| Name | Description | Type | Additional information |
|---|---|---|---|
| AllowClaimLimitChecksOnFutureRules |
Gets or sets whether this rule allows checks on future rules |
boolean |
None. |
| QuantityLimitPerFill |
Gets or sets the maximum quantity allowed per fill |
decimal number |
None. |
| QuantityLimitPerDaysSupply |
Gets or sets the maximum quantity allowed per days supply |
decimal number |
None. |
| QuantityLimitPerInterval |
Gets or sets the maximum quantity allowed per time interval |
decimal number |
None. |
| QuantityLimitIntervalDays |
Gets or sets the number of days for the time interval |
integer |
None. |
| QuantityLimitGraceDays |
Gets or sets the number of grace days allowed for the per interval period |
integer |
None. |
| QuantityLimitPerPeriod |
Gets or sets the number of max quantity allowed per benefit period |
decimal number |
None. |
| QuantityLimitPerPeriodGPIChars |
Gets or sets the number of GPI characters to group by when evaluating the MaxQtyPerPeriod value |
string |
None. |
| QuantityLimitPerYear |
Gets or sets the maximum quantity allowed per calendar year |
decimal number |
None. |
| QuantityLimitPerYearGPIChars |
Gets or sets the number of GPI characters to group by when evaluating the MaxQtyPerYear value |
string |
None. |
| QuantityLimitTotal |
Gets or sets the maximum quantity allowed |
decimal number |
None. |
| QuantityLimitTotalGPIChars |
Gets or sets the number of GPI characters to group by when evaluating the MaxQtyTotal value |
string |
None. |
| MinDaysSupplyPerFill |
Gets or sets the minimum days supply per fill |
integer |
None. |
| MaxDaysSupplyPerFill |
Gets or sets the maximum days supply per fill |
integer |
None. |
| MaxDaysSupplyPerPeriod |
Gets or sets the maximum days supply allowed per benefit period |
integer |
None. |
| MaxDaysSupplyPerPeriodGPIChars |
Gets or sets number of GPI characters to group by when evaluating the MaxDaysSupplyPerPeriod value |
string |
None. |
| MaxDaysSupplyPerYear |
Gets or sets the maximum days supply per calendar year |
integer |
None. |
| MaxDaysSupplyPerYearGPIChars |
Gets or sets the number of GPI characters to group by when evaluating the MaxDaysSupplyPerYear value |
string |
None. |
| MaxDaysSupplyTotal |
Gets or sets the maximum days supply allowed |
integer |
None. |
| MaxDaysSupplyTotalGPIChars |
Gets or sets the number of GPI characters to group by when evaluating the MaxDaysSupplyTotal value |
string |
None. |
| MaxPricePerFill |
Gets or sets the maximum dollar amount per fill |
decimal number |
None. |
| MaxPricePerFillNetworkResultID |
Gets or sets the action to enforce a limit on MaxPricePerFill for network pricing" |
integer |
None. |
| MaxPricePerFillNetworkOnly |
Gets or sets the action to enforce a limit on MaxPricePerFill for network pricing only" |
boolean |
None. |
| MaxPricePerDaySupply |
Gets or sets the maximum dollar amount per days supply |
decimal number |
None. |
| MaxPricePerDaySupplyNetworkResultID |
Gets or sets the action to enforce a limit on MaxPricePerDaySupply for network pricing" |
integer |
None. |
| MaxPricePerDaySupplyNetworkOnly |
Gets or sets the action to enforce a limit on MaxPricePerDaySupply for network pricing only" |
boolean |
None. |
| MaxPricePerUnit |
Gets or sets the maximum dollar amount per quantity dispensed |
decimal number |
None. |
| MaxPricePerUnitNetworkResultID |
Gets or sets the action to enforce a limit on MaxPricePerUnit for network pricing" |
integer |
None. |
| MaxPricePerUnitNetworkOnly |
Gets or sets the action to enforce a limit on MaxPricePerUnit for network pricing only" |
boolean |
None. |
| RefillTooSoonMinPercentConsumed |
Gets or sets the minimum percentage that must be consumed so that a refill too soon edit is not generated |
decimal number |
None. |
| MaxFillsPerInterval |
Gets or sets the maximum fills allowed for a drug per interval |
integer |
None. |
| MaxFillsIntervalDays |
Gets or sets the number of days for the time interval |
integer |
None. |
| MaxFillsGraceDays |
Gets or sets the number of grace days allowed for the interval period |
integer |
None. |
| MaxFillsPerPeriod |
Gets or sets the maximum number of fills allowoed per benefit period |
integer |
None. |
| MaxFillsPerPeriodGPIChars |
Gets or sets the number of GPI characters to group by when evaluating the MaxFillsPerPeriod value |
string |
None. |
| MaxFillsPerYear |
Gets or sets the maximum number of fills allowed per calendar year |
integer |
None. |
| MaxFillsPerYearGPIChars |
Gets or sets the number of GPI characters to group by when evaluating the MaxFillsPerYear value |
string |
None. |
| MaxFillsTotal |
Gets or sets the maximum number of fills allowed |
integer |
None. |
| MaxFillsTotalGPIChars |
Gets or sets the number of GPI characters to group by when evaluating the MaxFillsTotal value |
string |
None. |
| ClaimLimitsMinMemberAge |
Gets or sets the minimum age allowed for a member |
integer |
None. |
| ClaimLimitsMaxMemberAge |
Gets or sets the maximum age allowed for a member |
integer |
None. |
| ClaimLimitsMemberAgeUnits |
Gets or sets the age units used when determining the age limits |
string |
None. |
| UsualAndCustomaryMarginPercent |
Gets or sets usual and customary margin deviation percentage allowed compared to AWP |
decimal number |
None. |
| LimitQtyToPackageSize |
Gets or sets option to limit quantity to factors of the package size |
boolean |
None. |
| MaxFillsPerDaysIntervalSpecial | integer |
None. |
|
| FillDaysIntervalSpecial | integer |
None. |
|
| FillGraceDaysSpecial | integer |
None. |