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rule","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DeductibleModel"}}}}},"/api/groups/{groupid}/groupplans/{groupplanid}/deductibles":{"get":{"tags":["Deductibles"],"summary":"Gets a collection of deductible resources for a Group Plan","operationId":"Deductible_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/DeductibleModel"}}}}},"post":{"tags":["Deductibles"],"summary":"Posts a new deductible for a group plan","operationId":"Deductibles_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"deductibleModel","in":"body","description":"New Deductible","required":true,"schema":{"$ref":"#/definitions/DeductibleModel"}},{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DeductibleModel"}}}}},"/api/groups/{groupid}/groupplans/{groupplanid}/deductibles/{id}":{"get":{"tags":["Deductibles"],"summary":"Gets a deductible resource","operationId":"Deductible_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Deductible identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DeductibleModel"}}}},"patch":{"tags":["Deductibles"],"summary":"Patches an existing plan deductible","operationId":"Deductibles_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Pricing Group Identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target rule","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DeductibleModel"}}}}},"/api/groups/{groupid}/members/{memberid}/dependents":{"get":{"tags":["Dependents"],"summary":"Gets a collection of Dependents for a specified group and member.\r\nThis method retrieves all dependents associated with the given group and member ID.","operationId":"Dependents_GetAll","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group to which the dependents belong","required":true,"type":"integer","format":"int64"},{"name":"memberid","in":"path","description":"The ID of the member to whom the dependents are related","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/DependentModel"}}}}},"post":{"tags":["Dependents"],"summary":"Adds a new dependent for the specified group and member.","description":"This method performs several validation checks and ensures that the dependent is correctly linked to the specified member and group.\r\nIt also handles the creation and association of addresses and phone numbers for the dependent.","operationId":"Dependents_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group to which the member belongs.","required":true,"type":"integer","format":"int64"},{"name":"memberid","in":"path","description":"The ID of the member to whom the dependent will be added.","required":true,"type":"integer","format":"int64"},{"name":"dependentModel","in":"body","description":"The model containing the dependent's details.","required":true,"schema":{"$ref":"#/definitions/DependentModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DependentModel"}}}}},"/api/groups/{groupid}/members/{memberid}/dependents/{id}":{"get":{"tags":["Dependents"],"summary":"Gets a Dependent by ID for a specified group and member.\r\nThis method retrieves a specific dependent based on the given group ID, member ID, and dependent ID.","operationId":"Dependents_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group to which the dependent belongs","required":true,"type":"integer","format":"int64"},{"name":"memberid","in":"path","description":"The ID of the member to whom the dependent is related","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the dependent to retrieve","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DependentModel"}}}},"patch":{"tags":["Dependents"],"summary":"Patches an existing Dependent. \r\nUnlike other endpoints, this controller/endpoint allows you to patch the dependent's child objects, such as phone and address.\r\nOther endpoints require you to use the child object's endpoint directly for updates.","operationId":"Dependents_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group to which the Dependent belongs","required":true,"type":"integer","format":"int64"},{"name":"memberid","in":"path","description":"The ID of the member to whom the Dependent is related","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the Dependent to update","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The JSON Patch document containing the changes","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DependentModel"}}}}},"/api/globalcompanydiagnosiscodelimits":{"get":{"tags":["DiagnosisCodeLimits"],"summary":"Gets a collection of global Company Diagnosis Code Limits","operationId":"GlobalCompanyDiagnosisCodeLimits_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"page","in":"query","description":"The 1-based index of the page of company diagnosis code limits to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of company diagnosis code limits to return per page (optional, 25 by default, max 100)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[CompanyDiagnosisCodeLimitModel]"}}}},"post":{"tags":["DiagnosisCodeLimits"],"summary":"Posts a new Global Company Diagnosis Code Limit\r\n<param name=\"companyDiagnosisCodeLimitModel\"></param>","operationId":"GlobalCompanyDiagnosisCodeLimits_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"companyDiagnosisCodeLimitModel","in":"body","required":true,"schema":{"$ref":"#/definitions/CompanyDiagnosisCodeLimitModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/CompanyDiagnosisCodeLimitModel"}}}}},"/api/globalcompanydiagnosiscodelimits/{id}":{"get":{"tags":["DiagnosisCodeLimits"],"summary":"Gets a global diagnosis code limit by id","operationId":"GlobalCompanyDiagnosisCodeLimits_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Diagnosis code limit identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/CompanyDiagnosisCodeLimitModel"}}}},"delete":{"tags":["DiagnosisCodeLimits"],"summary":"Deletes a global Company Diagnosis Code Limit by ID","operationId":"GlobalCompanyDiagnoisCodeLimits_Delete","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Company Diagnosis Code Limit identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}},"patch":{"tags":["DiagnosisCodeLimits"],"summary":"Patches an existing Global Company Diagnosis Code Limit object","operationId":"GlobalCompanyDiagnosisCodeLimits_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Diagnosis Code Limit identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target global company diagnosis code limit object","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/CompanyDiagnosisCodeLimitModel"}}}}},"/api/formularies/{formularyid}/formularycompanydiagnosiscodelimits":{"get":{"tags":["DiagnosisCodeLimits"],"summary":"Gets a collection of diagnosis code limits tied to the specified formulary","operationId":"FormularyCompanyDiagnosisCodeLimits_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"formularyid","in":"path","description":"The id of the formulary for which diagnosis code limits will be returned","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The 1-based index of the page of diagnosis code limits to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of diagnosis code limits to return per page (optional, 25 by default, max 100)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[FormularyCompanyDiagnosisCodeLimitModel]"}}}},"post":{"tags":["DiagnosisCodeLimits"],"summary":"Posts a new Formulary Company Diagnosis Code Limit","operationId":"FormularyCompanyDiagnosisCodeLimits_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"formularyCompanyDiagnosisCodeLimitModel","in":"body","description":"","required":true,"schema":{"$ref":"#/definitions/FormularyCompanyDiagnosisCodeLimitModel"}},{"name":"formularyid","in":"path","description":"The id of the formulary for which diagnosis code limit","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/FormularyCompanyDiagnosisCodeLimitModel"}}}}},"/api/formularies/{formularyid}/formularycompanydiagnosiscodelimits/{id}":{"get":{"tags":["DiagnosisCodeLimits"],"summary":"Gets a Company Diagnosis Code Limit by formulary identifier and company diagnosis code limit identifier","operationId":"FormularyCompanyDiagnosisCodeLimits_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"formularyid","in":"path","description":"The id of the formulary for which diagnosis code limits will be returned","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Diagnosis Code limit identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/FormularyCompanyDiagnosisCodeLimitModel"}}}},"delete":{"tags":["DiagnosisCodeLimits"],"summary":"Deletes a Company Diagnosis Code Limit by formulary identifier and company diagnosis code limit identifier","operationId":"FormularyCompanyDiagnosisCodeLimits_Delete","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"formularyid","in":"path","description":"The id of the formulary company diagnosis code limit","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Company Diagnosis Code Limits identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}},"patch":{"tags":["DiagnosisCodeLimits"],"summary":"Patches an existing Formulary Company Diagnosis Code Limit object","operationId":"FormularyCompanyDiagnosisCodeLimits_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"formularyid","in":"path","description":"The id of the formulary for which diagnosis code limit","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Diagnosis Code Limit identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target formulary company diagnosis code limit object","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/FormularyCompanyDiagnosisCodeLimitModel"}}}}},"/api/diagnosiscodes/{description}":{"get":{"tags":["DiagnosisCodes"],"summary":"Gets a diagnosis code resource","operationId":"DiagnosisCodes_GetByDescription","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"description","in":"path","description":"Diagnosis Code description","required":true,"type":"string"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/DiagnosisCodeModel"}}}}}},"/api/dosageforms":{"get":{"tags":["DosageForms"],"summary":"Retrieves all dosage forms.","description":"This method retrieves all records from the database and maps them to DosageFormModel instances.","operationId":"DosageForms_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/DosageFormModel"}}}}}},"/api/drugprofiles/{drugprofileid}/drugprofileddids":{"get":{"tags":["DrugProfileDDIDs"],"summary":"Retrieves a paginated list of global drug profile DDIDs for a given drug profile ID.","operationId":"DrugProfileDDIDs_GetAllGlobal","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The ID of the drug profile to retrieve DDIDs for.","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The page number of the results to fetch.","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of records per page.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResult[DrugProfileDDIDModel]"}}}},"post":{"tags":["DrugProfileDDIDs"],"summary":"Creates a new global drug profile DDID.","operationId":"GlobalDrugProfileDDIDs_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the new DDID.","required":true,"type":"integer","format":"int64"},{"name":"drugProfileDDIDModel","in":"body","description":"The drug profile DDID model to add.","required":true,"schema":{"$ref":"#/definitions/DrugProfileDDIDModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/CompanyAgeLimitModel"}}}}},"/api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofileddids":{"get":{"tags":["DrugProfileDDIDs"],"summary":"Retrieves a paginated list of drug profile DDIDs for a specific group and drug profile ID.","operationId":"DrugProfileDDIDs_GetAllByPharmacy","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID to retrieve DDIDs for.","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The page number of the results to fetch.","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of records per page.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResult[DrugProfileDDIDModel]"}}}},"post":{"tags":["DrugProfileDDIDs"],"summary":"Creates a new drug profile DDID associated with a specified group.","operationId":"PharmacyDrugProfileDDIDs_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the new DDID.","required":true,"type":"integer","format":"int64"},{"name":"drugProfileDDIDModel","in":"body","description":"The drug profile DDID model to add.","required":true,"schema":{"$ref":"#/definitions/DrugProfileDDIDModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/CompanyAgeLimitModel"}}}}},"/api/drugprofiles/{drugprofileid}/drugprofileddids/{id}":{"get":{"tags":["DrugProfileDDIDs"],"summary":"Retrieves a single global drug profile DDID by ID for a given drug profile.","operationId":"DrugProfileDDIDs_GetGlobalByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the DDID.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile DDID to retrieve.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileDDIDModel"}}}},"delete":{"tags":["DrugProfileDDIDs"],"summary":"Deletes a single global drug profile DDID by ID for a given drug profile.","operationId":"GlobalDrugProfileDDIDs_Delete","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the DDID.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile DDID to delete.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}},"patch":{"tags":["DrugProfileDDIDs"],"summary":"This endpoint allows modification of a global drug profile DDID.","operationId":"GlobalDrugProfileDDIDs_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The ID of the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile DDID to update.","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The JSON Patch document containing the changes.","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileDDIDModel"}}}}},"/api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofileddids/{id}":{"get":{"tags":["DrugProfileDDIDs"],"summary":"Retrieves a single drug profile DDID for a specific group and drug profile.","operationId":"DrugProfileDDIDs_GetPharmacyByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The group ID associated with the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the DDID to retrieve.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileDDIDModel"}}}},"delete":{"tags":["DrugProfileDDIDs"],"summary":"Deletes a single drug profile DDID for a specific group and drug profile.","operationId":"DrugProfileDDIDs_Delete","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The group ID associated with the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the DDID to delete.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}},"patch":{"tags":["DrugProfileDDIDs"],"summary":"This endpoint allows modification of a group's drug profile DDID.","operationId":"PharmacyDrugProfileDDIDs_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The ID of the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile DDID to update.","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The JSON Patch document containing the changes.","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileDDIDModel"}}}}},"/api/drugprofiles/{drugprofileid}/drugprofiledosageforms":{"get":{"tags":["DrugProfileDosageForms"],"summary":"Retrieves a paginated list of global drug profile Dosage Forms for a given drug profile ID.","operationId":"DrugProfileDosageForms_GetAllGlobal","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The ID of the drug profile to retrieve Dosage Forms for.","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The page number of the results to fetch.","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of records per page.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResult[DrugProfileDosageFormModel]"}}}},"post":{"tags":["DrugProfileDosageForms"],"summary":"Creates a new global drug profile DosageForm.","operationId":"GlobalDrugProfileDosageForms_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the new DosageForm.","required":true,"type":"integer","format":"int64"},{"name":"drugProfileDosageFormModel","in":"body","description":"The drug profile DosageForm model to add.","required":true,"schema":{"$ref":"#/definitions/DrugProfileDosageFormModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/CompanyAgeLimitModel"}}}}},"/api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofiledosageforms":{"get":{"tags":["DrugProfileDosageForms"],"summary":"Retrieves a paginated list of drug profile Dosage Forms for a specific group and drug profile ID.","operationId":"DrugProfileDosageForms_GetAllByPharmacy","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID to retrieve Dosage Forms for.","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The page number of the results to fetch.","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of records per page.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResult[DrugProfileDosageFormModel]"}}}},"post":{"tags":["DrugProfileDosageForms"],"summary":"Creates a new drug profile DosageForm associated with a specified group.","operationId":"PharmacyDrugProfileDosageForms_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the new DosageForm.","required":true,"type":"integer","format":"int64"},{"name":"drugProfileDosageFormModel","in":"body","description":"The drug profile DosageForm model to add.","required":true,"schema":{"$ref":"#/definitions/DrugProfileDosageFormModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/CompanyAgeLimitModel"}}}}},"/api/drugprofiles/{drugprofileid}/drugprofiledosageforms/{id}":{"get":{"tags":["DrugProfileDosageForms"],"summary":"Retrieves a single global drug profile DosageForm by ID for a given drug profile.","operationId":"DrugProfileDosageForms_GetGlobalByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the DosageForm.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile DosageForm to retrieve.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileDosageFormModel"}}}},"delete":{"tags":["DrugProfileDosageForms"],"summary":"Deletes a single global drug profile DosageForm by ID for a given drug profile.","operationId":"GlobalDrugProfileDosageForms_Delete","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the DosageForm.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile DosageForm to delete.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}},"patch":{"tags":["DrugProfileDosageForms"],"summary":"This endpoint allows modification of a global drug profile DosageForm.","operationId":"GlobalDrugProfileDosageForms_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The ID of the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile DosageForm to update.","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The JSON Patch document containing the changes.","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileDosageFormModel"}}}}},"/api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofiledosageforms/{id}":{"get":{"tags":["DrugProfileDosageForms"],"summary":"Retrieves a single drug profile DosageForm for a specific group and drug profile.","operationId":"DrugProfileDosageForms_GetPharmacyByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The group ID associated with the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the DosageForm to retrieve.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileDosageFormModel"}}}},"delete":{"tags":["DrugProfileDosageForms"],"summary":"Deletes a single drug profile DosageForm for a specific group and drug profile.","operationId":"DrugProfileDosageForms_Delete","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The group ID associated with the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the DosageForm to delete.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}},"patch":{"tags":["DrugProfileDosageForms"],"summary":"This endpoint allows modification of a group's drug profile DosageForm.","operationId":"PharmacyDrugProfileDosageForms_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The ID of the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile DosageForm to update.","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The JSON Patch document containing the changes.","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileDosageFormModel"}}}}},"/api/drugprofiles/{drugprofileid}/drugprofilegpis":{"get":{"tags":["DrugProfileGPIs"],"summary":"Retrieves a paginated list of global drug profile GPIs for a given drug profile ID.","operationId":"DrugProfileGPIs_GetAllGlobal","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The ID of the drug profile to retrieve GPIs for.","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The page number of the results to fetch.","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of records per page.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResult[DrugProfileGPIModel]"}}}},"post":{"tags":["DrugProfileGPIs"],"summary":"Creates a new global drug profile GPI.","operationId":"GlobalDrugProfileGPIs_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the new GPI.","required":true,"type":"integer","format":"int64"},{"name":"drugProfileGPIModel","in":"body","description":"The drug profile GPI model to add.","required":true,"schema":{"$ref":"#/definitions/DrugProfileGPIModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileGPIModel"}}}}},"/api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilegpis":{"get":{"tags":["DrugProfileGPIs"],"summary":"Retrieves a paginated list of drug profile GPIs for a specific group and drug profile ID.","operationId":"DrugProfileGPIs_GetAllByPharmacy","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID to retrieve GPIs for.","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The page number of the results to fetch.","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of records per page.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResult[DrugProfileGPIModel]"}}}},"post":{"tags":["DrugProfileGPIs"],"summary":"Creates a new drug profile GPI associated with a specified group.","operationId":"PharmacyDrugProfileGPIs_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the new GPI.","required":true,"type":"integer","format":"int64"},{"name":"drugProfileGPIModel","in":"body","description":"The drug profile GPI model to add.","required":true,"schema":{"$ref":"#/definitions/DrugProfileGPIModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileGPIModel"}}}}},"/api/drugprofiles/{drugprofileid}/drugprofilegpis/{id}":{"get":{"tags":["DrugProfileGPIs"],"summary":"Retrieves a single global drug profile GPI by ID for a given drug profile.","operationId":"DrugProfileGPIs_GetGlobalByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the GPI.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile GPI to retrieve.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileGPIModel"}}}},"delete":{"tags":["DrugProfileGPIs"],"summary":"Deletes a single global drug profile GPI by ID for a given drug profile.","operationId":"GlobalDrugProfileGPIs_Delete","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the GPI.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile GPI to delete.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}},"patch":{"tags":["DrugProfileGPIs"],"summary":"This endpoint allows modification of a global drug profile GPI.","operationId":"GlobalDrugProfileGPIs_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The ID of the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile GPI to update.","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The JSON Patch document containing the changes.","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileGPIModel"}}}}},"/api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilegpis/{id}":{"get":{"tags":["DrugProfileGPIs"],"summary":"Retrieves a single drug profile GPI for a specific group and drug profile.","operationId":"DrugProfileGPIs_GetPharmacyByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The group ID associated with the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the GPI to retrieve.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileGPIModel"}}}},"delete":{"tags":["DrugProfileGPIs"],"summary":"Deletes a single drug profile GPI for a specific group and drug profile.","operationId":"DrugProfileGPIs_Delete","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The group ID associated with the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the GPI to delete.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}},"patch":{"tags":["DrugProfileGPIs"],"summary":"This endpoint allows modification of a group's drug profile GPI.","operationId":"PharmacyDrugProfileGPIs_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The ID of the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile GPI to update.","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The JSON Patch document containing the changes.","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileGPIModel"}}}}},"/api/drugprofiles/{drugprofileid}/drugprofilegpis/batch":{"post":{"tags":["DrugProfileGPIs"],"summary":"Creates multiple global drug 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GenericProductIdentifiers are deleted.\r\nReturns 204 No Content on success.","operationId":"GlobalDrugProfileGPIs_DeleteBatch","consumes":["application/json","text/json","application/json-patch+json"],"produces":[],"parameters":[{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the GPIs.","required":true,"type":"integer","format":"int64"},{"name":"genericProductIdentifiers","in":"body","description":"A list of GenericProductIdentifiers to delete if deleteAll is false.","required":true,"schema":{"type":"array","items":{"type":"string"}}},{"name":"deleteAll","in":"query","description":"A boolean indicating whether to delete all GPIs (true) or only the provided GPIs (false).","required":false,"type":"boolean"}],"responses":{"204":{"description":"No Content"}}}},"/api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilegpis/batch/delete":{"post":{"tags":["DrugProfileGPIs"],"summary":"Deletes multiple drug profile GPI records at the group level. \r\nIf deleteAll=true, all GPIs are deleted for the specified drug profile.\r\nIf deleteAll=false, only the provided GenericProductIdentifiers are deleted.\r\nReturns 204 No Content on success.","operationId":"PharmacyDrugProfileGPIs_DeleteBatch","consumes":["application/json","text/json","application/json-patch+json"],"produces":[],"parameters":[{"name":"groupid","in":"path","description":"The group ID associated with the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the GPIs.","required":true,"type":"integer","format":"int64"},{"name":"genericProductIdentifiers","in":"body","description":"A list of GenericProductIdentifiers to delete if deleteAll is false.","required":true,"schema":{"type":"array","items":{"type":"string"}}},{"name":"deleteAll","in":"query","description":"A boolean indicating whether to delete all GPIs (true) or only the provided GPIs (false).","required":false,"type":"boolean"}],"responses":{"204":{"description":"No Content"}}}},"/api/drugprofiles/{drugprofileid}/drugprofilendcs":{"get":{"tags":["DrugProfileNDCs"],"summary":"Retrieves a paginated list of global drug profile NDCs for a given drug profile ID.","operationId":"DrugProfileNDCs_GetAllGlobal","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The ID of the drug profile to retrieve NDCs for.","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The page number of the results to fetch.","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of records per page.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResult[DrugProfileNDCModel]"}}}},"post":{"tags":["DrugProfileNDCs"],"summary":"Creates a new global drug profile NDC.","operationId":"GlobalDrugProfileNDCs_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the new NDC.","required":true,"type":"integer","format":"int64"},{"name":"drugProfileNDCModel","in":"body","description":"The drug profile NDC model to add.","required":true,"schema":{"$ref":"#/definitions/DrugProfileNDCModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/CompanyAgeLimitModel"}}}}},"/api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilendcs":{"get":{"tags":["DrugProfileNDCs"],"summary":"Retrieves a paginated list of drug profile NDCs for a specific group and drug profile ID.","operationId":"DrugProfileNDCs_GetAllByPharmacy","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID to retrieve NDCs for.","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The page number of the results to fetch.","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of records per page.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResult[DrugProfileNDCModel]"}}}},"post":{"tags":["DrugProfileNDCs"],"summary":"Creates a new drug profile NDC associated with a specified group.","operationId":"PharmacyDrugProfileNDCs_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the new NDC.","required":true,"type":"integer","format":"int64"},{"name":"drugProfileNDCModel","in":"body","description":"The drug profile NDC model to add.","required":true,"schema":{"$ref":"#/definitions/DrugProfileNDCModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/CompanyAgeLimitModel"}}}}},"/api/drugprofiles/{drugprofileid}/drugprofilendcs/{id}":{"get":{"tags":["DrugProfileNDCs"],"summary":"Retrieves a single global drug profile NDC by ID for a given drug profile.","operationId":"DrugProfileNDCs_GetGlobalByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the NDC.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile NDC to retrieve.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileNDCModel"}}}},"delete":{"tags":["DrugProfileNDCs"],"summary":"Deletes a single global drug profile NDC by ID for a given drug profile.","operationId":"GlobalDrugProfileNDCs_Delete","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the NDC.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile NDC to delete.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}},"patch":{"tags":["DrugProfileNDCs"],"summary":"This endpoint allows modification of a global drug profile NDC.","operationId":"GlobalDrugProfileNDCs_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The ID of the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile NDC to update.","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The JSON Patch document containing the changes.","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileNDCModel"}}}}},"/api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilendcs/{id}":{"get":{"tags":["DrugProfileNDCs"],"summary":"Retrieves a single drug profile NDC for a specific group and drug profile.","operationId":"DrugProfileNDCs_GetPharmacyByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The group ID associated with the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the NDC to retrieve.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileNDCModel"}}}},"delete":{"tags":["DrugProfileNDCs"],"summary":"Deletes a single drug profile NDC for a specific group and drug profile.","operationId":"DrugProfileNDCs_Delete","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The group ID associated with the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the NDC to delete.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}},"patch":{"tags":["DrugProfileNDCs"],"summary":"This endpoint allows modification of a group's drug profile NDC.","operationId":"PharmacyDrugProfileNDCs_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The ID of the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile NDC to update.","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The JSON Patch document containing the changes.","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileNDCModel"}}}}},"/api/drugprofiles/{drugprofileid}/drugprofilerouteofadministrations":{"get":{"tags":["DrugProfileRouteOfAdministrations"],"summary":"Retrieves a paginated list of global drug profile RouteOfAdministrations for a given drug profile ID.","operationId":"DrugProfileRouteOfAdministrations_GetAllGlobal","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The ID of the drug profile to retrieve RouteOfAdministrations for.","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The page number of the results to fetch.","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of records per page.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResult[DrugProfileRouteOfAdministrationModel]"}}}},"post":{"tags":["DrugProfileRouteOfAdministrations"],"summary":"Creates a new global drug profile RouteOfAdministration.","operationId":"GlobalDrugProfileRouteOfAdministrations_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the new RouteOfAdministration.","required":true,"type":"integer","format":"int64"},{"name":"drugProfileRouteOfAdministrationModel","in":"body","description":"The drug profile RouteOfAdministration model to add.","required":true,"schema":{"$ref":"#/definitions/DrugProfileRouteOfAdministrationModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/CompanyAgeLimitModel"}}}}},"/api/groups/{groupid}/drugprofiles/{drugprofileid}/drugprofilerouteofadministrations":{"get":{"tags":["DrugProfileRouteOfAdministrations"],"summary":"Retrieves a paginated list of drug profile RouteOfAdministrations for a specific group and drug profile ID.","operationId":"DrugProfileRouteOfAdministrations_GetAllByPharmacy","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID to retrieve RouteOfAdministrations for.","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The page number of the results to fetch.","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of records per page.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResult[DrugProfileRouteOfAdministrationModel]"}}}},"post":{"tags":["DrugProfileRouteOfAdministrations"],"summary":"Creates a new drug profile RouteOfAdministration associated with a specified group.","operationId":"PharmacyDrugProfileRouteOfAdministrations_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the new RouteOfAdministration.","required":true,"type":"integer","format":"int64"},{"name":"drugProfileRouteOfAdministrationModel","in":"body","description":"The drug profile RouteOfAdministration model to add.","required":true,"schema":{"$ref":"#/definitions/DrugProfileRouteOfAdministrationModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/CompanyAgeLimitModel"}}}}},"/api/drugprofiles/{drugprofileid}/drugprofilerouteofadministrations/{id}":{"get":{"tags":["DrugProfileRouteOfAdministrations"],"summary":"Retrieves a single global drug profile RouteOfAdministration by ID for a given drug profile.","operationId":"DrugProfileRouteOfAdministrations_GetGlobalByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the RouteOfAdministration.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile RouteOfAdministration to retrieve.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileRouteOfAdministrationModel"}}}},"delete":{"tags":["DrugProfileRouteOfAdministrations"],"summary":"Deletes a single global drug profile RouteOfAdministration by ID for a given drug profile.","operationId":"GlobalDrugProfileRouteOfAdministrations_Delete","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugprofileid","in":"path","description":"The drug profile ID associated with the RouteOfAdministration.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile RouteOfAdministration to 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delete.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}},"patch":{"tags":["DrugProfileRouteOfAdministrations"],"summary":"This endpoint allows modification of a group's drug profile RouteOfAdministration.","operationId":"PharmacyDrugProfileRouteOfAdministrations_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group.","required":true,"type":"integer","format":"int64"},{"name":"drugprofileid","in":"path","description":"The ID of the drug profile.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the drug profile RouteOfAdministration to update.","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The JSON Patch document containing the 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a new global drug profile .","operationId":"GlobalDrugProfiles_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugProfileModel","in":"body","description":"The drug profile  model to add.","required":true,"schema":{"$ref":"#/definitions/DrugProfileModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/CompanyAgeLimitModel"}}}}},"/api/groups/{groupid}/drugprofiles":{"get":{"tags":["DrugProfiles"],"summary":"Retrieves a paginated list of drug profiles for a specific group.","operationId":"DrugProfiles_GetByGroup","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group to filter the drug profiles.","required":true,"type":"integer","format":"int64"},{"name":"name","in":"query","description":"Optional name to filter the drug 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.","operationId":"GlobalDrugProfiles_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"The ID of the drug profile  to update.","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The JSON Patch document containing the changes.","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/DrugProfileModel"}}}}},"/api/groups/{groupid}/drugprofiles/{id}":{"get":{"tags":["DrugProfiles"],"summary":"Retrieves a single drug profile by ID for a specific group.","operationId":"DrugProfiles_PharmacyGetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the 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If true, only formularies that haven't been delete will be returned.  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returned","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Gender limit identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/FormularyCompanyGenderLimitModel"}}}},"delete":{"tags":["GenderLimits"],"summary":"Deletes a Company Gender Limit by formulary identifier and company gender limit identifier","operationId":"FormularyCompanyGenderLimits_Delete","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"formularyid","in":"path","description":"The id of the formulary company gender limits","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Gender limit identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}},"patch":{"tags":["GenderLimits"],"summary":"Patches an existing Formulary Company Gender Limit object","operationId":"FormularyCompanyGenderLimits_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"formularyid","in":"path","description":"The id of the formulary for which gender limits","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Gender limit identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target formulary company gender limit object","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/FormularyCompanyGenderLimitModel"}}}}},"/api/groups/{groupid}/members":{"get":{"tags":["GroupMembers"],"summary":"Gets a collection of members based on the search paramaters and the group and plan (optional) associated with the authenticated user","operationId":"GroupMembers_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Identifier for Group for which you want to find members","required":true,"type":"integer","format":"int32"},{"name":"lastName","in":"query","description":"Last name of member","required":true,"type":"string"},{"name":"groupPlanNo","in":"query","description":"Identifier for Plan for which you want to find members (optional)","required":false,"type":"integer","format":"int32"},{"name":"firstName","in":"query","description":"First name of member (optional)","required":false,"type":"string"},{"name":"page","in":"query","description":"Page number of result set to return (optional, default is 1)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"Number of results to return per page (optional, default is 50, max is 100)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[MemberModel]"}}}}},"/api/groups/{groupid}/membersetup":{"get":{"tags":["GroupMembers"],"summary":"Gets a collection of members based on the provided identifier and the company associated with the authenticated user","operationId":"GroupMembers_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Identifier for Group for which you want to find members","required":true,"type":"integer","format":"int32"},{"name":"lastName","in":"query","description":"Last name of member (optional)","required":false,"type":"string"},{"name":"page","in":"query","description":"Page number of result set to return (optional, default is 1)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"Number of results to return per page (optional, default is 50, max is 100)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[MemberSetupModel]"}}}},"post":{"tags":["GroupMembers"],"summary":"Adds a new member to the group and plan based on the information sent in the posted model","operationId":"GroupMembersSetup_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"memberSetupModel","in":"body","description":"The json formatted member setup model object supplied in the request body that is to be added","required":true,"schema":{"$ref":"#/definitions/MemberSetupModel"}},{"name":"groupid","in":"path","required":true,"type":"string"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MemberSetupModel"}}}}},"/api/groups/{groupid}/groupplans/{id}/copyplan":{"post":{"tags":["GroupPlans"],"summary":"Creates a copy of an existing group plan using the specified template and settings.","description":"This method duplicates an existing group plan based on the provided template and configuration settings.","operationId":"GroupPlanCopyPlan_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":[],"parameters":[{"name":"groupPlanCopyPlanModel","in":"body","description":"The model containing information about the new plan to be created.","required":true,"schema":{"$ref":"#/definitions/GroupPlanCopyPlanModel"}},{"name":"groupid","in":"path","description":"The identifier of the group associated with the plan to be copied.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The identifier of the group plan to be copied.","required":true,"type":"integer","format":"int64"}],"responses":{"204":{"description":"No Content"}}}},"/api/groups/{groupid}/groupplans":{"get":{"tags":["GroupPlans"],"summary":"Gets a collection of Plans for a group by the group identifier","operationId":"GroupPlan_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/GroupPlanModel"}}}}},"post":{"tags":["GroupPlans"],"summary":"Posts a new group plan to an existing group","operationId":"GroupPlans_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupPlanModel","in":"body","description":"The group plan to be added to the specified group's available plans","required":true,"schema":{"$ref":"#/definitions/GroupPlanModel"}},{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/GroupPlanModel"}}}}},"/api/groups/{groupid}/groupplans/{id}":{"get":{"tags":["GroupPlans"],"summary":"Gets a Plan for the specified group and plan identifier","operationId":"GroupPlan_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Plan identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/GroupPlanModel"}}}},"patch":{"tags":["GroupPlans"],"summary":"Patches an existing group plan","operationId":"GroupPlans_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target rule","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/GroupPlanModel"}}}}},"/api/groupplantemplates/{id}/copyplan":{"post":{"tags":["GroupPlanTemplates"],"summary":"Creates a copy of an existing group plan template.","description":"This method duplicates a group plan template based on the provided identifier.","operationId":"GroupPlanTemplateCopyPlan_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":[],"parameters":[{"name":"groupPlanTemplateCopyPlanModel","in":"body","description":"The model containing information about the new plan to be created","required":true,"schema":{"$ref":"#/definitions/GroupPlanTemplateCopyPlanModel"}},{"name":"id","in":"path","description":"The identifier of the group plan template to be copied","required":true,"type":"integer","format":"int64"}],"responses":{"204":{"description":"No Content"}}}},"/api/groupplantemplates":{"get":{"tags":["GroupPlanTemplates"],"summary":"Gets a collection of global Plan Templates","operationId":"GroupPlanTemplate_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/GroupPlanTemplateModel"}}}}},"post":{"tags":["GroupPlanTemplates"],"summary":"Posts a new global group plan template","operationId":"GroupPlanTemplates_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"GroupPlanTemplateModel","in":"body","description":"The group plan template to be added","required":true,"schema":{"$ref":"#/definitions/GroupPlanTemplateModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/GroupPlanTemplateModel"}}}}},"/api/groupplantemplates/{id}":{"get":{"tags":["GroupPlanTemplates"],"summary":"Gets a Plan Template for the specified plan template identifier","operationId":"GroupPlanTemplate_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Plan Template identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/GroupPlanTemplateModel"}}}},"patch":{"tags":["GroupPlanTemplates"],"summary":"Patches an existing plan template","operationId":"GroupPlanTemplates_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Plan Template Identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target group plan template","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/GroupPlanTemplateModel"}}}}},"/api/groups":{"get":{"tags":["Groups"],"summary":"Gets a collection of Groups based on the company associated with the authenticated user","operationId":"Group_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"showGroupPlans","in":"query","description":"Flag whether to show the associated group plans","required":false,"type":"boolean"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/GroupModel"}}}}}},"/api/groups/{id}":{"get":{"tags":["Groups"],"summary":"Gets a a Group based on provided identifier of and the company associated with the authenticated user","operationId":"Group_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"showGroupPlans","in":"query","description":"Flag whether to show the associated group plan(s)","required":false,"type":"boolean"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/GroupModel"}}}}},"/api/groupsetup":{"post":{"tags":["GroupSetup"],"summary":"Adds a new group, facility, and plan with the minimum requirements","operationId":"GroupSetup_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupSetupModel","in":"body","description":"The json formatted group setup model object supplied in the request body that is to be added","required":true,"schema":{"$ref":"#/definitions/GroupSetupModel"}},{"name":"createPlan","in":"query","description":"Bool value indicating if a Plan should be created","required":false,"type":"boolean"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/GroupSetupModel"}}}}},"/api/pharmacyheadquarters/{headquarterid}/headquarterglobalplanlists":{"get":{"tags":["HeadquarterGlobalPlanLists"],"summary":"Gets a collection of global plan name value pairs tied to a headquarter based on the company associated with the authenticated user","operationId":"HeadquarterGlobalPlanLists_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"headquarterid","in":"path","description":"Pharmacy Headquarter identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/NameValuePairModel"}}}}}},"/api/pharmacyheadquarters/{headquarterid}/headquarterglobalplanlists/{id}":{"get":{"tags":["HeadquarterGlobalPlanLists"],"summary":"Gets a global plan name value pair tied to a pharmacy headquarter","operationId":"HeadquarterGlobalPlanLists_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"headquarterid","in":"path","description":"Pharmacy Headquarter identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Plan identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/NameValuePairModel"}}}}},"/api/headquarterpharmacylocationdeltas":{"get":{"tags":["HeadquarterPharmacyLocationDeltas"],"summary":"Retrieves a paginated list of historical change records from the pharmacy headquarter location delta table.\r\nThis endpoint allows filtering the records based on their last modification date or a specific initial sequence number.\r\nThe initialHeadquarterPharmacyLocationsDeltaID, if provided, takes precedence over the lastModifiedAfter parameter.\r\nThis method was created to allow synchronizing or tracking changes to pharmacy headquarter locations.\r\n\r\nOnce a change record is retrieved, the application can use the sequence number to retrieve the details of the changed record\r\non the HeadquarterPharmacyLocations endpoint, using the PharmacyLocationSeqNo as the ID parameter","operationId":"HeadquarterPharmacyLocationDeltas_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"lastModifiedAfter","in":"query","description":"Optional. Filters the results to include only records modified after this date.\r\n            This parameter is ignored if initialHeadquarterPharmacyLocationsDeltaID is provided.","required":false,"type":"string","format":"date-time"},{"name":"initialHeadquarterPharmacyLocationsDeltaID","in":"query","description":"Optional. Prioritized parameter. The initial sequence number from which to start listing historical changes.\r\n            When provided, lastModifiedAfter is ignored.","required":false,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The page number for pagination, starting from 1. Defaults to 1 if not specified.","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of records per page for pagination. Defaults to 100 and is capped at 1000 for performance reasons.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[HeadquarterPharmacyLocationDeltaModel]"}}}}},"/api/headquarterpharmacylocationdeltas/{id}":{"get":{"tags":["HeadquarterPharmacyLocationDeltas"],"summary":"Retrieves the details of a specific pharmacy headquarter location delta by its sequence number.\r\nThis endpoint is particularly used for obtaining information about changes or updates\r\nat a specific pharmacy headquarter location identified by the sequence number.","operationId":"HeadquarterPharmacyLocationDeltas_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"The sequence number of the pharmacy headquarter location delta to retrieve.\r\n            This is a unique identifier that corresponds to a specific change or update record.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/HeadquarterPharmacyLocationDeltaModel"}}}}},"/api/HeadquarterPharmacyLocations":{"get":{"tags":["HeadquarterPharmacyLocations"],"summary":"Gets a collection of pharmacy locations associated with a pharmacy headquarter, paged.","operationId":"HeadquarterPharmacyLocation_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"pharmacyheadquarterid","in":"query","description":"Pharmacy Headquarter's identifier","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"1-based page index indicating which page of the results should be returned (optional, default is 1)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of results to return per page (optional, default is 100, max is 250)","required":false,"type":"integer","format":"int32"},{"name":"lastModifiedAfter","in":"query","description":"This parameter is obsolete and is no longer functional.  It will be removed completely in a future release","required":false,"type":"string","format":"date-time"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[HeadquarterPharmacyLocationModel]"}}}}},"/api/HeadquarterPharmacyLocations/{id}":{"get":{"tags":["HeadquarterPharmacyLocations"],"summary":"Retrieves details of a single pharmacy location associated with a pharmacy headquarter using its unique identifier.\r\nThis endpoint can be used in combination with the HeadquarterPharmacyLocationDeltas endpoint to keep a local copy of \r\nthe pharmacy location data in sync with the server.","operationId":"HeadquarterPharmacyLocation_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"The unique identifier of the pharmacy location.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/HeadquarterPharmacyLocationModel"}}}}},"/api/pharmacyheadquarters/{headquarterid}/headquarterplanlists":{"get":{"tags":["HeadquarterPlanLists"],"summary":"Gets a collection of headquarter plan name value pairs based on the company associated with the authenticated user","operationId":"HeadquarterPlanLists_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"headquarterid","in":"path","description":"Pharmacy Headquarter identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/NameValuePairModel"}}}}}},"/api/pharmacyheadquarters/{headquarterid}/headquarterplanlists/{id}":{"get":{"tags":["HeadquarterPlanLists"],"summary":"Gets a headquarter plan name value pair","operationId":"HeadquarterPlanLists_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"headquarterid","in":"path","description":"Pharmacy Headquarter identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Plan identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/NameValuePairModel"}}}}},"/api/groups/{groupid}/membermanualclaim":{"post":{"tags":["ManualClaimEntry"],"summary":"Processes a manual claim for a member. This involves validating various claim details and, if valid, processing the claim.","description":"<para>- The RxCPersonID property of the posted JSON object should be the ID of the member returned from the GroupMembers or Members endpoint.</para>\r\n<para>- Member information must not be null.</para>\r\n<para>- Drug NDC (National Drug Code) must be specified.</para>\r\n<para>- Prescription number must be provided.</para>\r\n<para>- Quantity dispensed, if provided, must be a non-negative value.</para>\r\n<para>- Days supply, if provided, must be a non-negative value.</para>\r\n<para>- Date of service must be specified.</para>\r\n<para>- Flat sales tax and sales tax percent, if provided, must be non-negative values.</para>\r\n<para>- Prescriber ID must be valid if provided.</para>\r\n<para>- Emergency prescriptions are limited to a 3 days supply.</para>\r\n<para>- Other payer patient responsibility amount, if provided, must be non-null.</para>\r\n<para>- Pharmacy NPI is optional, but if it's provided, ingredient cost, dispense fee, incentive fee, usual and customary amount, and gross amount due must be specified and non-negative.</para>\r\n<para>- Price Override Conditions (all conditions must be met for a price override):</para>\r\n<para>  -   Ingredient Cost Paid must be non-null and non-negative.</para>\r\n<para>  -   Dispense Fee Paid must be non-null and non-negative.</para>\r\n<para>  -   Incentive Fee must be non-null and non-negative.</para>\r\n<para>  -   Sales Tax Paid must be non-null and non-negative.</para>\r\n<para>  -   Flat Sales Tax must be  &gt; Sales Tax Amount</para>\r\n<para>- Copay Overrides Conditions (all conditions must be met for copay override):</para>\r\n<para>  -   Copay must be non-null and non-negative.</para>\r\n<para>  -   Coinsurance Rate must be non-null, non-negative, and not greater than 100%.</para>\r\n<para>  -   Out Of Pocket Copay (OOPCopay), if provided, must be non-negative.</para>\r\n<para>  -   Out Of Pocket Coinsurance Rate (OOPCoinsuranceRate), if provided, must be within 0-100%.</para>\r\n<para>  -   If Out Of Pocket Copay (OOPCopay) is provided, Out Of Pocket Coinsurance Rate (OOPCoinsuranceRate) is also required, and vice versa.</para>\r\n<para>- Pharmacy Network Validation:</para>\r\n<para>  - If pharmacy information is provided, the pharmacy must be on a contract.</para>\r\n<para>  - The network must be active on the date of service.</para>\r\n<para>  - If the pharmacy is excluded from the plan, the claim is invalid.</para>","operationId":"MemberManualClaims_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"memberManualClaimEntryModel","in":"body","description":"The model containing the claim details.","required":true,"schema":{"$ref":"#/definitions/MemberManualClaimEntryModel"}},{"name":"groupid","in":"path","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/ManualClaimEntryResultModel"}}}}},"/api/groups/{groupid}/pharmacymanualclaim":{"post":{"tags":["ManualClaimEntry"],"summary":"Adds a Pharmacy Manual Claim","description":"<para>- The RxCPersonID property of the posted JSON object should be the ID of the member returned from the GroupMembers or Members endpoint.</para>\r\n<para>- Member information must not be null.</para>\r\n<para>- Drug NDC (National Drug Code) must be specified.</para>\r\n<para>- Prescription number must be provided.</para>\r\n<para>- Quantity dispensed, if provided, must be a non-negative value.</para>\r\n<para>- Days supply, if provided, must be a non-negative value.</para>\r\n<para>- Date of service must be specified.</para>\r\n<para>- Flat sales tax and sales tax percent, if provided, must be non-negative values.</para>\r\n<para>- Prescriber ID must be valid if provided.</para>\r\n<para>- Emergency prescriptions are limited to a 3 days supply.</para>\r\n<para>- Other payer patient responsibility amount, if provided, must be non-null.</para>\r\n<para>- Pharmacy NPI is required</para>\r\n<para>- Ingredient cost, dispense fee, incentive fee, usual and customary amount, and gross amount due must be specified and non-negative.</para>\r\n<para>- Price Override Conditions (all conditions must be met for a price override):  </para>\r\n<para>  -   Ingredient Cost Paid must be non-null and non-negative.  </para>\r\n<para>  -   Dispense Fee Paid must be non-null and non-negative.  </para>\r\n<para>  -   Incentive Fee must be non-null and non-negative.  </para>\r\n<para>  -   Sales Tax Paid must be non-null and non-negative.  </para>\r\n<para>  -   Flat Sales Tax must be  &gt; Sales Tax Amount</para>\r\n<para>- Copay Overrides Conditions (all conditions must be met for copay override):</para>\r\n<para>  -   Copay must be non-null and non-negative.</para>\r\n<para>  -   Coinsurance Rate must be non-null, non-negative, and not greater than 100%.</para>\r\n<para>  -   Out Of Pocket Copay (OOPCopay), if provided, must be non-negative.</para>\r\n<para>  -   Out Of Pocket Coinsurance Rate (OOPCoinsuranceRate), if provided, must be within 0-100%.</para>\r\n<para>  -   If Out Of Pocket Copay (OOPCopay) is provided, Out Of Pocket Coinsurance Rate (OOPCoinsuranceRate) is also required, and vice versa.</para>\r\n<para>- Pharmacy Network Validation:</para>\r\n<para>  - The pharmacy must be on a contract.</para>\r\n<para>  - The network must be active on the date of service.</para>\r\n<para>  - If the pharmacy is excluded from the plan, the claim is invalid.</para>","operationId":"PharmacyManualClaims_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"pharmacyManualClaimEntryModel","in":"body","description":"The json formatted pharmacy manual claim entry model object supplied in the request body that is to be added","required":true,"schema":{"$ref":"#/definitions/PharmacyManualClaimEntryModel"}},{"name":"groupid","in":"path","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/ManualClaimEntryResultModel"}}}}},"/api/groups/{groupid}/testmanualclaim":{"post":{"tags":["ManualClaimEntry"],"summary":"Adds a Test Manual Claim","description":"<para>- The RxCPersonID property of the posted JSON object should be the ID of the member returned from the GroupMembers or Members endpoint.</para>\r\n<para>- Member information must not be null.</para>\r\n<para>- Drug NDC (National Drug Code) must be specified.</para>\r\n<para>- Prescription number must be provided.</para>\r\n<para>- Quantity dispensed, if provided, must be a non-negative value.</para>\r\n<para>- Days supply, if provided, must be a non-negative value.</para>\r\n<para>- Date of service must be specified.</para>\r\n<para>- Flat sales tax and sales tax percent, if provided, must be non-negative values.</para>\r\n<para>- Prescriber ID must be valid if provided.</para>\r\n<para>- Emergency prescriptions are limited to a 3 days supply.</para>\r\n<para>- Other payer patient responsibility amount, if provided, must be non-null.</para>\r\n<para>- Pharmacy information is required if it's a pharmacy claim or if pharmacy information is provided.</para>\r\n<para>- For pharmacy claims, ingredient cost, dispense fee, incentive fee, usual and customary amount, and gross amount due must be specified and non-negative.</para>\r\n<para>- Price Override Conditions (all conditions must be met for a price override):  </para>\r\n<para>  -   Ingredient Cost Paid must be non-null and non-negative.  </para>\r\n<para>  -   Dispense Fee Paid must be non-null and non-negative.  </para>\r\n<para>  -   Incentive Fee must be non-null and non-negative.  </para>\r\n<para>  -   Sales Tax Paid must be non-null and non-negative.  </para>\r\n<para>  -   Flat Sales Tax must be  &gt; Sales Tax Amount</para>\r\n<para>- Copay Overrides Conditions (all conditions must be met for copay override):</para>\r\n<para>  -   Copay must be non-null and non-negative.</para>\r\n<para>  -   Coinsurance Rate must be non-null, non-negative, and not greater than 100%.</para>\r\n<para>  -   Out Of Pocket Copay (OOPCopay), if provided, must be non-negative.</para>\r\n<para>  -   Out Of Pocket Coinsurance Rate (OOPCoinsuranceRate), if provided, must be within 0-100%.</para>\r\n<para>  -   If Out Of Pocket Copay (OOPCopay) is provided, Out Of Pocket Coinsurance Rate (OOPCoinsuranceRate) is also required, and vice versa.</para>\r\n<para>- Pharmacy Network Validation:</para>\r\n<para>  - If pharmacy information is provided or it's a pharmacy claim, the pharmacy must be on a contract.</para>\r\n<para>  - The network must be active on the date of service.</para>\r\n<para>  - If the pharmacy is excluded from the plan, the claim is invalid.</para>","operationId":"TestManualClaims_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"testManualClaimEntryModel","in":"body","description":"The json formatted test manual claim entry model object supplied in the request body that is to be added","required":true,"schema":{"$ref":"#/definitions/TestManualClaimEntryModel"}},{"name":"groupid","in":"path","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/ManualClaimEntryResultModel"}}}}},"/api/maxoutofpockets/{maxoutofpocketid}/maxoutofpocketrates":{"get":{"tags":["MaxOutOfPocketRates"],"summary":"Gets a collection of Max Out Of Pocket rates for a Global Max Out Of Pocket resource","operationId":"MaxOutOfPocketRate_GetGlobal","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"maxoutofpocketid","in":"path","description":"Global Max Out Of Pocket identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/MaxOutOfPocketRateModel"}}}}},"post":{"tags":["MaxOutOfPocketRates"],"summary":"Posts a new max out of pocket rate object to the specified global max out of pocket record","operationId":"GlobalMaxOutOfPocketRate_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"maxOutOfPocketRateModel","in":"body","description":"The max out of pocket rate to add","required":true,"schema":{"$ref":"#/definitions/MaxOutOfPocketRateModel"}},{"name":"maxoutofpocketid","in":"path","description":"Identifier for the global Max Out Of Pocket record to which this Max Out Of Pocket Rate will be added","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MaxOutOfPocketRateModel"}}}}},"/api/maxoutofpockets/{maxoutofpocketid}/maxoutofpocketrates/{id}":{"get":{"tags":["MaxOutOfPocketRates"],"summary":"Gets a max out of pocket rate for a global max out of pocket resource","operationId":"MaxOutOfPocketRate_GlobalGetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"maxoutofpocketid","in":"path","description":"Global Max Out Of Pocket identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Max Out Of Pocket Rate identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MaxOutOfPocketRateModel"}}}},"patch":{"tags":["MaxOutOfPocketRates"],"summary":"Patches an existing max out of pocket rate object for a global max out of pocket resource","operationId":"GlobalMaxOutOfPocketRates_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"maxoutofpocketid","in":"path","description":"Identifier for the global Max Out Of Pocket record to which this Max Out Of Pocket Rate belongs","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Max Out Of Pocket Rate Identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target rule","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MaxOutOfPocketRateModel"}}}}},"/api/groups/{groupid}/groupplans/{groupplanid}/maxoutofpockets/{maxoutofpocketid}/maxoutofpocketrates":{"get":{"tags":["MaxOutOfPocketRates"],"summary":"Gets a collection of Max Out Of Pocket resources for a Group Plan","operationId":"MaxOutOfPocketRate_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan identifier","required":true,"type":"integer","format":"int64"},{"name":"maxoutofpocketid","in":"path","description":"Max Out Of Pocket identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/MaxOutOfPocketRateModel"}}}}},"post":{"tags":["MaxOutOfPocketRates"],"summary":"Posts a new max out of pocket rate object to the specified max out of pocket record","operationId":"MaxOutOfPocketRates_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"maxOutOfPocketRateModel","in":"body","description":"The max out of pocket rate to add","required":true,"schema":{"$ref":"#/definitions/MaxOutOfPocketRateModel"}},{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"maxoutofpocketid","in":"path","description":"Identifier for the Max Out Of Pocket record to which this Max Out Of Pocket Rate will be added","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MaxOutOfPocketRateModel"}}}}},"/api/groups/{groupid}/groupplans/{groupplanid}/maxoutofpockets/{maxoutofpocketid}/maxoutofpocketrates/{id}":{"get":{"tags":["MaxOutOfPocketRates"],"summary":"Gets a max out of pocket resource","operationId":"MaxOutOfPocketRate_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan identifier","required":true,"type":"integer","format":"int64"},{"name":"maxoutofpocketid","in":"path","description":"Max Out Of Pocket identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Max Out Of Pocket Rate identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MaxOutOfPocketRateModel"}}}},"patch":{"tags":["MaxOutOfPocketRates"],"summary":"Patches an existing max out of pocket rate object","operationId":"MaxOutOfPocketRates_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"maxoutofpocketid","in":"path","description":"Identifier for the Max Out Of Pocket record to which this Max Out Of Pocket Rate belongs","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Max Out Of Pocket Rate Identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target rule","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MaxOutOfPocketRateModel"}}}}},"/api/maxoutofpockets":{"get":{"tags":["MaxOutOfPockets"],"summary":"Retrieves a paginated list of global Max out of pocket resources.","operationId":"MaxOutOfPocket_GetGlobal","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"page","in":"query","description":"The page number of the results to fetch.","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of records per page.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResult[MaxOutOfPocketModel]"}}}},"post":{"tags":["MaxOutOfPockets"],"summary":"Posts a new global max out of pocket resource","operationId":"GlobalMaxOutOfPocket_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"maxOutOfPocketModel","in":"body","description":"The global max out of pocket model to add.","required":true,"schema":{"$ref":"#/definitions/MaxOutOfPocketModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MaxOutOfPocketModel"}}}}},"/api/maxoutofpockets/{id}":{"get":{"tags":["MaxOutOfPockets"],"summary":"Retrieves a single global max out of pocket resource by ID.","operationId":"MaxOutOfPocket_GlobalGetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"The ID of the Max out of pocket to retrieve.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MaxOutOfPocketModel"}}}},"patch":{"tags":["MaxOutOfPockets"],"summary":"Patches an existing global max out of pocket resource","operationId":"GlobalMaxOutOfPocket_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Global Max out of pocket identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target rule","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MaxOutOfPocketModel"}}}}},"/api/groups/{groupid}/groupplans/{groupplanid}/maxoutofpockets":{"get":{"tags":["MaxOutOfPockets"],"summary":"Gets a collection of max out of pocket resources for a Group Plan","operationId":"MaxOutOfPocket_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/MaxOutOfPocketModel"}}}}},"post":{"tags":["MaxOutOfPockets"],"summary":"Posts a new max out of pocket to an existing group","operationId":"MaxOutOfPockets_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"maxOutOfPocketModel","in":"body","description":"A new max out of pocket to add to the specified existing group","required":true,"schema":{"$ref":"#/definitions/MaxOutOfPocketModel"}},{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MaxOutOfPocketModel"}}}}},"/api/groups/{groupid}/groupplans/{groupplanid}/maxoutofpockets/{id}":{"get":{"tags":["MaxOutOfPockets"],"summary":"Gets a single max out of pocket resource for a group plan","operationId":"MaxOutOfPocket_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"MaxOutOfPocket identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MaxOutOfPocketModel"}}}},"patch":{"tags":["MaxOutOfPockets"],"summary":"Patches an existing max out of pocket for a group plan","operationId":"MaxOutOfPockets_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"MaxOutOfPocket identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target rule","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MaxOutOfPocketModel"}}}}},"/api/memberclaims/{memberid}":{"get":{"tags":["MemberClaims"],"summary":"Retrieves a list of member claims for a specified member within an optional date range.","description":"**Overview:**  \r\nThis endpoint returns all claims for a member identified by the RxClearinghouse/Adjudicator patient identifier, filtered by the date of service.\r\n\r\n**Usage:**  \r\n- Provide the member's unique identifier (`memberid`).  \r\n- Optionally, specify a start date (`from`) and an end date (`to`) to filter claims by their service date.  \r\n  If these are not provided, they default to today's date.\r\n\r\n**Behavior:**  \r\n- If matching claims are found, they are returned with an HTTP 200 status code.\r\n- If no claims are found, an HTTP 404 Not Found is returned.\r\n- In case of an unexpected error, an HTTP 500 Internal Server Error is returned.","operationId":"MemberClaims_GetByMember","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"memberid","in":"path","description":"The RxClearinghouse/Adjudicator assigned identifier for the member.","required":true,"type":"integer","format":"int32"},{"name":"from","in":"query","description":"Optional start date for filtering claims. Defaults to today's date if omitted.","required":false,"type":"string","format":"date-time"},{"name":"to","in":"query","description":"Optional end date for filtering claims. Defaults to today's date if omitted.","required":false,"type":"string","format":"date-time"}],"responses":{"200":{"description":"Successfully retrieved the member claims.","schema":{"type":"array","items":{"$ref":"#/definitions/MemberClaimModel"}}},"404":{"description":"No member claims were found"},"500":{"description":"An unexpected error occurred on the server."}}}},"/api/memberclaims/{memberid}/{id}":{"get":{"tags":["MemberClaims"],"summary":"Retrieves a member claim.","description":"This endpoint returns detailed information about a specific claim for a member.  \r\n\r\n**Usage:**  \r\n- Provide the member's unique identifier (`memberid`) and the claim's identifier (`id`).  \r\n- If a matching claim is found, its details are returned with an HTTP 200 status code.  \r\n- If no matching claim exists, the endpoint returns an HTTP 404 Not Found.  \r\n- In case of an unexpected error, an HTTP 500 Internal Server Error is returned.","operationId":"MemberClaims_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"memberid","in":"path","description":"The unique identifier of the member.  This can be retrieved from the members or groupmembers endpoint in the ID property.  This value is sometimes known as the RxCPersonID.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The identifier of the claim.","required":true,"type":"integer","format":"int32"}],"responses":{"200":{"description":"The member claim was successfully retrieved.","schema":{"$ref":"#/definitions/MemberClaimModel"}},"404":{"description":"No claim was found for the specified member or claim identifier."},"500":{"description":"An unexpected error occurred on the server."}}}},"/api/MemberDirectory":{"get":{"tags":["MemberDirectory"],"summary":"Retrieves a paginated list of members.","description":"**Search Criteria:**  \r\n- **Required:** At least one of `lastName`, `cardholderID`, `firstName`, `arCode`, or `contractCode` must be provided.  \r\n- **Note:** If `personCode` is provided, then `cardholderID` must also be provided.  \r\n  \r\n**Pagination:**  \r\n- Use the `page` and `pagesize` parameters to control pagination.  \r\n- Default `pagesize` is 50 and the maximum allowed is 100.  \r\n  \r\n**Response Codes:**  \r\n- **200 OK:** Successfully retrieved the list of members.  \r\n- **400 Bad Request:** Invalid request parameters (e.g., missing required search criteria, `pagesize` exceeds maximum, or `personCode` provided without `cardholderID`).  \r\n- **404 Not Found:** No members found matching the search criteria, or the authenticated user's company is invalid.  \r\n- **500 Internal Server Error:** An unexpected error occurred on the server.","operationId":"MemberDirectory_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"lastName","in":"query","description":"The last name of the member to search for. Required if no other primary search parameter is provided.","required":false,"type":"string"},{"name":"firstName","in":"query","description":"The first name of the member to search for. *Optional*.","required":false,"type":"string"},{"name":"cardholderID","in":"query","description":"The cardholder ID of the member to search for. Required if `lastName` is not provided or when `personCode` is used.","required":false,"type":"string"},{"name":"personCode","in":"query","description":"The person code associated with the member. *Optional.* Must not be used as the only search parameter.","required":false,"type":"string"},{"name":"arCode","in":"query","description":"The AR code associated with the member. *Optional*.","required":false,"type":"string"},{"name":"contractCode","in":"query","description":"The contract code associated with the member. *Optional*.","required":false,"type":"string"},{"name":"page","in":"query","description":"The page number of the results to return. *Optional*; default is 1. Must be a positive integer.","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of results to return per page. *Optional*; default is 50. Must be between 1 and 100.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"Successfully retrieved the list of members.","schema":{"$ref":"#/definitions/PagedResultModel[MemberModel]"}},"400":{"description":"Invalid request parameters."},"404":{"description":"No members found matching the search criteria."},"500":{"description":"An unexpected error occurred on the server."}}}},"/api/memberotherclaims/{memberid}":{"get":{"tags":["MemberOtherClaims"],"summary":"Gets a list of member other claims by member and date range","operationId":"MemberOtherClaims_GetByMember","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"memberid","in":"path","description":"This is the RxClearinghouse assigned patient identifier","required":true,"type":"integer","format":"int32"},{"name":"from","in":"query","description":"Optional parameter to be used to set the begin date range.  If not supplied, the default will be today's date.","required":false,"type":"string","format":"date-time"},{"name":"to","in":"query","description":"Optional parameter to be used to set the end date range.  If not supplied, the default will be today's date.","required":false,"type":"string","format":"date-time"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/MemberOtherClaimModel"}}}}}},"/api/memberotherclaims/{memberid}/{id}":{"get":{"tags":["MemberOtherClaims"],"summary":"Gets a member other claim by ID","operationId":"MemberOtherClaims_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"memberid","in":"path","description":"This is the RxClearinghouse assigned patient identifier","required":true,"type":"integer","format":"int32"},{"name":"id","in":"path","description":"This is the ID of the other claim","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MemberOtherClaimModel"}}}},"delete":{"tags":["MemberOtherClaims"],"summary":"Deletes a member other claim by ID","operationId":"MemberOtherClaims_Delete","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"memberid","in":"path","description":"This is the RxClearinghouse assigned patient identifier","required":true,"type":"integer","format":"int32"},{"name":"id","in":"path","description":"This is the ID of the other claim","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}}},"/api/memberotherclaims":{"post":{"tags":["MemberOtherClaims"],"summary":"Adds a a member other claim to the patient based on the information sent in the posted model","operationId":"MemberOtherClaims_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"memberOtherClaimModel","in":"body","description":"The json formatted member other claim model object supplied in the request body that is to be added","required":true,"schema":{"$ref":"#/definitions/MemberOtherClaimModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MemberOtherClaimModel"}}}}},"/api/groups/{groupid}/members/{memberid}/memberotherstatuses":{"get":{"tags":["MemberOtherStatuses"],"summary":"Gets a collection of MemberOtherStatuses.","operationId":"MemberOtherStatuses_GetAll","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group to which the member and other status belong","required":true,"type":"integer","format":"int64"},{"name":"memberid","in":"path","description":"The ID of the member to retrieve statuses for.","required":true,"type":"integer","format":"int64"},{"name":"otherStatusNumber","in":"query","description":"The number of the other status to filter by (optional).","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/MemberOtherStatusModel"}}}}},"post":{"tags":["MemberOtherStatuses"],"summary":"Posts a new MemberOtherStatus.","description":"**Validation Requirements:**\r\n- `OtherStatusNo` is required\r\n- `MemberNo` is required\r\n- EffectiveDate and EffectiveEndDate must form a valid date range.\r\n- There cannot be two status records with the same start date for the same member.\r\n- OtherStatusNumber must be 1 through 8","operationId":"MemberOtherStatuses_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","required":true,"type":"integer","format":"int64"},{"name":"memberid","in":"path","required":true,"type":"integer","format":"int64"},{"name":"memberOtherStatusModel","in":"body","description":"MemberOtherStatusModel to add.","required":true,"schema":{"$ref":"#/definitions/MemberOtherStatusModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MemberOtherStatusModel"}}}}},"/api/groups/{groupid}/members/{memberid}/memberotherstatuses/{id}":{"get":{"tags":["MemberOtherStatuses"],"summary":"Gets a MemberOtherStatus by ID.","operationId":"MemberOtherStatuses_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group to which the member and other status belong","required":true,"type":"integer","format":"int64"},{"name":"memberid","in":"path","description":"The ID of the member to retrieve statuses for.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the MemberOtherStatus to retrieve.","required":true,"type":"integer","format":"int64"},{"name":"otherStatusNumber","in":"query","description":"The number of the other status to filter by.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MemberOtherStatusModel"}}}},"delete":{"tags":["MemberOtherStatuses"],"summary":"Deletes a MemberOtherStatus.","operationId":"MemberOtherStatuses_Delete","consumes":[],"produces":[],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group to which the member and other status belong.","required":true,"type":"integer","format":"int64"},{"name":"memberid","in":"path","description":"The ID of the member to delete the status for.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the MemberOtherStatus to delete.","required":true,"type":"integer","format":"int64"},{"name":"otherStatusNumber","in":"query","description":"The number of the other status to delete. Values of 1 through 8 are valid.","required":true,"type":"integer","format":"int32"}],"responses":{"204":{"description":"No Content"}}},"patch":{"tags":["MemberOtherStatuses"],"summary":"Patches an existing MemberOtherStatus.","description":"**Validation Requirements:**\r\n- `OtherStatusNo` is required\r\n- `MemberNo` is required\r\n- EffectiveDate and EffectiveEndDate must form a valid date range.\r\n- There cannot be two status records with the same start date for the same member.","operationId":"MemberOtherStatuses_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The ID of the group to which the member and other status belong","required":true,"type":"integer","format":"int64"},{"name":"memberid","in":"path","description":"The ID of the member to update the status for.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The ID of the MemberOtherStatus to update.","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The JSON Patch document containing the changes.","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}},{"name":"otherStatusNumber","in":"query","description":"The number of the other status to update.  Values of 1 through 8 are valid.","required":true,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MemberOtherStatusModel"}}}}},"/api/memberpricecheckclaims/{id}":{"get":{"tags":["MemberPriceCheckClaims"],"summary":"Gets a list of Member Test (price check) claims by member and date range","operationId":"MemberPriceCheckClaims_GetByMember","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"This is the RxClearinghouse assigned patient identifier","required":true,"type":"integer","format":"int32"},{"name":"from","in":"query","description":"Optional parameter to be used to set the begin date range.  If not supplied, the default will be today's date.","required":false,"type":"string","format":"date-time"},{"name":"to","in":"query","description":"Optional parameter to be used to set the end date range.  If not supplied, the default will be today's date.","required":false,"type":"string","format":"date-time"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/MemberClaimModel"}}}}}},"/api/members":{"get":{"tags":["Members"],"summary":"Retrieves a paginated list of members associated with the authenticated user's company,\r\nbased on the provided search parameters.\r\n\r\n**Search Criteria:**\r\n- **Required:** Either lastName or cardholderID must be provided.\r\n- **Optional:** Additional parameters like firstName, personCode, and arCode can refine the search.\r\n\r\n**Pagination:**\r\n- Use the page and pagesize parameters to control the pagination of the results.\r\n- The pagesize has a default value of 50 and a maximum allowed value of 100.\r\n\r\n**Response Codes:**\r\n- **200 OK:** Successfully retrieved the list of members.\r\n- **400 Bad Request:** Invalid request parameters (e.g., neither lastName nor cardholderID provided, or pagesize exceeds the maximum allowed).\r\n- **404 Not Found:** No members found matching the search criteria, or the authenticated user's company is invalid.\r\n- **500 Internal Server Error:** An unexpected error occurred on the server.","operationId":"Member_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"lastName","in":"query","description":"The last name of the member to search for. **Required** if cardholderID is not provided.","required":false,"type":"string"},{"name":"firstName","in":"query","description":"The first name of the member to search for. Optional.","required":false,"type":"string"},{"name":"cardholderID","in":"query","description":"The cardholder ID of the member to search for. **Required** if lastName is not provided.","required":false,"type":"string"},{"name":"personCode","in":"query","description":"The person code associated with the member.  This should be padded to three digits (e.g. 001). Optional.","required":false,"type":"string"},{"name":"arCode","in":"query","description":"The AR code associated with the member. This value can be looked up on the FacilityArTypes endpoint - the ARShortCode is the value that should be used here. Optional.","required":false,"type":"string"},{"name":"page","in":"query","description":"The page number of the results to return. Optional; default is 1. Must be a positive integer.","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of results to return per page. Optional; default is 50. Must be between 1 and 100.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"Successfully retrieved the list of members.","schema":{"$ref":"#/definitions/PagedResultModel[MemberModel]"}},"400":{"description":"Invalid request parameters."},"404":{"description":"No members found matching the search criteria."},"500":{"description":"An unexpected error occurred on the server."}}}},"/api/members/{id}":{"get":{"tags":["Members"],"operationId":"Member_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MemberModel"}}}},"patch":{"tags":["Members"],"summary":"Patches an existing member","operationId":"Member_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Member Identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target rule","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/MemberModel"}}}}},"/api/multisourcecodes":{"get":{"tags":["MultiSourceCodes"],"operationId":"MultiSourceCodes_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}}}}}},"/api/networkaccessfeereversals":{"get":{"tags":["NetworkAccessFeeReversals"],"summary":"Gets a collection of network access fee reversal values based on the company associated with the authenticated user","operationId":"NetworkAccessFee_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/NetworkAccessFeeReversalModel"}}}}}},"/api/networkaccessfeereversals/{id}":{"get":{"tags":["NetworkAccessFeeReversals"],"summary":"Gets a network access fee reversal value","operationId":"NetworkAccessFee_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Network Access Fee Reversal value identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/NetworkAccessFeeReversalModel"}}}}},"/api/networkpharmacyheadquarterdeltas":{"get":{"tags":["NetworkPharmacyHeadquarterDeltas"],"summary":"Retrieves a paginated list of Network Pharmacy Headquarter Delta records. \r\nThis endpoint allows filtering by last modification date or a specific initial sequence number (the initialNetworkPharmacyHeadquarterDeltaID).  \r\nEither lastModifiedAfter or initialNetworkPharmacyHeadquarterDeltaID must be provided.","operationId":"NetworkPharmacyHeadquarterDeltas_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"lastModifiedAfter","in":"query","description":"The date to filter records that were modified after this date. \r\n            If null, the filter is not applied. If 'initialNetworkPharmacyHeadquarterDeltaID' is provided, \r\n            this parameter is ignored.","required":false,"type":"string","format":"date-time"},{"name":"initialNetworkPharmacyHeadquarterDeltaID","in":"query","description":"The initial sequence number to start filtering from. \r\n            If provided, 'lastModifiedAfter' is ignored.","required":false,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The page number of the result set to return. Defaults to 1.","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of records per page. Defaults to 100, with a maximum allowed value of 1000.