openapi: 3.2.0 info: title: Prior Authorization v1 Noa API description: '' version: 1.1.0 contact: email: '' servers: - url: https://sandbox-apigw.optum.com/rcm/prior-authorization/v1/ - url: /processor security: - bearerAuth: [] tags: - name: Noa paths: /noa/x12: post: summary: 278x216 Prior Authorization Notice Of Admission description: Prior authorization noa using EDI X12 278x216 requests tags: - Noa parameters: - $ref: '#/components/parameters/x-optum-tenant-id' - $ref: '#/components/parameters/x-optum-correlation-id' requestBody: description: Authorization Noa request content: application/json: schema: $ref: '#/components/schemas/NoaX12Request' responses: '200': description: Success headers: x-amzn-trace-id: $ref: '#/components/headers/x-amzn-trace-id' transaction-id: $ref: '#/components/headers/transaction-id' content: application/json: schema: $ref: '#/components/schemas/NoaResponse' examples: subscriber: $ref: '#/components/examples/UserNoaResponse' '400': $ref: '#/components/responses/400' '401': $ref: '#/components/responses/401' '403': $ref: '#/components/responses/403' '500': $ref: '#/components/responses/500' /noa: post: summary: JSON Notice of Admission description: Prior authorization notice of admission using JSON requests tags: - Noa parameters: - $ref: '#/components/parameters/x-optum-tenant-id' - $ref: '#/components/parameters/x-optum-correlation-id' requestBody: description: Authorization notice of admission request content: application/json: schema: $ref: '#/components/schemas/AuthorizationNoaJSON' examples: subscriber: $ref: '#/components/examples/UserNoaRequest' responses: '200': description: Success headers: x-amzn-trace-id: $ref: '#/components/headers/x-amzn-trace-id' transaction-id: $ref: '#/components/headers/transaction-id' content: application/json: schema: $ref: '#/components/schemas/NoaResponse' examples: subscriber: $ref: '#/components/examples/UserNoaResponse' '400': $ref: '#/components/responses/400' '401': $ref: '#/components/responses/401' '403': $ref: '#/components/responses/403' '500': $ref: '#/components/responses/500' components: examples: UserNoaRequest: summary: Notice of admission Request (JSON) value: senderId: 201985AAS submitterTransactionIdentifier: 222438911WEB payerId: '60054' payerName: AETNA umClearingHouseId: IMNDIRECT source: sourceType: FA organizationName: B'enefits Health System' lastName: Benefits Health System npi: '1881650737' contactTelephone: '4064552959' subscriber: lastName: LNAME firstName: FNAME memberId: NOA-01-SUCCESS supplementalIdentification: groupNumber: 0123456789012 dateOfBirth: '19700101' patientEventDetail: requestCategoryCode: AR certificationTypeCode: I serviceTypeCode: '1' facilityTypeCode: '11' facilityCodeQualifier: A accidentDate: '20260101' lastMenstrualPeriodDate: '20260101' estimatedDateOfBirth: '20260101' onsetDate: '20260101' eventDateBegin: '20260101' admissionDateBegin: '20260101' admissionDateEnd: '20260101' dischargeDate: '20260101' certificationIssueDateBegin: '20260101' certificationExpirationDateBegin: '20260101' certificationEffectiveDateBegin: '20260101' diagnosisTypeCode1: ABJ diagnosisCode1: N1330 freeFormMessageText: AT=061500;ICD=N1330 patientEventProviderName: - entityIdentifierCode: '71' organizationName: Benefits Health System lastName: SLATER firstName: RICHARD identificationCodeQualifier: XX identifier: '1285928754' UserNoaResponse: summary: Noa Response Subscriber Only value: authorizationId: 16665bb7-3040-4d4d-a889-123a27b29789 noa: x12: ISA*00*6666 *00*5555 *ZZ*6546564 *ZZ*6546564 *0623 *1301*^*00501*000000001*0*T*:~GS*HI*FL0738*PERSEPVS*20090601*040612*1*X*005010X216~ST*278*0001*005010X216~BHT*0007*11*165932*20055002*0815*18~HL*1**20*1~NM1*X3*2*ABC PAYER*****PI*1234560010~HL*2*1*21*1~NM1*1P*1*XYZ AMBULANCE SVC*****24*7759621873~HL*3*2*22*1~NM1*IL*1*SMITH*JOE****MI*12345689001~REF*EJ*1234567890~DMG*D8*19700101*M~HL*4*3*EV*1~UM*HS*I*56*41:B~HCR*A1*1234567890123~DTP*AAH*D8*20250101~CR1***X**DH*27~NM1*PW*2*HOME~N3*123 SOME ROAD~N4*SACRAMENTO*CA*95826~NM1*ND*2*DOCTOR OFFICE~N3*123 SOME AVENUE~N4*SACRAMENTO*CA*95624~NM1*R3*2*SOME DIALYSIS CENTER~N3*123 SOME ROAD~N4*SACRAMENTO*CA*95826~NM1*FS*2*HOME~N3*123 SOME ROAD~N4*SACRAMENTO*CA*95826~HL*5*4*SS*0~SV1*HC:A0428:RX**UN*5~HL*6*4*SS*0~SV1*HC:A0428:PD**UN*8~HL*7*4*SS*0~SV1*HC:A0428:DR**UN*14~SE*34*0001~GE*1*1~IEA*1*000000001~ json: submitterTransactionIdentifier: '165932' payerId: '1234560010' payerName: ABC PAYER umClearingHouseId: PERSEPVS umRequestValidation: null requester: requesterType: 1P lastName: XYZ AMBULANCE SVC requesterIdentification: {} employersId: '7759621873' subscriber: lastName: SMITH firstName: JOE memberId: '12345689001' dateOfBirth: '19700101' genderCode: M supplementalIdentification: patientAccountNumber: '1234567890' dependent: supplementalIdentification: {} patientEventDetail: requestCategoryCode: HS certificationTypeCode: I serviceTypeCode: '56' facilityTypeCode: '41' facilityCodeQualifier: B certificationActionCode: A1 reviewIdentificationNumber: '1234567890123' eventDateBegin: '20250101' ambulanceTransportCode: X ambulanceUnitOrBasisForMeasurementCode: DH ambulanceTransportDistance: '27' patientEventAdditionalPatientInformationContactName: - {} patientEventTransportInformation: - entityIdentifierCode: PW transportLocationName: HOME address1: 123 SOME ROAD city: SACRAMENTO state: CA postalCode: '95826' - entityIdentifierCode: ND transportLocationName: DOCTOR OFFICE address1: 123 SOME AVENUE city: SACRAMENTO state: CA postalCode: '95624' - entityIdentifierCode: R3 transportLocationName: SOME DIALYSIS CENTER address1: 123 SOME ROAD city: SACRAMENTO state: CA postalCode: '95826' - entityIdentifierCode: FS transportLocationName: HOME address1: 123 SOME ROAD city: SACRAMENTO state: CA postalCode: '95826' serviceLevel: - professionalService: productOrServiceIDQualifier: HC procedureCode: A0428 procedureModifier: RX unitOrBasisForMeasurementCode: UN serviceUnitCount: '5' institutionalService: {} dentalService: {} serviceDetailAdditionalServiceInformationContactName: - {} - professionalService: productOrServiceIDQualifier: HC procedureCode: A0428 procedureModifier: PD unitOrBasisForMeasurementCode: UN serviceUnitCount: '8' institutionalService: {} dentalService: {} serviceDetailAdditionalServiceInformationContactName: - {} - professionalService: productOrServiceIDQualifier: HC procedureCode: A0428 procedureModifier: DR unitOrBasisForMeasurementCode: UN serviceUnitCount: '14' institutionalService: {} dentalService: {} serviceDetailAdditionalServiceInformationContactName: - {} schemas: NoaX12Request: type: object properties: x12: type: string description: EDI X12 278x216 Request example: ISA*00* *00* *ZZ*83825418A *ZZ*IMNDIRECT *260203*0815*^*00501*375720525*0*P*:~GS*HI*LRX1210001*MTEXE*20260203*0815*1234*X*005010X216~ST*278*0001*005010X216~BHT*0007*CN*222438911WEB*20260203*0815*NO~HL*1**20*1~NM1*FA*2*Benefis Health System*****XX*1881650737~PER*IC**TE*4064552959~HL*2*1*21*1~NM1*X3*2*AETNA*****PI*60054~HL*3*2*22*1~NM1*IL*1*LNAME*FNAME****MI*NOA-01-SUCCESS~REF*6P*0123456789012~DMG*D8*19700101~HL*4*3*EV*1~UM*AR*I*1*11:A~DTP*435*D8*20260101~HI*ABJ:N1330~MSG*AT=061500;ICD=N1330~NM1*71*1*SLATER*RICHARD****XX*1285928754~NM1*FA*2*Benefis Health System*****XX*1881650737~NM1*AAJ*1*SLATER*RICHARD****XX*1285928754~SE*20*0001~GE*1*1234~IEA*1*375720525~ Errors: type: array items: type: string example: This is an example error string AuthorizationNoaJSON: type: object properties: senderId: type: string submitterTransactionIdentifier: type: string payerId: type: string payerName: type: string umClearingHouseId: type: string requester: type: object properties: requesterType: type: string organizationName: type: string lastName: type: string firstName: type: string requesterIdentification: type: object properties: providerUpinNumber: type: string facilityIdNumber: type: string employerIdentificationNumber: type: string providerSiteNumber: type: string providerPlanNetworkIdNumber: type: string facilityNetworkIdNumber: type: string socialSecurityNumber: type: string carrierAssignedReferenceNumber: type: string address1: type: string address2: type: string city: type: string state: type: string postalCode: type: string countryCode: type: string countrySubDivisionCode: type: string npi: type: string ssn: type: string servicesPlanID: type: string employersId: type: string etin: type: string contactName: type: string contactElectronicMail: type: string contactFacsimile: type: string contactTelephone: type: string contactTelephoneExtension: type: string providerCode: type: string referenceIdentification: type: string subscriber: type: object properties: lastName: type: string firstName: type: string middleName: type: string suffix: type: string memberId: type: string dateOfBirth: type: string genderCode: type: string supplementalIdentification: type: object properties: policyNumber: type: string branchIdentifier: type: string groupNumber: type: string departmentNumber: type: string patientAccountNumber: type: string healthInsuranceClaimNumber: type: string idCard: type: string insurancePolicyNumber: type: string planNetworkIdentificationNumber: type: string medicaidRecipientIdentificationNumber: type: string ssn: type: string address1: type: string address2: type: string city: type: string state: type: string postalCode: type: string countryCode: type: string countrySubDivisionCode: type: string insuredIndicator: type: string militaryRelationship: type: string dependent: type: object properties: lastName: type: string firstName: type: string middleName: type: string suffix: type: string dateOfBirth: type: string genderCode: type: string supplementalIdentification: type: object properties: patientAccountNumber: type: string ssn: type: string address1: type: string address2: type: string city: type: string state: type: string postalCode: type: string countryCode: type: string countrySubDivisionCode: type: string insuredIndicator: type: string relationshipToInsuredCode: type: string birthSequenceNumber: type: string patientEventDetail: type: object properties: requestCategoryCode: type: string certificationTypeCode: type: string serviceTypeCode: type: string facilityTypeCode: type: string facilityCodeQualifier: type: string relatedCausesCode1: type: string relatedCausesCode2: type: string relatedCausesCode3: type: string stateCode: type: string countryCode: type: string levelOfServiceCode: type: string currentHealthConditionCode: type: string prognosisCode: type: string releaseOfInformationCode: type: string delayReasonCode: type: string previousReviewAuthorizationNumber: type: string previousAdministrativeReferenceNumber: type: string accidentDate: type: string lastMenstrualPeriodDate: type: string estimatedDateOfBirth: type: string onsetDate: type: string eventDateBegin: type: string eventDateEnd: type: string admissionDateBegin: type: string admissionDateEnd: type: string dischargeDate: type: string diagnosisTypeCode1: type: string diagnosisCode1: type: string diagnosisDate1: type: string diagnosisTypeCode2: type: string diagnosisCode2: type: string diagnosisDate2: type: string diagnosisTypeCode3: type: string diagnosisCode3: type: string diagnosisDate3: type: string diagnosisTypeCode4: type: string diagnosisCode4: type: string diagnosisDate4: type: string diagnosisTypeCode5: type: string diagnosisCode5: type: string diagnosisDate5: type: string diagnosisTypeCode6: type: string diagnosisCode6: type: string diagnosisDate6: type: string diagnosisTypeCode7: type: string diagnosisCode7: type: string diagnosisDate7: type: string diagnosisTypeCode8: type: string diagnosisCode8: type: string diagnosisDate8: type: string diagnosisTypeCode9: type: string diagnosisCode9: type: string diagnosisDate9: type: string diagnosisTypeCode10: type: string diagnosisCode10: type: string diagnosisDate10: type: string diagnosisTypeCode11: type: string diagnosisCode11: type: string diagnosisDate11: type: string diagnosisTypeCode12: type: string diagnosisCode12: type: string diagnosisDate12: type: string quantityQualifier: type: string serviceUnitCount: type: string unitOrBasisForMeasurementCode: type: string sampleSelectionModulus: type: string timePeriodQualifier: type: string periodCount: type: string deliveryFrequencyCode: type: string deliveryPatternTimeCode: type: string ambulanceCertificationConditionIndicator: type: string ambulanceCertificationConditionCode1: type: string ambulanceCertificationConditionCode2: type: string ambulanceCertificationConditionCode3: type: string ambulanceCertificationConditionCode4: type: string ambulanceCertificationConditionCode5: type: string chiropracticCertificationConditionIndicator: type: string chiropracticCertificationConditionCode1: type: string chiropracticCertificationConditionCode2: type: string chiropracticCertificationConditionCode3: type: string chiropracticCertificationConditionCode4: type: string chiropracticCertificationConditionCode5: type: string durableMedicalEquipmentCertificationConditionIndicator: type: string durableMedicalEquipmentCertificationConditionCode1: type: string durableMedicalEquipmentCertificationConditionCode2: type: string durableMedicalEquipmentCertificationConditionCode3: type: string durableMedicalEquipmentCertificationConditionCode4: type: string durableMedicalEquipmentCertificationConditionCode5: type: string oxygenTherapyCertificationConditionIndicator: type: string oxygenTherapyCertificationConditionCode1: type: string oxygenTherapyCertificationConditionCode2: type: string oxygenTherapyCertificationConditionCode3: type: string oxygenTherapyCertificationConditionCode4: type: string oxygenTherapyCertificationConditionCode5: type: string functionalLimitationsCertificationConditionIndicator: type: string functionalLimitationsCertificationConditionCode1: type: string functionalLimitationsCertificationConditionCode2: type: string functionalLimitationsCertificationConditionCode3: type: string functionalLimitationsCertificationConditionCode4: type: string functionalLimitationsCertificationConditionCode5: type: string