components: schemas: AdditionalDocumentation: properties: additionalDocumentationTypeId: description: 006 - Medicare equals 04.04B Lymphedema Pumps, 007 - Medicare equals 04.05C Osteogenesis Stimulator, 008 - Medicare equals 06.03B Transcutaneous Electrical NerveStimulator (TENS), 009 - Medicare equals 07.03A Seat Lift Mechanisms, 012 - Medicare equals 09.02 Infusion Pump, 015 - Medicare equals 484.03 Oxygen, 016 - Medicare equals 10.03 Enteral and Parenteral Nutrition, 017 - Medicare equals 11.02 Section C Continuation Form format: ncpdp-alphanumeric maxLength: 9 type: string lengthOfNeed: $ref: '#/components/schemas/LengthOfNeed' prescriberOrSupplierDateSigned: example: '2023-10-01' format: rxn-date type: string question: items: $ref: '#/components/schemas/Question' type: array requestPeriodBeginDate: example: '2023-10-01' format: rxn-date type: string requestPeriodRecertOrRevisedDate: example: '2023-10-01' format: rxn-date type: string requestStatus: description: Code identifying type of request. 0 - Not Specified, 1 - Initial, 2 - Revision, 3 - Recertification format: ncpdp-alphanumeric maxLength: 3 type: string supportingDocumentation: format: ncpdp-alphanumeric maxLength: 195 type: string type: object AdditionalDocumentationV1: properties: additionalDocumentationTypeId: description: 006 - Medicare equals 04.04B Lymphedema Pumps, 007 - Medicare equals 04.05C Osteogenesis Stimulator, 008 - Medicare equals 06.03B Transcutaneous Electrical NerveStimulator (TENS), 009 - Medicare equals 07.03A Seat Lift Mechanisms, 012 - Medicare equals 09.02 Infusion Pump, 015 - Medicare equals 484.03 Oxygen, 016 - Medicare equals 10.03 Enteral and Parenteral Nutrition, 017 - Medicare equals 11.02 Section C Continuation Form errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 9. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 9 type: string lengthOfNeed: errorMessage: minProperties: must have at least one property. minProperties: 1 properties: days: errorMessage: maxLength: exceeds the maximum limit of 3. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 3 pattern: ^[0-9]*$ type: string hours: errorMessage: maxLength: exceeds the maximum limit of 3. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 3 pattern: ^[0-9]*$ type: string lifetime: errorMessage: maxLength: exceeds the maximum limit of 3. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 3 pattern: ^[0-9]*$ type: string months: errorMessage: maxLength: exceeds the maximum limit of 3. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 3 pattern: ^[0-9]*$ type: string weeks: errorMessage: maxLength: exceeds the maximum limit of 3. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 3 pattern: ^[0-9]*$ type: string years: errorMessage: maxLength: exceeds the maximum limit of 3. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 3 pattern: ^[0-9]*$ type: string required: - hours - days - weeks - months - years - lifetime type: object prescriberOrSupplierDateSigned: errorMessage: format: invalid date. type: invalid type, expected string. example: '2023-10-01' format: rxn-date type: string question: items: errorMessage: required: alphanumericResponse: alphanumericResponse is required. dateResponse: dateResponse is required. dollarAmountResponse: dollarAmountResponse is required. numberOrLetter: numberOrLetter is required. numericResponse: numericResponse is required. percentResponse: percentResponse is required. properties: alphanumericResponse: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string dateResponse: errorMessage: format: invalid date. type: invalid type, expected string. example: '2023-10-01' format: rxn-date type: string dollarAmountResponse: errorMessage: maxLength: exceeds the maximum limit of 16. pattern: not valid amount. type: invalid type, expected string. maxLength: 16 pattern: ^-?(\d{1,9}(?:[.]\d{1,6})?)?$ type: string numberOrLetter: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 9. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 9 type: string numericResponse: errorMessage: maxLength: exceeds the maximum limit of 11. pattern: invalid value,only numeric expected. type: invalid type, expected string. maxLength: 11 pattern: ^[0-9]*$ type: string percentResponse: errorMessage: maxLength: exceeds the maximum limit of 5. pattern: not valid percent. type: invalid type, expected string. maxLength: 5 pattern: ^(\d{1,3}(?:[.]\d{1,2})?)?$ type: string required: - numberOrLetter - percentResponse - dateResponse - dollarAmountResponse - numericResponse - alphanumericResponse type: object type: array requestPeriodBeginDate: errorMessage: format: invalid date. type: invalid type, expected string. example: '2023-10-01' format: rxn-date type: string requestPeriodRecertOrRevisedDate: errorMessage: format: invalid date. type: invalid type, expected string. example: '2023-10-01' format: rxn-date type: string requestStatus: description: Code identifying type of request. 0 - Not Specified, 1 - Initial, 2 - Revision, 3 - Recertification errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 3. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 3 type: string supportingDocumentation: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 195. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 195 type: string type: object AdditionalMessageInformationGrouping: properties: additionalMessageInformation: $ref: '#/components/schemas/NcpdpAlphaNumericType' additionalMessageInformationContinuity: $ref: '#/components/schemas/NcpdpCodeType' additionalMessageInformationQualifier: $ref: '#/components/schemas/NcpdpCodeType' empty: type: boolean present: type: boolean type: object AdditionalMessageInformationGroupingV1: properties: code: type: string continuity: type: string value: type: string type: object AlternateCardHolderIdentifier: properties: alienNumber: type: string apprissHealthPatientId: type: string driversLicenseNumber: type: string employerAssignedId: type: string evernorthUniversalPatientIdentifier: type: string facilityIdNumber: type: string governmentStudentVISANumber: type: string indianTribalId: type: string lexIdUniversalPatientIdentifier: type: string medicaidId: type: string medicareBeneficiaryId: type: string ncpdpUniversalPatientIdentifier: type: string nonSSNPatientIdentifier: type: string otherId: type: string passportId: type: string payerAssignedId: type: string socialSecurityNumber: type: string ssnBasedPatientIdentifier: type: string stateIssuedId: type: string usMilitaryId: type: string type: object BenefitStageAmount: properties: catastrophicCoverage: type: string coverageGap: type: string deductible: type: string enhanceOrOtcDrug: type: string initialBenefit: type: string nonPartDDrug: type: string paidUnderCoAdministeredBenefitOnly: type: string paidUnderCoAdministeredInsuredBenefitOnly: type: string paidUnderMedicaidBenefitOnly: type: string paidUnderPartC: type: string paidUnderPartCBenefit: type: string paidUnderSupplemental: type: string partDDrug: type: string type: object BenefitStageGrouping: properties: benefitStageAmount: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true benefitStageQualifier: $ref: '#/components/schemas/NcpdpCodeType' deprecated: true empty: type: boolean present: type: boolean type: object Claim: properties: alternateId: format: ncpdp-alphanumeric maxLength: 60 type: string associatedPrescriptionOrServiceDate: type: string associatedPrescriptionOrServiceReferenceNumber: type: string compoundCode: description: Code indicating whether or not the prescription is a compound. 0 - Not Specified, 1 - Not a Compound, 2 - Compound maxLength: 1 pattern: ^[0-9]*$ type: string compoundType: format: ncpdp-alphanumeric maxLength: 6 type: string datePrescriptionWritten: example: '2023-10-01' format: rxn-date type: string daysSupply: maxLength: 3 pattern: ^[0-9]*$ type: string daysSupplyIntendedToBeDispensed: maxLength: 3 pattern: ^[0-9]*$ type: string delayReasonCode: description: Code to specify the reason that submission of the transactions has been delayed. 