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[NetworkPharmacyHeadquarterDeltaModel]"}}}}},"/api/networkpharmacyheadquarterdeltas/{id}":{"get":{"tags":["NetworkPharmacyHeadquarterDeltas"],"summary":"This is used to get the details of a specific change (delta) to a network pharmacy headquarter.","operationId":"NetworkPharmacyHeadquarterDeltas_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"The id of the network pharmacy headquarter delta which should be returned","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/NetworkPharmacyHeadquarterDeltaModel"}}}}},"/api/networks/{networkid}/networkpharmacyheadquarters":{"get":{"tags":["NetworkPharmacyHeadquarters"],"summary":"Gets a collection of network pharmacy headquarter resources for a network","operationId":"NetworkPharmacyHeadquarters_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"networkid","in":"path","description":"Network identifier","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"1-based index identifying the page # of results to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of records to return per page (optional, 25 by default, max 100)","required":false,"type":"integer","format":"int32"},{"name":"lastModifiedAfter","in":"query","description":"This parameter is obsolete and is no longer functional.  It will be removed completely in a future release","required":false,"type":"string","format":"date-time"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[NetworkPharmacyHeadquarterConsolidatedModel]"}}}},"post":{"tags":["NetworkPharmacyHeadquarters"],"summary":"Posts a new network pharmacy headquarter object to the specified network record","operationId":"NetworkPharmacyHeadquarters_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"networkPharmacyHeadquarterConsolidatedModel","in":"body","description":"The network pharmacy headquarter to add","required":true,"schema":{"$ref":"#/definitions/NetworkPharmacyHeadquarterConsolidatedModel"}},{"name":"networkid","in":"path","description":"Network identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/NetworkPharmacyHeadquarterConsolidatedModel"}},"201":{"description":"Created","schema":{"$ref":"#/definitions/NetworkPharmacyHeadquarterConsolidatedModel"}}}}},"/api/networks/{networkid}/networkpharmacyheadquarters/{id}":{"get":{"tags":["NetworkPharmacyHeadquarters"],"summary":"Gets a network pharmacy headquarter resource","operationId":"NetworkPharmacyHeadquarters_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"networkid","in":"path","description":"Network identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Network Pharmacy Headquarter identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/NetworkPharmacyHeadquarterConsolidatedModel"}}}},"delete":{"tags":["NetworkPharmacyHeadquarters"],"summary":"Deletes a network pharmacy headquarter","operationId":"NetworkPharmacyHeadquarters_DeleteByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"networkid","in":"path","description":"Network identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Network Pharmacy Headquarter identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}},"patch":{"tags":["NetworkPharmacyHeadquarters"],"summary":"Patches an existing network pharmacy headquarter","operationId":"NetworkPharmacyHeadquarters_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"networkid","in":"path","description":"Network identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Network Pharmacy Headquarter Identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target rate","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/NetworkPharmacyHeadquarterConsolidatedModel"}}}}},"/api/networkplans":{"get":{"tags":["NetworkPlans"],"summary":"Gets a collection of global Network Plans for a company","operationId":"NetworkPlan_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/NetworkPlanModel"}}}}},"post":{"tags":["NetworkPlans"],"operationId":"NetworkPlan_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"networkPlanModel","in":"body","required":true,"schema":{"$ref":"#/definitions/NetworkPlanModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/NetworkPlanModel"}}}}},"/api/networkplans/{id}":{"get":{"tags":["NetworkPlans"],"summary":"Gets a global Network Plan for the specified network plan identifier","operationId":"NetworkPlan_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Network Plan identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/NetworkPlanModel"}}}},"patch":{"tags":["NetworkPlans"],"summary":"Patches an existing network plan","operationId":"NetworkPlan_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Network plan identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target rule","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/NetworkPlanModel"}}}}},"/api/networkplans/{id}/copyplan":{"post":{"tags":["NetworkPlans"],"summary":"Creates a copy of an existing network plan","description":"This method duplicates a network plan based on the provided identifier.","operationId":"NetworkGroupCopyPlan_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":[],"parameters":[{"name":"networkGroupCopyPlanModel","in":"body","description":"The model containing information about the new network plan to be created","required":true,"schema":{"$ref":"#/definitions/NetworkPlanCopyPlanModel"}},{"name":"id","in":"path","description":"The identifier of the network plan to be copied","required":true,"type":"integer","format":"int64"}],"responses":{"204":{"description":"No Content"}}}},"/api/networkplantemplates":{"get":{"tags":["NetworkPlanTemplates"],"summary":"Gets a collection of global Network Plan Templates","operationId":"NetworkPlanTemplate_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/NetworkPlanTemplateModel"}}}}},"post":{"tags":["NetworkPlanTemplates"],"summary":"Posts a new global network plan template","operationId":"NetworkPlanTemplates_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"NetworkPlanTemplateModel","in":"body","description":"The plan template to be added","required":true,"schema":{"$ref":"#/definitions/NetworkPlanTemplateModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/NetworkPlanTemplateModel"}}}}},"/api/networkplantemplates/{id}":{"get":{"tags":["NetworkPlanTemplates"],"summary":"Gets a Network Plan Template for the specified plan template identifier","operationId":"NetworkPlanTemplate_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Network Plan Template identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/NetworkPlanTemplateModel"}}}},"patch":{"tags":["NetworkPlanTemplates"],"summary":"Patches an existing network plan template","operationId":"NetworkPlanTemplates_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Network Plan Template Identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target network plan template","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/NetworkPlanTemplateModel"}}}}},"/api/networkplantemplates/{id}/copyplan":{"post":{"tags":["NetworkPlanTemplates"],"summary":"Creates a copy of an existing network plan template.","description":"This method duplicates a specified plan template within a network group, allowing the creation of a new plan based on existing configurations.\r\nThe method performs validation checks and copies various plan-specific rules and configurations if validation is successful.","operationId":"NetworkGroupTemplateCopyPlan_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":[],"parameters":[{"name":"networkTemplateCopyPlanModel","in":"body","description":"The model containing information about the new plan to be created.","required":true,"schema":{"$ref":"#/definitions/NetworkPlanTemplateCopyPlanModel"}},{"name":"id","in":"path","description":"The identifier of the network plan template to be copied.","required":true,"type":"integer","format":"int64"}],"responses":{"204":{"description":"No Content"}}}},"/api/networks":{"get":{"tags":["Networks"],"summary":"Gets a collection of networks based on the company associated with the authenticated user","operationId":"Network_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/NetworkModel"}}}}},"post":{"tags":["Networks"],"summary":"Adds a new network","operationId":"Network_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"networkModel","in":"body","description":"The json formatted network model object supplied in the request body that is to be added","required":true,"schema":{"$ref":"#/definitions/NetworkModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/NetworkModel"}}}}},"/api/networks/{id}":{"get":{"tags":["Networks"],"summary":"Gets a network","operationId":"Network_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Network identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/NetworkModel"}}}},"patch":{"tags":["Networks"],"summary":"Patches an existing network","operationId":"Network_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Network Identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target rule","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/NetworkModel"}}}}},"/api/groups/{groupid}/groupplans/{groupplanid}/plancontracts/{plancontractid}/openenrollmentsubmissionclarificationcodes":{"get":{"tags":["OpenEnrollmentSubmissionClarificationCodes"],"summary":"Gets a collection of open enrollment submission clarification code resources for a Plan Contract","operationId":"OpenEnrollmentSubmissionClarificationCode_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan identifier","required":true,"type":"integer","format":"int64"},{"name":"plancontractid","in":"path","description":"Plan Contract identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/OpenEnrollmentSubmissionClarificationCodeModel"}}}}}},"/api/groups/{groupid}/groupplans/{groupplanid}/plancontracts/{plancontractid}/openenrollmentsubmissionclarificationcodes/{id}":{"get":{"tags":["OpenEnrollmentSubmissionClarificationCodes"],"summary":"Gets an open enrollment submission clarification code resource","operationId":"OpenEnrollmentSubmissionClarificationCode_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan identifier","required":true,"type":"integer","format":"int64"},{"name":"plancontractid","in":"path","description":"Plan Contract identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Open Enrollment Submission Clarification Code identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/OpenEnrollmentSubmissionClarificationCodeModel"}}}}},"/api/groups/{groupid}/otherstatuses":{"get":{"tags":["OtherStatuses"],"summary":"Retrieves a collection of other statuses for a specified group and status type (other status #).","operationId":"OtherStatuses_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The identifier of the group for which other statuses will be returned.","required":true,"type":"integer","format":"int64"},{"name":"otherStatusNumber","in":"query","description":"The number of the other status to return (optional). Values of 1, 2 and 3 returns other status 1, 2 and 3 records, respectively.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"Returns a list of other status objects ordered by status.","schema":{"type":"array","items":{"$ref":"#/definitions/OtherStatusModel"}}},"404":{"description":"If the company ID or other statuses are not found."},"500":{"description":"If an internal server error occurs."}}}},"/api/groups/{groupid}/otherstatuses/{id}":{"get":{"tags":["OtherStatuses"],"summary":"Retrieves an other status by its identifier.","operationId":"OtherStatuses_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The identifier of the group for which the other status will be returned.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The identifier of the other status.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"Returns the other status resource.","schema":{"$ref":"#/definitions/OtherStatusModel"}},"404":{"description":"If the company ID or other status is not found."},"500":{"description":"If an internal server error occurs."}}}},"/api/overridetypes":{"get":{"tags":["OverrideTypes"],"summary":"Gets override type resources for the current user's company","operationId":"OverrideType_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/OverrideTypeModel"}}}}}},"/api/overridetypes/{id}":{"get":{"tags":["OverrideTypes"],"summary":"Gets override type resource by id","operationId":"OverrideType_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"The identifier for the override type to be returned","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/OverrideTypeModel"}}}}},"/api/members/{memberid}/patientplans":{"get":{"tags":["PatientPlans"],"summary":"Gets a collection of PatientPlan resources for a member","operationId":"PatientPlan_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"memberid","in":"path","description":"Member identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/PatientPlanModel"}}}}},"post":{"tags":["PatientPlans"],"summary":"Adds a new patient plan (AR status history) record to an existing member","operationId":"PatientPlans_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"patientPlanModel","in":"body","description":"The patient plan (AR status history) record to be added for the specified member.","required":true,"schema":{"$ref":"#/definitions/PatientPlanModel"}},{"name":"memberid","in":"path","description":"Member identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PatientPlanModel"}}}}},"/api/members/{memberid}/patientplans/{id}":{"get":{"tags":["PatientPlans"],"summary":"Gets a patient plan resource","operationId":"PatientPlan_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"memberid","in":"path","description":"Member identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Patient Plan identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PatientPlanModel"}}}},"patch":{"tags":["PatientPlans"],"summary":"Patches an existing patient plan (AR status history) record","operationId":"PatientPlans_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"memberid","in":"path","description":"Member identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"PatientPlan identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target rule","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PatientPlanModel"}}}}},"/api/payablescenters":{"get":{"tags":["PayablesCenters"],"summary":"Gets a collection of payables center resources for a Group Plan","operationId":"PayablesCenter_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"pharmacyHeadquarterNo","in":"query","description":"The identifier representing a pharmacy headquarter by which payables centers will be filtered","required":false,"type":"integer","format":"int64"},{"name":"name","in":"query","description":"name by which payables centers will be filtered","required":false,"type":"string"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/PayablesCenterModel"}}}}},"post":{"tags":["PayablesCenters"],"summary":"Posts a new payables center to an existing group","operationId":"PayablesCenters_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"payablesCenterModel","in":"body","description":"A new payables center to add","required":true,"schema":{"$ref":"#/definitions/PayablesCenterModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PayablesCenterModel"}}}}},"/api/payablescenters/{id}":{"get":{"tags":["PayablesCenters"],"summary":"Gets payables center resource","operationId":"PayablesCenter_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"PayablesCenter identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PayablesCenterModel"}}}}},"/api/groups/{groupid}/groupplans/{groupplanid}/penaltybasises":{"get":{"tags":["PenaltyBasises"],"summary":"Gets a collection of drug selection penalty basis resources","operationId":"PenaltyBasis_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/PenaltyBasisModel"}}}}},"post":{"tags":["PenaltyBasises"],"summary":"Posts a penalty basis record","operationId":"PenaltyBasises_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"penaltyBasisModel","in":"body","required":true,"schema":{"$ref":"#/definitions/PenaltyBasisModel"}},{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PenaltyBasisModel"}}}}},"/api/groups/{groupid}/groupplans/{groupplanid}/penaltybasises/{id}":{"get":{"tags":["PenaltyBasises"],"summary":"Gets a drug selection penalty basis resource","operationId":"PenaltyBasis_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Drug Selection Penalty Basis identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PenaltyBasisModel"}}}},"patch":{"tags":["PenaltyBasises"],"summary":"Patches a penalty basis record","operationId":"PenaltyBasises_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Penalty Basis Identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target rule","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PenaltyBasisModel"}}}}},"/api/groups/{groupid}/groupplans/{groupplanid}/perdiems/{perdiemid}/perdiemrates":{"get":{"tags":["PerDiemRates"],"summary":"Gets a collection of per diem rates for a per diem resource","operationId":"PerDiemRate_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan identifier","required":true,"type":"integer","format":"int64"},{"name":"perdiemid","in":"path","description":"Per Diem identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/PerDiemRateModel"}}}}}},"/api/groups/{groupid}/groupplans/{groupplanid}/perdiems/{perdiemid}/perdiemrates/{id}":{"get":{"tags":["PerDiemRates"],"summary":"Gets a per diem rate","operationId":"PerDiemRate_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan identifier","required":true,"type":"integer","format":"int64"},{"name":"perdiemid","in":"path","description":"Per Diem identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Per Diem Rate identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PerDiemRateModel"}}}}},"/api/groups/{groupid}/groupplans/{groupplanid}/perdiems":{"get":{"tags":["PerDiems"],"summary":"Gets a collection of per diem resources for a Group Plan","operationId":"PerDiem_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan identifier","required":true,"type":"integer","format":"int64"},{"name":"showRates","in":"query","description":"Flag to indicate whether or not to include the rates","required":false,"type":"boolean"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/PerDiemModel"}}}}}},"/api/groups/{groupid}/groupplans/{groupplanid}/perdiems/{id}":{"get":{"tags":["PerDiems"],"summary":"Gets a per diem resource","operationId":"PerDiem_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Per Diem Rate identifier","required":true,"type":"integer","format":"int64"},{"name":"showRates","in":"query","description":"Flag to indicate whether or not to include the rates for the per diem resource","required":false,"type":"boolean"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PerDiemModel"}}}}},"/api/pharmacyclasses":{"get":{"tags":["PharmacyClasses"],"summary":"Gets a collection of pharmacy classes","operationId":"PharmacyClasses_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/PharmacyClassModel"}}}}}},"/api/pharmacyclasses/{id}":{"get":{"tags":["PharmacyClasses"],"summary":"Gets a pharmacy class resource","operationId":"PharmacyClasses_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"pharmacy class identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PharmacyClassModel"}}}}},"/api/pharmacyheadquarters/{headquarterID}/codes":{"get":{"tags":["PharmacyHeadquarterCodes"],"summary":"Gets a collection of Pharmacy Headquarter Codes associated with the Pharmacy Headquarter Identifier.","operationId":"PharmacyHeadquarterCodes_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"headquarterID","in":"path","description":"The Pharmacy Headquarter Identifier.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/PharmacyHeadquarterCodeModel"}}}}},"post":{"tags":["PharmacyHeadquarterCodes"],"summary":"Posts a new Relationship Code to a Pharmacy Headquarter.","operationId":"PharmacyHeadquarterCode_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"headquarterID","in":"path","description":"The Pharmacy Headquarter Identifier.","required":true,"type":"integer","format":"int64"},{"name":"pharmacyHeadquarterCodeModel","in":"body","description":"The Pharmacy Headquarter Code model to add.","required":true,"schema":{"$ref":"#/definitions/PharmacyHeadquarterCodeModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PharmacyHeadquarterCodeModel"}},"201":{"description":"Created","schema":{"$ref":"#/definitions/PharmacyHeadquarterCodeModel"}}}}},"/api/pharmacyheadquarters/{headquarterID}/codes/{id}":{"get":{"tags":["PharmacyHeadquarterCodes"],"summary":"Gets a Pharmacy Headquarter Code.","operationId":"PharmacyHeadquarterCode_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"headquarterID","in":"path","description":"The Pharmacy Headquarter Identifier.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The Pharmacy Headquarter Code Identifier.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PharmacyHeadquarterCodeModel"}}}},"delete":{"tags":["PharmacyHeadquarterCodes"],"summary":"Deletes a Pharmacy Headquarter Code.","operationId":"PharmacyHeadquarterCode_DeleteByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"headquarterID","in":"path","description":"The Pharmacy Headquarter Identifier.","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The Pharmacy Headquarter Code Identifier to delete.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}}},"/api/pharmacyheadquarters":{"get":{"tags":["PharmacyHeadquarters"],"summary":"Gets a collection of Pharmacy Headquarters for the company of the authenticated user.","operationId":"PharmacyHeadquarters_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"nameFilter","in":"query","description":"Optional querystring filter that does a starts with comparison (Example: api/pharmacyheadquarters?nameFilter=[value]).","required":false,"type":"string"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/PharmacyHeadquarterModel"}}}}},"post":{"tags":["PharmacyHeadquarters"],"summary":"Posts a new Pharmacy Headquarter model to a company.","operationId":"PharmacyHeadquarters_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"pharmacyHeadquarterModel","in":"body","description":"The new Pharmacy Headquarter model to add.","required":true,"schema":{"$ref":"#/definitions/PharmacyHeadquarterModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PharmacyHeadquarterModel"}},"201":{"description":"Created","schema":{"$ref":"#/definitions/PharmacyHeadquarterCodeModel"}}}}},"/api/pharmacyheadquarters/{id}":{"get":{"tags":["PharmacyHeadquarters"],"summary":"Gets a Pharmacy Headquarter.","operationId":"PharmacyHeadquarters_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"The Pharmacy Headquarter Identifier to get.","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PharmacyHeadquarterModel"}}}},"patch":{"tags":["PharmacyHeadquarters"],"summary":"Patches an existing Pharmacy Headquarter.","operationId":"PharmacyHeadquarters_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"The Pharmacy Headquarter Identifier to modify.","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target pharmacy headquarter","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PharmacyHeadquarterModel"}}}}},"/api/PharmacyLocations":{"get":{"tags":["PharmacyLocations"],"summary":"Gets all pharmacy locations for this company matching the optional filters provided","operationId":"PharmacyLocations_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"page","in":"query","description":"1-based index identifying the page # of results to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of records to return per page (optional, 25 by default, max 100)","required":false,"type":"integer","format":"int32"},{"name":"pharmacyHeadquarterNo","in":"query","description":"The optional pharmacy headquarter id by which results will be filtered","required":false,"type":"integer","format":"int64"},{"name":"name","in":"query","description":"The optional name to use when filtering results","required":false,"type":"string"},{"name":"city","in":"query","description":"The optional city to use when filtering results","required":false,"type":"string"},{"name":"npi","in":"query","description":"The optional npi to use when filtering results","required":false,"type":"string"},{"name":"ncpdp","in":"query","description":"The optional ncpdp to use when filtering results","required":false,"type":"string"},{"name":"state","in":"query","description":"The optional state to use when filtering results","required":false,"type":"string"},{"name":"activeOnly","in":"query","description":"Value that determines whether only active results should be returned","required":false,"type":"boolean"},{"name":"lastModifiedAfter","in":"query","description":"This parameter is obsolete and is no longer functional.  It will be removed completely in a future release","required":false,"type":"string","format":"date-time"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[PharmacyLocationModel]"}}}},"post":{"tags":["PharmacyLocations"],"summary":"Posts a new PharmacyLocation to an existing group plan.","operationId":"PharmacyLocations_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"pharmacyLocationModel","in":"body","description":"The Pharmacy Location to be added.","required":true,"schema":{"$ref":"#/definitions/PharmacyLocationModel"}},{"name":"dataQProviderID","in":"query","description":"Data for the new pharmacy location will be initialized with data from dataQ for the given dataQProviderID and overridden with values provided on the pharmacyLocationModel.","required":false,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PharmacyLocationModel"}},"201":{"description":"Created","schema":{"$ref":"#/definitions/PharmacyLocationModel"}}}},"patch":{"tags":["PharmacyLocations"],"summary":"Patches an existing Pharmacy Location record","operationId":"PharmacyLocations_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"query","description":"PharmacyLocation identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target rule","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PharmacyLocationModel"}}}}},"/api/PharmacyLocations/{id}":{"get":{"tags":["PharmacyLocations"],"summary":"Gets a single Pharmacy Location by id","operationId":"PharmacyLocations_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"The value used to find the Pharmacy Location that should be returned","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PharmacyLocationModel"}}}}},"/api/PharmacyLocator":{"get":{"tags":["PharmacyLocator"],"summary":"Retrieves a list of pharmacies within a specified distance from a given zip code.","operationId":"PharmacyLocator_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"zipCode","in":"query","description":"The zip code used as the center point for locating pharmacies.","required":true,"type":"string"},{"name":"maxDistance","in":"query","description":"The maximum distance (in miles) from the zip code within which to search for pharmacies.\r\nThis parameter is optional. Its default value is 10 and its maximum is 100.","required":false,"type":"integer","format":"int32"},{"name":"bin","in":"query","description":"The BIN used for filtering pharmacies. This parameter is optional if both `bin` and `groupCode` are not provided.\r\nIf either `bin` or `groupCode` is provided, both are required.","required":false,"type":"string"},{"name":"groupCode","in":"query","description":"The group code used for filtering pharmacies. This parameter is optional if both `bin` and `groupCode` are not provided.\r\nIf either `bin` or `groupCode` is provided, both are required.","required":false,"type":"string"}],"responses":{"200":{"description":"Returns the list of pharmacies.","schema":{"type":"array","items":{"$ref":"#/definitions/PharmacyLocatorResponseModel"}}},"400":{"description":"If the zipCode is not provided, maxDistance is greater than 100, or only one of `bin` or `groupCode` is provided."},"404":{"description":"No pharmacies found for the given parameters."},"500":{"description":"Internal server error."}}},"post":{"tags":["PharmacyLocator"],"summary":"Retrieves a list of pharmacies within a specified distance from a given address.","operationId":"PharmacyLocator_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"addressData","in":"body","description":"The address used as the center point for locating pharmacies. The `AddressDataModel` must include `Address`, `City`, `StateCode`, and `ZipCode`.","required":true,"schema":{"$ref":"#/definitions/AddressDataModel"}},{"name":"maxDistance","in":"query","description":"The maximum distance (in miles) from the address within which to search for pharmacies.\r\nThis parameter is optional. Its default value is 10 and its maximum is 100.","required":false,"type":"integer","format":"int32"},{"name":"bin","in":"query","description":"The BIN used for filtering pharmacies. This parameter is optional if both `bin` and `groupCode` are not provided.\r\nIf either `bin` or `groupCode` is provided, both are required.","required":false,"type":"string"},{"name":"groupCode","in":"query","description":"The group code used for filtering pharmacies. This parameter is optional if both `bin` and `groupCode` are not provided.\r\nIf either `bin` or `groupCode` is provided, both are required.","required":false,"type":"string"}],"responses":{"200":{"description":"Returns the list of pharmacies.","schema":{"type":"array","items":{"$ref":"#/definitions/PharmacyLocatorResponseModel"}}},"400":{"description":"If the `addressData` is not provided, required address fields are missing, `maxDistance` is greater than 100, or only one of `bin` or `groupCode` is provided."},"404":{"description":"No pharmacies found for the given parameters, the geocoding service failed to retrieve coordinates, or the request to the geocoding service timed out."},"500":{"description":"Internal server error."}}}},"/api/PharmacyLocator/paged":{"get":{"tags":["PharmacyLocator"],"summary":"Retrieves a list of pharmacies within a specified distance from a given zip code.","operationId":"PharmacyLocator_GetPaged","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"zipCode","in":"query","description":"The zip code used as the center point for locating pharmacies.","required":true,"type":"string"},{"name":"page","in":"query","description":"The 1-based index of the page of pharmacy locations to return ( 1 by default)","required":true,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of pharmacy locations to return per page (25 by default, max 100)","required":true,"type":"integer","format":"int32"},{"name":"maxDistance","in":"query","description":"The maximum distance (in miles) from the zip code within which to search for pharmacies.\r\nThis parameter is optional. Its default value is 10 and its maximum is 100.","required":false,"type":"integer","format":"int32"},{"name":"bin","in":"query","description":"The BIN used for filtering pharmacies. This parameter is optional if both `bin` and `groupCode` are not provided.\r\nIf either `bin` or `groupCode` is provided, both are required.","required":false,"type":"string"},{"name":"groupCode","in":"query","description":"The group code used for filtering pharmacies. This parameter is optional if both `bin` and `groupCode` are not provided.\r\nIf either `bin` or `groupCode` is provided, both are required.","required":false,"type":"string"}],"responses":{"200":{"description":"Returns the list of pharmacies.","schema":{"$ref":"#/definitions/PagedResultModel[PharmacyLocatorResponseModel]"}},"400":{"description":"If the zipCode is not provided, maxDistance is greater than 100, or only one of `bin` or `groupCode` is provided."},"404":{"description":"No pharmacies found for the given parameters."},"500":{"description":"Internal server error."}}}},"/api/pharmacyprofiles":{"get":{"tags":["PharmacyProfiles"],"summary":"Gets a collection of pharmacy profiles","operationId":"PharmacyProfiles_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/PharmacyProfileModel"}}}}}},"/api/pharmacyprofiles/{id}":{"get":{"tags":["PharmacyProfiles"],"summary":"Gets a pharmacy profile resource","operationId":"PharmacyProfiles_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"pharmacy profile identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PharmacyProfileModel"}}}}},"/api/pharmacytypes":{"get":{"tags":["PharmacyType"],"summary":"Gets a collection of all pharmacy types","operationId":"PharmacyType_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/PharmacyTypeModel"}}}}}},"/api/pharmacywholesalers":{"get":{"tags":["PharmacyWholesalers"],"summary":"Gets a collection of pharmacy wholesalers","operationId":"PharmacyWholesalers_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/PharmacyWholesalerModel"}}}}}},"/api/pharmacywholesalers/{id}":{"get":{"tags":["PharmacyWholesalers"],"summary":"Gets a pharmacy wholesaler resource","operationId":"PharmacyWholesalers_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"pharmacy wholesaler identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PharmacyWholesalerModel"}}}}},"/api/groupplans/{groupplanid}/formularies/{formularyid}/planagelimits":{"get":{"tags":["PlanAgeLimits"],"summary":"Gets a collection of Plan Age Limits by formulary identifier and group plan identifier","operationId":"PlanAgeLimits_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"formularyid","in":"path","description":"Plan Formulary Identifier","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The 1-based index of the page of plan age limits to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of plan age limits to return per page (optional, 25 by default, max 100)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[PlanAgeLimitModel]"}}}}},"/api/groupplans/{groupplanid}/formularies/{formularyid}/planagelimits/{id}":{"get":{"tags":["PlanAgeLimits"],"summary":"Gets a Plan Age Limit by formulary identifier and group plan identifier and plan age limit id","operationId":"PlanAgeLimits_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"formularyid","in":"path","description":"Formulary Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Plan Age limit identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PlanAgeLimitModel"}}}}},"/api/groupplans/{groupplanid}/planonlyagelimits":{"get":{"tags":["PlanAgeLimits"],"summary":"Gets a collection of Plan Only Age Limits","operationId":"PlanOnlyAgeLimits_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The 1-based index of the page of age limits to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of age limits to return per page (optional, 25 by default, max 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Identifier","required":true,"type":"integer","format":"int64"},{"name":"formularyid","in":"path","description":"Plan Formulary Identifier","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The 1-based index of the page of plan quantity limits to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of plan quantity limits to return per page (optional, 25 by default, max 100)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[PlanQuantityLimitModel]"}}}}},"/api/groupplans/{groupplanid}/formularies/{formularyid}/planquantitylimits/{id}":{"get":{"tags":["PlanQuantityLimits"],"summary":"Gets a Plan Quantity Limit by formulary identifier and group plan identifier and plan quantity limit id","operationId":"PlanQuantityLimits_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"formularyid","in":"path","description":"Formulary Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Plan Quantity limit identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PlanQuantityLimitModel"}}}}},"/api/groupplans/{groupplanid}/planonlyquantitylimits":{"get":{"tags":["PlanQuantityLimits"],"summary":"Gets a collection of Plan Only Quantity Limits","operationId":"PlanOnlyQuantityLimits_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The 1-based index of the page of quantity limits to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of quantity limits to return per page (optional, 25 by default, max 100)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[PlanQuantityLimitModel]"}}}}},"/api/groupplans/{groupplanid}/planonlyquantitylimits/{id}":{"get":{"tags":["PlanQuantityLimits"],"summary":"Gets a Plan Only Quantity Limit by group plan identifier and plan quantity limit id","operationId":"PlanOnlyQuantityLimits_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Plan Only Quantity limit identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PlanQuantityLimitModel"}}}}},"/api/groupplans/{groupplanid}/formularies/{formularyid}/planquantitylimits/optin-all":{"post":{"tags":["PlanQuantityLimits"],"summary":"Opt-in of all Quantity Limits for all plans tied to a formulary","operationId":"PlanQuantityLimits_OptInAll","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"formularyid","in":"path","description":"Formulary Identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}}},"/api/groupplans/{groupplanid}/formularies/{formularyid}/planquantitylimits/optout-all":{"post":{"tags":["PlanQuantityLimits"],"summary":"Opt-out of all Quantity Limits for all plans tied to a formulary","operationId":"PlanQuantityLimits_OptOutAll","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"formularyid","in":"path","description":"Formulary Identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}}},"/api/groupplans/{groupplanid}/formularies/{formularyid}/planstepmedicationmultisourcecodes":{"get":{"tags":["PlanStepMedicationMultiSourceCode"],"summary":"Gets a collection of plan step medication multi source codes by formulary identifier and group plan identifier","operationId":"PlanStepMedicationMultiSourceCodes_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"formularyid","in":"path","description":"Plan Formulary Identifier","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The 1-based index of the page of plan step medication multi source codes to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of plan step medication multi source codes to return per page (optional, 25 by default, max 100)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[PlanStepMedicationMultiSourceCodeModel]"}}}}},"/api/groupplans/{groupplanid}/formularies/{formularyid}/planstepmedicationmultisourcecodes/{id}":{"get":{"tags":["PlanStepMedicationMultiSourceCode"],"summary":"Gets a plan step medication multi source code by formulary identifier and group plan identifier and plan step medication multi source code id","operationId":"PlanStepMedicationMultiSourceCodes_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"formularyid","in":"path","description":"Formulary Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Plan Step medication Multi source code identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PlanStepMedicationMultiSourceCodeModel"}}}}},"/api/groupplans/{groupplanid}/planonlystepmedicationmultisourcecodes":{"get":{"tags":["PlanStepMedicationMultiSourceCode"],"summary":"Gets a collection of plan only step medication multi source codes","operationId":"PlanOnlyStepMedicationMultiSourceCodes_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The 1-based index of the page of plan only step medication multi source codes to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of plan only step medication multi source codes to return per page (optional, 25 by default, max 100)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[PlanStepMedicationMultiSourceCodeModel]"}}}}},"/api/groupplans/{groupplanid}/planonlystepmedicationmultisourcecodes/{id}":{"get":{"tags":["PlanStepMedicationMultiSourceCode"],"summary":"Gets a plan only step medication multi source code by formulary identifier and group plan identifier and plan only step medication multisource code id","operationId":"PlanOnlyStepMedicationMultiSourceCodes_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Plan Only Step Medication Multi Source Code Identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PlanStepMedicationMultiSourceCodeModel"}}}}},"/api/groupplans/{groupplanid}/formularies/{formularyid}/planstepmedications":{"get":{"tags":["PlanStepMedications"],"summary":"Gets a collection of plan step medications by formulary identifier and group plan identifier","operationId":"PlanStepMedications_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"formularyid","in":"path","description":"Plan Formulary Identifier","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The 1-based index of the page of plan step medications to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of plan step medications to return per page (optional, 25 by default, max 100)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[PlanStepMedicationModel]"}}}}},"/api/groupplans/{groupplanid}/formularies/{formularyid}/planstepmedications/{id}":{"get":{"tags":["PlanStepMedications"],"summary":"Gets a plan step medication by formulary identifier and group plan identifier and plan step medication id","operationId":"PlanStepMedications_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"formularyid","in":"path","description":"Formulary Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Plan Step Medication Identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PlanStepMedicationModel"}}}}},"/api/groupplans/{groupplanid}/planonlystepmedications":{"get":{"tags":["PlanStepMedications"],"summary":"Gets a collection of plan only step medications","operationId":"PlanOnlyStepMedications_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The 1-based index of the page of plan only step medications to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of plan only step medications to return per page (optional, 25 by default, max 100)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[PlanStepMedicationModel]"}}}}},"/api/groupplans/{groupplanid}/planonlystepmedications/{id}":{"get":{"tags":["PlanStepMedications"],"summary":"Gets a plan only step medication by group plan identifier and plan only step medication id","operationId":"PlanOnlyStepMedications_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Plan Only Step Medication identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PlanStepMedicationModel"}}}}},"/api/groupplans/{groupplanid}/formularies/{formularyid}/planstepmedications/optin-all":{"post":{"tags":["PlanStepMedications"],"summary":"Opt-in of all plan step medications for all plans tied to a formulary","operationId":"PlanStepMedications_OptInAll","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"formularyid","in":"path","description":"Formulary Identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}}},"/api/groupplans/{groupplanid}/formularies/{formularyid}/planstepmedications/optout-all":{"post":{"tags":["PlanStepMedications"],"summary":"Opt-out of all Plan Step Medications for all plans tied to a formulary","operationId":"PlanStepMedications_OptOutAll","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"formularyid","in":"path","description":"Formulary Identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}}},"/api/groupplans/{groupplanid}/formularies/{formularyid}/planstepmedicationstepdrugs":{"get":{"tags":["PlanStepMedicationStepDrugs"],"summary":"Gets a collection of plan step medication step drugs by group plan identifier","operationId":"PlanStepMedicationStepDrugs_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"formularyid","in":"path","description":"Plan Formulary Identifier","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The 1-based index of the page of plan step medication step drugs to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of plan step medication step drugs to return per page (optional, 25 by default, max 100)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[PlanStepMedicationStepDrugModel]"}}}}},"/api/groupplans/{groupplanid}/formularies/{formularyid}/planstepmedicationstepdrugs/{id}":{"get":{"tags":["PlanStepMedicationStepDrugs"],"summary":"Gets a plan step medication step drug by formulary identifier and group plan identifier and plan step medication step drug id","operationId":"PlanStepMedicationStepDrugs_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"formularyid","in":"path","description":"Formulary Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Plan Step Medication Step Drug Identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PlanStepMedicationStepDrugModel"}}}}},"/api/groupplans/{groupplanid}/planonlystepmedicationstepdrugs":{"get":{"tags":["PlanStepMedicationStepDrugs"],"summary":"Gets a collection of plan only step medication step drugs","operationId":"PlanOnlyStepMedicationStepDrugs_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The 1-based index of the page of plan only step medication step drugs to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of  plan only step medication step drugs to return per page (optional, 25 by default, max 100)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[PlanStepMedicationStepDrugModel]"}}}}},"/api/groupplans/{groupplanid}/planonlystepmedicationstepdrugs/{id}":{"get":{"tags":["PlanStepMedicationStepDrugs"],"summary":"Gets a plan only step medication step drug by formulary identifier and group plan identifier and plan step medication step drug id","operationId":"PlanOnlyStepMedicationStepDrug_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Plan Only Step Medication Step Drug Identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PlanStepMedicationStepDrugModel"}}}}},"/api/groupplans/{groupplanid}/PlanTemplatePricingGroups":{"get":{"tags":["PlanTemplatePricingGroups"],"summary":"Gets a collection of Plan Template Pricing Groups for a Group Plan","operationId":"PlanTemplatePricingGroup_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Plan Template identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/PlanTemplatePricingGroupModel"}}}}},"post":{"tags":["PlanTemplatePricingGroups"],"summary":"Posts a new plan templat epricing group","operationId":"PlanTemplatePricingGroup_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"PlanTemplatePricingGroupModel","in":"body","description":"New Pricing Group","required":true,"schema":{"$ref":"#/definitions/PlanTemplatePricingGroupModel"}},{"name":"groupplanid","in":"path","description":"Plan Identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PlanTemplatePricingGroupModel"}}}}},"/api/groupplans/{groupplanid}/PlanTemplatePricingGroups/{id}":{"get":{"tags":["PlanTemplatePricingGroups"],"summary":"Gets a Plan Template Pricing Group","operationId":"PlanTemplatePricingGroup_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Plan Template identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Plan Template Pricing Group identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PlanTemplatePricingGroupModel"}}}},"patch":{"tags":["PlanTemplatePricingGroups"],"summary":"Patches an existing Plan Template Pricing Group","operationId":"PlanTemplatePricingGroup_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupplanid","in":"path","description":"Plan Template Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Pricing Group Identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target rule","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PlanTemplatePricingGroupModel"}}}}},"/api/groups/{groupid}/groupplans/{groupplanid}/formularies/{formularyid}/plantiercopays":{"get":{"tags":["PlanTierCopays"],"summary":"Gets a collection of Plan Tier Copays by formulary identifier, group identifier, and group plan identifier","operationId":"PlanTierCopays_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"formularyid","in":"path","description":"Plan Formulary Identifier","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The 1-based index of the page of plan tier copays to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of plan tier copays to return per page (optional, 25 by default, max 100)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[PlanTierCopayModel]"}}}}},"/api/groups/{groupid}/groupplans/{groupplanid}/formularies/{formularyid}/plantiercopays/{id}":{"get":{"tags":["PlanTierCopays"],"summary":"Gets a Plan Tier Copay by formulary identifier, group identifier, group plan identifier and plan tier copay id","operationId":"PlanTierCopays_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"groupplanid","in":"path","description":"Group Plan Identifier","required":true,"type":"integer","format":"int64"},{"name":"formularyid","in":"path","description":"Formulary Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Plan Tier Copay identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PlanTierCopayModel"}}}}},"/api/portaldrugsearch":{"get":{"tags":["PortalDrugSearch"],"summary":"Searches for drugs by name and retrieves matching results for autocomplete functionality.","operationId":"PortalDrugSearchGetByName","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugName","in":"query","description":"The name of the drug to search for (at least 2 characters).","required":true,"type":"string"}],"responses":{"200":{"description":"Returns a list of drugs matching the specified name.","schema":{"type":"array","items":{"$ref":"#/definitions/PortalDrugModel"}}},"400":{"description":"If the drug name does not meet the minimum length of 2 characters."},"404":{"description":"If no matching drugs are found."},"500":{"description":"If an internal server error occurs."}}}},"/api/portaldrugselect/drugID":{"get":{"tags":["PortalDrugSelect"],"summary":"Retrieves detailed drug information by National Drug Code (NDC).\r\nUse this endpoint after selecting an NDC from the Drug Search endpoint to explore specific drug details, \r\nincluding available forms, strengths, and packages.","operationId":"PortalDrugSelectGetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"ndc","in":"query","description":"The National Drug Code (NDC) for the selected drug. \r\nThis is a unique identifier for the drug returned by the Drug Search endpoint.","required":true,"type":"string"},{"name":"matchDrugNameOnly","in":"query","description":"Only return results that match drug name. Default is false.","required":false,"type":"boolean"},{"name":"page","in":"query","description":"The page number for paginated results. Default is 1.","required":false,"type":"integer","format":"int32"},{"name":"pageSize","in":"query","description":"The number of results per page. Default is 10, with a maximum limit of 20.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"Successfully returns drug details for the specified NDC.","schema":{"$ref":"#/definitions/PagedResultModel[PortalDrugDetailModel]"}},"400":{"description":"If the NDC is invalid, less than 10 characters, or any required parameter is missing."},"404":{"description":"If no drug details are found for the given NDC and member."},"500":{"description":"If an internal server error occurs."}}}},"/api/portaldrugselect/drugname":{"get":{"tags":["PortalDrugSelect"],"summary":"Retrieves detailed drug information by drug name.\r\nUse this endpoint to find drug details if a full drug name is known but the NDC is not available.","operationId":"PortalDrugSelectGetByName","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"drugName","in":"query","description":"The full name of the drug to search for. \r\nPartial matches are not supported; the full drug name must be provided.","required":true,"type":"string"},{"name":"matchDrugNameOnly","in":"query","description":"Only return results that match drug name. Default is false.","required":false,"type":"boolean"},{"name":"page","in":"query","description":"The page number for paginated results. Default is 1.","required":false,"type":"integer","format":"int32"},{"name":"pageSize","in":"query","description":"The number of results per page. Default is 10, with a maximum limit of 20.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"Successfully returns drug details for the specified drug name.","schema":{"$ref":"#/definitions/PagedResultModel[PortalDrugDetailModel]"}},"400":{"description":"If the drug name is null, empty, or any required parameter is missing."},"404":{"description":"If no drug details are found for the given drug name and member."},"500":{"description":"If an internal server error occurs."}}}},"/api/portalnetworklogo/{id}":{"get":{"tags":["PortalNetworkLogo"],"summary":"Gets a logo image for a network if it exists with ability to specify new dimensions.  If network does not have a logo, an optional placeholder image can be returned or a 404 status code.","operationId":"PortalNetworkLogoGet_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Network identifier","required":true,"type":"integer","format":"int64"},{"name":"width","in":"query","description":"Optional image width (in pixels)","required":false,"type":"integer","format":"int32"},{"name":"height","in":"query","description":"Optional image height (in pixels)","required":false,"type":"integer","format":"int32"},{"name":"crop","in":"query","description":"Optional paramter that indicates how to handle resizing the image if the new dimensions are not proportional to the old dimensions.  \r\n            When cropping is enabled, the image will be cropped as needed to keep the image proporitioanl to the original.  \r\n            When cropping is disabled (default behavior), the image will be scaled to the new size but with padding added as needed accommodate the new dimensions","required":false,"type":"boolean"},{"name":"hexColor","in":"query","description":"When crop is not used, the image may be padded in order to scale to requested size.  The hex color controls the color of the padded margins.","required":false,"type":"string"},{"name":"placeholderForMissingLogo","in":"query","description":"Optional parameter used to indicate if placeholder image should be returned if the network does not have an image loaded.","required":false,"type":"boolean"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}}},"/api/portalpricecheck/{ndc}":{"get":{"tags":["PortalPriceCheck"],"summary":"Gets price check information for a specified drug (NDC) and member. By default, networks within 20 miles of the member’s address are returned, or, if provided, the specified zip code is used as the search location.","operationId":"PortalPriceCheck_GetPriceCheck","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"ndc","in":"path","description":"The NDC for the drug.","required":true,"type":"string"},{"name":"quantity","in":"query","description":"Quantity for pricing.","required":true,"type":"number","format":"double"},{"name":"dayssupply","in":"query","description":"Days supply for the drug.","required":true,"type":"integer","format":"int32"},{"name":"memberid","in":"query","description":"Member's unique identifier - RxCPersonID (also referred to as the MemberSeqNo on some endpoints).","required":true,"type":"integer","format":"int64"},{"name":"zipCode","in":"query","description":"Optional zip code for the price check to use when finding nearby pharmacies. If provided, it will be used instead of the member's address.  This may be useful if the member’s address is incorrect or if a different location is desired.","required":false,"type":"string"},{"name":"page","in":"query","description":"Page number for pagination, default is 1.","required":false,"type":"integer","format":"int32"},{"name":"pageSize","in":"query","description":"Results per page, max 20.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"Returns a list of pricing details.","schema":{"$ref":"#/definitions/PagedResultModel[PortalPriceCheckModel]"}},"400":{"description":"If required parameters are missing or invalid."},"404":{"description":"If no pricing information is found."},"500":{"description":"If an internal server error occurs."}}}},"/api/portalpricecheck/bypharmacyHQ/{ndc}":{"get":{"tags":["PortalPriceCheck"],"summary":"Gets price check information for a specified drug (NDC) and member. By default, networks within 20 miles of the member’s address are returned, or, if provided, the specified zip code is used as the search location.","operationId":"PortalPriceCheck_GetPriceCheck","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"ndc","in":"path","description":"The NDC for the drug.","required":true,"type":"string"},{"name":"quantity","in":"query","description":"Quantity for pricing.","required":true,"type":"number","format":"double"},{"name":"dayssupply","in":"query","description":"Days supply for the drug.","required":true,"type":"integer","format":"int32"},{"name":"memberid","in":"query","description":"Member's unique identifier - RxCPersonID (also referred to as the MemberSeqNo on some endpoints).","required":true,"type":"integer","format":"int64"},{"name":"zipCode","in":"query","description":"Optional zip code for the price check to use when finding nearby pharmacies. If provided, it will be used instead of the member's address.  This may be useful if the member’s address is incorrect or if a different location is desired.","required":false,"type":"string"},{"name":"page","in":"query","description":"Page number for pagination, default is 1.","required":false,"type":"integer","format":"int32"},{"name":"pageSize","in":"query","description":"Results per page, max 20.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"Returns a list of pricing details.","schema":{"$ref":"#/definitions/PagedResultModel[PortalPriceCheckModel]"}},"400":{"description":"If required parameters are missing or invalid."},"404":{"description":"If no pricing information is found."},"500":{"description":"If an internal server error occurs."}}}},"/api/portalpricecheck/bypharmacylocation/{ndc}":{"get":{"tags":["PortalPriceCheck"],"summary":"Retrieves price check information for a specified drug (NDC) and member. \r\nBy default, pharmacies within a 20-mile radius of the member's geocoded address are returned, \r\nor, if provided, the specified zip code is used as the search location. \r\nSupports pagination and returns pharmacy pricing details sorted by distance.","operationId":"PortalPriceCheck_GetPriceCheckByLocation","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"ndc","in":"path","description":"The National Drug Code (NDC) for the drug to retrieve pricing information for.","required":true,"type":"string"},{"name":"quantity","in":"query","description":"The quantity of the drug for pricing calculations.","required":true,"type":"number","format":"double"},{"name":"dayssupply","in":"query","description":"Days supply for the drug.","required":true,"type":"integer","format":"int32"},{"name":"memberid","in":"query","description":"The unique identifier for the member (RxCPersonID or MemberSeqNo).","required":true,"type":"integer","format":"int64"},{"name":"zipCode","in":"query","description":"Optional zip code for the search location. If provided, it overrides the member's geocoded address.","required":false,"type":"string"},{"name":"page","in":"query","description":"The page number for pagination. Defaults to 1 if not provided.","required":false,"type":"integer","format":"int32"},{"name":"pageSize","in":"query","description":"The number of results per page. Maximum value is 20.","required":false,"type":"integer","format":"int32"},{"name":"distanceRadius","in":"query","description":"The search radius in miles for nearby pharmacies. Defaults to 20 miles.","required":false,"type":"integer","format":"int32"},{"name":"npi","in":"query","description":"Optional NPI(s) for the search location. If provided, it limits the results to that specific NPI(s). (Multiple NPIs can be provided in a comma delimited string)","required":false,"type":"string"},{"name":"includeRetail","in":"query","description":"Optional include retail pharmacies. (Default value is true)","required":false,"type":"boolean"},{"name":"includeMailOrder","in":"query","description":"Optional include mail order pharmacies. (Default value is false)","required":false,"type":"boolean"},{"name":"includeInternational","in":"query","description":"Optional include international pharmacies). (Default value is false)","required":false,"type":"boolean"}],"responses":{"200":{"description":"Returns a paginated list of pricing details sorted by distance.","schema":{"$ref":"#/definitions/PagedResultModel[PortalPriceCheckByLocationModel]"}},"400":{"description":"Occurs if required parameters are missing, invalid, or member/zip code cannot be resolved."},"404":{"description":"Occurs if no company ID is found or no pharmacy locations are available."},"500":{"description":"Occurs if an internal server error prevents the process from completing."}}}},"/api/portalstorelocations/{networkID}":{"get":{"tags":["PortalStoreLocations"],"summary":"Gets store locations by network and member's location details.","operationId":"PortalStoreLocations_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"networkID","in":"path","description":"Network ID.","required":true,"type":"integer","format":"int64"},{"name":"memberid","in":"query","description":"Member ID.","required":true,"type":"integer","format":"int64"},{"name":"zipCode","in":"query","description":"Optional zip code for the price check to use when searching for pharmacy locations. If provided, it will be used instead of the member's address.  This may be useful if the member’s address is incorrect or if a different location is desired.","required":false,"type":"string"},{"name":"page","in":"query","description":"Page number for pagination, default is 1.","required":false,"type":"integer","format":"int32"},{"name":"pageSize","in":"query","description":"Results per page, max 20.","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"Returns a list of store locations.","schema":{"$ref":"#/definitions/PagedResultModel[PortalStoreLocationModel]"}},"400":{"description":"If required parameters are missing or invalid."},"404":{"description":"If no store locations are found."},"500":{"description":"If an internal server error occurs."}}}},"/api/portalstorelocations/{networkID}/{id}":{"get":{"tags":["PortalStoreLocations"],"operationId":"PortalStoreLocations_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"networkID","in":"path","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PortalStoreLocationModel"}}}}},"/api/PriceCheck":{"post":{"tags":["PriceCheck"],"operationId":"PriceCheck_PriceCheck","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"model","in":"body","required":true,"schema":{"$ref":"#/definitions/PriceCheckModel"}}],"responses":{"200":{"description":"Returns a list of PriceCheckDrugModel objects","schema":{"type":"array","items":{"$ref":"#/definitions/PriceCheckResultModel"}}},"400":{"description":"Bad Request","schema":{"type":"string"}}}}},"/api/pricecodes":{"get":{"tags":["PriceCodes"],"summary":"Gets a collection of Price Codes","operationId":"PriceCode_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/PriceCodeModel"}}}}}},"/api/pricecodes/{id}":{"get":{"tags":["PriceCodes"],"summary":"Gets a Price Code","operationId":"PriceCode_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Price Code identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PriceCodeModel"}}}}},"/api/priorauthorizationpersistlimitintervals":{"get":{"tags":["PriorAuthorizationPersistLimitInterval"],"summary":"Gets a collection of Prior Authorization Persist Limit Intervals","operationId":"PriorAuthorizationPersistLimitInterval_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/PriorAuthorizationPersistLimitIntervalModel"}}}}}},"/api/priorauthorizationpersistlimitintervals/{id}":{"get":{"tags":["PriorAuthorizationPersistLimitInterval"],"summary":"Gets a Prior Authorization Persist Limit Interval","operationId":"PriorAuthorizationPersistLimitInterval_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"Prior Authorization Persist Limit Interval identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PriorAuthorizationPersistLimitIntervalModel"}}}}},"/api/groups/{groupid}/priorauthpersistents/{id}/priorauthorizationpersistpharmacies":{"get":{"tags":["PriorAuthorizationPersistPharmacy"],"summary":"Gets a Persistent Prior Authorization Pharmacy object by Persistent Prior Authorization Identifier","operationId":"PriorAuthorizationPersistPharmacy_GetAll","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Persistent Prior Authorization Identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PriorAuthorizationPersistPharmacyModel"}}}},"post":{"tags":["PriorAuthorizationPersistPharmacy"],"summary":"Posts a new Persistent Prior Authorization Pharmacy to an existing group","operationId":"PriorAuthorizationPersistPharmacy_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"priorAuthorizationPersistPharmacyModel","in":"body","description":"A new Persistent Prior Authorization Pharmacy to add to the specified existing group","required":true,"schema":{"$ref":"#/definitions/PriorAuthorizationPersistPharmacyModel"}},{"name":"groupid","in":"path","description":"Group Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Persistent Prior Authorization Identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PriorAuthorizationPersistPharmacyModel"}}}}},"/api/groups/{groupid}/priorauthpersistents/{id}/priorauthorizationpersistpharmacies/{priorAuthorizationPersistPharmacyId}":{"get":{"tags":["PriorAuthorizationPersistPharmacy"],"summary":"Gets a Persistent Prior Authorization Pharmacy object by Persistent Prior Authorization Identifier and Persistent Prior Authorization Pharmacy Identifier","operationId":"PriorAuthorizationPersistPharmacy_GetById","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Persistent Prior Authorization Identifier","required":true,"type":"integer","format":"int64"},{"name":"priorAuthorizationPersistPharmacyId","in":"path","description":"Persistent Prior Authorization Pharmacy Identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PriorAuthorizationPersistPharmacyModel"}}}}},"/api/groups/{groupid}/priorauthpersistents/{id}/priorauthorizationpersistpharmacy/{priorAuthorizationPersistPharmacyId}":{"delete":{"tags":["PriorAuthorizationPersistPharmacy"],"summary":"Deletes a Persistent Prior Authorization Pharmacy by ID","operationId":"PriorAuthorizationPersistPharmacy_Delete","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Persistent Prior Authorization Identifier","required":true,"type":"integer","format":"int64"},{"name":"priorAuthorizationPersistPharmacyId","in":"path","description":"Persistent Prior Authorization Pharmacy Identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}}},"/api/groups/{groupid}/priorauthpersistents":{"get":{"tags":["PriorAuthPersistents"],"summary":"Gets a collection of Persisted Prior Authorizations","operationId":"PriorAuthorizationPersist_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The Group that any returned persistent prior auths will be related to","required":true,"type":"integer","format":"int64"},{"name":"activeDate","in":"query","description":"A date that will be active during the effective period of any returned prior auths","required":false,"type":"string","format":"date-time"},{"name":"memberNo","in":"query","description":"The ID identifying the member that any returned persistent prior auths will be related to","required":false,"type":"integer","format":"int64"},{"name":"cardholderNo","in":"query","description":"The ID identifying the cardholder that any returned persistent prior auths will be related to","required":false,"type":"integer","format":"int64"},{"name":"NDC","in":"query","description":"An NDC used to filter the prior auths that will be returned.  Only persistent prior auths for this NDC will be returned, if provided","required":false,"type":"string"},{"name":"GPI","in":"query","description":"An Generic Product Identifier used to filter the prior auths that will be returned.  Only persistent prior auths for this GPI will be returned, if provided","required":false,"type":"string"},{"name":"rxNumber","in":"query","description":"An Rx# used to filter the prior auths that will be returned.  Only persistent prior auths for this Rx# will be returned, if provided","required":false,"type":"string"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/PriorAuthorizationPersistModel"}}}}},"post":{"tags":["PriorAuthPersistents"],"summary":"Creates a new persistent prior authorization for an existing group.","description":"Validation rules enforced by the API:\r\n- Exactly one of NDC, GenericProductIdentifier, or RxNumber must be provided.\r\n- EffectiveStartDate is required; EffectiveEndDate must be on/after EffectiveStartDate.\r\n- If RxNumber is provided, a Pharmacy NPI list is required (PharmacyNPIs or PharmacyNPI).\r\n- DaysSupply and DaysSupplyLimit are mutually exclusive.\r\n- IngredientCostRateOverride and DispenseFeeOverride must be provided together (both or neither).\r\n- LimitToPrincipalPlans and LimitToAlternatePlans cannot both be true.\r\n- CoinsuranceOverride and OOPCoinsuranceOverride must be between 0 and 1 (use 0.25 for 25%).\r\n- If PlanPricingGroupSeqNo, PlanContractSeqNo, or FormularyTierSeqNo is provided, PlanSeqNo is required and must be valid for the group.\r\n- PlanPricingGroupSeqNo must belong to the same plan as PlanSeqNo.","operationId":"PriorAuthPersistents_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"paPersistModel","in":"body","description":"Request body. Required fields: MemberSeqNo, EffectiveStartDate, and exactly one of NDC, GenericProductIdentifier, or RxNumber.\r\nIf RxNumber is provided, at least one Pharmacy NPI is required (PharmacyNPIs or PharmacyNPI).","required":true,"schema":{"$ref":"#/definitions/PriorAuthorizationPersistModel"}},{"name":"groupid","in":"path","description":"Group identifier from the route.","required":true,"type":"integer","format":"int64"},{"name":"priorAuthID","in":"query","description":"Optional prior auth identifier (currently not used).","required":false,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PriorAuthorizationPersistModel"}}}}},"/api/groups/{groupid}/priorauthpersistents/{id}":{"get":{"tags":["PriorAuthPersistents"],"summary":"Gets a Persistent Prior Authorization object by group and id","operationId":"PriorAuthorizationPersist_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group Identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Persistent Prior Authorization Identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PriorAuthorizationPersistModel"}}}},"patch":{"tags":["PriorAuthPersistents"],"summary":"Patches an existing persistent prior auth","operationId":"PriorAuthPersistents_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Persistent Prior Auth identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target persistent prior auth","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PriorAuthorizationPersistModel"}}}}},"/api/groups/{groupid}/priorauths":{"get":{"tags":["PriorAuths"],"summary":"Get a prior authorization model by group, group plan, and optionally memberNo, and dateOfService startDate and endDate","operationId":"PriorAuths_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"approvedStatus","in":"query","description":"Status of the Prior Auth (null=pending, true=approved, false=rejected)","required":false,"type":"boolean"},{"name":"memberNo","in":"query","description":"Optional memberNo by which the prior auths will be filtered","required":false,"type":"integer","format":"int64"},{"name":"startDate","in":"query","description":"Prior auths for claims on or after this date will be returned, if its provided. If no start date is specified, the last 7 days will be loaded by default","required":false,"type":"string","format":"date-time"},{"name":"endDate","in":"query","description":"Prior auths for claims on or before this date will be returned, if its provided.","required":false,"type":"string","format":"date-time"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/PriorAuthorizationModel"}}}}}},"/api/groups/{groupid}/priorauths/{id}":{"get":{"tags":["PriorAuths"],"summary":"Gets a single prior authorization by its uniqueidentifier and group","operationId":"PriorAuths_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"The group with which a prior auth is associated","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"The identifier representing a prior authorization","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PriorAuthorizationModel"}}}},"patch":{"tags":["PriorAuths"],"summary":"Patches an existing prior auth","operationId":"PriorAuths_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"groupid","in":"path","description":"Group identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"PriorAuth identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target prior auth","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PriorAuthorizationModel"}}}}},"/api/formularies/{formularyid}/formularyproductcoverageexclusions":{"get":{"tags":["ProductCoverageExclusions"],"summary":"Gets a collection of product exclusions tied to the specified formulary","operationId":"FormularyProductCoverageExclusions_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"formularyid","in":"path","description":"The id of the formulary for which product exclusions will be returned","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The 1-based index of the page of product exclusions to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of product exclusions to return per page (optional, 100 by default, max 200)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[ProductCoverageExclusionModel]"}}}},"post":{"tags":["ProductCoverageExclusions"],"summary":"Posts a new Product Coverage Exclusion","operationId":"FormularyProductCoverageExclusions_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"productCoverageExclusionModel","in":"body","description":"","required":true,"schema":{"$ref":"#/definitions/ProductCoverageExclusionModel"}},{"name":"formularyid","in":"path","description":"The id of the formulary for which product coverage exclusion","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/ProductCoverageExclusionModel"}}}}},"/api/formularies/{formularyid}/formularyproductcoverageexclusions/{id}":{"get":{"tags":["ProductCoverageExclusions"],"summary":"Gets a Company Product Exclusion by formulary identifier and company product exclusion identifier","operationId":"FormularyProductCoverageExclusions_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"formularyid","in":"path","description":"The id of the formulary for which product exclusions will be returned","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Gender limit identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/ProductCoverageExclusionModel"}}}},"delete":{"tags":["ProductCoverageExclusions"],"summary":"Deletes a Product Coverage Exclusion by formulary identifier and product coverage exclusion identifier","operationId":"FormularyProductCoverageExclusions_Delete","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"formularyid","in":"path","description":"The id of the formulary product coverage exclusion","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Product Coverage Exclusion identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"object"}}}},"patch":{"tags":["ProductCoverageExclusions"],"summary":"Patches an existing Product Coverage Exclusion object","operationId":"FormularyProductCoverageExclusions_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"formularyid","in":"path","description":"The id of the formulary for which product coverage exclusion","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Product coverage exclusion identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target formulary product coverage exclusion","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/ProductCoverageExclusionModel"}}}}},"/api/globalcompanyquantitylimits":{"get":{"tags":["QuantityLimits"],"summary":"Gets a collection of global Company Quantity Limits","operationId":"GlobalCompanyQuantityLimits_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"page","in":"query","description":"The 1-based index of the page of company quantity limits to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of company quantity limits to return per page (optional, 25 by default, max 100)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[CompanyQuantityLimitModel]"}}}},"post":{"tags":["QuantityLimits"],"summary":"Posts a new Global Company Quantity Limit","operationId":"GlobalCompanyQuantityLimits_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"companyQuantityLimitModel","in":"body","required":true,"schema":{"$ref":"#/definitions/CompanyQuantityLimitModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/CompanyQuantityLimitModel"}}}}},"/api/formularies/{formularyid}/formularycompanyquantitylimits":{"get":{"tags":["QuantityLimits"],"summary":"Gets a collection of quantity limits tied to the specified formulary","operationId":"FormularyCompanyQuantityLimits_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"formularyid","in":"path","description":"The id of the formulary for which quantity limits will be returned","required":true,"type":"integer","format":"int64"},{"name":"page","in":"query","description":"The 1-based index of the page of quantity limits to return (optional, 1 by default)","required":false,"type":"integer","format":"int32"},{"name":"pagesize","in":"query","description":"The number of quantity limits to return per page (optional, 25 by default, max 100)","required":false,"type":"integer","format":"int32"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/PagedResultModel[FormularyCompanyQuantityLimitModel]"}}}},"post":{"tags":["QuantityLimits"],"summary":"Posts a new Formulary Company Quantity Limit","operationId":"FormularyCompanyQuantityLimits_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"formularyCompanyQuantityLimitModel","in":"body","description":"","required":true,"schema":{"$ref":"#/definitions/FormularyCompanyQuantityLimitModel"}},{"name":"formularyid","in":"path","description":"The id of the formulary for which quantity 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Coupon","operationId":"VariableCopayCouponDrug_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"variablecopaycouponid","in":"path","description":"Variable Copay Coupon identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/VariableCopayCouponDrugModel"}}}}},"post":{"tags":["VariableCopayCouponDrugs"],"summary":"Posts a new variableCopayCouponDrug object to the specified variableCopayCoupon record","operationId":"VariableCopayCouponDrugs_Post","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"variableCopayCouponDrugModel","in":"body","description":"The variableCopayCouponDrug to add","required":true,"schema":{"$ref":"#/definitions/VariableCopayCouponDrugModel"}},{"name":"variablecopaycouponid","in":"path","description":"Identifier for the variable copay coupon record to which this drug will be added","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/VariableCopayCouponDrugModel"}}}}},"/api/variablecopaycoupons/{variablecopaycouponid}/VariableCopayCouponDrugs/{id}":{"get":{"tags":["VariableCopayCouponDrugs"],"summary":"Gets a Variable Copay Coupon Drug resource","operationId":"VariableCopayCouponDrug_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"variablecopaycouponid","in":"path","description":"Variable Copay Coupon identifier","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"Variable Copay Coupon Drug identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/VariableCopayCouponDrugModel"}}}}},"/api/variablecopaycoupons/{variableCopayCouponid}/VariableCopayCouponDrugs/{id}":{"patch":{"tags":["VariableCopayCouponDrugs"],"summary":"Patches an existing variable copay coupon drug","operationId":"VariableCopayCouponDrugs_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"variableCopayCouponid","in":"path","description":"Identifier for the variable copay coupon record to which this drug belongs","required":true,"type":"integer","format":"int64"},{"name":"id","in":"path","description":"variable copay coupon drug Identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target rule","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/VariableCopayCouponDrugModel"}}}}},"/api/variablecopaycoupons":{"get":{"tags":["VariableCopayCoupons"],"summary":"Gets a collection of VariableCopayCoupon/Copay resources for a Group Plan","operationId":"VariableCopayCoupons_Get","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"responses":{"200":{"description":"OK","schema":{"type":"array","items":{"$ref":"#/definitions/VariableCopayCouponModel"}}}}},"post":{"tags":["VariableCopayCoupons"],"summary":"Posts a new variableCopayCoupon to an existing group plan","operationId":"VariableCopayCoupons_Add","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"variableCopayCouponModel","in":"body","description":"The variableCopayCoupon model to be added to the specified plan.  VariableCopayCoupon Drugs included in the model will also be added.","required":true,"schema":{"$ref":"#/definitions/VariableCopayCouponModel"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/VariableCopayCouponModel"}}}}},"/api/variablecopaycoupons/{id}":{"get":{"tags":["VariableCopayCoupons"],"summary":"Gets a Variable Copay Coupon resource","operationId":"VariableCopayCoupons_GetByID","consumes":[],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"VariableCopayCoupon identifier","required":true,"type":"integer","format":"int64"}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/VariableCopayCouponModel"}}}},"patch":{"tags":["VariableCopayCoupons"],"summary":"Patches an existing variableCopayCoupon record","operationId":"VariableCopayCoupons_Patch","consumes":["application/json","text/json","application/json-patch+json"],"produces":["application/json","text/json","application/json-patch+json"],"parameters":[{"name":"id","in":"path","description":"VariableCopayCoupon identifier","required":true,"type":"integer","format":"int64"},{"name":"patchDocument","in":"body","description":"The json formatted patch document (https://tools.ietf.org/html/rfc6902) containing operations to apply to the target rule","required":true,"schema":{"$ref":"#/definitions/JsonPatchDocument"}}],"responses":{"200":{"description":"OK","schema":{"$ref":"#/definitions/VariableCopayCouponModel"}}}}}},"definitions":{"TokenModel":{"type":"object","properties":{"token":{"type":"string"},"refreshToken":{"type":"string"}}},"AccumulatorExportSettingsModel":{"description":"Accumulator Export Settings in FacilityBranch_PharmacyBranch","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"accumulatorExportClientID":{"description":"Gets or sets the Accumulator export client ID","maxLength":50,"minLength":0,"type":"string"},"accumulatorExportClientIDFromClaim":{"description":"Gets or sets to use client id from claim","type":"boolean","x-nullable":true},"accumulatorExportARTypes":{"description":"Gets or sets the Accumulator export A/R codes","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"accumulatorExportARClassCodes":{"description":"Gets or sets the Accumulator export A/R classes","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"accumulatorExportIncludeDeductible":{"description":"Gets or sets to include deductibles","type":"boolean","x-nullable":true},"accumulatorExportIncludeDeductibleARTypes":{"description":"Gets or sets the Accumulator export Deductible A/R codes","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"accumulatorExportIncludeDeductibleARClassCodes":{"description":"Gets or sets the Accumulator export Deductible A/R classes","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"accumulatorExportIncludeOOP":{"description":"Gets or sets to include OOP","type":"boolean","x-nullable":true},"accumulatorExportIncludeOOPARTypes":{"description":"Gets or sets the Accumulator export OOP A/R codes","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"accumulatorExportIncludeOOPARClassCodes":{"description":"Gets or sets the Accumulator export OOP A/R classes","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"accumulatorExportIncludePlanPaidAmount":{"description":"Gets or sets to include plan paid amount","type":"boolean","x-nullable":true},"accumulatorExportIncludePlanPaidAmountARTypes":{"description":"Gets or sets the Accumulator export plan paid amount A/R codes","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"accumulatorExportIncludePlanPaidAmountARClassCodes":{"description":"Gets or sets the Accumulator export plan paid amount A/R classes","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"accumulatorExportIncludeClaimAdjustments":{"description":"Gets or sets to include claim adjustments","type":"boolean","x-nullable":true},"accumulatorExportIncludeOtherClaims":{"description":"Gets or sets to include other claims","type":"boolean","x-nullable":true},"accumulatorExportStripCardholderIDPrefix":{"description":"Gets or sets the prefix to strip from cardholder ID","maxLength":20,"minLength":0,"type":"string"},"accumulatorExportAddCardholderIDPrefix":{"description":"Gets or sets the prefix to add to cardholder ID","maxLength":20,"minLength":0,"type":"string"},"accumulatorExportStripCardholderIDSuffix":{"description":"Gets or sets the suffix to strip from cardholder ID","maxLength":20,"minLength":0,"type":"string"},"accumulatorExportAddCardholderIDSuffix":{"description":"Gets or sets the suffix to add to cardholder ID","maxLength":20,"minLength":0,"type":"string"}}},"JsonPatchDocument":{"description":"Array of operations to perform","type":"array","items":{"$ref":"#/definitions/Operation"}},"Operation":{"type":"object","properties":{"op":{"type":"string"},"value":{"type":"object"},"path":{"type":"string"},"from":{"type":"string"}}},"AccumulatorImportSettingsModel":{"description":"Accumulator Import Settings in FacilityBranch_PharmacyBranch","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"accumulatorImportUseARTypesAsClientID":{"description":"Gets or sets if A/R Type is ID","type":"boolean","x-nullable":true},"accumulatorImportClientID":{"description":"Gets or sets ClientID (Accepts multiple values separated by '|')","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"accumulatorImportContainsRxDeductible":{"description":"Gets or sets if contains amounts for Rx deductible","type":"boolean","x-nullable":true},"accumulatorImportContainsRxDeductibleARTypes":{"description":"Gets or sets Rx deductible A/R codes (Accepts multiple values separated by '|')","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"accumulatorImportContainsRxOOP":{"description":"Gets or sets if contains amounts for Rx OOP","type":"boolean","x-nullable":true},"accumulatorImportContainsRxOOPARTypes":{"description":"Gets or sets OOP A/R codes (Accepts multiple values separated by '|')","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"accumulatorImportContainsRxPlanPaidAmount":{"description":"Gets or sets if contains amounts for Rx plan paid","type":"boolean","x-nullable":true},"accumulatorImportContainsRxPlanPaidAmountARTypes":{"description":"Gets or sets plan paid amount A/R codes (Accepts multiple values separated by '|')","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"accumulatorImportApplyDeductible":{"description":"Gets or sets to apply deductible values","type":"boolean","x-nullable":true},"accumulatorImportApplyDeductibleARTypes":{"description":"Gets or sets Rx deductible A/R codes (Accepts multiple values separated by '|')","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"accumulatorImportApplyOOP":{"description":"Gets or sets to apply OOP values","type":"boolean","x-nullable":true},"accumulatorImportApplyOOPARTypes":{"description":"Gets or sets Rx OOP A/R Types to apply (Accepts multiple values separated by '|')","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"accumulatorImportApplyPlanPaidAmount":{"description":"Gets or sets to apply plan paid amount","type":"boolean","x-nullable":true},"accumulatorImportApplyPlanPaidAmountARTypes":{"description":"Gets or sets plan paid A/R Types to apply (Accepts multiple values separated by '|')","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"accumulatorImportApplyDeductibleAsOOP":{"description":"Gets or sets to apply deductible as OOP","type":"boolean","x-nullable":true},"accumulatorImportApplyDeductibleAsOOPARTypes":{"description":"Gets or sets deductible as OOP A/R Types to apply (Accepts multiple values separated by '|')","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"accumulatorImportAddDeductibleToOOP":{"description":"Gets or sets to add deductible values to OOP","type":"boolean","x-nullable":true},"accumulatorImportSkipOutOfNetworkDeductible":{"description":"Gets or sets to ignore deductible values if claim is out of network","type":"boolean","x-nullable":true},"accumulatorImportSkipOutOfNetworkOOP":{"description":"Gets or sets to ignore OOP values if claim is out of network","type":"boolean","x-nullable":true},"accumulatorImportSkipOutOfNetworkPlanPaidAmount":{"description":"Gets or sets to ignore plan paid amount values if claim is out of network","type":"boolean","x-nullable":true},"accumulatorImportAllowBlankValues":{"description":"Gets or sets to allow blank values","type":"boolean","x-nullable":true},"accumulatorImportPeriodBeginMonth":{"description":"Gets or sets the month that the benefit period begins","maxLength":2,"minLength":0,"type":"string"},"accumulatorImportStripCardholderIDPrefix":{"description":"Gets or sets the prefix to strip from cardholder ID","maxLength":20,"minLength":0,"type":"string"},"accumulatorImportAddCardholderIDPrefix":{"description":"Gets or sets the prefix to add from cardholder ID","maxLength":20,"minLength":0,"type":"string"},"accumulatorImportStripCardholderIDSuffix":{"description":"Gets or sets the suffix to strip from cardholder ID","maxLength":20,"minLength":0,"type":"string"},"accumulatorImportAddCardholderIDSuffix":{"description":"Gets or sets the suffix to add from cardholder ID","maxLength":20,"minLength":0,"type":"string"}}},"PagedResultModel[CompanyAgeLimitModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/CompanyAgeLimitModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"CompanyAgeLimitModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"name":{"description":"Gets or sets the description of the age limit resource","type":"string"},"isGlobal":{"description":"Gets or sets whether this is a global age limit resource (true if Global, false if Formulary-level)\r\nObsolete - will be removed at a later date","type":"boolean","x-nullable":true},"minAge":{"format":"int32","description":"Gets or sets the Min Age of the age limit resource","type":"integer","x-nullable":true},"minAgeQualifier":{"description":"Gets or sets the Min Age Qualifier of the age limit resource\r\nD=Days, Y=Years","type":"string"},"maxAge":{"format":"int32","description":"Gets or sets the Max Age of the age limit resource","type":"integer","x-nullable":true},"maxAgeQualifier":{"description":"Gets or sets the Max Age Qualifier of the age limit resource\r\nD=Days, Y=Years","type":"string"},"createdOn":{"format":"date-time","description":"Gets or sets the datetime when the age limit was created","type":"string","x-nullable":true},"auditNote":{"description":"Gets or sets the value indicating (for audit purposes) why the most current change was made","type":"string"},"active":{"description":"Gets or sets the value indicating whether this age limit is currently active.","type":"boolean","x-nullable":true}}},"PagedResultModel[FormularyCompanyAgeLimitModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/FormularyCompanyAgeLimitModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"FormularyCompanyAgeLimitModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"companyAgeLimitNo":{"format":"int64","description":"Gets or sets the value indicating whether this formulary age limit is inheriting from a global/company-level age limit.","type":"integer","x-nullable":true},"companyAgeLimitUrl":{"description":"Gets the url where the global/company-level age limit resource can be found","type":"string","readOnly":true},"productID":{"description":"Gets or sets the product ID for this resource.  