom pricing rate (markup amount) |
decimal number |
None. |
| CustomPriceRatePerUnit |
Gets or sets whether the custom pricing rate is calculated per unit (each) or per fill |
boolean |
None. |
| CustomPricePerDiemRate |
Gets or sets the custom pricing per diem rate |
decimal number |
None. |
| CustomPriceDispenseFee |
Gets or sets the custom pricing dispense fee |
decimal number |
None. |
| CustomPriceDispenseFeeDaysInterval |
Gets or sets the custom pricing dispense fee days interval for dispense fee |
byte |
None. |
| CustomPriceDispenseFeePercentIC |
Gets or sets the custom pricing dispense fee percentage of IC for dispense fee. The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value) |
decimal number |
None. |
| PriceMemberClaimFee |
Gets or sets the price member claim fee. |
decimal number |
None. |
| PriceMemberClaimFeeIC |
Gets or sets the price member claim fee IC. |
decimal number |
None. |
| AltPriceCodeNo |
Gets or sets the first alternate pricing price code identifier |
integer |
None. |
| AltPriceCode |
Gets or sets the first alternate pricing price code |
string |
None. |
| AltPriceAdjustment |
Gets or sets the first alternate pricing adjustment. The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value) |
decimal number |
None. |
| AltPriceRate |
Gets or sets the first alternate pricing rate (markup amount) |
decimal number |
None. |
| AltPriceRatePerUnit |
Gets or sets whether the first alternate pricing rate is calculated per unit (each) or per fill |
boolean |
None. |
| AltPricePerDiemRate |
Gets or sets the first alternate pricing per diem rate |
decimal number |
None. |
| AltPriceDispenseFee |
Gets or sets the first alternate pricing dispense fee |
decimal number |
None. |
| AltPriceDispenseFeeDaysInterval |
Gets or sets the first alternate pricing dispense fee days interval for dispense fee |
byte |
None. |
| AltPriceDispenseFeePercentIC |
Gets or sets the first alternate pricing dispense fee percentage of IC for dispense fee. The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value) |
decimal number |
None. |
| AltPriceMemberClaimFee |
Gets or sets the alternative price member claim fee. |
decimal number |
None. |
| AltPriceMemberClaimFeeIC |
Gets or sets the alternative price member claim fee IC. |
decimal number |
None. |
| Alt2PriceCodeNo |
Gets or sets the second alternate pricing price code identifier |
integer |
None. |
| Alt2PriceCode |
Gets or sets the second alternate pricing price code |
string |
None. |
| Alt2PriceAdjustment |
Gets or sets the second alternate pricing adjustment. The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value) |
decimal number |
None. |
| Alt2PriceRate |
Gets or sets the second alternate pricing rate (markup amount) |
decimal number |
None. |
| Alt2PriceRatePerUnit |
Gets or sets whether the second alternate pricing rate is calculated per unit (each) or per fill |
boolean |
None. |
| Alt2PricePerDiemRate |
Gets or sets the second alternate pricing per diem rate |
decimal number |
None. |
| Alt2PriceDispenseFee |
Gets or sets the second alternate pricing dispense fee |
decimal number |
None. |
| Alt2PriceDispenseFeeDaysInterval |
Gets or sets the second alternate pricing dispense fee days interval for dispense fee |
byte |
None. |
| Alt2PriceDispenseFeePercentIC |
Gets or sets the second alternate pricing dispense fee percentage of IC for dispense fee. The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value) |
decimal number |
None. |
| Alt2PriceMemberClaimFee |
Gets or sets the second alternative price member claim fee. |
decimal number |
None. |
| Alt2PriceMemberClaimFeeIC |
Gets or sets the second alternative price member claim fee IC. |
decimal number |
None. |
| Alt3PriceCodeNo |
Gets or sets the third alternate pricing price code identifier |
integer |
None. |
| Alt3PriceCode |
Gets or sets the third alternate pricing price code |
string |
None. |
| Alt3PriceAdjustment |
Gets or sets the third alternate pricing adjustment. The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value) |