1 - Proof of eligibility unknown or unavailable, 2 - Litigation, 3 - Authorization delays, 4 - Delay in certifying provider, 5 - Delay in supplying billing forms, 6 - Delay in delivery of custom-made appliances, 7 - Third party processing delay, 8 - Delay in eligibility determination, 9 - Original claims rejected or denied due to a reason unrelated to the billing limitation rules, 10 - Administration delay in the prior approval process, 11 - Other, 12 - Received late with no exceptions, 13 - Substantial damage by fire, etc. to provider records, 14 - Theft, sabotage/other willful acts by employee maxLength: 2 pattern: ^[0-9]*$ type: string dispenseAsWrittenOrProductSelectionCode: type: string dispensingStatus: description: Code indicating the quantity dispensed is a partial fill or the completion of a partial fill. P - Partial Fill, C - Completion of Partial Fill format: ncpdp-alphanumeric maxLength: 3 type: string fillNumber: maxLength: 2 pattern: ^[0-9]*$ type: string intermediaryAuthorizationId: type: string intermediaryAuthorizationTypeId: type: string levelOfService: description: Coding indicating the type of service the provider rendered. 0 - Not Specified, 1 - Patient Consultation, 2 - Home Delivery, 3 - Emergency, 4 - 24 Hour Service, 5 - Patient Consultation regarding generic product selection, 6 - In-Home Service, 7 - Medical at home with special pharmacy services identical to Long Term Care maxLength: 2 pattern: ^[0-9]*$ type: string medicaidSubrogationIcnOrTcn: type: string numberOfRefillsAuthorized: maxLength: 2 pattern: ^[0-9]*$ type: string originallyPrescribedProductOrServiceCode: $ref: '#/components/schemas/OriginallyPrescribedProductOrServiceCode' originallyPrescribedQuantity: maxLength: 11 pattern: ^(\d{1,7}(?:[.]\d{1,3})?)?$ type: string otherCoverageCode: maxLength: 2 pattern: ^[0-9]*$ type: string patientAssignmentIndicator: description: Code to indicate a patient's choice on assignment of benefits. Y - Patient assigns benefits, N - Patient does not assign benefits format: ncpdp-alphanumeric maxLength: 3 type: string pharmacyServiceType: type: string preferredProduct: items: $ref: '#/components/schemas/PreferredProductGrouping' type: array preferredProductCount: type: string prescriptionOriginCode: description: Code indicating the origin of the prescription. 0 - Not Known, 1 - Written, 2 - Telephone, 3 - Electronic, 4 - Facsimile, 5 - Pharmacy maxLength: 1 pattern: ^[0-9]*$ type: string prescriptionOrServiceReferenceNumberIdentifier: $ref: '#/components/schemas/PrescriptionOrServiceReferenceNumberIdentifier' priorAuthorizationIdSubmitted: type: string priorAuthorizationTypeCode: type: string procedureModifierCodes: items: type: string type: array productOrServiceIdentifier: $ref: '#/components/schemas/ProductOrServiceIdentifier' quantityDispensed: maxLength: 11 pattern: ^(\d{1,7}(?:[.]\d{1,3})?)?$ type: string quantityIntendedToBeDispensed: maxLength: 11 pattern: ^(\d{0,7}(\.?\d{1,3}+))*$ type: string quantityPrescribed: maxLength: 11 pattern: ^(\d{1,7}(?:[.]\d{1,3})?)?$ type: string routeOfAdministration: format: ncpdp-alphanumeric maxLength: 33 type: string scheduledPrescriptionIdNumber: format: ncpdp-alphanumeric maxLength: 36 type: string specialPackagingIndicator: description: Code indicating the type of dispensing dose. 0 - Not Specified, 1 - Not Unit Dose, 2 - Manufacturer Unit Dose, 3 - Pharmacy Unit Dose, 4 - Pharmacy Unit Dose Patient Compliance Packaging, 5 - Pharmacy Multi-drug Patient Compliance Packaging, 6 - Remote Device Unit Dose, 7 - Remote Device Multi-drug Compliance, 8 - Manufacturer Unit of Use Package (not unit dose) maxLength: 1 pattern: ^[0-9]*$ type: string submissionClarificationCodes: items: type: string type: array transactionReferenceNumber: format: ncpdp-alphanumeric maxLength: 30 type: string unitOfMeasure: format: ncpdp-alphanumeric maxLength: 6 type: string type: object ClaimSegment: properties: benefitTypeOpportunities: items: $ref: '#/components/schemas/NcpdpCodeType' type: array benefitTypeOpportunityCount: $ref: '#/components/schemas/NcpdpCountType' empty: type: boolean formularyAlternativeProductCount: $ref: '#/components/schemas/NcpdpCountType' formularyAlternativeProductGroupings: items: $ref: '#/components/schemas/FormularyAlternativeProductGrouping' type: array maximumAge: $ref: '#/components/schemas/NcpdpIntegerType' maximumAgeQualifier: $ref: '#/components/schemas/NcpdpCodeType' maximumAmount: $ref: '#/components/schemas/NcpdpDecimalType' maximumAmountQualifier: $ref: '#/components/schemas/NcpdpCodeType' maximumAmountTimePeriod: $ref: '#/components/schemas/NcpdpCodeType' maximumAmountTimePeriodEndDate: $ref: '#/components/schemas/NcpdpDateType' maximumAmountTimePeriodStartDate: $ref: '#/components/schemas/NcpdpDateType' maximumAmountTimePeriodUnits: $ref: '#/components/schemas/NcpdpIntegerType' medicaidSubrogationIcnOrTcn: $ref: '#/components/schemas/NcpdpAlphaNumericType' deprecated: true minimumAge: $ref: '#/components/schemas/NcpdpIntegerType' minimumAgeQualifier: $ref: '#/components/schemas/NcpdpCodeType' minimumAmount: $ref: '#/components/schemas/NcpdpDecimalType' minimumAmountQualifier: $ref: '#/components/schemas/NcpdpCodeType' planBenefitOverrideIndicator: $ref: '#/components/schemas/NcpdpAlphaNumericType' planBenefitOverrideValueCount: $ref: '#/components/schemas/NcpdpCountType' planBenefitOverrideValues: items: $ref: '#/components/schemas/NcpdpAlphaNumericType' type: array preferredProductCount: $ref: '#/components/schemas/NcpdpCountType' deprecated: true preferredProductGroupings: deprecated: true items: $ref: '#/components/schemas/FormularyAlternativeProductGrouping' type: array prescriptionOrServiceReferenceNumber: $ref: '#/components/schemas/NcpdpLongType' prescriptionOrServiceReferenceNumberQualifier: $ref: '#/components/schemas/NcpdpCodeType' present: type: boolean remainingAmount: $ref: '#/components/schemas/NcpdpDecimalType' remainingAmountQualifier: $ref: '#/components/schemas/NcpdpCodeType' subrogationRequestorsReconciliationId: $ref: '#/components/schemas/NcpdpAlphaNumericType' type: object ClaimV1: properties: preferredProduct: items: $ref: '#/components/schemas/PreferredProductGroupingV1' type: array prescriptionServiceReferenceNumberId: $ref: '#/components/schemas/IdentifierV1' type: object Clinical: properties: clinicalInformation: items: $ref: '#/components/schemas/ClinicalInformation' type: array diagnosisCodes: items: $ref: '#/components/schemas/DiagnosisCodes' type: array type: object ClinicalInformation: properties: measurementDate: type: string measurementDimension: type: string measurementTime: type: string measurementUnit: type: string measurementValue: type: string type: object CobOtherPayments: properties: otherPayerId: items: $ref: '#/components/schemas/OtherPayerIds' type: array type: object CobOtherPaymentsV1: properties: otherPayerId: items: $ref: '#/components/schemas/OtherPayerIdsV1' type: array type: object CodeValuePairV1: properties: code: type: string value: type: string type: object Compound: properties: compoundDispensingUnitFormIndicator: type: string compoundDosageFormDescriptionCode: type: string compoundProductIngredient: items: $ref: '#/components/schemas/CompoundProductIngredient' type: array type: object CompoundProductIdentifier: properties: departmentOfDefense: type: string deviceIdentifier: type: string drugIdentificationNumber: type: string firstDataBankClinicalFormulationIDSequenceNumber: type: string firstDataBankFormulationIdGCN: type: string firstDataBankIngredientListID: type: string firstDataBankMedicationID: type: string firstDataBankMedicationNameID: type: string firstDataBankRoutedDosageFormID: type: string firstDataBankRoutedMedicationID: type: string globalTradeIdentificationNumber: type: string healthIndustryBusinessCommunicationsCouncil: type: string healthRelatedItem: type: string nationalDrugCode: type: string nationalPharmaceuticalProductInterfaceCode: type: string other: type: string