The value should be a valid NDC, DDID or GPI.","type":"string"},"productIDType":{"description":"Gets or sets the product ID Type for this resource.  The value will indicate whether the product ID for this resource is an NDC or DDID . \r\nString values other than 'NDC' or 'DDID' will not be valid.","type":"string"},"minAge":{"format":"int32","description":"Gets or sets the Min Age of the age limit resource","type":"integer","x-nullable":true},"minAgeQualifier":{"description":"Gets or sets the Min Age Qualifier of the age limit resource\r\nD=Days, Y=Years","type":"string"},"maxAge":{"format":"int32","description":"Gets or sets the Max Age of the age limit resource","type":"integer","x-nullable":true},"maxAgeQualifier":{"description":"Gets or sets the Max Age Qualifier of the age limit resource\r\nD=Days, Y=Years","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date of this resource","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date of this resource","type":"string","x-nullable":true},"active":{"description":"Gets or sets the value indicating whether this age limit is currently active.","type":"boolean","x-nullable":true}}},"AlternateProcessorModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"alternateProcessorVendorUrl":{"type":"string"},"alternateProcessorVendorNo":{"format":"int64","type":"integer"},"description":{"description":"","type":"string"},"bin":{"description":"","type":"string"},"pcn":{"description":"","type":"string"},"groupID":{"description":"","type":"string"},"approveMessage":{"description":"","type":"string"},"apiKey":{"description":"","type":"string"},"oAuthClientID":{"description":"","type":"string"},"oAuthClientSecret":{"description":"","type":"string"},"clientID":{"description":"","type":"string"},"active":{"description":"","type":"boolean"},"allowPartialFills":{"description":"","type":"boolean","x-nullable":true}}},"AlternateProcessorVendorModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"description":{"description":"The description of the alternate processor vendor.","type":"string"}}},"AppliedNetworkModel":{"description":"Applied Network","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"groupPlanNo":{"format":"int64","description":"Gets or sets the identifier for the Group Plan associated with this Applied Network","type":"integer"},"networkUrl":{"description":"Gets or sets the link to the underyling Network","type":"string"},"networkNo":{"format":"int64","description":"Gets or sets the identifier for the Network associated with this Applied Network","type":"integer"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date for the Applied Network","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date for the Applied Network","type":"string","x-nullable":true},"pharmacyTier":{"description":"Tier associated with the Applied Network","type":"string"},"showInPharmacyLocator":{"description":"Gets or sets the ShowInPharmacyLocator flag, which controls whether the network's pharmacies are displayed in the pharmacy locator via the API or member portal","type":"boolean"}}},"AppliedPharmacyHeadquarterExceptionModel":{"description":"Applied Pharmacy Headquarter Exception","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"appliedPharmacyHeadquarterInclusionsUrl":{"description":"Gets or sets the link of associated pharmacies included for this headquarter exception","type":"string"},"groupPlanNo":{"format":"int64","description":"Gets or sets the identifier for the group plan associated with this Applied Pharmacy Headquarter Exception","type":"integer"},"pharmacyHeadquarterUrl":{"description":"Gets or sets the link to the underlying Pharmacy Headquarter","type":"string"},"pharmacyHeadquarterNo":{"format":"int64","description":"Gets or sets the identifier for the pharmacy headquarter associated with this Applied Pharmacy Headquarter Exception","type":"integer","x-nullable":true},"active":{"description":"Gets or sets whether the exception is active","type":"boolean","x-nullable":true}}},"AppliedPharmacyHeadquarterInclusionModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"appliedPharmacyHeadquarterExceptionNo":{"format":"int64","description":"Gets or sets the identifier for the Applied Pharmacy Headquarter Exception associated with this pharmacy inclusion","type":"integer","x-nullable":true},"npi":{"description":"Gets or sets the NPI for the included pharmacy","type":"string"}}},"PharmacyHeadquarterModel":{"description":"Pharmacy Headquarter","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"description":{"description":"Gets or sets the description of the HQ","type":"string"},"federalTaxID":{"description":"Gets or sets the federal tax id for the HQ","type":"string"},"notes":{"description":"Gets or sets the notes for the HQ","type":"string"},"networkAccessFee":{"format":"double","description":"Gets or sets the fee for submitted claims","type":"number","x-nullable":true},"networkAccessFeeManualClaim":{"format":"double","description":"Gets or sets the fee for manually submitted claims","type":"number","x-nullable":true},"inactive":{"description":"Gets or sets whether the HQ is inactive","type":"boolean","x-nullable":true},"networkAccessFeeUsualAndCustomary":{"format":"double","description":"Gets or sets the fee for claims that use usual and customary","type":"number","x-nullable":true},"networkAccessFeeManualClaimUsualAndCustomary":{"format":"double","description":"Gets or sets the fee for manual claims that use usual and customary","type":"number","x-nullable":true},"parentCode":{"description":"Gets or sets the parent organization","type":"string"},"defaultPaymentPayablesCenterNo":{"format":"int64","description":"Gets or sets Default Payment Payables Center","type":"integer","x-nullable":true},"defaultPaymentPayablesCenterUrl":{"description":"Gets or sets the Default Payment Payables Center Url","type":"string"},"defaultRemitPayablesCenterNo":{"format":"int64","description":"Gets or sets Default Remit Payables Center","type":"integer","x-nullable":true},"defaultRemitPayablesCenterUrl":{"description":"Gets or sets the Default Remit Payables Center Url","type":"string"},"alwaysUseDefaultPaymentPayablesCenter":{"description":"Gets or sets value for whether to Always Use Default Payment Payables Center","type":"boolean"},"alwaysUseDefaultRemitPayablesCenter":{"description":"Gets or sets value for whether to Always Use Default Remit Payables Center","type":"boolean"},"networkAccessFeeReversalNo":{"format":"int64","description":"Gets or sets type of reversals allowed for Network Access Fee for submitted claims","type":"integer","x-nullable":true},"networkAccessFeeReversalUrl":{"description":"Gets or sets the Network Access Fee Reversal Url","type":"string"},"networkAccessFeeManualClaimReversalNo":{"format":"int64","description":"Gets or sets type of reversals allowed for Network Access Fee Manual Claims","type":"integer","x-nullable":true},"networkAccessFeeManualClaimReversalUrl":{"description":"Gets or sets the Network Access Fee Manual Claim Reversal Url","type":"string"},"networkAccessFeeUsualAndCustomaryReversalNo":{"format":"int64","description":"Gets or sets type of reversals allowed for Network Access Fee (U/C)","type":"integer","x-nullable":true},"networkAccessFeeUsualAndCustomaryReversalUrl":{"description":"Gets or sets the Network Access Fee Usual and Customary Reversal Url","type":"string"},"networkAccessFeeManualClaimUsualAndCustomaryReversalNo":{"format":"int64","description":"Gets or sets types of reversal allowed for Network Access Fee Manual (U/C)","type":"integer","x-nullable":true},"networkAccessFeeManualClaimUsualAndCustomaryReversalUrl":{"description":"Gets or sets the Network Access Fee Manual Claim Usual and Customary Reversal Url","type":"string"},"fallbackPharmacyHeadquarterNo":{"format":"int64","description":"Gets or sets fallback pharmacy headquarters","type":"integer","x-nullable":true},"fallbackPharmacyHeadquarterUrl":{"description":"Gets or sets the Fallback Pharmacy Headquarter Url","type":"string"},"headquarterPricingPlansUrl":{"description":"Gets or sets the Headquarter Pricing Plans Url.  These represent the headquarter plans used for pricing that are editable from the Global &gt; Pharmacy HQ Maintenance page\r\nin the grid labeled \"Pricing\".  The endpoint at this URL only contains the HQ Plans, not the global plans.  Use the HeadquarterGlobalPricingPlansUrl to navigate to the \r\nglobal plans for this Pharmacy HQ.","type":"string"},"headquarterGlobalPricingPlansUrl":{"description":"Gets or sets the Headquarter Global Pricing Plans Url.  These represent the global headquarter plans used for pricing that are editable from the Global &gt; Pharmacy HQ Maintenance page\r\nin the grid labeled \"Pricing\" - those plans marked \"Y\" for global.   The endpoint at this URL only contains the global plans used for pricing.  Use the HeadquarterPricingPlansUrl to navigate to the \r\nnon-global plans for this Pharmacy HQ.","type":"string"},"pharmacyLocationsUrl":{"description":"Gets or sets the Pharmacy Locations Url","type":"string"},"relationshipCodes":{"description":"Gets or sets the Relationship Code list","type":"array","items":{"$ref":"#/definitions/PharmacyHeadquarterCodeModel"}},"networks":{"description":"Gets or sets Network list","type":"array","items":{"$ref":"#/definitions/NetworkPharmacyHeadquarterModel"}},"payablesCentersUrl":{"description":"Gets or sets the Payables Centers Url","type":"string"}}},"PharmacyHeadquarterCodeModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"code":{"description":"Code value","type":"string"},"relationshipName":{"description":"Display name","type":"string"},"relationshipType":{"description":"Display name of relationship code type","type":"string"}}},"NetworkPharmacyHeadquarterModel":{"description":"NetworkPharmacyHeadquarter","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"pharmacyHeadquarterNo":{"format":"int64","description":"Gets or sets the pharmacy headquarter identifier","type":"integer"},"pharmacyHeadquarterName":{"description":"Gets or sets the pharmacy headquarter name","type":"string"},"pharmacyHeadquarterInactive":{"description":"Gets or sets whether the pharmacy headquarter is inactive","type":"boolean","x-nullable":true},"planNo":{"format":"int64","description":"Gets or sets the Plan number","type":"integer","x-nullable":true},"planName":{"description":"Gets or sets the Plan name","type":"string"},"networkNo":{"format":"int64","description":"Gets or sets the Network number","type":"integer","x-nullable":true},"networkName":{"description":"Gets or sets the Network name","type":"string"},"comment":{"description":"Gets or sets the comment for the network pharmacy headquarter","type":"string"}}},"BenefitCheckModel":{"description":"Benefit Check object used in the Benefit Check api","type":"object","properties":{"claimHistories":{"description":"Collection of objects showing claim history for different time periods","type":"array","items":{"$ref":"#/definitions/AuditClaimHistoryModel"}},"maxOutOfPockets":{"description":"Collection of Max Out Of Pocket Checks associated with a plan/member whose benefit details are being requested","type":"array","items":{"$ref":"#/definitions/MOOPCheckModel"}},"deductibles":{"description":"Collection of Deductible Checks associated with a plan/member whose benefit details are being requested","type":"array","items":{"$ref":"#/definitions/DeductibleCheckModel"}}}},"AuditClaimHistoryModel":{"type":"object","properties":{"amountAppliedToPeriodicDeductibleMember":{"format":"double","description":"Amount applied to periodic deductible for member","type":"number","x-nullable":true},"amountAppliedToPeriodicDeductibleFamily":{"format":"double","description":"Amount applied to periodic deductible for family","type":"number","x-nullable":true},"amountEligibleTowardsDeductibleMember":{"format":"double","description":"Dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a person deductible","type":"number","x-nullable":true},"amountEligibleTowardsDeductibleFamily":{"format":"double","description":"Dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a family deductible","type":"number","x-nullable":true},"amountEligibleTowardsOutOfPocketLimitMember":{"format":"double","description":"Dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a person max out of pocket limit","type":"number","x-nullable":true},"amountEligibleTowardsOutOfPocketLimitFamily":{"format":"double","description":"Dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a family max out of pocket limit","type":"number","x-nullable":true},"planPaidAmountMember":{"format":"double","description":"Dollar amount of claims during the specified interval and for a benefit code (if supplied) that the plan has paid for a member","type":"number","x-nullable":true},"planPaidAmountFamily":{"format":"double","description":"Dollar amount of claims during the specified interval and for a benefit code (if supplied) that the plan has paid for a member's family","type":"number","x-nullable":true},"planIncentiveAmountMember":{"format":"double","description":"Dollar amount of claims during the specified interval and for a benefit code (if supplied) that apply toward a plan incentive for a member","type":"number","x-nullable":true},"startDate":{"format":"date-time","description":"Start date of the period for which the claim dollar amounts apply","type":"string","x-nullable":true},"endDate":{"format":"date-time","description":"End date of the period for which the claim dollar amounts apply","type":"string","x-nullable":true},"interval":{"description":"Interval for which the claim dollar amounts apply (M=Month, P=Period, L=Lifetime)","type":"string"},"benefitCodeDescription":{"description":"If a benefit code description is present here, the amounts for MOOP, deductible and plan incentive only apply to this benefit code","type":"string"},"rxDeductibleMember":{"format":"double","description":"Rx dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a person deductible","type":"number","x-nullable":true},"rxDeductibleFamily":{"format":"double","description":"Rx dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a family deductible","type":"number","x-nullable":true},"rxDeductibleAppliedMember":{"format":"double","description":"Amount applied to periodic deductible for member for Rx claims only","type":"number","x-nullable":true},"rxDeductibleAppliedFamily":{"format":"double","description":"Amount applied to periodic deductible for member for Rx claims only","type":"number","x-nullable":true},"rxOutOfPocketLimitMember":{"format":"double","description":"Rx dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a person max out of pocket limit","type":"number","x-nullable":true},"rxOutOfPocketLimitFamily":{"format":"double","description":"Rx dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a family max out of pocket limit","type":"number","x-nullable":true},"rxPlanPaidAmountMember":{"format":"double","description":"Rx dollar amount of claims during the specified interval and for a benefit code (if supplied) that the plan has paid for a member","type":"number","x-nullable":true},"rxPlanPaidAmountFamily":{"format":"double","description":"Rx dollar amount of claims during the specified interval and for a benefit code (if supplied) that the plan has paid for a member's family","type":"number","x-nullable":true},"accumulatorDeductibleMember":{"format":"double","description":"Accumulator dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a person deductible","type":"number","x-nullable":true},"accumulatorDeductibleFamily":{"format":"double","description":"Accumulator dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a family deductible","type":"number","x-nullable":true},"accumulatorDeductibleAppliedMember":{"format":"double","description":"Amount applied to periodic deductible for member for medical accumulator only","type":"number","x-nullable":true},"accumulatorDeductibleAppliedFamily":{"format":"double","description":"Amount applied to periodic deductible for member for medical accumulator only","type":"number","x-nullable":true},"accumulatorOutOfPocketLimitMember":{"format":"double","description":"Accumulator dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a person max out of pocket limit","type":"number","x-nullable":true},"accumulatorOutOfPocketLimitFamily":{"format":"double","description":"Accumulator dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a family max out of pocket limit","type":"number","x-nullable":true},"accumulatorPlanPaidAmountMember":{"format":"double","description":"Accumulator dollar amount of claims during the specified interval and for a benefit code (if supplied) that the plan has paid for a member","type":"number","x-nullable":true},"accumulatorPlanPaidAmountFamily":{"format":"double","description":"Accumulator dollar amount of claims during the specified interval and for a benefit code (if supplied) that the plan has paid for a member's family","type":"number","x-nullable":true},"otherClaimDeductibleMember":{"format":"double","description":"Other claim dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a person deductible","type":"number","x-nullable":true},"otherClaimDeductibleFamily":{"format":"double","description":"Other claim dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a family deductible","type":"number","x-nullable":true},"otherClaimDeductibleAppliedMember":{"format":"double","description":"Amount applied to periodic deductible for member for other claims only","type":"number","x-nullable":true},"otherClaimDeductibleAppliedFamily":{"format":"double","description":"Amount applied to periodic deductible for member for other claims only","type":"number","x-nullable":true},"otherClaimOutOfPocketLimitMember":{"format":"double","description":"Other claim dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a person max out of pocket limit","type":"number","x-nullable":true},"otherClaimOutOfPocketLimitFamily":{"format":"double","description":"Other claim dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a family max out of pocket limit","type":"number","x-nullable":true},"otherClaimPlanPaidAmountMember":{"format":"double","description":"Other claim dollar amount of claims during the specified interval and for a benefit code (if supplied) that the plan has paid for a member","type":"number","x-nullable":true},"otherClaimPlanPaidAmountFamily":{"format":"double","description":"Other claim dollar amount of claims during the specified interval and for a benefit code (if supplied) that the plan has paid for a member's family","type":"number","x-nullable":true},"claimAdjDeductibleMember":{"format":"double","description":"Claim adjustment dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a person deductible","type":"number","x-nullable":true},"claimAdjDeductibleFamily":{"format":"double","description":"Claim adjustment dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a family deductible","type":"number","x-nullable":true},"claimAdjDeductibleAppliedMember":{"format":"double","description":"Amount applied to periodic deductible for member for claim adjustments only","type":"number","x-nullable":true},"claimAdjDeductibleAppliedFamily":{"format":"double","description":"Amount applied to periodic deductible for member for claim adjustments only","type":"number","x-nullable":true},"claimAdjOutOfPocketLimitMember":{"format":"double","description":"Claim adjustment dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a person max out of pocket limit","type":"number","x-nullable":true},"claimAdjOutOfPocketLimitFamily":{"format":"double","description":"Claim adjustment dollar amount of claims during the specified interval and for a benefit code (if supplied) that count toward a family max out of pocket limit","type":"number","x-nullable":true},"claimAdjPlanPaidAmountMember":{"format":"double","description":"Claim adjustment dollar amount of claims during the specified interval and for a benefit code (if supplied) that the plan has paid for a member","type":"number","x-nullable":true},"claimAdjPlanPaidAmountFamily":{"format":"double","description":"Claim adjustment dollar amount of claims during the specified interval and for a benefit code (if supplied) that the plan has paid for a member's family","type":"number","x-nullable":true}}},"MOOPCheckModel":{"type":"object","properties":{"isPeriodMOOPMet":{"description":"Read-only property used during a benefit check indicating whether the max out of pocket has been met for a period","type":"boolean","x-nullable":true},"moop":{"$ref":"#/definitions/MaxOutOfPocketModel"}}},"DeductibleCheckModel":{"description":"Deductible Check object used in the Benefit Check api","type":"object","properties":{"isPeriodDeductibleMet":{"description":"Value set during a benefit check indicating whether the deductible has been met for a period","type":"boolean","x-nullable":true},"deductible":{"$ref":"#/definitions/DeductibleModel","description":"Deductible values returned as a result of a Deductible/Benefit check"}}},"MaxOutOfPocketModel":{"description":"Max Out of Pocket","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"groupPlanNo":{"format":"int64","description":"Gets or sets the identifier for the Group Plan associated with this MaxOutOfPocket","type":"integer","x-nullable":true},"description":{"description":"Gets or sets the description of this max out of pocket resource","type":"string"},"personAmount":{"format":"double","description":"Gets or sets the max out of pocket amount for members\r\n*DEPRECATED - moved to MaxOutOfPocketRates. will be removed at a later date","type":"number","x-nullable":true},"familyAmount":{"format":"double","description":"Gets or sets the max out of pocket amount for families\r\n*DEPRECATED - moved to MaxOutOfPocketRates. will be removed at a later date","type":"number","x-nullable":true},"memberPortalDescription":{"description":"Gets or sets the description to show on the member portal","type":"string"},"maxOutOfPocketRates":{"description":"Gets or sets the MaxOutOfPocketRates associated with this MaxOutOfPocket model","type":"array","items":{"$ref":"#/definitions/MaxOutOfPocketRateModel"}}}},"DeductibleModel":{"description":"Deductible","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"groupPlanNo":{"format":"int64","description":"Gets or sets the identifier for the Group Plan associated with this deductible","type":"integer","x-nullable":true},"description":{"description":"Gets or sets the description of the deductible resource","type":"string"},"personAmount":{"format":"double","description":"Gets or sets the deductible amount for members\r\n*DEPRECATED - moved to DeductibleRates. will be removed at a later date","type":"number","x-nullable":true},"familyAmount":{"format":"double","description":"Gets or sets the deductible amount for families\r\n*DEPRECATED - moved to DeductibleRates. will be removed at a later date","type":"number","x-nullable":true},"memberPortalDescription":{"description":"Gets or sets the description to show on the member portal","type":"string"},"deductibleRates":{"description":"Gets or sets the deductibleRates associated with this deductible model","type":"array","items":{"$ref":"#/definitions/DeductibleRateModel"}}}},"MaxOutOfPocketRateModel":{"description":"Max Out Of Pocket Rate","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date of the max out of pocket rate","type":"string"},"personAmount":{"format":"double","description":"Gets or sets the max out of pocket amount for members","type":"number","x-nullable":true},"familyAmount":{"format":"double","description":"Gets or sets the max out of pocket amount for families","type":"number","x-nullable":true},"maxOutOfPocketNo":{"format":"int64","description":"Gets or sets the max out of pocket id","type":"integer"}}},"DeductibleRateModel":{"description":"Deductible Rate","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date of the deductible rate","type":"string"},"personAmount":{"format":"double","description":"Gets or sets the deductible amount for members","type":"number","x-nullable":true},"familyAmount":{"format":"double","description":"Gets or sets the deductible amount for families","type":"number","x-nullable":true},"deductibleNo":{"format":"int64","description":"Gets or sets the deductible id","type":"integer"}}},"BenefitCodeModel":{"description":"Benefit Code","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"groupNo":{"format":"int64","description":"Gets or sets the group No for the pharmacy branch","type":"integer"},"code":{"description":"Gets or sets the code of the benefit code","type":"string"},"description":{"description":"Gets or sets the description of the benefit code","type":"string"}}},"BenefitPeriodModel":{"description":"Benefit Period","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"planContractNo":{"format":"int64","description":"Gets or sets the identifier for the Plan Contract associated with this benefit period","type":"integer"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date of the benefit period","type":"string"},"facilityARTypeNo":{"format":"int64","description":"Gets or sets the Facility AR Type of the benefit period.  This value is not required.","type":"integer","x-nullable":true},"facilityARTypeUrl":{"description":"Url for the facility AR Type resource of this benefit period.","type":"string"}}},"BillingGroupModel":{"description":"Billing Group","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"name":{"description":"Gets or sets the Name","type":"string"},"streetAddress":{"description":"Gets or sets the Street Address","type":"string"},"streetAddressLineTwo":{"description":"Gets or sets the Street Address Line 2","type":"string"},"city":{"description":"Gets or sets the City","type":"string"},"stateCode":{"description":"Gets or sets the State Code","type":"string"},"zipCode":{"description":"Gets or sets the Zip code","type":"string"},"phoneNumber":{"description":"Gets or sets the Phone number","type":"string"},"phoneExt":{"description":"Gets or sets the Phone extension","type":"string"},"faxNumber":{"description":"Gets or sets the Fax number","type":"string"},"contactName":{"description":"Gets or sets the Contact name","type":"string"},"contactTitle":{"description":"Gets or sets the Contact title","type":"string"},"contactEmailAddress":{"description":"Gets or sets the Contact Email address","type":"string"},"notes":{"description":"Gets or sets the Notes","type":"string"}}},"BrandNameCodeModel":{"type":"object","properties":{"displayName":{"type":"string"}}},"ClaimAdjustmentResponseModel":{"description":"Claim Adjustment","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"rxCPersonID":{"format":"int64","description":"Gets or sets the RxClearinghouse Person ID","type":"integer","x-nullable":true},"dateOfBirth":{"format":"date-time","description":"Gets or sets the member's Date of Birth.","type":"string","x-nullable":true},"cardholderID":{"description":"Gets or sets the member's cardholder Id","type":"string"},"planPaidAmount":{"format":"double","description":"Gets or sets the amount paid by the plan.","type":"number"},"patientPayAmount":{"format":"double","description":"Gets or sets the amount paid by the patient.","type":"number"},"amountAppliedToPeriodicDeductible":{"format":"double","description":"Gets or sets the amount applied to the periodic deductible.","type":"number"},"amountEligibleTowardsDeductible":{"format":"double","description":"Gets or sets the amount eligible towards the deductible.","type":"number"},"amountEligibleTowardsOutOfPocketLimit":{"format":"double","description":"Gets or sets the amount eligible towards the out-of-pocket limit.","type":"number"},"planIncentiveAmount":{"format":"double","description":"Gets or sets the plan incentive amount.","type":"number"},"amountOfCopay":{"format":"double","description":"Gets or sets the amount of copay.","type":"number"},"amountOfCoinsurance":{"format":"double","description":"Gets or sets the amount of coinsurance.","type":"number"},"amountOfCopayCoinsurance":{"format":"double","description":"Gets or sets the amount of copay and coinsurance combined.","type":"number"},"amountAttributedToProductSelection":{"format":"double","description":"Gets or sets the amount attributed to product selection.","type":"number"},"amountExceedingPeriodicBenefitMaximum":{"format":"double","description":"Gets or sets the amount exceeding the periodic benefit maximum.","type":"number"},"note":{"description":"Gets or sets additional notes.","type":"string"},"createdOn":{"format":"date-time","description":"Gets or sets created on timestamp.","type":"string","x-nullable":true}}},"ClaimAdjustmentModel":{"description":"Claim Adjustment","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"rxCPersonID":{"format":"int64","description":"Gets or sets the RxClearinghouse Person ID.\r\n<para>\r\n**Member Identification Requirement:**<br />\r\nEither RxCPersonID *or* both {ClaimsAPI.Models.ClaimAdjustmentModel.CardholderID} and {ClaimsAPI.Models.ClaimAdjustmentModel.DateOfBirth} must be provided.<br />\r\nIf RxCPersonID is provided:\r\n<ul><li>It must correspond to a member in the company.</li><li>The member's ID must match the MemberID on the claim.</li></ul></para>","type":"integer","x-nullable":true},"dateOfBirth":{"format":"date-time","description":"Gets or sets the member's Date of Birth.\r\n<para>\r\n**Member Identification Requirement:**<br />\r\nRequired if {ClaimsAPI.Models.ClaimAdjustmentModel.CardholderID} is provided.<br />\r\nIf both {ClaimsAPI.Models.ClaimAdjustmentModel.CardholderID} and DateOfBirth are provided:\r\n<ul><li>They must match the member associated with the claim.</li></ul></para>","type":"string","x-nullable":true},"cardholderID":{"description":"Gets or sets the member's cardholder ID.\r\n<para>\r\n**Member Identification Requirement:**<br />\r\nRequired if {ClaimsAPI.Models.ClaimAdjustmentModel.DateOfBirth} is provided.<br />\r\nIf both CardholderID and {ClaimsAPI.Models.ClaimAdjustmentModel.DateOfBirth} are provided:\r\n<ul><li>They must match the member associated with the claim.</li></ul></para>","type":"string"},"planPaidAmount":{"format":"double","description":"Gets or sets the amount paid by the plan.\r\n<para>\r\n**Financial Balance Requirement:**<br />\r\nThe sum of PlanPaidAmount and {ClaimsAPI.Models.ClaimAdjustmentModel.PatientPayAmount} must equal zero.\r\n</para>","type":"number"},"patientPayAmount":{"format":"double","description":"Gets or sets the amount paid by the patient.\r\n<para>\r\n**Financial Balance Requirement:**<br />\r\nThe sum of {ClaimsAPI.Models.ClaimAdjustmentModel.PlanPaidAmount} and PatientPayAmount must equal zero.\r\n</para>","type":"number"},"amountAppliedToPeriodicDeductible":{"format":"double","description":"Gets or sets the amount applied to the periodic deductible.","type":"number"},"amountEligibleTowardsDeductible":{"format":"double","description":"Gets or sets the amount eligible towards the deductible.","type":"number"},"amountEligibleTowardsOutOfPocketLimit":{"format":"double","description":"Gets or sets the amount eligible towards the out-of-pocket limit.","type":"number"},"planIncentiveAmount":{"format":"double","description":"Gets or sets the plan incentive amount.","type":"number"},"amountOfCopay":{"format":"double","description":"Gets or sets the amount of copay.","type":"number"},"amountOfCoinsurance":{"format":"double","description":"Gets or sets the amount of coinsurance.","type":"number"},"amountOfCopayCoinsurance":{"format":"double","description":"Gets or sets the combined amount of copay and coinsurance.","type":"number"},"amountAttributedToProductSelection":{"format":"double","description":"Gets or sets the amount attributed to product selection.","type":"number"},"amountExceedingPeriodicBenefitMaximum":{"format":"double","description":"Gets or sets the amount exceeding the periodic benefit maximum.","type":"number"},"note":{"description":"Gets or sets additional notes.","type":"string"}}},"ValidationErrorModel":{"type":"object","properties":{"message":{"type":"string"},"fields":{"type":"array","items":{"type":"string"}}}},"ClaimTagItemModel":{"description":"Coinsurance","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"itemText":{"description":"Gets or sets the item text of the claim tag item resource","type":"string"}}},"ClaimTagModel":{"description":"Claim Tag","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"tagName":{"description":"Gets or sets the tag name of the claim tag resource","type":"string"},"description":{"description":"Gets or sets the description of the claim tag resource","type":"string"},"claimTagItems":{"description":"Gets or sets the claim tag items associated with this claim tag model","type":"array","items":{"$ref":"#/definitions/ClaimTagItemModel"}}}},"FormularyCMPPModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"name":{"description":"Gets or sets the Name","type":"string"},"effectiveDate":{"format":"date-time","description":"Gets or sets the Effective Date","type":"string","x-nullable":true}}},"PagedResultModel[FormularyProductCMPPModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/FormularyProductCMPPModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"FormularyProductCMPPModel":{"description":"Formulary Product CMPP Model","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"productID":{"description":"Gets or sets the product identifier","type":"string"},"productIDType":{"description":"Gets or sets the product id type (e.g. DDID)","type":"string"},"tier":{"format":"int32","description":"Gets or sets the tier number for which the product is under","type":"integer"},"tierName":{"description":"Gets or sets the tier name","type":"string"},"drugName":{"description":"Gets or sets the product's drug name","type":"string"},"genericName":{"description":"Gets or sets the product's generic name","type":"string"},"dosageForm":{"description":"Gets or sets the products dosage form","type":"string"},"dosageFormDescription":{"description":"Gets or sets the products dosage form description","type":"string"},"strength":{"description":"Gets or sets the product's strength","type":"string"},"strengthUnitOfMeasure":{"description":"Gets or sets the product's strength unit of measure","type":"string"},"strengthDescription":{"description":"Gets or sets the product's strength description","type":"string"},"drugAndStrength":{"description":"Gets or sets the product's drug and strength","type":"string"},"routeOfAdministration":{"description":"Gets or sets the product's Route of Administration","type":"string"},"isBrand":{"description":"Gets or sets whether the product is a brand or generic product","type":"boolean","x-nullable":true},"therapeuticGroup":{"description":"Gets or sets the product's therapeutic group","type":"string"},"quantity":{"format":"double","description":"Gets or sets the default quantity to that the CMPPPrice is based on","type":"number"},"networkPriceInfo":{"description":"Gets or sets the product's Network pricing information","type":"array","items":{"$ref":"#/definitions/NetworkPriceInfoModel"}}}},"NetworkPriceInfoModel":{"description":"Network Price Info Model","type":"object","properties":{"networkName":{"description":"Gets or sets the network name","type":"string"},"avgWAC":{"format":"double","description":"Gets or sets the average wholesale acquisition cost (price per unit)","type":"number","x-nullable":true},"cmppPrice":{"format":"double","description":"Gets or sets the CMPP Price (price based on quantity supplied in the Quantity field)","type":"number","x-nullable":true},"logoURL":{"description":"Gets or sets the link to the network's logo","type":"string"},"seqNo":{"format":"int64","description":"Gets or sets the sequence number for the network","type":"integer"}}},"CoinsuranceRateModel":{"description":"Coinsurance","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"daysSupply":{"format":"int32","description":"Gets or sets the days supply of the coinsurance rate","type":"integer"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date of the coinsurance rate","type":"string","x-nullable":true},"coinsRate":{"format":"double","description":"Gets or sets the coinsurance rate (Enter the percentage in decimal form (e.g., 0.25 for 25%))","type":"number","x-nullable":true},"coinsMin":{"format":"double","description":"Gets or sets the coinsurance min of the coinsurance rate","type":"number","x-nullable":true},"coinsMax":{"format":"double","description":"Gets or sets the coinsurance max of the coinsurance rate","type":"number","x-nullable":true},"copayAmount":{"format":"double","description":"Gets or sets the copay amount of the coinsurance rate","type":"number","x-nullable":true},"planPaidMax":{"format":"double","description":"Gets or sets the max plan responsibility amount of the coinsurance rate","type":"number","x-nullable":true},"inactive":{"description":"Gets or sets whether the coinsurance rate is inactive","type":"boolean"},"coinsuranceNo":{"format":"int64","description":"Gets or sets whether the coinsurance rate is inactive","type":"integer"}}},"PagedResult[CoinsuranceModel]":{"type":"object","properties":{"pageIndex":{"format":"int32","type":"integer","readOnly":true},"pageSize":{"format":"int32","type":"integer","readOnly":true},"totalCount":{"format":"int32","type":"integer"},"totalPageCount":{"format":"int32","type":"integer"},"items":{"type":"array","items":{"$ref":"#/definitions/CoinsuranceModel"},"readOnly":true},"hasPreviousPage":{"type":"boolean","readOnly":true},"hasNextPage":{"type":"boolean","readOnly":true}}},"CoinsuranceModel":{"description":"Coinsurance","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"groupPlanNo":{"format":"int64","description":"Gets or sets the identifier for the Group Plan associated with this Coinsurance","type":"integer","x-nullable":true},"description":{"description":"Gets or sets the description of the coinsurance resource","type":"string"},"isMinimumAmount":{"description":"Gets or sets whether the plan will use as minimum amount for ingredient cost (including tax) if calculated price is less","type":"boolean","x-nullable":true},"applyCoinsuranceFirst":{"description":"Gets or sets whether the plan will apply coinsurance before the copay is applied","type":"boolean","x-nullable":true},"coinsuranceRates":{"description":"Gets or sets the coinsuranceRates associated with this coinsurance model","type":"array","items":{"$ref":"#/definitions/CoinsuranceRateModel"}}}},"CompanyModel":{"description":"Company","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"companyName":{"description":"Company Name","type":"string"},"ruleChangeNoteRequired":{"description":"Indicates if rule changes require a note for the change","type":"boolean"},"groups":{"description":"A list of groups associated with the Company","type":"array","items":{"$ref":"#/definitions/GroupModel"}}}},"GroupModel":{"description":"Group","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"groupName":{"description":"Gets or sets the name of the location representing the group","type":"string"},"groupPlans":{"description":"Gets or sets the list of Group Plans utilized by the Group","type":"array","items":{"$ref":"#/definitions/GroupPlanModel"}}}},"GroupPlanModel":{"description":"Group Plan","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the 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Pricing Groups resource for the plan","type":"string"},"groupNo":{"format":"int64","description":"Gets or sets the identifier for the Group/Employer Group/Branch","type":"integer","x-nullable":true},"planName":{"description":"Gets or sets the name given to represent the Plan","type":"string"},"groupName":{"description":"Gets or sets the alternative name given to the Group","type":"string"},"description":{"description":"Gets or sets the description given to represent the plan","type":"string"},"bin":{"description":"Gets or sets the BIN used for claims processing","type":"string"},"pcn":{"description":"Gets or sets the PCN used for claims processing","type":"string"},"validatePCN":{"description":"Gets or sets whether the PCN should match when processing claims","type":"boolean","x-nullable":true},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the date the plan is 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If not provided, the plan is active indefinitely","type":"string","x-nullable":true},"basePerDiemUrl":{"description":"Gets or sets the link to the Base Per Diem resource for the plan","type":"string"},"basePerDiemNo":{"format":"int64","description":"Gets or sets the identifier for the Base Per Diem used for the plan","type":"integer","x-nullable":true},"newStartDays":{"format":"int32","description":"Gets or sets the number of days that must lapse before drug is considered new.  Ex: Setting to 365 days would require the member to have stopped therapy for 365 days before it's considered new therapy again.","type":"integer","x-nullable":true},"maxClaimDays":{"format":"int32","description":"Gets or sets the maximum number of days the plan allows for submitting a claim based on the date of service","type":"integer","x-nullable":true},"maxReversalDays":{"format":"int32","description":"Gets or sets the maximum number days the plan allows for reversing a claim","type":"integer","x-nullable":true},"defaultDrugTier":{"format":"int32","description":"Gets or sets the the default Tier captured if not specified on the formulary","type":"integer","x-nullable":true},"enforceFormularyLimits":{"description":"Gets or sets the option to enforce formulary limits","type":"boolean","x-nullable":true},"standardMessage":{"description":"Gets or sets the standard message in the claim header","type":"string"},"approveMessage":{"description":"Gets or sets the approve message in the claim header when claim is paid","type":"string"},"requiredOverrideMessage":{"description":"Gets or sets the prior authorization message in the claim header when drug requires a PA","type":"string"},"notCoveredMessage":{"description":"Gets or sets the not covered message in the claim header when drug is not covered","type":"string"},"outOfPocketMessage":{"description":"Gets or sets the out of pocket message in the claim header when out of pocket limit has been reached","type":"string"},"helpDeskPhoneNumber":{"description":"Gets or sets the help desk phone number","type":"string"},"unknownDispenseFee":{"format":"double","description":"Gets or sets the the catch-all dispense fee for the plan (obsolete)","type":"number","x-nullable":true},"unknownUseSubmittedDispenseFee":{"description":"Gets or sets whether to use the submitted dispense fee for unknown/undefined drugs (obsolete)","type":"boolean","x-nullable":true},"unknownUseUsualAndCustomary":{"description":"Gets or sets whether to use Usual and Customary for unknown/undefined drugs (obsolete)","type":"boolean","x-nullable":true},"unknownUseGrossAmountDue":{"description":"Gets or sets whether to use Gross Amount Due for unknown/undefined drugs (obsolete)","type":"boolean","x-nullable":true},"unknownCoinsuranceUrl":{"description":"Gets or sets the link to the Coinsurance resource for unkown or undefined drugs","type":"string"},"unknownCoinsuranceNo":{"format":"int64","description":"Gets or sets the identifier for the Copay/Coinsurance used for unknown or undefined drugs","type":"integer","x-nullable":true},"unknownOutOfPocketCoinsuranceUrl":{"description":"Gets or sets the link to the Coinsurance resource for unkown or undefined drugs after out of pocket limits have been reached","type":"string"},"unknownOutOfPocketCoinsuranceNo":{"format":"int64","description":"Gets or sets the link to the identifier for the Copay/Coinsurance used for unknown or undefined drugs after out of pocket limits have been 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dispense fee to be applied for a compound (level of effort 0) (obsolete)","type":"number","x-nullable":true},"compoundEffort1Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 1 (obsolete)","type":"number","x-nullable":true},"compoundEffort2Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 2 (obsolete)","type":"number","x-nullable":true},"compoundEffort3Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 3 (obsolete)","type":"number","x-nullable":true},"compoundEffort4Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 4 (obsolete)","type":"number","x-nullable":true},"compoundEffort5Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 5 (obsolete)","type":"number","x-nullable":true},"compoundUseSubmittedDispenseFee":{"description":"Gets or sets the indicates whether to use the submitted dispense fee from the pharmacy for the compound (obsolete)","type":"boolean","x-nullable":true},"compoundUseUsualAndCustomary":{"description":"Gets or sets the indicates whether to use the submitted Usual and Customary price from the pharmacy for the compound (obsolete)","type":"boolean","x-nullable":true},"compoundUseGrossAmountDue":{"description":"Gets or sets the indicates whether to use the Gross Amount Due price from the pharmacy for the compound (obsolete)","type":"boolean","x-nullable":true},"compoundCoinsuranceUrl":{"description":"Gets or sets the link to the Coinsurance resource for compound drugs","type":"string"},"compoundCoinsuranceNo":{"format":"int64","description":"Gets or sets the identifier for the Copay/Coinsurance used for compounds","type":"integer","x-nullable":true},"compoundOutOfPocketCoinsuranceUrl":{"description":"Gets or sets the link to the Coinsurance resource for compound drugs after out of pocket limits have been reached","type":"string"},"compoundOutOfPocketCoinsuranceNo":{"format":"int64","description":"Gets or sets the identifier for the Copay/Coinsurance used for compounds after out of pocket limits have been reached","type":"integer","x-nullable":true},"compoundDrugPricingUrl":{"description":"Gets or sets the link to the Drug Pricing resource for compound drugs","type":"string"},"compoundDrugPricingNo":{"format":"int64","description":"Gets or sets the identifier of the special drug pricing for a compound.","type":"integer","x-nullable":true},"altCompoundDrugPricingNo":{"format":"int64","description":"Gets or sets the identifier representing the Alternate compound pricing option (If two options are defined, then the lower pricing option will be used)","type":"integer","x-nullable":true},"altCompoundDrugPricingUrl":{"description":"Gets or sets the link to the Alt Drug Pricing resource for compound drugs","type":"string"},"unknownDrugPricingUrl":{"description":"Gets or sets the link to the Drug Pricing resource for unknown/undefined drugs","type":"string"},"unknownDrugPricingNo":{"format":"int64","description":"Gets or sets the identifier of the special drug pricing for an unknown/undefined drug.","type":"integer","x-nullable":true},"useNetworkCoinsurance":{"description":"Gets or sets whether to use Network Coinsurance if available","type":"boolean","x-nullable":true},"useNetworkIncentive":{"description":"Gets or sets whether to use Network Incentive if available","type":"boolean","x-nullable":true},"useNetworkDeductibleOptions":{"description":"Gets or set whether to use Network deductible options if available","type":"boolean","x-nullable":true},"durDrugDrugCheck":{"description":"Gets or sets whether to use Drug-Drug DUR (obsolete)","type":"boolean","x-nullable":true},"durDrugDrugLevelSeverity":{"description":"Gets or sets the least severe level of DUR the plan enforces  (obsolete)","type":"string"},"durDrugDrugMessage":{"description":"Gets or sets the message to send in the claim response when severity is exceeded (obsolete)","type":"string"},"durDrugDrugActionTypeNo":{"format":"int64","description":"Gets or sets the action to take when severity level threshold is crossed (obsolete)","type":"integer","x-nullable":true},"mmeActionTypeNo":{"format":"int64","description":"Gets or sets the action to take when threshold is exceeded","type":"integer","x-nullable":true},"mmeThresholdCheck":{"description":"Gets or sets whether the system will determine if the patient is exceeding the daily dosage threshold for opioid medications","type":"boolean","x-nullable":true},"mmeThreshold":{"format":"int32","description":"Gets or sets the daily dosage threshold for opioid medications","type":"integer","x-nullable":true},"mmeResponseMessage":{"description":"Gets or sets the message to send in the claim response when MME Threshold is exceeded","type":"string"},"allowFutureDateOfService":{"description":"Gets or sets whether the plan allows claims with future date of service","type":"boolean","x-nullable":true},"defaultPharmacyTier":{"description":"Gets or sets the default pharmacy tier value that will be saved on the claim audit if it isn't specified elsewhere during processing of a claim","type":"string"},"templateOverrideOptions":{"description":"Gets or sets whether the plan overrides the template options when deriving from a Group Template","type":"boolean","x-nullable":true},"templateOverrideMessages":{"description":"Gets or sets whether the plan overrides the template messages when deriving from a Group Template","type":"boolean","x-nullable":true},"templateOverridePrescriptionEdits":{"description":"Gets or sets whether the plan overrides the template prescription edits when deriving from a Group Template","type":"boolean","x-nullable":true},"templateOverrideDUR":{"description":"Gets or sets whether the plan overrides the template DUR options when deriving from a Group Template","type":"boolean","x-nullable":true},"templateOverrideCompoundPricing":{"description":"Gets or sets whether the plan overrides the template compound pricing options when deriving from a Group Template","type":"boolean","x-nullable":true},"templateOverrideUnknownPricing":{"description":"Gets or sets whether the plan overrides the template unkown/undefined drug pricing options when deriving from a Group Template","type":"boolean","x-nullable":true},"templateOverrideFormulary":{"description":"Gets or sets whether the plan overrides the template formulary options when deriving from a Group Template","type":"boolean","x-nullable":true},"templateOverrideGlobalPricing":{"description":"Gets or sets whether the plan overrides the template Location/Global pricing when deriving from a Group Template","type":"boolean","x-nullable":true},"returnMemberLookupMessages":{"description":"Gets or sets whether the eligibility messages are returned when using open enrollment and if the member was either found using an alternate lookup or was added to the system","type":"boolean","x-nullable":true},"subscribeToGlobalPricingACI":{"description":"Gets or sets whether the plan subscribes to Location/Global ACI pricing","type":"boolean","x-nullable":true},"subscribeToGlobalPricingAcqCost":{"description":"Gets or sets whether the plan subscribes to Location/Global acquisition pricing","type":"boolean","x-nullable":true},"subscribeToGlobalPricingCustomMAC":{"description":"Gets or sets whether the plan subscribes to Location/Global Custom MAC pricing","type":"boolean","x-nullable":true},"subscribeToGlobalPricingRefPrice":{"description":"Gets or sets whether the plan subscribes to Location/Global reference pricing","type":"boolean","x-nullable":true},"rxExpireDays":{"format":"int32","description":"Gets or sets the number of days to indicate that a prescription is \"expired.\"  An Rx is expired if the date of service is later than the first fill for the Rx plus the RxExpireDays.","type":"integer","x-nullable":true},"prescriberGraceDays":{"format":"int32","description":"Gets or sets the Prescriber Grace Days to be used in conjuction with prescriber effective dates in rules.  If a prescriber's effective date has expired, but the grace period has not been exceeded, the claim will continue processing.","type":"integer","x-nullable":true},"eligibilityRejectMessage":{"description":"Get or sets the message for eligibility rejects","type":"string"},"prescriptionWrittenMaxDays":{"format":"int32","type":"integer","x-nullable":true},"rejectClaimIfNoCustomPrice":{"description":"Gets or sets whether claims should reject if there is no custom pricing","type":"boolean","x-nullable":true},"planTemplateNo":{"format":"int64","description":"Gets or sets the Plan Template from which this plan inherits","type":"integer","x-nullable":true},"planTemplateUrl":{"description":"Gets or sets the link to the Plan Template resource for this plan","type":"string"},"planIncentiveLimitAmountPeriod":{"format":"double","description":"Plan's Incentive Limit Amount for a member for a period","type":"number","x-nullable":true},"planIncentiveLimitAmountMonth":{"format":"double","description":"Plan's Incentive Limit Amount for a member for a month","type":"number","x-nullable":true},"planIncentiveLimitMonthRollover":{"description":"Value indicating whether the Plan's Incentive Limit Amount should roll over to the next period","type":"boolean","x-nullable":true}}},"CompanyDiagnosisCodeLimitDxCodeModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"seqNo":{"format":"int64","description":"","type":"integer"},"companyDiagnosisCodeLimitSeqNo":{"format":"int64","type":"integer"},"diagnosisCode":{"description":"","type":"string"},"diagnosisCodeType":{"description":"","type":"string"},"isActive":{"description":"","type":"boolean","x-nullable":true},"createdOn":{"format":"date-time","description":"","type":"string","x-nullable":true},"changedOn":{"format":"date-time","description":"","type":"string","x-nullable":true}}},"CompanyStepMedicationMultiSourceCodeModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"seqNo":{"format":"int64","description":"","type":"integer"},"companyStepMedicationSeqNo":{"format":"int64","type":"integer"},"multiSourceCode":{"description":"","type":"string"},"isActive":{"description":"","type":"boolean","x-nullable":true},"createdOn":{"format":"date-time","description":"","type":"string","x-nullable":true},"changedOn":{"format":"date-time","description":"","type":"string","x-nullable":true}}},"CompanyStepMedicationStepDrugModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"seqNo":{"format":"int64","description":"","type":"integer"},"companyStepMedicationSeqNo":{"format":"int64","type":"integer"},"stepDrugProductID":{"description":"","type":"string"},"stepDrugProductIDType":{"description":"","type":"string"},"stepDrugClassID":{"description":"","type":"string"},"stepDrugSubClassID":{"description":"","type":"string"},"isActive":{"description":"","type":"boolean","x-nullable":true},"createdOn":{"format":"date-time","description":"","type":"string","x-nullable":true},"changedOn":{"format":"date-time","description":"","type":"string","x-nullable":true}}},"PagedResultModel[CoveragePriorAuthorizationModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/CoveragePriorAuthorizationModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"CoveragePriorAuthorizationModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"productID":{"description":"Gets or sets the product ID for this resource.  The value should be a valid NDC, DDID or GPI.","type":"string"},"productIDType":{"description":"Gets or sets the product ID Type for the ProductID value set on this resource.  The value will indicate whether the product ID for this resource is an NDC or DDID . \r\nString values other than 'NDC' or 'DDID' will not be valid.","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date of this resource","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date of this resource","type":"string","x-nullable":true},"auditNote":{"description":"Gets or sets the value indicating (for audit purposes) why the most current change was made","type":"string"}}},"PagedResultModel[DataQProviderModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/DataQProviderModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"DataQProviderModel":{"type":"object","properties":{"dataQProviderID":{"description":"Data Q Provider Identifier","type":"string"},"name":{"description":"Name","type":"string"},"storeNumber":{"description":"Store Number","type":"string"},"physicalLocationAddress1":{"description":"Physical Address Line 1","type":"string"},"physicalLocationAddress2":{"description":"Physical Address Line 2","type":"string"},"physicalLocationCity":{"description":"Physical Address City","type":"string"},"physicalLocationStateCode":{"description":"Physical Address State Code","type":"string"},"physicalLocationZipCode":{"description":"Physical Address Zip Code","type":"string"},"physicalLocationPhoneNumber":{"description":"Primary Phone Number","type":"string"},"physicalLocationExtension":{"description":"Primary Phone Number Extension","type":"string"},"physicalLocationFaxNumber":{"description":"Location's Fax Number","type":"string"},"physicalLocationEmailAddress":{"description":"Location's Email Address","type":"string"},"physicalLocation24HourOperationFlag":{"description":"Flag indicating whether location operates 24 hours","type":"string"},"physicalLocationProviderHours":{"description":"Location hours","type":"string"},"physicalLocationStoreOpenDate":{"format":"date-time","description":"Location open date","type":"string","x-nullable":true},"physicalLocationStoreClosureDate":{"format":"date-time","description":"Location closure date","type":"string","x-nullable":true},"mailingAddress1":{"description":"Mailing Address Street Line 1","type":"string"},"mailingAddress2":{"description":"Mailing Address Street Line 2","type":"string"},"mailingAddressCity":{"description":"Mailing Address City","type":"string"},"mailingAddressStateCode":{"description":"Mailing Address State Code","type":"string"},"mailingAddressZipCode":{"description":"Mailing Address Zip Code","type":"string"},"contactLastName":{"description":"Contact Last Name","type":"string"},"contactFirstName":{"description":"Contact First Name","type":"string"},"contactMiddleInitial":{"description":"Contact Middle Initial","type":"string"},"contactTitle":{"description":"Contact Title","type":"string"},"contactEmailAddress":{"description":"Contact Email address","type":"string"},"contactPhoneNumber":{"description":"Contact Phone Number","type":"string"},"contactExtension":{"description":"Contact Phone Number Extension","type":"string"},"dispenserClassCode":{"description":"Dispenser Class Code","type":"string"},"providerTypeCodePrimary":{"description":"Primary Provider Type Code","type":"string"},"providerTypeCodeSecondary":{"description":"Secondary Provider Type Code","type":"string"},"providerTypeCodeTertiary":{"description":"Tertiary Provider Type Code","type":"string"},"medicareID":{"description":"Medicare ID","type":"string"},"npi":{"description":"NPI","type":"string"},"dea":{"description":"DEA","type":"string"},"ncpdpProviderID":{"description":"NCPDP ID Number","type":"string"},"federalTaxID":{"description":"Federal Tax ID","type":"string"},"primaryRelationshipCode":{"description":"Primary Relationship Code","type":"string"},"chainCode":{"description":"Chain Code","type":"string"},"franchiseCode":{"description":"Franchise Code","type":"string"},"deactivationCode":{"description":"Deactivation Code","type":"string"},"reinstatementCode":{"description":"Reinstatement Code","type":"string"},"reinstatementDate":{"format":"date-time","description":"Reinstatement Date","type":"string","x-nullable":true}}},"PagedResultModel[DataQRelationshipModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/DataQRelationshipModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"DataQRelationshipModel":{"description":"Data Q Relationship","type":"object","properties":{"dataQRelationshipID":{"description":"","type":"string"},"code":{"description":"","type":"string"},"type":{"description":"","type":"string"},"relationshipTypeDescription":{"description":"","type":"string"},"name":{"description":"","type":"string"},"parentOrganizationID":{"description":"","type":"string"},"parentOrganizationName":{"description":"","type":"string"}}},"DAWCodeModel":{"type":"object","properties":{"displayName":{"type":"string"}}},"DEAScheduleModel":{"type":"object","properties":{"displayName":{"type":"string"}}},"PagedResult[DeductibleModel]":{"type":"object","properties":{"pageIndex":{"format":"int32","type":"integer","readOnly":true},"pageSize":{"format":"int32","type":"integer","readOnly":true},"totalCount":{"format":"int32","type":"integer"},"totalPageCount":{"format":"int32","type":"integer"},"items":{"type":"array","items":{"$ref":"#/definitions/DeductibleModel"},"readOnly":true},"hasPreviousPage":{"type":"boolean","readOnly":true},"hasNextPage":{"type":"boolean","readOnly":true}}},"DependentModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"The ID of the dependent.  This is the value that should be used to reference the dependent elsewhere in the system, such as on the member other status endpoint.","type":"integer"},"memberNo":{"format":"int64","type":"integer"},"dependentCode":{"description":"A three digit code indicating the relationship of the dependent to the patient.","type":"string"},"secondaryCoverageOnly":{"description":"Gets or sets a value indicating whether the dependent has secondary coverage only.","type":"boolean","x-nullable":true},"cobra":{"description":"Gets or sets a value indicating whether the dependent is covered under COBRA.","type":"boolean","x-nullable":true},"clientID":{"description":"Gets or sets the client ID associated with the dependent.","type":"string"},"externalID":{"description":"Gets or sets the ExternalID associated with the dependent","type":"string"},"firstName":{"description":"Gets or sets the first name for this person.","type":"string"},"middleName":{"description":"Gets or sets the middle name for this person.","type":"string"},"lastName":{"description":"Gets or sets the last name for this person.","type":"string"},"emailAddress":{"description":"Gets or sets the email address for this person.","type":"string"},"gender":{"description":"Gets or sets the gender for this person.","type":"string"},"ssn":{"description":"Gets or sets the social security number for this person.","type":"string"},"alternateID":{"description":"Gets or sets the alternate ID for this person.","type":"string"},"dateOfBirth":{"format":"date-time","description":"Gets or sets the date of birth for this person.","type":"string"},"maritalStatus":{"enum":["Unknown","Divorced","Married","RegisteredDomesticPartner","Remarried","Separated","Single","Widowed","Widower"],"type":"string","x-nullable":true},"birthPlace":{"description":"Gets or sets the Birthplace for this person.","type":"string"},"occupation":{"description":"Gets or sets the occupation for this person.","type":"string"},"usCitizen":{"description":"Gets or sets a value indicating if this person is a US Citizen","type":"boolean","x-nullable":true},"military":{"description":"Gets or sets a value indicating if this person is in the Military","type":"boolean","x-nullable":true},"active":{"format":"int32","description":"Gets or sets the active status for this person.","type":"integer"},"memberComment":{"description":"Gets or sets the member comment for this person.","type":"string"},"hasMedicare":{"description":"Gets or sets the flag to indicate this person has medicare.","type":"boolean"},"medicareID":{"description":"Gets or sets the Medicare ID for this person.","type":"string"},"medicarePlan":{"description":"Gets or sets the Medicare plan for this person.","type":"string"},"medicareEffectiveDate":{"format":"date-time","description":"Gets or sets the Medicare effective date for this person.","type":"string"},"relationship":{"description":"","enum":["NotSpecified","Spouse","Child","Other"],"type":"string","x-nullable":true},"personCode":{"description":"Gets or sets the person code value for this dependent.  This value is likely obsolete and should not be used.  \r\nUse the DependentCode property to set a value for the dependent's person code.","type":"string"},"homeAddress":{"$ref":"#/definitions/PersonAddressModel"},"mailingAddress":{"$ref":"#/definitions/PersonAddressModel"},"homePhone":{"$ref":"#/definitions/PersonPhoneModel"},"businessPhone":{"$ref":"#/definitions/PersonPhoneModel"},"mobilePhone":{"$ref":"#/definitions/PersonPhoneModel"},"faxPhone":{"$ref":"#/definitions/PersonPhoneModel"},"wirelessCarrier":{"enum":["Alltel","ATT","Nextel","Sprint","Tmobile","Verizon","VirginMobile"],"type":"string","x-nullable":true}}},"PersonAddressModel":{"type":"object","properties":{"addressType":{"enum":["Business","Mailing","Home","Other","Primary"],"type":"string"},"address":{"description":"Address line 1","type":"string"},"addressLineTwo":{"description":"Address line two","type":"string"},"city":{"description":"City","type":"string"},"stateCode":{"description":"Two letter state code","type":"string"},"zipCode":{"description":"Zip code","type":"string"},"country":{"description":"Country","type":"string"}}},"PersonPhoneModel":{"type":"object","properties":{"phoneType":{"enum":["Home","Pager","PrimaryFax","Other","Refill","Fax","Primary","Cell","Business"],"type":"string"},"phone":{"description":"Phone number (digits only)","type":"string"},"ext":{"description":"Extension","type":"string"}}},"PagedResultModel[CompanyDiagnosisCodeLimitModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/CompanyDiagnosisCodeLimitModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"CompanyDiagnosisCodeLimitModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"name":{"description":"Gets or sets the description of the diagnosis code limit resource","type":"string"},"isGlobal":{"description":"Gets or sets whether this is a global diagnosis code limit resource (true if Global, false if Formulary-level)\r\nObsolete - will be removed at a later date","type":"boolean","x-nullable":true},"createdOn":{"format":"date-time","description":"Gets or sets the datetime when the diagnosis code limit was created","type":"string","x-nullable":true},"auditNote":{"description":"Gets or sets the value indicating (for audit purposes) why the most current change was made","type":"string"},"active":{"description":"Gets or sets the value indicating whether this diagnosis code limit is currently active.","type":"boolean","x-nullable":true},"dxCodes":{"type":"array","items":{"$ref":"#/definitions/CompanyDiagnosisCodeLimitDxCodeModel"}},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date of the formulary level resource","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date of the formulary resource","type":"string","x-nullable":true},"productID":{"description":"Gets or sets the product ID for the formulary level resource.  The value should be a valid NDC, DDID or GPI.","type":"string"},"productIDType":{"description":"Gets or sets the product ID Type for the ProductID value set on the formulary level resource.  The value will indicate whether the product ID for this resource is an NDC or DDID . \r\nString values other than 'NDC' or 'DDID' will not be valid.","type":"string"}}},"PagedResultModel[FormularyCompanyDiagnosisCodeLimitModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/FormularyCompanyDiagnosisCodeLimitModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"FormularyCompanyDiagnosisCodeLimitModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"companyDiagnosisCodeLimitSeqNo":{"format":"int64","description":"Gets or sets the value indicating whether this formulary diagnosis code limit is inheriting from a global/company-level diagnosis code limit.","type":"integer","x-nullable":true},"companyDiagnosisCodeLimitUrl":{"description":"Gets the url where the global/company-level diagnosis code limit resource can be found","type":"string","readOnly":true},"productID":{"description":"Gets or sets the product ID for this resource.  The value should be a valid NDC, DDID or GPI.","type":"string"},"productIDType":{"description":"Gets or sets the product ID Type for the ProductID value set on this resource.  The value will indicate whether the product ID for this resource is an NDC or DDID . \r\nString values other than 'NDC' or 'DDID' will not be valid.","type":"string"},"name":{"description":"Gets or sets the description of the diagnosis code limit company level resource","type":"string"},"active":{"description":"Gets or sets the value indicating whether this diagnosis code limit is currently active.","type":"boolean","x-nullable":true},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date of this resource","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date of this resource","type":"string","x-nullable":true},"dxCodesUrl":{"description":"Gets or sets the URL that can be accessed to find which dx codes should be tried as part of this Diagnosis Code Limit resource.","type":"string"},"dxCodes":{"type":"array","items":{"$ref":"#/definitions/CompanyDiagnosisCodeLimitDxCodeModel"}}}},"DiagnosisCodeModel":{"description":"Diagnosis Code","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"dxCode":{"description":"Gets or sets the DxCode","type":"string"},"dxCodeDescription":{"description":"Gets or sets the DxCodeDescription","type":"string"}}},"DosageFormModel":{"description":"Diagnosis Code","type":"object","properties":{"dosageForm":{"description":"Gets or sets the DosageForm value","type":"string"},"description":{"description":"Gets or sets the dosage form description","type":"string"}}},"PagedResult[DrugProfileDDIDModel]":{"type":"object","properties":{"pageIndex":{"format":"int32","type":"integer","readOnly":true},"pageSize":{"format":"int32","type":"integer","readOnly":true},"totalCount":{"format":"int32","type":"integer"},"totalPageCount":{"format":"int32","type":"integer"},"items":{"type":"array","items":{"$ref":"#/definitions/DrugProfileDDIDModel"},"readOnly":true},"hasPreviousPage":{"type":"boolean","readOnly":true},"hasNextPage":{"type":"boolean","readOnly":true}}},"DrugProfileDDIDModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"drugDescriptorIdentifier":{"format":"int32","description":"Gets or sets the Drug Descriptor Identifier for the associated drug profile","type":"integer"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date for the associated drug profile","type":"string"},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date for the associated drug profile","type":"string","x-nullable":true}}},"PagedResult[DrugProfileDosageFormModel]":{"type":"object","properties":{"pageIndex":{"format":"int32","type":"integer","readOnly":true},"pageSize":{"format":"int32","type":"integer","readOnly":true},"totalCount":{"format":"int32","type":"integer"},"totalPageCount":{"format":"int32","type":"integer"},"items":{"type":"array","items":{"$ref":"#/definitions/DrugProfileDosageFormModel"},"readOnly":true},"hasPreviousPage":{"type":"boolean","readOnly":true},"hasNextPage":{"type":"boolean","readOnly":true}}},"DrugProfileDosageFormModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"dosageForm":{"description":"Gets or sets the Dosage Form for the associated drug profile","type":"string"}}},"PagedResult[DrugProfileGPIModel]":{"type":"object","properties":{"pageIndex":{"format":"int32","type":"integer","readOnly":true},"pageSize":{"format":"int32","type":"integer","readOnly":true},"totalCount":{"format":"int32","type":"integer"},"totalPageCount":{"format":"int32","type":"integer"},"items":{"type":"array","items":{"$ref":"#/definitions/DrugProfileGPIModel"},"readOnly":true},"hasPreviousPage":{"type":"boolean","readOnly":true},"hasNextPage":{"type":"boolean","readOnly":true}}},"DrugProfileGPIModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"genericProductIdentifier":{"description":"Gets or sets the GPI for the associated drug profile","type":"string"}}},"PagedResult[DrugProfileNDCModel]":{"type":"object","properties":{"pageIndex":{"format":"int32","type":"integer","readOnly":true},"pageSize":{"format":"int32","type":"integer","readOnly":true},"totalCount":{"format":"int32","type":"integer"},"totalPageCount":{"format":"int32","type":"integer"},"items":{"type":"array","items":{"$ref":"#/definitions/DrugProfileNDCModel"},"readOnly":true},"hasPreviousPage":{"type":"boolean","readOnly":true},"hasNextPage":{"type":"boolean","readOnly":true}}},"DrugProfileNDCModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ndc":{"description":"Gets or sets the NDC associated with the drug profile","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date for the associated drug profile","type":"string"},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date for the associated drug profile","type":"string","x-nullable":true}}},"PagedResult[DrugProfileRouteOfAdministrationModel]":{"type":"object","properties":{"pageIndex":{"format":"int32","type":"integer","readOnly":true},"pageSize":{"format":"int32","type":"integer","readOnly":true},"totalCount":{"format":"int32","type":"integer"},"totalPageCount":{"format":"int32","type":"integer"},"items":{"type":"array","items":{"$ref":"#/definitions/DrugProfileRouteOfAdministrationModel"},"readOnly":true},"hasPreviousPage":{"type":"boolean","readOnly":true},"hasNextPage":{"type":"boolean","readOnly":true}}},"DrugProfileRouteOfAdministrationModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"routeOfAdministration":{"description":"Gets or sets the Route of Administration associated with the drug profile","type":"string"}}},"PagedResult[DrugProfileModel]":{"type":"object","properties":{"pageIndex":{"format":"int32","type":"integer","readOnly":true},"pageSize":{"format":"int32","type":"integer","readOnly":true},"totalCount":{"format":"int32","type":"integer"},"totalPageCount":{"format":"int32","type":"integer"},"items":{"type":"array","items":{"$ref":"#/definitions/DrugProfileModel"},"readOnly":true},"hasPreviousPage":{"type":"boolean","readOnly":true},"hasNextPage":{"type":"boolean","readOnly":true}}},"DrugProfileModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"groupNo":{"format":"int64","description":"The identifier for the drug profile's group.  This value will only be populated if the drug profile is not global.","type":"integer","x-nullable":true},"profileName":{"description":"Gets or sets the Name of the Drug Profile","type":"string"},"description":{"description":"Gets or sets the description of the drug profile.","type":"string"},"isBrand":{"description":"Gets or sets a value indicating whether the drug is a brand.","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets a value indicating whether the drug is prescription.","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets a value indicating whether a generic version is available.","type":"boolean","x-nullable":true},"otcAvailable":{"description":"Gets or sets a value indicating whether an over-the-counter version is available.","type":"boolean","x-nullable":true},"isMultiSourced":{"description":"Gets or sets a value indicating whether the drug is multi-sourced.","type":"boolean","x-nullable":true},"isRepackaged":{"description":"Gets or sets a value indicating whether the drug is repackaged.","type":"boolean","x-nullable":true},"isMaintenanceDrug":{"description":"Gets or sets a value indicating whether the drug is a maintenance drug.","type":"boolean","x-nullable":true},"deaClassCodes":{"description":"Gets or sets the applicable DEA schedules for the drug criteria","type":"array","items":{"$ref":"#/definitions/DEAScheduleModel"}},"brandNameCodes":{"description":"Gets or sets the applicable brand codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/BrandNameCodeModel"}},"multiSourceCodes":{"description":"Gets or sets the applicable multi-source codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}},"drugProfileGPIsUrl":{"description":"Gets the Url where the GPI's for this Drug Profile can be found and updated.","type":"string"},"drugProfileNDCsUrl":{"description":"Gets the Url where the NDC's for this Drug Profile can be found and updated.","type":"string"},"drugProfileDDIDsUrl":{"description":"Gets the Url where the DDID's for this Drug Profile can be found and updated.","type":"string"},"drugProfileRoutesOfAdministrationUrl":{"description":"Gets the Url where the Routes of Administration for this Drug Profile can be found and updated.","type":"string"},"drugProfileDosageFormsUrl":{"description":"Gets the Url where the Dosage Forms for this Drug Profile can be found and updated.","type":"string"},"ndcListIsExclusion":{"description":"Gets or sets the NDCListIsExclusion for this Drug Profile.","type":"boolean"},"ddidListIsExclusion":{"description":"Gets or sets the DDIDListIsExclusion for this Drug Profile.","type":"boolean"}}},"MultiSourceCodeModel":{"type":"object","properties":{"displayName":{"type":"string"}}},"EligibilityImportSettingsModel":{"description":"Eligibility Import Settings in FacilityBranch_PharmacyBranch","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"eligibilityUseARTypesAsClientID":{"description":"Gets or sets if A/R Type is ID","type":"boolean","x-nullable":true},"eligibilityClientID":{"description":"Gets or sets ClientID (Accepts multiple values separated by '|')","maxLength":2000,"minLength":0,"type":"array","items":{"type":"string"}},"eligibilityUseCOB":{"description":"Gets or sets to use COB","type":"boolean","x-nullable":true},"eligibilityTrackDependentChanges":{"description":"Gets or sets to track eligibility for dependents","type":"boolean","x-nullable":true},"eligibilityTermFutureEntries":{"description":"Gets or sets if all status entries where start date isn't in file and greater than the earliest date specifed in file","type":"boolean","x-nullable":true},"eligibilityUpdateStatusDescriptions":{"description":"Gets or sets to update description codes for employee location, employee status, and other status","type":"boolean","x-nullable":true},"eligibilityCardholderPersonCode":{"description":"Gets or sets cardholder person code","maxLength":3,"minLength":0,"type":"string"},"eligibilityStripCardholderIDPrefix":{"description":"Gets or sets prefix to strip from cardholder ID","maxLength":20,"minLength":0,"type":"string"},"eligibilityAddCardholderIDPrefix":{"description":"Gets or sets prefix to add to cardholder ID","maxLength":20,"minLength":0,"type":"string"},"eligibilityStripCardholderIDSuffix":{"description":"Gets or sets suffix to strip from cardholder ID","maxLength":20,"minLength":0,"type":"string"},"eligibilityAddCardholderIDSuffix":{"description":"Gets or sets suffix to add to cardholder ID","maxLength":20,"minLength":0,"type":"string"},"eligibilityCoverageLevelCodes":{"description":"Use the values below in an array to specify the coverage levels you want to include in the eligibility import.\r\n            \r\nAllowed values:  \r\n\"CHD - Children Only\",  \r\n\"DEP - Dependents Only\",  \r\n\"E1D - Employee and One Dependent\",  \r\n\"E2D - Employee and Two Dependents\",  \r\n\"E3D - Employee and Three Dependents\",  \r\n\"E5D - Employee and One or More Dependents\",  \r\n\"E6D - Employee and Two or More Dependents\",  \r\n\"E7D - Employee and Three or More Dependents\",  \r\n\"E8D - Employee and Four or More Dependents\",  \r\n\"E9D - Employee and Five or More Dependents\",  \r\n\"ECH - Employee and Children\",  \r\n\"EMP - Employee Only\",  \r\n\"ESP - Employee and Spouse\",  \r\n\"FAM - Family\",  \r\n\"IND - Individual\",  \r\n\"SPC - Spouse and Children\",  \r\n\"SPO - Spouse Only\",  \r\n\"TWO - Two Party\"","type":"array","items":{"enum":["CHD - Children Only","DEP - Dependents Only","E1D - Employee and One Dependent","E2D - Employee and Two Dependents","E3D - Employee and Three Dependents","E5D - Employee and One or More Dependents","E6D - Employee and Two or More Dependents","E7D - Employee and Three or More Dependents","E8D - Employee and Four or More Dependents","E9D - Employee and Five or More Dependents","ECH - Employee and Children","EMP - Employee Only","ESP - Employee and Spouse","FAM - Family","IND - Individual","SPC - Spouse and Children","SPO - Spouse Only","TWO - Two Party"],"type":"string"}},"eligibilityCoverageLevelCodesExclusion":{"description":"Gets or sets the coverage level codes to exclude","type":"array","items":{"enum":["CHD - Children Only","DEP - Dependents Only","E1D - Employee and One Dependent","E2D - Employee and Two Dependents","E3D - Employee and Three Dependents","E5D - Employee and One or More Dependents","E6D - Employee and Two or More Dependents","E7D - Employee and Three or More Dependents","E8D - Employee and Four or More Dependents","E9D - Employee and Five or More Dependents","ECH - Employee and Children","EMP - Employee Only","ESP - Employee and Spouse","FAM - Family","IND - Individual","SPC - Spouse and Children","SPO - Spouse Only","TWO - Two Party"],"type":"string"}},"eligibilityTermByAbsence":{"description":"Gets or sets terming by absense","type":"boolean","x-nullable":true},"eligibilityTermByAbsenceType":{"description":"Gets or sets terming by absense type","enum":["End of Current Month","Day Of File"],"type":"string","x-nullable":true},"eligibilityTermByAbsenceDaysOffset":{"format":"int32","description":"Gets or sets number of days to offset the term date","type":"integer","x-nullable":true},"eligibilityTermByAbsenceLockCOBRA":{"description":"Gets or sets if COBRA members will be considered locked and will not term by absense","type":"boolean","x-nullable":true},"eligibilityTermByAbsenceByContractCode":{"description":"Gets or sets if only members that currently are assigned to a contract code in the submitted file are termed","type":"boolean","x-nullable":true},"eligibilityTermByAbsenceThreshold":{"format":"double","description":"Gets or sets max percent of members that can be termed","type":"number","x-nullable":true},"eligibilityCardholderUsePatientID":{"description":"Gets or sets if looking up cardholders by patient ID","type":"boolean","x-nullable":true},"eligibilityCardholderUseAlternateID":{"description":"Gets or sets if looking up cardholders by alternate ID","type":"boolean","x-nullable":true},"eligibilityCardholderUseSSN":{"description":"Gets or sets if looking up cardholders by SSN","type":"boolean","x-nullable":true},"eligibilityCardholderUseMemberInfo":{"description":"Gets or sets if looking up cardholders by name and DOB","type":"boolean","x-nullable":true},"eligibilityUseMemberInfoAllowSecondID":{"description":"Gets or sets if a member will be added with a new ID if the old ID is in the file when using member info to find cardholders","type":"boolean","x-nullable":true},"eligibilityMergeSecondID":{"description":"Gets or sets if a member is mergered with the latest ID if multiple entries found in file","type":"boolean","x-nullable":true},"eligibilityLogShowMissingMembers":{"description":"Gets or sets to list missing members","type":"boolean","x-nullable":true},"eligibilityLogShowMissingMembersGraceDays":{"format":"int32","description":"Gets or sets number of grace days for excluding members with term dates within that count","type":"integer","x-nullable":true},"eligibilityLogShowMissingEmployeeStatusCodes":{"description":"Gets or sets to list members missing an employee status code","type":"boolean","x-nullable":true},"eligibilityLogShowMissingOtherStatusCodes":{"description":"Gets or sets to list members missing an other status code","type":"boolean","x-nullable":true},"eligibilityLogShowMissingEmployeeLocationCodes":{"description":"Gets or sets to list members missing an employee location code","type":"boolean","x-nullable":true},"eligibilityLogShowNewEmployeeStatusCodes":{"description":"Gets or sets to list new employee status codes","type":"boolean","x-nullable":true},"eligibilityLogShowNewOtherStatusCodes":{"description":"Gets or sets to list new employee other status codes","type":"boolean","x-nullable":true},"eligibilityLogShowNewEmployeeLocationCodes":{"description":"Gets or sets to list new employee location codes","type":"boolean","x-nullable":true},"eligibilityLogShowTermedMemberDetails":{"description":"Gets or sets to show list of cardholder ID, name, and DOB for termed employees","type":"boolean","x-nullable":true},"eligibilityLogShowTermedFutureEntries":{"description":"Gets or sets to list termed future status entries","type":"boolean","x-nullable":true}}},"FacilityARTypeModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"facilityBranchSeqNo":{"format":"int64","description":"The facility branch associated with an AR Type","type":"integer"},"externalID":{"description":"The external identifier for an AR Type","type":"string"},"description":{"description":"The description for a AR Type","type":"string"},"arShortCode":{"description":"The AR short code for a AR Type","type":"string"},"arClassCode":{"description":"The class code associated with an AR Type","type":"string"},"effectiveStartDate":{"format":"date-time","description":"The effective start date associated with an AR Type","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"The effective end date associated with an AR Type","type":"string","x-nullable":true}}},"FacilityBranchModel":{"description":"Facility Branch","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"locationName":{"description":"Gets or sets the Location Name","type":"string"},"address":{"description":"Gets or sets the Address","type":"string"},"city":{"description":"Gets or sets the City","type":"string"},"state":{"description":"Gets or sets the State","type":"string"},"zipCode":{"description":"Gets or sets the Zip Code","type":"string"},"companyID":{"format":"uuid","description":"Gets or sets the Company ID","type":"string","example":"00000000-0000-0000-0000-000000000000"},"companyName":{"description":"Gets or sets the Company Name","type":"string"},"npi":{"description":"Gets or sets the NPI","type":"string"},"active":{"format":"int32","description":"Gets or sets the Active status","type":"integer","x-nullable":true}}},"FacilityAddModel":{"required":["facilityName","facilityNPI","facilityAdminFirstName","facilityAdminLastName","facilityLogonName","facilityLogonPassword"],"type":"object","properties":{"facilityName":{"description":"Sets the name of the location representing the new facility","type":"string"},"facilityNPI":{"description":"Sets the npi of the facility","type":"string"},"facilityAdminFirstName":{"description":"Sets the first name of the new facility admin","type":"string"},"facilityAdminLastName":{"description":"Sets the last name of the new facility admin","type":"string"},"facilityLogonName":{"description":"Sets the logon name for the new facility","type":"string"},"facilityLogonPassword":{"description":"Sets the logon password for the new facility","type":"string"}}},"FormularyModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"name":{"description":"The name of formulary","type":"string"},"effectiveDate":{"format":"date-time","description":"Effective Start Date of the Formulary","type":"string","x-nullable":true},"nonListedRxBrandFormularyStatus":{"format":"int32","description":"<para>This is the default Formulary Status for Brand Prescription Drugs that do not appear on the Formulary</para>\r\n<para>Formulary status is defined by using a simple, low-to-high scale. Drugs with a lower formulary status are considered less preferable by the payer; those with a higher status are more preferable. </para>\r\n<para>This value is only used when sending formulary status values to Surescripts. If no interface with Surescripts exists, these values can be ignored.