| Name | 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. |
|
| MemberDxCodeCriteriaType | string |
None. |
|
| IsPrescriberOutOfNetwork | boolean |
None. |
|
| HasLetterOfMedicalNecessity | 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. |