activitiesPermittedCertificationConditionIndicator: type: string activitiesPermittedCertificationConditionCode1: type: string activitiesPermittedCertificationConditionCode2: type: string activitiesPermittedCertificationConditionCode3: type: string activitiesPermittedCertificationConditionCode4: type: string activitiesPermittedCertificationConditionCode5: type: string mentalStatusCertificationConditionIndicator: type: string mentalStatusCertificationConditionCode1: type: string mentalStatusCertificationConditionCode2: type: string mentalStatusCertificationConditionCode3: type: string mentalStatusCertificationConditionCode4: type: string mentalStatusCertificationConditionCode5: type: string admissionToFacility: type: object properties: admissionTypeCode: type: string admissionSourceCode: type: string patientStatusCode: type: string nursingHomeResidentialStatusCode: type: string ambulanceTransport: type: object properties: patientWeight: type: string transportCode: type: string transportReasonCode: type: string transportDistance: type: string roundTripPurposeDescription: type: string stretcherPurposeDescription: type: string spinalManipulation: type: object properties: treatmentSeriesNumber: type: string treatmentCount: type: string subluxationBeginningLevelCode: type: string subluxationEndLevelCode: type: string patientConditionCode: type: string complicationIndicator: type: string patientConditionDescription1: type: string patientConditionDescription2: type: string xrayAvailabilityIndicator: type: string homeOxygenTherapyInformation: type: object properties: equipmentTypeCode1: type: string equipmentTypeCode2: type: string equipmentTypeCode3: type: string equipmentReasonDescription: type: string flowRate: type: string dailyUseCount: type: string usePeriodHourCount: type: string respiratoryTherapistOrderText: type: string arterialBloodGasQuantity: type: string saturationQuantity: type: string testConditionCode: type: string testFindingsCode1: type: string testFindingsCode2: type: string testFindingsCode3: type: string portableSystemFlowRate: type: string deliverySystemCode: type: string homeHealth: type: object properties: prognosisCode: type: string startDate: type: string certificationPeriodStartDate: type: string certificationPeriodEndDate: type: string medicareCoverageIndicator: type: string certificationTypeCode: type: string surgeryDate: type: string productOrServiceQualifier: type: string surgicalProcedureCode: type: string physicalOrderDate: type: string lastVisitDate: type: string physicianContactDate: type: string lastAdmissionPeriodStartDate: type: string lastAdmissionPeriodEndDate: type: string patientLocationCode: type: string attachments: type: array items: type: object properties: reportTypeCode: type: string transmissionCode: type: string controlNumber: type: string description: type: string freeFormMessageText: type: string patientEventProviderName: type: array items: type: object properties: entityIdentifierCode: type: string organizationName: type: string lastName: type: string firstName: type: string middleName: type: string namePrefix: type: string nameSuffix: type: string identificationCodeQualifier: type: string identifier: type: string address1: type: string address2: type: string city: type: string state: type: string postalCode: type: string countryCode: type: string countrySubDivisionCode: type: string providerSupplementalInformation: type: object properties: stateLicenseNumber: type: string licenseNumberStateCode: type: string providerUpinNumber: type: string facilityIdNumber: type: string employersIdentificationNumber: type: string providerPlanNetworkIdentificationNumber: type: string facilityNetworkIdentificationNumber: type: string ssn: type: string carrierAssignedReferenceNumber: type: string contactName: type: string contactElectronicMail: type: string contactFacsimile: type: string contactTelephone: type: string contactTelephoneExtension: type: string providerCode: type: string providerTaxonomyCode: type: string patientEventTransportInformation: type: array items: type: object properties: entityIdentifierCode: type: string transportLocationName: type: string address1: type: string address2: type: string city: type: string state: type: string postalCode: type: string patientEventOtherUmoName: type: array items: type: object properties: entityIdentifierCode: type: string otherUmoName: type: string otherUmoDenialReason1: type: string otherUmoDenialReason2: type: string otherUmoDenialReason3: type: string otherUmoDenialReason4: type: string otherUmoDenialDate: type: string serviceLevel: type: array items: type: object properties: requestCategoryCode: type: string certificationTypeCode: type: string serviceTypeCode: type: string facilityTypeCode: type: string facilityCodeQualifier: type: string previousReviewAuthorizationNumber: type: string previousAdministrativeReferenceNumber: type: string serviceDateBegin: type: string serviceDateEnd: type: string professionalService: type: object properties: productOrServiceIDQualifier: type: string procedureCode: type: string procedureModifier1: type: string procedureModifier2: type: string procedureModifier3: type: string procedureModifier4: type: string procedureCodeDescription: type: string procedureCode2: type: string serviceLineAmount: type: string unitOrBasisForMeasurementCode: type: string serviceUnitCount: type: string diagnosisCodePointer1: type: string diagnosisCodePointer2: type: string diagnosisCodePointer3: type: string diagnosisCodePointer4: type: string epsdtIndicator: type: string nursingHomeLevelOfCare: type: string institutionalService: type: object properties: serviceLineRevenueCode: type: string productOrServiceIDQualifier: type: string procedureCode: type: string procedureModifier1: type: string procedureModifier2: type: string procedureModifier3: type: string procedureModifier4: type: string procedureCodeDescription: type: string procedureCode2: type: string serviceLineAmount: type: string unitOrBasisForMeasurementCode: type: string serviceUnitCount: type: string serviceLineRate: type: string nursingHomeResidentialStatusCode: type: string nursingHomeLevelOfCare: type: string dentalService: type: object properties: procedureCode: type: string procedureModifier1: type: string procedureModifier2: type: string procedureModifier3: type: string procedureModifier4: type: string procedureCodeDescription: type: string procedureCode2: type: string serviceLineAmount: type: string oralCavityDesignationCode: type: string oralCavityDesignationCode2: type: string oralCavityDesignationCode3: type: string oralCavityDesignationCode4: type: string oralCavityDesignationCode5: type: string prosthesisCrownOrInlayCode: type: string serviceUnitCount: type: string description: type: string toothInformation: type: array items: type: object properties: toothCode: type: string toothSurfaceCode1: type: string toothSurfaceCode2: type: string toothSurfaceCode3: type: string toothSurfaceCode4: type: string toothSurfaceCode5: type: string healthCareServiceDelivery: type: object properties: quantityQualifier: type: string serviceQuantity: type: string unitOrBasisForMeasurementCode: type: string sampleSelectionModulus: type: string timePeriodQualifier: type: string periodCount: type: string deliveryFrequencyCode: type: string deliveryPatternTimeCode: type: string attachments: type: array items: type: object properties: reportTypeCode: type: string transmissionCode: type: string controlNumber: type: string description: type: string freeFormMessageText: type: string serviceProviderName: type: array items: type: object properties: entityIdentifierCode: type: string organizationName: type: string lastName: type: string firstName: type: string middleName: type: string namePrefix: type: string nameSuffix: type: string identificationCodeQualifier: type: string identifier: type: string address1: type: string address2: type: string city: type: string state: type: string postalCode: type: string countryCode: type: string countrySubDivisionCode: type: string providerSupplementalInformation: type: object properties: stateLicenseNumber: type: string licenseNumberStateCode: type: string providerUpinNumber: type: string facilityIdNumber: type: string employersIdentificationNumber: type: string providerPlanNetworkIdentificationNumber: type: string facilityNetworkIdentificationNumber: type: string ssn: type: string carrierAssignedReferenceNumber: type: string contactName: type: string contactElectronicMail: type: string contactFacsimile: type: string contactTelephone: type: string providerCode: type: string providerTaxonomyCode: type: string NoaResponse: type: object properties: authorizationId: type: string submission: type: object properties: x12: type: string json: $ref: '#/components/schemas/NoaJSONResponse' NoaJSONResponse: type: object properties: requestValidation: type: array items: type: object properties: responseCode: type: string rejectReasonCode: type: string followupActionCode: type: string submitterTransactionIdentifier: type: string payerId: type: string payerName: type: string umClearingHouseId: type: string contactName: type: string contactElectronicMail: type: string contactFacsimile: type: string contactTelephone: type: string umRequestValidation: type: array items: type: object properties: responseCode: type: string rejectReasonCode: type: string followupActionCode: type: string requester: type: object properties: requesterRequestValidation: type: array items: type: object properties: responseCode: type: string rejectReasonCode: type: string followupActionCode: type: string requesterType: type: string organizationName: type: string firstName: type: string requesterIdentification: type: object properties: facilityIdNumber: type: string socialSecurityNumber: type: string npi: type: string providerCode: type: string referenceIdentification: type: string subscriber: type: object properties: subscriberRequestValidation: type: array items: type: object properties: responseCode: type: string rejectReasonCode: type: string followupActionCode: type: string lastName: type: string firstName: type: string middleName: type: string prefix: type: string suffix: type: string memberId: type: string dateOfBirth: type: string genderCode: type: string supplementalIdentification: type: object properties: medicaidRecipientIdentificationNumber: type: string ssn: type: string address1: type: string address2: type: string city: type: string state: type: string postalCode: type: string countryCode: type: string countrySubDivisionCode: type: string insuredIndicator: type: string militaryRelationship: type: string dependent: type: object properties: dependentRequestValidation: type: array items: type: object properties: responseCode: type: string rejectReasonCode: type: string followupActionCode: type: string lastName: type: string firstName: type: string middleName: type: string suffix: type: string dateOfBirth: type: string genderCode: type: string supplementalIdentification: type: object properties: patientAccountNumber: type: string ssn: type: string address1: type: string address2: type: string city: type: string state: type: string postalCode: type: string countryCode: type: string countrySubDivisionCode: type: string insuredIndicator: type: string relationshipToInsuredCode: type: string birthSequenceNumber: type: string patientEventDetail: type: object properties: patientEventRequestValidation: type: array items: type: object properties: responseCode: type: string rejectReasonCode: type: string followupActionCode: type: string requestCategoryCode: type: string certificationTypeCode: type: string serviceTypeCode: type: string facilityTypeCode: type: string facilityCodeQualifier: type: string levelOfServiceCode: type: string certificationActionCode: type: string reviewIdentificationNumber: type: string reviewDecisionReasonCode: type: string secondSurgicalOpinionIndicator: type: string administrativeReferenceNumber: type: string previousReviewAuthorizationNumber: type: string accidentDate: type: string lastMenstrualPeriodDate: type: string estimatedDateOfBirth: type: string onsetOfCurrentSymptomsOrIllnessDate: type: string eventDateBegin: type: string eventDateEnd: type: string admissionDateBegin: type: string admissionDateEnd: type: string dischargeDate: type: string certificationIssueDate: type: string certificationExpirationDate: type: string certificationEffectiveDateBegin: type: string certificationEffectiveDateEnd: type: string diagnosisTypeCode1: type: string diagnosisCode1: type: string diagnosisDate1: type: string diagnosisTypeCode2: type: string diagnosisCode2: type: string diagnosisDate2: type: string diagnosisTypeCode3: type: string diagnosisCode3: type: string diagnosisDate3: type: string diagnosisTypeCode4: type: string diagnosisCode4: type: string diagnosisDate4: type: string diagnosisTypeCode5: type: string diagnosisCode5: type: string diagnosisDate5: type: string diagnosisTypeCode6: type: string diagnosisCode6: type: string diagnosisDate6: type: string diagnosisTypeCode7: type: string diagnosisCode7: type: string diagnosisDate7: type: string diagnosisTypeCode8: type: string diagnosisCode8: type: string diagnosisDate8: type: string diagnosisTypeCode9: type: string diagnosisCode9: type: string diagnosisDate9: type: string diagnosisTypeCode10: type: string diagnosisCode10: type: string diagnosisDate10: type: string diagnosisTypeCode11: type: string diagnosisCode11: type: string diagnosisDate11: type: string diagnosisTypeCode12: type: string diagnosisCode12: type: string diagnosisDate12: type: string quantityQualifier: type: string serviceUnitCount: type: string unitOrBasisForMeasurementCode: type: string sampleSelectionModulus: type: string timePeriodQualifier: type: string periodCount: type: string deliveryFrequencyCode: type: string deliveryPatternTimeCode: type: string institutionalAdmissionTypeCode: type: string institutionalAdmissionSourceCode: type: string institutionalPatientStatusCode: type: string ambulanceTransportCode: type: string ambulanceUnitOrBasisForMeasurementCode: type: string