</para>\r\n<para /> 0 = Non-Reimbursable (Patient pays the full cost) \r\n            <para /> 1 = Non-Formulary \r\n            <para /> 2 = On Formulary/Non-Preferred \r\n            <para /> 3 - 99 = On Formulary/Preferred(higher number means more preferred)\r\n            <para /> U = Unknown Status","type":"integer","x-nullable":true},"nonListedRxGenericFormularyStatus":{"format":"int32","description":"<para>This is the default Formulary Status for Generic Prescription Drugs that do not appear on the Formulary</para>\r\n<para>Formulary status is defined by using a simple, low-to-high scale. Drugs with a lower formulary status are considered less preferable by the payer; those with a higher status are more preferable. </para>\r\n<para>This value is only used when sending formulary status values to Surescripts. If no interface with Surescripts exists, these values can be ignored.</para>\r\n<para /> 0 = Non-Reimbursable (Patient pays the full cost) \r\n            <para /> 1 = Non-Formulary \r\n            <para /> 2 = On Formulary/Non-Preferred \r\n            <para /> 3 - 99 = On Formulary/Preferred(higher number means more preferred)\r\n            <para /> U = Unknown Status","type":"integer","x-nullable":true},"nonListedBrandOTCFormularyStatus":{"format":"int32","description":"<para>This is the default Formulary Status for Brand OTC Drugs that do not appear on the Formulary</para>\r\n<para>Formulary status is defined by using a simple, low-to-high scale. Drugs with a lower formulary status are considered less preferable by the payer; those with a higher status are more preferable. </para>\r\n<para>This value is only used when sending formulary status values to Surescripts. If no interface with Surescripts exists, these values can be ignored.</para>\r\n<para /> 0 = Non-Reimbursable (Patient pays the full cost) \r\n            <para /> 1 = Non-Formulary \r\n            <para /> 2 = On Formulary/Non-Preferred \r\n            <para /> 3 - 99 = On Formulary/Preferred(higher number means more preferred)\r\n            <para /> U = Unknown Status","type":"integer","x-nullable":true},"nonListedGenericOTCFormularyStatus":{"format":"int32","description":"<para>This is the default Formulary Status for Generic OTC Drugs that do not appear on the Formulary</para>\r\n<para>Formulary status is defined by using a simple, low-to-high scale. Drugs with a lower formulary status are considered less preferable by the payer; those with a higher status are more preferable. </para>\r\n<para>This value is only used when sending formulary status values to Surescripts. If no interface with Surescripts exists, these values can be ignored.</para>\r\n<para /> 0 = Non-Reimbursable (Patient pays the full cost) \r\n            <para /> 1 = Non-Formulary \r\n            <para /> 2 = On Formulary/Non-Preferred \r\n            <para /> 3 - 99 = On Formulary/Preferred(higher number means more preferred)\r\n            <para /> U = Unknown Status","type":"integer","x-nullable":true},"nonListedSuppliesFormularyStatus":{"format":"int32","description":"<para>This is the default Formulary Status for Supplies that do not appear on the Formulary</para>\r\n<para>Formulary status is defined by using a simple, low-to-high scale. Drugs with a lower formulary status are considered less preferable by the payer; those with a higher status are more preferable. </para>\r\n<para>This value is only used when sending formulary status values to Surescripts. If no interface with Surescripts exists, these values can be ignored.</para>\r\n<para /> 0 = Non-Reimbursable (Patient pays the full cost) \r\n            <para /> 1 = Non-Formulary \r\n            <para /> 2 = On Formulary/Non-Preferred \r\n            <para /> 3 - 99 = On Formulary/Preferred(higher number means more preferred)\r\n            <para /> U = Unknown Status","type":"integer","x-nullable":true},"publishToSurescripts":{"description":"The value that determines whether this Formulary is sent to Surescripts (if a Surescripts interface is set up for this account)","type":"boolean","x-nullable":true},"nonListedRxBrandFormularyTierNo":{"format":"int64","description":"The SeqNo of the Non Listed Brand Rx drugs that should be used for this formulary.  \r\nAny brand Rx drug that is not listed on the formulary will be processed as if it were on the tier set here.","type":"integer","x-nullable":true},"nonListedRxBrandFormularyTierUrl":{"description":"The URL for the NonListedRxBrandFormularyTier resource","type":"string"},"nonListedRxGenericFormularyTierNo":{"format":"int64","description":"The SeqNo of the Non Listed Generic Rx drugs that should be used for this formulary.  \r\nAny generic Rx drug that is not listed on the formulary will be processed as if it were on the tier set here.","type":"integer","x-nullable":true},"nonListedRxGenericFormularyTierUrl":{"description":"The URL for the NonListedRxGenericFormularyTier resource","type":"string"},"nonListedBrandOTCFormularyTierNo":{"format":"int64","description":"The SeqNo of the Non Listed Brand OTC drugs that should be used for this formulary.  \r\nAny brand OTC drug that is not listed on the formulary will be processed as if it were on the tier set here.","type":"integer","x-nullable":true},"nonListedBrandOTCFormularyTierUrl":{"description":"The URL for the NonListedBrandOTCFormularyTier resource","type":"string"},"nonListedGenericOTCFormularyTierNo":{"format":"int64","description":"The SeqNo of the Non Listed Generic OTC drugs that should be used for this formulary.  \r\nAny generic OTC drug that is not listed on the formulary will be processed as if it were on the tier set here.","type":"integer","x-nullable":true},"nonListedGenericOTCFormularyTierUrl":{"description":"The URL for the NonListedGenericOTCFormularyTier resource","type":"string"},"nonListedSuppliesFormularyTierNo":{"format":"int64","description":"The SeqNo of the Non Listed Supplies Tier drugs that should be used for this formulary.  \r\nAny supply that is not listed on the formulary will be processed as if it were on the tier set here.","type":"integer","x-nullable":true},"nonListedSuppliesFormularyTierUrl":{"description":"The URL for the NonListedSuppliesFormularyTier resource","type":"string"},"isDeleted":{"description":"Sets or gets the value that determines whether this formulary is \"deleted\" or not","type":"boolean"}}},"PagedResultModel[FormularyProductModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/FormularyProductModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"FormularyProductModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"formularyTierId":{"format":"int64","description":"Gets or sets the Formulary Tier ID","type":"integer"},"formularyTierUrl":{"description":"Gets or sets the Formulary Tier Url","type":"string"},"productID":{"description":"Gets or sets the Product ID","type":"string"},"productIDType":{"description":"Gets or sets the product ID Type for this resource.  The value will indicate whether the product ID for this resource is an NDC or DDID . \r\nString values other than 'NDC' or 'DDID' will not be valid.","type":"string"},"therapeuticGroup":{"description":"Gets or sets the Therapeutic Group","type":"string"},"therapeuticClass":{"description":"Gets or sets the Therapeutic Class","type":"string"},"therapeuticSubClass":{"description":"Gets or sets the Therapeutic Subclass","type":"string"},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date","type":"string","x-nullable":true},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date","type":"string","x-nullable":true},"auditNote":{"description":"Gets or sets the Audit note","type":"string"}}},"FormularyTierModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"formularyStatus":{"format":"int32","description":"Gets or sets the Formulary Status","type":"integer","x-nullable":true},"name":{"description":"Gets or sets the Name","type":"string"},"description":{"description":"Gets or sets the Description","type":"string"},"tier":{"format":"int32","description":"Gets or sets the Tier","type":"integer","x-nullable":true},"formularyName":{"description":"Gets or sets the Formulary Name","type":"string"},"displayTextWithFormularyName":{"description":"Gets or sets the Display Text with Formulary Name","type":"string"}}},"PagedResultModel[CompanyGenderLimitModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/CompanyGenderLimitModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"CompanyGenderLimitModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"name":{"description":"Gets or sets the description of the gender limit resource","type":"string"},"isGlobal":{"description":"Gets or sets whether this is a global gender limit resource (true if Global, false if Formulary-level)\r\nObsolete - will be removed at a later date","type":"boolean","x-nullable":true},"gender":{"description":"Gets or sets the Gender","type":"string"},"createdOn":{"format":"date-time","description":"Gets or sets the Created On Date for this resource","type":"string","x-nullable":true},"auditNote":{"description":"Gets or sets the value indicating (for audit purposes) why the most current change to this resource was made","type":"string"},"active":{"description":"Gets or sets the value indicating whether this gender limit is currently active.","type":"boolean","x-nullable":true}}},"PagedResultModel[FormularyCompanyGenderLimitModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/FormularyCompanyGenderLimitModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"FormularyCompanyGenderLimitModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"companyGenderLimitNo":{"format":"int64","description":"Gets or sets the value indicating whether this formulary gender limit is inheriting from a global/company-level gender limit.","type":"integer","x-nullable":true},"companyGenderLimitUrl":{"description":"Gets the url where the global/company-level gender limit resource can be found","type":"string","readOnly":true},"productID":{"description":"Gets or sets the product ID for this resource.  The value should be a valid NDC, DDID or GPI.","type":"string"},"productIDType":{"description":"Gets or sets the product ID Type for this resource.  The value will indicate whether the product ID for this resource is an NDC or DDID . \r\nString values other than 'NDC' or 'DDID' will not be valid.","type":"string"},"gender":{"description":"Gets or sets the Gender value for this resource.  This should be an 'M' or an 'F'.","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date of this resource","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date of this resource","type":"string","x-nullable":true},"active":{"description":"Gets or sets the value indicating whether this gender limit is currently active.","type":"boolean","x-nullable":true}}},"PagedResultModel[MemberModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/MemberModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"MemberModel":{"description":"Rule Member","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"salutation":{"description":"Gets or sets the salutation for this person.","type":"string"},"firstName":{"description":"Gets or sets the first name for this person.","type":"string"},"middleName":{"description":"Gets or sets the middle name for this person.","type":"string"},"lastName":{"description":"Gets or sets the last name for this person.","type":"string"},"suffix":{"description":"Gets or sets the suffix for this person.","type":"string"},"emailAddress":{"description":"Gets or sets the email address for this person.","type":"string"},"gender":{"description":"Gets or sets the gender for this person.","type":"string"},"heightInches":{"format":"int32","description":"Gets or sets the height in inches for this person.","type":"integer","x-nullable":true},"ssn":{"description":"Gets or sets the social security number for this person.","type":"string"},"doNotEmail":{"description":"Gets or sets the do not email flag for this person.","type":"boolean"},"doNotPhone":{"description":"Gets or sets the do not phone flag for this person.","type":"boolean"},"alternateID":{"description":"Gets or sets the alternate ID for this person.","type":"string"},"dateOfBirth":{"format":"date-time","description":"Gets or sets the date of birth for this person.","type":"string","x-nullable":true},"comment":{"description":"Gets or sets the comment for this person.","type":"string"},"birthPlace":{"description":"Gets or sets the Birthplace for this person.","type":"string"},"occupation":{"description":"Gets or sets the occupation for this person.","type":"string"},"usCitizen":{"description":"Gets or sets a value indicating if this person is a US Citizen","type":"boolean","x-nullable":true},"military":{"description":"Gets or sets a value indicating if this person is in the Military","type":"boolean","x-nullable":true},"active":{"format":"int32","description":"Gets or sets the active status for this person.","type":"integer"},"memberComment":{"description":"Gets or sets the member comment for this person.","type":"string"},"hasMedicare":{"description":"Gets or sets the flag to indicate this person has medicare.","type":"boolean"},"medicareID":{"description":"Gets or sets the Medicare ID for this person.","type":"string"},"medicarePlan":{"description":"Gets or sets the Medicare plan for this person.","type":"string"},"medicareEffectiveDate":{"format":"date-time","description":"Gets or sets the Medicare effective date for this person.","type":"string","x-nullable":true},"locationName":{"description":"Gets or sets the location name associated with the member","type":"string"},"dependantIndicator":{"description":"Gets or sets the indicator tells you whether the member is a dependent (D) or a primary cardholder (P)","type":"string"},"criticalComment":{"description":"Gets or sets the critical comment for this Patient.","type":"string"},"identifier":{"description":"Gets or sets the custom identifier for this Patient.","type":"string"},"diabetic":{"description":"Gets or sets a value indicating if this Patient is diabetic.","type":"boolean"},"isHospice":{"description":"Gets or sets a value indicating if this Patient is in hospice.","type":"boolean","x-nullable":true},"nonCodedAllergies":{"description":"Gets or sets this Patients non coded allergies.","type":"string"},"sentToPharmacy":{"description":"Gets or sets a value indicating if this Patient was send to the pharmacy.","type":"boolean","x-nullable":true},"cardholderID":{"description":"Gets or sets the card holder id for this Patient.","type":"string"},"secondaryCoverageOnly":{"description":"Gets or sets a value indicating secondary coverage only for this patient.","type":"boolean","x-nullable":true},"locked":{"description":"Gets or sets a value indicating if this patient is locked.","type":"boolean","x-nullable":true},"coverageLevelCode":{"description":"Gets or sets the value associated with the coverage level code.","enum":["CHD - Children Only","DEP - Dependents Only","E1D - Employee and One Dependent","E2D - Employee and Two Dependents","E3D - Employee and Three Dependents","E5D - Employee and One or More Dependents","E6D - Employee and Two or More Dependents","E7D - Employee and Three or More Dependents","E8D - Employee and Four or More Dependents","E9D - Employee and Five or More Dependents","ECH - Employee and Children","EMP - Employee Only","ESP - Employee and Spouse","FAM - Family","IND - Individual","SPC - Spouse and Children","SPO - Spouse Only","TWO - Two Party"],"type":"string","x-nullable":true},"yearlyHouseholdIncome":{"format":"double","description":"Gets or sets the value associated with the patients yearly household income.","type":"number","x-nullable":true},"isMDCaresPatient":{"description":"Gets or sets the value indicating if the patient is MD Cares.","type":"boolean","x-nullable":true},"personCode":{"description":"Gets or sets the person code value for this patient.","type":"string"},"cobra":{"description":"Gets or sets the value indicating if the patient is COBRA.","type":"boolean","x-nullable":true},"isTestMember":{"description":"Gets or sets the value indicating if this is a test patient.","type":"boolean"},"ignoreMemberInfoInClaims":{"description":"Gets or sets the value indicating to ignore member info in claims. (CardHolder Only)","type":"boolean"},"setMemberInfoNextClaim":{"description":"Gets or sets the value indicating to set member info in the next claim. (CardHolder Only)","type":"boolean"},"roomNumber":{"description":"Gets or sets the room number for this patient.","type":"string"},"bedNumber":{"description":"Gets or sets the bed number for this patient.","type":"string"},"admittedDate":{"format":"date-time","description":"Gets or sets the datetime the patient was admitted.","type":"string","x-nullable":true},"dischargeDate":{"format":"date-time","description":"Gets or sets the datetime the patient was discharged.","type":"string","x-nullable":true},"cardHolderMemberID":{"format":"int64","description":"Gets the unique memberID of the cardholder associated with the current member.  If this value is equal to the ID of the current member, then this member is the cardholder.","type":"integer"},"currentPatientPlan":{"$ref":"#/definitions/CurrentPatientPlanModel","description":"The CurrentPatientPlan object will contain the details of the current patient plan for the member.  If no current plan exists, this object will be null."},"homeAddress":{"$ref":"#/definitions/PersonAddressModel","description":"The home address for the member.  This will be null if no home address exists."},"mailingAddress":{"$ref":"#/definitions/PersonAddressModel","description":"The mailing address for the member.  This will be null if no home address exists."},"clientID":{"type":"string"},"externalID":{"type":"string"},"currentFormulary":{"$ref":"#/definitions/MemberFormularyInfoModel"},"nextFuturePlan":{"$ref":"#/definitions/NextFuturePlanModel","description":"The FuturePatientPlan object will contain the details of the current patient plan for the member.  If no current plan exists, this object will be null."}}},"CurrentPatientPlanModel":{"description":"Represents the details of a current patient's plan, including contract and plan information.","type":"object","properties":{"planContractNo":{"format":"int64","description":"Gets or sets the unique contract number associated with the plan.  This value can be provided to the PlanContracts endpoint to retrieve additional contract details.","type":"integer","x-nullable":true},"contractCode":{"description":"Gets or sets the code identifying the contract.","type":"string"},"contractName":{"description":"Gets or sets the name of the contract.","type":"string"},"groupID":{"format":"int64","description":"Gets or sets the group identifier associated with the plan.  This value can be provided to the Groups endpoint to retrieve additional group details.","type":"integer","x-nullable":true},"groupPlanNo":{"format":"int64","description":"Gets or sets the unique number of the group plan.  This value can be provided to the GroupPlans endpoint to retrieve additional group plan details.","type":"integer","x-nullable":true},"planName":{"description":"Gets or sets the name of the plan.","type":"string"},"facilityARTypeNo":{"format":"int64","description":"Gets or sets unique identifier of the facility AR type with whith the patient is associated.  This value can be provided to the FacilityARTypes endpoint to retrieve additional facility AR type details.","type":"integer","x-nullable":true},"arShortCode":{"description":"Gets or sets the AR short code associated with the patient's current facilityARType.","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the start date of the plan's effective period.","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the end date of the plan's effective period.","type":"string","x-nullable":true},"patientPlanID":{"format":"int64","description":"The unique identifier for the patient's plan. This is used to reference the patient plan in other API calls.","type":"integer"}}},"MemberFormularyInfoModel":{"description":"This model is used to display which formulary a member is currently using","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"name":{"description":"The name of formulary","type":"string"}}},"NextFuturePlanModel":{"description":"Represents the details of a future patient's plan, including contract and plan information.","type":"object","properties":{"planContractNo":{"format":"int64","description":"Gets or sets the unique contract number associated with the plan.  This value can be provided to the PlanContracts endpoint to retrieve additional contract details.","type":"integer","x-nullable":true},"contractCode":{"description":"Gets or sets the code identifying the contract.","type":"string"},"contractName":{"description":"Gets or sets the name of the contract.","type":"string"},"groupID":{"format":"int64","description":"Gets or sets the group identifier associated with the plan.  This value can be provided to the Groups endpoint to retrieve additional group details.","type":"integer","x-nullable":true},"groupPlanNo":{"format":"int64","description":"Gets or sets the unique number of the group plan.  This value can be provided to the GroupPlans endpoint to retrieve additional group plan details.","type":"integer","x-nullable":true},"planName":{"description":"Gets or sets the name of the plan.","type":"string"},"facilityARTypeNo":{"format":"int64","description":"Gets or sets unique identifier of the facility AR type with whith the patient is associated.  This value can be provided to the FacilityARTypes endpoint to retrieve additional facility AR type details.","type":"integer","x-nullable":true},"arShortCode":{"description":"Gets or sets the AR short code associated with the patient's current facilityARType.","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the start date of the plan's effective period.","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the end date of the plan's effective period.","type":"string","x-nullable":true},"patientPlanID":{"format":"int64","description":"The unique identifier for the patient's plan. This is used to reference the patient plan in other API calls.","type":"integer"}}},"PagedResultModel[MemberSetupModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/MemberSetupModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"MemberSetupModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"lastName":{"description":"Gets or sets the member last name","type":"string"},"firstName":{"description":"Gets or sets the member first name","type":"string"},"middleName":{"description":"Gets or sets the member middle name","type":"string"},"dateOfBirth":{"format":"date-time","description":"Gets or sets the member date of birth","type":"string","x-nullable":true},"ssn":{"description":"Gets or sets the member SSN","type":"string"},"personCode":{"description":"Gets or sets the member person code","type":"string"},"gender":{"description":"Gets or sets the member gender - Valid values: M, F, O, U","type":"string"},"comment":{"description":"Gets or sets the member comment","type":"string"},"isTestMember":{"description":"Gets or sets whether the member is classified as a test member","type":"boolean"},"cardholderID":{"description":"Gets or sets the member's cardholder Id","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the member's effective start date; If not specified, the member's start date will be current date.","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the member's effective enddate.","type":"string","x-nullable":true},"planContractARTypeID":{"format":"int64","description":"Gets or sets the AR type associated to the member's plan","type":"integer"},"coverageLevelCode":{"description":"Gets or sets the member's coverage level code","type":"string"},"homePhone":{"description":"Gets or sets the member's home phone number","type":"string"},"homePhoneExt":{"description":"Gets or sets the member's home phone number extention","type":"string"},"emailAddress":{"description":"Gets or sets the member's email address","type":"string"},"homeAddress1":{"description":"Gets or sets the member's home address line 1","type":"string"},"homeAddress2":{"description":"Gets or sets the member's home address line 2","type":"string"},"homeCity":{"description":"Gets or sets the member's home address city","type":"string"},"homeState":{"description":"Gets or sets the member's home address state","type":"string"},"homeZip":{"description":"Gets or sets the member's home address zip code","type":"string"},"mailingAddress1":{"description":"Gets or sets the member's mailing address line 1","type":"string"},"mailingAddress2":{"description":"Gets or sets the member's mailing address line 2","type":"string"},"mailingCity":{"description":"Gets or sets the member's mailing address city","type":"string"},"mailingState":{"description":"Gets or sets the member's mailing address state","type":"string"},"mailingZip":{"description":"Gets or sets the member's mailing address zip code","type":"string"},"clientID":{"description":"","type":"string"},"externalID":{"description":"","type":"string"},"alternateID":{"description":"","type":"string"},"ignoreMemberInfoInClaims":{"description":"Gets or sets the value indicating to ignore member info in claims.","type":"boolean"},"setMemberInfoNextClaim":{"description":"Gets or sets the value indicating to set member info in the next claim.","type":"boolean"}}},"GroupPlanCopyPlanModel":{"type":"object","properties":{"destinationNo":{"format":"int64","description":"Gets or Sets the Destination PharmacyBranch ID","type":"integer"},"planTemplateNo":{"format":"int64","description":"Gets or sets the Template ID","type":"integer","x-nullable":true},"overrideTemplate":{"description":"Gets or sets the Override Template field","type":"boolean","x-nullable":true},"newPlanName":{"description":"The order in which this address should appear in a list","type":"string"},"startDate":{"format":"date-time","description":"Gets or sets the Start Date","type":"string","x-nullable":true},"endDate":{"format":"date-time","description":"Gets or sets the End Date","type":"string","x-nullable":true},"copyGeneralOptionsRules":{"description":"Gets or sets the Copy General Options Rules boolean.","type":"boolean"},"copyGeneralOptionsByDrugRules":{"description":"Gets or sets the Copy General Options By Drug Rules boolean.","type":"boolean"},"copyOverrideRules":{"description":"Gets or sets the Copy Override Rules boolean.","type":"boolean"},"copyStandardFormularyRules":{"description":"Gets or sets the Copy Standard Formulary Rules boolean.","type":"boolean"},"copyDAWRules":{"description":"Gets or sets the Copy DAW Rules boolean.","type":"boolean"},"copyPlanFormularyRules":{"description":"Gets or sets the Copy Plan Formulary Rules boolean.","type":"boolean"},"copyPharmacyFormularyRules":{"description":"Gets or sets the Copy Pharmacy Formulary Rules boolean.","type":"boolean"},"copyMemberFormularyRules":{"description":"Gets or sets the Copy Member Formualry Rules boolean.","type":"boolean"},"copyPrescriberFormularyRules":{"description":"Gets or sets the Copy Prescriber Formulary Rules boolean.","type":"boolean"},"copyStepTherapyRules":{"description":"Gets or sets the Copy Step Therapy Rules boolean.","type":"boolean"},"copyClaimLimitRules":{"description":"Gets or sets the Copy Claim Limit Rules boolean.","type":"boolean"},"copyClaimLimitDefaultRules":{"description":"Gets or sets the Copy ClaimLimitDefault Rules boolean.","type":"boolean"},"copyDrugOptionsRules":{"description":"Gets or sets the Copy Drug Options Rules boolean.","type":"boolean"},"copyClaimOptionsRules":{"description":"Gets or sets the Copy Claim Options Rules boolean.","type":"boolean"},"copyFinalFormularyRules":{"description":"Gets or sets the Copy Final Formulary Rules boolean.","type":"boolean"},"copyBenefitsRules":{"description":"Gets or sets the Copy Benefits Rules boolean.","type":"boolean"},"copyPostPricingRules":{"description":"Gets or sets the Copy Post Pricing Rules boolean.","type":"boolean"}}},"GroupPlanTemplateCopyPlanModel":{"type":"object","properties":{"newPlanName":{"description":"The order in which this address should appear in a list","type":"string"},"startDate":{"format":"date-time","description":"Gets or sets the Start Date","type":"string","x-nullable":true},"endDate":{"format":"date-time","description":"Gets or sets the End Date","type":"string","x-nullable":true},"copyGeneralOptionsRules":{"description":"Gets or sets the Copy General Options Rules boolean.","type":"boolean"},"copyGeneralOptionsByDrugRules":{"description":"Gets or sets the Copy General Options By Drug Rules boolean.","type":"boolean"},"copyOverrideRules":{"description":"Gets or sets the Copy Override Rules boolean.","type":"boolean"},"copyStandardFormularyRules":{"description":"Gets or sets the Copy Standard Formulary Rules boolean.","type":"boolean"},"copyDAWRules":{"description":"Gets or sets the Copy DAW Rules boolean.","type":"boolean"},"copyPlanFormularyRules":{"description":"Gets or sets the Copy Plan Formulary Rules boolean.","type":"boolean"},"copyPharmacyFormularyRules":{"description":"Gets or sets the Copy Pharmacy Formulary Rules boolean.","type":"boolean"},"copyMemberFormularyRules":{"description":"Gets or sets the Copy Member Formualry Rules boolean.","type":"boolean"},"copyPrescriberFormularyRules":{"description":"Gets or sets the Copy Prescriber Formulary Rules boolean.","type":"boolean"},"copyStepTherapyRules":{"description":"Gets or sets the Copy Step Therapy Rules boolean.","type":"boolean"},"copyClaimLimitRules":{"description":"Gets or sets the Copy Claim Limit Rules boolean.","type":"boolean"},"copyClaimLimitDefaultRules":{"description":"Gets or sets the Copy ClaimLimitDefault Rules boolean.","type":"boolean"},"copyDrugOptionsRules":{"description":"Gets or sets the Copy Drug Options Rules boolean.","type":"boolean"},"copyClaimOptionsRules":{"description":"Gets or sets the Copy Claim Options Rules boolean.","type":"boolean"},"copyFinalFormularyRules":{"description":"Gets or sets the Copy Final Formulary Rules boolean.","type":"boolean"},"copyBenefitsRules":{"description":"Gets or sets the Copy Benefits Rules boolean.","type":"boolean"},"copyPostPricingRules":{"description":"Gets or sets the Copy Post Pricing Rules boolean.","type":"boolean"}}},"GroupPlanTemplateModel":{"description":"Group Plan","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"planPricingGroupsUrl":{"description":"Gets or sets the link to the Plan Pricing Groups resource for the plan","type":"string"},"companyID":{"format":"uuid","description":"Gets or sets the identifier for the Company","type":"string","example":"00000000-0000-0000-0000-000000000000"},"planName":{"description":"Gets or sets the name given to represent the Plan","type":"string"},"description":{"description":"Gets or sets the description given to represent the plan","type":"string"},"validatePCN":{"description":"Gets or sets whether the PCN should match when processing claims","type":"boolean","x-nullable":true},"newStartDays":{"format":"int32","description":"Gets or sets the number of days that must lapse before drug is considered new.  Ex: Setting to 365 days would require the member to have stopped therapy for 365 days before it's considered new therapy again.","type":"integer","x-nullable":true},"maxClaimDays":{"format":"int32","description":"Gets or sets the maximum number of days the plan allows for submitting a claim based on the date of service","type":"integer","x-nullable":true},"maxReversalDays":{"format":"int32","description":"Gets or sets the maximum number days the plan allows for reversing a claim","type":"integer","x-nullable":true},"standardMessage":{"description":"Gets or sets the standard message in the claim header","type":"string"},"approveMessage":{"description":"Gets or sets the approve message in the claim header when claim is paid","type":"string"},"requiredOverrideMessage":{"description":"Gets or sets the prior authorization message in the claim header when drug requires a PA","type":"string"},"notCoveredMessage":{"description":"Gets or sets the not covered message in the claim header when drug is not covered","type":"string"},"outOfPocketMessage":{"description":"Gets or sets the out of pocket message in the claim header when out of pocket limit has been reached","type":"string"},"helpDeskPhoneNumber":{"description":"Gets or sets the help desk phone number","type":"string"},"unknownDispenseFee":{"format":"double","description":"Gets or sets the the catch-all dispense fee for the plan (obsolete)","type":"number","x-nullable":true},"unknownUseSubmittedDispenseFee":{"description":"Gets or sets whether to use the submitted dispense fee for unknown/undefined drugs (obsolete)","type":"boolean","x-nullable":true},"unknownUseUsualAndCustomary":{"description":"Gets or sets whether to use Usual and Customary for unknown/undefined drugs (obsolete)","type":"boolean","x-nullable":true},"unknownUseGrossAmountDue":{"description":"Gets or sets whether to use Gross Amount Due for unknown/undefined drugs (obsolete)","type":"boolean","x-nullable":true},"compoundPriceSubmittedDrugs":{"description":"Gets or sets the whether the plan will price each drug of a compound (obsolete)","type":"boolean","x-nullable":true},"compoundRequireValidNDC":{"description":"Gets or sets whether a valid NDC must be used in a compound claim (obsolete)","type":"boolean","x-nullable":true},"compoundMinimumDrugsToPrice":{"format":"int32","description":"Gets or sets the minimum number of drugs to price in the compound (obsolete)","type":"integer","x-nullable":true},"compoundMaxDrugsToPrice":{"format":"int32","description":"Gets or sets the maximum number of drugs to price in the compound (blank or null means all will be priced) (obsolete)","type":"integer","x-nullable":true},"compoundMinimumPrice":{"format":"double","description":"Gets or sets the minimum indgredient cost for the compound (obsolete)","type":"number","x-nullable":true},"compoundDefaultFee":{"format":"double","description":"Gets or sets the default dispense fee to be applied for a compound (level of effort 0) (obsolete)","type":"number","x-nullable":true},"compoundEffort1Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 1 (obsolete)","type":"number","x-nullable":true},"compoundEffort2Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 2 (obsolete)","type":"number","x-nullable":true},"compoundEffort3Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 3 (obsolete)","type":"number","x-nullable":true},"compoundEffort4Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 4 (obsolete)","type":"number","x-nullable":true},"compoundEffort5Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 5 (obsolete)","type":"number","x-nullable":true},"compoundUseSubmittedDispenseFee":{"description":"Gets or sets the indicates whether to use the submitted dispense fee from the pharmacy for the compound (obsolete)","type":"boolean","x-nullable":true},"compoundUseUsualAndCustomary":{"description":"Gets or sets the indicates whether to use the submitted Usual and Customary price from the pharmacy for the compound (obsolete)","type":"boolean","x-nullable":true},"compoundUseGrossAmountDue":{"description":"Gets or sets the indicates whether to use the Gross Amount Due price from the pharmacy for the compound (obsolete)","type":"boolean","x-nullable":true},"compoundDrugPricingUrl":{"description":"Gets or sets the link to the Drug Pricing resource for compound drugs","type":"string"},"compoundDrugPricingNo":{"format":"int64","description":"Gets or sets the identifier of the special drug pricing for a compound.","type":"integer","x-nullable":true},"unknownDrugPricingUrl":{"description":"Gets or sets the link to the Drug Pricing resource for unknown/undefined drugs","type":"string"},"unknownDrugPricingNo":{"format":"int64","description":"Gets or sets the identifier of the special drug pricing for an unknown/undefined drug.","type":"integer","x-nullable":true},"useNetworkCoinsurance":{"description":"Gets or sets whether to use Network Coinsurance if available","type":"boolean","x-nullable":true},"useNetworkIncentive":{"description":"Gets or sets whether to use Network Incentive if available","type":"boolean","x-nullable":true},"useNetworkDeductibleOptions":{"description":"Gets or set whether to use Network deductible options if available","type":"boolean","x-nullable":true},"durDrugDrugCheck":{"description":"Gets or sets whether to use Drug-Drug DUR","type":"boolean","x-nullable":true},"durDrugDrugLevelSeverity":{"description":"Gets or sets the least severe level of DUR the plan enforces","type":"string"},"durDrugDrugMessage":{"description":"Gets or sets the message to send in the claim response when severity is exceeded","type":"string"},"durDrugDrugActionTypeNo":{"format":"int64","description":"Gets or sets the action to take when severity level threshold is crossed","type":"integer","x-nullable":true},"mmeActionTypeNo":{"format":"int64","description":"Gets or sets the action to take when threshold is exceeded","type":"integer","x-nullable":true},"mmeThresholdCheck":{"description":"Gets or sets whether the system will determine if the patient is exceeding the daily dosage threshold for opioid medications","type":"boolean","x-nullable":true},"mmeThreshold":{"format":"int32","description":"Gets or sets the daily dosage threshold for opioid medications","type":"integer","x-nullable":true},"mmeResponseMessage":{"description":"Gets or sets the message to send in the claim response when MME Threshold is exceeded","type":"string"},"allowFutureDateOfService":{"description":"Gets or sets whether the plan allows claims with future date of service","type":"boolean","x-nullable":true},"defaultPharmacyTier":{"description":"Gets or sets the default pharmacy tier value that will be saved on the claim audit if it isn't specified elsewhere during processing of a claim","type":"string"},"returnMemberLookupMessages":{"description":"Gets or sets whether the eligibility messages are returned when using open enrollment and if the member was either found using an alternate lookup or was added to the system","type":"boolean","x-nullable":true},"subscribeToGlobalPricingACI":{"description":"Gets or sets whether the plan subscribes to Location/Global ACI pricing","type":"boolean","x-nullable":true},"subscribeToGlobalPricingAcqCost":{"description":"Gets or sets whether the plan subscribes to Location/Global acquisition pricing","type":"boolean","x-nullable":true},"subscribeToGlobalPricingCustomMAC":{"description":"Gets or sets whether the plan subscribes to Location/Global Custom MAC pricing","type":"boolean","x-nullable":true},"subscribeToGlobalPricingRefPrice":{"description":"Gets or sets whether the plan subscribes to Location/Global reference pricing","type":"boolean","x-nullable":true},"rxExpireDays":{"format":"int32","description":"Gets or sets the number of days to indicate that a prescription is \"expired.\"  An Rx is expired if the date of service is later than the first fill for the Rx plus the RxExpireDays.","type":"integer","x-nullable":true},"prescriberGraceDays":{"format":"int32","description":"Gets or sets the Prescriber Grace Days to be used in conjuction with prescriber effective dates in rules.  If a prescriber's effective date has expired, but the grace period has not been exceeded, the claim will continue processing.","type":"integer","x-nullable":true},"eligibilityRejectMessage":{"description":"Get or sets the message for eligibility rejects","type":"string"},"rejectClaimIfNoCustomPrice":{"description":"Gets or sets whether claims should reject if there is no custom pricing","type":"boolean","x-nullable":true},"prescriptionWrittenMaxDays":{"format":"int32","description":"Gets or sets the Prescription Written Max Days","type":"integer","x-nullable":true}}},"GroupSetupModel":{"description":"Represents the information needed to create a new group, facility, and plan with the minimum requirements","required":["groupName","groupNPI","existingGroupLogonName","facilityName","facilityNPI","facilityAdminFirstName","facilityAdminLastName","facilityLogonName","facilityLogonPassword"],"type":"object","properties":{"groupName":{"description":"Gets or sets the name of the location representing the new group","type":"string"},"groupNPI":{"description":"Gets or sets the NPI of the group","type":"string"},"existingGroupLogonName":{"description":"Gets or sets the exisitng Logon name for the new group, this exising logon will become the admin for the new group","type":"string"},"facilityName":{"description":"Gets or sets the name of the location representing the new facility","type":"string"},"facilityNPI":{"description":"Gets or sets the npi of the facility","type":"string"},"facilityAdminFirstName":{"description":"Gets or sets the first name of the new facility admin","type":"string"},"facilityAdminLastName":{"description":"Gets or sets the last name of the new facility admin","type":"string"},"facilityLogonName":{"description":"Gets or sets the logon name for the new facility","type":"string"},"facilityLogonPassword":{"description":"Gets or sets the logon password for the new facility","type":"string"},"groupPlanName":{"description":"Gets or sets the plan name for the new group plan","type":"string"},"groupPlanBin":{"description":"Gets or sets the bin for the new group plan","type":"string"},"groupPlanPcn":{"description":"Gets or sets the pcn for the new group plan","type":"string"},"groupPlanEffectiveStart":{"format":"date-time","description":"Gets or sets the effective start date for the new group plan","type":"string","x-nullable":true},"groupPlanEffectiveEnd":{"format":"date-time","description":"Gets or sets the effective end date for the new group plan","type":"string","x-nullable":true},"defaultEnforceQtyLimit":{"type":"boolean","x-nullable":true},"defaultEnforceDaysSupplyLimit":{"type":"boolean","x-nullable":true},"defaultEnforceRefillTooSoon":{"type":"boolean","x-nullable":true},"defaultEnforceMaxFillsLimit":{"type":"boolean","x-nullable":true},"defaultEnforceMaxPriceLimit":{"type":"boolean","x-nullable":true},"defaultEnforceStepTherapy":{"type":"boolean","x-nullable":true},"defaultEnforceAgeRestriction":{"type":"boolean","x-nullable":true},"defaultEnforcePlanFormulary":{"type":"boolean","x-nullable":true},"defaultEnforcePharmacyFormulary":{"type":"boolean","x-nullable":true},"defaultEnforceMemberFormulary":{"type":"boolean","x-nullable":true},"defaultEnforcePrescriberFormulary":{"type":"boolean","x-nullable":true},"defaultEnforceDAW":{"type":"boolean","x-nullable":true},"defaultEnforceFinalFormulary":{"type":"boolean","x-nullable":true},"defaultEnforcePostPricing":{"type":"boolean","x-nullable":true},"defaultEnforceRestrictedOverride":{"type":"boolean","x-nullable":true},"defaultEnforceFormularyNotCovered":{"type":"boolean","x-nullable":true},"defaultEnforceFormularyAgeLimit":{"type":"boolean","x-nullable":true},"defaultEnforceFormularyGenderLimit":{"type":"boolean","x-nullable":true},"defaultEnforceFormularyQtyLimit":{"type":"boolean","x-nullable":true},"defaultEnforceFormularyStepMed":{"type":"boolean","x-nullable":true},"defaultEnforceFormularyPriorAuth":{"type":"boolean","x-nullable":true},"defaultEnforceFormularyDiagnosisCodeLimit":{"type":"boolean","x-nullable":true},"groupID":{"format":"int64","description":"Gets the ID of the newly created group","type":"integer"}}},"NameValuePairModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"name":{"description":"Display name value of name value pair","type":"string"}}},"PagedResultModel[HeadquarterPharmacyLocationDeltaModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/HeadquarterPharmacyLocationDeltaModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"HeadquarterPharmacyLocationDeltaModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"pharmacyLocationNo":{"format":"int64","description":"The unique ID that identifies a pharmacy location record","type":"integer","x-nullable":true},"auditDate":{"format":"date-time","description":"The date of the change to the Headquarter Pharmacy Location record","type":"string","x-nullable":true},"transactionType":{"description":"This is the type of transaction that was performed on the record.  I for Insert, U for Update, D for Delete","type":"string"},"oldPharmacyHeadquarterNo":{"format":"int64","description":"The ID of the Pharmacy Headquarter Location record before the change","type":"integer","x-nullable":true},"newPharmacyHeadquarterNo":{"format":"int64","description":"The ID of the Pharmacy Headquarter Location record after the change","type":"integer","x-nullable":true}}},"PagedResultModel[HeadquarterPharmacyLocationModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/HeadquarterPharmacyLocationModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"HeadquarterPharmacyLocationModel":{"type":"object","properties":{"id":{"format":"int64","type":"integer"},"npi":{"type":"string"},"locationName":{"type":"string"},"city":{"type":"string"},"stateCode":{"type":"string"},"comment":{"type":"string"},"primaryPharmacyType":{"type":"string"},"ncpdp":{"type":"string"},"primaryRelationshipCode":{"type":"string"},"pharmacyHeadquarterNo":{"format":"int64","type":"integer"}}},"MemberManualClaimEntryModel":{"description":"Member Manual Claim","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"pharmacyNPI":{"description":"Gets or sets a Pharmacy NPI. If this field is supplied IngredientCostSubmitted, DispenseFeeSubmitted, IncentiveFeeSubmitted, UsualAndCustomaryAmount, and GrossAmountDue are required.","type":"string"},"ingredientCostSubmitted":{"format":"double","description":"Gets or sets the ingredient cost submitted. If this field is supplied PharmacyNPI, DispenseFeeSubmitted, IncentiveFeeSubmitted, UsualAndCustomaryAmount, and GrossAmountDue are required.","type":"number","x-nullable":true},"dispenseFeeSubmitted":{"format":"double","description":"Gets or sets the dispense fee submitted. If this field is supplied PharmacyNPI, IngredientCostSubmitted, IncentiveFeeSubmitted, UsualAndCustomaryAmount, and GrossAmountDue are required.","type":"number","x-nullable":true},"incentiveFeeSubmitted":{"format":"double","description":"Gets or sets the incentive fee submitted. If this field is supplied PharmacyNPI, IngredientCostSubmitted, DispenseFeeSubmitted, UsualAndCustomaryAmount, and GrossAmountDue are required.","type":"number","x-nullable":true},"usualAndCustomaryAmount":{"format":"double","description":"Gets or sets the usual and customary amount. If this field is supplied PharmacyNPI, IngredientCostSubmitted, DispenseFeeSubmitted, IncentiveFeeSubmitted, and GrossAmountDue are required.","type":"number","x-nullable":true},"grossAmountDue":{"format":"double","description":"Gets or sets the gross amount due. If this field is supplied PharmacyNPI, IngredientCostSubmitted, DispenseFeeSubmitted, IncentiveFeeSubmitted, and UsualAndCustomaryAmount are required.","type":"number","x-nullable":true},"rxCPersonID":{"format":"int32","description":"Gets or sets the patient's RxClearinghouse ID","type":"integer"},"ndc":{"description":"Gets or sets the drug's NDC","type":"string"},"planContractNo":{"format":"int64","description":"Gets or sets the plan contract identifier","type":"integer","x-nullable":true},"prescriptionReferenceNumber":{"description":"Gets or sets the claim's Rx Number","type":"string"},"fillNumber":{"format":"int32","description":"Gets or sets the claim's Fill Number","type":"integer","x-nullable":true},"quantityDispensed":{"format":"double","description":"Gets or sets the claim's Quantity Dispensed","type":"number","x-nullable":true},"quantityPrescribed":{"format":"int32","description":"Gets or sets the claim's quantity prescribed.","type":"integer"},"daysSupply":{"format":"int32","description":"Gets or sets the claim's Days Supply","type":"integer","x-nullable":true},"dateOfService":{"format":"date-time","description":"Gets or sets the claim's Date of Service","type":"string","x-nullable":true},"flatSalesTax":{"format":"double","description":"Gets or sets the claim's flat sales tax.","type":"number","x-nullable":true},"salesTaxPercent":{"format":"double","description":"Gets or sets the claim's sales tax percent.","type":"number","x-nullable":true},"dawCode":{"description":"Gets or sets the claim's Dispense as Written code","type":"string"},"dateWritten":{"format":"date-time","description":"Gets or sets the claim's date the prescription was written.","type":"string","x-nullable":true},"prescriberID":{"description":"Gets or sets the claim's prescriber's ID, typically the NPI number.","type":"string"},"prescriberFirstName":{"description":"Gets or sets the claim's prescriber's first name.","type":"string"},"prescriberLastName":{"description":"Gets or sets the claim's prescriber's last name.","type":"string"},"submissionClarificationCode":{"description":"Gets or sets the claim's submission clarification code.","type":"string"},"reasonForServiceCode":{"description":"Gets or sets the claim's reason for service code.","type":"string"},"professionalServiceCode":{"description":"Gets or sets the claim's professional service code.","type":"string"},"resultOfServiceCode":{"description":"Gets or sets the claim's result of service code.","type":"string"},"otherPayerPatientResponsibilityAmount":{"format":"double","description":"Gets or sets the claim's other payer balance if this is a secondary claim.","type":"number","x-nullable":true},"isEmergencyPrescription":{"description":"Gets or sets whether the prescription is an emergency prescription for the claim.","type":"boolean","x-nullable":true},"isCompound":{"description":"Gets or sets whether the prescription is a compound for the claim.","type":"boolean","x-nullable":true},"compoundIngredients":{"type":"array","items":{"$ref":"#/definitions/CompoundIngredientModel"}},"ingredientCostPaid":{"format":"double","description":"Gets or sets the ingredient cost paid. If this field is supplied DispenseFeePaid, IncentiveFee, and SalesTaxPaid are required.","type":"number","x-nullable":true},"dispenseFeePaid":{"format":"double","description":"Gets or sets the dispense fee paid. If this field is supplied IngredientCostPaid, IncentiveFee, and SalesTaxPaid are required.","type":"number","x-nullable":true},"incentiveFee":{"format":"double","description":"Gets or sets the incentive fee that is added to the drug price. If this field is supplied IngredientCostPaid, DispenseFeePaid, and SalesTaxPaid are required.","type":"number","x-nullable":true},"salesTaxPaid":{"format":"double","description":"Gets or sets the total amount of sales tax paid (including flat rate amount). If this field is supplied IngredientCostPaid, DispenseFeePaid, and IncentiveFee are required.","type":"number","x-nullable":true},"copay":{"format":"double","description":"Gets or sets the member responsible amount. If this field is supplied CoinsuranceRate is required.","type":"number","x-nullable":true},"coinsuranceRate":{"format":"double","description":"Gets or sets the member responsible rate. If this field is supplied Copay is required.","type":"number","x-nullable":true},"oopCopay":{"format":"double","description":"Gets or sets the member out of pocket amount. If this field is supplied OOPCoinsuranceRate is required.","type":"number","x-nullable":true},"oopCoinsuranceRate":{"format":"double","description":"Gets or sets the member out of pocket rate. If this field is supplied OOPCopay is required.","type":"number","x-nullable":true},"exemptFromDeductible":{"description":"Gets or sets a value indicating whether the claim is exempt from deductible.","type":"boolean","x-nullable":true},"exemptFromOutOfPocketLimit":{"description":"Gets or sets a value indicating whether the claim is exempt from out-of-pocket limit.","type":"boolean","x-nullable":true},"externalClaimNo":{"description":"Gets or sets an external claim number.","type":"string"},"notes":{"description":"Gets or sets a claim's notes.","type":"string"},"diagnosisCodes":{"type":"array","items":{"$ref":"#/definitions/DiagnosisCodeModel"}}}},"CompoundIngredientModel":{"type":"object","properties":{"productID":{"description":"Gets or sets the ID of the compound ingredient product.","type":"string"},"quantity":{"format":"int32","description":"Gets or sets the quantity of the compound ingredient.","type":"integer"},"drugCost":{"format":"double","description":"Gets or sets the cost of the compound ingredient drug.","type":"number","x-nullable":true},"basisOfCostDetermination":{"description":"Gets or sets the basis used to determine the cost of the compound ingredient, selected from a predefined list of options.","type":"string"}}},"ManualClaimEntryResultModel":{"type":"object","properties":{"claimNo":{"format":"int64","type":"integer"},"transactionResponseStatus":{"type":"string"},"rejectMessage":{"type":"string"},"pharmacyPrice":{"format":"double","type":"number"},"patientPayAmount":{"format":"double","type":"number"},"totalAmountPaid":{"format":"double","type":"number"},"isSuccessful":{"type":"boolean"},"responseString":{"description":"NCPDP Response String (Base64 encoded)","type":"string"},"adminFee":{"format":"double","type":"number"},"amountAppliedToPeriodicDeductible":{"format":"double","type":"number","x-nullable":true},"amountOfCoPay":{"format":"double","type":"number"},"amountOfCoInsurance":{"format":"double","type":"number"},"ingredientCostPaid":{"format":"double","type":"number","x-nullable":true},"dispensingFeePaid":{"format":"double","type":"number","x-nullable":true},"basisOfReimbursement":{"type":"string"}}},"PharmacyManualClaimEntryModel":{"description":"Pharmacy Manual Claim","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"pharmacyNPI":{"description":"Gets or sets a Pharmacy NPI. If this field is supplied IngredientCostSubmitted, DispenseFeeSubmitted, IncentiveFeeSubmitted, UsualAndCustomaryAmount, and GrossAmountDue are required.","type":"string"},"ingredientCostSubmitted":{"format":"double","description":"Gets or sets the ingredient cost submitted. If this field is supplied PharmacyNPI, DispenseFeeSubmitted, IncentiveFeeSubmitted, UsualAndCustomaryAmount, and GrossAmountDue are required.","type":"number","x-nullable":true},"dispenseFeeSubmitted":{"format":"double","description":"Gets or sets the dispense fee submitted. If this field is supplied PharmacyNPI, IngredientCostSubmitted, IncentiveFeeSubmitted, UsualAndCustomaryAmount, and GrossAmountDue are required.","type":"number","x-nullable":true},"incentiveFeeSubmitted":{"format":"double","description":"Gets or sets the incentive fee submitted. If this field is supplied PharmacyNPI, IngredientCostSubmitted, DispenseFeeSubmitted, UsualAndCustomaryAmount, and GrossAmountDue are required.","type":"number","x-nullable":true},"usualAndCustomaryAmount":{"format":"double","description":"Gets or sets the usual and customary amount. If this field is supplied PharmacyNPI, IngredientCostSubmitted, DispenseFeeSubmitted, IncentiveFeeSubmitted, and GrossAmountDue are required.","type":"number","x-nullable":true},"grossAmountDue":{"format":"double","description":"Gets or sets the gross amount due. If this field is supplied PharmacyNPI, IngredientCostSubmitted, DispenseFeeSubmitted, IncentiveFeeSubmitted, and UsualAndCustomaryAmount are required.","type":"number","x-nullable":true},"rxCPersonID":{"format":"int32","description":"Gets or sets the patient's RxClearinghouse ID","type":"integer"},"ndc":{"description":"Gets or sets the drug's NDC","type":"string"},"planContractNo":{"format":"int64","description":"Gets or sets the plan contract identifier","type":"integer","x-nullable":true},"prescriptionReferenceNumber":{"description":"Gets or sets the claim's Rx Number","type":"string"},"fillNumber":{"format":"int32","description":"Gets or sets the claim's Fill Number","type":"integer","x-nullable":true},"quantityDispensed":{"format":"double","description":"Gets or sets the claim's Quantity Dispensed","type":"number","x-nullable":true},"quantityPrescribed":{"format":"int32","description":"Gets or sets the claim's quantity prescribed.","type":"integer"},"daysSupply":{"format":"int32","description":"Gets or sets the claim's Days Supply","type":"integer","x-nullable":true},"dateOfService":{"format":"date-time","description":"Gets or sets the claim's Date of Service","type":"string","x-nullable":true},"flatSalesTax":{"format":"double","description":"Gets or sets the claim's flat sales tax.","type":"number","x-nullable":true},"salesTaxPercent":{"format":"double","description":"Gets or sets the claim's sales tax percent.","type":"number","x-nullable":true},"dawCode":{"description":"Gets or sets the claim's Dispense as Written code","type":"string"},"dateWritten":{"format":"date-time","description":"Gets or sets the claim's date the prescription was written.","type":"string","x-nullable":true},"prescriberID":{"description":"Gets or sets the claim's prescriber's ID, typically the NPI number.","type":"string"},"prescriberFirstName":{"description":"Gets or sets the claim's prescriber's first name.","type":"string"},"prescriberLastName":{"description":"Gets or sets the claim's prescriber's last name.","type":"string"},"submissionClarificationCode":{"description":"Gets or sets the claim's submission clarification code.","type":"string"},"reasonForServiceCode":{"description":"Gets or sets the claim's reason for service code.","type":"string"},"professionalServiceCode":{"description":"Gets or sets the claim's professional service code.","type":"string"},"resultOfServiceCode":{"description":"Gets or sets the claim's result of service code.","type":"string"},"otherPayerPatientResponsibilityAmount":{"format":"double","description":"Gets or sets the claim's other payer balance if this is a secondary claim.","type":"number","x-nullable":true},"isEmergencyPrescription":{"description":"Gets or sets whether the prescription is an emergency prescription for the claim.","type":"boolean","x-nullable":true},"isCompound":{"description":"Gets or sets whether the prescription is a compound for the claim.","type":"boolean","x-nullable":true},"compoundIngredients":{"type":"array","items":{"$ref":"#/definitions/CompoundIngredientModel"}},"ingredientCostPaid":{"format":"double","description":"Gets or sets the ingredient cost paid. If this field is supplied DispenseFeePaid, IncentiveFee, and SalesTaxPaid are required.","type":"number","x-nullable":true},"dispenseFeePaid":{"format":"double","description":"Gets or sets the dispense fee paid. If this field is supplied IngredientCostPaid, IncentiveFee, and SalesTaxPaid are required.","type":"number","x-nullable":true},"incentiveFee":{"format":"double","description":"Gets or sets the incentive fee that is added to the drug price. If this field is supplied IngredientCostPaid, DispenseFeePaid, and SalesTaxPaid are required.","type":"number","x-nullable":true},"salesTaxPaid":{"format":"double","description":"Gets or sets the total amount of sales tax paid (including flat rate amount). If this field is supplied IngredientCostPaid, DispenseFeePaid, and IncentiveFee are required.","type":"number","x-nullable":true},"copay":{"format":"double","description":"Gets or sets the member responsible amount. If this field is supplied CoinsuranceRate is required.","type":"number","x-nullable":true},"coinsuranceRate":{"format":"double","description":"Gets or sets the member responsible rate. If this field is supplied Copay is required.","type":"number","x-nullable":true},"oopCopay":{"format":"double","description":"Gets or sets the member out of pocket amount. If this field is supplied OOPCoinsuranceRate is required.","type":"number","x-nullable":true},"oopCoinsuranceRate":{"format":"double","description":"Gets or sets the member out of pocket rate. If this field is supplied OOPCopay is required.","type":"number","x-nullable":true},"exemptFromDeductible":{"description":"Gets or sets a value indicating whether the claim is exempt from deductible.","type":"boolean","x-nullable":true},"exemptFromOutOfPocketLimit":{"description":"Gets or sets a value indicating whether the claim is exempt from out-of-pocket limit.","type":"boolean","x-nullable":true},"externalClaimNo":{"description":"Gets or sets an external claim number.","type":"string"},"notes":{"description":"Gets or sets a claim's notes.","type":"string"},"diagnosisCodes":{"type":"array","items":{"$ref":"#/definitions/DiagnosisCodeModel"}}}},"TestManualClaimEntryModel":{"description":"Test Manual Claim","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"pharmacyNPI":{"description":"Gets or sets a Pharmacy NPI. If this field is supplied IngredientCostSubmitted, DispenseFeeSubmitted, IncentiveFeeSubmitted, UsualAndCustomaryAmount, and GrossAmountDue are required.","type":"string"},"ingredientCostSubmitted":{"format":"double","description":"Gets or sets the ingredient cost submitted. If this field is supplied PharmacyNPI, DispenseFeeSubmitted, IncentiveFeeSubmitted, UsualAndCustomaryAmount, and GrossAmountDue are required.","type":"number","x-nullable":true},"dispenseFeeSubmitted":{"format":"double","description":"Gets or sets the dispense fee submitted. If this field is supplied PharmacyNPI, IngredientCostSubmitted, IncentiveFeeSubmitted, UsualAndCustomaryAmount, and GrossAmountDue are required.","type":"number","x-nullable":true},"incentiveFeeSubmitted":{"format":"double","description":"Gets or sets the incentive fee submitted. If this field is supplied PharmacyNPI, IngredientCostSubmitted, DispenseFeeSubmitted, UsualAndCustomaryAmount, and GrossAmountDue are required.","type":"number","x-nullable":true},"usualAndCustomaryAmount":{"format":"double","description":"Gets or sets the usual and customary amount. If this field is supplied PharmacyNPI, IngredientCostSubmitted, DispenseFeeSubmitted, IncentiveFeeSubmitted, and GrossAmountDue are required.","type":"number","x-nullable":true},"grossAmountDue":{"format":"double","description":"Gets or sets the gross amount due. If this field is supplied PharmacyNPI, IngredientCostSubmitted, DispenseFeeSubmitted, IncentiveFeeSubmitted, and UsualAndCustomaryAmount are required.","type":"number","x-nullable":true},"rxCPersonID":{"format":"int32","description":"Gets or sets the patient's RxClearinghouse ID","type":"integer"},"ndc":{"description":"Gets or sets the drug's NDC","type":"string"},"planContractNo":{"format":"int64","description":"Gets or sets the plan contract identifier","type":"integer","x-nullable":true},"prescriptionReferenceNumber":{"description":"Gets or sets the claim's Rx Number","type":"string"},"fillNumber":{"format":"int32","description":"Gets or sets the claim's Fill Number","type":"integer","x-nullable":true},"quantityDispensed":{"format":"double","description":"Gets or sets the claim's Quantity Dispensed","type":"number","x-nullable":true},"quantityPrescribed":{"format":"int32","description":"Gets or sets the claim's quantity prescribed.","type":"integer"},"daysSupply":{"format":"int32","description":"Gets or sets the claim's Days Supply","type":"integer","x-nullable":true},"dateOfService":{"format":"date-time","description":"Gets or sets the claim's Date of Service","type":"string","x-nullable":true},"flatSalesTax":{"format":"double","description":"Gets or sets the claim's flat sales tax.","type":"number","x-nullable":true},"salesTaxPercent":{"format":"double","description":"Gets or sets the claim's sales tax percent.","type":"number","x-nullable":true},"dawCode":{"description":"Gets or sets the claim's Dispense as Written code","type":"string"},"dateWritten":{"format":"date-time","description":"Gets or sets the claim's date the prescription was written.","type":"string","x-nullable":true},"prescriberID":{"description":"Gets or sets the claim's prescriber's ID, typically the NPI number.","type":"string"},"prescriberFirstName":{"description":"Gets or sets the claim's prescriber's first name.","type":"string"},"prescriberLastName":{"description":"Gets or sets the claim's prescriber's last name.","type":"string"},"submissionClarificationCode":{"description":"Gets or sets the claim's submission clarification code.","type":"string"},"reasonForServiceCode":{"description":"Gets or sets the claim's reason for service code.","type":"string"},"professionalServiceCode":{"description":"Gets or sets the claim's professional service code.","type":"string"},"resultOfServiceCode":{"description":"Gets or sets the claim's result of service code.","type":"string"},"otherPayerPatientResponsibilityAmount":{"format":"double","description":"Gets or sets the claim's other payer balance if this is a secondary claim.","type":"number","x-nullable":true},"isEmergencyPrescription":{"description":"Gets or sets whether the prescription is an emergency prescription for the claim.","type":"boolean","x-nullable":true},"isCompound":{"description":"Gets or sets whether the prescription is a compound for the claim.","type":"boolean","x-nullable":true},"compoundIngredients":{"type":"array","items":{"$ref":"#/definitions/CompoundIngredientModel"}},"ingredientCostPaid":{"format":"double","description":"Gets or sets the ingredient cost paid. If this field is supplied DispenseFeePaid, IncentiveFee, and SalesTaxPaid are required.","type":"number","x-nullable":true},"dispenseFeePaid":{"format":"double","description":"Gets or sets the dispense fee paid. If this field is supplied IngredientCostPaid, IncentiveFee, and SalesTaxPaid are required.","type":"number","x-nullable":true},"incentiveFee":{"format":"double","description":"Gets or sets the incentive fee that is added to the drug price. If this field is supplied IngredientCostPaid, DispenseFeePaid, and SalesTaxPaid are required.","type":"number","x-nullable":true},"salesTaxPaid":{"format":"double","description":"Gets or sets the total amount of sales tax paid (including flat rate amount). If this field is supplied IngredientCostPaid, DispenseFeePaid, and IncentiveFee are required.","type":"number","x-nullable":true},"copay":{"format":"double","description":"Gets or sets the member responsible amount. If this field is supplied CoinsuranceRate is required.","type":"number","x-nullable":true},"coinsuranceRate":{"format":"double","description":"Gets or sets the member responsible rate. If this field is supplied Copay is required.","type":"number","x-nullable":true},"oopCopay":{"format":"double","description":"Gets or sets the member out of pocket amount. If this field is supplied OOPCoinsuranceRate is required.","type":"number","x-nullable":true},"oopCoinsuranceRate":{"format":"double","description":"Gets or sets the member out of pocket rate. If this field is supplied OOPCopay is required.","type":"number","x-nullable":true},"exemptFromDeductible":{"description":"Gets or sets a value indicating whether the claim is exempt from deductible.","type":"boolean","x-nullable":true},"exemptFromOutOfPocketLimit":{"description":"Gets or sets a value indicating whether the claim is exempt from out-of-pocket limit.","type":"boolean","x-nullable":true},"externalClaimNo":{"description":"Gets or sets an external claim number.","type":"string"},"notes":{"description":"Gets or sets a claim's notes.","type":"string"},"diagnosisCodes":{"type":"array","items":{"$ref":"#/definitions/DiagnosisCodeModel"}}}},"PagedResult[MaxOutOfPocketModel]":{"type":"object","properties":{"pageIndex":{"format":"int32","type":"integer","readOnly":true},"pageSize":{"format":"int32","type":"integer","readOnly":true},"totalCount":{"format":"int32","type":"integer"},"totalPageCount":{"format":"int32","type":"integer"},"items":{"type":"array","items":{"$ref":"#/definitions/MaxOutOfPocketModel"},"readOnly":true},"hasPreviousPage":{"type":"boolean","readOnly":true},"hasNextPage":{"type":"boolean","readOnly":true}}},"MemberClaimModel":{"description":"Member Claim","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"originalClaimNo":{"format":"int64","description":"Gets or sets Original Claim Number","type":"integer"},"transactionResponseStatus":{"description":"Gets or sets the claim's transaction response status","type":"string"},"transactionCode":{"description":"Gets or sets the claim's transaction code (e.g. B1 or B2)","type":"string"},"rxCPatientID":{"format":"int32","description":"Gets or sets the patient's RxClearinghouse ID","type":"integer"},"dateOfBirth":{"format":"date-time","type":"string","x-nullable":true},"bin":{"description":"Gets or sets the claim's Bin","type":"string"},"pcn":{"description":"Gets or sets the claim's PCN","type":"string"},"groupID":{"description":"Gets or sets the claim's Group ID","type":"string"},"prescriptionReferenceNumber":{"description":"Gets or sets the claim's Rx Number","type":"string"},"fillNumber":{"format":"int32","description":"Gets or sets the claim's Fill Number","type":"integer","x-nullable":true},"dawCode":{"description":"Gets or sets the claim's Dispense as Written code","type":"string"},"submissionClarificationCode":{"description":"Gets or sets the claim's Submission Clarification Code","type":"string"},"claimDate":{"format":"date-time","description":"Gets or sets the claim's date received by processor","type":"string","x-nullable":true},"reversed":{"description":"Gets or sets the claim's Reversed status flag","type":"boolean"},"reversedDate":{"format":"date-time","description":"Gets or sets the claim's reversed date if it has been reversed","type":"string","x-nullable":true},"dateOfService":{"format":"date-time","description":"Gets or sets the claim's Date of Service","type":"string","x-nullable":true},"datePrescriptionWritten":{"format":"date-time","description":"Gets or sets the claim's Date Prescription Written","type":"string","x-nullable":true},"quantityDispensed":{"format":"double","description":"Gets or sets the claim's Quantity Dispensed","type":"number","x-nullable":true},"daysSupply":{"format":"int32","description":"Gets or sets the claim's Days Supply","type":"integer","x-nullable":true},"drugName":{"description":"Gets or sets claim's drug name","type":"string"},"genericName":{"description":"Gets or sets the drug's generic drug name","type":"string"},"strengthDescription":{"description":"Gets or sets the drug's strength and description (e.g. 0.50 MG - TABS)","type":"string"},"dosageFormDescription":{"description":"Gets or sets the drug's dosage form description (e.g. Tablet)","type":"string"},"routeOfAdministrationDescription":{"description":"Gets or sets the drug's route of adminisration (e.g. Oral)","type":"string"},"genericProductIdentifier":{"description":"Gets or sets the drug's Generic Product Identifier (GPI)","type":"string"},"isMultiSourced":{"description":"Gets or sets whether the drug on the claim is multi-sourced","type":"boolean","x-nullable":true},"multiSourceCode":{"description":"Gets or sets the drug's multi-source code","type":"string"},"deaClassCode":{"description":"Gets or sets the drug's DEA class code","type":"string"},"isRx":{"description":"Gets or sets whether the drug requires written prescription","type":"boolean","x-nullable":true},"ndc":{"description":"Gets or sets the drug's NDC","type":"string"},"ingredientCostPaid":{"format":"double","description":"Gets or sets the claim's ingredient cost paid according to plan","type":"number","x-nullable":true},"dispensingFeePaid":{"format":"double","description":"Gets or sets the claim's dispensing fee paid according to plan","type":"number","x-nullable":true},"incentiveAmountPaid":{"format":"double","description":"Gets or sets the claim's incentive amount paid accourding to plan","type":"number","x-nullable":true},"professionalServiceFeePaid":{"format":"double","description":"Gets or sets the claim's professional service fee paid according to plan","type":"number","x-nullable":true},"flatSalesTaxAmountPaid":{"format":"double","description":"Gets or sets the claim's flat sales tax amount paid","type":"number","x-nullable":true},"percentageSalesTaxAmountPaid":{"format":"double","description":"Gets or sets the claim's percentage sales tax amount paid","type":"number","x-nullable":true},"percentageSalesTaxRatePaid":{"format":"double","description":"Gets or sets the claim's percentage sales tax rate","type":"number","x-nullable":true},"pharmacyPrice":{"format":"double","description":"Gets or sets the claim's pharmcy price","type":"number","x-nullable":true},"amountOfCoPay":{"format":"double","description":"Gets or sets the claim's Copay according to plan","type":"number","x-nullable":true},"amountOfCoInsurance":{"format":"double","description":"Gets or sets the claim's Coinsurance according to plan","type":"number","x-nullable":true},"drugSelectionPenalty":{"format":"double","description":"Gets or sets the claim's drug selection penalty","type":"number","x-nullable":true},"amountExceedingPeriodicBenefitMaximum":{"format":"double","description":"Gets or sets the claim's amount that exceeded periodic benefit maximum according to plan","type":"number","x-nullable":true},"totalAmountPaid":{"format":"double","description":"Gets or sets the claim's total amount paid","type":"number","x-nullable":true},"patientPayAmount":{"format":"double","description":"Gets or sets the claim's patient pay amount","type":"number","x-nullable":true},"grossAmountDue":{"format":"double","description":"Gets or sets the gross amount due supplied in the claim","type":"number","x-nullable":true},"secondaryPayer":{"description":"Gets or sets whether claim is secondary payer","type":"boolean","x-nullable":true},"cobAmount":{"format":"double","description":"Gets or sets the coordination of benefit amount","type":"number","x-nullable":true},"deductibleDescription":{"description":"Gets or sets the claim's deductible description set by plan","type":"string"},"moopDescription":{"description":"Gets or sets the claims max out of pocket description set by plan","type":"string"},"planIncentiveDescription":{"description":"Gets or sets the plan incentive description set by plan","type":"string"},"benefitCodeDescription":{"description":"Gets or sets the benefit code description set by plan","type":"string"},"pharmacyNPI":{"description":"Gets or sets the NPI of the pharmacy","type":"string"},"pharmacyLocationName":{"description":"Gets or sets the name of the pharmacy","type":"string"},"prescriberID":{"description":"Gets or set the ID of the prescriber submitted in the claim","type":"string"},"prescriberName":{"description":"Gets or sets the name of the prescriber","type":"string"},"amountAppliedToPeriodicDeductible":{"format":"double","description":"Gets or sets the amount applied to periodic deductible","type":"number","x-nullable":true},"pricingMethod":{"description":"Gets or sets the pricing method used when the claim was processed","type":"string"},"pricingMethodDetail":{"description":"Gets or sets the pricing method detail used when the claim was processed","type":"string"},"therapeuticClass02":{"description":"Gets or sets the Therapeutic class (level 2)","type":"string"},"therapeuticClass04":{"description":"Gets or sets the Therapeutic class (level 4)","type":"string"},"therapeuticClass06":{"description":"Gets or sets the Therapeutic class (level 6)","type":"string"},"therapeuticClass08":{"description":"Gets or sets the Therapeutic class (level 8)","type":"string"},"therapeuticClass10":{"description":"Gets or sets the Therapeutic class (level 10)","type":"string"},"therapeuticClass12":{"description":"Gets or sets the Therapeutic class (level 12)","type":"string"},"therapeuticClass14":{"description":"Gets or sets the Therapeutic class (level 14)","type":"string"},"brandNameCode":{"description":"Gets or sets the brand name code of the drug (B/G/T)","type":"string"},"planPricingGroup":{"description":"Gets or sets the plan pricing group used for processing","type":"string"},"enforcedRules":{"description":"Gets or sets a delimited (^) list of enforced rules","type":"string"},"otherStatusCode":{"description":"Gets or sets the code representing the other status.","type":"string"},"otherStatus":{"description":"Gets or sets the status.","type":"string"},"otherStatusDetail":{"description":"Gets or sets the detailed description of the status.","type":"string"},"otherStatusCode2":{"description":"Gets or sets the code representing the other status 2.","type":"string"},"otherStatus2":{"description":"Gets or sets the status 2.","type":"string"},"otherStatusDetail2":{"description":"Gets or sets the detailed description of the status 2.","type":"string"},"otherStatusCode3":{"description":"Gets or sets the code representing the other status 3.","type":"string"},"otherStatus3":{"description":"Gets or sets the status 3.","type":"string"},"otherStatusDetail3":{"description":"Gets or sets the detailed description of the status 3.","type":"string"},"otherStatusCode4":{"description":"Gets or sets the code representing the other status 4.","type":"string"},"otherStatus4":{"description":"Gets or sets the status 4.","type":"string"},"otherStatusDetail4":{"description":"Gets or sets the detailed description of the status 4.","type":"string"},"otherStatusCode5":{"description":"Gets or sets the code representing the other status 5.","type":"string"},"otherStatus5":{"description":"Gets or sets the status 5.","type":"string"},"otherStatusDetail5":{"description":"Gets or sets the detailed description of the status 5.","type":"string"},"otherStatusCode6":{"description":"Gets or sets the code representing the other status 6.","type":"string"},"otherStatus6":{"description":"Gets or sets the status 6.","type":"string"},"otherStatusDetail6":{"description":"Gets or sets the detailed description of the status 6.","type":"string"},"otherStatusCode7":{"description":"Gets or sets the code representing the other status 7.","type":"string"},"otherStatus7":{"description":"Gets or sets the status 7.","type":"string"},"otherStatusDetail7":{"description":"Gets or sets the detailed description of the status 7.","type":"string"},"otherStatusCode8":{"description":"Gets or sets the code representing the other status 8.","type":"string"},"otherStatus8":{"description":"Gets or sets the status 8.","type":"string"},"otherStatusDetail8":{"description":"Gets or sets the detailed description of the status 8.","type":"string"},"primaryRules":{"description":"Gets or sets the list of rules that were examined during adjudication","type":"array","items":{"$ref":"#/definitions/MemberClaimRuleModel"}},"secondaryRules":{"description":"Get or sets the secondary list of rules that were examined during adjudication (secondary rules may be plan specific if template level rules were applied earlier)","type":"array","items":{"$ref":"#/definitions/MemberClaimRuleModel"}},"additionalMessageInfo":{"description":"Gets or sets the list of additional messages that were supplied in the claim response","type":"array","items":{"$ref":"#/definitions/MessageInfoModel"}},"rejectInfo":{"description":"Gets or sets the list of reject messages and descriptions that were supplied in the claim response","type":"array","items":{"$ref":"#/definitions/RejectInfoModel"}},"isManualClaim":{"description":"Gets or sets the value indicating whether this claim is a manual claim","type":"boolean"}}},"MemberClaimRuleModel":{"description":"Rule information representing rules that were applied during adjudication","type":"object","properties":{"ruleType":{"description":"Gets or sets the type of applied rule","type":"string"},"description":{"description":"Gets or sets the description of applied rule","type":"string"},"ruleActionType":{"description":"Gets or sets the action type of the applied rule","type":"string"},"enforced":{"description":"Gets or sets whether the rule was actually enforced","type":"boolean"},"usedDAW":{"description":"Gets or sets whether DAW was used","type":"boolean"},"overriden":{"description":"Gets or sets whether the rule was overriden","type":"boolean"},"processingEnded":{"description":"Gets or sets whether processing ended","type":"boolean","x-nullable":true},"note":{"description":"Gets or sets the note, if any applied","type":"string"},"sortKey":{"format":"int32","description":"Gets or sets the order in which the rules were applied","type":"integer"}}},"MessageInfoModel":{"description":"Message information that was returned in claim response","type":"object","properties":{"messageInfo":{"description":"Gets or sets the message information associated with claim response","type":"string"}}},"RejectInfoModel":{"description":"Reject information that was returned in claim response","type":"object","properties":{"rejectCode":{"description":"Gets or sets the reject code associated with claim response","type":"string"},"messageInfo":{"description":"Gets or sets the message information associated with claim response","type":"string"}}},"CancellationToken":{"type":"object","properties":{"isCancellationRequested":{"type":"boolean","readOnly":true},"canBeCanceled":{"type":"boolean","readOnly":true},"waitHandle":{"$ref":"#/definitions/WaitHandle","readOnly":true}}},"WaitHandle":{"type":"object","properties":{"handle":{"type":"object"},"safeWaitHandle":{"$ref":"#/definitions/SafeWaitHandle"}}},"SafeWaitHandle":{"type":"object","properties":{"isInvalid":{"type":"boolean","readOnly":true},"isClosed":{"type":"boolean","readOnly":true}}},"MemberOtherClaimModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"rxCPatientID":{"format":"int32","description":"Gets or sets the patient's RxClearinghouse ID.  This property is being deprecated.  Please use the MemberID property moving forward","type":"integer"},"memberID":{"format":"int64","description":"Gets or sets the unique identifier for a member to whom an other claim belongs.  The value used here should match the ID returned\r\non the members or groupmembers endpoint for a member.","type":"integer","x-nullable":true},"cardholderMemberID":{"format":"int64","type":"integer","x-nullable":true},"dateOfService":{"format":"date-time","description":"Gets or sets the other claim's Date of Service","type":"string"},"ndc":{"description":"Gets or sets the drug's NDC","type":"string"},"quantityDispensed":{"format":"double","description":"Gets or sets the other claim's Quantity Dispensed","type":"number","x-nullable":true},"daysSupply":{"format":"int32","description":"Gets or sets the other claim's Days Supply","type":"integer","x-nullable":true},"patientPayAmount":{"format":"double","description":"Gets or sets the other claim's patient pay amount","type":"number","x-nullable":true},"planPaidAmount":{"format":"double","description":"Gets or sets the other claim's plan paid amount paid","type":"number","x-nullable":true},"amountEligibleTowardsDeductible":{"format":"double","description":"Gets or sets the amount eligible towards the patient's deductible","type":"number","x-nullable":true},"amountEligibleTowardsOOP":{"format":"double","description":"Gets or sets the amount eligible towards the patient's out of pocket","type":"number","x-nullable":true},"benefitCode":{"description":"Gets or sets the other claim's benefit code","type":"string"},"note":{"description":"Gets or sets the other claim's note","type":"string"},"prescriptionReferenceNumber":{"description":"Gets or sets the other claim's RxNumber","type":"string"},"pharmacyLocationSeqNo":{"format":"int64","description":"Gets or sets the other claim's pharmacy location SeqNo","type":"integer","x-nullable":true},"pharmacyLocationUrl":{"description":"Gets or sets the other claim's pharmacy location URL","type":"string"}}},"MemberOtherStatusModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"memberNo":{"format":"int64","description":"Gets or sets the id of the member that this other status is assigned to.","type":"integer"},"otherStatusNo":{"format":"int64","description":"Gets or sets the id of the other status to assign to this MemberOtherStatus.  Valid values can be looked up by group in the OtherStatus endpoint.","type":"integer"},"effectiveDate":{"format":"date-time","description":"Gets or sets the effective date of the status.","type":"string"},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the end date of the effective status.","type":"string","x-nullable":true},"inactive":{"description":"Gets or sets a value indicating whether the status is inactive.","type":"boolean"},"otherStatusNumber":{"format":"int32","description":"This field indicates whether the status is a 1, 2, 3, 4, 5, 6, 7, or 8","type":"integer"}}},"NetworkAccessFeeReversalModel":{"description":"Network Access Fee Reversal Value","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"description":{"description":"Gets or sets the description of the network access fee reversal value","type":"string"},"sortKey":{"format":"int32","description":"Gets or sets the sort key of the network access fee reversal value","type":"integer"}}},"PagedResultModel[NetworkPharmacyHeadquarterDeltaModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/NetworkPharmacyHeadquarterDeltaModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"NetworkPharmacyHeadquarterDeltaModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"networkPharmacyHeadquarterSeqNo":{"format":"int64","description":"This is the ID that uniquely identifies a network pharmacy headquarter record (the record that associates a pharmacy headquarter to a network)","type":"integer","x-nullable":true},"auditDate":{"format":"date-time","description":"The date of the change to the NetworkPharmacyHeadquarter record","type":"string","x-nullable":true},"transactionType":{"description":"This is the type of transaction that was performed on the record.  