decimal number |
None. |
| Alt3PriceRate |
Gets or sets the third alternate pricing rate (markup amount) |
decimal number |
None. |
| Alt3PriceRatePerUnit |
Gets or sets whether the third alternate pricing rate is calculated per unit (each) or per fill |
boolean |
None. |
| Alt3PricePerDiemRate |
Gets or sets the third alternate pricing per diem rate |
decimal number |
None. |
| Alt3PriceDispenseFee |
Gets or sets the third alternate pricing dispense fee |
decimal number |
None. |
| Alt3PriceDispenseFeeDaysInterval |
Gets or sets the third alternate pricing dispense fee days interval for dispense fee |
byte |
None. |
| Alt3PriceDispenseFeePercentIC |
Gets or sets the third alternate pricing dispense fee percentage of IC for dispense fee. The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value) |
decimal number |
None. |
| Alt3PriceMemberClaimFee |
Gets or sets the third alternative price member claim fee. |
decimal number |
None. |
| Alt3PriceMemberClaimFeeIC |
Gets or sets the third alternative price member claim fee IC. |
decimal number |
None. |
| Alt4PriceCodeNo |
Gets or sets the fourth alternate pricing price code identifier |
integer |
None. |
| Alt4PriceCode |
Gets or sets the fourth alternate pricing price code |
string |
None. |
| Alt4PriceAdjustment |
Gets or sets the fourth alternate pricing adjustment. The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value) |
decimal number |
None. |
| Alt4PriceRate |
Gets or sets the fourth alternate pricing rate (markup amount) |
decimal number |
None. |
| Alt4PriceRatePerUnit |
Gets or sets whether the fourth alternate pricing rate is calculated per unit (each) or per fill |
boolean |
None. |
| Alt4PricePerDiemRate |
Gets or sets the fourth alternate pricing per diem rate |
decimal number |
None. |
| Alt4PriceDispenseFee |
Gets or sets the fourth alternate pricing dispense fee |
decimal number |
None. |
| Alt4PriceDispenseFeeDaysInterval |
Gets or sets the fourth alternate pricing dispense fee days interval for dispense fee |
byte |
None. |
| Alt4PriceDispenseFeePercentIC |
Gets or sets the fourth alternate pricing dispense fee percentage of IC for dispense fee. The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value) |
decimal number |
None. |
| Alt4PriceMemberClaimFee |
Gets or sets the fourth alternative price member claim fee. |
decimal number |
None. |
| Alt4PriceMemberClaimFeeIC |
Gets or sets the fourth alternative price member claim fee IC. |
decimal number |
None. |
| MinimumPriceCodeNo |
Gets or sets the minimum pricing price code identifier |
integer |
None. |
| MinimumPriceCode |
Gets or sets the minimum pricing price code |
string |
None. |
| MinimumPriceAdjustment |
Gets or sets the minimum pricing adjustment. The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value) |
decimal number |
None. |
| MinimumPriceRate |
Gets or sets the minimum pricing rate (markup amount) |
decimal number |
None. |
| MinimumPriceRatePerUnit |
Gets or sets whether the minimum pricing rate is calculated per unit (each) or per fill |
boolean |
None. |
| MinimumPricePerDiemRate |
Gets or sets the minimum pricing per diem rate |
decimal number |
None. |
| MinimumPriceDispenseFee |
Gets or sets the minimum pricing dispense fee |
decimal number |
None. |
| MinimumPriceDispenseFeeDaysInterval |
Gets or sets the minimum dispense fee days interval for dispense fee |
byte |
None. |
| MinimumPriceDispenseFeePercentIC |
Gets or sets the minimum dispense fee percentage of IC for dispense fee. The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value) |
decimal number |
None. |
| MinimumPriceMemberClaimFee |
Gets or sets the minimum price member claim fee. |
decimal number |
None. |
| MinimumPriceMemberClaimFeeIC |
Gets or sets the minimum price member claim fee IC. |
decimal number |
None. |
| FlatRate |
Gets or sets the flat rate pricing rate (markup amount) |
decimal number |
None. |
| FlatRateDaysInterval |
Gets or sets the flat rate days interval |
byte |
None. |
| FlatRateDispenseFee |
Gets or sets the flat rate pricing dispense fee |