universalProductCode: type: string type: object CompoundProductIngredient: properties: compoundIngredientBasisOfCostDetermination: type: string compoundIngredientDrugCost: type: string compoundIngredientModifierCode: items: type: string type: array compoundIngredientQuantity: type: string compoundProductIdentifier: $ref: '#/components/schemas/CompoundProductIdentifier' type: object CoordinationOfBenefitsItem: properties: benefitStageAmount: $ref: '#/components/schemas/BenefitStageAmount' internalControlNumber: format: ncpdp-alphanumeric maxLength: 90 type: string otherPayerAmountPaid: $ref: '#/components/schemas/OtherPayerAmountPaid' otherPayerCoverageType: description: Code identifying the type or order of processing associated with the Other Payer ID. 01 - Primary (First), 02 - Secondary (Second), 03 Tertiary (Third), 04 - Quaternary (Fourth) format: ncpdp-alphanumeric maxLength: 6 type: string otherPayerDate: example: '2023-10-01' format: rxn-date type: string otherPayerIdentifier: $ref: '#/components/schemas/OtherPayerIdentifier' otherPayerPatientResponsibilityAmount: $ref: '#/components/schemas/OtherPayerPatientResponsibilityAmount' otherPayerRejectCodes: items: type: string type: array type: object Coupon: properties: couponNumber: type: string couponType: type: string couponValueAmount: type: string type: object CouponV1: properties: number: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 45. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 45 type: string type: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number valueAmount: errorMessage: maxLength: exceeds the maximum limit of 13. pattern: not valid amount. type: invalid type, expected string. maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string type: object DiagnosisCodes: properties: americanPsychiatricAssociationDiagnosticStatisticalManualOfMentalDisorders: type: string commonDentalTerminology: type: string firstDataBankDiseaseCode: type: string firstDataBankFMLDiseaseIdentifier: type: string internationalClassificationOfDiseases: type: string internationalClassificationOfDiseases10ClinicalModifications: type: string mediSpanProductLineDiagnosisCode: type: string nationalCriteriaCareInstitute: type: string other: type: string theSystematizedNomenclatureOfHumanAndVeterinaryMedicine: type: string type: object DurCoAgentIdentifier: properties: americanHospitalFormularyService: type: string americanPsychiatricAssociationDiagnosticStatisticalManualOfMentalDisordersDsmIV: type: string americanPsychiatricAssociationDiagnosticStatisticalManualOfMentalDisordersDsmV: type: string currentDentalTerminology: type: string currentProceduralTerminologyFive: type: string currentProceduralTerminologyFour: type: string deviceIdentifier: type: string firstDataBankClinicalFormulationIDSequenceNumber: type: string firstDataBankFormulationIDGCN: type: string firstDataBankIngredientListID: type: string firstDataBankMedicationID: type: string firstDataBankMedicationNameID: type: string firstDataBankRoutedDosageFormID: type: string firstDataBankRoutedMedicationID: type: string firstDataBankSmartKey: type: string globalTradeIdentificationNumber: type: string healthcareCommonProcedureCodingSystem: type: string healthIndustryBusinessCommunicationsCouncil: type: string healthRelatedItem: type: string internationalClassificationOfDiseases10ProcedureCodingSystem: type: string internationalClassificationOfDiseasesICD10CM: type: string internationalClassificationOfDiseasesICD9: type: string logicalObservationIdentifierNamesAndCodes: type: string medispanDrugDescriptorId: type: string medispanGenericProductIdentifier: type: string nationalCriteriaCareInstitute: type: string nationalDrugCode: type: string nationalPharmaceuticalProductInterfaceCode: type: string other: type: string rxNormBrandedPackage: type: string rxNormGenericPackage: type: string rxNormSemanticBrandedDrug: type: string rxNormSemanticClinicalDrug: type: string systematizedNomenclatureOfMedicineClinicalTerms: type: string truvenOrMicromedexGenericFormulationCode: type: string truvenOrMicromedexGenericMaster: type: string universalProductCode: type: string type: object DurItem: properties: durCoAgentIdentifier: $ref: '#/components/schemas/DurCoAgentIdentifier' durOrPpsLevelOfEffort: maxLength: 2 pattern: ^[0-9]*$ type: string professionalServiceCode: description: Code identifying pharmacist intervention when a conflict code has been identified or service has been rendered. 00 - No intervention, AS - Patient assessment, AS - Patient assessment, CC - Coordination of care, DE - Dosing evaluation/determination, DP - Dosage evaluated, FE - Formulary enforcement, GP - Generic product selection, GP - Generic product selection, M0 - Prescriber consulted, M0 - Prescriber consulted, MA - Medication administration, MB - Medication benefit outweighs risk, MB - Overriding benefit, MP - Patient will be monitored, MR - Medication review, NM - Non-Medication Counseling, PA - Previous patient tolerance, PE - Patient education/instruction, PE - Patient education/instruction, PH - Patient medication history, PM - Patient monitoring, PM - Patient monitoring, P0 - Patient consulted, P0 - Patient consulted, PT - Perform laboratory test, R0 - Pharmacist consulted other source, R0 - Pharmacist consulted other source, RT - Recommend laboratory test, SC - Self-care consultation, SC - Self-care consultation, SW - Literature search/review, TC - Payer/processor consulted, TH - Therapeutic product interchang, UA - Unavailable to Confirm Medication Delivery Device Method and Patient Requires Immediate Access format: ncpdp-alphanumeric maxLength: 6 type: string reasonForServiceCode: description: Code identifying the type of utilization conflict detected by the prescriber or the pharmacist or the reason for the pharmacist's professional service. AD - Additional Drug Needed, AN - Prescription Authentication, AR - Adverse Drug Reaction, AT - Additive Toxicity, CD - Chronic Disease Management, CH - Call Help Desk, CS - Patient Complaint/Symptom, DA - Drug-Allergy, DC - Drug-Disease (Inferred), DD - Drug-Drug Interaction, DF - Drug-Food Interaction, DI - Drug Incompatibility, DI - Drug Incompatibility, DL - Drug-Lab Conflict, DM - Apparent Drug Misuse, DP - Partial Lot Drug Recall Warning, DR - Dose Range Conflict, DS - Tobacco Use, ED - Patient Education/Instruction, ER - Overuse, EX - Excessive Quantity, HC - High Cumulative Dose, HD - High Dose, IC - Iatrogenic Condition, IC - Iatrogenic Condition, ID - Ingredient Duplication, LD - Low Dose, LK - Lock In Recipient, LR - Underuse, MC - Drug-Disease (Reported), MD - Medication Delivery Device Method Required, MN - Insufficient Duration, MP - Poly-Pharmacy Detected, MS - Missing Information/Clarification, MX - Excessive Duration, NA - Drug Not Available, NC - Non-covered Drug Purchase, ND - New Disease/Diagnosis, NF - Non-Formulary Drug, NN - Unnecessary Drug, NP - New Patient Processing, NR - Lactation/Nursing Interaction, NS - Insufficient Quantity, OH - Alcohol Conflict, PA - Drug-Age, PA - Drug-Age, PC - Patient Question/Concern, PG - Drug-Pregnancy, PH - Preventive Health Care, PN - Prescriber Consultation, PP - Plan Protocol, PR - Prior Adverse Reaction, PS - Product Selection Opportunity, RE - Suspected Environmental Risk, RF - Health Provider Referral, SC - Suboptimal Compliance, SD - Suboptimal Drug/Indication, SE - Side Effect, SF - Suboptimal Dosage Form, SR - Suboptimal Regimen, SX - Drug-Gender, TD - Therapeutic Duplication, TD - Therapeutic, TN - Laboratory Test Needed, TP - Payer/Processor Question, UD - Duplicate Drug format: ncpdp-alphanumeric maxLength: 6 type: string resultOfServiceCode: description: Action taken by a pharmacist or prescriber in response to a conflict or the result of a pharmacist's professional service. 