I for Insert, U for Update, D for Delete","type":"string"},"networkNo":{"format":"int64","description":"This is the ID that uniquely identifies a network record","type":"integer","x-nullable":true},"pharmacyHeadquarterNo":{"format":"int64","description":"This is the ID that uniquely identifies a pharmacy headquarter record","type":"integer","x-nullable":true}}},"PagedResultModel[NetworkPharmacyHeadquarterConsolidatedModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/NetworkPharmacyHeadquarterConsolidatedModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"NetworkPharmacyHeadquarterConsolidatedModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"pharmacyHeadquarterNo":{"format":"int64","description":"Gets or sets the pharmacy headquarter identifier","type":"integer"},"pharmacyHeadquarterName":{"description":"Gets or sets the pharmacy headquarter name","type":"string"},"pharmacyHeadquarterInactive":{"description":"Gets or sets whether the pharmacy headquarter is inactive","type":"boolean","x-nullable":true},"planNo":{"format":"int64","description":"Gets or sets the Plan number","type":"integer","x-nullable":true},"planName":{"description":"Gets or sets the Plan name","type":"string"},"networkNo":{"format":"int64","description":"Gets or sets the Network number","type":"integer","x-nullable":true},"networkName":{"description":"Gets or sets the Network name","type":"string"},"comment":{"description":"Gets or sets the comment for the network pharmacy headquarter","type":"string"}}},"NetworkPlanModel":{"description":"Group Plan","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"deductiblesUrl":{"description":"Gets or sets the link to the Deductibles resource for the plan","type":"string"},"planIncentivesUrl":{"description":"Gets or sets the link to the Plan Incentive resource for the plan","type":"string"},"planPricingGroupsUrl":{"description":"Gets or sets the link to the Plan Pricing Groups resource for the plan","type":"string"},"planName":{"description":"Gets or sets the name given to represent the Plan","type":"string"},"description":{"description":"Gets or sets the description given to represent the plan","type":"string"},"maxClaimDays":{"format":"int32","description":"Gets or sets the maximum number of days the plan allows for submitting a claim based on the date of service","type":"integer","x-nullable":true},"maxReversalDays":{"format":"int32","description":"Gets or sets the maximum number days the plan allows for reversing a claim","type":"integer","x-nullable":true},"defaultDrugTier":{"format":"int32","description":"Gets or sets the the default Tier captured if not specified on the formulary (obsolete)","type":"integer","x-nullable":true},"enforceFormularyLimits":{"description":"Gets or sets the option to enforce formulary limits (obsolete)","type":"boolean","x-nullable":true},"standardMessage":{"description":"Gets or sets the standard message in the claim header","type":"string"},"approveMessage":{"description":"Gets or sets the approve message in the claim header when claim is paid","type":"string"},"requiredOverrideMessage":{"description":"Gets or sets the prior authorization message in the claim header when drug requires a PA","type":"string"},"notCoveredMessage":{"description":"Gets or sets the not covered message in the claim header when drug is not covered","type":"string"},"outOfPocketMessage":{"description":"Gets or sets the out of pocket message in the claim header when out of pocket limit has been reached","type":"string"},"unknownDispenseFee":{"format":"double","description":"Gets or sets the the catch-all dispense fee for the plan (obsolete)","type":"number","x-nullable":true},"unknownUseSubmittedDispenseFee":{"description":"Gets or sets whether to use the submitted dispense fee for unknown/undefined drugs (obsolete)","type":"boolean","x-nullable":true},"unknownUseUsualAndCustomary":{"description":"Gets or sets whether to use Usual and Customary for unknown/undefined drugs (obsolete)","type":"boolean","x-nullable":true},"unknownUseGrossAmountDue":{"description":"Gets or sets whether to use Gross Amount Due for unknown/undefined drugs (obsolete)","type":"boolean","x-nullable":true},"unknownCoinsuranceUrl":{"description":"Gets or sets the link to the Coinsurance resource for unkown or undefined drugs","type":"string"},"unknownCoinsuranceNo":{"format":"int64","description":"Gets or sets the identifier for the Copay/Coinsurance used for unknown or undefined drugs","type":"integer","x-nullable":true},"unknownOutOfPocketCoinsuranceUrl":{"description":"Gets or sets the link to the Coinsurance resource for unkown or undefined drugs after out of pocket limits have been reached","type":"string"},"unknownOutOfPocketCoinsuranceNo":{"format":"int64","description":"Gets or sets the link to the identifier for the Copay/Coinsurance used for unknown or undefined drugs after out of pocket limits have been reached","type":"integer","x-nullable":true},"compoundPriceSubmittedDrugs":{"description":"Gets or sets the whether the plan will price each drug of a compound (obsolete)","type":"boolean","x-nullable":true},"compoundRequireValidNDC":{"description":"Gets or sets whether a valid NDC must be used in a compound claim (obsolete)","type":"boolean","x-nullable":true},"compoundMinimumDrugsToPrice":{"format":"int32","description":"Gets or sets the minimum number of drugs to price in the compound (obsolete)","type":"integer","x-nullable":true},"compoundMaxDrugsToPrice":{"format":"int32","description":"Gets or sets the maximum number of drugs to price in the compound (blank or null means all will be priced) (obsolete)","type":"integer","x-nullable":true},"compoundMinimumPrice":{"format":"double","description":"Gets or sets the minimum indgredient cost for the compound (obsolete)","type":"number","x-nullable":true},"compoundDefaultFee":{"format":"double","description":"Gets or sets the default dispense fee to be applied for a compound (level of effort 0) (obsolete)","type":"number","x-nullable":true},"compoundEffort1Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 1 (obsolete)","type":"number","x-nullable":true},"compoundEffort2Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 2 (obsolete)","type":"number","x-nullable":true},"compoundEffort3Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 3 (obsolete)","type":"number","x-nullable":true},"compoundEffort4Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 4 (obsolete)","type":"number","x-nullable":true},"compoundEffort5Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 5 (obsolete)","type":"number","x-nullable":true},"compoundUseSubmittedDispenseFee":{"description":"Gets or sets the indicates whether to use the submitted dispense fee from the pharmacy for the compound (obsolete)","type":"boolean","x-nullable":true},"compoundUseUsualAndCustomary":{"description":"Gets or sets the indicates whether to use the submitted Usual and Customary price from the pharmacy for the compound (obsolete)","type":"boolean","x-nullable":true},"compoundUseGrossAmountDue":{"description":"Gets or sets the indicates whether to use the Gross Amount Due price from the pharmacy for the compound (obsolete)","type":"boolean","x-nullable":true},"compoundCoinsuranceUrl":{"description":"Gets or sets the link to the Coinsurance resource for compound drugs","type":"string"},"compoundCoinsuranceNo":{"format":"int64","description":"Gets or sets the identifier for the Copay/Coinsurance used for compounds","type":"integer","x-nullable":true},"compoundOutOfPocketCoinsuranceUrl":{"description":"Gets or sets the link to the Coinsurance resource for compound drugs after out of pocket limits have been reached","type":"string"},"compoundOutOfPocketCoinsuranceNo":{"format":"int64","description":"Gets or sets the identifier for the Copay/Coinsurance used for compounds after out of pocket limits have been reached","type":"integer","x-nullable":true},"compoundDrugPricingUrl":{"description":"Gets or sets the link to the Drug Pricing resource for compound drugs","type":"string"},"compoundDrugPricingNo":{"format":"int64","description":"Gets or sets the identifier of the special drug pricing for a compound.","type":"integer","x-nullable":true},"altCompoundDrugPricingNo":{"format":"int64","description":"Gets or sets the identifier representing the Alternate compound pricing option (If two options are defined, then the lower pricing option will be used)","type":"integer","x-nullable":true},"altCompoundDrugPricingUrl":{"description":"Gets or sets the link to the Alt Drug Pricing resource for compound drugs","type":"string"},"unknownDrugPricingUrl":{"description":"Gets or sets the link to the Drug Pricing resource for unknown/undefined drugs","type":"string"},"unknownDrugPricingNo":{"format":"int64","description":"Gets or sets the identifier of the special drug pricing for an unknown/undefined drug.","type":"integer","x-nullable":true},"durDrugDrugCheck":{"type":"boolean","x-nullable":true},"durDrugDrugLevel":{"type":"string"},"durDrugDrugMessage":{"type":"string"},"durDrugDrugActionTypeNo":{"format":"int64","type":"integer","x-nullable":true},"mmeActionTypeNo":{"format":"int64","description":"Gets or sets the action to take when threshold is exceeded","type":"integer","x-nullable":true},"mmeThresholdCheck":{"description":"Gets or sets whether the system will determine if the patient is exceeding the daily dosage threshold for opioid medications","type":"boolean","x-nullable":true},"mmeThreshold":{"format":"int32","description":"Gets or sets the daily dosage threshold for opioid medications","type":"integer","x-nullable":true},"mmeResponseMessage":{"description":"Gets or sets the message to send in the claim response when MME Threshold is exceeded","type":"string"},"templateOverrideOptions":{"description":"Gets or sets whether the plan overrides the template options when deriving from a Group Template","type":"boolean","x-nullable":true},"templateOverrideMessages":{"description":"Gets or sets whether the plan overrides the template messages when deriving from a Group Template","type":"boolean","x-nullable":true},"templateOverridePrescriptionEdits":{"description":"Gets or sets whether the plan overrides the template prescription edits when deriving from a Group Template","type":"boolean","x-nullable":true},"templateOverrideDUR":{"description":"Gets or sets whether the plan overrides the template DUR options when deriving from a Group Template","type":"boolean","x-nullable":true},"templateOverrideCompoundPricing":{"description":"Gets or sets whether the plan overrides the template compound pricing options when deriving from a Group Template","type":"boolean","x-nullable":true},"templateOverrideUnknownPricing":{"description":"Gets or sets whether the plan overrides the template unkown/undefined drug pricing options when deriving from a Group Template","type":"boolean","x-nullable":true},"templateOverrideFormulary":{"description":"Gets or sets whether the plan overrides the template formulary options when deriving from a Group Template","type":"boolean","x-nullable":true},"templateOverrideGlobalPricing":{"description":"Gets or sets whether the plan overrides the template Location/Global pricing when deriving from a Group Template","type":"boolean","x-nullable":true},"subscribeToGlobalPricingACI":{"description":"Gets or sets whether the plan subscribes to Location/Global ACI pricing","type":"boolean","x-nullable":true},"subscribeToGlobalPricingAcqCost":{"description":"Gets or sets whether the plan subscribes to Location/Global acquisition pricing","type":"boolean","x-nullable":true},"subscribeToGlobalPricingCustomMAC":{"description":"Gets or sets whether the plan subscribes to Location/Global Custom MAC pricing","type":"boolean","x-nullable":true},"subscribeToGlobalPricingRefPrice":{"description":"Gets or sets whether the plan subscribes to Location/Global reference pricing","type":"boolean","x-nullable":true},"prescriberGraceDays":{"format":"int32","description":"Gets or sets the Prescriber Grace Days to be used in conjuction with prescriber effective dates in rules.  If a prescriber's effective date has expired, but the grace period has not been exceeded, the claim will continue processing.","type":"integer","x-nullable":true},"eligibilityRejectMessage":{"description":"Get or sets the message for eligibility rejects","type":"string"},"prescriptionWrittenMaxDays":{"format":"int32","description":"Maximum number of days a prescription is valid from the date written","type":"integer","x-nullable":true},"rejectClaimIfNoCustomPrice":{"description":"Gets or sets whether claims should reject if there is no custom pricing","type":"boolean","x-nullable":true},"planTemplateNo":{"format":"int64","description":"Gets or sets the Plan Template from which this plan inherits","type":"integer","x-nullable":true},"planTemplateUrl":{"description":"Gets or sets the link to the Plan Template resource for this plan","type":"string"}}},"NetworkPlanCopyPlanModel":{"type":"object","properties":{"templateNo":{"format":"int64","description":"Gets or sets the Template ID","type":"integer","x-nullable":true},"overrideTemplate":{"description":"Gets or sets the Override Template field","type":"boolean","x-nullable":true},"newPlanName":{"description":"The order in which this address should appear in a list","type":"string"},"startDate":{"format":"date-time","description":"Gets or sets the Start Date","type":"string","x-nullable":true},"endDate":{"format":"date-time","description":"Gets or sets the End Date","type":"string","x-nullable":true},"copyGeneralOptionsRules":{"description":"Gets or sets the Copy General Options Rules boolean.","type":"boolean"},"copyGeneralOptionsByDrugRules":{"description":"Gets or sets the Copy General Options By Drug Rules boolean.","type":"boolean"},"copyOverrideRules":{"description":"Gets or sets the Copy Override Rules boolean.","type":"boolean"},"copyStandardFormularyRules":{"description":"Gets or sets the Copy Standard Formulary Rules boolean.","type":"boolean"},"copyDAWRules":{"description":"Gets or sets the Copy DAW Rules boolean.","type":"boolean"},"copyPlanFormularyRules":{"description":"Gets or sets the Copy Plan Formulary Rules boolean.","type":"boolean"},"copyPharmacyFormularyRules":{"description":"Gets or sets the Copy Pharmacy Formulary Rules boolean.","type":"boolean"},"copyMemberFormularyRules":{"description":"Gets or sets the Copy Member Formualry Rules boolean.","type":"boolean"},"copyPrescriberFormularyRules":{"description":"Gets or sets the Copy Prescriber Formulary Rules boolean.","type":"boolean"},"copyStepTherapyRules":{"description":"Gets or sets the Copy Step Therapy Rules boolean.","type":"boolean"},"copyClaimLimitRules":{"description":"Gets or sets the Copy Claim Limit Rules boolean.","type":"boolean"},"copyClaimLimitDefaultRules":{"description":"Gets or sets the Copy ClaimLimitDefault Rules boolean.","type":"boolean"},"copyDrugOptionsRules":{"description":"Gets or sets the Copy Drug Options Rules boolean.","type":"boolean"},"copyClaimOptionsRules":{"description":"Gets or sets the Copy Claim Options Rules boolean.","type":"boolean"},"copyFinalFormularyRules":{"description":"Gets or sets the Copy Final Formulary Rules boolean.","type":"boolean"},"copyBenefitsRules":{"description":"Gets or sets the Copy Benefits Rules boolean.","type":"boolean"},"copyPostPricingRules":{"description":"Gets or sets the Copy Post Pricing Rules boolean.","type":"boolean"}}},"NetworkPlanTemplateModel":{"description":"Group Plan","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"planPricingGroupsUrl":{"description":"Gets or sets the link to the Plan Pricing Groups resource for the plan","type":"string"},"planName":{"description":"Gets or sets the name given to represent the Plan","type":"string"},"description":{"description":"Gets or sets the description given to represent the plan","type":"string"},"validatePCN":{"description":"Gets or sets whether the PCN should match when processing claims","type":"boolean","x-nullable":true},"newStartDays":{"format":"int32","description":"Gets or sets the number of days that must lapse before drug is considered new.  Ex: Setting to 365 days would require the member to have stopped therapy for 365 days before it's considered new therapy again.","type":"integer","x-nullable":true},"maxClaimDays":{"format":"int32","description":"Gets or sets the maximum number of days the plan allows for submitting a claim based on the date of service","type":"integer","x-nullable":true},"maxReversalDays":{"format":"int32","description":"Gets or sets the maximum number days the plan allows for reversing a claim","type":"integer","x-nullable":true},"standardMessage":{"description":"Gets or sets the standard message in the claim header","type":"string"},"approveMessage":{"description":"Gets or sets the approve message in the claim header when claim is paid","type":"string"},"requiredOverrideMessage":{"description":"Gets or sets the prior authorization message in the claim header when drug requires a PA","type":"string"},"notCoveredMessage":{"description":"Gets or sets the not covered message in the claim header when drug is not covered","type":"string"},"outOfPocketMessage":{"description":"Gets or sets the out of pocket message in the claim header when out of pocket limit has been reached","type":"string"},"helpDeskPhoneNumber":{"description":"Gets or sets the help desk phone number","type":"string"},"unknownDispenseFee":{"format":"double","description":"Gets or sets the the catch-all dispense fee for the plan (obsolete)","type":"number","x-nullable":true},"unknownUseSubmittedDispenseFee":{"description":"Gets or sets whether to use the submitted dispense fee for unknown/undefined drugs (obsolete)","type":"boolean","x-nullable":true},"unknownUseUsualAndCustomary":{"description":"Gets or sets whether to use Usual and Customary for unknown/undefined drugs (obsolete)","type":"boolean","x-nullable":true},"unknownUseGrossAmountDue":{"description":"Gets or sets whether to use Gross Amount Due for unknown/undefined drugs (obsolete)","type":"boolean","x-nullable":true},"compoundPriceSubmittedDrugs":{"description":"Gets or sets the whether the plan will price each drug of a compound (obsolete)","type":"boolean","x-nullable":true},"compoundRequireValidNDC":{"description":"Gets or sets whether a valid NDC must be used in a compound claim (obsolete)","type":"boolean","x-nullable":true},"compoundMinimumDrugsToPrice":{"format":"int32","description":"Gets or sets the minimum number of drugs to price in the compound (obsolete)","type":"integer","x-nullable":true},"compoundMaxDrugsToPrice":{"format":"int32","description":"Gets or sets the maximum number of drugs to price in the compound (blank or null means all will be priced) (obsolete)","type":"integer","x-nullable":true},"compoundMinimumPrice":{"format":"double","description":"Gets or sets the minimum indgredient cost for the compound (obsolete)","type":"number","x-nullable":true},"compoundDefaultFee":{"format":"double","description":"Gets or sets the default dispense fee to be applied for a compound (level of effort 0) (obsolete)","type":"number","x-nullable":true},"compoundEffort1Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 1 (obsolete)","type":"number","x-nullable":true},"compoundEffort2Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 2 (obsolete)","type":"number","x-nullable":true},"compoundEffort3Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 3 (obsolete)","type":"number","x-nullable":true},"compoundEffort4Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 4 (obsolete)","type":"number","x-nullable":true},"compoundEffort5Fee":{"format":"double","description":"Gets or sets the dispense fee for level of effort 5 (obsolete)","type":"number","x-nullable":true},"compoundUseSubmittedDispenseFee":{"description":"Gets or sets the indicates whether to use the submitted dispense fee from the pharmacy for the compound (obsolete)","type":"boolean","x-nullable":true},"compoundUseUsualAndCustomary":{"description":"Gets or sets the indicates whether to use the submitted Usual and Customary price from the pharmacy for the compound (obsolete)","type":"boolean","x-nullable":true},"compoundUseGrossAmountDue":{"description":"Gets or sets the indicates whether to use the Gross Amount Due price from the pharmacy for the compound (obsolete)","type":"boolean","x-nullable":true},"compoundDrugPricingUrl":{"description":"Gets or sets the link to the Drug Pricing resource for compound drugs","type":"string"},"compoundDrugPricingNo":{"format":"int64","description":"Gets or sets the identifier of the special drug pricing for a compound.","type":"integer","x-nullable":true},"unknownDrugPricingUrl":{"description":"Gets or sets the link to the Drug Pricing resource for unknown/undefined drugs","type":"string"},"unknownDrugPricingNo":{"format":"int64","description":"Gets or sets the identifier of the special drug pricing for an unknown/undefined drug.","type":"integer","x-nullable":true},"useNetworkCoinsurance":{"description":"Gets or sets whether to use Network Coinsurance if available","type":"boolean","x-nullable":true},"useNetworkIncentive":{"description":"Gets or sets whether to use Network Incentive if available","type":"boolean","x-nullable":true},"useNetworkDeductibleOptions":{"description":"Gets or set whether to use Network deductible options if available","type":"boolean","x-nullable":true},"durDrugDrugCheck":{"description":"Gets or sets whether to use Drug-Drug DUR (obsolete)","type":"boolean","x-nullable":true},"durDrugDrugLevelSeverity":{"description":"Gets or sets the least severe level of DUR the plan enforces  (obsolete)","type":"string"},"durDrugDrugMessage":{"description":"Gets or sets the message to send in the claim response when severity is exceeded  (obsolete)","type":"string"},"durDrugDrugActionTypeNo":{"format":"int64","description":"Gets or sets the action to take when severity level threshold is crossed  (obsolete)","type":"integer","x-nullable":true},"mmeActionTypeNo":{"format":"int64","description":"Gets or sets the action to take when threshold is exceeded","type":"integer","x-nullable":true},"mmeThresholdCheck":{"description":"Gets or sets whether the system will determine if the patient is exceeding the daily dosage threshold for opioid medications","type":"boolean","x-nullable":true},"mmeThreshold":{"format":"int32","description":"Gets or sets the daily dosage threshold for opioid medications","type":"integer","x-nullable":true},"mmeResponseMessage":{"description":"Gets or sets the message to send in the claim response when MME Threshold is exceeded","type":"string"},"allowFutureDateOfService":{"description":"Gets or sets whether the plan allows claims with future date of service","type":"boolean","x-nullable":true},"defaultPharmacyTier":{"description":"Gets or sets the default pharmacy tier value that will be saved on the claim audit if it isn't specified elsewhere during processing of a claim","type":"string"},"returnMemberLookupMessages":{"description":"Gets or sets whether the eligibility messages are returned when using open enrollment and if the member was either found using an alternate lookup or was added to the system","type":"boolean","x-nullable":true},"subscribeToGlobalPricingACI":{"description":"Gets or sets whether the plan subscribes to Location/Global ACI pricing","type":"boolean","x-nullable":true},"subscribeToGlobalPricingAcqCost":{"description":"Gets or sets whether the plan subscribes to Location/Global acquisition pricing","type":"boolean","x-nullable":true},"subscribeToGlobalPricingCustomMAC":{"description":"Gets or sets whether the plan subscribes to Location/Global Custom MAC pricing","type":"boolean","x-nullable":true},"subscribeToGlobalPricingRefPrice":{"description":"Gets or sets whether the plan subscribes to Location/Global reference pricing","type":"boolean","x-nullable":true},"rxExpireDays":{"format":"int32","description":"Gets or sets the number of days to indicate that a prescription is \"expired.\"  An Rx is expired if the date of service is later than the first fill for the Rx plus the RxExpireDays.","type":"integer","x-nullable":true},"prescriberGraceDays":{"format":"int32","description":"Gets or sets the Prescriber Grace Days to be used in conjuction with prescriber effective dates in rules.  If a prescriber's effective date has expired, but the grace period has not been exceeded, the claim will continue processing.","type":"integer","x-nullable":true},"eligibilityRejectMessage":{"description":"Get or sets the message for eligibility rejects","type":"string"},"rejectClaimIfNoCustomPrice":{"description":"Gets or sets whether claims should reject if there is no custom pricing","type":"boolean","x-nullable":true},"prescriptionWrittenMaxDays":{"format":"int32","description":"Gets or sets the Prescription Written Max Days","type":"integer","x-nullable":true}}},"NetworkPlanTemplateCopyPlanModel":{"type":"object","properties":{"newPlanName":{"description":"The order in which this address should appear in a list","type":"string"},"startDate":{"format":"date-time","description":"Gets or sets the Start Date","type":"string","x-nullable":true},"endDate":{"format":"date-time","description":"Gets or sets the End Date","type":"string","x-nullable":true},"copyGeneralOptionsRules":{"description":"Gets or sets the Copy General Options Rules boolean.","type":"boolean"},"copyGeneralOptionsByDrugRules":{"description":"Gets or sets the Copy General Options By Drug Rules boolean.","type":"boolean"},"copyOverrideRules":{"description":"Gets or sets the Copy Override Rules boolean.","type":"boolean"},"copyStandardFormularyRules":{"description":"Gets or sets the Copy Standard Formulary Rules boolean.","type":"boolean"},"copyDAWRules":{"description":"Gets or sets the Copy DAW Rules boolean.","type":"boolean"},"copyPlanFormularyRules":{"description":"Gets or sets the Copy Plan Formulary Rules boolean.","type":"boolean"},"copyPharmacyFormularyRules":{"description":"Gets or sets the Copy Pharmacy Formulary Rules boolean.","type":"boolean"},"copyMemberFormularyRules":{"description":"Gets or sets the Copy Member Formualry Rules boolean.","type":"boolean"},"copyPrescriberFormularyRules":{"description":"Gets or sets the Copy Prescriber Formulary Rules boolean.","type":"boolean"},"copyStepTherapyRules":{"description":"Gets or sets the Copy Step Therapy Rules boolean.","type":"boolean"},"copyClaimLimitRules":{"description":"Gets or sets the Copy Claim Limit Rules boolean.","type":"boolean"},"copyClaimLimitDefaultRules":{"description":"Gets or sets the Copy ClaimLimitDefault Rules boolean.","type":"boolean"},"copyDrugOptionsRules":{"description":"Gets or sets the Copy Drug Options Rules boolean.","type":"boolean"},"copyClaimOptionsRules":{"description":"Gets or sets the Copy Claim Options Rules boolean.","type":"boolean"},"copyFinalFormularyRules":{"description":"Gets or sets the Copy Final Formulary Rules boolean.","type":"boolean"},"copyBenefitsRules":{"description":"Gets or sets the Copy Benefits Rules boolean.","type":"boolean"},"copyPostPricingRules":{"description":"Gets or sets the Copy Post Pricing Rules boolean.","type":"boolean"}}},"NetworkModel":{"description":"Network","required":["description"],"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"networkPharmacyHeadquartersUrl":{"description":"Gets or sets the link to the Network Pharmacy Headquarters resource for the network","type":"string"},"description":{"description":"Gets or sets the description of the Network","type":"string"},"notes":{"description":"Gets or sets the notes for the network","type":"string"},"networkAccessFee":{"format":"double","description":"Gets or sets the fee for submitted claims","type":"number","x-nullable":true},"networkAccessFeeUsualAndCustomary":{"format":"double","description":"Gets or sets the fee for claims that use usual and customary","type":"number","x-nullable":true},"networkAccessFeeManualClaim":{"format":"double","description":"Gets or sets the fee for manually submitted claims","type":"number","x-nullable":true},"networkAccessFeeManualClaimUsualAndCustomary":{"format":"double","description":"Gets or sets the fee for manual claims that use usual and customary","type":"number","x-nullable":true},"useHeadquarterNetworkAccessFees":{"description":"Gets or sets whether headquarter fees are to be used if defined","type":"boolean","x-nullable":true},"networkAccessFeeReversalNo":{"format":"int64","description":"Gets or sets the network access fee reversal value identifier","type":"integer","x-nullable":true},"networkAccessFeeUsualAndCustomaryReversalNo":{"format":"int64","description":"Gets or sets the network access fee usual and customary reversal value identifier","type":"integer","x-nullable":true},"networkAccessFeeManualClaimReversalNo":{"format":"int64","description":"Gets or sets the network access fee manual claim reversal value identifier","type":"integer","x-nullable":true},"networkAccessFeeManualClaimUsualAndCustomaryReversalNo":{"format":"int64","description":"Gets or sets the network access fee manual claim usual and customary reversal value identifier","type":"integer","x-nullable":true}}},"OpenEnrollmentSubmissionClarificationCodeModel":{"description":"Open Enrollment Submission Clarification Code","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"planContractNo":{"format":"int64","description":"Gets or sets the identifier for the Plan Contract associated with this open enrollment submission clarification code","type":"integer"},"submissionClarificationCode":{"description":"Gets or sets a Submission Clarification Code used to indicate open enrollment for the plan contract","type":"string"}}},"OtherStatusModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"pharmacyBranchNo":{"format":"int64","type":"integer"},"otherStatusCode":{"description":"Gets or sets the code representing the other status.","type":"string"},"status":{"description":"Gets or sets the status.","type":"string"},"statusDetail":{"description":"Gets or sets the detailed description of the status.","type":"string"},"note1":{"description":"Gets or sets the first note associated with the status.","type":"string"},"note2":{"description":"Gets or sets the second note associated with the status.","type":"string"},"note3":{"description":"Gets or sets the third note associated with the status.","type":"string"},"otherStatusNumber":{"format":"int32","description":"This field indicates whether the status is a 1, 2 or 3","type":"integer","x-nullable":true},"inactive":{"description":"Gets or sets a value indicating whether the status is inactive.","type":"boolean"}}},"OverrideTypeModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"overrideName":{"description":"Gets or sets the Override name","type":"string"},"description":{"description":"Gets or sets the Description","type":"string"}}},"PatientPlanModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"memberID":{"format":"int64","description":"Gets or sets the Member ID","type":"integer","x-nullable":true},"memberUrl":{"description":"Gets or sets the Member Url","type":"string"},"facilityARTypeID":{"format":"int64","description":"Gets or sets the Facility AR Type ID","type":"integer"},"facilityARTypeUrl":{"description":"Gets or sets the Facility AR Type Url","type":"string"},"inactive":{"description":"Gets or sets the Inactive indicator","type":"boolean"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date","type":"string","x-nullable":true},"suspended":{"description":"Gets or sets the Suspended indicator","type":"boolean","x-nullable":true},"deleted":{"description":"Gets or sets the Deleted indicator","type":"boolean","x-nullable":true},"termedByAbsence":{"description":"Gets or sets the Termed By Absence indicator","type":"boolean","x-nullable":true},"termedFutureDate":{"description":"Gets or sets the Termed Future Date indicator","type":"boolean","x-nullable":true}}},"PayablesCenterModel":{"description":"Pharmacy Headquarter","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"paymentCenterID":{"description":"Gets or sets the Payment Center ID","type":"string"},"remitAndReconciliationID":{"description":"Gets or sets the Remit and Reconciliation ID","type":"string"},"centerType":{"description":"Gets or sets the Center Type","type":"string"},"name":{"description":"Gets or sets the Name","type":"string"},"streetAddress":{"description":"Gets or sets the Street Address","type":"string"},"streetAddressLineTwo":{"description":"Gets or sets the Street Address Line 2","type":"string"},"city":{"description":"Gets or sets the City","type":"string"},"stateCode":{"description":"Gets or sets the State Code","type":"string"},"zipCode":{"description":"Gets or sets the Zip Code","type":"string"},"phoneNumber":{"description":"Gets or sets the Phone number","type":"string"},"phoneExt":{"description":"Gets or sets the Phone extension","type":"string"},"faxNumber":{"description":"Gets or sets the Fax Number","type":"string"},"contactName":{"description":"Gets or sets the Contact Name","type":"string"},"contactTitle":{"description":"Gets or sets the Contact Title","type":"string"},"contactEmailAddress":{"description":"Gets or sets the Contact Email Address","type":"string"},"npi":{"description":"Gets or sets the NPI","type":"string"},"receiverID":{"description":"Gets or sets the Receiver ID","type":"string"},"remitType":{"description":"Gets or sets the Remit Type","type":"string"},"remitPaymentMethod":{"description":"Gets or sets the Remit Payment Method","type":"string"},"remitPaymentFormat":{"description":"Gets or sets the Remit Payment Format","type":"string"},"remitFinancialInstitutionID":{"description":"Gets or sets the Remit Financial Institution ID","type":"string"},"remitFinancialInstitutionAccountNo":{"description":"Gets or sets the Remit Financial Institution Account number","type":"string"},"ftpNo":{"format":"int64","description":"Gets or sets the Ftp number","type":"integer","x-nullable":true},"ftpFileName":{"description":"Gets or sets the Ftp Filename","type":"string"},"ftpRemit":{"description":"Gets or sets the Ftp Remit","type":"boolean","x-nullable":true},"deleteDate":{"format":"date-time","description":"Gets or sets the Delete Date","type":"string","x-nullable":true},"notes":{"description":"Gets or sets the Notes","type":"string"}}},"PenaltyBasisModel":{"description":"Drug Selection Penalty","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"groupPlanNo":{"format":"int64","description":"Gets or sets the identifier for the Group Plan associated with this PenaltyBasis","type":"integer"},"description":{"description":"Gets or sets the description of the penalty basis","type":"string"}}},"PerDiemRateModel":{"description":"Per Diem Rate","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"perDiemNo":{"format":"int64","description":"Gets or sets the identifier for the Per Diem associated with this Per Diem Rate","type":"integer"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date of the per diem rate","type":"string","x-nullable":true},"rate":{"format":"double","description":"Gets or sets the rate","type":"number","x-nullable":true}}},"PerDiemModel":{"description":"Per Diem","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"groupPlanNo":{"format":"int64","description":"Gets or sets the identifier for the Group Plan associated with this Per Diem","type":"integer"},"perDiemName":{"description":"Gets or sets the name of the per diem resource","type":"string"},"description":{"description":"Gets or sets the description of the per diem resource","type":"string"},"perDiemRates":{"description":"Gets or sets the collection of rates for the per diem resource","type":"array","items":{"$ref":"#/definitions/PerDiemRateModel"}}}},"PharmacyClassModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"className":{"description":"Gets or sets the pharmacy class name","type":"string"},"description":{"description":"Gets or sets the pharmacy class description","type":"string"}}},"PagedResultModel[PharmacyLocationModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/PharmacyLocationModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"PharmacyLocationModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"taxRate":{"format":"double","description":"Tax Rate (in percent, 0-100)","type":"number"},"taxExempt":{"description":"Tax Exempt","type":"boolean"},"primaryPharmacyType":{"$ref":"#/definitions/PharmacyTypeModel","description":"Primary Pharmacy Type"},"secondaryPharmacyType":{"$ref":"#/definitions/PharmacyTypeModel","description":"Secondary Pharmacy Type"},"tertiaryPharmacyType":{"$ref":"#/definitions/PharmacyTypeModel","description":"Tertiary Pharmacy Type"},"is24HourOperation":{"description":"Is this a 24 Hour Operation","type":"boolean"},"providerHours":{"description":"Provider Hours","type":"string"},"dispenserClassCode":{"description":"Dispenser Class Code","type":"string"},"contactFirstName":{"description":"Contact Person's First Name","type":"string"},"contactMiddleName":{"description":"Contact Person's Middle Name","type":"string"},"contactLastName":{"description":"Contact Person's Last Name","type":"string"},"contactTitle":{"description":"Contact Person's Title","type":"string"},"contactEmailAddress":{"description":"Contact Person's Email Address","type":"string"},"contactPhone":{"description":"Contact Person's Phone","type":"string"},"contactPhoneExt":{"description":"Contact Person's Phone Extension","type":"string"},"storeNumber":{"description":"Store Number","type":"string"},"primaryRelationshipCode":{"description":"Primary Relationship Chain Code","type":"string"},"chainCode":{"description":"Chain Code","type":"string"},"franchiseCode":{"description":"Franchise Code","type":"string"},"pharmacyHeadquarterNo":{"format":"int64","description":"Identifier for the pharmacy headquarter to which this location is tied","type":"integer"},"pharmacyHeadquarterUrl":{"description":"Url at which the pharmacy headquarter to which this location is tied can be viewed","type":"string"},"pharmacyHeadquarterLock":{"description":"Lock the HQ","type":"boolean"},"overridePaymentCenters":{"description":"Override the payment centers","type":"boolean"},"paymentPayablesCenterNo":{"format":"int64","description":"Payment payables center identifier","type":"integer","x-nullable":true},"paymentPayablesCenterUrl":{"description":"Url for the payment payables center to be viewed/modified","type":"string"},"remitPayablesCenterNo":{"format":"int64","description":"Remit payables center identifier","type":"integer","x-nullable":true},"remitPayablesCenterUrl":{"description":"Url for the remit payables center to be viewed/modified","type":"string"},"openDate":{"format":"date-time","description":"Open date","type":"string"},"closureDate":{"format":"date-time","description":"Closure Date","type":"string"},"reinstatementDate":{"format":"date-time","description":"Reinstatement date","type":"string"},"paymentMethod":{"description":"Payment Method","type":"string"},"financialInstitutionID":{"description":"Financial institution identifier","type":"string"},"financialInstitutionAccountNo":{"description":"Account number for the location's financial institution","type":"string"},"sync":{"description":"Sync this with DataQ","type":"boolean"},"locationName":{"description":"Name","type":"string"},"locationPrintName":{"description":"Print name","type":"string"},"primaryAddress":{"$ref":"#/definitions/AddressModel","description":"Primary/Physical Address"},"mailingAddress":{"$ref":"#/definitions/AddressModel","description":"Mailing Address"},"primaryPhone":{"$ref":"#/definitions/PhoneModel","description":"Primary Phone"},"dea":{"description":"DEA Number","type":"string"},"ncpdp":{"description":"NCPDP Number","type":"string"},"npi":{"description":"NPI","type":"string"},"emailAddress":{"description":"Email address","type":"string"},"webAddress":{"description":"Web address","type":"string"},"federalTaxID":{"description":"Federal tax id","type":"string"},"comment":{"description":"Comment about this location","type":"string"},"active":{"format":"int32","description":"Active flag.  0=inactive, 1=active","type":"integer","x-nullable":true},"timeZone":{"description":"Time Zone","type":"string"},"medicareID":{"description":"Medicare ID","type":"string"}}},"PharmacyTypeModel":{"description":"Rule Pharmacy Type","type":"object","properties":{"description":{"description":"Gets or sets the description associated with this rule pharmacy type","type":"string"},"pharmacyTypeCode":{"description":"Gets or sets the pharmacy type code associated with this rule pharmacy type","type":"string"}}},"AddressModel":{"type":"object","properties":{"addressType":{"enum":["Unknown","Business","Home","Other","Primary","Mailing"],"type":"string"},"displaySequence":{"format":"int32","description":"The order in which this address should appear in a list","type":"integer","x-nullable":true},"address1":{"description":"Address line 1","type":"string"},"addressLineTwo":{"description":"Address line two","type":"string"},"city":{"description":"City","type":"string"},"stateCode":{"description":"Two letter state code","type":"string"},"zipCode":{"description":"Zip code","type":"string"},"country":{"description":"Country","type":"string"},"latitude":{"format":"double","description":"The latitude of the Address","type":"number","x-nullable":true},"longitude":{"format":"double","description":"The longitude of the Address","type":"number","x-nullable":true}}},"PhoneModel":{"type":"object","properties":{"phoneType":{"enum":["Unknown","Business","Fax"],"type":"string"},"displaySequence":{"format":"int32","description":"The order in which this phone record should be displayed in a list","type":"integer"},"phone1":{"description":"Phone number (digits only)","type":"string"},"ext":{"description":"Extension","type":"string"},"dialString":{"description":"Dial String","type":"string"}}},"PharmacyLocatorResponseModel":{"type":"object","properties":{"npi":{"type":"string"},"locationName":{"description":"The name of the pharmacy","type":"string"},"streetAddress":{"description":"The address of the pharmacy","type":"string"},"city":{"description":"The city of the pharmacy","type":"string"},"stateCode":{"description":"The state of the pharmacy","type":"string"},"zipCode":{"description":"The zip code of the pharmacy","type":"string"},"phoneNumber":{"description":"The phone number of the pharmacy","type":"string"},"phoneExt":{"description":"The phone number extension of the pharmacy","type":"string"},"phoneNumberFull":{"description":"The full phone number of the pharmacy","type":"string"},"distance":{"format":"double","description":"The distancy of the pharmacy from the zip code entered","type":"number"},"latitude":{"format":"double","description":"The latitude of the pharmacy","type":"number","x-nullable":true},"longitude":{"format":"double","description":"The longitude of the pharmacy","type":"number","x-nullable":true}}},"AddressDataModel":{"type":"object","properties":{"address":{"description":"Address line","type":"string"},"city":{"description":"City","type":"string"},"stateCode":{"description":"Two letter state code","type":"string"},"zipCode":{"description":"Zip code","type":"string"}}},"PagedResultModel[PharmacyLocatorResponseModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/PharmacyLocatorResponseModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"PharmacyProfileModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"pharmacyBranchNo":{"format":"int64","type":"integer","x-nullable":true},"pharmacyBranchUrl":{"description":"Gets or sets the group url for this resource","type":"string"},"profileName":{"description":"Gets or sets the profile name for this pharmacy profile","type":"string"},"description":{"description":"Gets or sets the description for this pharmacy profile","type":"string"},"pharmacyRelationshipCodeCriteriaType":{"description":"Gets or sets the pharmacy relationship code criteria type for this pharmacy profile","type":"string"},"pharmacyListIsExlusionCriteria":{"description":"Gets or sets the pharmacy list is an exclusion or not for this pharmacy profile","type":"boolean"}}},"PharmacyWholesalerModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"wholesalerName":{"description":"Gets or sets the wholesaler name","type":"string"},"description":{"description":"Gets or sets the description for this wholesaler","type":"string"}}},"PagedResultModel[PlanAgeLimitModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/PlanAgeLimitModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"PlanAgeLimitModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"formularyCompanyAgeLimitId":{"format":"int64","description":"Gets or sets the Formulary Company Age Limit ID","type":"integer","x-nullable":true},"formularyCompanyAgeLimitUrl":{"description":"Gets or sets the Formulary Company Age Limit Url","type":"string"},"productID":{"description":"Gets or sets the product ID for this resource.  The value should be a valid NDC, DDID or GPI.","type":"string"},"productIDType":{"description":"Gets or sets the product ID Type for this resource.  The value will indicate whether the product ID for this resource is an NDC or DDID . \r\nString values other than 'NDC' or 'DDID' will not be valid.","type":"string"},"minAge":{"format":"int32","description":"Gets or sets the Min Age of the age limit resource","type":"integer","x-nullable":true},"minAgeQualifier":{"description":"Gets or sets the Min Age Qualifier of the age limit resource\r\nD=Days, Y=Years","type":"string"},"maxAge":{"format":"int32","description":"Gets or sets the Max Age of the age limit resource","type":"integer","x-nullable":true},"maxAgeQualifier":{"description":"Gets or sets the Max Age Qualifier of the age limit resource\r\nD=Days, Y=Years","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date of this resource","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date of this resource","type":"string","x-nullable":true},"createdOn":{"format":"date-time","description":"Gets or sets the datetime when the age limit was created","type":"string","x-nullable":true},"needsReview":{"description":"Gets or sets the value indicating whether this age limit needs review.","type":"boolean","x-nullable":true},"optOut":{"description":"Gets or sets the value indicating whether to opt out of this age limit.","type":"boolean","x-nullable":true},"modified":{"description":"Gets or sets the value indicating whether this age limit is modified.","type":"boolean","x-nullable":true}}},"PlanAlternateProcessorModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"planNo":{"format":"int64","type":"integer"},"planUrl":{"type":"string"},"alternateProcessorNo":{"format":"int64","type":"integer"},"alternateProcessorUrl":{"type":"string"},"description":{"description":"","type":"string"},"bin":{"description":"","type":"string"},"pcn":{"description":"","type":"string"},"groupID":{"description":"","type":"string"},"cardholderIDPrefix":{"description":"","type":"string"},"cardholderIDSuffix":{"description":"","type":"string"},"approveMessage":{"description":"","type":"string"},"submittedPlanIncludeUC":{"description":"","type":"boolean","x-nullable":true},"submittedPlanIncludeGAD":{"description":"","type":"boolean","x-nullable":true},"submittedPlanIncludeNotCovered":{"description":"","type":"boolean","x-nullable":true},"exemptFromDeductible":{"description":"","type":"boolean","x-nullable":true},"exemptFromOutOfPocketLimit":{"description":"","type":"boolean","x-nullable":true},"active":{"description":"","type":"boolean"}}},"PlanBenefitLimitModel":{"description":"Plan Benefit Limit","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"groupPlanNo":{"format":"int64","description":"Gets or sets the identifier for the Group Plan associated with this benefit limit","type":"integer"},"description":{"description":"Gets or sets the description of the benefit limit resource","type":"string"},"cardholderAmount":{"format":"double","description":"Gets or sets the benefit limit amount for the member","type":"number","x-nullable":true},"spouseAmount":{"format":"double","description":"Gets or sets the benefit limit amount for the spouse","type":"number","x-nullable":true},"otherDependentAmount":{"format":"double","description":"Gets or sets the benefit limit amount for other dependents","type":"number","x-nullable":true},"familyAmount":{"format":"double","description":"Gets or sets the benefit amount for families","type":"number","x-nullable":true}}},"AlternatePlanContractARTypeModel":{"description":"Plan Contract AR Type Model","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"description":{"description":"Gets or sets the description of the AR Type","type":"string"},"arShortCode":{"description":"Gets or sets code for the AR Type","type":"string"},"arClassCode":{"description":"Gets or sets the class code for the AR Type","type":"string"},"groupPlanNo":{"format":"int64","description":"Gets or sets the plan identifier","type":"integer"},"planContractNo":{"format":"int64","description":"Gets or sets the plan contract identifier","type":"integer"},"facilityARTypeSeqNo":{"format":"int64","description":"Gets or sets the Facility AR Type sequence number","type":"integer"}}},"PlanContractARTypeModel":{"description":"Plan Contract AR Type Model","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"description":{"description":"Gets or sets the description of the AR Type","type":"string"},"arShortCode":{"description":"Gets or sets code for the AR Type","type":"string"},"arClassCode":{"description":"Gets or sets the class code for the AR Type","type":"string"},"groupPlanNo":{"format":"int64","description":"Gets or sets the plan identifier","type":"integer"},"planContractNo":{"format":"int64","description":"Gets or sets the plan contract identifier","type":"integer"},"facilityARTypeSeqNo":{"format":"int64","description":"Gets or sets the Facility AR Type sequence number","type":"integer"}}},"PlanContractModel":{"description":"Plan Contract","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"benefitPeriodsUrl":{"description":"Gets or sets the link to the Benefit Period resource for the plan contract","type":"string"},"openEnrollmentSubmissionClarificationCodesUrl":{"description":"Gets or sets the link to the Open Enrollment Submission Clarification Code resource for the plan contract","type":"string"},"groupPlanNo":{"format":"int64","description":"Gets or sets the identifier for the Group Plan associated with this plan contract","type":"integer"},"facilityBranchNo":{"format":"int64","description":"Gets or sets the seqno of the associated Facility Branch","type":"integer"},"contractCode":{"description":"Gets or sets the contract code","type":"string"},"contractName":{"description":"Gets or sets the contract name","type":"string"},"description":{"description":"Gets or sets the the description","type":"string"},"openEnrollment":{"description":"Gets or sets whether open enrollment is enabled","type":"boolean","x-nullable":true},"useCustomCardholderID":{"description":"Gets or sets whether the contract uses a custom cardholder id","type":"boolean","x-nullable":true},"allowSecondaryPayer":{"description":"Gets or sets whether the contract allows secondary payer","type":"boolean","x-nullable":true},"secondaryPayerOnly":{"description":"Gets or sets whether the contract is secondary only","type":"boolean","x-nullable":true},"payClaimsRejectedByOtherPayer":{"description":"Gets or sets whether the contract pays other payer rejected claims","type":"boolean","x-nullable":true},"openEnrollmentBackdateDays":{"format":"int32","description":"Gets or sets the number of days to backdate eligibility for open enrollment","type":"integer","x-nullable":true},"deductibleUrl":{"description":"Gets or sets the link to the periodic deductible resource","type":"string"},"deductibleNo":{"format":"int64","description":"Gets or sets the periodic deductible identifier","type":"integer","x-nullable":true},"maxOutOfPocketUrl":{"description":"Gets or sets the link to the periodic max out of pocket resource","type":"string"},"maxOutOfPocketNo":{"format":"int64","description":"Gets or sets the periodic max out of pocket identifier","type":"integer","x-nullable":true},"personDeductibleIsMinimum":{"description":"Gets or sets whether the member deductible is required to be met for the family deductible","type":"boolean","x-nullable":true},"personDeductibleIsCapped":{"description":"Gets or sets whether additional amounts paid by the member after deductible has been met is applied toward the family deductible the member's deductible (true = cap member deductible)","type":"boolean","x-nullable":true},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"helpDeskPhoneNumber":{"description":"Gets or sets the help desk phone number (if set, overrides the plan's help desk phone number)","type":"string"},"standardMessage":{"description":"Gets or sets the standard message in the claim header (if set, overrides the plan's standard message)","type":"string"},"approveMessage":{"description":"Gets or sets the approve message in the claim header when claim is paid (if set, overrides the plan's approve message)","type":"string"},"requirePAMessage":{"description":"Gets or sets the prior authorization message in the claim header when drug requires a PA (if set, overrides the plan's require PA message)","type":"string"},"notCoveredMessage":{"description":"Gets or sets the not covered message in the claim header when drug is not covered (if set, overrides the plan's not covered message)","type":"string"},"outOfPocketMessage":{"description":"Gets or sets the out of pocket message in the claim header when out of pocket limit has been reached (if set, overrides the plan's out of pocket message)","type":"string"},"waiveDeductibleAfterOOPMet":{"description":"Gets or sets whether remaining deductible amounts are waived after the member's OOP limit has been reached","type":"boolean","x-nullable":true},"dependentsCovered":{"description":"Gets or sets whether dependents are covered","type":"boolean","x-nullable":true},"monthlyDeductibleUrl":{"description":"Gets or sets the link to the monthly deductible resource","type":"string"},"monthlyDeductibleNo":{"format":"int64","description":"Gets or sets the monthly deductible identifier","type":"integer","x-nullable":true},"monthlyMaxOutOfPocketUrl":{"description":"Gets or sets the link to the monthly max out of pocket resource","type":"string"},"monthlyMaxOutOfPocketNo":{"format":"int64","description":"Gets or sets the monthly max out of pocket identifier","type":"integer","x-nullable":true},"planBenefitLimitMonthUrl":{"description":"Gets or sets the link to the monthly plan benefit limit resource","type":"string"},"planBenefitLimitMonthNo":{"format":"int64","description":"Gets or sets the monthly plan benefit limit identifier","type":"integer","x-nullable":true},"planBenefitLimitPeriodUrl":{"description":"Gets or sets the link to the periodic plan benefit limit resource","type":"string"},"planBenefitLimitPeriodNo":{"format":"int64","description":"Gets or sets the periodic plan benefit limit identifier","type":"integer","x-nullable":true},"planBenefitLimitLifeUrl":{"description":"Gets or sets the link to the lifetime plan benefit limit resource","type":"string"},"planBenefitLimitLifeNo":{"format":"int64","description":"Gets or sets the lifetime plan benefit limit identifier","type":"integer","x-nullable":true},"planBenefitLimitRxOnlyMonthUrl":{"description":"Gets or sets the link to the Rx only monthly plan benefit limit resource","type":"string"},"planBenefitLimitRxOnlyMonthNo":{"format":"int64","description":"Gets or sets the Rx only monthly plan benefit limit identifier","type":"integer","x-nullable":true},"planBenefitLimitRxOnlyPeriodUrl":{"description":"Gets or sets the link to the Rx only periodic plan benefit limit resource","type":"string"},"planBenefitLimitRxOnlyPeriodNo":{"format":"int64","description":"Gets or sets the Rx only periodic plan benefit limit identifier","type":"integer","x-nullable":true},"planBenefitLimitRxOnlyLifeUrl":{"description":"Gets or sets the link to the Rx only lifetime plan benefit limit resource","type":"string"},"planBenefitLimitRxOnlyLifeNo":{"format":"int64","description":"Gets or sets the Rx only lifetime plan benefit limit identifier","type":"integer","x-nullable":true},"claimUseCardholderID":{"description":"Get or sets whether to use the card holder ID to look up member when processing claim","type":"boolean","x-nullable":true},"claimUsePatientID":{"description":"Get or sets whether to use the patient ID to look up member when processing claim","type":"boolean","x-nullable":true},"claimUseAlternateID":{"description":"Get or sets whether to use the alternate ID to look up member when processing claim\r\nThis field will be deprecated as of 03/30/2025.  Use ClaimUseAlternateIDForMember and ClaimUseAlternateIDForCardholder instead","type":"boolean","x-nullable":true},"claimUseAlternateIDForMember":{"description":"Get or sets whether to use the member alternate ID to look up member when processing claim","type":"boolean","x-nullable":true},"claimUseAlternateIDForCardholder":{"description":"Get or sets whether to use the cardholder alternate ID to look up member when processing claim","type":"boolean","x-nullable":true},"claimUseMemberInfo":{"description":"Get or sets whether to use the member name and date of birth to look up member when processing claim","type":"boolean","x-nullable":true},"planIncentiveLimitAmountPeriod":{"format":"double","description":"Get or sets the max plan incentive amount allowed for a month","type":"number","x-nullable":true},"planIncentiveLimitAmountMonth":{"format":"double","description":"Get or sets the max plan incentive amount allowed for a month","type":"number","x-nullable":true},"planIncentiveLimitMonthRollover":{"description":"Get or sets whether plan incentive balances for a month rollover to the next month","type":"boolean","x-nullable":true},"eligibilityRejectMessage":{"description":"Get or sets the message for eligibility rejects","type":"string"},"applyDeductibleToOOP":{"description":"Get or sets whether to apply deductible amounts to the OOP when processing claim","type":"boolean","x-nullable":true},"defaultBenefitCodeUrl":{"description":"Gets or sets the link to the default benefit code when processing claim","type":"string"},"defaultBenefitCodeNo":{"format":"int64","description":"Gets or sets the default benefit code identifier","type":"integer","x-nullable":true},"claimsStorePatientID":{"description":"Get or sets whether to use the internal member ID for the cardholder when processing claim","type":"boolean","x-nullable":true},"benefitCodesShareValuesForDeductible":{"description":"Get or sets whether deductible values are shared across all benefit codes","type":"boolean","x-nullable":true},"benefitCodesShareValuesForOutOfPocket":{"description":"Get or sets whether OOP values are shared across all benefit codes","type":"boolean","x-nullable":true},"benefitCodesShareValuesForPlanPaidAmt":{"description":"Get or sets whether plan paid amount values are shared across all benefit codes","type":"boolean","x-nullable":true},"benefitCodesShareValuesForPlanIncentive":{"description":"Get or sets whether plan incentive values are shared across all benefit codes","type":"boolean","x-nullable":true},"claimReqMemberNameMatch":{"description":"Get or sets whether the member name has to match what is being submitted when processing claim","type":"boolean","x-nullable":true},"isAlternate":{"description":"Gets or sets the value indicating whether the plan contract is an alternate plan contract","type":"boolean","x-nullable":true},"claimSend":{"description":"Gets or sets whether claim send is enabled","type":"boolean","x-nullable":true},"bin":{"description":"Gets or sets the BIN used for claims processing","type":"string"},"pharmacyStartDate":{"format":"date-time","description":"Gets or sets the pharmacy start date","type":"string","x-nullable":true},"pharmacyEndDate":{"format":"date-time","description":"Gets or sets the pharmacy end date","type":"string","x-nullable":true}}},"PlanFormularyModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"effectiveStartDate":{"format":"date-time","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","type":"string","x-nullable":true},"formularyURL":{"type":"string"},"formularyNo":{"format":"int64","type":"integer"}}},"PagedResultModel[PlanFormularyProductModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/PlanFormularyProductModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"PlanFormularyProductModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"formularyProductId":{"format":"int64","description":"Gets or sets the Formulary Product ID","type":"integer","x-nullable":true},"formularyProductUrl":{"description":"Gets or sets the Formulary Product Url","type":"string"},"formularyTierId":{"format":"int64","description":"Gets or sets the Formulary Tier ID","type":"integer","x-nullable":true},"formularyTierUrl":{"description":"Gets or sets the Formulary Tier Url","type":"string"},"productID":{"description":"Gets or sets the Product ID","type":"string"},"productIDType":{"description":"Gets or sets the product ID Type for this resource.  The value will indicate whether the product ID for this resource is an NDC or DDID . \r\nString values other than 'NDC' or 'DDID' will not be valid.","type":"string"},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date","type":"string","x-nullable":true},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date","type":"string","x-nullable":true},"needsReview":{"description":"Gets or sets the value indicating whether this age limit needs review.","type":"boolean","x-nullable":true},"optOut":{"description":"Gets or sets the value indicating whether to opt out of this age limit.","type":"boolean","x-nullable":true},"modified":{"description":"Gets or sets the value indicating whether this age limit is modified.","type":"boolean","x-nullable":true},"auditNote":{"description":"Gets or sets the Audit note","type":"string"},"parentRemoved":{"description":"Gets or sets the value indicating whether the parent was removed.","type":"boolean","x-nullable":true}}},"PagedResultModel[PlanGenderLimitModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/PlanGenderLimitModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"PlanGenderLimitModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"formularyCompanyGenderLimitId":{"format":"int64","description":"Gets or sets the Formulary Company Gender Limit ID","type":"integer","x-nullable":true},"formularyCompanyGenderLimitUrl":{"description":"Gets or sets the Formulary Company Gender Limit Url","type":"string"},"productID":{"description":"Gets or sets the product ID for this resource.  The value should be a valid NDC, DDID or GPI.","type":"string"},"productIDType":{"description":"Gets or sets the product ID Type for this resource.  The value will indicate whether the product ID for this resource is an NDC or DDID . \r\nString values other than 'NDC' or 'DDID' will not be valid.","type":"string"},"gender":{"description":"Gets or sets the Gender","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date of this resource","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date of this resource","type":"string","x-nullable":true},"createdOn":{"format":"date-time","description":"Gets or sets the datetime when the age limit was created","type":"string","x-nullable":true},"needsReview":{"description":"Gets or sets the value indicating whether this age limit needs review.","type":"boolean","x-nullable":true},"optOut":{"description":"Gets or sets the value indicating whether to opt out of this age limit.","type":"boolean","x-nullable":true},"modified":{"description":"Gets or sets the value indicating whether this age limit is modified.","type":"boolean","x-nullable":true}}},"PlanIncentiveRateModel":{"description":"PlanIncentiveRate","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"daysSupply":{"format":"int32","description":"Gets or sets the days supply of the plan incentive rate","type":"integer"},"priceCodeNo":{"format":"int64","description":"Gets or sets the price code identifier of the plan incentive rate","type":"integer","x-nullable":true},"priceAdjustment":{"format":"double","description":"Gets or sets the price adjustment of the plan incentive rate.  The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value)","type":"number","x-nullable":true},"amount":{"format":"double","description":"Gets or sets the amount of the plan incentive rate","type":"number","x-nullable":true},"amountPerUnit":{"description":"Gets or sets the amount per unit of the plan incentive rate","type":"boolean","x-nullable":true},"inactive":{"description":"Gets or sets whether the plan incentive rate is inactive","type":"boolean"},"priceCode2No":{"format":"int64","description":"Gets or sets the second price code identifier of the plan incentive rate","type":"integer","x-nullable":true},"priceAdjustment2":{"format":"double","description":"Gets or sets the second price adjustment of the plan incentive rate.  The value must be entered as a decimal (e.g. for a 20% adjustment, enter 0.20 as the value)","type":"number","x-nullable":true},"amount2":{"format":"double","description":"Gets or sets the second amount of the plan incentive rate","type":"number","x-nullable":true},"amountPerUnit2":{"description":"Gets or sets the second amount per unit of the plan incentive rate","type":"boolean","x-nullable":true},"applyDeductibleFirst":{"description":"Gets or sets the apply deductible first of the plan incentive rate","type":"boolean","x-nullable":true},"includeDeductibleInPostCalc":{"description":"Gets or sets the include deductible in post calc of the plan incentive rate","type":"boolean","x-nullable":true},"planIncentiveNo":{"format":"int64","description":"Gets or sets the plan incentive identifier of the plan incentive rate","type":"integer"}}},"PlanIncentiveModel":{"description":"Plan Incentive","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"priceCodesUrl":{"description":"Gets or sets a link to the price code","type":"string"},"groupPlanNo":{"format":"int64","description":"Gets or sets the identifier for the Group Plan associated with this plan incentive","type":"integer"},"description":{"description":"Gets or sets the description of the plan incentive resource","type":"string"},"useNetworkDrugPrice":{"description":"Gets or sets whether to use the drug unit price from the network plan","type":"boolean","x-nullable":true},"limitAmountPeriod":{"format":"double","description":"Gets or sets the plan incentive limit per member for a period","type":"number","x-nullable":true},"limitAmountMonth":{"format":"double","description":"Gets or sets the plan incentive limit per member for a month","type":"number","x-nullable":true},"limitMonthRollover":{"description":"Gets or sets whether to allow monthly amount to rollover within a period","type":"boolean","x-nullable":true},"planIncentiveRates":{"description":"Gets or sets the plan insentive rates associated with this plan insentive model","type":"array","items":{"$ref":"#/definitions/PlanIncentiveRateModel"}}}},"PlanPricingGroupDrugModel":{"description":"Plan Pricing Group Drug","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"groupPlanNo":{"format":"int64","description":"Gets or sets the identifier for the Group Plan associated with this pricing group drug","type":"integer"},"ndc":{"description":"Gets or sets the NDC for the drug","type":"string"},"planPricingGroupNo":{"format":"int64","description":"Gets or sets the identifier for the Pricing Group associated with this pricing group drug","type":"integer"}}},"PlanPricingGroupModel":{"description":"Plan Pricing Group","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"perDiemUrl":{"description":"Gets or sets the link back to the per diem resource","type":"string"},"perDiemNo":{"format":"int64","description":"Gets or sets the per diem identifier","type":"integer","x-nullable":true},"exemptFromDeductible":{"description":"Gets or sets whether the pricing group is exempt from the deductible","type":"boolean","x-nullable":true},"exemptFromOutOfPocketLimit":{"description":"Gets or sets whether the pricing group is exempt from max out of pocket limits","type":"boolean","x-nullable":true},"brandCoinsuranceUrl":{"description":"Gets or sets the link back to the coinsurance resource for brand drugs in this pricing group","type":"string"},"brandCoinsuranceNo":{"format":"int64","description":"Gets or sets the coinsurance identifier for brand drugs in this pricing group","type":"integer","x-nullable":true},"genericCoinsuranceUrl":{"description":"Gets or sets the link back to the coinsurance resource for generic drugs in this pricing group","type":"string"},"genericCoinsuranceNo":{"format":"int64","description":"Gets or sets the coinsurance identifier for generic drugs in this pricing group","type":"integer","x-nullable":true},"brandOutOfPocketCoinsuranceUrl":{"description":"Gets or sets the link back to the coinsurance resource for brand drugs after max out of pocket limits reached","type":"string"},"brandOutOfPocketCoinsuranceNo":{"format":"int64","description":"Gets or sets the coinsurance identifier for brand drugs after max out of pocket limits reached","type":"integer","x-nullable":true},"genericOutOfPocketCoinsuranceUrl":{"description":"Gets or sets the link back to the coinsurance resource for generic drugs after max out of pocket limits reached","type":"string"},"genericOutOfPocketCoinsuranceNo":{"format":"int64","description":"Gets or sets the coinsurance identifier for generic drugs after max out of pocket limits reached","type":"integer","x-nullable":true},"brandPlanIncentiveUrl":{"description":"Gets or sets the link back to the plan incentive resource for brand drugs in this pricing group","type":"string"},"brandPlanIncentiveNo":{"format":"int64","description":"Gets or sets the plan incentive identifier for brand drugs in this pricing group","type":"integer","x-nullable":true},"genericPlanIncentiveUrl":{"description":"Gets or sets the link back to the incentive resource for generic drugs in this pricing group","type":"string"},"genericPlanIncentiveNo":{"format":"int64","description":"Gets or sets the plan incentive identifier for generic drugs in this pricing group","type":"integer","x-nullable":true},"priceCodesUrl":{"description":"Gets or sets the link to the Price Codes resource for the pricing group","type":"string"},"planPricingGroupDrugsUrl":{"description":"Gets or sets the link to the drugs  for the pricing group","type":"string"},"groupPlanNo":{"format":"int64","description":"Gets or sets the identifier for the Group Plan associated with this pricing group","type":"integer"},"name":{"description":"Gets or sets the name of the pricing group","type":"string"},"description":{"description":"Gets or sets the description of the pricing group","type":"string"},"priceCodeNo":{"format":"int64","description":"Gets or sets the custom pricing price code identifier","type":"integer","x-nullable":true},"priceCode":{"description":"Gets or sets the custom pricing price code","type":"string"},"customPriceAdjustment":{"format":"double","description":"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)","type":"number","x-nullable":true},"customPriceRate":{"format":"double","description":"Gets or sets the custom pricing rate (markup amount)","type":"number","x-nullable":true},"customPriceRatePerUnit":{"description":"Gets or sets whether the custom pricing rate is calculated per unit (each) or per fill","type":"boolean","x-nullable":true},"customPricePerDiemRate":{"format":"double","description":"Gets or sets the custom pricing per diem rate","type":"number","x-nullable":true},"customPriceDispenseFee":{"format":"double","description":"Gets or sets the custom pricing dispense fee","type":"number","x-nullable":true},"customPriceDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the custom pricing dispense fee days interval for dispense fee","type":"integer","x-nullable":true},"customPriceDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"priceMemberClaimFee":{"format":"double","description":"Gets or sets the price member claim fee.","type":"number","x-nullable":true},"priceMemberClaimFeeIC":{"format":"double","description":"Gets or sets the price member claim fee IC.","type":"number","x-nullable":true},"altPriceCodeNo":{"format":"int64","description":"Gets or sets the first alternate pricing price code identifier","type":"integer","x-nullable":true},"altPriceCode":{"description":"Gets or sets the first alternate pricing price code","type":"string"},"altPriceAdjustment":{"format":"double","description":"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)","type":"number","x-nullable":true},"altPriceRate":{"format":"double","description":"Gets or sets the first alternate pricing rate (markup amount)","type":"number","x-nullable":true},"altPriceRatePerUnit":{"description":"Gets or sets whether the first alternate pricing rate is calculated per unit (each) or per fill","type":"boolean","x-nullable":true},"altPricePerDiemRate":{"format":"double","description":"Gets or sets the first alternate pricing per diem rate","type":"number","x-nullable":true},"altPriceDispenseFee":{"format":"double","description":"Gets or sets the first alternate pricing dispense fee","type":"number","x-nullable":true},"altPriceDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the first alternate pricing dispense fee days interval for dispense fee","type":"integer","x-nullable":true},"altPriceDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"altPriceMemberClaimFee":{"format":"double","description":"Gets or sets the alternative price member claim fee.","type":"number","x-nullable":true},"altPriceMemberClaimFeeIC":{"format":"double","description":"Gets or sets the alternative price member claim fee IC.","type":"number","x-nullable":true},"alt2PriceCodeNo":{"format":"int64","description":"Gets or sets the second alternate pricing price code identifier","type":"integer","x-nullable":true},"alt2PriceCode":{"description":"Gets or sets the second alternate pricing price code","type":"string"},"alt2PriceAdjustment":{"format":"double","description":"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)","type":"number","x-nullable":true},"alt2PriceRate":{"format":"double","description":"Gets or sets the second alternate pricing rate (markup amount)","type":"number","x-nullable":true},"alt2PriceRatePerUnit":{"description":"Gets or sets whether the second alternate pricing rate is calculated per unit (each) or per fill","type":"boolean","x-nullable":true},"alt2PricePerDiemRate":{"format":"double","description":"Gets or sets the second alternate pricing per diem rate","type":"number","x-nullable":true},"alt2PriceDispenseFee":{"format":"double","description":"Gets or sets the second alternate pricing dispense fee","type":"number","x-nullable":true},"alt2PriceDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the second alternate pricing dispense fee days interval for dispense fee","type":"integer","x-nullable":true},"alt2PriceDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"alt2PriceMemberClaimFee":{"format":"double","description":"Gets or sets the second alternative price member claim fee.","type":"number","x-nullable":true},"alt2PriceMemberClaimFeeIC":{"format":"double","description":"Gets or sets the second alternative price member claim fee IC.","type":"number","x-nullable":true},"alt3PriceCodeNo":{"format":"int64","description":"Gets or sets the third alternate pricing price code identifier","type":"integer","x-nullable":true},"alt3PriceCode":{"description":"Gets or sets the third alternate pricing price code","type":"string"},"alt3PriceAdjustment":{"format":"double","description":"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)","type":"number","x-nullable":true},"alt3PriceRate":{"format":"double","description":"Gets or sets the third alternate pricing rate (markup amount)","type":"number","x-nullable":true},"alt3PriceRatePerUnit":{"description":"Gets or sets whether the third alternate pricing rate is calculated per unit (each) or per fill","type":"boolean","x-nullable":true},"alt3PricePerDiemRate":{"format":"double","description":"Gets or sets the third alternate pricing per diem rate","type":"number","x-nullable":true},"alt3PriceDispenseFee":{"format":"double","description":"Gets or sets the third alternate pricing dispense fee","type":"number","x-nullable":true},"alt3PriceDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the third alternate pricing dispense fee days interval for dispense fee","type":"integer","x-nullable":true},"alt3PriceDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"alt3PriceMemberClaimFee":{"format":"double","description":"Gets or sets the third alternative price member claim fee.","type":"number","x-nullable":true},"alt3PriceMemberClaimFeeIC":{"format":"double","description":"Gets or sets the third alternative price member claim fee IC.","type":"number","x-nullable":true},"alt4PriceCodeNo":{"format":"int64","description":"Gets or sets the fourth alternate pricing price code identifier","type":"integer","x-nullable":true},"alt4PriceCode":{"description":"Gets or sets the fourth alternate pricing price code","type":"string"},"alt4PriceAdjustment":{"format":"double","description":"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)","type":"number","x-nullable":true},"alt4PriceRate":{"format":"double","description":"Gets or sets the fourth alternate pricing rate (markup amount)","type":"number","x-nullable":true},"alt4PriceRatePerUnit":{"description":"Gets or sets whether the fourth alternate pricing rate is calculated per unit (each) or per fill","type":"boolean","x-nullable":true},"alt4PricePerDiemRate":{"format":"double","description":"Gets or sets the fourth alternate pricing per diem rate","type":"number","x-nullable":true},"alt4PriceDispenseFee":{"format":"double","description":"Gets or sets the fourth alternate pricing dispense fee","type":"number","x-nullable":true},"alt4PriceDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the fourth alternate pricing dispense fee days interval for dispense fee","type":"integer","x-nullable":true},"alt4PriceDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"alt4PriceMemberClaimFee":{"format":"double","description":"Gets or sets the fourth alternative price member claim fee.","type":"number","x-nullable":true},"alt4PriceMemberClaimFeeIC":{"format":"double","description":"Gets or sets the fourth alternative price member claim fee IC.","type":"number","x-nullable":true},"minimumPriceCodeNo":{"format":"int64","description":"Gets or sets the minimum pricing price code identifier","type":"integer","x-nullable":true},"minimumPriceCode":{"description":"Gets or sets the minimum pricing price code","type":"string"},"minimumPriceAdjustment":{"format":"double","description":"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)","type":"number","x-nullable":true},"minimumPriceRate":{"format":"double","description":"Gets or sets the minimum pricing rate (markup amount)","type":"number","x-nullable":true},"minimumPriceRatePerUnit":{"description":"Gets or sets whether the minimum pricing rate is calculated per unit (each) or per fill","type":"boolean","x-nullable":true},"minimumPricePerDiemRate":{"format":"double","description":"Gets or sets the minimum pricing per diem rate","type":"number","x-nullable":true},"minimumPriceDispenseFee":{"format":"double","description":"Gets or sets the minimum pricing dispense fee","type":"number","x-nullable":true},"minimumPriceDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the minimum dispense fee days interval for dispense fee","type":"integer","x-nullable":true},"minimumPriceDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"minimumPriceMemberClaimFee":{"format":"double","description":"Gets or sets the minimum price member claim fee.","type":"number","x-nullable":true},"minimumPriceMemberClaimFeeIC":{"format":"double","description":"Gets or sets the minimum price member claim fee IC.","type":"number","x-nullable":true},"flatRate":{"format":"double","description":"Gets or sets the flat rate pricing rate (markup amount)","type":"number","x-nullable":true},"flatRateDaysInterval":{"format":"int32","description":"Gets or sets the flat rate days interval","type":"integer","x-nullable":true},"flatRateDispenseFee":{"format":"double","description":"Gets or sets the flat rate pricing dispense fee","type":"number","x-nullable":true},"flatRateDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the flat rate dispense fee days interval for dispense fee","type":"integer","x-nullable":true},"flatRateDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"flatRateMemberClaimFee":{"format":"double","description":"Gets or sets the flat rate member claim fee.","type":"number","x-nullable":true},"flatRateMemberClaimFeeIC":{"format":"double","description":"Gets or sets the flat rate member claim fee IC.","type":"number","x-nullable":true},"minimumRate":{"format":"double","description":"Gets or sets the minimum rate pricing rate (markup amount)","type":"number","x-nullable":true},"minimumRateDaysInterval":{"format":"int32","description":"Gets or sets the minimum rate days interval","type":"integer","x-nullable":true},"minimumRateDispenseFee":{"format":"double","description":"Gets or sets the minimim rate pricing dispense fee","type":"number","x-nullable":true},"minimumRateDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the minimum rate dispense fee days interval for dispense fee","type":"integer","x-nullable":true},"minimumRateDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"minimumRateMemberClaimFee":{"format":"double","description":"Gets or sets the minimum rate member claim fee.","type":"number","x-nullable":true},"minimumRateMemberClaimFeeIC":{"format":"double","description":"Gets or sets the minimum rate member claim fee IC.","type":"number","x-nullable":true},"professionalFee":{"format":"double","description":"Gets or sets the professional fee amount","type":"number","x-nullable":true},"memberClaimFee":{"format":"double","description":"Gets or sets the member claim fee amount","type":"number","x-nullable":true},"useUsualAndCustomary":{"description":"Gets or sets whether to use the pharmacy's submitted usual and customary","type":"boolean","x-nullable":true},"usualAndCustomaryRate":{"format":"double","description":"Gets or sets the usual and customary rate (markup amount)","type":"number","x-nullable":true},"usualAndCustomaryRatePerUnit":{"description":"Gets or sets whether the usual and customary rate is calculated per unit (each) or per fill","type":"boolean","x-nullable":true},"usualAndCustomaryPerDiemRate":{"format":"double","description":"Gets or sets the usual and customary per diem rate","type":"number","x-nullable":true},"usualAndCustomaryAdjustmentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"usualAndCustomaryDispenseFee":{"format":"double","description":"Gets or sets the dispense fee when usual and customary pricing is used","type":"number","x-nullable":true},"usualAndCustomaryDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the dispense fee days interval when usual and customary pricing is used","type":"integer","x-nullable":true},"usualAndCustomaryDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"usualAndCustomaryMemberClaimFee":{"format":"double","description":"Gets or sets the usual and customary member claim fee.","type":"number","x-nullable":true},"usualAndCustomaryMemberClaimFeeIC":{"format":"double","description":"Gets or sets the usual and customary member claim fee IC.","type":"number","x-nullable":true},"useGrossAmountDue":{"description":"Gets or sets whether to use the pharmacy's submitted gross amount due","type":"boolean","x-nullable":true},"useGrossAmountDueIfNoPricing":{"description":"Gets or sets whether to use the pharmacy's submitted gross amount due if there is no other pricing available","type":"boolean","x-nullable":true},"useClaimAcqCost":{"description":"Gets or sets whether to take amount from claim into account when using acquistion cost","type":"boolean","x-nullable":true},"alwaysUseAltPricing":{"description":"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","type":"boolean","x-nullable":true},"flatRateIncludesTax":{"description":"Gets or sets whether the flat rate includes tax","type":"boolean","x-nullable":true},"noCustomPriceAltGroupUrl":{"description":"Gets or sets the link back to a fall back pricing group if no pricing could be determined","type":"string"},"noCustomPriceAltGroupNo":{"format":"int64","description":"Gets or sets the identifier to the fall back pricing group if not pricing could be determined","type":"integer","x-nullable":true},"requiresOverride":{"description":"Gets or sets whether the pricing group requires an override","type":"boolean","x-nullable":true},"requiresOverrideRestricted":{"description":"Gets or sets whether the pricing group requires a restricted override","type":"boolean","x-nullable":true},"notCovered":{"description":"Gets or sets whether this pricing group is covered","type":"boolean","x-nullable":true},"specialty":{"description":"Gets or sets whether this pricing group is tagged as specialty","type":"boolean","x-nullable":true},"is340B":{"description":"Gets or sets whether this pricing group is tagged as 340B","type":"boolean","x-nullable":true},"patientAssistanceProgram":{"description":"Gets or sets whether this pricing group is tagged as a patient assistance program","type":"boolean","x-nullable":true},"rejectClaimIfNoCustomPrice":{"description":"Gets or sets whether claims should reject if there is no custom pricing","type":"boolean","x-nullable":true},"approveMessage":{"description":"Gets or sets the message for paid claim","type":"string"},"requireOverrideMessage":{"description":"Gets or sets the message for claims that require override","type":"string"},"notCoveredMessage":{"description":"Gets or sets the message for claims that are not covered","type":"string"},"altMinimumPriceCodeNo":{"format":"int64","description":"Gets or sets the alternative minimum price code ID.","type":"integer","x-nullable":true},"altMinimumPriceCode":{"description":"Gets or sets the alternative minimum price code.","type":"string"},"altMinimumPriceAdjustment":{"format":"double","description":"Gets or sets the alternative minimum price adjustment.","type":"number","x-nullable":true},"altMinimumPriceRate":{"format":"double","description":"Gets or sets the alternative minimum price rate.","type":"number","x-nullable":true},"altMinimumPriceRatePerUnit":{"description":"Gets or sets the alternative minimum price rate is per unit.","type":"boolean","x-nullable":true},"altMinimumPricePerDiemRate":{"format":"double","description":"Gets or sets the alternative minimum price per diem rate.","type":"number","x-nullable":true},"altMinimumPriceDispenseFee":{"format":"double","description":"Gets or sets the alternative minimum price dispense fee.","type":"number","x-nullable":true},"altMinimumPriceDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the interval of days for the alternative minimum price dispense fee.","type":"integer","x-nullable":true},"altMinimumPriceDispenseFeePercentIC":{"format":"double","description":"Gets or sets the alternative minimum price dispense fee percent IC.","type":"number","x-nullable":true},"altMinimumPriceMemberClaimFee":{"format":"double","description":"Gets or sets the alternative minimum price member claim fee.","type":"number","x-nullable":true},"altMinimumPriceMemberClaimFeeIC":{"format":"double","description":"Gets or sets the alternative minimum price member claim fee IC.","type":"number","x-nullable":true},"alt2MinimumPriceCodeNo":{"format":"int64","description":"Gets or sets the second alternative minimum price code ID.","type":"integer","x-nullable":true},"alt2MinimumPriceCode":{"description":"Gets or sets the second alternative minimum price code.","type":"string"},"alt2MinimumPriceAdjustment":{"format":"double","description":"Gets or sets the second alternative minimum price adjustment.","type":"number","x-nullable":true},"alt2MinimumPriceRate":{"format":"double","description":"Gets or sets the second alternative minimum price rate.","type":"number","x-nullable":true},"alt2MinimumPriceRatePerUnit":{"description":"Gets or sets the second alternative minimum price rate is per unit.","type":"boolean","x-nullable":true},"alt2MinimumPricePerDiemRate":{"format":"double","description":"Gets or sets the second alternative minimum price per diem rate.","type":"number","x-nullable":true},"alt2MinimumPriceDispenseFee":{"format":"double","description":"Gets or sets the second alternative minimum price dispense fee.","type":"number","x-nullable":true},"alt2MinimumPriceDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the interval of days for the second alternative minimum price dispense fee.","type":"integer","x-nullable":true},"alt2MinimumPriceDispenseFeePercentIC":{"format":"double","description":"Gets or sets the second alternative minimum price dispense fee percent IC.","type":"number","x-nullable":true},"alt2MinimumPriceMemberClaimFee":{"format":"double","description":"Gets or sets the second alternative minimum price member claim fee.","type":"number","x-nullable":true},"alt2MinimumPriceMemberClaimFeeIC":{"format":"double","description":"Gets or sets the second alternative minimum price member claim fee IC.","type":"number","x-nullable":true},"grossAmountDueMemberClaimFee":{"format":"double","description":"Gets or sets the amount added to the claim as ingredient cost that the member is responsible \r\nfor when using gross amount due pricing","type":"number","x-nullable":true},"grossAmountDueMemberClaimFeeIC":{"format":"double","description":"Gets or sets the percentage amount of the ingredient cost added to the claim \r\nthat the member is responsible for when using gross amount due pricing","type":"number","x-nullable":true}}},"PagedResultModel[PlanPriorAuthorizationModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/PlanPriorAuthorizationModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"PlanPriorAuthorizationModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"coveragePriorAuthorizationId":{"format":"int64","description":"Gets or sets the Coverage Prior Authorization ID","type":"integer","x-nullable":true},"coveragePriorAuthorizationUrl":{"description":"Gets or sets the Coverage Prior Authorization Url","type":"string"},"productID":{"description":"Gets or sets the product ID for this resource.  