ambulanceTransportDistance: type: string spinalManipulationTreatmentSeriesNumber: type: string spinalManipulationTreatmentCount: type: string spinalManipulationSubluxationLevelCode: type: string spinalManipulationSubluxationLevelCode2: type: string oxygenEquipmentTypeCode: type: string oxygenEquipmentTypeCode2: type: string oxygenFlowRate: type: string dailyOxygenUseCount: type: string oxygenUsePeriodHourCount: type: string respiratoryTherapistOrderText: type: string portableOxygenSystemFlowRate: type: string oxygenDeliverySystemCode: type: string oxygenSystemTypeCode: type: string homeHealthPrognosisCode: type: string homeHealthStartDate: type: string homeHealthCertificationPeriodStartDate: type: string homeHealthMedicareCoverageIndicator: type: string homeHealthCertificationTypeCode: type: string attachments: type: array items: type: object properties: reportTypeCode: type: string transmissionCode: type: string controlNumber: type: string description: type: string freeFormMessageText: type: string patientEventProviderName: type: array items: type: object properties: patientEventProviderRequestValidation: type: array items: type: object properties: responseCode: type: string rejectReasonCode: type: string followupActionCode: type: string entityIdentifierCode: type: string lastName: type: string firstName: type: string middleName: type: string namePrefix: type: string nameSuffix: type: string identificationCodeQualifier: type: string identifier: type: string address1: type: string address2: type: string city: type: string state: type: string postalCode: type: string countryCode: type: string countrySubDivisionCode: type: string providerSupplementalInformation: type: object properties: ssn: type: string carrierAssignedReferenceNumber: type: string contactName: type: string contactElectronicMail: type: string contactFacsimile: type: string contactTelephone: type: string providerCode: type: string providerTaxonomyCode: type: string patientEventAdditionalPatientInformationContactName: type: array items: type: object properties: organizationName: type: string middleName: type: string nameSuffix: type: string identificationCodeQualifier: type: string identifier: type: string address1: type: string address2: type: string city: type: string state: type: string postalCode: type: string countryCode: type: string countrySubDivisionCode: type: string contactName: type: string contactElectronicMail: type: string contactFacsimile: type: string contactTelephone: type: string patientEventTransportInformation: type: array items: type: object properties: patientEventTransportInformationValidation: type: array items: type: object properties: responseCode: type: string rejectReasonCode: type: string followupActionCode: type: string entityIdentifierCode: type: string transportLocationName: type: string address1: type: string address2: type: string city: type: string state: type: string postalCode: type: string serviceLevel: type: array items: type: object properties: serviceRequestValidation: type: array items: type: object properties: responseCode: type: string rejectReasonCode: type: string followupActionCode: type: string requestCategoryCode: type: string certificationTypeCode: type: string serviceTypeCode: type: string facilityTypeCode: type: string facilityCodeQualifier: type: string certificationActionCode: type: string reviewIdentificationNumber: type: string reviewDecisionReasonCode: type: string secondSurgicalOpinionIndicator: type: string administrativeReferenceNumber: type: string previousReviewAuthorizationNumber: type: string serviceDateBegin: type: string serviceDateEnd: type: string certificationIssueDate: type: string certificationExpirationDate: type: string certificationEffectiveDateBegin: type: string certificationEffectiveDateEnd: type: string professionalService: type: object properties: productOrServiceIDQualifier: type: string procedureCode: type: string procedureModifier: type: string procedureModifier2: type: string procedureModifier3: type: string procedureModifier4: type: string procedureCodeDescription: type: string procedureCode2: type: string serviceLineAmount: type: string unitOrBasisForMeasurementCode: type: string serviceUnitCount: type: string epsdtIndicator: type: string nursingHomeLevelOfCareCode: type: string institutionalService: type: object properties: serviceLineRevenueCode: type: string productOrServiceIDQualifier: type: string procedureCode: type: string procedureModifier: type: string procedureModifier2: type: string procedureModifier3: type: string procedureModifier4: type: string procedureCodeDescription: type: string procedureCode2: type: string serviceLineAmount: type: string unitOrBasisForMeasurementCode: type: string serviceUnitCount: type: string serviceLineRate: type: string nursingHomeLevelOfCare: type: string dentalService: type: object properties: procedureCode: type: string procedureModifier: type: string procedureModifier2: type: string procedureModifier3: type: string procedureModifier4: type: string procedureCodeDescription: type: string procedureCode2: type: string serviceLineAmount: type: string americanDentalAssociationCodes: type: string americanDentalAssociationCodes2: type: string americanDentalAssociationCodes3: type: string americanDentalAssociationCodes4: type: string americanDentalAssociationCodes5: type: string prosthesisCrownOrInlayCode: type: string serviceUnitCount: type: string toothInformation: type: array items: type: object properties: toothCode: type: string toothSurfaceCode: type: string toothSurfaceCode2: type: string toothSurfaceCode3: type: string toothSurfaceCode4: type: string toothSurfaceCode5: type: string quantityQualifier: type: string serviceUnitCount: type: string unitOrBasisForMeasurementCode: type: string sampleSelectionModulus: type: string timePeriodQualifier: type: string periodCount: type: string deliveryFrequencyCode: type: string deliveryPatternTimeCode: type: string attachments: type: array items: type: object properties: reportTypeCode: type: string transmissionCode: type: string controlNumber: type: string description: type: string freeFormMessageText: type: string serviceProviderName: type: array items: type: object properties: serviceProviderRequestValidation: type: array items: type: object properties: responseCode: type: string rejectReasonCode: type: string followupActionCode: type: string entityIdentifierCode: type: string lastName: type: string firstName: type: string middleName: type: string namePrefix: type: string nameSuffix: type: string identificationCodeQualifier: type: string identifier: type: string address1: type: string address2: type: string city: type: string state: type: string postalCode: type: string countryCode: type: string countrySubDivisionCode: type: string providerSupplementalInformation: type: object properties: ssn: type: string carrierAssignedReferenceNumber: type: string contactName: type: string contactElectronicMail: type: string contactFacsimile: type: string contactTelephone: type: string providerCode: type: string providerTaxonomyCode: type: string serviceDetailAdditionalServiceInformationContactName: type: array items: type: object properties: organizationName: type: string middleName: type: string nameSuffix: type: string identificationCodeQualifier: type: string identifier: type: string address1: type: string address2: type: string city: type: string state: type: string postalCode: type: string countryCode: type: string countrySubDivisionCode: type: string contactName: type: string contactElectronicMail: type: string contactFacsimile: type: string contactTelephone: type: string headers: transaction-id: description: Transaction Id of the request required: true schema: type: string format: uuid example: c9476bc2-b563-4555-9527-4afe9dccaf9a x-amzn-trace-id: description: Generated traceId of the request required: true example: Root=1-61d7441a-56e4c77350687b5230e5707 schema: type: string responses: '403': headers: x-amzn-trace-id: $ref: '#/components/headers/x-amzn-trace-id' description: Forbidden. Authentication succeeded but authenticated user doesn't have access to the resource content: application/json: schema: $ref: '#/components/schemas/Errors' '400': headers: x-amzn-trace-id: $ref: '#/components/headers/x-amzn-trace-id' description: Bad Request. The request body is malformed or missing required information. content: application/json: schema: $ref: '#/components/schemas/Errors' '500': headers: x-amzn-trace-id: $ref: '#/components/headers/x-amzn-trace-id' description: Internal Server Error. An unexpected error has occurred. content: application/json: schema: $ref: '#/components/schemas/Errors' '401': description: Unauthorized. No or invalid authentication details are provided headers: x-amzn-trace-id: $ref: '#/components/headers/x-amzn-trace-id' content: application/json: schema: $ref: '#/components/schemas/Errors' parameters: x-optum-tenant-id: description: The unique ID of the tenant that the invoking user belongs to. in: header name: x-optum-tenant-id schema: type: string format: uuid example: 9fb77454-8c58-4345-aa50-43f133e06d20 required: true x-optum-correlation-id: description: A unique identifier assigned to each request. in: header name: x-optum-correlation-id schema: type: string format: uuid example: c9476bc2-b563-4555-9527-4afe9dccaf9a securitySchemes: bearerAuth: type: http scheme: bearer bearerFormat: JWT