decimal number |
None. |
| FlatRateDispenseFeeDaysInterval |
Gets or sets the flat rate dispense fee days interval for dispense fee |
byte |
None. |
| FlatRateDispenseFeePercentIC |
Gets or sets the flat rate dispense fee percentage of IC for dispense fee. The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value) |
decimal number |
None. |
| FlatRateMemberClaimFee |
Gets or sets the flat rate member claim fee. |
decimal number |
None. |
| FlatRateMemberClaimFeeIC |
Gets or sets the flat rate member claim fee IC. |
decimal number |
None. |
| MinimumRate |
Gets or sets the minimum rate pricing rate (markup amount) |
decimal number |
None. |
| MinimumRateDaysInterval |
Gets or sets the minimum rate days interval |
byte |
None. |
| MinimumRateDispenseFee |
Gets or sets the minimim rate pricing dispense fee |
decimal number |
None. |
| MinimumRateDispenseFeeDaysInterval |
Gets or sets the minimum rate dispense fee days interval for dispense fee |
byte |
None. |
| MinimumRateDispenseFeePercentIC |
Gets or sets the minimum rate dispense fee percentage of IC for dispense fee. The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value) |
decimal number |
None. |
| MinimumRateMemberClaimFee |
Gets or sets the minimum rate member claim fee. |
decimal number |
None. |
| MinimumRateMemberClaimFeeIC |
Gets or sets the minimum rate member claim fee IC. |
decimal number |
None. |
| ProfessionalFee |
Gets or sets the professional fee amount |
decimal number |
None. |
| MemberClaimFee |
Gets or sets the member claim fee amount |
decimal number |
None. |
| UseUsualAndCustomary |
Gets or sets whether to use the pharmacy's submitted usual and customary |
boolean |
None. |
| UsualAndCustomaryRate |
Gets or sets the usual and customary rate (markup amount) |
decimal number |
None. |
| UsualAndCustomaryRatePerUnit |
Gets or sets whether the usual and customary rate is calculated per unit (each) or per fill |
boolean |
None. |
| UsualAndCustomaryPerDiemRate |
Gets or sets the usual and customary per diem rate |
decimal number |
None. |
| UsualAndCustomaryAdjustmentIC |
Gets or sets the usual and customary total pricing adjustment. The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value) |
decimal number |
None. |
| UsualAndCustomaryDispenseFee |
Gets or sets the dispense fee when usual and customary pricing is used |
decimal number |
None. |
| UsualAndCustomaryDispenseFeeDaysInterval |
Gets or sets the dispense fee days interval when usual and customary pricing is used |
byte |
None. |
| UsualAndCustomaryDispenseFeePercentIC |
Gets or sets the dispense fee percentage of IC for dispense fee when usual and customary pricing is used. The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value) |
decimal number |
None. |
| UsualAndCustomaryMemberClaimFee |
Gets or sets the usual and customary member claim fee. |
decimal number |
None. |
| UsualAndCustomaryMemberClaimFeeIC |
Gets or sets the usual and customary member claim fee IC. |
decimal number |
None. |
| UseGrossAmountDue |
Gets or sets whether to use the pharmacy's submitted gross amount due |
boolean |
None. |
| UseGrossAmountDueIfNoPricing |
Gets or sets whether to use the pharmacy's submitted gross amount due if there is no other pricing available |
boolean |
None. |
| UseClaimAcqCost |
Gets or sets whether to take amount from claim into account when using acquistion cost |
boolean |
None. |
| AlwaysUseAltPricing |
Gets or sets whether the pricing group takes takes the lowest of all pricing methods that return a price or the first pricing method that returns a price |
boolean |
None. |
| FlatRateIncludesTax |
Gets or sets whether the flat rate includes tax |
boolean |
None. |
| NoCustomPriceAltGroupUrl |
Gets or sets the link back to a fall back pricing group if no pricing could be determined |
string |
None. |
| NoCustomPriceAltGroupNo |
Gets or sets the identifier to the fall back pricing group if not pricing could be determined |
integer |
None. |
| RequiresOverride |
Gets or sets whether the pricing group requires an override |