The value should be a valid NDC, DDID or GPI.","type":"string"},"productIDType":{"description":"Gets or sets the product ID Type for this resource.  The value will indicate whether the product ID for this resource is an NDC or DDID . \r\nString values other than 'NDC' or 'DDID' will not be valid.","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date of this resource","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date of this resource","type":"string","x-nullable":true},"createdOn":{"format":"date-time","description":"Gets or sets the datetime when the age limit was created","type":"string","x-nullable":true},"needsReview":{"description":"Gets or sets the value indicating whether this age limit needs review.","type":"boolean","x-nullable":true},"optOut":{"description":"Gets or sets the value indicating whether to opt out of this age limit.","type":"boolean","x-nullable":true},"modified":{"description":"Gets or sets the value indicating whether this age limit is modified.","type":"boolean","x-nullable":true}}},"PagedResultModel[PlanProductExclusionModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/PlanProductExclusionModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"PlanProductExclusionModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"productCoverageExclusionId":{"format":"int64","description":"Gets or sets the Product Coverage Exclusion ID","type":"integer","x-nullable":true},"productCoverageExclusionUrl":{"description":"Gets or sets the Product Coverage Exclusion Url","type":"string"},"productID":{"description":"Gets or sets the product ID for this resource.  The value should be a valid NDC, DDID or GPI.","type":"string"},"productIDType":{"description":"Gets or sets the product ID Type for this resource.  The value will indicate whether the product ID for this resource is an NDC or DDID . \r\nString values other than 'NDC' or 'DDID' will not be valid.","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date of this resource","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date of this resource","type":"string","x-nullable":true},"createdOn":{"format":"date-time","description":"Gets or sets the datetime when the age limit was created","type":"string","x-nullable":true},"needsReview":{"description":"Gets or sets the value indicating whether this age limit needs review.","type":"boolean","x-nullable":true},"optOut":{"description":"Gets or sets the value indicating whether to opt out of this age limit.","type":"boolean","x-nullable":true},"modified":{"description":"Gets or sets the value indicating whether this age limit is modified.","type":"boolean","x-nullable":true}}},"PagedResultModel[PlanQuantityLimitModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/PlanQuantityLimitModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"PlanQuantityLimitModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"formularyCompanyQuantityLimitId":{"format":"int64","description":"Gets or sets the Formulary Company Quantity Limit ID","type":"integer","x-nullable":true},"formularyCompanyQuantityLimitUrl":{"description":"Gets or sets the Formulary Company Quantity Limit Url","type":"string"},"productID":{"description":"Gets or sets the product ID for this resource.  The value should be a valid NDC, DDID or GPI.","type":"string"},"productIDType":{"description":"Gets or sets the product ID Type for this resource.  The value will indicate whether the product ID for this resource is an NDC or DDID . \r\nString values other than 'NDC' or 'DDID' will not be valid.","type":"string"},"maxAmount":{"format":"double","description":"Gets or sets the Max Amount","type":"number","x-nullable":true},"maxAmountQualifier":{"description":"Gets or sets the two letter code representing the qualifier for the max amount value\r\nDS - Days Supply\r\nFL - Fills\r\nDL - Dollar Amount\r\nQY - Quantity","enum":["DS - Days Supply","DL - Dollar Amount","FL - Fills","QY - Quantity"],"type":"string","x-nullable":true},"maxAmountTimePeriod":{"description":"Gets or sets the two letter code representing the time period for the max amount \r\nSP - Specific Date Range\r\nDY - Days\r\nCM - Calendar Month\r\nLT - Lifetime\r\nCY - Calendar Year\r\nPD - Per Dispensing\r\nCQ - Calendar Quarter","enum":["CM - Calendar Month","CQ - Calendar Quarter","CY - Calendar Year","DY - Days","DS - Days Supply","LT - Lifetime","PD - Per Dispensing","SP - Specific Date Range"],"type":"string","x-nullable":true},"maxAmountTimePeriodStartDate":{"format":"date-time","description":"Gets or sets the Max Amount Time Period Start Date","type":"string","x-nullable":true},"maxAmountTimePeriodEndDate":{"format":"date-time","description":"Gets or sets the Max Amount Time Period End Date","type":"string","x-nullable":true},"maxAmountTimePeriodUnits":{"description":"Gets or sets the units to use in combination with the max amount time period(e.g.MaxAmountTimePeriodUnits= 30 and a MaxAmountTimePeriod of 'DY' would indicate 30 days)","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date of this resource","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date of this resource","type":"string","x-nullable":true},"createdOn":{"format":"date-time","description":"Gets or sets the datetime when the quantity limit was created","type":"string","x-nullable":true},"needsReview":{"description":"Gets or sets the value indicating whether this quantity limit needs review.","type":"boolean","x-nullable":true},"optOut":{"description":"Gets or sets the value indicating whether to opt out of this quantity limit.","type":"boolean","x-nullable":true},"modified":{"description":"Gets or sets the value indicating whether this quantity limit is modified.","type":"boolean","x-nullable":true}}},"PagedResultModel[PlanStepMedicationMultiSourceCodeModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/PlanStepMedicationMultiSourceCodeModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"PlanStepMedicationMultiSourceCodeModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"planStepMedicationUrl":{"description":"Gets or sets the Plan Step Medication URL","type":"string"},"planStepMedicationId":{"format":"int64","description":"Gets or sets the Plan Step Medication ID","type":"integer","x-nullable":true},"multiSourceCode":{"description":"Gets or sets the Multi Source Code","type":"string"},"isActive":{"description":"Gets or sets IsActive flag","type":"boolean","x-nullable":true},"createdOn":{"format":"date-time","description":"Gets or sets the datetime when the resource was created","type":"string","x-nullable":true},"changedOn":{"format":"date-time","description":"Gets or sets the datetime when the resource was changed","type":"string","x-nullable":true}}},"PagedResultModel[PlanStepMedicationModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/PlanStepMedicationModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"PlanStepMedicationModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"formularyCompanyStepMedicationId":{"format":"int64","description":"Gets or sets the Formulary Company Step Medication ID","type":"integer","x-nullable":true},"formularyCompanyStepMedicationUrl":{"description":"Gets or sets the Formulary Company Step Medication Url","type":"string"},"productID":{"description":"Gets or sets the product ID for this resource.  The value should be a valid NDC, DDID or GPI.","type":"string"},"productIDType":{"description":"Gets or sets the product ID Type for this resource.  The value will indicate whether the product ID for this resource is an NDC or DDID . \r\nString values other than 'NDC' or 'DDID' will not be valid.","type":"string"},"noOfDrugsToTry":{"format":"int32","description":"Gets or sets the number of Drugs to Try","type":"integer","x-nullable":true},"stepOrder":{"description":"Gets or sets the Step Order","type":"string"},"diagnosisCode":{"description":"Gets or sets the Diagnosis Code","type":"string"},"diagnosisCodeQualifier":{"description":"Gets or sets the Diagnosis Code Qualifier","type":"string"},"needsReview":{"description":"Gets or sets the value indicating whether this needs review.","type":"boolean","x-nullable":true},"optOut":{"description":"Gets or sets the value indicating whether to opt out.","type":"boolean","x-nullable":true},"modified":{"description":"Gets or sets the value indicating whether is modified.","type":"boolean","x-nullable":true},"createdOn":{"format":"date-time","description":"Gets or sets the Created On Date for this resource","type":"string","x-nullable":true},"stepDrugMultiSourceCodesUrl":{"description":"Gets or sets the URL that can be accessed to find the Multi Source Codes used to identify step medication products to try.  This list of Multi Source Codes \r\nwill be used in combination with the StepDrugProducts list to indicate which products should be tried as part of this step medication.","type":"string"},"stepDrugProductsUrl":{"description":"Gets or sets the URL that can be accessed to find which ProductID's (NDC or GPI) should be tried as part of this Step Medication resource.  This list of products \r\nwill be used in combination with the Multi Source Code list to indicate which products should be tried as part of this step medication.","type":"string"},"stepDrugs":{"type":"array","items":{"$ref":"#/definitions/PlanStepMedicationStepDrugModel"}},"multiSourceCodes":{"type":"array","items":{"$ref":"#/definitions/PlanStepMedicationMultiSourceCodeModel"}}}},"PlanStepMedicationStepDrugModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"planStepMedicationUrl":{"description":"Gets or sets the Plan Step Medication URL","type":"string"},"planStepMedicationId":{"format":"int64","description":"Gets or sets the Plan Step Medication Id","type":"integer","x-nullable":true},"stepDrugProductID":{"description":"Gets or sets the Step Drug Product ID","type":"string"},"stepDrugProductIDType":{"description":"Gets or sets the Step Drug Product ID Type","type":"string"},"stepDrugClassID":{"description":"Gets or sets the Step Drug Class ID","type":"string"},"stepDrugSubClassID":{"description":"Gets or sets the Step Drug Subclass ID","type":"string"},"createdOn":{"format":"date-time","description":"Gets or sets the Created On Date for this resource","type":"string","x-nullable":true},"changedOn":{"format":"date-time","description":"Gets or sets the Changed On Date for this resource","type":"string","x-nullable":true}}},"PagedResultModel[PlanStepMedicationStepDrugModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/PlanStepMedicationStepDrugModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"PlanTemplatePricingGroupModel":{"description":"Plan Pricing Group","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"priceCodesUrl":{"description":"Gets or sets the link to the Price Codes resource for the pricing group","type":"string"},"planPricingGroupDrugsUrl":{"description":"Gets or sets the link to the drugs  for the pricing group","type":"string"},"groupPlanNo":{"format":"int64","description":"Gets or sets the identifier for the Group Plan associated with this pricing group","type":"integer"},"name":{"description":"Gets or sets the name of the pricing group","type":"string"},"description":{"description":"Gets or sets the description of the pricing group","type":"string"},"priceCodeNo":{"format":"int64","description":"Gets or sets the custom pricing price code identifier","type":"integer","x-nullable":true},"priceCode":{"description":"Gets or sets the custom pricing price code","type":"string"},"customPriceAdjustment":{"format":"double","description":"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)","type":"number","x-nullable":true},"customPriceRate":{"format":"double","description":"Gets or sets the custom pricing rate (markup amount)","type":"number","x-nullable":true},"customPriceRatePerUnit":{"description":"Gets or sets whether the custom pricing rate is calculated per unit (each) or per fill","type":"boolean","x-nullable":true},"customPricePerDiemRate":{"format":"double","description":"Gets or sets the custom pricing per diem rate","type":"number","x-nullable":true},"customPriceDispenseFee":{"format":"double","description":"Gets or sets the custom pricing dispense fee","type":"number","x-nullable":true},"customPriceDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the custom pricing dispense fee days interval for dispense fee","type":"integer","x-nullable":true},"customPriceDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"priceMemberClaimFee":{"format":"double","description":"Gets or sets the price member claim fee.","type":"number","x-nullable":true},"priceMemberClaimFeeIC":{"format":"double","description":"Gets or sets the price member claim fee IC.","type":"number","x-nullable":true},"altPriceCodeNo":{"format":"int64","description":"Gets or sets the first alternate pricing price code identifier","type":"integer","x-nullable":true},"altPriceCode":{"description":"Gets or sets the first alternate pricing price code","type":"string"},"altPriceAdjustment":{"format":"double","description":"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)","type":"number","x-nullable":true},"altPriceRate":{"format":"double","description":"Gets or sets the first alternate pricing rate (markup amount)","type":"number","x-nullable":true},"altPriceRatePerUnit":{"description":"Gets or sets whether the first alternate pricing rate is calculated per unit (each) or per fill","type":"boolean","x-nullable":true},"altPricePerDiemRate":{"format":"double","description":"Gets or sets the first alternate pricing per diem rate","type":"number","x-nullable":true},"altPriceDispenseFee":{"format":"double","description":"Gets or sets the first alternate pricing dispense fee","type":"number","x-nullable":true},"altPriceDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the first alternate pricing dispense fee days interval for dispense fee","type":"integer","x-nullable":true},"altPriceDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"altPriceMemberClaimFee":{"format":"double","description":"Gets or sets the alternative price member claim fee.","type":"number","x-nullable":true},"altPriceMemberClaimFeeIC":{"format":"double","description":"Gets or sets the alternative price member claim fee IC.","type":"number","x-nullable":true},"alt2PriceCodeNo":{"format":"int64","description":"Gets or sets the second alternate pricing price code identifier","type":"integer","x-nullable":true},"alt2PriceCode":{"description":"Gets or sets the second alternate pricing price code","type":"string"},"alt2PriceAdjustment":{"format":"double","description":"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)","type":"number","x-nullable":true},"alt2PriceRate":{"format":"double","description":"Gets or sets the second alternate pricing rate (markup amount)","type":"number","x-nullable":true},"alt2PriceRatePerUnit":{"description":"Gets or sets whether the second alternate pricing rate is calculated per unit (each) or per fill","type":"boolean","x-nullable":true},"alt2PricePerDiemRate":{"format":"double","description":"Gets or sets the second alternate pricing per diem rate","type":"number","x-nullable":true},"alt2PriceDispenseFee":{"format":"double","description":"Gets or sets the second alternate pricing dispense fee","type":"number","x-nullable":true},"alt2PriceDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the second alternate pricing dispense fee days interval for dispense fee","type":"integer","x-nullable":true},"alt2PriceDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"alt2PriceMemberClaimFee":{"format":"double","description":"Gets or sets the second alternative price member claim fee.","type":"number","x-nullable":true},"alt2PriceMemberClaimFeeIC":{"format":"double","description":"Gets or sets the second alternative price member claim fee IC.","type":"number","x-nullable":true},"alt3PriceCodeNo":{"format":"int64","description":"Gets or sets the third alternate pricing price code identifier","type":"integer","x-nullable":true},"alt3PriceCode":{"description":"Gets or sets the third alternate pricing price code","type":"string"},"alt3PriceAdjustment":{"format":"double","description":"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)","type":"number","x-nullable":true},"alt3PriceRate":{"format":"double","description":"Gets or sets the third alternate pricing rate (markup amount)","type":"number","x-nullable":true},"alt3PriceRatePerUnit":{"description":"Gets or sets whether the third alternate pricing rate is calculated per unit (each) or per fill","type":"boolean","x-nullable":true},"alt3PricePerDiemRate":{"format":"double","description":"Gets or sets the third alternate pricing per diem rate","type":"number","x-nullable":true},"alt3PriceDispenseFee":{"format":"double","description":"Gets or sets the third alternate pricing dispense fee","type":"number","x-nullable":true},"alt3PriceDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the third alternate pricing dispense fee days interval for dispense fee","type":"integer","x-nullable":true},"alt3PriceDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"alt3PriceMemberClaimFee":{"format":"double","description":"Gets or sets the third alternative price member claim fee.","type":"number","x-nullable":true},"alt3PriceMemberClaimFeeIC":{"format":"double","description":"Gets or sets the third alternative price member claim fee IC.","type":"number","x-nullable":true},"alt4PriceCodeNo":{"format":"int64","description":"Gets or sets the fourth alternate pricing price code identifier","type":"integer","x-nullable":true},"alt4PriceCode":{"description":"Gets or sets the fourth alternate pricing price code","type":"string"},"alt4PriceAdjustment":{"format":"double","description":"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)","type":"number","x-nullable":true},"alt4PriceRate":{"format":"double","description":"Gets or sets the fourth alternate pricing rate (markup amount)","type":"number","x-nullable":true},"alt4PriceRatePerUnit":{"description":"Gets or sets whether the fourth alternate pricing rate is calculated per unit (each) or per fill","type":"boolean","x-nullable":true},"alt4PricePerDiemRate":{"format":"double","description":"Gets or sets the fourth alternate pricing per diem rate","type":"number","x-nullable":true},"alt4PriceDispenseFee":{"format":"double","description":"Gets or sets the fourth alternate pricing dispense fee","type":"number","x-nullable":true},"alt4PriceDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the fourth alternate pricing dispense fee days interval for dispense fee","type":"integer","x-nullable":true},"alt4PriceDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"alt4PriceMemberClaimFee":{"format":"double","description":"Gets or sets the fourth alternative price member claim fee.","type":"number","x-nullable":true},"alt4PriceMemberClaimFeeIC":{"format":"double","description":"Gets or sets the fourth alternative price member claim fee IC.","type":"number","x-nullable":true},"minimumPriceCodeNo":{"format":"int64","description":"Gets or sets the minimum pricing price code identifier","type":"integer","x-nullable":true},"minimumPriceCode":{"description":"Gets or sets the minimum pricing price code","type":"string"},"minimumPriceAdjustment":{"format":"double","description":"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)","type":"number","x-nullable":true},"minimumPriceRate":{"format":"double","description":"Gets or sets the minimum pricing rate (markup amount)","type":"number","x-nullable":true},"minimumPriceRatePerUnit":{"description":"Gets or sets whether the minimum pricing rate is calculated per unit (each) or per fill","type":"boolean","x-nullable":true},"minimumPricePerDiemRate":{"format":"double","description":"Gets or sets the minimum pricing per diem rate","type":"number","x-nullable":true},"minimumPriceDispenseFee":{"format":"double","description":"Gets or sets the minimum pricing dispense fee","type":"number","x-nullable":true},"minimumPriceDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the minimum dispense fee days interval for dispense fee","type":"integer","x-nullable":true},"minimumPriceDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"minimumPriceMemberClaimFee":{"format":"double","description":"Gets or sets the minimum price member claim fee.","type":"number","x-nullable":true},"minimumPriceMemberClaimFeeIC":{"format":"double","description":"Gets or sets the minimum price member claim fee IC.","type":"number","x-nullable":true},"flatRate":{"format":"double","description":"Gets or sets the flat rate pricing rate (markup amount)","type":"number","x-nullable":true},"flatRateDaysInterval":{"format":"int32","description":"Gets or sets the flat rate days interval","type":"integer","x-nullable":true},"flatRateDispenseFee":{"format":"double","description":"Gets or sets the flat rate pricing dispense fee","type":"number","x-nullable":true},"flatRateDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the flat rate dispense fee days interval for dispense fee","type":"integer","x-nullable":true},"flatRateDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"flatRateMemberClaimFee":{"format":"double","description":"Gets or sets the flat rate member claim fee.","type":"number","x-nullable":true},"flatRateMemberClaimFeeIC":{"format":"double","description":"Gets or sets the flat rate member claim fee IC.","type":"number","x-nullable":true},"minimumRate":{"format":"double","description":"Gets or sets the minimum rate pricing rate (markup amount)","type":"number","x-nullable":true},"minimumRateDaysInterval":{"format":"int32","description":"Gets or sets the minimum rate days interval","type":"integer","x-nullable":true},"minimumRateDispenseFee":{"format":"double","description":"Gets or sets the minimim rate pricing dispense fee","type":"number","x-nullable":true},"minimumRateDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the minimum rate dispense fee days interval for dispense fee","type":"integer","x-nullable":true},"minimumRateDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"minimumRateMemberClaimFee":{"format":"double","description":"Gets or sets the minimum rate member claim fee.","type":"number","x-nullable":true},"minimumRateMemberClaimFeeIC":{"format":"double","description":"Gets or sets the minimum rate member claim fee IC.","type":"number","x-nullable":true},"professionalFee":{"format":"double","description":"Gets or sets the professional fee amount","type":"number","x-nullable":true},"memberClaimFee":{"format":"double","description":"Gets or sets the member claim fee amount","type":"number","x-nullable":true},"useUsualAndCustomary":{"description":"Gets or sets whether to use the pharmacy's submitted usual and customary","type":"boolean","x-nullable":true},"usualAndCustomaryRate":{"format":"double","description":"Gets or sets the usual and customary rate (markup amount)","type":"number","x-nullable":true},"usualAndCustomaryRatePerUnit":{"description":"Gets or sets whether the usual and customary rate is calculated per unit (each) or per fill","type":"boolean","x-nullable":true},"usualAndCustomaryPerDiemRate":{"format":"double","description":"Gets or sets the usual and customary per diem rate","type":"number","x-nullable":true},"usualAndCustomaryAdjustmentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"usualAndCustomaryDispenseFee":{"format":"double","description":"Gets or sets the dispense fee when usual and customary pricing is used","type":"number","x-nullable":true},"usualAndCustomaryDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the dispense fee days interval when usual and customary pricing is used","type":"integer","x-nullable":true},"usualAndCustomaryDispenseFeePercentIC":{"format":"double","description":"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)","type":"number","x-nullable":true},"usualAndCustomaryMemberClaimFee":{"format":"double","description":"Gets or sets the usual and customary member claim fee.","type":"number","x-nullable":true},"usualAndCustomaryMemberClaimFeeIC":{"format":"double","description":"Gets or sets the usual and customary member claim fee IC.","type":"number","x-nullable":true},"useGrossAmountDue":{"description":"Gets or sets whether to use the pharmacy's submitted gross amount due","type":"boolean","x-nullable":true},"useGrossAmountDueIfNoPricing":{"description":"Gets or sets whether to use the pharmacy's submitted gross amount due if there is no other pricing available","type":"boolean","x-nullable":true},"useClaimAcqCost":{"description":"Gets or sets whether to take amount from claim into account when using acquistion cost","type":"boolean","x-nullable":true},"alwaysUseAltPricing":{"description":"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","type":"boolean","x-nullable":true},"flatRateIncludesTax":{"description":"Gets or sets whether the flat rate includes tax","type":"boolean","x-nullable":true},"noCustomPriceAltGroupUrl":{"description":"Gets or sets the link back to a fall back pricing group if no pricing could be determined","type":"string"},"noCustomPriceAltGroupNo":{"format":"int64","description":"Gets or sets the identifier to the fall back pricing group if not pricing could be determined","type":"integer","x-nullable":true},"requiresOverride":{"description":"Gets or sets whether the pricing group requires an override","type":"boolean","x-nullable":true},"requiresOverrideRestricted":{"description":"Gets or sets whether the pricing group requires a restricted override","type":"boolean","x-nullable":true},"notCovered":{"description":"Gets or sets whether this pricing group is covered","type":"boolean","x-nullable":true},"specialty":{"description":"Gets or sets whether this pricing group is tagged as specialty","type":"boolean","x-nullable":true},"is340B":{"description":"Gets or sets whether this pricing group is tagged as 340B","type":"boolean","x-nullable":true},"patientAssistanceProgram":{"description":"Gets or sets whether this pricing group is tagged as a patient assistance program","type":"boolean","x-nullable":true},"rejectClaimIfNoCustomPrice":{"description":"Gets or sets whether claims should reject if there is no custom pricing","type":"boolean","x-nullable":true},"approveMessage":{"description":"Gets or sets the message for paid claim","type":"string"},"requireOverrideMessage":{"description":"Gets or sets the message for claims that require override","type":"string"},"notCoveredMessage":{"description":"Gets or sets the message for claims that are not covered","type":"string"},"altMinimumPriceCodeNo":{"format":"int64","description":"Gets or sets the alternative minimum price code ID.","type":"integer","x-nullable":true},"altMinimumPriceCode":{"description":"Gets or sets the alternative minimum price code.","type":"string"},"altMinimumPriceAdjustment":{"format":"double","description":"Gets or sets the alternative minimum price adjustment.","type":"number","x-nullable":true},"altMinimumPriceRate":{"format":"double","description":"Gets or sets the alternative minimum price rate.","type":"number","x-nullable":true},"altMinimumPriceRatePerUnit":{"description":"Gets or sets the alternative minimum price rate is per unit.","type":"boolean","x-nullable":true},"altMinimumPricePerDiemRate":{"format":"double","description":"Gets or sets the alternative minimum price per diem rate.","type":"number","x-nullable":true},"altMinimumPriceDispenseFee":{"format":"double","description":"Gets or sets the alternative minimum price dispense fee.","type":"number","x-nullable":true},"altMinimumPriceDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the interval of days for the alternative minimum price dispense fee.","type":"integer","x-nullable":true},"altMinimumPriceDispenseFeePercentIC":{"format":"double","description":"Gets or sets the alternative minimum price dispense fee percent IC.","type":"number","x-nullable":true},"altMinimumPriceMemberClaimFee":{"format":"double","description":"Gets or sets the alternative minimum price member claim fee.","type":"number","x-nullable":true},"altMinimumPriceMemberClaimFeeIC":{"format":"double","description":"Gets or sets the alternative minimum price member claim fee IC.","type":"number","x-nullable":true},"alt2MinimumPriceCodeNo":{"format":"int64","description":"Gets or sets the second alternative minimum price code ID.","type":"integer","x-nullable":true},"alt2MinimumPriceCode":{"description":"Gets or sets the second alternative minimum price code.","type":"string"},"alt2MinimumPriceAdjustment":{"format":"double","description":"Gets or sets the second alternative minimum price adjustment.","type":"number","x-nullable":true},"alt2MinimumPriceRate":{"format":"double","description":"Gets or sets the second alternative minimum price rate.","type":"number","x-nullable":true},"alt2MinimumPriceRatePerUnit":{"description":"Gets or sets the second alternative minimum price rate is per unit.","type":"boolean","x-nullable":true},"alt2MinimumPricePerDiemRate":{"format":"double","description":"Gets or sets the second alternative minimum price per diem rate.","type":"number","x-nullable":true},"alt2MinimumPriceDispenseFee":{"format":"double","description":"Gets or sets the second alternative minimum price dispense fee.","type":"number","x-nullable":true},"alt2MinimumPriceDispenseFeeDaysInterval":{"format":"int32","description":"Gets or sets the interval of days for the second alternative minimum price dispense fee.","type":"integer","x-nullable":true},"alt2MinimumPriceDispenseFeePercentIC":{"format":"double","description":"Gets or sets the second alternative minimum price dispense fee percent IC.","type":"number","x-nullable":true},"alt2MinimumPriceMemberClaimFee":{"format":"double","description":"Gets or sets the second alternative minimum price member claim fee.","type":"number","x-nullable":true},"alt2MinimumPriceMemberClaimFeeIC":{"format":"double","description":"Gets or sets the second alternative minimum price member claim fee IC.","type":"number","x-nullable":true},"grossAmountDueMemberClaimFee":{"format":"double","description":"Gets or sets the amount added to the claim as ingredient cost that the member is responsible \r\nfor when using gross amount due pricing","type":"number","x-nullable":true},"grossAmountDueMemberClaimFeeIC":{"format":"double","description":"Gets or sets the percentage amount of the ingredient cost added to the claim \r\nthat the member is responsible for when using gross amount due pricing","type":"number","x-nullable":true}}},"PagedResultModel[PlanTierCopayModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/PlanTierCopayModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"PlanTierCopayModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"formularyTierId":{"format":"int64","description":"Gets or sets the Formulary Tier ID","type":"integer","x-nullable":true},"formularyTierUrl":{"description":"Gets or sets the Formulary Tier Url","type":"string"},"copayId":{"format":"int64","description":"Gets or sets the Copay ID","type":"integer","x-nullable":true},"oopCopayUrl":{"description":"Gets or sets the OOP Copay Url","type":"string"},"oopCopayId":{"format":"int64","description":"Gets or sets the OOP Copay ID","type":"integer","x-nullable":true},"copayUrl":{"description":"Gets or sets the Copay Url","type":"string"},"createdOn":{"format":"date-time","description":"Gets or sets the datetime when the age limit was created","type":"string","x-nullable":true}}},"PortalDrugModel":{"description":"Represents a drug with basic details used in the search process.","type":"object","properties":{"id":{"format":"int64","description":"The MedispanDrugDescriptor Identifier for this drug","type":"integer"},"drugName":{"description":"Gets or sets the primary name of the drug.","type":"string"},"drugIdentifier":{"description":"Gets or sets the NDC for the drug.  This NDC can be passed to the PortalDrugSelect endpoint to get detailed drug information for display before a PortalPriceCheck call.","type":"string"},"drugIdentifierAlt":{"description":"Gets or sets an alternate identifier for the drug, if applicable.","type":"string"}}},"PagedResultModel[PortalDrugDetailModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/PortalDrugDetailModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"PortalDrugDetailModel":{"description":"Represents detailed information about a drug, including available forms and strengths.","type":"object","properties":{"drugType":{"description":"Gets or sets the type of drug (e.g., brand or generic).","type":"string"},"drugName":{"description":"Gets or sets the name of the drug.","type":"string"},"forms":{"description":"Gets or sets a list of forms in which the drug is available, each with associated strengths.","type":"array","items":{"$ref":"#/definitions/FormContainerModel"}}}},"FormContainerModel":{"description":"Represents a specific form of a drug (e.g., tablet, capsule), along with its strengths.","type":"object","properties":{"isDefault":{"description":"Indicates if this form is the default selection for the drug.","type":"boolean"},"form":{"description":"Gets or sets the dosage form of the drug, such as tablet or capsule.","type":"string"},"strengths":{"description":"Gets or sets a list of available strengths for this form of the drug.","type":"array","items":{"$ref":"#/definitions/StrengthModel"}}}},"StrengthModel":{"description":"Represents a specific strength of a drug form, along with package descriptions.","type":"object","properties":{"isDefault":{"description":"Indicates if this strength is the default option for the drug form.","type":"boolean"},"strengthValue":{"description":"Gets or sets the strength value (e.g., \"500 mg\") of the drug.","type":"string"},"packageDescriptions":{"description":"Gets or sets a list of available package descriptions for this strength.","type":"array","items":{"$ref":"#/definitions/PackageModel"}}}},"PackageModel":{"description":"Represents a package option for a specific drug strength, including NDC and quantity options.","type":"object","properties":{"isDefault":{"description":"Indicates if this package is the default selection for the strength.","type":"boolean"},"ndc":{"description":"Gets or sets the National Drug Code (NDC) for the package.","type":"string"},"gpi":{"description":"Gets or sets the Generic Product Identifier (GPI) for the package, if applicable.","type":"string"},"packageDescription":{"description":"Gets or sets a description of the package (e.g., \"1x 1.000 EA Box\").","type":"string"},"showPackageIndicator":{"description":"Indicates whether a special indicator should be shown for this package.","type":"boolean"},"quantities":{"description":"Gets or sets a list of available quantities for this package.","type":"array","items":{"$ref":"#/definitions/QuantityContainerModel"}}}},"QuantityContainerModel":{"description":"Represents an available quantity option for a specific package of a drug.","type":"object","properties":{"isDefault":{"description":"Indicates if this quantity is the default selection for the package.","type":"boolean"},"quantity":{"format":"double","description":"Gets or sets the quantity for this package.  This is the friendly quantity we've attempted to calculate that can be presented to a user.","type":"number"},"dispenseQuantity":{"format":"double","description":"Gets or sets the quantity for this package that the price check endpoint requires.  If the user is shown the friendly quantity and runs a price check on this package, send the DispenseQuantity as the quantity parameter of the portal price check API endpoint.","type":"number"}}},"PagedResultModel[PortalPriceCheckModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/PortalPriceCheckModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"PortalPriceCheckModel":{"type":"object","properties":{"networkID":{"format":"int64","description":"Gets or sets the unique identifier for the pharmacy network.","type":"integer"},"networkName":{"description":"Gets or sets the name of the pharmacy network.","type":"string"},"networkSortOrder":{"format":"int32","description":"Gets or sets the display order for the network in sorted results.","type":"integer"},"logoUrl":{"description":"Gets or sets the URL for the network's logo.","type":"string"},"averageWac":{"format":"double","description":"Gets or sets the average wholesale acquisition cost (WAC) of the drug.","type":"number"},"networkPrice":{"format":"double","description":"Gets or sets the price of the drug within this network.","type":"number"},"mailOrderLocation":{"description":"Indicates whether this a mail order pharmacy","type":"boolean"},"mailOrderPhoneNumber":{"description":"Gets or sets the phone number for the mail order pharmacy, if applicable.","type":"string"},"ndc":{"description":"Gets or sets the National Drug Code (NDC) associated with this entry.","type":"string"},"drugName":{"description":"Gets or sets the drug's commercial name.","type":"string"},"genericName":{"description":"Gets or sets the drug's generic name.","type":"string"},"strengthDescription":{"description":"Gets or sets a description of the drug's strength (e.g., 10mg).","type":"string"},"drugAndStrength":{"description":"Gets or sets the drug name combined with its strength for display purposes.","type":"string"},"routeOfAdministration":{"description":"Gets or sets the route of administration (e.g., oral, topical).","type":"string"},"isBrand":{"description":"Indicates whether the drug is a brand name.","type":"boolean","x-nullable":true},"drugDescriptorIdentifier":{"format":"int32","description":"Gets or sets the Drug Descriptor Identifier (DDID).","type":"integer"},"rejectMessage":{"description":"Gets or sets any rejection message associated with this entry.","type":"string"},"rejectCode":{"description":"Gets or sets any rejection code associated with this entry.","type":"string"},"memberPay":{"format":"double","description":"Gets or sets the amount the member will pay for the drug.","type":"number"},"copay":{"format":"double","description":"Gets or sets the copayment amount.","type":"number"},"coinsurance":{"format":"double","description":"Gets or sets the coinsurance amount.","type":"number"},"deductible":{"format":"double","description":"Gets or sets the deductible amount (the amount applied to the periodic deductible).","type":"number"},"planPay":{"format":"double","description":"Gets or sets the amount paid by the plan for the drug.","type":"number"},"isSuccessful":{"description":"For the portal price-check endpoints (unlike api/PriceCheck), this flag\r\nindicates whether the underlying test claim was paid.\r\nTrue = paid (no reject codes). False = not paid due to reject codes.","type":"boolean"},"drugTier":{"description":"Gets or sets the numerical value of the drug's plan formulary tier (e.g. Tier 1, Tier 2, etc.) .","type":"string"},"drugTierDescription":{"description":"Gets or sets a description of the drug's plan formulary tier.","type":"string"},"daw":{"description":"Gets or sets the Dispense as Written (DAW) code for the drug.","type":"string"},"priceCheckOrigin":{"$ref":"#/definitions/LatLongModel"},"stepTherapyChecked":{"description":"Gets or sets the status if any step therapy rules are checked","type":"boolean"},"stepTherapyPrerequisiteMet":{"description":"Gets or sets the status if any step therapy prerequisites were met","type":"boolean","x-nullable":true},"usedPersistentOverride":{"description":"Gets or sets the status if a persistent override was used","type":"boolean"},"usedOverrideRule":{"description":"Gets or sets the status if any override rule was used","type":"boolean"}}},"LatLongModel":{"type":"object","properties":{"latitude":{"format":"double","type":"number"},"longitude":{"format":"double","type":"number"}}},"PagedResultModel[PortalPriceCheckByLocationModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/PortalPriceCheckByLocationModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"PortalPriceCheckByLocationModel":{"type":"object","properties":{"networkID":{"format":"int64","description":"Gets or sets the unique identifier for the pharmacy network.","type":"integer"},"averageWac":{"format":"double","description":"Gets or sets the average wholesale acquisition cost (WAC) of the drug.","type":"number"},"networkPrice":{"format":"double","description":"Gets or sets the price of the drug within this network.","type":"number"},"mailOrderLocation":{"description":"Indicates whether this a mail order pharmacy","type":"boolean"},"mailOrderPhoneNumber":{"description":"Gets or sets the phone number for the mail order pharmacy, if applicable.","type":"string"},"ndc":{"description":"Gets or sets the National Drug Code (NDC) associated with this entry.","type":"string"},"drugName":{"description":"Gets or sets the drug's commercial name.","type":"string"},"genericName":{"description":"Gets or sets the drug's generic name.","type":"string"},"strengthDescription":{"description":"Gets or sets a description of the drug's strength (e.g., 10mg).","type":"string"},"drugAndStrength":{"description":"Gets or sets the drug name combined with its strength for display purposes.","type":"string"},"routeOfAdministration":{"description":"Gets or sets the route of administration (e.g., oral, topical).","type":"string"},"isBrand":{"description":"Indicates whether the drug is a brand name.","type":"boolean","x-nullable":true},"drugDescriptorIdentifier":{"format":"int32","description":"Gets or sets the Drug Descriptor Identifier (DDID).","type":"integer"},"rejectMessage":{"description":"Gets or sets any rejection message associated with this entry.","type":"string"},"rejectCode":{"description":"Gets or sets any rejection code associated with this entry.","type":"string"},"memberPay":{"format":"double","description":"Gets or sets the amount the member will pay for the drug.","type":"number"},"copay":{"format":"double","description":"Gets or sets the copayment amount.","type":"number"},"coinsurance":{"format":"double","description":"Gets or sets the coinsurance amount.","type":"number"},"deductible":{"format":"double","description":"Gets or sets the deductible amount (the amount applied to the periodic deductible).","type":"number"},"planPay":{"format":"double","description":"Gets or sets the amount paid by the plan for the drug.","type":"number"},"isSuccessful":{"description":"For the portal price-check endpoints (unlike api/PriceCheck), this flag\r\nindicates whether the underlying test claim was paid.\r\nTrue = paid (no reject codes). False = not paid due to reject codes.","type":"boolean"},"drugTier":{"description":"Gets or sets the numerical value of the drug's plan formulary tier (e.g. Tier 1, Tier 2, etc.) .","type":"string"},"drugTierDescription":{"description":"Gets or sets a description of the drug's plan formulary tier.","type":"string"},"daw":{"description":"Gets or sets the Dispense as Written (DAW) code for the drug.","type":"string"},"pharmacyLocation":{"$ref":"#/definitions/PortalStoreLocationModel","description":"Gets or sets the model representing the pharmacy location's details."},"priceCheckOrigin":{"$ref":"#/definitions/LatLongModel"},"stepTherapyChecked":{"description":"Gets or sets the status if any step therapy rules are checked","type":"boolean"},"stepTherapyPrerequisiteMet":{"description":"Gets or sets the status if any step therapy prerequisites were met","type":"boolean","x-nullable":true},"usedPersistentOverride":{"description":"Gets or sets the status if a persistent override was used","type":"boolean"},"usedOverrideRule":{"description":"Gets or sets the status if any override rule was used","type":"boolean"}}},"PortalStoreLocationModel":{"description":"Represents a pharmacy store location within a specific headquarter/network","type":"object","properties":{"id":{"format":"int64","description":"The unique identifier of the pharmacy store.","type":"integer"},"networkID":{"format":"int64","description":"The value that represents the network ID of the pharmacy store (this is referred to as the pharmacy HQ ID internally).","type":"integer"},"storeNCPDP":{"description":"The unique NCPDP (National Council for Prescription Drug Programs) identifier for the pharmacy store.","type":"string"},"storeNPI":{"description":"The National Provider Identifier (NPI) for the pharmacy store.","type":"string"},"storeName":{"description":"The name of the pharmacy store.","type":"string"},"latitude":{"format":"double","description":"The latitude coordinate of the pharmacy store's location.","type":"number","x-nullable":true},"longitude":{"format":"double","description":"The longitude coordinate of the pharmacy store's location.","type":"number","x-nullable":true},"distance":{"format":"double","description":"The distance from the search origin to the pharmacy store, in miles.","type":"number","x-nullable":true},"address1":{"description":"The primary street address of the pharmacy store.","type":"string"},"address2":{"description":"The secondary address information for the pharmacy store (e.g., suite or unit number).","type":"string"},"city":{"description":"The city where the pharmacy store is located.","type":"string"},"state":{"description":"The state or province where the pharmacy store is located.","type":"string"},"zip":{"description":"The postal (ZIP) code of the pharmacy store's location.","type":"string"},"telephoneNumber":{"description":"The telephone number of the pharmacy store.","type":"string"},"faxNumber":{"description":"The fax number of the pharmacy store.","type":"string"},"hours":{"description":"The encoded operating hours of the pharmacy store.\r\n            \r\n**Decoding Instructions:**\r\n            \r\n- The `Hours` field is a 35-character string divided into 7 segments, each representing a day of the week from **Sunday (`1`)** to **Saturday (`7`)**.\r\n- Each segment is **5 characters long**:\r\n  - **First character**: Day identifier (`1` = Sunday, `2` = Monday, ..., `7` = Saturday).\r\n  - **Next four characters**: Opening and closing times in 24-hour format (`HHHH`) or blank spaces if the store is closed on that day.\r\n    - **First two digits**: Opening hour (`HH`).\r\n    - **Last two digits**: Closing hour (`HH`).\r\n- If the store is **closed** on a day, the four characters are blank spaces.\r\n            \r\n**Example:**\r\n            \r\n```\r\nHours = \"1    210193101941019510196101971018\"\r\n```\r\nThis represents:\r\n- **Sunday (`1`)**: Closed\r\n- **Monday (`2`)**: Open from **10 AM** to **7 PM**\r\n- **Tuesday (`3`)**: Open from **10 AM** to **7 PM**\r\n- **Wednesday (`4`)**: Open from **10 AM** to **7 PM**\r\n- **Thursday (`5`)**: Open from **10 AM** to **7 PM**\r\n- **Friday (`6`)**: Open from **10 AM** to **7 PM**\r\n- **Saturday (`7`)**: Open from **10 AM** to **6 PM**\r\n\r\n**Notes:**\r\n            \r\n- If the entire `Hours` string is blank, no operating hours information is available.\r\n- The encoded string does not explicitly include a 24-hour flag.\r\n  - If a store is open 24 hours, the `Hours` string may be entirely blank","type":"string"},"customAttribute1":{"description":"Custom attribute 1 for additional store information.","type":"string"},"customAttribute2":{"description":"Custom attribute 2 for additional store information.","type":"string"},"customAttribute3":{"description":"Custom attribute 3 for additional store information.","type":"string"},"primaryPharmacyType":{"description":"The primary type of the pharmacy store (e.g., Retail, Specialty).","type":"string"},"mailOrderLocation":{"description":"Indicates if the pharmacy is a mail order location.","type":"boolean"},"internationalLocation":{"description":"Indicates if the pharmacy is a international location.","type":"boolean"}}},"PagedResultModel[PortalStoreLocationModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/PortalStoreLocationModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"PriceCheckModel":{"type":"object","properties":{"memberSeqNo":{"format":"int64","description":"The unique identifier for the member within the claims system. Also known as the RxCPersonID, it can be retrieved from the ID property of the GroupMembers and Members endpoints.","type":"integer"},"drugNDCs":{"description":"A list of National Drug Codes (NDC) representing the drugs to be price-checked.","type":"array","items":{"type":"string"}},"pharmacyNPIs":{"description":"A list of National Provider Identifier (NPI) numbers for the pharmacies where the price check will be performed.","type":"array","items":{"type":"string"}},"quantity":{"format":"double","description":"The quantity of each drug to be dispensed.","type":"number"},"daysSupply":{"format":"int32","description":"The number of days' supply for each drug.","type":"integer"},"dawCodes":{"description":"A list of Dispense As Written (DAW) codes indicating specific dispensing instructions for each drug.","type":"array","items":{"type":"string"}}}},"PriceCheckResultModel":{"type":"object","properties":{"ndc":{"type":"string"},"drugName":{"type":"string"},"genericName":{"type":"string"},"strengthDescription":{"type":"string"},"drugAndStrength":{"type":"string"},"routeOfAdministration":{"type":"string"},"isBrand":{"type":"boolean"},"drugDescriptorIdentifier":{"format":"int32","type":"integer"},"rejectMessage":{"type":"string"},"memberPay":{"format":"double","type":"number"},"copay":{"format":"double","type":"number"},"coinsurance":{"format":"double","type":"number"},"deductible":{"format":"double","type":"number"},"planPay":{"format":"double","type":"number"},"rejectMsg":{"type":"string"},"isSuccessful":{"description":"True if the price check completed (even if it returned a reject code);\r\nfalse if a system or claims processing error prevented completion.","type":"boolean"},"drugTier":{"type":"string"},"drugTierDescription":{"type":"string"},"daw":{"type":"string"},"npi":{"type":"string"},"rejectCode":{"type":"string"},"stepTherapyChecked":{"description":"Gets or sets the status if any step therapy rules are checked","type":"boolean"},"stepTherapyPrerequisiteMet":{"description":"Gets or sets the status if any step therapy prerequisites were met","type":"boolean","x-nullable":true},"usedPersistentOverride":{"description":"Gets or sets the status if a persistent override was used","type":"boolean"},"usedOverrideRule":{"description":"Gets or sets the status if any override rule was used","type":"boolean"},"isPaid":{"description":"This property indicates if the price check's underlying test claim was paid.","type":"boolean"}}},"PriceCodeModel":{"description":"Price Code","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"code":{"description":"Gets or sets the price code name","type":"string"},"description":{"description":"Gets or sets the price code description","type":"string"},"pharmacyPriceCode":{"description":"Gets or sets the pharmacy price code name","type":"string"}}},"PriorAuthorizationPersistLimitIntervalModel":{"description":"Prior Authorization Persist Limit Interval","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"description":{"description":"Gets or sets the description of the prior authorization persist limit interval","type":"string"}}},"PriorAuthorizationPersistPharmacyModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"pharmacyNPI":{"description":"Gets or sets the NPI of the pharmacy","type":"string"}}},"PriorAuthorizationPersistModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"groupNo":{"format":"int64","description":"Gets or sets the Group identifier","type":"integer","x-nullable":true},"memberSeqNo":{"format":"int64","description":"Gets or sets the Member sequence number","type":"integer","x-nullable":true},"cardholderSeqNo":{"format":"int64","type":"integer","x-nullable":true},"memberUrl":{"description":"Gets or sets the Member Url","type":"string"},"cardHolderUrl":{"description":"Gets or sets the Cardholder Url","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date","type":"string","x-nullable":true},"ndc":{"description":"Gets or sets the NDC","type":"string"},"genericProductIdentifier":{"description":"Gets or sets the Generic Product Identifier","type":"string"},"gpiChars":{"description":"Gets or sets the GPI Chars","type":"string"},"rxNumber":{"description":"Gets or sets the RX number","type":"string"},"pharmacyNPI":{"description":"Gets or sets the Pharmacy NPI","type":"string"},"pharmacyNPIs":{"description":"Gets or sets Pharmacy NPI list","type":"array","items":{"$ref":"#/definitions/PriorAuthorizationPersistPharmacyModel"}},"prescriberNPI":{"description":"Gets or sets the Prescriber NPI","type":"string"},"allowBrand":{"description":"Gets or sets the Allow Brand indicator","type":"boolean","x-nullable":true},"allowOTC":{"description":"Gets or sets the Allow OTC indicator","type":"boolean","x-nullable":true},"allowRepackaged":{"description":"Gets or sets the Allow Repackaged indicator","type":"boolean","x-nullable":true},"daysSupply":{"format":"int32","description":"Gets or sets the days supply amount","type":"integer","x-nullable":true},"copayOverride":{"format":"double","description":"Gets or sets the copay override amount","type":"number","x-nullable":true},"copayOverrideDaysInterval":{"format":"int32","description":"Gets or sets the copay override days interval","type":"integer","x-nullable":true},"coinsuranceOverride":{"format":"double","description":"Gets or sets the Coinsurance override amount (Enter the percentage in decimal form (e.g., 0.25 for 25%))","type":"number","x-nullable":true},"variableCopayAmount":{"format":"double","description":"Gets or sets the Variable Copay amount","type":"number","x-nullable":true},"enforceQtyLimit":{"description":"Gets or sets Enforce Quantity Limit indicator","type":"boolean","x-nullable":true},"enforceDaysSupplyLimit":{"description":"Gets or sets Enforce Quantity Supply Limit indicator","type":"boolean","x-nullable":true},"enforceRefillTooSoon":{"description":"Gets or sets Enforce Refill Too Soon indicator","type":"boolean","x-nullable":true},"enforceMaxFillsLimit":{"description":"Gets or sets Enforce Max Fills Limit indicator","type":"boolean","x-nullable":true},"enforceMaxPriceLimit":{"description":"Gets or sets Enforce Max Price Limit indicator","type":"boolean","x-nullable":true},"enforceStepTherapy":{"description":"Gets or sets Enforce Step Therapy indicator","type":"boolean","x-nullable":true},"enforceAgeRestriction":{"description":"Gets or sets Enforce Age Restriction indicator","type":"boolean","x-nullable":true},"qtyLimit":{"format":"double","description":"Gets or sets Quantity Limit","type":"number","x-nullable":true},"daysSupplyLimit":{"format":"int32","description":"Gets or sets Days Supply Limit","type":"integer","x-nullable":true},"maxPrice":{"format":"double","description":"Gets or sets Maximum Price","type":"number","x-nullable":true},"maxPriceDaysInterval":{"format":"int32","description":"Gets or sets Maximum Price Days Interval","type":"integer","x-nullable":true},"maxPriceCompound":{"format":"double","description":"Gets or sets Maximum Price Compound","type":"number","x-nullable":true},"maxPriceCompoundDaysInterval":{"format":"int32","description":"Gets or sets Maximum Price Compound Days Interval","type":"integer","x-nullable":true},"grandfathered":{"description":"Gets or sets Grandathered indicator","type":"boolean","x-nullable":true},"notes":{"description":"Gets or sets Notes","type":"string"},"enforcePlanFormulary":{"description":"Gets or sets Enforce Plan Formulary indicator","type":"boolean","x-nullable":true},"enforcePharmacyFormulary":{"description":"Gets or sets Enforce Pharmacy Formulary indicator","type":"boolean","x-nullable":true},"enforceMemberFormulary":{"description":"Gets or sets Enforce Member Formulary indicator","type":"boolean","x-nullable":true},"enforcePrescriberFormulary":{"description":"Gets or sets Enforce Prescriber Formulary indicator","type":"boolean","x-nullable":true},"enforceDAW":{"description":"Gets or sets Enforce DAW indicator","type":"boolean","x-nullable":true},"enforceFinalFormulary":{"description":"Gets or sets Enforce Final Formulary indicator","type":"boolean","x-nullable":true},"enforcePostPricing":{"description":"Gets or sets Enforce Post Pricing indicator","type":"boolean","x-nullable":true},"enforceRestrictedOverride":{"description":"Gets or sets Enforce Restricted Override indicator","type":"boolean","x-nullable":true},"enforceRestrictedOverride2":{"description":"Gets or sets Enforce Restricted Override2 indicator","type":"boolean","x-nullable":true},"enforceRestrictedOverride3":{"description":"Gets or sets Enforce Restricted Override3 indicator","type":"boolean","x-nullable":true},"enforceRestrictedOverride4":{"description":"Gets or sets Enforce Restricted Override4 indicator","type":"boolean","x-nullable":true},"enforceFormularyNotCovered":{"description":"Gets or sets whether to enforce formulary not covered limits","type":"boolean","x-nullable":true},"enforceFormularyAgeLimit":{"description":"Gets or sets whether to enforce formulary age limits","type":"boolean","x-nullable":true},"enforceFormularyGenderLimit":{"description":"Gets or sets whether to enforce formulary gender limits","type":"boolean","x-nullable":true},"enforceFormularyQtyLimit":{"description":"Gets or sets whether to enforce formulary quantity limits","type":"boolean","x-nullable":true},"enforceFormularyStepMed":{"description":"Gets or sets whether to enforce formulary step med limits","type":"boolean","x-nullable":true},"enforceFormularyPriorAuth":{"description":"Gets or sets whether to enforce formulary prior auth limits","type":"boolean","x-nullable":true},"enforceFormularyDiagnosisCodeLimit":{"description":"Gets or sets whether to enforce formulary diagnosis code limits","type":"boolean","x-nullable":true},"oopCopayOverride":{"format":"double","description":"Gets or sets Out of Pocket Copay Override","type":"number","x-nullable":true},"oopCopayOverrideDaysInterval":{"format":"int32","description":"Gets or sets Out of Pocket Copay Override Days Interval","type":"integer","x-nullable":true},"oopCoinsuranceOverride":{"format":"double","description":"Gets or sets Out of Pocket Coinsurance Override (Enter the percentage in decimal form (e.g., 0.25 for 25%))","type":"number","x-nullable":true},"exemptFromDeductible":{"description":"Gets or sets Exempty From Deductible indicator","type":"boolean","x-nullable":true},"exemptFromOutOfPocketLimit":{"description":"Gets or sets Exempt From Out of Pocket Limit indicator","type":"boolean","x-nullable":true},"maxNumberOfFills":{"format":"int32","description":"Gets or sets Maximum number of Fills","type":"integer","x-nullable":true},"maxNumberOfFillsIntervalUrl":{"description":"Gets or sets Maximum number of Fills Interval","type":"string"},"maxNumberOfFillsIntervalSeqNo":{"format":"int64","description":"Gets or sets Maximum number of Fills Interval","type":"integer","x-nullable":true},"minQuantityPerDaysSupply":{"format":"double","description":"Gets or sets Minimum Quantity Per Days Supply","type":"number","x-nullable":true},"maxQuantityPerDaysSupply":{"format":"double","description":"Gets or sets Maximum Quantity Per Days Supply","type":"number","x-nullable":true},"isMultiSourced":{"description":"Gets or sets Is MultiSourced indicator","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets Is Generic Available indicator","type":"boolean","x-nullable":true},"planSeqNo":{"format":"int64","description":"Gets or sets Plan sequence number","type":"integer","x-nullable":true},"planUrl":{"description":"Gets or sets Plan Url","type":"string"},"planPricingGroupSeqNo":{"format":"int64","description":"Gets or sets Plan Pricing Group sequence number","type":"integer","x-nullable":true},"planPricingGroupUrl":{"description":"Gets or sets Plan Pricing Group Url","type":"string"},"skipAlternatePricingRules":{"description":"Gets or sets Skip Alternate Pricing Rules indicator","type":"boolean","x-nullable":true},"ignoreDrugSelectionPenalty":{"description":"Gets or sets Ignore Drug Selection Penalty indicator","type":"boolean","x-nullable":true},"overrideTypeSeqNo":{"format":"int64","description":"Gets or sets Override Type sequence number","type":"integer","x-nullable":true},"overrideTypeUrl":{"description":"Gets or sets Override Type Url","type":"string"},"limitToPrincipalPlans":{"description":"Gets or set Limit To Principal Plans","type":"boolean"},"limitToAlternatePlans":{"description":"Gets or set Limit To Alternate Plans","type":"boolean"},"limitToSecondaryPlans":{"description":"Gets or set Limit To Secondary Plans (obsolete)","type":"boolean"},"applyToCompoundRuleChecks":{"description":"Gets or sets Apply Compound Rules","type":"boolean","x-nullable":true},"copayCardAmount":{"format":"double","description":"Gets or set the Copay Card Amount","type":"number","x-nullable":true},"vendorCouponAmount":{"format":"double","description":"Gets or set the Vendor Coupon Amount","type":"number","x-nullable":true},"qtyLimitTotal":{"format":"double","description":"Gets or sets Quantity Limit Total","type":"number","x-nullable":true},"qtyLimitTotalIntervalUrl":{"description":"Gets or sets Quantity Limit Total Interval","type":"string"},"qtyLimitTotalIntervalSeqNo":{"format":"int64","description":"Gets or sets Quantity Limit Total Interval","type":"integer","x-nullable":true},"pharmacyHeadquarterSeqNo":{"format":"int64","description":"Gets or sets the Pharmacy Headquarter sequence number","type":"integer","x-nullable":true},"pharmacyHeadquarterUrl":{"description":"Gets or sets the Pharmacy Headquarter url","type":"string"},"planContractSeqNo":{"format":"int64","description":"Gets or sets the Plan Contract sequence number","type":"integer","x-nullable":true},"planContractUrl":{"description":"Gets or sets the Plan Contrct url","type":"string"},"formularyTierSeqNo":{"format":"int64","description":"Gets or sets the Formulary Tier sequence number","type":"integer","x-nullable":true},"formularyTierUrl":{"description":"Gets or sets the Formulary Tier url","type":"string"},"mmeThreshold":{"format":"int32","description":"Gets or sets MME Threshold amount","type":"integer","x-nullable":true},"ingredientCostRateOverride":{"format":"double","description":"Gets or sets Ingredient Cost override amount","type":"number","x-nullable":true},"dispenseFeeOverride":{"format":"double","description":"Gets or sets the Dispense Fee Override amount","type":"number","x-nullable":true},"hasLetterOfMedicalNecessity":{"description":"Gets or sets the Had Letter of Medicial Necessity flag","type":"boolean","x-nullable":true},"maxPlanPaidAmount":{"format":"double","description":"Gets or sets Max Plan Paid Amount","type":"number","x-nullable":true},"otherCoverageCode":{"description":"Gets or sets Other Coverage Code","type":"string"},"changeNote":{"description":"Gets or sets the Change Note","type":"string"},"genericCoinsuranceSeqNo":{"format":"int64","description":"Gets or sets Generic Coinsurance sequence number","type":"integer","x-nullable":true},"genericCoinsuranceUrl":{"description":"Gets or sets Generic Coinsurance url","type":"string"},"genericOutOfPocketCoinsuranceSeqNo":{"format":"int64","description":"Gets or sets Generic Out of Pocket Coinsurance sequence number","type":"integer","x-nullable":true},"genericOutOfPocketCoinsuranceUrl":{"description":"Gets or sets Generic Out of Pocket Coinsurance url","type":"string"},"brandCoinsuranceSeqNo":{"format":"int64","description":"Gets or sets Brand Coinsurance sequence number","type":"integer","x-nullable":true},"brandCoinsuranceUrl":{"description":"Gets or sets Brand Coinsurance url","type":"string"},"brandOutOfPocketCoinsuranceSeqNo":{"format":"int64","description":"Gets or sets Brand Out of Pocket Coinsurance sequence number","type":"integer","x-nullable":true},"brandOutOfPocketCoinsuranceUrl":{"description":"Gets or sets Brand Out of Pocket Coinsurance url","type":"string"},"specialCoinsuranceSeqNo":{"format":"int64","description":"Gets or sets Special Coinsurance sequence number","type":"integer","x-nullable":true},"specialCoinsuranceUrl":{"description":"Gets or sets Special Coinsurance url","type":"string"},"specialOutOfPocketCoinsuranceSeqNo":{"format":"int64","description":"Gets or sets Special Out of Pocket Coinsurance sequence number","type":"integer","x-nullable":true},"specialOutOfPocketCoinsuranceUrl":{"description":"Gets or sets Special Out of Pocket Coinsurance url","type":"string"},"claimTags":{"$ref":"#/definitions/ClaimTags"}}},"ClaimTags":{"type":"object","properties":{"claimTag1":{"$ref":"#/definitions/ClaimTag"},"claimTag2":{"$ref":"#/definitions/ClaimTag"},"claimTag3":{"$ref":"#/definitions/ClaimTag"}}},"ClaimTag":{"type":"object","properties":{"claimTagNo":{"format":"int64","description":"Gets or sets ClaimTag number","type":"integer","x-nullable":true},"claimTagUrl":{"description":"Gets or sets ClaimTag url","type":"string"},"claimTagItemNo":{"format":"int64","description":"Gets or sets ClaimTagItem number","type":"integer","x-nullable":true},"claimTagItemUrl":{"description":"Gets or sets ClaimTagItem url","type":"string"}}},"PriorAuthorizationModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"groupNo":{"format":"int64","description":"Gets or sets Group identifier","type":"integer","x-nullable":true},"facilityBranchNo":{"format":"int64","description":"Gets or sets the Facility Branch identifier","type":"integer","x-nullable":true},"facilityUrl":{"description":"Gets or sets the Facility Url","type":"string"},"transactionCode":{"description":"Gets or sets the Transaction code","type":"string"},"memberSeqNo":{"format":"int64","description":"Gets or sets the Member sequence identifier","type":"integer","x-nullable":true},"member":{"$ref":"#/definitions/MemberModel","description":"Gets or sets the Member"},"prescriptionReferenceNumber":{"description":"Gets or sets the Prescription reference number","type":"string"},"fillNumber":{"format":"int32","description":"Gets or sets the Fill number","type":"integer"},"productID":{"description":"Gets or sets the Product identifier","type":"string"},"dateOfService":{"format":"date-time","description":"Gets or sets the Date of Service","type":"string","x-nullable":true},"submittedClaimNumber":{"description":"Gets or sets the Submitted Claim number","type":"string"},"resubmittedClaimNumber":{"description":"Gets or sets the Resubmitted Claim number","type":"string"},"approved":{"description":"Gets or sets the Approved indicator","type":"boolean","x-nullable":true},"notes":{"description":"Gets or sets the Notes","type":"string"},"priorAuthPersistentNo":{"format":"int64","description":"Gets or sets the Prior Auth Presistent identifier","type":"integer","x-nullable":true},"priorAuthPersistentUrl":{"description":"Gets or sets the Prior Auth Persistent Url","type":"string"},"quantityDispensed":{"format":"double","description":"Gets or sets the Quantity Dispensed","type":"number","x-nullable":true},"daysSupply":{"format":"int32","description":"Gets or sets the Days supply","type":"integer","x-nullable":true},"copayOverride":{"format":"double","description":"Gets or sets the Copay override","type":"number","x-nullable":true},"coinsuranceOverride":{"format":"double","description":"Gets or sets the Coinsurance override (Enter the percentage in decimal form (e.g., 0.25 for 25%))","type":"number","x-nullable":true},"overrideTypeNo":{"format":"int64","description":"Gets or sets the Override type identifier","type":"integer","x-nullable":true},"overrideTypeUrl":{"description":"Gets or sets the Override Type Url","type":"string"},"variableCopayAmount":{"format":"double","description":"Gets or sets the Variable Copay Amount","type":"number","x-nullable":true},"oopCopayOverride":{"format":"double","description":"Gets or sets the out of pocket Copay Override","type":"number","x-nullable":true},"oopCoinsuranceOverride":{"format":"double","description":"Gets or sets the out of pocket Coinsurance Override (Enter the percentage in decimal form (e.g., 0.25 for 25%))","type":"number","x-nullable":true},"copayCardAmount":{"format":"double","description":"Gets or sets the Copay Card Amount","type":"number","x-nullable":true},"exemptFromDeductible":{"description":"Gets or sets Exempty From Deductible indicator","type":"boolean","x-nullable":true},"exemptFromOutOfPocketLimit":{"description":"Gets or sets Exempt From Out of Pocket Limit indicator","type":"boolean","x-nullable":true}}},"PagedResultModel[ProductCoverageExclusionModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/ProductCoverageExclusionModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"ProductCoverageExclusionModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"productID":{"description":"Gets or sets the product ID for this resource.  The value should be a valid NDC, DDID or GPI.","type":"string"},"productIDType":{"description":"Gets or sets the product ID Type for the ProductID value set on this resource.  The value will indicate whether the product ID for this resource is an NDC or DDID . \r\nString values other than 'NDC' or 'DDID' will not be valid.","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date of this resource","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date of this resource","type":"string","x-nullable":true},"auditNote":{"description":"Gets or sets the value indicating (for audit purposes) why the most current change was made","type":"string"}}},"PagedResultModel[CompanyQuantityLimitModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/CompanyQuantityLimitModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"CompanyQuantityLimitModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"name":{"description":"Gets or sets the description of the quantity limit resource","type":"string"},"isGlobal":{"description":"Gets or sets whether this is a global quantity limit resource (true if Global, false if Formulary-level)\r\nObsolete - will be removed at a later date","type":"boolean","x-nullable":true},"maxAmount":{"format":"double","description":"Gets or sets the Max Amount","type":"number","x-nullable":true},"maxAmountQualifier":{"description":"Gets or sets the two letter code representing the qualifier for the max amount value\r\nDS - Days Supply\r\nFL - Fills\r\nDL - Dollar Amount\r\nQY - Quantity","enum":["DS - Days Supply","DL - Dollar Amount","FL - Fills","QY - Quantity"],"type":"string","x-nullable":true},"maxAmountTimePeriod":{"description":"Gets or sets the two letter code representing the time period for the max amount \r\nSP - Specific Date Range\r\nDY - Days\r\nCM - Calendar Month\r\nLT - Lifetime\r\nCY - Calendar Year\r\nPD - Per Dispensing\r\nCQ - Calendar Quarter","enum":["CM - Calendar Month","CQ - Calendar Quarter","CY - Calendar Year","DY - Days","DS - Days Supply","LT - Lifetime","PD - Per Dispensing","SP - Specific Date Range"],"type":"string","x-nullable":true},"maxAmountTimePeriodStartDate":{"format":"date-time","description":"Gets or sets the Max Amount Time Period Start Date","type":"string","x-nullable":true},"maxAmountTimePeriodEndDate":{"format":"date-time","description":"Gets or sets the Max Amount Time Period End Date","type":"string","x-nullable":true},"maxAmountTimePeriodUnits":{"description":"Gets or sets the units to use in combination with the max amount time period (e.g. MaxAmountTimePeriodUnits= 30 and a MaxAmountTimePeriod of 'DY' would indicate 30 days)","type":"string"},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date of this resource","type":"string","x-nullable":true},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date of this resource","type":"string","x-nullable":true},"createdOn":{"format":"date-time","description":"Gets or sets the Created On Date for this resource","type":"string","x-nullable":true},"changedOn":{"format":"date-time","description":"Gets or sets the Changed On Date for this resource","type":"string","x-nullable":true},"auditNote":{"description":"Gets or sets the Audit Note for this resource","type":"string"},"active":{"description":"Gets or sets the Active status for this resource","type":"boolean","x-nullable":true}}},"PagedResultModel[FormularyCompanyQuantityLimitModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/FormularyCompanyQuantityLimitModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"FormularyCompanyQuantityLimitModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"companyQuantityLimitNo":{"format":"int64","description":"Gets or sets the value indicating whether this formulary quantity limit is inheriting from a global/company-level quantity limit.","type":"integer","x-nullable":true},"companyQuantityLimitUrl":{"description":"Gets the url where the global/company-level quantity limit resource can be found","type":"string","readOnly":true},"productID":{"description":"Gets or sets the product ID for this resource.  The value should be a valid NDC, DDID or GPI.","type":"string"},"productIDType":{"description":"Gets or sets the product ID Type for this resource.  The value will indicate whether the product ID for this resource is an NDC or DDID . \r\nString values other than 'NDC' or 'DDID' will not be valid.","type":"string"},"maxAmount":{"format":"double","description":"Gets or sets the Max Amount for this resource","type":"number","x-nullable":true},"maxAmountQualifier":{"description":"Gets or sets the two letter code representing the qualifier for the max amount value\r\nDS - Days Supply\r\nFL - Fills\r\nDL - Dollar Amount\r\nQY - Quantity","enum":["DS - Days Supply","DL - Dollar Amount","FL - Fills","QY - Quantity"],"type":"string","x-nullable":true},"maxAmountTimePeriod":{"description":"Gets or sets the two letter code representing the time period for the max amount \r\nSP - Specific Date Range\r\nDY - Days\r\nCM - Calendar Month\r\nLT - Lifetime\r\nCY - Calendar Year\r\nPD - Per Dispensing\r\nCQ - Calendar Quarter","enum":["CM - Calendar Month","CQ - Calendar Quarter","CY - Calendar Year","DY - Days","DS - Days Supply","LT - Lifetime","PD - Per Dispensing","SP - Specific Date Range"],"type":"string","x-nullable":true},"maxAmountTimePeriodStartDate":{"format":"date-time","description":"Gets or sets the Max Amount Time Period Start Date","type":"string","x-nullable":true},"maxAmountTimePeriodEndDate":{"format":"date-time","description":"Gets or sets the Max Amount Time Period End Date","type":"string","x-nullable":true},"maxAmountTimePeriodUnits":{"description":"Gets or sets the units to use in combination with the max amount time period (e.g. MaxAmountTimePeriodUnits=30 and a MaxAmountTimePeriod of 'DY' would indicate 30 days)","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date of this resource","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date of this resource","type":"string","x-nullable":true},"active":{"description":"Gets or sets the Active status for this resource","type":"boolean","x-nullable":true}}},"RelationshipModel":{"type":"object","properties":{"displayName":{"type":"string"}}},"RouteOfAdministrationModel":{"description":"Diagnosis Code","type":"object","properties":{"routeOfAdministration":{"description":"Gets or sets the Route of Administration code","type":"string"},"description":{"description":"Gets or sets the Route of Administration description","type":"string"}}},"RuleActionTypeModel":{"description":"Rule Action Type","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"description":{"description":"Gets or sets the description of the rule action type","type":"string"}}},"RuleAlternateProcessorModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the identifier for the rule that will be associated with an plan alternate processor","type":"integer"},"description":{"description":"Gets the description of the plan alternate processor associated with this rule","type":"string"},"planAlternateProcessorNo":{"format":"int64","description":"Gets or sets the plan alternate processor no associated with the rule specified by the RuleNo property","type":"integer"}}},"RuleARCodeModel":{"description":"Rule AR Code","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule ar code","type":"integer"},"arShortCode":{"description":"Gets or sets the AR short code associated with this rule","type":"string"}}},"RuleBenefitNDCSpecificModel":{"description":"Rule Benefit NDC Specific","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"genericCoinsuranceUrl":{"description":"Gets or sets the link to the generic coinsurance resource for the rule","type":"string"},"genericCoinsuranceNo":{"format":"int64","description":"Gets or sets the identifier for the generic coinsurance","type":"integer","x-nullable":true},"genericOutOfPocketCoinsuranceUrl":{"description":"Gets or sets the link to the generic out of pocket coinsurance resource for the rule","type":"string"},"genericOutOfPocketCoinsuranceNo":{"format":"int64","description":"Gets or sets the identifier for the generic out of pocket coinsurance","type":"integer","x-nullable":true},"brandCoinsuranceUrl":{"description":"Gets or sets the link to the brand coinsurance resource for the rule","type":"string"},"brandCoinsuranceNo":{"format":"int64","description":"Gets or sets the identifier for the brand coinsurance","type":"integer","x-nullable":true},"brandOutOfPocketCoinsuranceUrl":{"description":"Gets or sets the link to the brand out of pocket coinsurance resource for the rule","type":"string"},"brandOutOfPocketCoinsuranceNo":{"format":"int64","description":"Gets or sets the identifier for the brand out of pocket coinsurance","type":"integer","x-nullable":true},"planBenefitLimitMonthUrl":{"description":"Gets or sets the link to the monthly plan benefit limit resource for the rule","type":"string"},"planBenefitLimitMonthNo":{"format":"int64","description":"Gets or sets the monthly plan benefit limit identifier","type":"integer","x-nullable":true},"planBenefitLimitPeriodUrl":{"description":"Gets or sets the link to the periodic plan benefit limit resource for the rule","type":"string"},"planBenefitLimitPeriodNo":{"format":"int64","description":"Gets or sets the periodic plan benefit limit identifier","type":"integer","x-nullable":true},"planBenefitLimitLifeUrl":{"description":"Gets or sets the link to the lifetime plan benefit limit resource for the rule","type":"string"},"planBenefitLimitLifeNo":{"format":"int64","description":"Gets or sets the lifetime plan benefit limit identifier","type":"integer","x-nullable":true},"planBenefitLimitRxOnlyMonthUrl":{"description":"Gets or sets the link to the Rx only monthly plan benefit limit resource","type":"string"},"planBenefitLimitRxOnlyMonthNo":{"format":"int64","description":"Gets or sets the Rx only monthly plan benefit limit identifier","type":"integer","x-nullable":true},"planBenefitLimitRxOnlyPeriodUrl":{"description":"Gets or sets the link to the Rx only periodic plan benefit limit resource","type":"string"},"planBenefitLimitRxOnlyPeriodNo":{"format":"int64","description":"Gets or sets the Rx only periodic plan benefit limit identifier","type":"integer","x-nullable":true},"planBenefitLimitRxOnlyLifeUrl":{"description":"Gets or sets the link to the Rx only lifetime plan benefit limit resource","type":"string"},"planBenefitLimitRxOnlyLifeNo":{"format":"int64","description":"Gets or sets the Rx only lifetime plan benefit limit identifier","type":"integer","x-nullable":true},"brandMaxPlanPaidAmount":{"format":"double","description":"Gets or sets whether the max amount that can be applied as the plan responsibility for brand drugs(takes priority over the patient pay limit).  Amounts in excess of the cap will be added to the copay.","type":"number","x-nullable":true},"genericMaxPlanPaidAmount":{"format":"double","description":"Gets or sets whether the max amount that can be applied as the plan responsibility for generic drugs(takes priority over the patient pay limit).  Amounts in excess of the cap will be added to the copay.","type":"number","x-nullable":true},"brandMaxPatientPayAmt":{"format":"double","description":"Gets or sets whether the max amount that can be applied as the patient responsibility for brand drugs","type":"number","x-nullable":true},"genericMaxPatientPayAmt":{"format":"double","description":"Gets or sets whether the max amount that can be applied as the patient responsibility for generic drugs","type":"number","x-nullable":true},"maxPatientPayAmtIncludeDrugSelPenalty":{"description":"Gets or sets whether the drug selection penalties are included in the limit(only applies if an amount is defined)","type":"boolean","x-nullable":true},"maxPatientPayAmtIncludeMemberClaimFee":{"description":"Gets or sets whether the member claim fees are included in the limit(only applies if an amount is defined)","type":"boolean","x-nullable":true},"exemptFromDeductible":{"description":"Gets or sets whether the rule marks claim as exempt from the deductible","type":"boolean","x-nullable":true},"exemptFromOutOfPocketLimit":{"description":"Gets or sets whether the rule marks claim as exempt from max out of pocket limits","type":"boolean","x-nullable":true},"applyCoinsuranceAsDeductible":{"description":"Gets or sets whether the rule applies coinsurance/copay amounts as the deductible amount(even if exempt from deductible)","type":"boolean","x-nullable":true},"deductibleSplit":{"format":"double","description":"Gets or sets whether the percent of the deductible to be paid by the plan","type":"number","x-nullable":true},"incentiveSplit":{"format":"double","description":"Gets or sets whether the percent of the incentive fee to be paid by the plan","type":"number","x-nullable":true},"genericPlanIncentiveUrl":{"description":"Gets or sets the link back to the incentive resource for generic drugs for the rule","type":"string"},"genericPlanIncentiveNo":{"format":"int64","description":"Gets or sets the plan incentive identifier for generic drugs","type":"integer","x-nullable":true},"brandPlanIncentiveUrl":{"description":"Gets or sets the link back to the plan incentive resource for brand drugs for the rule","type":"string"},"brandPlanIncentiveNo":{"format":"int64","description":"Gets or sets the plan incentive identifier for brand drugs","type":"integer","x-nullable":true},"periodDeductibleUrl":{"description":"Gets or sets the link to the periodic deductible resource for the rule","type":"string"},"periodDeductibleNo":{"format":"int64","description":"Gets or sets the periodic deductible identifier","type":"integer","x-nullable":true},"periodMaxOutOfPocketUrl":{"description":"Gets or sets the link to the periodic max out of pocket resource for the rule","type":"string"},"periodMaxOutOfPocketNo":{"format":"int64","description":"Gets or sets the periodic max out of pocket identifier","type":"integer","x-nullable":true},"monthlyDeductibleUrl":{"description":"Gets or sets the link to the monthly deductible resource for the rule","type":"string"},"monthlyDeductibleNo":{"format":"int64","description":"Gets or sets the monthly deductible identifier","type":"integer","x-nullable":true},"monthlyMaxOutOfPocketUrl":{"description":"Gets or sets the link to the monthly max out of pocket resource","type":"string"},"monthlyMaxOutOfPocketNo":{"format":"int64","description":"Gets or sets the monthly max out of pocket identifier","type":"integer","x-nullable":true},"pharmacyPriceMin":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceMax":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPricePreTax":{"description":"Gets or sets the option for whether the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsMin":{"format":"double","description":"Gets or sets the minimum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsMax":{"format":"double","description":"Gets or sets the maximum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsPreTax":{"description":"Gets or sets the option for whether the cents portion of the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"stepTherapy":{"description":"Gets or sets whether the rule applies to step therapy medication","type":"boolean","x-nullable":true},"drugSelectionPenaltyUsed":{"description":"Gets or sets whether the rule applies to claims where a drug penalty has been applied","type":"boolean","x-nullable":true},"onFormulary":{"description":"Gets or sets whether the rule on formulary","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"ndcListIsExclusion":{"description":"Gets or sets a value indicating whether the ndc list is treated as an exclusion list.  