00 - Not Specified, 1A - Dispensed As Is, False Positive, 1B - Dispensed Prescription As Is, 1C - Dispensed, With Different Dose, 1D - Dispensed, With Different Directions, 1E - Dispensed, With Different Drug, 1F - Dispensed, With Different Quantity, 1G - Dispensed, With Prescriber Approval, 1H - Brand-to-Generic Change, 1J - Rx-to-OTC Change, 1K - Dispensed with Different Dosage Form, 2A - Prescription Not Dispensed, 2B - Not Dispensed, Directions Clarified, 3A - Recommendation Accepted, 3B - Recommendation Not Accepted, 3C - Discontinued Drug, 3D - Regimen Changed, 3E - Therapy Changed, 3F - Therapy Changed-cost increased acknowledged, 3G - Drug Therapy Unchanged, 3H - Follow-Up/Report, 3J - Patient Referral, 3K - Instructions Understood, 3M - Compliance Aid Provided, 3N - Medication Administered, 4A - Prescribed With Acknowledgments, 4B - Dispensed, Palliative Care, 4C - Dispensed, Hospice, 4D - Dispensed, Cancer Treatment, 4E - Dispensed, Chronic Pain, 4F - Dispensed, Exempt Per Prescriber, 4G - Dispensed, Surgery/Trauma, 4H - Dispensed, Hospital Admission/Discharge, 4J - Dispensed, Patient is Not Opioid Naive, 4K - Prescriber Specialty Exemption-Oncology Or Non-Hospice Palliative Care, 4L - Prescriber Specialty Exemption - Hospice, 4M - Dispensed, Sex Assigned at Birth is Male, 4N - Dispensed, Sex Assigned at Birth is Female, 4P - Dispensed, Sex Assigned at Birth is Unknown, 4Q - Dispensed, Sex Assigned at Birth is Intersex, 4R - Dispensed, Sickle Cell Disease, 5A - DME Pump Delivery Device Method, 5B - Non-DME or Disposable Delivery Device Method, 5C - Unknown Delivery Device Method and Immediate Access Required format: ncpdp-alphanumeric maxLength: 6 type: string type: object DurOrPps: properties: durPpsResponseCode: items: $ref: '#/components/schemas/DurPpsResponseCode' type: array type: object DurOrPpsGrouping: properties: clinicalSignificanceCode: $ref: '#/components/schemas/NcpdpCodeType' databaseIndicator: $ref: '#/components/schemas/NcpdpCodeType' durAdditionalText: $ref: '#/components/schemas/NcpdpAlphaNumericType' deprecated: true durFreeTextMessage: $ref: '#/components/schemas/NcpdpAlphaNumericType' deprecated: true durOrDueCoAgentDescription: $ref: '#/components/schemas/NcpdpAlphaNumericType' durOrDueCoAgentId: $ref: '#/components/schemas/NcpdpAlphaNumericType' durOrDueCoAgentIdQualifier: $ref: '#/components/schemas/NcpdpCodeType' durOrDueCompoundProductId: $ref: '#/components/schemas/NcpdpAlphaNumericType' durOrDueCompoundProductIdQualifier: $ref: '#/components/schemas/NcpdpCodeType' durOrDueFreeTextMessage: $ref: '#/components/schemas/NcpdpAlphaNumericType' durOrDueMaximumDailyDoseQuantity: $ref: '#/components/schemas/NcpdpDecimalType' durOrDueMaximumDailyDoseUnitOfMeasure: $ref: '#/components/schemas/NcpdpCodeType' durOrDueMinimumDailyDoseQuantity: $ref: '#/components/schemas/NcpdpDecimalType' durOrDueMinimumDailyDoseUnitOfMeasure: $ref: '#/components/schemas/NcpdpCodeType' durOrPpsCodeCounter: $ref: '#/components/schemas/NcpdpCounterType' empty: type: boolean otherPharmacyId: $ref: '#/components/schemas/NcpdpAlphaNumericType' otherPharmacyIdQualifier: $ref: '#/components/schemas/NcpdpCodeType' otherPharmacyIndicator: $ref: '#/components/schemas/NcpdpCodeType' otherPharmacyName: $ref: '#/components/schemas/NcpdpAlphaNumericType' otherPharmacyTelephone: $ref: '#/components/schemas/NcpdpPhoneNumberType' otherPrescriberId: $ref: '#/components/schemas/NcpdpAlphaNumericType' otherPrescriberIdQualifier: $ref: '#/components/schemas/NcpdpCodeType' otherPrescriberIndicator: $ref: '#/components/schemas/NcpdpCodeType' otherPrescriberLastName: $ref: '#/components/schemas/NcpdpAlphaNumericType' otherPrescriberTelephoneNumber: $ref: '#/components/schemas/NcpdpPhoneNumberType' present: type: boolean previousDateOfFill: $ref: '#/components/schemas/NcpdpDateType' deprecated: true previousDateOfService: $ref: '#/components/schemas/NcpdpDateType' quantityOfPreviousDispensing: $ref: '#/components/schemas/NcpdpDecimalType' quantityOfPreviousFill: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true reasonForServiceCode: $ref: '#/components/schemas/NcpdpCodeType' unitOfMeasureForPreviousDispensedQuantity: $ref: '#/components/schemas/NcpdpAlphaNumericType' type: object DurOrPpsSegment: properties: durOrPpsGroupings: items: $ref: '#/components/schemas/DurOrPpsGrouping' type: array empty: type: boolean present: type: boolean type: object DurOrPpsV1: properties: durPpsResponseCode: items: $ref: '#/components/schemas/DurPpsResponseCodeV1' type: array type: object DurPpsResponseCode: properties: clinicalSignificanceCode: type: string databaseIndicator: type: string durAdditionalText: type: string durFreeTextMessage: type: string otherPharmacyIndicator: type: string otherPrescriberIndicator: type: string previousDateOfFill: format: date type: string quantityOfPreviousFill: type: number reasonForServiceCode: type: string type: object DurPpsResponseCodeV1: properties: clinicalSignificanceCode: type: string databaseIndicator: type: string durAdditionalText: type: string durFreeTextMessage: type: string otherPharmacyIndicator: type: string otherPrescriberIndicator: type: string previousDateOfFill: format: date type: string quantityOfPreviousFill: type: number reasonForServiceCode: type: string type: object Facility: properties: facilityCityAddress: type: string facilityId: type: string facilityName: type: string facilityStateOrProvinceAddress: type: string facilityStreetAddress: type: string facilityZipOrPostalZone: type: string type: object FormularyAlternativeProductGrouping: properties: empty: type: boolean formularyAlternativeDescription: $ref: '#/components/schemas/NcpdpAlphaNumericType' formularyAlternativeEffectiveDate: $ref: '#/components/schemas/NcpdpDateType' formularyAlternativeEstimatedPatientCostShare: $ref: '#/components/schemas/NcpdpDecimalType' formularyAlternativeId: $ref: '#/components/schemas/NcpdpAlphaNumericType' formularyAlternativeIdQualifier: $ref: '#/components/schemas/NcpdpCodeType' formularyAlternativeIncentive: $ref: '#/components/schemas/NcpdpDecimalType' formularyAlternativePlanBenefitTier: $ref: '#/components/schemas/NcpdpCodeType' formularyAlternativeReasonCode: $ref: '#/components/schemas/NcpdpCodeType' formularyAlternativeRequiredTherapyIndicatorCount: $ref: '#/components/schemas/NcpdpCountType' formularyAlternativeRequiredTherapyIndicatorGroupings: items: $ref: '#/components/schemas/FormularyAlternativeRequiredTherapyIndicatorGrouping' type: array preferredProductCostShareIncentive: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true preferredProductDescription: $ref: '#/components/schemas/NcpdpAlphaNumericType' deprecated: true preferredProductId: $ref: '#/components/schemas/NcpdpAlphaNumericType' deprecated: true preferredProductIdQualifier: $ref: '#/components/schemas/NcpdpCodeType' deprecated: true preferredProductIncentive: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true present: type: boolean type: object FormularyAlternativeRequiredTherapyIndicatorGrouping: properties: empty: type: boolean formularyAlternativeRequiredTherapyIndicator: $ref: '#/components/schemas/NcpdpCodeType' formularyAlternativeRequiredTherapyTimePeriodDuration: $ref: '#/components/schemas/NcpdpAlphaNumericType' formularyAlternativeRequiredTherapyTimePeriodEndDate: $ref: '#/components/schemas/NcpdpDateType' formularyAlternativeRequiredTherapyTimePeriodQualifier: $ref: '#/components/schemas/NcpdpCodeType' formularyAlternativeRequiredTherapyTimePeriodStartDate: $ref: '#/components/schemas/NcpdpDateType' present: type: boolean type: object GenderAndSexCode: properties: genderCode: enum: - NOT_SPECIFIED - MALE - FEMALE - NON_BINARY maxLength: 1 type: string sexCode: enum: - NOT_SPECIFIED - MALE - FEMALE - NON_BINARY maxLength: 1 type: string type: object GenericEquivalentProductIdentifier: properties: currentProceduralTerminologyFive: type: string currentProceduralTerminologyFour: type: string deviceIdentifier: type: string drugUseReviewOrProfessionalPharmacyService: type: string elsevierGoldStandardSpecificProductIdentifier: type: string firstDataBankClinicalFormulationIDSequenceNumber: type: string firstDataBankFormulationIdGCB: type: string firstDataBankFormulationIdGCN: type: string firstDataBankIngredientListID: type: string firstDataBankMedicationID: type: string firstDataBankMedicationNameID: type: string firstDataBankRoutedDosageFormID: type: string firstDataBankRoutedMedicationID: type: string globalTradeIdentificationNumber: type: string healthcareCommonProcedureCodingSystem: type: string healthIndustryBusinessCommunicationsCouncil: type: string healthRelatedItem: type: string nationalDrugCode: type: string nationalPharmaceuticalProductInterfaceCode: type: string other: type: string pharmacyPracticeActivityClassification: type: string universalProductCode: type: string universalProductNumber: type: string type: object Header: properties: binNumber: maxLength: 6 pattern: ^[0-9]*$ type: string chainID: format: ncpdp-alphanumeric maxLength: 30 type: string claimFormatCode: format: ncpdp-alphanumeric maxLength: 9 type: string dateOfService: example: '2023-10-01' format: rxn-date type: string externalMessageId: maxLength: 30 pattern: ^[0-9]*$ type: string groupCode: format: ncpdp-alphanumeric maxLength: 45 type: string pharmacistInitials: type: string processorControlNumber: format: ncpdp-alphanumeric maxLength: 30 type: string rems: maxLength: 1 type: string serviceProviderIdentifier: $ref: '#/components/schemas/ServiceProviderIdentifier' siteCode: format: ncpdp-alphanumeric maxLength: 240 type: string softwareVendorId: format: ncpdp-alphanumeric maxLength: 30 type: string sourceSystemId: maxLength: 30 pattern: ^[0-9]*$ type: string standard: $ref: '#/components/schemas/Standard' standardName: type: string submitterID: type: string transactionCode: maxLength: 2 type: string transactionCount: maxLength: 1 type: string type: object HeaderRequestV1: properties: chainID: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 30. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 30 type: string dateOfService: errorMessage: format: invalid date. type: invalid type. example: '2023-10-01' format: rxn-date type: string externalMessageId: errorMessage: maxLength: exceeds the maximum limit of 30. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 30 pattern: ^[0-9]*$ type: string sourceSystemId: errorMessage: maxLength: exceeds the maximum limit of 30. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 30 pattern: ^[0-9]*$ type: string standard: errorMessage: required: standardName: standardName is required. transactionType: transactionType is required. type: type is required. versionOrReleaseNumber: versionOrReleaseNumber is required. properties: standardName: enum: - TELECOM - '' errorMessage: enum: invalid value, only expected TELECOM. type: invalid type, expected string. type: string transactionType: enum: - B1 - B2 - B3 - C1 - C2 - C3 - D1 - E1 - N1 - N2 - N3 - P1 - P2 - P3 - P4 - S1 - S2 - S3 - '' errorMessage: enum: invalid value, expected values are B1,B2,B3,C1,C2,C3,D1,E1,N1,N2,N3,P1,P2,P3,P4,S1,S2,S3. maxLength: exceeds the maximum limit of 2. type: invalid type, expected string. maxLength: 2 type: string type: enum: - request - response - '' errorMessage: enum: invalid value, expected values are request or response. type: invalid type, expected string. type: string versionOrReleaseNumber: enum: - D0 - '' errorMessage: enum: invalid value, only expected D0. maxLength: exceeds the maximum limit of 2. type: invalid type, expected string. maxLength: 2 type: string required: - standardName - versionOrReleaseNumber - transactionType - type type: object transactionCode: enum: - B1 - B2 - B3 - C1 - C2 - C3 - D1 - E1 - N1 - N2 - N3 - P1 - P2 - P3 - P4 - S1 - S2 - S3 - '' errorMessage: enum: invalid value, expected values are B1,B2,B3,C1,C2,C3,D1,E1,N1,N2,N3,P1,P2,P3,P4,S1,S2,S3. maxLength: exceeds the maximum limit of 2. type: invalid type, expected string. maxLength: 2 type: string type: object HeaderSegment: properties: dateOfService: $ref: '#/components/schemas/NcpdpDateType' empty: type: boolean headerResponseStatus: $ref: '#/components/schemas/NcpdpCodeType' present: type: boolean serviceProviderId: $ref: '#/components/schemas/NcpdpAlphaNumericType' serviceProviderIdQualifier: $ref: '#/components/schemas/NcpdpCodeType' transactionCode: $ref: '#/components/schemas/NcpdpCodeType' transactionCount: $ref: '#/components/schemas/NcpdpCountType' versionOrReleaseNumber: $ref: '#/components/schemas/NcpdpCodeType' type: object HeaderV1: properties: chainID: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 30. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 30 type: string dateOfService: errorMessage: format: invalid date. type: invalid type. example: '2023-10-01' format: rxn-date type: string externalMessageId: errorMessage: maxLength: exceeds the maximum limit of 30. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 30 pattern: ^[0-9]*$ type: string sourceSystemId: errorMessage: maxLength: exceeds the maximum limit of 30. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 30 pattern: ^[0-9]*$ type: string standard: errorMessage: required: standardName: standardName is required. transactionType: transactionType is required. type: type is required. versionOrReleaseNumber: versionOrReleaseNumber is required. properties: standardName: enum: - TELECOM - '' errorMessage: enum: invalid value, only expected TELECOM. type: invalid type, expected string. type: string transactionType: enum: - B1 - B2 - B3 - C1 - C2 - C3 - D1 - E1 - N1 - N2 - N3 - P1 - P2 - P3 - P4 - S1 - S2 - S3 - '' errorMessage: enum: invalid value, expected values are B1,B2,B3,C1,C2,C3,D1,E1,N1,N2,N3,P1,P2,P3,P4,S1,S2,S3. maxLength: exceeds the maximum limit of 2. type: invalid type, expected string. maxLength: 2 type: string type: enum: - request - response - '' errorMessage: enum: invalid value, expected values are request or response. type: invalid type, expected string. type: string versionOrReleaseNumber: enum: - D0 - '' errorMessage: enum: invalid value, only expected D0. maxLength: exceeds the maximum limit of 2. type: invalid type, expected string. maxLength: 2 type: string required: - standardName - versionOrReleaseNumber - transactionType - type type: object transactionCode: enum: - B1 - B2 - B3 - C1 - C2 - C3 - D1 - E1 - N1 - N2 - N3 - P1 - P2 - P3 - P4 - S1 - S2 - S3 - '' errorMessage: enum: invalid value, expected values are B1,B2,B3,C1,C2,C3,D1,E1,N1,N2,N3,P1,P2,P3,P4,S1,S2,S3. maxLength: exceeds the maximum limit of 2. type: invalid type, expected string. maxLength: 2 type: string type: object HelpDeskBusinessUnitTypeGrouping: properties: empty: type: boolean helpDeskBusinessUnitType: $ref: '#/components/schemas/NcpdpCodeType' helpDeskContactInformation: $ref: '#/components/schemas/NcpdpAlphaNumericType' helpDeskContactInformationExtension: $ref: '#/components/schemas/NcpdpAlphaNumericType' helpDeskContactInformationQualifier: $ref: '#/components/schemas/NcpdpCodeType' present: type: boolean type: object HelpDeskPhoneNumber: properties: helpDeskSwitch: type: string intermediary: type: string other: type: string processorOrPBM: type: string type: object HelpDeskSupportTypeGrouping: properties: empty: type: boolean helpDeskBusinessUnitTypeCount: $ref: '#/components/schemas/NcpdpCountType' helpDeskBusinessUnitTypeGroupings: items: $ref: '#/components/schemas/HelpDeskBusinessUnitTypeGrouping' type: array helpDeskSupportType: $ref: '#/components/schemas/NcpdpCodeType' present: type: boolean type: object IdentifierV1: properties: code: format: int32 type: integer value: type: string type: object Insurance: properties: alternateCardholderIdentifier: $ref: '#/components/schemas/AlternateCardHolderIdentifier' cardholderFirstName: type: string cardholderId: type: string cardholderLastName: type: string cmsPartDDefinedQualifiedFacility: maxLength: 1 type: string eligibilityClarificationCode: description: 0 - Not Specified, 1 - No Override, 2 - Override, 3 - Full Time Student, 4 - Disabled Dependent, 5 - Dependent Parent, 6 - Significant Other, 7 - Non-human, 8 - Third Party Liability - Patient also