boolean |
None. |
| RequiresOverrideRestricted |
Gets or sets whether the pricing group requires a restricted override |
boolean |
None. |
| NotCovered |
Gets or sets whether this pricing group is covered |
boolean |
None. |
| Specialty |
Gets or sets whether this pricing group is tagged as specialty |
boolean |
None. |
| Is340B |
Gets or sets whether this pricing group is tagged as 340B |
boolean |
None. |
| PatientAssistanceProgram |
Gets or sets whether this pricing group is tagged as a patient assistance program |
boolean |
None. |
| RejectClaimIfNoCustomPrice |
Gets or sets whether claims should reject if there is no custom pricing |
boolean |
None. |
| ApproveMessage |
Gets or sets the message for paid claim |
string |
None. |
| RequireOverrideMessage |
Gets or sets the message for claims that require override |
string |
None. |
| NotCoveredMessage |
Gets or sets the message for claims that are not covered |
string |
None. |
| AltMinimumPriceCodeNo |
Gets or sets the alternative minimum price code ID. |
integer |
None. |
| AltMinimumPriceCode |
Gets or sets the alternative minimum price code. |
string |
None. |
| AltMinimumPriceAdjustment |
Gets or sets the alternative minimum price adjustment. |
decimal number |
None. |
| AltMinimumPriceRate |
Gets or sets the alternative minimum price rate. |
decimal number |
None. |
| AltMinimumPriceRatePerUnit |
Gets or sets the alternative minimum price rate is per unit. |
boolean |
None. |
| AltMinimumPricePerDiemRate |
Gets or sets the alternative minimum price per diem rate. |
decimal number |
None. |
| AltMinimumPriceDispenseFee |
Gets or sets the alternative minimum price dispense fee. |
decimal number |
None. |
| AltMinimumPriceDispenseFeeDaysInterval |
Gets or sets the interval of days for the alternative minimum price dispense fee. |
byte |
None. |
| AltMinimumPriceDispenseFeePercentIC |
Gets or sets the alternative minimum price dispense fee percent IC. |
decimal number |
None. |
| AltMinimumPriceMemberClaimFee |
Gets or sets the alternative minimum price member claim fee. |
decimal number |
None. |
| AltMinimumPriceMemberClaimFeeIC |
Gets or sets the alternative minimum price member claim fee IC. |
decimal number |
None. |
| Alt2MinimumPriceCodeNo |
Gets or sets the second alternative minimum price code ID. |
integer |
None. |
| Alt2MinimumPriceCode |
Gets or sets the second alternative minimum price code. |
string |
None. |
| Alt2MinimumPriceAdjustment |
Gets or sets the second alternative minimum price adjustment. |
decimal number |
None. |
| Alt2MinimumPriceRate |
Gets or sets the second alternative minimum price rate. |
decimal number |
None. |
| Alt2MinimumPriceRatePerUnit |
Gets or sets the second alternative minimum price rate is per unit. |
boolean |
None. |
| Alt2MinimumPricePerDiemRate |
Gets or sets the second alternative minimum price per diem rate. |
decimal number |
None. |
| Alt2MinimumPriceDispenseFee |
Gets or sets the second alternative minimum price dispense fee. |
decimal number |
None. |
| Alt2MinimumPriceDispenseFeeDaysInterval |
Gets or sets the interval of days for the second alternative minimum price dispense fee. |
byte |
None. |
| Alt2MinimumPriceDispenseFeePercentIC |
Gets or sets the second alternative minimum price dispense fee percent IC. |
decimal number |
None. |
| Alt2MinimumPriceMemberClaimFee |
Gets or sets the second alternative minimum price member claim fee. |
decimal number |
None. |
| Alt2MinimumPriceMemberClaimFeeIC |
Gets or sets the second alternative minimum price member claim fee IC. |
decimal number |
None. |
| GrossAmountDueMemberClaimFee |
Gets or sets the amount added to the claim as ingredient cost that the member is responsible for when using gross amount due pricing |
decimal number |
None. |
| GrossAmountDueMemberClaimFeeIC |
Gets or sets the percentage amount of the ingredient cost added to the claim that the member is responsible for when using gross amount due pricing |
decimal number |
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. |