If this is true, ndcs in the list will be excluded from the rule; if false, only ndcs in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"variableCopayProgramType":{"description":"Gets or sets flag indicating whether this rule should use variable copay","enum":["Accum","Max","None"],"type":"string","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"ndCs":{"description":"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}.","type":"array","items":{"$ref":"#/definitions/RuleDrugModel"}}}},"RuleDiagnosisCodeModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule drug","type":"integer"},"diagnosisCode":{"description":"Gets or sets the diagnosis code associated with this rule","type":"string"},"description":{"description":"Gets or sets the description associated with this rule","type":"string"}}},"RuleMemberModel":{"description":"Rule Member","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule drug","type":"integer"},"lastName":{"description":"Gets or sets the member last name","type":"string"},"firstName":{"description":"Gets or sets the member first name","type":"string"},"middleName":{"description":"Gets or sets the member middle name","type":"string"},"dateOfBirth":{"format":"date-time","description":"Gets or sets the member date of birth","type":"string","x-nullable":true},"ssn":{"description":"Gets or sets the member SSN","type":"string"},"memberSeqNo":{"format":"int64","description":"Gets or sets the MemberSeqNo, a uniquely identifying number for a member","type":"integer"},"locationName":{"description":"Gets or sets the location name associated with the memember","type":"string"}}},"RuleNetworkModel":{"description":"Rule Network","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule network","type":"integer"},"description":{"description":"Gets or sets the network description associated with this rule","type":"string"},"networkNo":{"format":"int64","description":"Gets or sets network identifier","type":"integer"}}},"RulePharmacyHeadquarterModel":{"description":"Rule Pharmacy Headquarter","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule pharmacy headquarter","type":"integer"},"description":{"description":"Gets or sets the description associated with this rule pharmacy headquarter","type":"string"},"pharmacyHeadquarterNo":{"format":"int64","description":"Gets or sets the Pharmacy Headquarter identifier","type":"integer"}}},"RulePharmacyModel":{"description":"Rule Pharmacy","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule pharmacy","type":"integer"},"npi":{"description":"Gets or sets the NPI associated with this rule pharmacy","type":"string"},"pharmacyName":{"description":"Gets or sets the pharmacy name associated with this rule pharmacy","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date for the pharmacy","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date for the pharmacy","type":"string","x-nullable":true}}},"RulePrescriberModel":{"description":"Rule Prescriber Model","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule drug","type":"integer"},"npi":{"description":"Gets or sets the NPI associated with this rule","type":"string"},"prescriberName":{"description":"Gets or sets the prescriber name associated with this rule","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date for the prescriber","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date for the prescriber","type":"string","x-nullable":true}}},"RuleFacilityBranchModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule drug","type":"integer"},"facilityName":{"description":"Gets or sets the facility name associated with this rule","type":"string"},"pharmacyBranch":{"description":"Gets or sets the pharmacy branch associated with this rule","type":"string"},"facilityBranchSeqNo":{"format":"int64","description":"Gets or sets the FacilityBranchSeqNo, a uniquely identifying number for a member","type":"integer"}}},"RulePricingGroupModel":{"description":"Rule Pricing Group","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule pricing group","type":"integer"},"name":{"description":"Gets or sets the name of the pricing group used in the rule drug criteria","type":"string"},"description":{"description":"Gets or sets the description of the pricing group used in the rule drug criteria","type":"string"},"planPricingGroupNo":{"format":"int64","description":"Gets or sets the Plan Pricing Group identifier","type":"integer"}}},"RuleFormularyTierModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the Rule number","type":"integer"},"name":{"description":"Gets or sets the Name","type":"string"},"description":{"description":"Gets or sets the Description","type":"string"},"tier":{"format":"int32","description":"Gets or sets the Tier","type":"integer","x-nullable":true},"formularyTierNo":{"format":"int32","description":"Gets or sets the Formulary Tier number","type":"integer"}}},"RulePharmacyTypeModel":{"description":"Rule Pharmacy Type","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule pharmacy","type":"integer"},"description":{"description":"Gets or sets the description associated with this rule pharmacy type","type":"string"},"pharmacyTypeCode":{"description":"Gets or sets the pharmacy type code associated with this rule pharmacy type","type":"string"}}},"RuleSubmissionClarificationCodeModel":{"description":"Rule Submission Clarification Code Model","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this submission clarification code rule","type":"integer"},"submissionClarificationCode":{"description":"Gets or sets the submission clarification code used in the rule drug criteria","type":"string"}}},"RuleContractCodeModel":{"description":"Rule Contract Code","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule ar code","type":"integer"},"contractCode":{"description":"Gets or sets the contract code associated with this rule","type":"string"}}},"RuleCoverageLevelModel":{"description":"Rule Coverage Level","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule coverage level","type":"integer"},"coverageLevelCode":{"description":"Gets or sets the coverage level associated with this rule","type":"string"}}},"RuleEmployeeStatusModel":{"description":"Rule Employee Status","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule employee status","type":"integer"},"employeeStatus":{"description":"Gets or sets the employee status associated with this rule","type":"string"}}},"RuleOtherStatusModel":{"description":"Rule Other Status","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule other status","type":"integer"},"otherStatus":{"description":"Gets or sets the other status associated with this rule","type":"string"}}},"RuleMemberStateModel":{"description":"Rule Member State","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule member state","type":"integer"},"stateCode":{"description":"Gets or sets the state code used in the rule member state (standard state abbreviation)","type":"string"}}},"RuleStateModel":{"description":"Rule State","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule state","type":"integer"},"stateCode":{"description":"Gets or sets the state code used in the rule drug criteria (standard state abbreviation)","type":"string"}}},"RuleDrugModel":{"description":"Rule Drug","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule drug","type":"integer"},"ndc":{"description":"Gets or sets the NDC associated with this rule","type":"string"}}},"RuleBenefitModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"genericCoinsuranceUrl":{"description":"Gets or sets the link to the generic coinsurance resource for the rule","type":"string"},"genericCoinsuranceNo":{"format":"int64","description":"Gets or sets the identifier for the generic coinsurance","type":"integer","x-nullable":true},"genericOutOfPocketCoinsuranceUrl":{"description":"Gets or sets the link to the generic out of pocket coinsurance resource for the rule","type":"string"},"genericOutOfPocketCoinsuranceNo":{"format":"int64","description":"Gets or sets the identifier for the generic out of pocket coinsurance","type":"integer","x-nullable":true},"brandCoinsuranceUrl":{"description":"Gets or sets the link to the brand coinsurance resource for the rule","type":"string"},"brandCoinsuranceNo":{"format":"int64","description":"Gets or sets the identifier for the brand coinsurance","type":"integer","x-nullable":true},"brandOutOfPocketCoinsuranceUrl":{"description":"Gets or sets the link to the brand out of pocket coinsurance resource for the rule","type":"string"},"brandOutOfPocketCoinsuranceNo":{"format":"int64","description":"Gets or sets the identifier for the brand out of pocket coinsurance","type":"integer","x-nullable":true},"planBenefitLimitMonthUrl":{"description":"Gets or sets the link to the monthly plan benefit limit resource for the rule","type":"string"},"planBenefitLimitMonthNo":{"format":"int64","description":"Gets or sets the monthly plan benefit limit identifier","type":"integer","x-nullable":true},"planBenefitLimitPeriodUrl":{"description":"Gets or sets the link to the periodic plan benefit limit resource for the rule","type":"string"},"planBenefitLimitPeriodNo":{"format":"int64","description":"Gets or sets the periodic plan benefit limit identifier","type":"integer","x-nullable":true},"planBenefitLimitLifeUrl":{"description":"Gets or sets the link to the lifetime plan benefit limit resource for the rule","type":"string"},"planBenefitLimitLifeNo":{"format":"int64","description":"Gets or sets the lifetime plan benefit limit identifier","type":"integer","x-nullable":true},"planBenefitLimitRxOnlyMonthUrl":{"description":"Gets or sets the link to the Rx only monthly plan benefit limit resource","type":"string"},"planBenefitLimitRxOnlyMonthNo":{"format":"int64","description":"Gets or sets the Rx only monthly plan benefit limit identifier","type":"integer","x-nullable":true},"planBenefitLimitRxOnlyPeriodUrl":{"description":"Gets or sets the link to the Rx only periodic plan benefit limit resource","type":"string"},"planBenefitLimitRxOnlyPeriodNo":{"format":"int64","description":"Gets or sets the Rx only periodic plan benefit limit identifier","type":"integer","x-nullable":true},"planBenefitLimitRxOnlyLifeUrl":{"description":"Gets or sets the link to the Rx only lifetime plan benefit limit resource","type":"string"},"planBenefitLimitRxOnlyLifeNo":{"format":"int64","description":"Gets or sets the Rx only lifetime plan benefit limit identifier","type":"integer","x-nullable":true},"brandMaxPlanPaidAmount":{"format":"double","description":"Gets or sets whether the max amount that can be applied as the plan responsibility for brand drugs(takes priority over the patient pay limit).  Amounts in excess of the cap will be added to the copay.","type":"number","x-nullable":true},"genericMaxPlanPaidAmount":{"format":"double","description":"Gets or sets whether the max amount that can be applied as the plan responsibility for generic drugs(takes priority over the patient pay limit).  Amounts in excess of the cap will be added to the copay.","type":"number","x-nullable":true},"brandMaxPatientPayAmt":{"format":"double","description":"Gets or sets whether the max amount that can be applied as the patient responsibility for brand drugs","type":"number","x-nullable":true},"genericMaxPatientPayAmt":{"format":"double","description":"Gets or sets whether the max amount that can be applied as the patient responsibility for generic drugs","type":"number","x-nullable":true},"maxPatientPayAmtIncludeDrugSelPenalty":{"description":"Gets or sets whether the drug selection penalties are included in the limit(only applies if an amount is defined)","type":"boolean","x-nullable":true},"maxPatientPayAmtIncludeMemberClaimFee":{"description":"Gets or sets whether the member claim fees are included in the limit(only applies if an amount is defined)","type":"boolean","x-nullable":true},"exemptFromDeductible":{"description":"Gets or sets whether the rule marks claim as exempt from the deductible","type":"boolean","x-nullable":true},"exemptFromOutOfPocketLimit":{"description":"Gets or sets whether the rule marks claim as exempt from max out of pocket limits","type":"boolean","x-nullable":true},"applyCoinsuranceAsDeductible":{"description":"Gets or sets whether the rule applies coinsurance/copay amounts as the deductible amount(even if exempt from deductible)","type":"boolean","x-nullable":true},"deductibleSplit":{"format":"double","description":"Gets or sets whether the percent of the deductible to be paid by the plan","type":"number","x-nullable":true},"incentiveSplit":{"format":"double","description":"Gets or sets whether the percent of the incentive fee to be paid by the plan","type":"number","x-nullable":true},"genericPlanIncentiveUrl":{"description":"Gets or sets the link back to the incentive resource for generic drugs for the rule","type":"string"},"genericPlanIncentiveNo":{"format":"int64","description":"Gets or sets the plan incentive identifier for generic drugs","type":"integer","x-nullable":true},"brandPlanIncentiveUrl":{"description":"Gets or sets the link back to the plan incentive resource for brand drugs for the rule","type":"string"},"brandPlanIncentiveNo":{"format":"int64","description":"Gets or sets the plan incentive identifier for brand drugs","type":"integer","x-nullable":true},"periodDeductibleUrl":{"description":"Gets or sets the link to the periodic deductible resource for the rule","type":"string"},"periodDeductibleNo":{"format":"int64","description":"Gets or sets the periodic deductible identifier","type":"integer","x-nullable":true},"periodMaxOutOfPocketUrl":{"description":"Gets or sets the link to the periodic max out of pocket resource for the rule","type":"string"},"periodMaxOutOfPocketNo":{"format":"int64","description":"Gets or sets the periodic max out of pocket identifier","type":"integer","x-nullable":true},"monthlyDeductibleUrl":{"description":"Gets or sets the link to the monthly deductible resource for the rule","type":"string"},"monthlyDeductibleNo":{"format":"int64","description":"Gets or sets the monthly deductible identifier","type":"integer","x-nullable":true},"monthlyMaxOutOfPocketUrl":{"description":"Gets or sets the link to the monthly max out of pocket resource","type":"string"},"monthlyMaxOutOfPocketNo":{"format":"int64","description":"Gets or sets the monthly max out of pocket identifier","type":"integer","x-nullable":true},"pharmacyPriceMin":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceMax":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPricePreTax":{"description":"Gets or sets the option for whether the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsMin":{"format":"double","description":"Gets or sets the minimum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsMax":{"format":"double","description":"Gets or sets the maximum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsPreTax":{"description":"Gets or sets the option for whether the cents portion of the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"stepTherapy":{"description":"Gets or sets whether the rule applies to step therapy medication","type":"boolean","x-nullable":true},"drugSelectionPenaltyUsed":{"description":"Gets or sets whether the rule applies to claims where a drug penalty has been applied","type":"boolean","x-nullable":true},"onFormulary":{"description":"Gets or sets whether the rule on formulary","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"priorFillsPharmacyPriceMin":{"format":"double","description":"Gets or set the prior fills pharmacy price min","type":"number","x-nullable":true},"priorFillsPharmacyPriceMax":{"format":"double","description":"Gets or sets the prior fills pharmacy price max","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMin":{"format":"double","description":"Gets or sets the prior fills pharmacy price per day supply min","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMax":{"format":"double","description":"gets or sets the prior fills pharmacy price per day supply max","type":"number","x-nullable":true},"variableCopayProgramType":{"description":"Gets or sets flag indicating whether this rule should use variable copay","enum":["Accum","Max","None"],"type":"string","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"isBrand":{"description":"Gets or sets whether the drug criteria is based on brand","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets whether the drug criteria is for prescription only (non-OTC)","type":"boolean","x-nullable":true},"isMultiSourced":{"description":"Gets or sets whether the drug criteria is based on multi-source","type":"boolean","x-nullable":true},"isRepackaged":{"description":"Gets or sets whether the drug criteria is based on repackaged value","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets whether the drug criteria applies if a generic is available","type":"boolean","x-nullable":true},"otcAvailable":{"description":"Gets or sets whether the drug criteria applies if an OTC is available","type":"boolean","x-nullable":true},"isMaintenanceDrug":{"description":"Gets or sets whether the drug criteria applies to maintenance drug","type":"boolean","x-nullable":true},"deaClassCodes":{"description":"Gets or sets the applicable DEA schedules for the drug criteria","type":"array","items":{"$ref":"#/definitions/DEAScheduleModel"}},"brandNameCodes":{"description":"Gets or sets the applicable brand codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/BrandNameCodeModel"}},"multiSourceCodes":{"description":"Gets or sets the applicable multi-source codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}},"rX_OTCIndicatorCodes":{"description":"Gets or sets the applicable Rx-OTC Indicator codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/RX_OTCIndicatorCodeModel"}},"includeCustomDrugs":{"description":"Gets or sets whether the drug criteria applies to custom drugs","type":"boolean","x-nullable":true},"gpiListIsExclusion":{"description":"Gets or sets whether the drug criteria GPI list is excluded","type":"boolean","x-nullable":true},"drugProfileListIsExclusion":{"description":"Gets or sets whether the drug criteria drug profile list is excluded","type":"boolean","x-nullable":true},"gpIs":{"description":"Gets or sets the list of GPIs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleGPIModel"}},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"roAs":{"description":"Gets or sets the list of ROAs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleROAModel"}},"dosageForms":{"description":"Gets or sets the dosage forms associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleDosageFormModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"drugProfiles":{"description":"Gets or Sets a a list of which drug profiles are associated with this rule","type":"array","items":{"$ref":"#/definitions/RuleDrugProfileModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true}}},"RX_OTCIndicatorCodeModel":{"type":"object","properties":{"displayName":{"type":"string"}}},"RuleGPIModel":{"description":"Rule GPI","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule GPI","type":"integer"},"genericProductIdentifier":{"description":"Gets or sets the GPI associated with this rule","type":"string"}}},"RuleROAModel":{"description":"Rule ROA","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule route of administration","type":"integer"},"routeOfAdministration":{"description":"Gets or sets the route of administration used in the rule drug criteria","type":"string"}}},"RuleDosageFormModel":{"description":"Rule Dosage Model","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule dosage form","type":"integer"},"dosageForm":{"description":"Gets or sets the doseage form associated with this rule","type":"string"}}},"RuleDrugProfileModel":{"description":"Rule Drug","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule drug profile","type":"integer"},"drugProfileUrl":{"description":"Gets or sets the url associated with the drug profile associated with this rule drug profile","type":"string"},"drugProfileNo":{"format":"int64","description":"Gets or sets the identifier of the drug profile associated with this rule drug profile","type":"integer"}}},"RuleBenefitSpecialDrugModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"specialCoinsuranceUrl":{"description":"Gets or sets the link to the coinsurance resource for the rule","type":"string"},"specialCoinsuranceNo":{"format":"int64","description":"Gets or sets the identifier for the coinsurance","type":"integer","x-nullable":true},"specialOutOfPocketCoinsuranceUrl":{"description":"Gets or sets the link to the out of pocket coinsurance resource for the rule","type":"string"},"specialOutOfPocketCoinsuranceNo":{"format":"int64","description":"Gets or sets the identifier for the out of pocket coinsurance","type":"integer","x-nullable":true},"specialPlanBenefitLimitMonthUrl":{"description":"Gets or sets the link to the monthly plan benefit limit resource for the rule","type":"string"},"specialPlanBenefitLimitMonthNo":{"format":"int64","description":"Gets or sets the monthly plan benefit limit identifier","type":"integer","x-nullable":true},"specialPlanBenefitLimitPeriodUrl":{"description":"Gets or sets the link to the periodic plan benefit limit resource for the rule","type":"string"},"specialPlanBenefitLimitPeriodNo":{"format":"int64","description":"Gets or sets the periodic plan benefit limit identifier","type":"integer","x-nullable":true},"specialPlanBenefitLimitLifeUrl":{"description":"Gets or sets the link to the lifetime plan benefit limit resource for the rule","type":"string"},"specialPlanBenefitLimitLifeNo":{"format":"int64","description":"Gets or sets the lifetime plan benefit limit identifier","type":"integer","x-nullable":true},"specialPlanBenefitLimitRxOnlyMonthUrl":{"description":"Gets or sets the link to the Rx only monthly plan benefit limit resource","type":"string"},"specialPlanBenefitLimitRxOnlyMonthNo":{"format":"int64","description":"Gets or sets the Rx only monthly plan benefit limit identifier","type":"integer","x-nullable":true},"specialPlanBenefitLimitRxOnlyPeriodUrl":{"description":"Gets or sets the link to the Rx only periodic plan benefit limit resource","type":"string"},"specialPlanBenefitLimitRxOnlyPeriodNo":{"format":"int64","description":"Gets or sets the Rx only periodic plan benefit limit identifier","type":"integer","x-nullable":true},"specialPlanBenefitLimitRxOnlyLifeUrl":{"description":"Gets or sets the link to the Rx only lifetime plan benefit limit resource","type":"string"},"specialPlanBenefitLimitRxOnlyLifeNo":{"format":"int64","description":"Gets or sets the Rx only lifetime plan benefit limit identifier","type":"integer","x-nullable":true},"specialMaxPlanPaidAmount":{"format":"double","description":"Gets or sets whether the max amount that can be applied as the plan responsibility for special drugs (takes priority over the patient pay limit).  Amounts in excess of the cap will be added to the copay.","type":"number","x-nullable":true},"specialMaxPatientPayAmt":{"format":"double","description":"Gets or sets whether the max amount that can be applied as the patient responsibility for special drugs","type":"number","x-nullable":true},"specialMaxPatientPayAmtIncludeDrugSelPenalty":{"description":"Gets or sets whether the drug selection penalties are included in the limit(only applies if an amount is defined)","type":"boolean","x-nullable":true},"specialMaxPatientPayAmtIncludeMemberClaimFee":{"description":"Gets or sets whether the member claim fees are included in the limit(only applies if an amount is defined)","type":"boolean","x-nullable":true},"specialExemptFromDeductible":{"description":"Gets or sets whether the rule marks claim as exempt from the deductible","type":"boolean","x-nullable":true},"specialExemptFromOutOfPocketLimit":{"description":"Gets or sets whether the rule marks claim as exempt from max out of pocket limits","type":"boolean","x-nullable":true},"specialApplyCoinsuranceAsDeductible":{"description":"Gets or sets whether the rule applies coinsurance/copay amounts as the deductible amount(even if exempt from deductible)","type":"boolean","x-nullable":true},"specialDeductibleSplit":{"format":"double","description":"Gets or sets whether the percent of the deductible to be paid by the plan","type":"number","x-nullable":true},"specialIncentiveSplit":{"format":"double","description":"Gets or sets whether the percent of the incentive that was added to the drug cost to be paid by the plan (This is not the plan incentive)","type":"number","x-nullable":true},"specialPlanIncentiveUrl":{"description":"Gets or sets the link back to the incentive resource for special drugs for the rule","type":"string"},"specialPlanIncentiveNo":{"format":"int64","description":"Gets or sets the plan incentive identifier for special drugs","type":"integer","x-nullable":true},"specialPeriodDeductibleUrl":{"description":"Gets or sets the link to the periodic deductible resource for the rule","type":"string"},"specialPeriodDeductibleNo":{"format":"int64","description":"Gets or sets the periodic deductible identifier","type":"integer","x-nullable":true},"specialPeriodMaxOutOfPocketUrl":{"description":"Gets or sets the link to the periodic max out of pocket resource for the rule","type":"string"},"specialPeriodMaxOutOfPocketNo":{"format":"int64","description":"Gets or sets the periodic max out of pocket identifier","type":"integer","x-nullable":true},"specialMonthlyDeductibleUrl":{"description":"Gets or sets the link to the monthly deductible resource for the rule","type":"string"},"specialMonthlyDeductibleNo":{"format":"int64","description":"Gets or sets the monthly deductible identifier","type":"integer","x-nullable":true},"specialMonthlyMaxOutOfPocketUrl":{"description":"Gets or sets the link to the monthly max out of pocket resource","type":"string"},"specialMonthlyMaxOutOfPocketNo":{"format":"int64","description":"Gets or sets the monthly max out of pocket identifier","type":"integer","x-nullable":true},"pharmacyPriceMin":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceMax":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPricePreTax":{"description":"Gets or sets the option for whether the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsMin":{"format":"double","description":"Gets or sets the minimum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsMax":{"format":"double","description":"Gets or sets the maximum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsPreTax":{"description":"Gets or sets the option for whether the cents portion of the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"exemptFromDeductible":{"description":"Gets or sets the Exempt from Deductible indicator","type":"boolean","x-nullable":true},"exemptFromOutOfPocketLimit":{"description":"Gets or sets the Exempt from Out of Pocket Limit indicator","type":"boolean","x-nullable":true},"applyCoinsuranceAsDeductible":{"description":"Gets or sets the Apply Coinsurance as Deductible indicator","type":"boolean","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"compoundDrugs":{"description":"Gets whether the special drug criteria applies to compound drugs","type":"boolean","x-nullable":true},"unknownDrugs":{"description":"Gets whether the special drug criteria applies to unknown drugs","type":"boolean","x-nullable":true},"undefinedDrugs":{"description":"Gets whether the special drug criteria applies to undefined drugs","type":"boolean","x-nullable":true},"compoundLevelOfEffort":{"description":"Gets level of effort values applicable to the special drug criteria","type":"array","items":{"$ref":"#/definitions/LevelOfEffortModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true}}},"LevelOfEffortModel":{"type":"object","properties":{"displayName":{"type":"string"}}},"RuleClaimLimitDefaultModel":{"description":"Rule Claim Limit Default","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"claimLimit":{"$ref":"#/definitions/RuleClaimLimitModel","description":"Gets or sets the claim limits associated with this rule claim limit"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"alternatePricingGroupUrl":{"description":"Gets or sets the link to the alternate pricing group used by this rule","type":"string"},"alternatePricingGroupNo":{"format":"int64","description":"Gets or sets the identifier to the alternate pricing group","type":"integer","x-nullable":true},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"pharmacyPriceMin":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceMax":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPricePreTax":{"description":"Gets or sets the option for whether the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsMin":{"format":"double","description":"Gets or sets the minimum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsMax":{"format":"double","description":"Gets or sets the maximum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsPreTax":{"description":"Gets or sets the option for whether the cents portion of the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"claimTagItemID1":{"format":"uuid","description":"Gets or sets the Claim Tag Item ID 1 identifier","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"claimTagItemID2":{"format":"uuid","description":"Gets or sets the Claim Tag Item ID 2 identifier","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"claimTagItemID3":{"format":"uuid","description":"Gets or sets the Claim Tag Item ID 3 identifier","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"dependentRelationshipCode":{"description":"Gets or sets the Dependent Relationship Code","type":"string"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"allowRefillPercentConsumedByNDC":{"description":"Gets or sets where to check for refill too soon by NDC. If false will be checked by GPI","type":"boolean","x-nullable":true},"allowRefillPercentConsumedGPIChars":{"description":"Gets or sets the the GPI Chars used to check for refill too soon if RefillTooSoonConsumedByNDC is false. If RefillTooSoonConsumedByNDC is true and RefillTooSoonConsumedGPIChars is not set then it will be defaulted to 10.","type":"string"},"priorFillsPharmacyPriceMin":{"format":"double","description":"Gets or set the prior fills pharmacy price min","type":"number","x-nullable":true},"priorFillsPharmacyPriceMax":{"format":"double","description":"Gets or sets the prior fills pharmacy price max","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMin":{"format":"double","description":"Gets or sets the prior fills pharmacy price per day supply min","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMax":{"format":"double","description":"gets or sets the prior fills pharmacy price per day supply max","type":"number","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"isBrand":{"description":"Gets or sets whether the drug criteria is based on brand","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets whether the drug criteria is for prescription only (non-OTC)","type":"boolean","x-nullable":true},"isMultiSourced":{"description":"Gets or sets whether the drug criteria is based on multi-source","type":"boolean","x-nullable":true},"isRepackaged":{"description":"Gets or sets whether the drug criteria is based on repackaged value","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets whether the drug criteria applies if a generic is available","type":"boolean","x-nullable":true},"otcAvailable":{"description":"Gets or sets whether the drug criteria applies if an OTC is available","type":"boolean","x-nullable":true},"isMaintenanceDrug":{"description":"Gets or sets whether the drug criteria applies to maintenance drug","type":"boolean","x-nullable":true},"deaClassCodes":{"description":"Gets or sets the applicable DEA schedules for the drug criteria","type":"array","items":{"$ref":"#/definitions/DEAScheduleModel"}},"brandNameCodes":{"description":"Gets or sets the applicable brand codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/BrandNameCodeModel"}},"multiSourceCodes":{"description":"Gets or sets the applicable multi-source codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}},"rX_OTCIndicatorCodes":{"description":"Gets or sets the applicable Rx-OTC Indicator codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/RX_OTCIndicatorCodeModel"}},"includeCustomDrugs":{"description":"Gets or sets whether the drug criteria applies to custom drugs","type":"boolean","x-nullable":true},"gpiListIsExclusion":{"description":"Gets or sets whether the drug criteria GPI list is excluded","type":"boolean","x-nullable":true},"drugProfileListIsExclusion":{"description":"Gets or sets whether the drug criteria drug profile list is excluded","type":"boolean","x-nullable":true},"gpIs":{"description":"Gets or sets the list of GPIs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleGPIModel"}},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"roAs":{"description":"Gets or sets the list of ROAs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleROAModel"}},"dosageForms":{"description":"Gets or sets the dosage forms associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleDosageFormModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"drugProfiles":{"description":"Gets or Sets a a list of which drug profiles are associated with this rule","type":"array","items":{"$ref":"#/definitions/RuleDrugProfileModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true}}},"RuleClaimLimitModel":{"description":"Rule Claim Limit","type":"object","properties":{"allowClaimLimitChecksOnFutureRules":{"description":"Gets or sets whether this rule allows checks on future rules","type":"boolean","x-nullable":true},"quantityLimitPerFill":{"format":"double","description":"Gets or sets the maximum quantity allowed per fill","type":"number","x-nullable":true},"quantityLimitPerDaysSupply":{"format":"double","description":"Gets or sets the maximum quantity allowed per days supply","type":"number","x-nullable":true},"quantityLimitPerInterval":{"format":"double","description":"Gets or sets the maximum quantity allowed per time interval","type":"number","x-nullable":true},"quantityLimitIntervalDays":{"format":"int32","description":"Gets or sets the number of days for the time interval","type":"integer","x-nullable":true},"quantityLimitGraceDays":{"format":"int32","description":"Gets or sets the number of grace days allowed for the per interval period","type":"integer","x-nullable":true},"quantityLimitPerPeriod":{"format":"double","description":"Gets or sets the number of max quantity allowed per benefit period","type":"number","x-nullable":true},"quantityLimitPerPeriodGPIChars":{"description":"Gets or sets the number of GPI characters to group by when evaluating the MaxQtyPerPeriod value","type":"string"},"quantityLimitPerYear":{"format":"double","description":"Gets or sets the maximum quantity allowed per calendar year","type":"number","x-nullable":true},"quantityLimitPerYearGPIChars":{"description":"Gets or sets the number of GPI characters to group by when evaluating the MaxQtyPerYear value","type":"string"},"quantityLimitTotal":{"format":"double","description":"Gets or sets the maximum quantity allowed","type":"number","x-nullable":true},"quantityLimitTotalGPIChars":{"description":"Gets or sets the number of GPI characters to group by when evaluating the MaxQtyTotal value","type":"string"},"minDaysSupplyPerFill":{"format":"int32","description":"Gets or sets the minimum days supply per fill","type":"integer","x-nullable":true},"maxDaysSupplyPerFill":{"format":"int32","description":"Gets or sets the maximum days supply per fill","type":"integer","x-nullable":true},"maxDaysSupplyPerPeriod":{"format":"int32","description":"Gets or sets the maximum days supply allowed per benefit period","type":"integer","x-nullable":true},"maxDaysSupplyPerPeriodGPIChars":{"description":"Gets or sets number of GPI characters to group by when evaluating the MaxDaysSupplyPerPeriod value","type":"string"},"maxDaysSupplyPerYear":{"format":"int32","description":"Gets or sets the maximum days supply per calendar year","type":"integer","x-nullable":true},"maxDaysSupplyPerYearGPIChars":{"description":"Gets or sets the number of GPI characters to group by when evaluating the MaxDaysSupplyPerYear value","type":"string"},"maxDaysSupplyTotal":{"format":"int32","description":"Gets or sets the maximum days supply allowed","type":"integer","x-nullable":true},"maxDaysSupplyTotalGPIChars":{"description":"Gets or sets the number of GPI characters to group by when evaluating the MaxDaysSupplyTotal value","type":"string"},"maxPricePerFill":{"format":"double","description":"Gets or sets the maximum dollar amount per fill","type":"number","x-nullable":true},"maxPricePerFillNetworkResultID":{"format":"int64","description":"Gets or sets the action to enforce a limit on MaxPricePerFill for network pricing\"","type":"integer","x-nullable":true},"maxPricePerFillNetworkOnly":{"description":"Gets or sets the action to enforce a limit on MaxPricePerFill for network pricing only\"","type":"boolean","x-nullable":true},"maxPricePerDaySupply":{"format":"double","description":"Gets or sets the maximum dollar amount per days supply","type":"number","x-nullable":true},"maxPricePerDaySupplyNetworkResultID":{"format":"int64","description":"Gets or sets the action to enforce a limit on MaxPricePerDaySupply for network pricing\"","type":"integer","x-nullable":true},"maxPricePerDaySupplyNetworkOnly":{"description":"Gets or sets the action to enforce a limit on MaxPricePerDaySupply for network pricing only\"","type":"boolean","x-nullable":true},"maxPricePerUnit":{"format":"double","description":"Gets or sets the maximum dollar amount per quantity dispensed","type":"number","x-nullable":true},"maxPricePerUnitNetworkResultID":{"format":"int64","description":"Gets or sets the action to enforce a limit on MaxPricePerUnit for network pricing\"","type":"integer","x-nullable":true},"maxPricePerUnitNetworkOnly":{"description":"Gets or sets the action to enforce a limit on MaxPricePerUnit for network pricing only\"","type":"boolean","x-nullable":true},"refillTooSoonMinPercentConsumed":{"format":"double","description":"Gets or sets the minimum percentage that must be consumed so that a refill too soon edit is not generated","type":"number","x-nullable":true},"maxFillsPerInterval":{"format":"int32","description":"Gets or sets the maximum fills allowed for a drug per interval","type":"integer","x-nullable":true},"maxFillsIntervalDays":{"format":"int32","description":"Gets or sets the number of days for the time interval","type":"integer","x-nullable":true},"maxFillsGraceDays":{"format":"int32","description":"Gets or sets the number of grace days allowed for the interval period","type":"integer","x-nullable":true},"maxFillsPerPeriod":{"format":"int32","description":"Gets or sets the maximum number of fills allowoed per benefit period","type":"integer","x-nullable":true},"maxFillsPerPeriodGPIChars":{"description":"Gets or sets the number of GPI characters to group by when evaluating the MaxFillsPerPeriod value","type":"string"},"maxFillsPerYear":{"format":"int32","description":"Gets or sets the maximum number of fills allowed per calendar year","type":"integer","x-nullable":true},"maxFillsPerYearGPIChars":{"description":"Gets or sets the number of GPI characters to group by when evaluating the MaxFillsPerYear value","type":"string"},"maxFillsTotal":{"format":"int32","description":"Gets or sets the maximum number of fills allowed","type":"integer","x-nullable":true},"maxFillsTotalGPIChars":{"description":"Gets or sets the number of GPI characters to group by when evaluating the MaxFillsTotal value","type":"string"},"claimLimitsMinMemberAge":{"format":"int32","description":"Gets or sets the minimum age allowed for a member","type":"integer","x-nullable":true},"claimLimitsMaxMemberAge":{"format":"int32","description":"Gets or sets the maximum age allowed for a member","type":"integer","x-nullable":true},"claimLimitsMemberAgeUnits":{"description":"Gets or sets the age units used when determining the age limits","type":"string"},"usualAndCustomaryMarginPercent":{"format":"double","description":"Gets or sets usual and customary margin deviation percentage allowed compared to AWP","type":"number","x-nullable":true},"limitQtyToPackageSize":{"description":"Gets or sets option to limit quantity to factors of the package size","type":"boolean","x-nullable":true},"maxFillsPerDaysIntervalSpecial":{"format":"int32","type":"integer","x-nullable":true},"fillDaysIntervalSpecial":{"format":"int32","type":"integer","x-nullable":true},"fillGraceDaysSpecial":{"format":"int32","type":"integer","x-nullable":true}}},"RuleClaimLimitNDCSpecificModel":{"description":"Rule Claim Limit NDC Specific","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"claimLimit":{"$ref":"#/definitions/RuleClaimLimitModel","description":"Gets or sets the claim limits associated with this rule claim limit"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"alternatePricingGroupUrl":{"description":"Gets or sets the link to the alternate pricing group used by this rule","type":"string"},"alternatePricingGroupNo":{"format":"int64","description":"Gets or sets the identifier to the alternate pricing group","type":"integer","x-nullable":true},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"pharmacyPriceMin":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceMax":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPricePreTax":{"description":"Gets or sets the option for whether the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsMin":{"format":"double","description":"Gets or sets the minimum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsMax":{"format":"double","description":"Gets or sets the maximum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsPreTax":{"description":"Gets or sets the option for whether the cents portion of the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"stepTherapy":{"description":"Gets or sets whether the rule applies to step therapy medication","type":"boolean","x-nullable":true},"claimTagItemID1":{"format":"uuid","description":"Gets or sets the Claim Tag Item ID 1 identifier","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"claimTagItemID2":{"format":"uuid","description":"Gets or sets the Claim Tag Item ID 2 identifier","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"claimTagItemID3":{"format":"uuid","description":"Gets or sets the Claim Tag Item ID 3 identifier","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"dependentRelationshipCode":{"description":"Gets or sets the Dependent Relationship Code","type":"string"},"onFormulary":{"description":"Gets or sets the On Formulary indicator","type":"boolean","x-nullable":true},"formularyNotCoveredException":{"description":"Gets or sets whether to enforce the formulary not covered exception indicator","type":"boolean","x-nullable":true},"formularyAgeLimitException":{"description":"Gets or sets whether to enforce the formulary age exception indicator","type":"boolean","x-nullable":true},"formularyGenderLimitException":{"description":"Gets or sets whether to enforce the formulary gender exception indicator","type":"boolean","x-nullable":true},"formularyQtyLimitException":{"description":"Gets or sets whether to enforce the formulary quantity exception indicator","type":"boolean","x-nullable":true},"formularyStepMedException":{"description":"Gets or sets whether to enforce the formulary step med exception indicator","type":"boolean","x-nullable":true},"formularyPriorAuthException":{"description":"Gets or sets whether to enforce the formulary prior auth exception indicator","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"allowRefillPercentConsumedByNDC":{"description":"Gets or sets where to check for refill too soon by NDC. If false will be checked by GPI","type":"boolean","x-nullable":true},"allowRefillPercentConsumedGPIChars":{"description":"Gets or sets the the GPI Chars used to check for refill too soon if RefillTooSoonConsumedByNDC is false. If RefillTooSoonConsumedByNDC is true and RefillTooSoonConsumedGPIChars is not set then it will be defaulted to 10.","type":"string"},"ndcListIsExclusion":{"description":"Gets or sets a value indicating whether the ndc list is treated as an exclusion list.  If this is true, ndcs in the list will be excluded from the rule; if false, only ndcs in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"priorFillsPharmacyPriceMin":{"format":"double","description":"Gets or set the prior fills pharmacy price min","type":"number","x-nullable":true},"priorFillsPharmacyPriceMax":{"format":"double","description":"Gets or sets the prior fills pharmacy price max","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMin":{"format":"double","description":"Gets or sets the prior fills pharmacy price per day supply min","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMax":{"format":"double","description":"gets or sets the prior fills pharmacy price per day supply max","type":"number","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"ndCs":{"description":"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}.","type":"array","items":{"$ref":"#/definitions/RuleDrugModel"}}}},"RuleClaimLimitStandardModel":{"description":"Rule Claim Limit Standard","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"claimLimit":{"$ref":"#/definitions/RuleClaimLimitModel","description":"Gets or sets the claim limits associated with this rule claim limit"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"alternatePricingGroupUrl":{"description":"Gets or sets the link to the alternate pricing group used by this rule","type":"string"},"alternatePricingGroupNo":{"format":"int64","description":"Gets or sets the identifier to the alternate pricing group","type":"integer","x-nullable":true},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"pharmacyPriceMin":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceMax":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPricePreTax":{"description":"Gets or sets the option for whether the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsMin":{"format":"double","description":"Gets or sets the minimum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsMax":{"format":"double","description":"Gets or sets the maximum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsPreTax":{"description":"Gets or sets the option for whether the cents portion of the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"stepTherapy":{"description":"Gets or sets whether the rule applies to step therapy medication","type":"boolean","x-nullable":true},"claimTagItemID1":{"format":"uuid","description":"Gets or sets the Claim Tag Item ID 1 identifier","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"claimTagItemID2":{"format":"uuid","description":"Gets or sets the Claim Tag Item ID 2 identifier","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"claimTagItemID3":{"format":"uuid","description":"Gets or sets the Claim Tag Item ID 3 identifier","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"dependentRelationshipCode":{"description":"Gets or sets the Dependent Relationship Code","type":"string"},"onFormulary":{"description":"Gets or sets the On Formulary indicator","type":"boolean","x-nullable":true},"formularyNotCoveredException":{"description":"Gets or sets whether to enforce the formulary not covered exception indicator","type":"boolean","x-nullable":true},"formularyAgeLimitException":{"description":"Gets or sets whether to enforce the formulary age exception indicator","type":"boolean","x-nullable":true},"formularyGenderLimitException":{"description":"Gets or sets whether to enforce the formulary gender exception indicator","type":"boolean","x-nullable":true},"formularyQtyLimitException":{"description":"Gets or sets whether to enforce the formulary quantity exception indicator","type":"boolean","x-nullable":true},"formularyStepMedException":{"description":"Gets or sets whether to enforce the formulary step med exception indicator","type":"boolean","x-nullable":true},"formularyPriorAuthException":{"description":"Gets or sets whether to enforce the formulary prior auth exception indicator","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"allowRefillPercentConsumedByNDC":{"description":"Gets or sets where to check for refill too soon by NDC. If false will be checked by GPI","type":"boolean","x-nullable":true},"allowRefillPercentConsumedGPIChars":{"description":"Gets or sets the the GPI Chars used to check for refill too soon if RefillTooSoonConsumedByNDC is false. If RefillTooSoonConsumedByNDC is true and RefillTooSoonConsumedGPIChars is not set then it will be defaulted to 10.","type":"string"},"priorFillsPharmacyPriceMin":{"format":"double","description":"Gets or set the prior fills pharmacy price min","type":"number","x-nullable":true},"priorFillsPharmacyPriceMax":{"format":"double","description":"Gets or sets the prior fills pharmacy price max","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMin":{"format":"double","description":"Gets or sets the prior fills pharmacy price per day supply min","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMax":{"format":"double","description":"gets or sets the prior fills pharmacy price per day supply max","type":"number","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"isBrand":{"description":"Gets or sets whether the drug criteria is based on brand","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets whether the drug criteria is for prescription only (non-OTC)","type":"boolean","x-nullable":true},"isMultiSourced":{"description":"Gets or sets whether the drug criteria is based on multi-source","type":"boolean","x-nullable":true},"isRepackaged":{"description":"Gets or sets whether the drug criteria is based on repackaged value","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets whether the drug criteria applies if a generic is available","type":"boolean","x-nullable":true},"otcAvailable":{"description":"Gets or sets whether the drug criteria applies if an OTC is available","type":"boolean","x-nullable":true},"isMaintenanceDrug":{"description":"Gets or sets whether the drug criteria applies to maintenance drug","type":"boolean","x-nullable":true},"deaClassCodes":{"description":"Gets or sets the applicable DEA schedules for the drug criteria","type":"array","items":{"$ref":"#/definitions/DEAScheduleModel"}},"brandNameCodes":{"description":"Gets or sets the applicable brand codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/BrandNameCodeModel"}},"multiSourceCodes":{"description":"Gets or sets the applicable multi-source codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}},"rX_OTCIndicatorCodes":{"description":"Gets or sets the applicable Rx-OTC Indicator codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/RX_OTCIndicatorCodeModel"}},"includeCustomDrugs":{"description":"Gets or sets whether the drug criteria applies to custom drugs","type":"boolean","x-nullable":true},"gpiListIsExclusion":{"description":"Gets or sets whether the drug criteria GPI list is excluded","type":"boolean","x-nullable":true},"drugProfileListIsExclusion":{"description":"Gets or sets whether the drug criteria drug profile list is excluded","type":"boolean","x-nullable":true},"gpIs":{"description":"Gets or sets the list of GPIs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleGPIModel"}},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"roAs":{"description":"Gets or sets the list of ROAs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleROAModel"}},"dosageForms":{"description":"Gets or sets the dosage forms associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleDosageFormModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"drugProfiles":{"description":"Gets or Sets a a list of which drug profiles are associated with this rule","type":"array","items":{"$ref":"#/definitions/RuleDrugProfileModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true}}},"RuleClaimLimitSpecialDrugModel":{"description":"Rule Claim Limit Special Drug","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"claimLimit":{"$ref":"#/definitions/RuleClaimLimitModel","description":"Gets or sets the claim limits associated with this rule claim limit"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"pharmacyPriceMin":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceMax":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPricePreTax":{"description":"Gets or sets the option for whether the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsMin":{"format":"double","description":"Gets or sets the minimum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsMax":{"format":"double","description":"Gets or sets the maximum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsPreTax":{"description":"Gets or sets the option for whether the cents portion of the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"maxFillsPerInterval":{"format":"int32","description":"Gets or sets the maximum fills allowed for a special drug per interval","type":"integer","x-nullable":true},"maxFillsIntervalDays":{"format":"int32","description":"Gets or sets the number of days for the time interval","type":"integer","x-nullable":true},"maxFillsGraceDays":{"format":"int32","description":"Gets or sets the number of grace days allowed for the interval period","type":"integer","x-nullable":true},"claimTagItemID1":{"format":"uuid","description":"Gets or sets the Claim Tag Item ID 1 identifier","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"claimTagItemID2":{"format":"uuid","description":"Gets or sets the Claim Tag Item ID 2 identifier","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"claimTagItemID3":{"format":"uuid","description":"Gets or sets the Claim Tag Item ID 3 identifier","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"dependentRelationshipCode":{"description":"Gets or sets the Dependent Relationship Code","type":"string"},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"priorFillsPharmacyPriceMin":{"format":"double","description":"Gets or set the prior fills pharmacy price min","type":"number","x-nullable":true},"priorFillsPharmacyPriceMax":{"format":"double","description":"Gets or sets the prior fills pharmacy price max","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMin":{"format":"double","description":"Gets or sets the prior fills pharmacy price per day supply min","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMax":{"format":"double","description":"gets or sets the prior fills pharmacy price per day supply max","type":"number","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"compoundDrugs":{"description":"Gets whether the special drug criteria applies to compound drugs","type":"boolean","x-nullable":true},"unknownDrugs":{"description":"Gets whether the special drug criteria applies to unknown drugs","type":"boolean","x-nullable":true},"undefinedDrugs":{"description":"Gets whether the special drug criteria applies to undefined drugs","type":"boolean","x-nullable":true},"compoundLevelOfEffort":{"description":"Gets level of effort values applicable to the special drug criteria","type":"array","items":{"$ref":"#/definitions/LevelOfEffortModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true}}},"RuleDAWModel":{"description":"Rule DAW","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"useGenericPrice":{"description":"Gets or sets whether to user generic price for generic drug","type":"boolean","x-nullable":true},"penaltyBasis":{"$ref":"#/definitions/PenaltyBasisModel","description":"Gets or sets the drug selection penalty basis"},"dawBrand":{"description":"Gets or sets whether to enforce brand criteria","type":"boolean","x-nullable":true},"dawMultiSource":{"description":"Gets or sets whether to enforce multi-source criteria","type":"boolean","x-nullable":true},"dawGenericAvailable":{"description":"Gets or sets whether to enforce generic availability","type":"boolean","x-nullable":true},"dawotcAvailable":{"description":"Gets or sets whether to enforce OTC availability","type":"boolean","x-nullable":true},"dawBrandNameCode":{"description":"Gets or sets whether to enforce brand name code","type":"boolean","x-nullable":true},"dawMultiSourceCode":{"description":"Gets or sets whether to enforce multi-source code","type":"boolean","x-nullable":true},"dawBenefitRule":{"description":"Gets or sets whether to enforce benefit rules","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"isBrand":{"description":"Gets or sets whether the drug criteria is based on brand","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets whether the drug criteria is for prescription only (non-OTC)","type":"boolean","x-nullable":true},"isMultiSourced":{"description":"Gets or sets whether the drug criteria is based on multi-source","type":"boolean","x-nullable":true},"isRepackaged":{"description":"Gets or sets whether the drug criteria is based on repackaged value","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets whether the drug criteria applies if a generic is available","type":"boolean","x-nullable":true},"otcAvailable":{"description":"Gets or sets whether the drug criteria applies if an OTC is available","type":"boolean","x-nullable":true},"isMaintenanceDrug":{"description":"Gets or sets whether the drug criteria applies to maintenance drug","type":"boolean","x-nullable":true},"deaClassCodes":{"description":"Gets or sets the applicable DEA schedules for the drug criteria","type":"array","items":{"$ref":"#/definitions/DEAScheduleModel"}},"brandNameCodes":{"description":"Gets or sets the applicable brand codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/BrandNameCodeModel"}},"multiSourceCodes":{"description":"Gets or sets the applicable multi-source codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}},"rX_OTCIndicatorCodes":{"description":"Gets or sets the applicable Rx-OTC Indicator codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/RX_OTCIndicatorCodeModel"}},"includeCustomDrugs":{"description":"Gets or sets whether the drug criteria applies to custom drugs","type":"boolean","x-nullable":true},"gpiListIsExclusion":{"description":"Gets or sets whether the drug criteria GPI list is excluded","type":"boolean","x-nullable":true},"drugProfileListIsExclusion":{"description":"Gets or sets whether the drug criteria drug profile list is excluded","type":"boolean","x-nullable":true},"gpIs":{"description":"Gets or sets the list of GPIs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleGPIModel"}},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"roAs":{"description":"Gets or sets the list of ROAs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleROAModel"}},"dosageForms":{"description":"Gets or sets the dosage forms associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleDosageFormModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"drugProfiles":{"description":"Gets or Sets a a list of which drug profiles are associated with this rule","type":"array","items":{"$ref":"#/definitions/RuleDrugProfileModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true}}},"RuleFinalFormularyModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"pharmacyPriceMin":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceMax":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPricePreTax":{"description":"Gets or sets the option for whether the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsMin":{"format":"double","description":"Gets or sets the minimum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsMax":{"format":"double","description":"Gets or sets the maximum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsPreTax":{"description":"Gets or sets the option for whether the cents portion of the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"stepTherapy":{"description":"Gets or sets whether the rule applies to step therapy medication","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"priorFillsPharmacyPriceMin":{"format":"double","description":"Gets or set the prior fills pharmacy price min","type":"number","x-nullable":true},"priorFillsPharmacyPriceMax":{"format":"double","description":"Gets or sets the prior fills pharmacy price max","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMin":{"format":"double","description":"Gets or sets the prior fills pharmacy price per day supply min","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMax":{"format":"double","description":"gets or sets the prior fills pharmacy price per day supply max","type":"number","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"isBrand":{"description":"Gets or sets whether the drug criteria is based on brand","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets whether the drug criteria is for prescription only (non-OTC)","type":"boolean","x-nullable":true},"isMultiSourced":{"description":"Gets or sets whether the drug criteria is based on multi-source","type":"boolean","x-nullable":true},"isRepackaged":{"description":"Gets or sets whether the drug criteria is based on repackaged value","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets whether the drug criteria applies if a generic is available","type":"boolean","x-nullable":true},"otcAvailable":{"description":"Gets or sets whether the drug criteria applies if an OTC is available","type":"boolean","x-nullable":true},"isMaintenanceDrug":{"description":"Gets or sets whether the drug criteria applies to maintenance drug","type":"boolean","x-nullable":true},"deaClassCodes":{"description":"Gets or sets the applicable DEA schedules for the drug criteria","type":"array","items":{"$ref":"#/definitions/DEAScheduleModel"}},"brandNameCodes":{"description":"Gets or sets the applicable brand codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/BrandNameCodeModel"}},"multiSourceCodes":{"description":"Gets or sets the applicable multi-source codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}},"rX_OTCIndicatorCodes":{"description":"Gets or sets the applicable Rx-OTC Indicator codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/RX_OTCIndicatorCodeModel"}},"includeCustomDrugs":{"description":"Gets or sets whether the drug criteria applies to custom drugs","type":"boolean","x-nullable":true},"gpiListIsExclusion":{"description":"Gets or sets whether the drug criteria GPI list is excluded","type":"boolean","x-nullable":true},"drugProfileListIsExclusion":{"description":"Gets or sets whether the drug criteria drug profile list is excluded","type":"boolean","x-nullable":true},"gpIs":{"description":"Gets or sets the list of GPIs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleGPIModel"}},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"roAs":{"description":"Gets or sets the list of ROAs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleROAModel"}},"dosageForms":{"description":"Gets or sets the dosage forms associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleDosageFormModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"drugProfiles":{"description":"Gets or Sets a a list of which drug profiles are associated with this rule","type":"array","items":{"$ref":"#/definitions/RuleDrugProfileModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true}}},"RuleFinalFormularyNDCSpecificModel":{"description":"Rule Final Formulary NDC Specific","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"pharmacyPriceMin":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceMax":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPricePreTax":{"description":"Gets or sets the option for whether the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsMin":{"format":"double","description":"Gets or sets the minimum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsMax":{"format":"double","description":"Gets or sets the maximum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsPreTax":{"description":"Gets or sets the option for whether the cents portion of the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"stepTherapy":{"description":"Gets or sets whether the rule applies to step therapy medication","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"ndcListIsExclusion":{"description":"Gets or sets a value indicating whether the ndc list is treated as an exclusion list.  If this is true, ndcs in the list will be excluded from the rule; if false, only ndcs in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"priorFillsPharmacyPriceMin":{"format":"double","description":"Gets or set the prior fills pharmacy price min","type":"number","x-nullable":true},"priorFillsPharmacyPriceMax":{"format":"double","description":"Gets or sets the prior fills pharmacy price max","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMin":{"format":"double","description":"Gets or sets the prior fills pharmacy price per day supply min","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMax":{"format":"double","description":"gets or sets the prior fills pharmacy price per day supply max","type":"number","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"ndCs":{"description":"Gets or sets the list of NDCs associated with the rule criteria.  These values can be posted/added at individual rule controllers, but should be patched at the RuleDrug endpoint - api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruledrugs/{id}.","type":"array","items":{"$ref":"#/definitions/RuleDrugModel"}}}},"RuleGeneralOptionModel":{"description":"Rule General Option","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"pharmacyTier":{"description":"Gets or sets the pharmacy tier to be applied if the rule is enforced","type":"string"},"flatTaxReject":{"description":"Gets or sets whether to reject claim if flat tax is submitted","type":"boolean","x-nullable":true},"useGroupPlanOnly":{"description":"Gets or sets whether to only use the group plan","type":"boolean","x-nullable":true},"processAsShortCycle":{"description":"Gets or sets whether to process as short cycle, if eligible and rule is enforced","type":"boolean","x-nullable":true},"sendRemitToPharmacy":{"description":"Gets or sets whether to send remit to pharmacy if rule is enforced","type":"boolean","x-nullable":true},"daysSupplyTermGraceDays":{"format":"int32","description":"Gets or sets the days supply grace days allowed if the rule is enforced (i.e. number of days supply to allow after a future term date for the member's current status)","type":"integer","x-nullable":true},"benefitCodeGenOptionUrl":{"description":"Gets or sets the Benefit Code Gen Option Url","type":"string"},"benefitCodeGenOptionNo":{"format":"int64","description":"Gets or sets the Benefit Code Gen Option number","type":"integer","x-nullable":true},"compoundDrugPricingUrl":{"description":"Gets or sets the link to the Drug Pricing resource for compound drugs","type":"string"},"compoundDrugPricingNo":{"format":"int64","description":"Gets or sets the identifier of the special drug pricing for a compound.","type":"integer","x-nullable":true},"unknownDrugPricingUrl":{"description":"Gets or sets the link to the Drug Pricing resource for unknown/undefined drugs","type":"string"},"unknownDrugPricingNo":{"format":"int64","description":"Gets or sets the identifier of the special drug pricing for an unknown/undefined drug.","type":"integer","x-nullable":true},"memberClaimFee":{"format":"double","description":"Gets or sets the member claim fee, which is the amount added to the claim as ingredient cost that the member is responsible for","type":"number","x-nullable":true},"reroutePlanAlternateProcessorNo":{"format":"int64","description":"Gets or sets the Alternate Processor used to reroute the claim to a different plan","type":"integer","x-nullable":true},"reroutePlanAlternateProcessorUrl":{"description":"The url for the reroute plan alternate processor resource","type":"string"},"memberClaimFeeIC":{"format":"double","description":"Percentage amount of the ingredient cost added to the claim that the member is responsible for","type":"number","x-nullable":true},"memberClaimFeeRecalcNtwk":{"description":"Gets or sets the value indicating whether to recalculate amount of member claim fee for the network plan","type":"boolean","x-nullable":true},"altCompoundDrugPricingNo":{"format":"int64","description":"Gets or sets the Alternate compound pricing option (If two options are defined, then the lower pricing option will be used)","type":"integer","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"alternateProcessors":{"description":"Gets or sets the Alternate Processors for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleAlternateProcessorModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true}}},"RuleGeneralOptionByDrugNDCSpecificModel":{"description":"Rule General Option","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"pharmacyTier":{"description":"Gets or sets the pharmacy tier to be applied if the rule is enforced","type":"string"},"flatTaxReject":{"description":"Gets or sets whether to reject claim if flat tax is submitted","type":"boolean","x-nullable":true},"useGroupPlanOnly":{"description":"Gets or sets whether to only use the group plan","type":"boolean","x-nullable":true},"processAsShortCycle":{"description":"Gets or sets whether to process as short cycle, if eligible and rule is enforced","type":"boolean","x-nullable":true},"sendRemitToPharmacy":{"description":"Gets or sets whether to send remit to pharmacy if rule is enforced","type":"boolean","x-nullable":true},"daysSupplyTermGraceDays":{"format":"int32","description":"Gets or sets the days supply grace days allowed if the rule is enforced (i.e. number of days supply to allow after a future term date for the member's current status)","type":"integer","x-nullable":true},"benefitCodeGenOptionUrl":{"description":"Gets or sets the Benefit Code Gen Option Url","type":"string"},"benefitCodeGenOptionNo":{"format":"int64","description":"Gets or sets the Benefit Code Gen Option number","type":"integer","x-nullable":true},"compoundDrugPricingUrl":{"description":"Gets or sets the link to the Drug Pricing resource for compound drugs","type":"string"},"compoundDrugPricingNo":{"format":"int64","description":"Gets or sets the identifier of the special drug pricing for a compound.","type":"integer","x-nullable":true},"unknownDrugPricingUrl":{"description":"Gets or sets the link to the Drug Pricing resource for unknown/undefined drugs","type":"string"},"unknownDrugPricingNo":{"format":"int64","description":"Gets or sets the identifier of the special drug pricing for an unknown/undefined drug.","type":"integer","x-nullable":true},"memberClaimFee":{"format":"double","description":"Gets or sets the member claim fee, which is the amount added to the claim as ingredient cost that the member is responsible for","type":"number","x-nullable":true},"reroutePlanAlternateProcessorNo":{"format":"int64","description":"Gets or sets the Alternate Processor used to reroute the claim to a different plan","type":"integer","x-nullable":true},"reroutePlanAlternateProcessorUrl":{"description":"The url for the reroute plan alternate processor resource","type":"string"},"memberClaimFeeIC":{"format":"double","description":"Percentage amount of the ingredient cost added to the claim that the member is responsible for","type":"number","x-nullable":true},"memberClaimFeeRecalcNtwk":{"description":"Gets or sets the value indicating whether to recalculate amount of member claim fee for the network plan","type":"boolean","x-nullable":true},"altCompoundDrugPricingNo":{"format":"int64","description":"Gets or sets the Alternate compound pricing option (If two options are defined, then the lower pricing option will be used)","type":"integer","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"alternateProcessors":{"description":"Gets or sets the Alternate Processors for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleAlternateProcessorModel"}},"ndcListIsExclusion":{"description":"Gets or sets a value indicating whether the ndc list is treated as an exclusion list.  If this is true, ndcs in the list will be excluded from the rule; if false, only ndcs in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"ndCs":{"description":"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}.","type":"array","items":{"$ref":"#/definitions/RuleDrugModel"}}}},"RuleGeneralOptionByDrugModel":{"description":"Rule General Option","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"pharmacyTier":{"description":"Gets or sets the pharmacy tier to be applied if the rule is enforced","type":"string"},"flatTaxReject":{"description":"Gets or sets whether to reject claim if flat tax is submitted","type":"boolean","x-nullable":true},"useGroupPlanOnly":{"description":"Gets or sets whether to only use the group plan","type":"boolean","x-nullable":true},"processAsShortCycle":{"description":"Gets or sets whether to process as short cycle, if eligible and rule is enforced","type":"boolean","x-nullable":true},"sendRemitToPharmacy":{"description":"Gets or sets whether to send remit to pharmacy if rule is enforced","type":"boolean","x-nullable":true},"daysSupplyTermGraceDays":{"format":"int32","description":"Gets or sets the days supply grace days allowed if the rule is enforced (i.e. number of days supply to allow after a future term date for the member's current status)","type":"integer","x-nullable":true},"benefitCodeGenOptionUrl":{"description":"Gets or sets the Benefit Code Gen Option Url","type":"string"},"benefitCodeGenOptionNo":{"format":"int64","description":"Gets or sets the Benefit Code value that will be used when applying this rule.  This field should not be used as the Benefit Code criteria for this rule.  For that, use the BenefitCodeNo field.","type":"integer","x-nullable":true},"compoundDrugPricingUrl":{"description":"Gets or sets the link to the Drug Pricing resource for compound drugs","type":"string"},"compoundDrugPricingNo":{"format":"int64","description":"Gets or sets the identifier of the special drug pricing for a compound.","type":"integer","x-nullable":true},"unknownDrugPricingUrl":{"description":"Gets or sets the link to the Drug Pricing resource for unknown/undefined drugs","type":"string"},"unknownDrugPricingNo":{"format":"int64","description":"Gets or sets the identifier of the special drug pricing for an unknown/undefined drug.","type":"integer","x-nullable":true},"memberClaimFee":{"format":"double","description":"Gets or sets the member claim fee, which is the amount added to the claim as ingredient cost that the member is responsible for","type":"number","x-nullable":true},"reroutePlanAlternateProcessorNo":{"format":"int64","description":"Gets or sets the Alternate Processor used to reroute the claim to a different plan","type":"integer","x-nullable":true},"reroutePlanAlternateProcessorUrl":{"description":"The url for the reroute plan alternate processor resource","type":"string"},"memberClaimFeeIC":{"format":"double","description":"Percentage amount of the ingredient cost added to the claim that the member is responsible for","type":"number","x-nullable":true},"memberClaimFeeRecalcNtwk":{"description":"Gets or sets the value indicating whether to recalculate amount of member claim fee for the network plan","type":"boolean","x-nullable":true},"altCompoundDrugPricingNo":{"format":"int64","description":"Gets or sets the Alternate compound pricing option (If two options are defined, then the lower pricing option will be used)","type":"integer","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"alternateProcessors":{"description":"Gets or sets the Alternate Processors for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleAlternateProcessorModel"}},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"isBrand":{"description":"Gets or sets whether the drug criteria is based on brand","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets whether the drug criteria is for prescription only (non-OTC)","type":"boolean","x-nullable":true},"isMultiSourced":{"description":"Gets or sets whether the drug criteria is based on multi-source","type":"boolean","x-nullable":true},"isRepackaged":{"description":"Gets or sets whether the drug criteria is based on repackaged value","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets whether the drug criteria applies if a generic is available","type":"boolean","x-nullable":true},"otcAvailable":{"description":"Gets or sets whether the drug criteria applies if an OTC is available","type":"boolean","x-nullable":true},"isMaintenanceDrug":{"description":"Gets or sets whether the drug criteria applies to maintenance drug","type":"boolean","x-nullable":true},"deaClassCodes":{"description":"Gets or sets the applicable DEA schedules for the drug criteria","type":"array","items":{"$ref":"#/definitions/DEAScheduleModel"}},"brandNameCodes":{"description":"Gets or sets the applicable brand codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/BrandNameCodeModel"}},"multiSourceCodes":{"description":"Gets or sets the applicable multi-source codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}},"rX_OTCIndicatorCodes":{"description":"Gets or sets the applicable Rx-OTC Indicator codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/RX_OTCIndicatorCodeModel"}},"includeCustomDrugs":{"description":"Gets or sets whether the drug criteria applies to custom drugs","type":"boolean","x-nullable":true},"gpiListIsExclusion":{"description":"Gets or sets whether the drug criteria GPI list is excluded","type":"boolean","x-nullable":true},"drugProfileListIsExclusion":{"description":"Gets or sets whether the drug criteria drug profile list is excluded","type":"boolean","x-nullable":true},"gpIs":{"description":"Gets or sets the list of GPIs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleGPIModel"}},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"roAs":{"description":"Gets or sets the list of ROAs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleROAModel"}},"dosageForms":{"description":"Gets or sets the dosage forms associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleDosageFormModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"drugProfiles":{"description":"Gets or Sets a a list of which drug profiles are associated with this rule","type":"array","items":{"$ref":"#/definitions/RuleDrugProfileModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true}}},"RuleMemberFormularyModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"alternatePricingGroupUrl":{"description":"Gets or sets the link to the alternate pricing group used by this rule","type":"string"},"alternatePricingGroupNo":{"format":"int64","description":"Gets or sets the identifier to the alternate pricing group","type":"integer","x-nullable":true},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"enforcePlanFormulary":{"description":"Gets or sets whether to allow plan formulary rules to cause a rejection","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets pharmacy headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"isBrand":{"description":"Gets or sets whether the drug criteria is based on brand","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets whether the drug criteria is for prescription only (non-OTC)","type":"boolean","x-nullable":true},"isMultiSourced":{"description":"Gets or sets whether the drug criteria is based on multi-source","type":"boolean","x-nullable":true},"isRepackaged":{"description":"Gets or sets whether the drug criteria is based on repackaged value","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets whether the drug criteria applies if a generic is available","type":"boolean","x-nullable":true},"otcAvailable":{"description":"Gets or sets whether the drug criteria applies if an OTC is available","type":"boolean","x-nullable":true},"isMaintenanceDrug":{"description":"Gets or sets whether the drug criteria applies to maintenance drug","type":"boolean","x-nullable":true},"deaClassCodes":{"description":"Gets or sets the applicable DEA schedules for the drug criteria","type":"array","items":{"$ref":"#/definitions/DEAScheduleModel"}},"brandNameCodes":{"description":"Gets or sets the applicable brand codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/BrandNameCodeModel"}},"multiSourceCodes":{"description":"Gets or sets the applicable multi-source codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}},"rX_OTCIndicatorCodes":{"description":"Gets or sets the applicable Rx-OTC Indicator codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/RX_OTCIndicatorCodeModel"}},"includeCustomDrugs":{"description":"Gets or sets whether the drug criteria applies to custom drugs","type":"boolean","x-nullable":true},"gpiListIsExclusion":{"description":"Gets or sets whether the drug criteria GPI list is excluded","type":"boolean","x-nullable":true},"drugProfileListIsExclusion":{"description":"Gets or sets whether the drug criteria drug profile list is excluded","type":"boolean","x-nullable":true},"gpIs":{"description":"Gets or sets the list of GPIs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleGPIModel"}},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"roAs":{"description":"Gets or sets the list of ROAs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleROAModel"}},"dosageForms":{"description":"Gets or sets the dosage forms associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleDosageFormModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"drugProfiles":{"description":"Gets or Sets a a list of which drug profiles are associated with this rule","type":"array","items":{"$ref":"#/definitions/RuleDrugProfileModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true}}},"RuleMemberFormularyNDCSpecificModel":{"description":"Rule Member Formulary NDC Specific","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"alternatePricingGroupUrl":{"description":"Gets or sets the link to the alternate pricing group used by this rule","type":"string"},"alternatePricingGroupNo":{"format":"int64","description":"Gets or sets the identifier to the alternate pricing group","type":"integer","x-nullable":true},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"enforcePlanFormulary":{"description":"Gets or sets whether to allow plan formulary rules to cause a rejection","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets pharmacy headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"ndcListIsExclusion":{"description":"Gets or sets a value indicating whether the ndc list is treated as an exclusion list.  If this is true, ndcs in the list will be excluded from the rule; if false, only ndcs in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"ndCs":{"description":"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}.","type":"array","items":{"$ref":"#/definitions/RuleDrugModel"}}}},"RuleOptionNDCSpecificModel":{"description":"Rule Option NDC Specific","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"secondaryPayerOnly":{"description":"Gets or sets whether processor is to treat as secondary payer","type":"boolean","x-nullable":true},"allowPrimaryPayer":{"description":"Gets or sets wehther processor is to be allowed as primary payer","type":"boolean","x-nullable":true},"billingGroup":{"$ref":"#/definitions/BillingGroupModel","description":"Gets or sets the billing group to be used if rule is enforced"},"perDiem":{"$ref":"#/definitions/PerDiemModel","description":"Gets or sets the per diem to be used if rule is enforced"},"pharmacyPriceCentsOverride":{"format":"double","description":"Gets or sets amount of the pharmacy price cents to use as an override","type":"number","x-nullable":true},"pharmacyPriceCentsOverridePreTax":{"description":"Gets or sets whether the pharmacy price cents override applies to the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsOverrideGroupPlan":{"description":"Gets or sets whether the pharmacy price cents override applies to the group plan","type":"boolean","x-nullable":true},"pharmacyPriceCentsOverrideNetworkPlan":{"description":"Gets or sets whether the pharmacy price cents override applies to the network plan","type":"boolean","x-nullable":true},"adminFee":{"format":"double","description":"Gets or sets amount of the admin fee","type":"number","x-nullable":true},"penaltyBasis":{"$ref":"#/definitions/PenaltyBasisModel","description":"Gets or sets the drug selection penalty basis"},"benefitCodeOptionUrl":{"type":"string"},"benefitCodeOptionNo":{"format":"int64","type":"integer","x-nullable":true},"pharmacyPriceMin":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceMax":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPricePreTax":{"description":"Gets or sets the option for whether the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsMin":{"format":"double","description":"Gets or sets the minimum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsMax":{"format":"double","description":"Gets or sets the maximum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsPreTax":{"description":"Gets or sets the option for whether the cents portion of the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"stepTherapy":{"description":"Gets or sets whether the rule applies to step therapy medication","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"ndcListIsExclusion":{"description":"Gets or sets a value indicating whether the ndc list is treated as an exclusion list.  If this is true, ndcs in the list will be excluded from the rule; if false, only ndcs in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"priorFillsPharmacyPriceMin":{"format":"double","description":"Gets or set the prior fills pharmacy price min","type":"number","x-nullable":true},"priorFillsPharmacyPriceMax":{"format":"double","description":"Gets or sets the prior fills pharmacy price max","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMin":{"format":"double","description":"Gets or sets the prior fills pharmacy price per day supply min","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMax":{"format":"double","description":"gets or sets the prior fills pharmacy price per day supply max","type":"number","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"ndCs":{"description":"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}.","type":"array","items":{"$ref":"#/definitions/RuleDrugModel"}}}},"RuleOptionModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"secondaryPayerOnly":{"description":"Gets or sets whether processor is to treat as secondary payer","type":"boolean","x-nullable":true},"allowPrimaryPayer":{"description":"Gets or sets wehther processor is to be allowed as primary payer","type":"boolean","x-nullable":true},"billingGroup":{"$ref":"#/definitions/BillingGroupModel","description":"Gets or sets the billing group to be used if rule is enforced"},"perDiem":{"$ref":"#/definitions/PerDiemModel","description":"Gets or sets the per diem to be used if rule is enforced"},"pharmacyPriceCentsOverride":{"format":"double","description":"Gets or sets amount of the pharmacy price cents to use as an override","type":"number","x-nullable":true},"pharmacyPriceCentsOverridePreTax":{"description":"Gets or sets whether the pharmacy price cents override applies to the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsOverrideGroupPlan":{"description":"Gets or sets whether the pharmacy price cents override applies to the group plan","type":"boolean","x-nullable":true},"pharmacyPriceCentsOverrideNetworkPlan":{"description":"Gets or sets whether the pharmacy price cents override applies to the network plan","type":"boolean","x-nullable":true},"adminFee":{"format":"double","description":"Gets or sets amount of the admin fee","type":"number","x-nullable":true},"penaltyBasis":{"$ref":"#/definitions/PenaltyBasisModel","description":"Gets or sets the drug selection penalty basis"},"benefitCodeOptionUrl":{"type":"string"},"benefitCodeOptionNo":{"format":"int64","type":"integer","x-nullable":true},"pharmacyPriceMin":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceMax":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPricePreTax":{"description":"Gets or sets the option for whether the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsMin":{"format":"double","description":"Gets or sets the minimum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsMax":{"format":"double","description":"Gets or sets the maximum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsPreTax":{"description":"Gets or sets the option for whether the cents portion of the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"stepTherapy":{"description":"Gets or sets whether the rule applies to step therapy medication","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"priorFillsPharmacyPriceMin":{"format":"double","description":"Gets or set the prior fills pharmacy price min","type":"number","x-nullable":true},"priorFillsPharmacyPriceMax":{"format":"double","description":"Gets or sets the prior fills pharmacy price max","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMin":{"format":"double","description":"Gets or sets the prior fills pharmacy price per day supply min","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMax":{"format":"double","description":"gets or sets the prior fills pharmacy price per day supply max","type":"number","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"isBrand":{"description":"Gets or sets whether the drug criteria is based on brand","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets whether the drug criteria is for prescription only (non-OTC)","type":"boolean","x-nullable":true},"isMultiSourced":{"description":"Gets or sets whether the drug criteria is based on multi-source","type":"boolean","x-nullable":true},"isRepackaged":{"description":"Gets or sets whether the drug criteria is based on repackaged value","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets whether the drug criteria applies if a generic is available","type":"boolean","x-nullable":true},"otcAvailable":{"description":"Gets or sets whether the drug criteria applies if an OTC is available","type":"boolean","x-nullable":true},"isMaintenanceDrug":{"description":"Gets or sets whether the drug criteria applies to maintenance drug","type":"boolean","x-nullable":true},"deaClassCodes":{"description":"Gets or sets the applicable DEA schedules for the drug criteria","type":"array","items":{"$ref":"#/definitions/DEAScheduleModel"}},"brandNameCodes":{"description":"Gets or sets the applicable brand codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/BrandNameCodeModel"}},"multiSourceCodes":{"description":"Gets or sets the applicable multi-source codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}},"rX_OTCIndicatorCodes":{"description":"Gets or sets the applicable Rx-OTC Indicator codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/RX_OTCIndicatorCodeModel"}},"includeCustomDrugs":{"description":"Gets or sets whether the drug criteria applies to custom drugs","type":"boolean","x-nullable":true},"gpiListIsExclusion":{"description":"Gets or sets whether the drug criteria GPI list is excluded","type":"boolean","x-nullable":true},"drugProfileListIsExclusion":{"description":"Gets or sets whether the drug criteria drug profile list is excluded","type":"boolean","x-nullable":true},"gpIs":{"description":"Gets or sets the list of GPIs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleGPIModel"}},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"roAs":{"description":"Gets or sets the list of ROAs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleROAModel"}},"dosageForms":{"description":"Gets or sets the dosage forms associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleDosageFormModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"drugProfiles":{"description":"Gets or Sets a a list of which drug profiles are associated with this rule","type":"array","items":{"$ref":"#/definitions/RuleDrugProfileModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true}}},"RuleOptionSpecialDrugModel":{"description":"Rule Option Special Drug","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"secondaryPayerOnly":{"description":"Gets or sets whether processor is to treat as secondary payer","type":"boolean","x-nullable":true},"allowPrimaryPayer":{"description":"Gets or sets wehther processor is to be allowed as primary payer","type":"boolean","x-nullable":true},"billingGroup":{"$ref":"#/definitions/BillingGroupModel","description":"Gets or sets the billing group to be used if rule is enforced"},"perDiem":{"$ref":"#/definitions/PerDiemModel","description":"Gets or sets the per diem to be used if rule is enforced"},"pharmacyPriceCentsOverride":{"format":"double","description":"Gets or sets amount of the pharmacy price cents to use as an override","type":"number","x-nullable":true},"adminFee":{"format":"double","description":"Gets or sets amount of the admin fee","type":"number","x-nullable":true},"pharmacyPriceCentsOverridePreTax":{"description":"Gets or sets whether the pharmacy price cents override applies to the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsOverrideGroupPlan":{"description":"Gets or sets whether the pharmacy price cents override applies to the group plan","type":"boolean","x-nullable":true},"pharmacyPriceCentsOverrideNetworkPlan":{"description":"Gets or sets whether the pharmacy price cents override applies to the network plan","type":"boolean","x-nullable":true},"benefitCodeOptionUrl":{"type":"string"},"benefitCodeOptionNo":{"format":"int64","type":"integer","x-nullable":true},"pharmacyPriceMin":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceMax":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPricePreTax":{"description":"Gets or sets the option for whether the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsMin":{"format":"double","description":"Gets or sets the minimum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsMax":{"format":"double","description":"Gets or sets the maximum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsPreTax":{"description":"Gets or sets the option for whether the cents portion of the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"priorFillsPharmacyPriceMin":{"format":"double","description":"Gets or set the prior fills pharmacy price min","type":"number","x-nullable":true},"priorFillsPharmacyPriceMax":{"format":"double","description":"Gets or sets the prior fills pharmacy price max","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMin":{"format":"double","description":"Gets or sets the prior fills pharmacy price per day supply min","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMax":{"format":"double","description":"gets or sets the prior fills pharmacy price per day supply max","type":"number","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"compoundDrugs":{"description":"Gets whether the special drug criteria applies to compound drugs","type":"boolean","x-nullable":true},"unknownDrugs":{"description":"Gets whether the special drug criteria applies to unknown drugs","type":"boolean","x-nullable":true},"undefinedDrugs":{"description":"Gets whether the special drug criteria applies to undefined drugs","type":"boolean","x-nullable":true},"compoundLevelOfEffort":{"description":"Gets level of effort values applicable to the special drug criteria","type":"array","items":{"$ref":"#/definitions/LevelOfEffortModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true}}},"RuleOverrideNDCSpecificModel":{"description":"Rule Override NDC Specific","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"endProcessing":{"description":"Gets or sets whether more override rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"ruleOverride":{"$ref":"#/definitions/RuleOverrideModel","description":"Gets or sets the rule overrides associated with this rule claim override"},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"ndcListIsExclusion":{"description":"Gets or sets a value indicating whether the ndc list is treated as an exclusion list.  If this is true, ndcs in the list will be excluded from the rule; if false, only ndcs in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"ndCs":{"description":"Gets or sets the list of NDCs associated with the rule criteria.  These values can be posted/added at individual rule controllers, but should be patched at the RuleDrug endpoint - api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruledrugs/{id}.","type":"array","items":{"$ref":"#/definitions/RuleDrugModel"}}}},"RuleOverrideModel":{"description":"Rule Override","type":"object","properties":{"enforcePlanFormulary":{"description":"Gets or sets whether to allow plan formulary rules to cause a rejection","type":"boolean","x-nullable":true},"enforcePharmacyFormulary":{"description":"Gets or sets whether to enforce the plan formulary rule type if this rule is enforced","type":"boolean","x-nullable":true},"enforceMemberFormulary":{"description":"Gets or sets whether to enforce the member formulary rule type if this rule is enforced","type":"boolean","x-nullable":true},"enforcePrescriberFormulary":{"description":"Gets or sets whether to enforce the prescriber formulary rule type if this rule is enforced","type":"boolean","x-nullable":true},"enforceDAW":{"description":"Gets or sets whether to enforce DAW rule type if this rule is enforced","type":"boolean","x-nullable":true},"enforceStepTherapy":{"description":"Gets or sets whether to enforce the step therapy rule formulary if this rule is enforced","type":"boolean","x-nullable":true},"enforceQtyLimit":{"description":"Gets or sets whether to enforce quantity limits if this rule is enforced","type":"boolean","x-nullable":true},"enforceDaysSupplyLimit":{"description":"Gets or sets whether to enforce days supply limits if this rule is enforced","type":"boolean","x-nullable":true},"enforceRefillTooSoon":{"description":"Gets or sets whether to enforce refill to soon if this rule is enforced","type":"boolean","x-nullable":true},"enforceMaxFillsLimit":{"description":"Gets or sets whether to enforce max fill limits if this rule is enforced","type":"boolean","x-nullable":true},"enforceMaxPriceLimit":{"description":"Gets or sets to enforce max price limits if this rule is enforced","type":"boolean","x-nullable":true},"enforceAgeRestriction":{"description":"Gets or sets whether to enforce age restriction limits if this rule is enforced","type":"boolean","x-nullable":true},"enforceFinalFormulary":{"description":"Gets or sets whether to enforce final formulary if this rule is enforced","type":"boolean","x-nullable":true},"enforcePostPricing":{"description":"Gets or sets whether to enforce post pricing rule type if this rule is enforced","type":"boolean","x-nullable":true},"enforceRestrictedOverride":{"description":"Gets or sets whether to enforce restricted override rules","type":"boolean","x-nullable":true},"enforceRestrictedOverride2":{"description":"Gets or sets whether to enforce restricted override2 rules","type":"boolean","x-nullable":true},"enforceRestrictedOverride3":{"description":"Gets or sets whether to enforce restricted override3 rules","type":"boolean","x-nullable":true},"enforceRestrictedOverride4":{"description":"Gets or sets whether to enforce restricted override4 rules","type":"boolean","x-nullable":true},"enforceFormularyNotCovered":{"description":"Gets or sets whether to enforce formulary not covered limits","type":"boolean","x-nullable":true},"enforceFormularyAgeLimit":{"description":"Gets or sets whether to enforce formulary age limits","type":"boolean","x-nullable":true},"enforceFormularyGenderLimit":{"description":"Gets or sets whether to enforce formulary gender limits","type":"boolean","x-nullable":true},"enforceFormularyQtyLimit":{"description":"Gets or sets whether to enforce formulary quantity limits","type":"boolean","x-nullable":true},"enforceFormularyStepMed":{"description":"Gets or sets whether to enforce formulary step med limits","type":"boolean","x-nullable":true},"enforceFormularyPriorAuth":{"description":"Gets or sets whether to enforce formulary prior auth limits","type":"boolean","x-nullable":true},"enforceFormularyDiagnosisCodeLimit":{"description":"Gets or sets whether to enforce formulary diagnosis code limits","type":"boolean","x-nullable":true},"maxPrice":{"format":"double","description":"Gets or sets whether to enforce max price if this rule is enforced","type":"number","x-nullable":true}}},"RuleOverrideStandardModel":{"description":"Rule Override Standard","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"endProcessing":{"description":"Gets or sets whether more override rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"ruleOverride":{"$ref":"#/definitions/RuleOverrideModel","description":"Gets or sets the rule override values"},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"isBrand":{"description":"Gets or sets whether the drug criteria is based on brand","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets whether the drug criteria is for prescription only (non-OTC)","type":"boolean","x-nullable":true},"isMultiSourced":{"description":"Gets or sets whether the drug criteria is based on multi-source","type":"boolean","x-nullable":true},"isRepackaged":{"description":"Gets or sets whether the drug criteria is based on repackaged value","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets whether the drug criteria applies if a generic is available","type":"boolean","x-nullable":true},"otcAvailable":{"description":"Gets or sets whether the drug criteria applies if an OTC is available","type":"boolean","x-nullable":true},"isMaintenanceDrug":{"description":"Gets or sets whether the drug criteria applies to maintenance drug","type":"boolean","x-nullable":true},"deaClassCodes":{"description":"Gets or sets the applicable DEA schedules for the drug criteria","type":"array","items":{"$ref":"#/definitions/DEAScheduleModel"}},"brandNameCodes":{"description":"Gets or sets the applicable brand codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/BrandNameCodeModel"}},"multiSourceCodes":{"description":"Gets or sets the applicable multi-source codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}},"rX_OTCIndicatorCodes":{"description":"Gets or sets the applicable Rx-OTC Indicator codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/RX_OTCIndicatorCodeModel"}},"includeCustomDrugs":{"description":"Gets or sets whether the drug criteria applies to custom drugs","type":"boolean","x-nullable":true},"gpiListIsExclusion":{"description":"Gets or sets whether the drug criteria GPI list is excluded","type":"boolean","x-nullable":true},"drugProfileListIsExclusion":{"description":"Gets or sets whether the drug criteria drug profile list is excluded","type":"boolean","x-nullable":true},"gpIs":{"description":"Gets or sets the list of GPIs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleGPIModel"}},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"roAs":{"description":"Gets or sets the list of ROAs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleROAModel"}},"dosageForms":{"description":"Gets or sets the dosage forms associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleDosageFormModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"drugProfiles":{"description":"Gets or Sets a a list of which drug profiles are associated with this rule","type":"array","items":{"$ref":"#/definitions/RuleDrugProfileModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true}}},"RuleOverrideSpecialDrugModel":{"description":"Rule Override Special Drug","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"endProcessing":{"description":"Gets or sets whether more override rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"ruleOverride":{"$ref":"#/definitions/RuleOverrideModel","description":"Gets or sets the rule overrides associated with this rule claim override"},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"compoundDrugs":{"description":"Gets whether the special drug criteria applies to compound drugs","type":"boolean","x-nullable":true},"unknownDrugs":{"description":"Gets whether the special drug criteria applies to unknown drugs","type":"boolean","x-nullable":true},"undefinedDrugs":{"description":"Gets whether the special drug criteria applies to undefined drugs","type":"boolean","x-nullable":true},"compoundLevelOfEffort":{"description":"Gets level of effort values applicable to the special drug criteria","type":"array","items":{"$ref":"#/definitions/LevelOfEffortModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true}}},"RulePharmacyFormularyModel":{"description":"Rule Pharmacy Formulary Model","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"alternatePricingGroupUrl":{"description":"Gets or sets the link to the alternate pricing group used by this rule","type":"string"},"alternatePricingGroupNo":{"format":"int64","description":"Gets or sets the identifier to the alternate pricing group","type":"integer","x-nullable":true},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"enforcePlanFormulary":{"description":"Gets or sets whether to allow plan formulary rules to cause a rejection","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"isBrand":{"description":"Gets or sets whether the drug criteria is based on brand","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets whether the drug criteria is for prescription only (non-OTC)","type":"boolean","x-nullable":true},"isMultiSourced":{"description":"Gets or sets whether the drug criteria is based on multi-source","type":"boolean","x-nullable":true},"isRepackaged":{"description":"Gets or sets whether the drug criteria is based on repackaged value","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets whether the drug criteria applies if a generic is available","type":"boolean","x-nullable":true},"otcAvailable":{"description":"Gets or sets whether the drug criteria applies if an OTC is available","type":"boolean","x-nullable":true},"isMaintenanceDrug":{"description":"Gets or sets whether the drug criteria applies to maintenance drug","type":"boolean","x-nullable":true},"deaClassCodes":{"description":"Gets or sets the applicable DEA schedules for the drug criteria","type":"array","items":{"$ref":"#/definitions/DEAScheduleModel"}},"brandNameCodes":{"description":"Gets or sets the applicable brand codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/BrandNameCodeModel"}},"multiSourceCodes":{"description":"Gets or sets the applicable multi-source codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}},"rX_OTCIndicatorCodes":{"description":"Gets or sets the applicable Rx-OTC Indicator codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/RX_OTCIndicatorCodeModel"}},"includeCustomDrugs":{"description":"Gets or sets whether the drug criteria applies to custom drugs","type":"boolean","x-nullable":true},"gpiListIsExclusion":{"description":"Gets or sets whether the drug criteria GPI list is excluded","type":"boolean","x-nullable":true},"drugProfileListIsExclusion":{"description":"Gets or sets whether the drug criteria drug profile list is excluded","type":"boolean","x-nullable":true},"gpIs":{"description":"Gets or sets the list of GPIs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleGPIModel"}},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"roAs":{"description":"Gets or sets the list of ROAs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleROAModel"}},"dosageForms":{"description":"Gets or sets the dosage forms associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleDosageFormModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"drugProfiles":{"description":"Gets or Sets a a list of which drug profiles are associated with this rule","type":"array","items":{"$ref":"#/definitions/RuleDrugProfileModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true}}},"RulePharmacyFormularyNDCSpecificModel":{"description":"Rule Pharmacy Formulary NDC Specific Model","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"alternatePricingGroupUrl":{"description":"Gets or sets the link to the alternate pricing group used by this rule","type":"string"},"alternatePricingGroupNo":{"format":"int64","description":"Gets or sets the identifier to the alternate pricing group","type":"integer","x-nullable":true},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"enforcePlanFormulary":{"description":"Gets or sets whether to allow plan formulary rules to cause a rejection","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"ndcListIsExclusion":{"description":"Gets or sets a value indicating whether the ndc list is treated as an exclusion list.  If this is true, ndcs in the list will be excluded from the rule; if false, only ndcs in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"ndCs":{"description":"Gets or sets the list of NDCs associated with the rule criteria.  These values can be posted/added at individual rule controllers, but should be patched at the RuleDrug endpoint - api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruledrugs/{id}.","type":"array","items":{"$ref":"#/definitions/RuleDrugModel"}}}},"RulePharmacyFormularySpecialDrugModel":{"description":"Rule Pharmacy Formulary Special Drug","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"enforcePlanFormulary":{"description":"Gets or sets whether to allow plan formulary rules to cause a rejection","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"compoundDrugs":{"description":"Gets whether the special drug criteria applies to compound drugs","type":"boolean","x-nullable":true},"unknownDrugs":{"description":"Gets whether the special drug criteria applies to unknown drugs","type":"boolean","x-nullable":true},"undefinedDrugs":{"description":"Gets whether the special drug criteria applies to undefined drugs","type":"boolean","x-nullable":true},"compoundLevelOfEffort":{"description":"Gets level of effort values applicable to the special drug criteria","type":"array","items":{"$ref":"#/definitions/LevelOfEffortModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true}}},"RulePlanFormularyModel":{"description":"Rule Plan Formulary","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"alternatePricingGroupUrl":{"description":"Gets or sets the link to the alternate pricing group used by this rule","type":"string"},"alternatePricingGroupNo":{"format":"int64","description":"Gets or sets the identifier to the alternate pricing group","type":"integer","x-nullable":true},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"isBrand":{"description":"Gets or sets whether the drug criteria is based on brand","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets whether the drug criteria is for prescription only (non-OTC)","type":"boolean","x-nullable":true},"isMultiSourced":{"description":"Gets or sets whether the drug criteria is based on multi-source","type":"boolean","x-nullable":true},"isRepackaged":{"description":"Gets or sets whether the drug criteria is based on repackaged value","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets whether the drug criteria applies if a generic is available","type":"boolean","x-nullable":true},"otcAvailable":{"description":"Gets or sets whether the drug criteria applies if an OTC is available","type":"boolean","x-nullable":true},"isMaintenanceDrug":{"description":"Gets or sets whether the drug criteria applies to maintenance drug","type":"boolean","x-nullable":true},"deaClassCodes":{"description":"Gets or sets the applicable DEA schedules for the drug criteria","type":"array","items":{"$ref":"#/definitions/DEAScheduleModel"}},"brandNameCodes":{"description":"Gets or sets the applicable brand codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/BrandNameCodeModel"}},"multiSourceCodes":{"description":"Gets or sets the applicable multi-source codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}},"rX_OTCIndicatorCodes":{"description":"Gets or sets the applicable Rx-OTC Indicator codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/RX_OTCIndicatorCodeModel"}},"includeCustomDrugs":{"description":"Gets or sets whether the drug criteria applies to custom drugs","type":"boolean","x-nullable":true},"gpiListIsExclusion":{"description":"Gets or sets whether the drug criteria GPI list is excluded","type":"boolean","x-nullable":true},"drugProfileListIsExclusion":{"description":"Gets or sets whether the drug criteria drug profile list is excluded","type":"boolean","x-nullable":true},"gpIs":{"description":"Gets or sets the list of GPIs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleGPIModel"}},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"roAs":{"description":"Gets or sets the list of ROAs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleROAModel"}},"dosageForms":{"description":"Gets or sets the dosage forms associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleDosageFormModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"drugProfiles":{"description":"Gets or Sets a a list of which drug profiles are associated with this rule","type":"array","items":{"$ref":"#/definitions/RuleDrugProfileModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true}}},"RulePlanFormularyNDCSpecificModel":{"description":"Rule Plan Formulary NDC Specific","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"alternatePricingGroupUrl":{"description":"Gets or sets the link to the alternate pricing group used by this rule","type":"string"},"alternatePricingGroupNo":{"format":"int64","description":"Gets or sets the identifier to the alternate pricing group","type":"integer","x-nullable":true},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"ndcListIsExclusion":{"description":"Gets or sets a value indicating whether the ndc list is treated as an exclusion list.  If this is true, ndcs in the list will be excluded from the rule; if false, only ndcs in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"ndCs":{"description":"Gets or sets the list of NDCs associated with the rule criteria.  These values can be posted/added at individual rule controllers, but should be patched at the RuleDrug endpoint - api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruledrugs/{id}.","type":"array","items":{"$ref":"#/definitions/RuleDrugModel"}}}},"RulePlanFormularySpecialDrugModel":{"description":"Rule Plan Formulary Special Drug","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"compoundDrugs":{"description":"Gets whether the special drug criteria applies to compound drugs","type":"boolean","x-nullable":true},"unknownDrugs":{"description":"Gets whether the special drug criteria applies to unknown drugs","type":"boolean","x-nullable":true},"undefinedDrugs":{"description":"Gets whether the special drug criteria applies to undefined drugs","type":"boolean","x-nullable":true},"compoundLevelOfEffort":{"description":"Gets level of effort values applicable to the special drug criteria","type":"array","items":{"$ref":"#/definitions/LevelOfEffortModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true}}},"RulePostPricingNDCSpecificModel":{"description":"Rule Post Pricing NDC Specific","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"pharmacyPriceMin":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceMax":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPricePreTax":{"description":"Gets or sets the option for whether the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsMin":{"format":"double","description":"Gets or sets the minimum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsMax":{"format":"double","description":"Gets or sets the maximum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsPreTax":{"description":"Gets or sets the option for whether the cents portion of the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"planPaidMin":{"format":"double","description":"Gets or sets the minimum plan paid amount in order for the rule to apply","type":"number","x-nullable":true},"planPaidMax":{"format":"double","description":"Gets or sets the maximum plan paid amount in order for the rule to apply","type":"number","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"stepTherapy":{"description":"Gets or sets whether the rule applies to step therapy medication","type":"boolean","x-nullable":true},"drugSelectionPenaltyUsed":{"description":"Gets or sets whether the rule applies to claims where a drug penalty has been applied","type":"boolean","x-nullable":true},"planBenefitLimitExceeded":{"description":"Gets or sets whether the rule applies to claims when the plan benefit limit is exceeded","type":"boolean","x-nullable":true},"deductibleMet":{"description":"Gets or sets whether the rule applies to claims based on whether the deductible is met","type":"boolean","x-nullable":true},"outOfPocketLimitMet":{"description":"Gets or sets whether the rule applies to claims based on whether the OOP is met","type":"boolean","x-nullable":true},"isExemptFromDeductible":{"description":"Gets or sets whether the rule applies to claims based on whether the deductible is exempt","type":"boolean","x-nullable":true},"isExemptFromOutOfPocketLimit":{"description":"Gets or sets whether the rule applies to claims based on whether the OOP is exempt","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"ndcListIsExclusion":{"description":"Gets or sets a value indicating whether the ndc list is treated as an exclusion list.  If this is true, ndcs in the list will be excluded from the rule; if false, only ndcs in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"priorFillsPharmacyPriceMin":{"format":"double","description":"Gets or set the prior fills pharmacy price min","type":"number","x-nullable":true},"priorFillsPharmacyPriceMax":{"format":"double","description":"Gets or sets the prior fills pharmacy price max","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMin":{"format":"double","description":"Gets or sets the prior fills pharmacy price per day supply min","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMax":{"format":"double","description":"gets or sets the prior fills pharmacy price per day supply max","type":"number","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"ndCs":{"description":"Gets or sets the list of NDCs associated with the rule criteria.  These values can be posted/added at individual rule controllers, but should be patched at the RuleDrug endpoint - api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruledrugs/{id}.","type":"array","items":{"$ref":"#/definitions/RuleDrugModel"}}}},"RulePostPricingModel":{"description":"Rule Post Pricing","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"pharmacyPriceMin":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceMax":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPricePreTax":{"description":"Gets or sets the option for whether the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsMin":{"format":"double","description":"Gets or sets the minimum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsMax":{"format":"double","description":"Gets or sets the maximum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsPreTax":{"description":"Gets or sets the option for whether the cents portion of the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"planPaidMin":{"format":"double","description":"Gets or sets the minimum plan paid amount in order for the rule to apply","type":"number","x-nullable":true},"planPaidMax":{"format":"double","description":"Gets or sets the maximum plan paid amount in order for the rule to apply","type":"number","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"stepTherapy":{"description":"Gets or sets whether the rule applies to step therapy medication","type":"boolean","x-nullable":true},"drugSelectionPenaltyUsed":{"description":"Gets or sets whether the rule applies to claims where a drug penalty has been applied","type":"boolean","x-nullable":true},"planBenefitLimitExceeded":{"description":"Gets or sets whether the rule applies to claims when the plan benefit limit is exceeded","type":"boolean","x-nullable":true},"deductibleMet":{"description":"Gets or sets whether the rule applies to claims based on whether the deductible is met","type":"boolean","x-nullable":true},"outOfPocketLimitMet":{"description":"Gets or sets whether the rule applies to claims based on whether the OOP is met","type":"boolean","x-nullable":true},"isExemptFromDeductible":{"description":"Gets or sets whether the rule applies to claims based on whether the deductible is exempt","type":"boolean","x-nullable":true},"isExemptFromOutOfPocketLimit":{"description":"Gets or sets whether the rule applies to claims based on whether the OOP is exempt","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"priorFillsPharmacyPriceMin":{"format":"double","description":"Gets or set the prior fills pharmacy price min","type":"number","x-nullable":true},"priorFillsPharmacyPriceMax":{"format":"double","description":"Gets or sets the prior fills pharmacy price max","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMin":{"format":"double","description":"Gets or sets the prior fills pharmacy price per day supply min","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMax":{"format":"double","description":"gets or sets the prior fills pharmacy price per day supply max","type":"number","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"isBrand":{"description":"Gets or sets whether the drug criteria is based on brand","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets whether the drug criteria is for prescription only (non-OTC)","type":"boolean","x-nullable":true},"isMultiSourced":{"description":"Gets or sets whether the drug criteria is based on multi-source","type":"boolean","x-nullable":true},"isRepackaged":{"description":"Gets or sets whether the drug criteria is based on repackaged value","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets whether the drug criteria applies if a generic is available","type":"boolean","x-nullable":true},"otcAvailable":{"description":"Gets or sets whether the drug criteria applies if an OTC is available","type":"boolean","x-nullable":true},"isMaintenanceDrug":{"description":"Gets or sets whether the drug criteria applies to maintenance drug","type":"boolean","x-nullable":true},"deaClassCodes":{"description":"Gets or sets the applicable DEA schedules for the drug criteria","type":"array","items":{"$ref":"#/definitions/DEAScheduleModel"}},"brandNameCodes":{"description":"Gets or sets the applicable brand codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/BrandNameCodeModel"}},"multiSourceCodes":{"description":"Gets or sets the applicable multi-source codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}},"rX_OTCIndicatorCodes":{"description":"Gets or sets the applicable Rx-OTC Indicator codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/RX_OTCIndicatorCodeModel"}},"includeCustomDrugs":{"description":"Gets or sets whether the drug criteria applies to custom drugs","type":"boolean","x-nullable":true},"gpiListIsExclusion":{"description":"Gets or sets whether the drug criteria GPI list is excluded","type":"boolean","x-nullable":true},"drugProfileListIsExclusion":{"description":"Gets or sets whether the drug criteria drug profile list is excluded","type":"boolean","x-nullable":true},"gpIs":{"description":"Gets or sets the list of GPIs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleGPIModel"}},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"roAs":{"description":"Gets or sets the list of ROAs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleROAModel"}},"dosageForms":{"description":"Gets or sets the dosage forms associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleDosageFormModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"drugProfiles":{"description":"Gets or Sets a a list of which drug profiles are associated with this rule","type":"array","items":{"$ref":"#/definitions/RuleDrugProfileModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true}}},"RulePostPricingSpecialDrugModel":{"description":"Rule Post Pricing Special Drug","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"pharmacyPriceMin":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceMax":{"format":"double","description":"Gets or sets the minimum pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPricePreTax":{"description":"Gets or sets the option for whether the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"pharmacyPriceCentsMin":{"format":"double","description":"Gets or sets the minimum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsMax":{"format":"double","description":"Gets or sets the maximum cents portion of the pharmacy price in order for the rule to apply","type":"number","x-nullable":true},"pharmacyPriceCentsPreTax":{"description":"Gets or sets the option for whether the cents portion of the pharmacy price range is the pre-tax amount","type":"boolean","x-nullable":true},"planPaidMin":{"format":"double","description":"Gets or sets the minimum plan paid amount in order for the rule to apply","type":"number","x-nullable":true},"planPaidMax":{"format":"double","description":"Gets or sets the maximum plan paid amount in order for the rule to apply","type":"number","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"planBenefitLimitExceeded":{"description":"Gets or sets whether the rule applies to claims when the plan benefit limit is exceeded","type":"boolean","x-nullable":true},"deductibleMet":{"description":"Gets or sets whether the rule applies to claims based on whether the deductible is met","type":"boolean","x-nullable":true},"outOfPocketLimitMet":{"description":"Gets or sets whether the rule applies to claims based on whether the OOP is met","type":"boolean","x-nullable":true},"isExemptFromDeductible":{"description":"Gets or sets whether the rule applies to claims based on whether the deductible is exempt","type":"boolean","x-nullable":true},"isExemptFromOutOfPocketLimit":{"description":"Gets or sets whether the rule applies to claims based on whether the OOP is exempt","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"priorFillsPharmacyPriceMin":{"format":"double","description":"Gets or set the prior fills pharmacy price min","type":"number","x-nullable":true},"priorFillsPharmacyPriceMax":{"format":"double","description":"Gets or sets the prior fills pharmacy price max","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMin":{"format":"double","description":"Gets or sets the prior fills pharmacy price per day supply min","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMax":{"format":"double","description":"gets or sets the prior fills pharmacy price per day supply max","type":"number","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"compoundDrugs":{"description":"Gets whether the special drug criteria applies to compound drugs","type":"boolean","x-nullable":true},"unknownDrugs":{"description":"Gets whether the special drug criteria applies to unknown drugs","type":"boolean","x-nullable":true},"undefinedDrugs":{"description":"Gets whether the special drug criteria applies to undefined drugs","type":"boolean","x-nullable":true},"compoundLevelOfEffort":{"description":"Gets level of effort values applicable to the special drug criteria","type":"array","items":{"$ref":"#/definitions/LevelOfEffortModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true}}},"RulePrerequisiteDrugModel":{"description":"Rule Prerequisite Drug","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule prerequisite","type":"integer"},"ndc":{"description":"Gets or sets the prequisite NDC associated with this rule","type":"string"}}},"RulePrerequisiteGPIModel":{"description":"Rule Prerequisite GPI","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleNo":{"format":"int64","description":"Gets or sets the rule identifier associated with this rule GPI","type":"integer"},"genericProductIdentifier":{"description":"Gets or sets the prequisite GPI associated with this rule","type":"string"},"isBrand":{"description":"Gets or sets whether the prequisite GPI is brand","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets whether the prequisite GPI criteria is prescription only (non-OTC)","type":"boolean","x-nullable":true}}},"RulePrescriberFormularyModel":{"description":"Rule Prescriber Formulary","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"alternatePricingGroupUrl":{"description":"Gets or sets the link to the alternate pricing group used by this rule","type":"string"},"alternatePricingGroupNo":{"format":"int64","description":"Gets or sets the identifier to the alternate pricing group","type":"integer","x-nullable":true},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"enforcePlanFormulary":{"description":"Gets or sets whether to allow plan formulary rules to cause a rejection","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"isBrand":{"description":"Gets or sets whether the drug criteria is based on brand","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets whether the drug criteria is for prescription only (non-OTC)","type":"boolean","x-nullable":true},"isMultiSourced":{"description":"Gets or sets whether the drug criteria is based on multi-source","type":"boolean","x-nullable":true},"isRepackaged":{"description":"Gets or sets whether the drug criteria is based on repackaged value","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets whether the drug criteria applies if a generic is available","type":"boolean","x-nullable":true},"otcAvailable":{"description":"Gets or sets whether the drug criteria applies if an OTC is available","type":"boolean","x-nullable":true},"isMaintenanceDrug":{"description":"Gets or sets whether the drug criteria applies to maintenance drug","type":"boolean","x-nullable":true},"deaClassCodes":{"description":"Gets or sets the applicable DEA schedules for the drug criteria","type":"array","items":{"$ref":"#/definitions/DEAScheduleModel"}},"brandNameCodes":{"description":"Gets or sets the applicable brand codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/BrandNameCodeModel"}},"multiSourceCodes":{"description":"Gets or sets the applicable multi-source codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}},"rX_OTCIndicatorCodes":{"description":"Gets or sets the applicable Rx-OTC Indicator codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/RX_OTCIndicatorCodeModel"}},"includeCustomDrugs":{"description":"Gets or sets whether the drug criteria applies to custom drugs","type":"boolean","x-nullable":true},"gpiListIsExclusion":{"description":"Gets or sets whether the drug criteria GPI list is excluded","type":"boolean","x-nullable":true},"drugProfileListIsExclusion":{"description":"Gets or sets whether the drug criteria drug profile list is excluded","type":"boolean","x-nullable":true},"gpIs":{"description":"Gets or sets the list of GPIs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleGPIModel"}},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"roAs":{"description":"Gets or sets the list of ROAs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleROAModel"}},"dosageForms":{"description":"Gets or sets the dosage forms associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleDosageFormModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"drugProfiles":{"description":"Gets or Sets a a list of which drug profiles are associated with this rule","type":"array","items":{"$ref":"#/definitions/RuleDrugProfileModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true}}},"RulePrescriberFormularyNDCSpecificModel":{"description":"Rule Prescriber Formulary NDC Specific","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"alternatePricingGroupUrl":{"description":"Gets or sets the link to the alternate pricing group used by this rule","type":"string"},"alternatePricingGroupNo":{"format":"int64","description":"Gets or sets the identifier to the alternate pricing group","type":"integer","x-nullable":true},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"enforcePlanFormulary":{"description":"Gets or sets whether to allow plan formulary rules to cause a rejection","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"ndcListIsExclusion":{"description":"Gets or sets a value indicating whether the ndc list is treated as an exclusion list.  If this is true, ndcs in the list will be excluded from the rule; if false, only ndcs in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"ndCs":{"description":"Gets or sets the list of NDCs associated with the rule criteria.  These values can be posted/added at individual rule controllers, but should be patched at the RuleDrug endpoint - api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruledrugs/{id}.","type":"array","items":{"$ref":"#/definitions/RuleDrugModel"}}}},"RuleRejectCodeModel":{"type":"object","properties":{"code":{"description":"Gets or sets Reject Code","type":"string"},"description":{"description":"Gets or sets the description of the Reject Code","type":"string"}}},"RuleStandardFormularyModel":{"description":"Rule Standard Formulary","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the action to be performed if all rule criteria is met","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"alternatePricingGroupUrl":{"description":"Gets or sets the link to the alternate pricing group used by this rule","type":"string"},"alternatePricingGroupNo":{"format":"int64","description":"Gets or sets the identifier to the alternate pricing group","type":"integer","x-nullable":true},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"aciOverride":{"format":"double","description":"Gets or sets the ACI Override price","type":"number","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"priorFillsPharmacyPriceMin":{"format":"double","description":"Gets or set the prior fills pharmacy price min","type":"number","x-nullable":true},"priorFillsPharmacyPriceMax":{"format":"double","description":"Gets or sets the prior fills pharmacy price max","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMin":{"format":"double","description":"Gets or sets the prior fills pharmacy price per day supply min","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMax":{"format":"double","description":"gets or sets the prior fills pharmacy price per day supply max","type":"number","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"isBrand":{"description":"Gets or sets whether the drug criteria is based on brand","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets whether the drug criteria is for prescription only (non-OTC)","type":"boolean","x-nullable":true},"isMultiSourced":{"description":"Gets or sets whether the drug criteria is based on multi-source","type":"boolean","x-nullable":true},"isRepackaged":{"description":"Gets or sets whether the drug criteria is based on repackaged value","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets whether the drug criteria applies if a generic is available","type":"boolean","x-nullable":true},"otcAvailable":{"description":"Gets or sets whether the drug criteria applies if an OTC is available","type":"boolean","x-nullable":true},"isMaintenanceDrug":{"description":"Gets or sets whether the drug criteria applies to maintenance drug","type":"boolean","x-nullable":true},"deaClassCodes":{"description":"Gets or sets the applicable DEA schedules for the drug criteria","type":"array","items":{"$ref":"#/definitions/DEAScheduleModel"}},"brandNameCodes":{"description":"Gets or sets the applicable brand codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/BrandNameCodeModel"}},"multiSourceCodes":{"description":"Gets or sets the applicable multi-source codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}},"rX_OTCIndicatorCodes":{"description":"Gets or sets the applicable Rx-OTC Indicator codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/RX_OTCIndicatorCodeModel"}},"includeCustomDrugs":{"description":"Gets or sets whether the drug criteria applies to custom drugs","type":"boolean","x-nullable":true},"gpiListIsExclusion":{"description":"Gets or sets whether the drug criteria GPI list is excluded","type":"boolean","x-nullable":true},"drugProfileListIsExclusion":{"description":"Gets or sets whether the drug criteria drug profile list is excluded","type":"boolean","x-nullable":true},"gpIs":{"description":"Gets or sets the list of GPIs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleGPIModel"}},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"roAs":{"description":"Gets or sets the list of ROAs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleROAModel"}},"dosageForms":{"description":"Gets or sets the dosage forms associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleDosageFormModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"drugProfiles":{"description":"Gets or Sets a a list of which drug profiles are associated with this rule","type":"array","items":{"$ref":"#/definitions/RuleDrugProfileModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true}}},"Rule":{"type":"object","properties":{"planID":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000"},"ruleTypeID":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000"},"byNDC":{"type":"boolean","x-nullable":true},"newStartDrug":{"type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"type":"boolean","x-nullable":true},"description":{"type":"string"},"priority":{"format":"int32","type":"integer","x-nullable":true},"ruleActionTypeID":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000"},"alternatePricingGroupID":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"message":{"type":"string"},"onPlan":{"type":"boolean","x-nullable":true},"onFormulary":{"type":"boolean","x-nullable":true},"inCompound":{"type":"boolean","x-nullable":true},"compoundDrugs":{"type":"boolean","x-nullable":true},"unknownDrugs":{"type":"boolean","x-nullable":true},"undefinedDrugs":{"type":"boolean","x-nullable":true},"memberGender":{"type":"string"},"levelOfEffort":{"type":"string"},"endProcessing":{"type":"boolean","x-nullable":true},"active":{"type":"boolean","x-nullable":true},"effectiveStartDate":{"format":"date-time","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","type":"string","x-nullable":true},"quantityMin":{"format":"double","type":"number","x-nullable":true},"quantityMax":{"format":"double","type":"number","x-nullable":true},"daysSupplyMin":{"format":"int32","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","type":"integer","x-nullable":true},"shortCycle":{"type":"boolean","x-nullable":true},"submissionClarificationCodeCriteriaType":{"type":"string"},"pharmacyServiceType":{"type":"string"},"pharmacyServiceTypeCriteriaType":{"type":"string"},"patientResidence":{"type":"string"},"patientResidenceCriteriaType":{"type":"string"},"placeOfService":{"type":"string"},"placeOfServiceCriteriaType":{"type":"string"},"serviceCategory":{"type":"string"},"newDrug":{"type":"boolean","x-nullable":true},"isTemplate":{"type":"boolean","x-nullable":true},"stepTherapy":{"type":"boolean","x-nullable":true},"enforcePlanFormulary":{"type":"boolean","x-nullable":true},"referenceCode":{"type":"string"},"rxExpired":{"type":"boolean","x-nullable":true},"claimTagItemID1":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"claimTagItemID2":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"claimTagItemID3":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"dawCode":{"type":"string"},"dependentRelationshipCode":{"type":"string"},"memberAgeMin":{"format":"int32","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","type":"integer","x-nullable":true},"memberAgeUnits":{"type":"string"},"rxFirstFill":{"type":"boolean","x-nullable":true},"overridingRuleID":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"overridingRuleActive":{"type":"boolean"},"pharmacyPriceMin":{"format":"double","type":"number","x-nullable":true},"pharmacyPriceMax":{"format":"double","type":"number","x-nullable":true},"drugSelectionPenaltyUsed":{"type":"boolean","x-nullable":true},"seqNo":{"format":"int64","type":"integer"},"benefitCodeID":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"pharmacyPriceCentsMin":{"format":"double","type":"number","x-nullable":true},"pharmacyPriceCentsMax":{"format":"double","type":"number","x-nullable":true},"pharmacyPriceCentsPreTax":{"type":"boolean","x-nullable":true},"pharmacyPricePreTax":{"type":"boolean","x-nullable":true},"pharmacyRelationshipCodeCriteriaType":{"type":"string"},"genericCostExceedsBrand":{"type":"boolean","x-nullable":true},"scheduleID":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"scheduleException":{"type":"boolean","x-nullable":true},"priorFillsMin":{"format":"int32","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","type":"integer","x-nullable":true},"priorFillsDrugProfileID":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"priorFillsPharmacyProfileID":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"priorFillsByRxNumber":{"type":"boolean","x-nullable":true},"priorFillsGPIChars":{"type":"string"},"priorFillsByNDC":{"type":"boolean","x-nullable":true},"priorFillsBysSpecialDrugType":{"type":"boolean","x-nullable":true},"rejectCode":{"type":"string"},"isSpecialty":{"type":"boolean","x-nullable":true},"priorFillsStartDate":{"format":"date-time","type":"string","x-nullable":true},"onCostcoJSONAWP":{"type":"boolean","x-nullable":true},"onCostcoJSONMAC":{"type":"boolean","x-nullable":true},"variableCopayCouponExists":{"type":"boolean","x-nullable":true},"isPrimaryClaim":{"type":"boolean","x-nullable":true},"isSecondaryClaimAsPrimary":{"type":"boolean","x-nullable":true},"priorFillsLimitToCurrentPeriod":{"type":"boolean","x-nullable":true},"createIssueTrackerTicket":{"type":"boolean","x-nullable":true},"issueProfileID":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"diagnosisCodeCriteriaType":{"type":"string"},"formularyNotCoveredException":{"type":"boolean","x-nullable":true},"formularyAgeLimitException":{"type":"boolean","x-nullable":true},"formularyGenderLimitException":{"type":"boolean","x-nullable":true},"formularyQtyLimitException":{"type":"boolean","x-nullable":true},"formularyStepMedException":{"type":"boolean","x-nullable":true},"formularyPriorAuthException":{"type":"boolean","x-nullable":true},"responseTimeException":{"type":"boolean","x-nullable":true},"pharmacyPriceAddProcFee":{"type":"boolean","x-nullable":true},"pharmacyPriceCentsAddProcFee":{"type":"boolean","x-nullable":true},"dawEnforceRule":{"type":"boolean","x-nullable":true},"onCostcoJSONProcessorFee":{"type":"boolean","x-nullable":true},"ndcListIsExclusion":{"type":"boolean","x-nullable":true},"submissionClarificationCodeLimit":{"format":"int32","type":"integer","x-nullable":true},"priorFillsPharmacyPriceMin":{"format":"double","type":"number","x-nullable":true},"priorFillsPharmacyPriceMax":{"format":"double","type":"number","x-nullable":true},"pharmacyHeadquarterListIsExclusion":{"type":"boolean","x-nullable":true},"memberListIsExclusion":{"type":"boolean","x-nullable":true},"priorFillsPricePerDaySupplyMin":{"format":"double","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMax":{"format":"double","type":"number","x-nullable":true},"formularyDiagnosisCodeLimitException":{"type":"boolean","x-nullable":true},"otherCoverageCodeCriteriaType":{"type":"string"},"pharmacyListIsExclusion":{"type":"boolean","x-nullable":true},"prescriberListIsExclusion":{"type":"boolean","x-nullable":true},"pharmacyProfileListIsExclusion":{"type":"boolean","x-nullable":true},"otherPayerIDQualifierCriteriaType":{"type":"string"},"memberProfileListIsExclusion":{"type":"boolean","x-nullable":true},"memberDxCodeCriteriaType":{"type":"string"},"isPrescriberOutOfNetwork":{"type":"boolean","x-nullable":true},"hasLetterOfMedicalNecessity":{"type":"boolean","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","type":"integer","x-nullable":true},"basisOfCostCriteriaType":{"type":"string"},"internalNote":{"type":"string"},"priorFillsByPharmacy":{"type":"boolean","x-nullable":true},"createdOn":{"format":"date-time","type":"string","x-nullable":true},"createdBy":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"changedOn":{"format":"date-time","type":"string","x-nullable":true},"changedBy":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"changedAt":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000","x-nullable":true},"id":{"format":"uuid","type":"string","example":"00000000-0000-0000-0000-000000000000"},"isNewRecord":{"type":"boolean"}}},"RuleStandardFormularyNDCSpecificModel":{"description":"Rule Standard Formulary NDC Specific","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"alternatePricingGroupUrl":{"description":"Gets or sets the link to the alternate pricing group used by this rule","type":"string"},"alternatePricingGroupNo":{"format":"int64","description":"Gets or sets the identifier to the alternate pricing group","type":"integer","x-nullable":true},"endProcessing":{"description":"Gets or sets whether more benefit rules are processed if all criteria has been met","type":"boolean","x-nullable":true},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"aciOverride":{"format":"double","description":"Gets or sets the ACI Override price","type":"number","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"prescribers":{"description":"Gets or sets prescribers for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePrescriberModel"}},"prescriberListIsExclusion":{"description":"Gets or sets a value indicating whether the prescriber list is treated as an exclusion list.  If this is true, prescribers in the list will be excluded from the rule; if false, only prescribers in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"ndcListIsExclusion":{"description":"Gets or sets a value indicating whether the ndc list is treated as an exclusion list.  If this is true, ndcs in the list will be excluded from the rule; if false, only ndcs in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"priorFillsPharmacyPriceMin":{"format":"double","description":"Gets or set the prior fills pharmacy price min","type":"number","x-nullable":true},"priorFillsPharmacyPriceMax":{"format":"double","description":"Gets or sets the prior fills pharmacy price max","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMin":{"format":"double","description":"Gets or sets the prior fills pharmacy price per day supply min","type":"number","x-nullable":true},"priorFillsPricePerDaySupplyMax":{"format":"double","description":"gets or sets the prior fills pharmacy price per day supply max","type":"number","x-nullable":true},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"ndCs":{"description":"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}.","type":"array","items":{"$ref":"#/definitions/RuleDrugModel"}}}},"RuleStepTherapyModel":{"description":"Rule Step Therapy","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"stepTherapyByDrugName":{"description":"Gets or sets whether to group by drug name (10 digit GPI level) when requiring more than one drug\r\n*DEPRECATED - will be removed at a later date","type":"boolean","x-nullable":true},"stepTherapyGPIChars":{"description":"Gets or sets the GPI Level for drug name when requiring more than one drug","type":"string"},"stepTherapyNumberOfDays":{"format":"int32","description":"Gets or sets the number of days to look back for fills (blank for all fills)","type":"integer","x-nullable":true},"prerequisiteDrugsRequired":{"format":"int32","description":"Gets or sets the number of prerequisite drugs required","type":"integer","x-nullable":true},"gpiListIndividualDrugs":{"description":"Gets or sets whether each entry in the Prerequisite GPI List counts as a single drug","type":"boolean","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"prerequisiteDrugs":{"description":"Gets or sets the prerequisite drugs (by NDC) for which the rule applies","type":"array","items":{"$ref":"#/definitions/RulePrerequisiteDrugModel"}},"prerequisiteGPIs":{"description":"Gets or sets the prerequisite GPIs for which the rule applies","type":"array","items":{"$ref":"#/definitions/RulePrerequisiteGPIModel"}},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"isBrand":{"description":"Gets or sets whether the drug criteria is based on brand","type":"boolean","x-nullable":true},"isRx":{"description":"Gets or sets whether the drug criteria is for prescription only (non-OTC)","type":"boolean","x-nullable":true},"isMultiSourced":{"description":"Gets or sets whether the drug criteria is based on multi-source","type":"boolean","x-nullable":true},"isRepackaged":{"description":"Gets or sets whether the drug criteria is based on repackaged value","type":"boolean","x-nullable":true},"genericAvailable":{"description":"Gets or sets whether the drug criteria applies if a generic is available","type":"boolean","x-nullable":true},"otcAvailable":{"description":"Gets or sets whether the drug criteria applies if an OTC is available","type":"boolean","x-nullable":true},"isMaintenanceDrug":{"description":"Gets or sets whether the drug criteria applies to maintenance drug","type":"boolean","x-nullable":true},"deaClassCodes":{"description":"Gets or sets the applicable DEA schedules for the drug criteria","type":"array","items":{"$ref":"#/definitions/DEAScheduleModel"}},"brandNameCodes":{"description":"Gets or sets the applicable brand codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/BrandNameCodeModel"}},"multiSourceCodes":{"description":"Gets or sets the applicable multi-source codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/MultiSourceCodeModel"}},"rX_OTCIndicatorCodes":{"description":"Gets or sets the applicable Rx-OTC Indicator codes for the drug criteria","type":"array","items":{"$ref":"#/definitions/RX_OTCIndicatorCodeModel"}},"includeCustomDrugs":{"description":"Gets or sets whether the drug criteria applies to custom drugs","type":"boolean","x-nullable":true},"gpiListIsExclusion":{"description":"Gets or sets whether the drug criteria GPI list is excluded","type":"boolean","x-nullable":true},"drugProfileListIsExclusion":{"description":"Gets or sets whether the drug criteria drug profile list is excluded","type":"boolean","x-nullable":true},"gpIs":{"description":"Gets or sets the list of GPIs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleGPIModel"}},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"roAs":{"description":"Gets or sets the list of ROAs associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleROAModel"}},"dosageForms":{"description":"Gets or sets the dosage forms associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleDosageFormModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"drugProfiles":{"description":"Gets or Sets a a list of which drug profiles are associated with this rule","type":"array","items":{"$ref":"#/definitions/RuleDrugProfileModel"}},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true}}},"RuleStepTherapyNDCSpecificModel":{"description":"Rule Step Therapy NDC Specific","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"ruleActionTypeUrl":{"description":"Gets or sets the link to the rule action type resource","type":"string"},"ruleActionTypeNo":{"format":"int64","description":"Gets or sets the identifier to the rule action type","type":"integer"},"dawEnforceRule":{"description":"Gets or sets whether to enforce drug criteria checks that would normally be skipped due to DAW","type":"boolean","x-nullable":true},"rejectCode":{"description":"Gets or sets Reject Code for which the rule applies","type":"string"},"stepTherapyByDrugName":{"description":"Gets or sets whether to group by drug name (10 digit GPI level) when requiring more than one drug\r\n*DEPRECATED - will be removed at a later date","type":"boolean","x-nullable":true},"stepTherapyGPIChars":{"description":"Gets or sets the GPI Level for drug name when requiring more than one drug","type":"string"},"stepTherapyNumberOfDays":{"format":"int32","description":"Gets or sets the number of days to look back for fills (blank for all fills)","type":"integer","x-nullable":true},"prerequisiteDrugsRequired":{"format":"int32","description":"Gets or sets the number of prerequisite drugs required","type":"integer","x-nullable":true},"gpiListIndividualDrugs":{"description":"Gets or sets whether each entry in the Prerequisite GPI List counts as a single drug","type":"boolean","x-nullable":true},"shortCycle":{"description":"Gets or sets whether the rule applies to claims identified as short cycle","type":"boolean","x-nullable":true},"newStartDrug":{"description":"Gets or sets whether the rule applies to new a start medication (based on plan's New Start Days)","type":"boolean","x-nullable":true},"newStartDrugByDrugName":{"description":"Gets or sets whether the new start drug is based on the drug name (10 digit GPI)","type":"boolean","x-nullable":true},"newDrug":{"description":"Gets or sets whether the rule is applied for drugs recently added to the catalog","type":"boolean","x-nullable":true},"firstFillByRx":{"description":"Gets or sets whether the rule applies to first fills","type":"boolean","x-nullable":true},"refillExpired":{"description":"Gets or sets whether the rule applies for expired refills (based on plan's Rx Expire Days)","type":"boolean","x-nullable":true},"onPlan":{"description":"Gets or sets whether the rule applies when the drug is on the plan","type":"boolean","x-nullable":true},"inCompound":{"description":"Gets or sets whether the rule applies to compounds being priced using ingredients","type":"boolean","x-nullable":true},"prerequisiteDrugs":{"description":"Gets or sets the prerequisite drugs (by NDC) for which the rule applies","type":"array","items":{"$ref":"#/definitions/RulePrerequisiteDrugModel"}},"prerequisiteGPIs":{"description":"Gets or sets the prerequisite GPIs for which the rule applies","type":"array","items":{"$ref":"#/definitions/RulePrerequisiteGPIModel"}},"diagnosisCodes":{"description":"Gets or sets the DiagnosisCodes for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleDiagnosisCodeModel"}},"members":{"description":"Gets or sets members for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleMemberModel"}},"memberListIsExclusion":{"description":"Gets or sets a value indicating whether the member list is treated as an exclusion list.  If this is true, members in the list will be excluded from the rule; if false, only members in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"memberProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the member profile list is treated as an exclusion list.  If this is true, member profiles in the list will be excluded from the rule; if false, only member profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"networks":{"description":"Gets or sets networks for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RuleNetworkModel"}},"headquarters":{"description":"Gets or sets headquarters for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyHeadquarterModel"}},"pharmacyHeadquarterListIsExclusion":{"description":"Gets or sets a value indicating whether the headquarter list is treated as an exclusion list.  If this is true, headquarters in the list will be excluded from the rule; if false, only headquarters in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacies":{"description":"Gets or sets pharmacies for which the rule applies; if the list is empty it applies to all","type":"array","items":{"$ref":"#/definitions/RulePharmacyModel"}},"pharmacyListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy list is treated as an exclusion list.  If this is true, pharmacies in the list will be excluded from the rule; if false, only pharmacies in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"pharmacyProfileListIsExclusion":{"description":"Gets or sets a value indicating whether the pharmacy profile list is treated as an exclusion list.  If this is true, pharmacy profiles in the list will be excluded from the rule; if false, only pharmacy profiles in the list will be included in the rule.  If the list is empty, it applies to all pharmacy profiles regardless of this value.","type":"boolean"},"facilities":{"description":"Gets or sets the Facilities for which the rule applies","type":"array","items":{"$ref":"#/definitions/RuleFacilityBranchModel"}},"ndcListIsExclusion":{"description":"Gets or sets a value indicating whether the ndc list is treated as an exclusion list.  If this is true, ndcs in the list will be excluded from the rule; if false, only ndcs in the list will be included in the rule.  If the list is empty, it applies to all pharmacies regardless of this value.","type":"boolean"},"isOverridden":{"description":"Gets or sets the flag if this rule is overridden","type":"boolean","x-nullable":true},"overridingRuleURL":{"description":"Gets or sets the rule template thats being overridden","type":"string"},"enabled":{"description":"Gets or sets the rule template is enabled","type":"boolean","x-nullable":true},"quantityMin":{"format":"double","description":"Gets or sets the minimum quantity in order for the rule to apply","type":"number","x-nullable":true},"quantityMax":{"format":"double","description":"Gets or sets the maximum quantity in order for the rule to apply","type":"number","x-nullable":true},"pricingGroups":{"description":"Gets or sets the list of pricing groups associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RulePricingGroupModel"}},"formularyTiers":{"description":"Gets or sets the list of formulary tiers associated with the drug criteria","type":"array","items":{"$ref":"#/definitions/RuleFormularyTierModel"}},"isSpecialty":{"description":"Gets or Sets a flag indicating whether this rule's criteria should include specialty drugs","type":"boolean","x-nullable":true},"groupPlanNo":{"format":"int64","description":"Gets or sets the group plan id associated with the rule","type":"integer"},"description":{"description":"Gets or sets the description","type":"string"},"priority":{"format":"int32","description":"Gets or sets the priority","type":"integer","x-nullable":true},"referenceCode":{"description":"Gets or sets the reference code","type":"string"},"message":{"description":"Gets or sets the message","type":"string"},"changeNote":{"description":"Gets the latest change note or sets a change note to be saved on a patch","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the effective start date","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the effective end date","type":"string","x-nullable":true},"active":{"description":"Gets or sets whether the rule is active","type":"boolean","x-nullable":true},"daysSupplyMin":{"format":"int32","description":"Gets or sets the minimum days supply in order for the rule to apply","type":"integer","x-nullable":true},"daysSupplyMax":{"format":"int32","description":"Gets or sets the maximum days supply in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMin":{"format":"int32","description":"Gets or sets the minimum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeMax":{"format":"int32","description":"Gets or sets the maximum age of the member in order for the rule to apply","type":"integer","x-nullable":true},"memberAgeUnits":{"description":"Gets or sets the age units.","type":"string"},"dependentRelationshipCodes":{"description":"Gets or sets the dependent relationship code as a delimited list for which the rule applies.","type":"array","items":{"$ref":"#/definitions/RelationshipModel"}},"serviceCategory":{"description":"Gets or sets the service category","type":"string"},"memberGender":{"description":"Gets or sets the gender (if necessary) for which the rule applies","type":"string"},"pharmacyTypes":{"description":"Gets or sets the list of acceptable pharmacy types","type":"array","items":{"$ref":"#/definitions/RulePharmacyTypeModel"}},"submissionClarificationCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"submissionClarificationCodes":{"description":"Gets or sets the submission clarification codes for which the rule applies (This list is only used if SubmissionClarificationCodeCriteriaType is set to match)","type":"array","items":{"$ref":"#/definitions/RuleSubmissionClarificationCodeModel"}},"pharmacyServiceTypeCriteriaType":{"description":"Gets or sets the pharmacy service criteria type","type":"string"},"pharmacyServiceType":{"description":"Gets or sets the pharmacy service value.  Uses standarded NCPDP values.","type":"string"},"patientResidenceCriteriaType":{"description":"Gets or sets the patient residence criteria type","type":"string"},"patientResidence":{"description":"Gets or sets the patient residence value.  Uses standarded NCPDP values.","type":"string"},"placeOfServiceCriteriaType":{"description":"Gets or sets the place of service criteria type","type":"string"},"placeOfService":{"description":"Gets or sets the place of service value.  Uses standarded NCPDP values.","type":"string"},"benefitCodeUrl":{"description":"Gets or sets the Benefit Code Url","type":"string"},"benefitCodeNo":{"format":"int64","description":"Gets or sets the Benefit Code number","type":"integer","x-nullable":true},"priorFillsMin":{"format":"int32","description":"Gets or sets the Prior Fills Minumum","type":"integer","x-nullable":true},"priorFillsMax":{"format":"int32","description":"Gets or sets the Prior Fills Maximum","type":"integer","x-nullable":true},"priorFillsDaysInterval":{"format":"int32","description":"Gets or sets the Prior Fills Interval Days","type":"integer","x-nullable":true},"priorFillsGraceDays":{"format":"int32","description":"Gets or sets the Prior Fills Grace Days","type":"integer","x-nullable":true},"priorFillsStartDate":{"format":"date-time","description":"Gets or sets the Prior Fills Start Date","type":"string","x-nullable":true},"priorFillsDaysSupplyMin":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Minimum","type":"integer","x-nullable":true},"priorFillsDaysSupplyMax":{"format":"int32","description":"Gets or sets the Prior Fills Days Supply Maximum","type":"integer","x-nullable":true},"priorFillsDrugProfileUrl":{"description":"Gets or sets the Prior Fills Drug Profile Url","type":"string"},"priorFillsDrugProfileNo":{"format":"int64","description":"Gets or sets the Prior Fill Drug Profile number","type":"integer","x-nullable":true},"priorFillsPharmacyProfileUrl":{"description":"Gets or sets the Prior Fills Pharmacy Profile Url","type":"string"},"priorFillsPharmacyProfileNo":{"format":"int64","description":"Gets or sets the Prior Fills Pharmacy Profile number","type":"integer","x-nullable":true},"priorFillsGPIChars":{"description":"Gets or sets the Prior Fills GPI Chars","type":"string"},"priorFillsLimitToCurrentPeriod":{"description":"Gets or sets the Prior Fills Limit to Current Period","type":"boolean","x-nullable":true},"priorFillsByRxNumber":{"description":"Gets or sets the Prior Fills Limit to Submitted Rx Number","type":"boolean","x-nullable":true},"priorFillsByNDC":{"description":"Gets or sets the Prior Fills Limit to Submitted NDC","type":"boolean","x-nullable":true},"diagnosisCodeCriteriaType":{"description":"Gets or sets the rule's submission clarification code match criteria if applicable (possible values: Blank, Match, n/a)","type":"string"},"dawCodes":{"description":"Gets or sets the acceptable DAW code values that apply to the rule","type":"array","items":{"$ref":"#/definitions/DAWCodeModel"}},"contractCodes":{"description":"Gets or sets the list of contract codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleContractCodeModel"}},"arCodes":{"description":"Gets or sets the list of AR codes associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleARCodeModel"}},"coverageLevels":{"description":"Gets or sets the coverage levels associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleCoverageLevelModel"}},"employeeStatuses":{"description":"Gets or sets the list of employee statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleEmployeeStatusModel"}},"otherStatuses":{"description":"Gets or sets the list of other statuses associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleOtherStatusModel"}},"memberStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleMemberStateModel"}},"pharmacyStates":{"description":"Gets or sets the list of US States associated with the general criteria","type":"array","items":{"$ref":"#/definitions/RuleStateModel"}},"isTemplate":{"description":"Gets or sets whether the rule is a template","type":"boolean","x-nullable":true},"ndCs":{"description":"Gets or sets the list of NDCs associated with the rule criteria.  These values can be posted/added at individual rule controllers, but should be patched at the RuleDrug endpoint - api/groups/{groupid}/groupplans/{groupplanid}/rules/{ruleid}/ruledrugs/{id}.","type":"array","items":{"$ref":"#/definitions/RuleDrugModel"}}}},"ServiceCategoryModel":{"type":"object","properties":{"displayName":{"description":"Gets or sets the Display name","type":"string"},"value":{"description":"Gets or sets the value","type":"string"}}},"SpecialDrugPricingModel":{"description":"Special Drug Pricing","type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"planNo":{"format":"int64","description":"Gets or sets the Plan number","type":"integer"},"compoundPricing":{"description":"Gets or sets the Compound Pricing","type":"boolean","x-nullable":true},"description":{"description":"Gets or sets the Description","type":"string"},"dispenseFee":{"format":"double","description":"Gets or sets the Dispense Fee","type":"number","x-nullable":true},"effort1Fee":{"format":"double","description":"Gets or sets the Effort1 Free","type":"number","x-nullable":true},"effort2Fee":{"format":"double","description":"Gets or sets the Effort2 Free","type":"number","x-nullable":true},"effort3Fee":{"format":"double","description":"Gets or sets the Effort3 Free","type":"number","x-nullable":true},"effort4Fee":{"format":"double","description":"Gets or sets the Effort4 Free","type":"number","x-nullable":true},"effort5Fee":{"format":"double","description":"Gets or sets the Effort5 Free","type":"number","x-nullable":true},"minimumDrugs":{"format":"int32","description":"Gets or sets the Minimum Drugs","type":"integer","x-nullable":true},"priceDrugs":{"description":"Gets or sets the value to Price Drugs","type":"boolean","x-nullable":true},"priceTopDrugs":{"format":"int32","description":"Gets or sets the value to Price Top Drugs","type":"integer","x-nullable":true},"requireValidNDC":{"description":"Gets or sets the value to Require Valid NDC","type":"boolean","x-nullable":true},"useGrossAmountDue":{"description":"Gets or sets the value to Use Gross Amount Due","type":"boolean","x-nullable":true},"useGrossAmountDueIfNoPricing":{"description":"Gets or sets the value to Use Gross Amount Due if no pricing","type":"boolean","x-nullable":true},"useNetworkOptions":{"description":"Gets or sets the value to Use Network Options","type":"boolean","x-nullable":true},"useSubmittedDispenseFee":{"description":"Gets or sets the value to Use Submitted Dispense Fee","type":"boolean","x-nullable":true},"useUsualAndCustomary":{"description":"Gets or sets the value to Use Usual and Customary","type":"boolean","x-nullable":true},"minimumRate":{"format":"double","description":"Gets or sets the minimum rate","type":"number","x-nullable":true},"minimumRateDaysInterval":{"format":"int32","description":"Gets or sets the minimum rate days interval","type":"integer","x-nullable":true},"usualAndCustomaryAdjustmentIC":{"format":"double","description":"Gets or sets the Usual and Customary Adjustment IC","type":"number","x-nullable":true},"usualAndCustomaryRate":{"format":"double","description":"Gets or sets the Usual and Customary Rate","type":"number","x-nullable":true},"usualAndCustomaryRatePerUnit":{"description":"Gets or sets the Usual and Customary Rate per Unit","type":"boolean","x-nullable":true},"usualAndCustomaryPerDiemRate":{"format":"double","description":"Gets or sets the Usual and Customary per Diem Rate","type":"number","x-nullable":true},"memberClaimFee":{"format":"double","description":"Gets or sets the Member Claim Fee","type":"number","x-nullable":true}}},"PagedResultModel[CompanyStepMedicationModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/CompanyStepMedicationModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"CompanyStepMedicationModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"name":{"description":"Gets or sets the description of the step medication resource","type":"string"},"isGlobal":{"description":"Gets or sets whether this is a global step medication resource (true if Global, false if Formulary-level)\r\nObsolete - will be removed at a later date","type":"boolean","x-nullable":true},"noOfDrugsToTry":{"format":"int32","description":"Gets or sets the number of Drugs to Try","type":"integer","x-nullable":true},"stepOrder":{"description":"Gets or sets the Step Order","type":"string"},"diagnosisCode":{"description":"Gets or sets the Diagnosis Code","type":"string"},"diagnosisCodeQualifier":{"description":"Gets or sets the Diagnosis Code Qualifier","type":"string"},"isActive":{"description":"Gets or sets value to indicate the Active status","type":"boolean","x-nullable":true},"createdOn":{"format":"date-time","description":"Gets or sets the Created On Date for this resource","type":"string","x-nullable":true},"auditNote":{"description":"Gets or sets the value indicating (for audit purposes) why the most current change was made","type":"string"},"active":{"description":"Gets or sets the value indicating whether this step medication is currently active.","type":"boolean","x-nullable":true},"stepDrugMultiSourceCodesUrl":{"description":"Gets or sets the URL that can be accessed to find the Multi Source Codes used to identify step medication products to try.  This list of Multi Source Codes \r\nwill be used in combination with the StepDrugProducts list to indicate which products should be tried as part of this step medication.","type":"string"},"stepDrugProductsUrl":{"description":"Gets or sets the URL that can be accessed to find which ProductID's (NDC or GPI) should be tried as part of this Step Medication resource.  This list of products \r\nwill be used in combination with the Multi Source Code list to indicate which products should be tried as part of this step medication.","type":"string"},"stepDrugs":{"type":"array","items":{"$ref":"#/definitions/CompanyStepMedicationStepDrugModel"}},"multiSourceCodes":{"type":"array","items":{"$ref":"#/definitions/CompanyStepMedicationMultiSourceCodeModel"}}}},"PagedResultModel[FormularyCompanyStepMedicationModel]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/FormularyCompanyStepMedicationModel"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"FormularyCompanyStepMedicationModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"companyStepMedicationSeqNo":{"format":"int64","description":"Gets or sets the value indicating whether this formulary step medication is inheriting from a global/company-level step medication.","type":"integer","x-nullable":true},"companyStepMedicationUrl":{"description":"Gets the url where the global/company-level step medication resource can be found","type":"string","readOnly":true},"productID":{"description":"Gets or sets the product ID for this resource.  The value should be a valid NDC, DDID or GPI.","type":"string"},"productIDType":{"description":"Gets or sets the product ID Type for the ProductID value set on this resource.  The value will indicate whether the product ID for this resource is an NDC or DDID . \r\nString values other than 'NDC' or 'DDID' will not be valid.","type":"string"},"name":{"description":"Gets or sets the description of the step medication resource","type":"string"},"noOfDrugsToTry":{"format":"int32","description":"Gets or sets the value of the number of drugs to try for this step medication","type":"integer","x-nullable":true},"stepOrder":{"description":"Gets or sets the suggested order in which the step medication should be tried","type":"string"},"diagnosisCode":{"description":"Gets or sets the ICD9 code identifying the diagnosis of the patient","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date of this resource","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date of this resource","type":"string","x-nullable":true},"active":{"description":"Gets or sets the value indicating whether this step medication is currently active.","type":"boolean","x-nullable":true},"stepDrugMultiSourceCodesUrl":{"description":"Gets or sets the URL that can be accessed to find the Multi Source Codes used to identify step medication products to try.  This list of Multi Source Codes \r\nwill be used in combination with the StepDrugProducts list to indicate which products should be tried as part of this step medication.","type":"string"},"stepDrugProductsUrl":{"description":"Gets or sets the URL that can be accessed to find which ProductID's (NDC or GPI) should be tried as part of this Step Medication resource.  This list of products \r\nwill be used in combination with the Multi Source Code list to indicate which products should be tried as part of this step medication.","type":"string"},"stepDrugs":{"type":"array","items":{"$ref":"#/definitions/CompanyStepMedicationStepDrugModel"}},"multiSourceCodes":{"type":"array","items":{"$ref":"#/definitions/CompanyStepMedicationMultiSourceCodeModel"}}}},"PagedResultModel[vwDataQProvider]":{"description":"Paged Result Model","type":"object","properties":{"pageNumber":{"format":"int32","description":"Gets or sets the current page index of the results of an api request","type":"integer"},"pageCount":{"format":"int32","description":"Gets or sets the total page count of the results of an api request","type":"integer"},"pageSize":{"format":"int32","description":"Gets or sets the page size of the results of an api request","type":"integer"},"items":{"description":"Gets or sets the results of an api request","type":"array","items":{"$ref":"#/definitions/vwDataQProvider"}},"totalRecordCount":{"format":"int32","description":"Gets or sets the total count of results","type":"integer"}}},"vwDataQProvider":{"type":"object","properties":{}},"DataQProviderRequestModel":{"type":"object","properties":{"dataQProviderID":{"description":"Data Q Provider Identifier","type":"string"}}},"DataQProviderResponseModel":{"type":"object","properties":{"dataQProviderID":{"description":"Data Q Provider Identifier","type":"string"},"pharmacyLocationNo":{"format":"int64","description":"Gets or sets the pharmacy location for this resource","type":"integer","x-nullable":true},"pharmacyLocationUrl":{"description":"Gets or sets the pharmacy location url for this resource","type":"string"}}},"UnitPriceOverridePriceCodeModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"priceCode":{"description":"Gets or sets the price code for this resource","type":"string"},"unitPrice":{"format":"double","description":"Gets or sets the unit price for this resource","type":"number"}}},"UnitPriceOverrideModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"priority":{"format":"int32","description":"Gets or sets the priority for this resource","type":"integer"},"active":{"description":"Gets or sets the active status for this resource","type":"boolean"},"description":{"description":"Gets or sets the description for this resource","type":"string"},"pharmacyBranchNo":{"format":"int64","description":"Gets or sets the group for this resource","type":"integer","x-nullable":true},"pharmacyBranchUrl":{"description":"Gets or sets the group url for this resource","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date for this resource","type":"string","x-nullable":true},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date for this resource","type":"string","x-nullable":true},"pharmacyStateCode":{"description":"Gets or sets the pharmacy state code for this resource","type":"string"},"pharmacyClassNo":{"format":"int64","description":"Gets or sets the pharmacy class for this resource","type":"integer","x-nullable":true},"pharmacyClassUrl":{"description":"Gets or sets the pharmacy class url for this resource","type":"string"},"pharmacyLocationNo":{"format":"int64","description":"Gets or sets the pharmacy location for this resource","type":"integer","x-nullable":true},"pharmacyLocationUrl":{"description":"Gets or sets the pharmacy location url for this resource","type":"string"},"pharmacyProfileNo":{"format":"int64","description":"Gets or sets the pharmacy profile for this resource","type":"integer","x-nullable":true},"pharmacyProfileUrl":{"description":"Gets or sets the pharmacy profile url for this resource","type":"string"},"drugProfileNo":{"format":"int64","description":"Gets or sets the drug profile for this resource","type":"integer","x-nullable":true},"drugProfileUrl":{"description":"Gets or sets the drug profile url for this resource","type":"string"},"prescriptionReferenceNumber":{"description":"Gets or sets the prescription reference number for this resource","type":"string"},"ndc":{"description":"Gets or sets the NDC for this resource","type":"string"},"pharmacyWholesalerNo":{"format":"int64","description":"Gets or sets the pharmacy wholesaler for this resource","type":"integer","x-nullable":true},"pharmacyWholesalerUrl":{"description":"Gets or sets the pharmacy wholesaler url for this resource","type":"string"},"isCompound":{"description":"Gets or sets the is compound flag for this resource","type":"boolean","x-nullable":true},"note":{"description":"Gets or sets the Note for this resource","type":"string"},"participatingPharmaciesOnly":{"description":"Gets or sets the participating pharmacies only flag for this resource","type":"boolean","x-nullable":true},"unitPriceOverridePriceCodes":{"description":"Gets or sets the Unit Price Override Price Codes for this resource","type":"array","items":{"$ref":"#/definitions/UnitPriceOverridePriceCodeModel"}}}},"VariableCopayCouponDrugModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"genericProductIdentifier":{"description":"Gets or sets the Generic Product Identifier","type":"string"},"active":{"description":"Gets or sets the Active status","type":"boolean"}}},"VariableCopayCouponModel":{"type":"object","properties":{"url":{"description":"Gets or sets the link representing a link back to the resource","type":"string"},"id":{"format":"int64","description":"Gets or sets the identifier for the resource","type":"integer"},"description":{"description":"Gets or sets the Description","type":"string"},"effectiveStartDate":{"format":"date-time","description":"Gets or sets the Effective Start Date","type":"string"},"effectiveEndDate":{"format":"date-time","description":"Gets or sets the Effective End Date","type":"string"},"active":{"description":"Gets or sets the Active status","type":"boolean"},"couponTotalValueAccum":{"format":"double","description":"Gets or sets the Coupon Total Value for the Accumulator program","type":"number"},"couponTotalValueMaximizer":{"format":"double","description":"Gets or sets the Coupon Total Value for the Maximizer program","type":"number"},"maxValuePerFillAccum":{"format":"double","description":"Gets or sets the Max Value Per Fill for the Accumulator program","type":"number","x-nullable":true},"maxValuePerFillMaximizer":{"format":"double","description":"Gets or sets the Max Value Per Fill for the Maximizer program","type":"number","x-nullable":true},"couponDurationDays":{"format":"int32","description":"Gets or sets the Coupon Duration Days","type":"integer"},"couponFee":{"format":"double","description":"Gets or sets the Coupon Fee","type":"number"},"minAge":{"format":"int32","description":"Gets or sets the Minimum Age","type":"integer","x-nullable":true},"maxAge":{"format":"int32","description":"Gets or sets the Maximum Age","type":"integer","x-nullable":true},"maxFills":{"format":"int32","description":"Gets or sets the Maximum Fills","type":"integer","x-nullable":true},"ssVersionID":{"format":"int64","description":"Gets or sets the SSVersionID","type":"integer","x-nullable":true},"variableCopayCouponDrugs":{"description":"Gets or sets the Variable Copay Coupon Drug list","type":"array","items":{"$ref":"#/definitions/VariableCopayCouponDrugModel"}}}}},"securityDefinitions":{"HMAC":{"type":"apiKey","description":"HMAC Authentication using Client ID and API Key. Format: 'ClientID:<client_id> ApiKey:<api_key>'","name":"Authorization","in":"header"}}}