eligible with federal/state funded program, coordination of benefit restrictions apply. maxLength: 1 pattern: ^[0-6]*$ type: string groupId: format: ncpdp-alphanumeric maxLength: 45 type: string homePlan: format: ncpdp-alphanumeric maxLength: 9 type: string internalControlNumber: format: ncpdp-alphanumeric maxLength: 90 type: string medicaidAgencyNumber: format: ncpdp-alphanumeric maxLength: 45 type: string medicaidIdNumber: format: ncpdp-alphanumeric maxLength: 60 type: string medicaidIndicator: description: Two character State Postal Code indicating the state where Medicaid coverage exists. format: ncpdp-alphanumeric maxLength: 6 type: string medigap: $ref: '#/components/schemas/Medigap' otherPayerBINNumber: type: string otherPayerCardholderId: type: string otherPayerGroupId: type: string otherPayerProcessorControlNumber: type: string patientRelationshipCode: maxLength: 1 pattern: ^[0-4]*$ type: string payerIdQualifier: $ref: '#/components/schemas/PayerIdentifier' personCode: format: ncpdp-alphanumeric maxLength: 9 type: string planId: format: ncpdp-alphanumeric maxLength: 24 type: string providerAcceptAssignmentIndicator: description: Code indicating whether the provider accepts assignment. Y - Assigned, N - Not Assigned format: ncpdp-alphanumeric maxLength: 3 type: string type: object InsuranceAdditionalInformationSegment: properties: benefitId: $ref: '#/components/schemas/NcpdpAlphaNumericType' cmsLowIncomeCostSharingLevel: $ref: '#/components/schemas/NcpdpAlphaNumericType' deprecated: true contractNumber: $ref: '#/components/schemas/NcpdpAlphaNumericType' empty: type: boolean formularyId: $ref: '#/components/schemas/NcpdpAlphaNumericType' medicarePartDCoverageCode: $ref: '#/components/schemas/NcpdpCodeType' nextMedicarePartDEffectiveDate: $ref: '#/components/schemas/NcpdpDateType' nextMedicarePartDTerminationDate: $ref: '#/components/schemas/NcpdpDateType' planName: $ref: '#/components/schemas/NcpdpAlphaNumericType' present: type: boolean type: object InsuranceAdditionalInformationV1: properties: benefitId: type: string cmsLowIncomeCostSharingLevel: type: string contractNumber: type: string formularyId: type: string medicarePartDCoverageCode: type: string nextMedicarePartDEffectiveDate: format: date type: string nextMedicarePartDExpirationDate: format: date type: string type: object InsuranceSegment: properties: cardholderId: $ref: '#/components/schemas/NcpdpAlphaNumericType' empty: type: boolean groupId: $ref: '#/components/schemas/NcpdpAlphaNumericType' medicaidAgencyNumber: $ref: '#/components/schemas/NcpdpAlphaNumericType' medicaidIdNumber: $ref: '#/components/schemas/NcpdpAlphaNumericType' networkReimbursementId: $ref: '#/components/schemas/NcpdpAlphaNumericType' payerId: $ref: '#/components/schemas/NcpdpAlphaNumericType' deprecated: true payerIdQualifier: $ref: '#/components/schemas/NcpdpAlphaNumericType' deprecated: true payerOrHealthPlanIdCount: $ref: '#/components/schemas/NcpdpCountType' payerOrHealthPlanIdGroupings: items: $ref: '#/components/schemas/PayerOrHealthPlanIdGrouping' type: array planId: $ref: '#/components/schemas/NcpdpAlphaNumericType' present: type: boolean type: object InsuranceV1: properties: cardholderId: type: string groupId: type: string medicaidAgencyNumber: type: string medicaidIdNumber: type: string networkReimbursementId: type: string payerId: $ref: '#/components/schemas/IdentifierV1' planId: type: string type: object IntermediaryHelpDeskBusinessUnitTypeGrouping: properties: empty: type: boolean intermediaryHelpDeskBusinessUnitType: $ref: '#/components/schemas/NcpdpCodeType' intermediaryHelpDeskContactInformation: $ref: '#/components/schemas/NcpdpAlphaNumericType' intermediaryHelpDeskContactInformationExtension: $ref: '#/components/schemas/NcpdpAlphaNumericType' intermediaryHelpDeskContactInformationQualifier: $ref: '#/components/schemas/NcpdpCodeType' present: type: boolean type: object IntermediaryHelpDeskSupportTypeGrouping: properties: empty: type: boolean intermediaryHelpDeskBusinessUnitTypeCount: $ref: '#/components/schemas/NcpdpCountType' intermediaryHelpDeskBusinessUnitTypeGroupings: items: $ref: '#/components/schemas/IntermediaryHelpDeskBusinessUnitTypeGrouping' type: array intermediaryHelpDeskSupportType: $ref: '#/components/schemas/NcpdpCodeType' present: type: boolean type: object IntermediarySegment: properties: empty: type: boolean intermediaryHelpDeskSupportTypeCount: $ref: '#/components/schemas/NcpdpCountType' intermediaryHelpDeskSupportTypeGroupings: items: $ref: '#/components/schemas/IntermediaryHelpDeskSupportTypeGrouping' type: array present: type: boolean responseIntermediaryAuthorizationCount: $ref: '#/components/schemas/NcpdpCountType' responseIntermediaryAuthorizationGroupings: items: $ref: '#/components/schemas/ResponseIntermediaryAuthorizationGrouping' type: array type: object LengthOfNeed: properties: days: maxLength: 3 pattern: ^[0-9]*$ type: string hours: maxLength: 3 pattern: ^[0-9]*$ type: string lifetime: maxLength: 3 pattern: ^[0-9]*$ type: string months: maxLength: 3 pattern: ^[0-9]*$ type: string weeks: maxLength: 3 pattern: ^[0-9]*$ type: string years: maxLength: 3 pattern: ^[0-9]*$ type: string type: object Medigap: properties: patientMedigapId: type: string supervisorPrescriberDEA: type: string type: object Message: properties: message: type: string type: object MessageSegment: properties: empty: type: boolean message: $ref: '#/components/schemas/NcpdpAlphaNumericType' present: type: boolean type: object MessageV1: properties: message: type: string type: object NameV1: properties: first: type: string last: type: string middle: type: string prefix: type: string suffix: type: string type: object Narrative: properties: narrativeMessage: format: ncpdp-alphanumeric maxLength: 600 type: string type: object NcpdpAlphaNumericType: properties: empty: type: boolean present: type: boolean raw: type: string rawEmpty: type: boolean rawPresent: type: boolean type: object NcpdpCodeType: properties: empty: type: boolean present: type: boolean raw: type: string rawEmpty: type: boolean rawPresent: type: boolean type: object NcpdpCounterType: properties: empty: type: boolean present: type: boolean raw: type: string rawEmpty: type: boolean rawPresent: type: boolean type: object NcpdpCountType: properties: empty: type: boolean present: type: boolean raw: type: string rawEmpty: type: boolean rawPresent: type: boolean type: object NcpdpDateType: properties: empty: type: boolean present: type: boolean raw: type: string rawEmpty: type: boolean rawPresent: type: boolean type: object NcpdpDecimalType: properties: empty: type: boolean present: type: boolean raw: type: string rawEmpty: type: boolean rawPresent: type: boolean type: object NcpdpFormatRequestData: properties: chainID: format: ncpdp-alphanumeric maxLength: 30 type: string externalMessageId: maxLength: 30 pattern: ^[0-9]*$ type: string response: $ref: '#/components/schemas/NcpdpResponse' sourceSystemId: maxLength: 30 pattern: ^[0-9]*$ type: string type: object NcpdpIntegerType: properties: empty: type: boolean present: type: boolean raw: type: string rawEmpty: type: boolean rawPresent: type: boolean type: object NcpdpLongType: properties: empty: type: boolean present: type: boolean raw: type: string rawEmpty: type: boolean rawPresent: type: boolean type: object NcpdpPhoneNumberType: properties: empty: type: boolean present: type: boolean raw: type: string rawEmpty: type: boolean rawPresent: type: boolean type: object NCPDPRequestConverterResponse: properties: ncpdpRequestString: type: string switchResponse: $ref: '#/components/schemas/NCPDPResponseConverterResponse' type: object NCPDPRequestConverterV1Response: properties: ncpdpRequestString: type: string switchResponse: $ref: '#/components/schemas/NCPDPResponseConverterV1Response' type: object NcpdpResponse: properties: claim: $ref: '#/components/schemas/ClaimSegment' durOrPps: $ref: '#/components/schemas/DurOrPpsSegment' empty: type: boolean header: $ref: '#/components/schemas/HeaderSegment' insurance: $ref: '#/components/schemas/InsuranceSegment' insuranceAdditionalInformation: $ref: '#/components/schemas/InsuranceAdditionalInformationSegment' intermediary: $ref: '#/components/schemas/IntermediarySegment' message: $ref: '#/components/schemas/MessageSegment' otherPayers: $ref: '#/components/schemas/OtherPayersSegment' otherRelatedBenefitDetail: $ref: '#/components/schemas/OtherRelatedBenefitDetailSegment' patient: $ref: '#/components/schemas/PatientSegment' present: type: boolean pricing: $ref: '#/components/schemas/PricingSegment' priorAuthorization: $ref: '#/components/schemas/PriorAuthorizationSegment' provider: $ref: '#/components/schemas/ProviderSegment' raw: type: string rawEmpty: type: boolean rawPresent: type: boolean status: $ref: '#/components/schemas/StatusSegment' transactions: items: $ref: '#/components/schemas/ResponseTransaction' type: array type: object NCPDPResponseConverterResponse: properties: insurance: $ref: '#/components/schemas/Insurance' patient: $ref: '#/components/schemas/Patient' responseMessage: $ref: '#/components/schemas/Message' telecomHeader: $ref: '#/components/schemas/Header' transactions: items: $ref: '#/components/schemas/Transaction' type: array type: object NCPDPResponseConverterV1Response: properties: header: $ref: '#/components/schemas/HeaderV1' insurance: $ref: '#/components/schemas/InsuranceV1' insuranceAdditionalInformation: $ref: '#/components/schemas/InsuranceAdditionalInformationV1' patient: $ref: '#/components/schemas/PatientV1' responseMessage: $ref: '#/components/schemas/MessageV1' transactions: items: $ref: '#/components/schemas/TransactionV1' type: array type: object OriginallyPrescribedProductOrServiceCode: properties: currentProceduralTerminologyFive: type: string currentProceduralTerminologyFour: type: string deviceIdentifier: type: string drugUseReviewOrProfessionalPharmacyService: type: string elsevierGoldStandardMarketedProductIdentifier: type: string elsevierGoldStandardProductIdentifier: type: string elsevierGoldStandardSpecificProductIdentifier: type: string firstDataBankClinicalFormulationIDSequenceNumber: type: string firstDataBankFormulationIdGCB: type: string firstDataBankIngredientListID: type: string firstDataBankMedicationID: type: string firstDataBankMedicationNameID: type: string firstDataBankRoutedDosageFormID: type: string firstDataBankRoutedMedicationID: type: string globalTradeIdentificationNumber: type: string healthcareCommonProcedureCodingSystem: type: string healthIndustryBusinessCommunicationsCouncil: type: string healthRelatedItem: type: string nationalDrugCode: type: string nationalPharmaceuticalProductInterfaceCode: type: string other: type: string pharmacyPracticeActivityClassification: type: string representativeNationalDrugCode: type: string rxNormBrandedPackage: type: string rxNormGenericPackage: type: string rxNormSemanticBrandedDrug: type: string rxNormSemanticClinicalDrug: type: string universalProductCode: type: string universalProductNumber: type: string type: object OtherAmountClaimedSubmitted: properties: administrativeCost: type: string compoundPreparationCost: type: string deliveryCost: type: string notSpecified: type: string other: type: string postageCost: type: string shippingCost: type: string type: object OtherAmountPaidGrouping: properties: empty: type: boolean otherAmountPaid: $ref: '#/components/schemas/NcpdpDecimalType' otherAmountPaidQualifier: $ref: '#/components/schemas/NcpdpCodeType' present: type: boolean type: object OtherBenefitDetailInformationGrouping: properties: empty: type: boolean otherBenefitDetailInformation: $ref: '#/components/schemas/NcpdpAlphaNumericType' otherBenefitDetailInformationEffectiveDate: $ref: '#/components/schemas/NcpdpDateType' otherBenefitDetailInformationFacilityName: $ref: '#/components/schemas/NcpdpAlphaNumericType' otherBenefitDetailInformationIndicator: $ref: '#/components/schemas/NcpdpCodeType' otherBenefitDetailInformationProviderNumber: $ref: '#/components/schemas/NcpdpAlphaNumericType' otherBenefitDetailInformationTerminationDate: $ref: '#/components/schemas/NcpdpDateType' otherBenefitFacilityDetailInformationTelephoneNumber: $ref: '#/components/schemas/NcpdpPhoneNumberType' present: type: boolean type: object OtherBenefitGrouping: properties: empty: type: boolean otherBenefitDetailInformationCount: $ref: '#/components/schemas/NcpdpCountType' otherBenefitDetailInformationGroupings: items: $ref: '#/components/schemas/OtherBenefitDetailInformationGrouping' type: array otherBenefitEffectiveDate: $ref: '#/components/schemas/NcpdpDateType' otherBenefitFacilityName: $ref: '#/components/schemas/NcpdpAlphaNumericType' otherBenefitFacilityTelephoneNumber: $ref: '#/components/schemas/NcpdpPhoneNumberType' otherBenefitTerminationDate: $ref: '#/components/schemas/NcpdpDateType' otherBenefitTypeCode: $ref: '#/components/schemas/NcpdpCodeType' otherBenefitTypeId: $ref: '#/components/schemas/NcpdpAlphaNumericType' present: type: boolean stateOrProvinceAddress: $ref: '#/components/schemas/NcpdpCodeType' type: object OtherPayerAmountPaid: properties: administrative: type: string cognitiveService: type: string compoundPreparation: type: string delivery: type: string drugBenefit: type: string incentive: type: string postage: type: string salesTax: type: string shipping: type: string type: object OtherPayerGrouping: properties: empty: type: boolean otherPayerAdjudicatedProgramType: $ref: '#/components/schemas/NcpdpCodeType' otherPayerBenefitClassification: $ref: '#/components/schemas/NcpdpCodeType' otherPayerBenefitEffectiveDate: $ref: '#/components/schemas/NcpdpDateType' otherPayerBenefitTerminationDate: $ref: '#/components/schemas/NcpdpDateType' otherPayerCardholderId: $ref: '#/components/schemas/NcpdpAlphaNumericType' otherPayerCoverageType: $ref: '#/components/schemas/NcpdpCodeType' otherPayerGroupId: $ref: '#/components/schemas/NcpdpAlphaNumericType' otherPayerHelpDeskTelephoneNumber: $ref: '#/components/schemas/NcpdpPhoneNumberType' otherPayerHelpDeskTelephoneNumberExtension: $ref: '#/components/schemas/NcpdpIntegerType' otherPayerId: $ref: '#/components/schemas/NcpdpAlphaNumericType' otherPayerIdQualifier: $ref: '#/components/schemas/NcpdpCodeType' otherPayerName: $ref: '#/components/schemas/NcpdpAlphaNumericType' otherPayerPatientRelationshipCode: $ref: '#/components/schemas/NcpdpCodeType' otherPayerPersonCode: $ref: '#/components/schemas/NcpdpAlphaNumericType' otherPayerProcessorControlNumber: $ref: '#/components/schemas/NcpdpAlphaNumericType' otherPayerRelationshipType: $ref: '#/components/schemas/NcpdpCodeType' present: type: boolean type: object OtherPayerId: properties: bin: type: string coupon: type: string healthIndustryNumber: type: string medicaidNumber: type: string medicareCarrierNumber: type: string medicareNumber: type: string nationalAssociationOfInsuranceCommissioners: type: string other: type: string payerName: type: string standardUniqueHealthPlanIdentifier: type: string type: object OtherPayerIdentifier: properties: bankInformationNumber: type: string coupon: type: string healthIndustryNumber: type: string medicaidNumber: type: string medicareCarrierNumber: type: string medicareNumber: type: string nationalAssociationOfInsuranceCommissioners: type: string nationalPayerID: type: string other: type: string type: object OtherPayerIds: properties: otherPayerBenefitEffectiveDate: format: date type: string otherPayerBenefitTerminationDate: format: date type: string otherPayerCardholderId: type: string otherPayerCoverage: type: string otherPayerGroupId: type: string otherPayerHelpDeskPhoneNumber: $ref: '#/components/schemas/PhoneNumber' otherPayerId: $ref: '#/components/schemas/OtherPayerId' otherPayerPatientRelationshipCode: type: string otherPayerPersonCode: type: string otherPayerProcessorControlNumber: type: string type: object OtherPayerIdsV1: properties: otherPayerBenefitEffectiveDate: format: date type: string otherPayerBenefitTerminationDate: format: date type: string otherPayerCardholderId: type: string otherPayerCoverage: type: string otherPayerGroupId: type: string otherPayerHelpDeskPhoneNumber: $ref: '#/components/schemas/PhoneNumber' otherPayerId: $ref: '#/components/schemas/IdentifierV1' otherPayerPatientRelationshipCode: type: string otherPayerPersonCode: type: string otherPayerProcessorControlNumber: type: string type: object OtherPayerPatientResponsibilityAmount: properties: amountAppliedToPeriodicDeductible: type: string amountAttributedToCoverageGap: type: string amountAttributedToHealthPlanAssistanceAmount: type: string amountAttributedToProcessorFee: type: string amountAttributedToProductSelectionOrBrandDrug: type: string amountAttributedToProductSelectionOrBrandNonPreferredFormularySelection: type: string amountAttributedToProductSelectionOrNonPreferredFormularySelection: type: string amountAttributedToProviderNetworkSelection: type: string amountAttributedToSalesTax: type: string amountExceedingPeriodicBenefitMaximum: type: string amountOfCoinsurance: type: string amountOfCopay: type: string patientPayAmount: type: string type: object OtherPayersSegment: properties: cobOrOtherPayersCount: $ref: '#/components/schemas/NcpdpCountType' deprecated: true cobOrOtherPayersGroupings: deprecated: true items: $ref: '#/components/schemas/OtherPayerGrouping' type: array empty: type: boolean otherPayerGroupings: items: $ref: '#/components/schemas/OtherPayerGrouping' type: array otherPayerIdCount: $ref: '#/components/schemas/NcpdpCountType' present: type: boolean type: object OtherRelatedBenefitDetailSegment: properties: disabilityEffectiveDate: $ref: '#/components/schemas/NcpdpDateType' empty: type: boolean esrdEffectiveDate: $ref: '#/components/schemas/NcpdpDateType' esrdIndicator: $ref: '#/components/schemas/NcpdpCodeType' esrdTerminationDate: $ref: '#/components/schemas/NcpdpDateType' hospiceEffectiveDate: $ref: '#/components/schemas/NcpdpDateType' hospiceFacilityName: $ref: '#/components/schemas/NcpdpAlphaNumericType' hospiceProviderNumber: $ref: '#/components/schemas/NcpdpAlphaNumericType' hospiceTelephoneNumber: $ref: '#/components/schemas/NcpdpPhoneNumberType' hospiceTerminationDate: $ref: '#/components/schemas/NcpdpDateType' institutionalEffectiveDate: $ref: '#/components/schemas/NcpdpDateType' institutionalIndicator: $ref: '#/components/schemas/NcpdpAlphaNumericType' institutionalTerminationDate: $ref: '#/components/schemas/NcpdpDateType' lisEffectiveDate: $ref: '#/components/schemas/NcpdpDateType' lisLevel: $ref: '#/components/schemas/NcpdpCodeType' lisTerminationDate: $ref: '#/components/schemas/NcpdpDateType' otherBenefitCount: $ref: '#/components/schemas/NcpdpCountType' otherBenefitGroupings: items: $ref: '#/components/schemas/OtherBenefitGrouping' type: array planType: $ref: '#/components/schemas/NcpdpCodeType' present: type: boolean type: object Patient: properties: dateOfBirth: example: '2023-10-01' format: rxn-date type: string employerId: format: ncpdp-alphanumeric maxLength: 45 type: string genderAndSexCode: $ref: '#/components/schemas/GenderAndSexCode' medicalRecordIdentificationNumber: type: string patientCityAddress: type: string patientEmailAddress: type: string patientFirstName: type: string patientIdentifier: $ref: '#/components/schemas/PatientIdentifier' patientLastName: type: string patientResidence: type: string patientStateOrProvinceAddress: type: string patientStreetAddress: type: string patientSuffix: type: string patientTelephoneNumber: $ref: '#/components/schemas/PhoneNumber' patientZipOrPostalCode: type: string placeOfService: type: string pregnancyIndicator: type: string smokerOrNonSmokerCode: type: string type: object PatientIdentifier: properties: alienNumber: type: string apprissHealthPatientId: type: string driversLicenseNumber: type: string employerAssignedId: type: string evernorthUniversalPatientIdentifier: type: string facilityIdNumber: type: string governmentStudentVISANumber: type: string indianTribalId: type: string lexIdUniversalPatientIdentifier: type: string medicaidId: type: string medicalRecordIdentificationNumber: type: string medicareBeneficiaryId: type: string ncpdpUniversalPatientIdentifier: type: string nonSSNPatientIdentifier: type: string otherId: type: string passportId: type: string payerAssignedId: type: string socialSecurityNumber: type: string ssnBasedPatientIdentifier: type: string stateIssuedId: type: string usMilitaryId: type: string type: object PatientIdGrouping: properties: empty: type: boolean patientId: $ref: '#/components/schemas/NcpdpAlphaNumericType' patientIdQualifier: $ref: '#/components/schemas/NcpdpCodeType' present: type: boolean type: object PatientPaidAmountSubmitted: properties: currentTPSubmitCopay: maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string previousTPFinalCopay: maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string type: object PatientPayComponentGrouping: properties: empty: type: boolean patientPayComponentAmount: $ref: '#/components/schemas/NcpdpDecimalType' patientPayComponentQualifier: $ref: '#/components/schemas/NcpdpCodeType' present: type: boolean type: object PatientRequestV1: properties: address: properties: cityName: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 60. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 60 type: string postalCode: errorMessage: format: invalid postal code. maxLength: exceeds the maximum limit of 15. type: invalid type, expected string. format: zip-or-postal-code maxLength: 15 type: string stateProvinceCode: enum: - AL - AK - AZ - AR - CA - CO - CT - DE - DC - FM - FL - GA - GU - HI - ID - IL - IN - IA - KS - KY - LA - ME - MD - MA - MI - MN - MS - MO - MT - NE - NV - NH - NJ - NM - NY - NC - ND - MP - OH - OK - OR - PW - PA - PR - RI - SC - SD - TN - TX - UT - VT - VI - VA - WA - WV - WI - WY - AB - BC - MB - NB - NF - NL - NS - NT - 'ON' - PE - QC - SK - YT - UM - '' errorMessage: enum: invalid state or province. maxLength: maximum length must be 2. type: invalid type, expected string. maxLength: 2 type: string streetLine1: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object clinical: properties: diagnosisCodes: errorMessage: minItems: must have at least one item. items: properties: code: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number value: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object minItems: 1 type: array information: items: errorMessage: minProperties: must have at least one property. minProperties: 1 properties: date: errorMessage: format: invalid date. type: invalid type, expected string. example: '2023-10-01' format: rxn-date type: string dimension: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 2 pattern: ^[0-9]*$ type: string time: errorMessage: maxLength: exceeds the maximum limit of 4. pattern: invalid value, only valid 4 digit miliary time is allowed. type: invalid type, expected string. maxLength: 4 pattern: ^([0-2][0-3][0-5][0-9])|^([0-1][0-9][0-5][0-9])|2400$ type: string unit: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 2 pattern: ^[0-9]*$ type: string value: errorMessage: maxLength: exceeds the maximum limit of 15. pattern: invalid value, only alphanumeric and special characters are allowed. type: invalid type, expected string. maxLength: 15 type: string type: object type: array type: object dateOfBirth: errorMessage: format: invalid date. type: invalid type. example: '2023-10-01' format: rxn-date type: string emailAddress: errorMessage: format: invalid email address. format: email employerId: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 45. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 45 type: string facility: properties: address: properties: cityName: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 60. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 60 type: string postalCode: errorMessage: format: invalid postal code. maxLength: exceeds the maximum limit of 15. type: invalid type, expected string. format: zip-or-postal-code maxLength: 15 type: string stateProvinceCode: enum: - AL - AK - AZ - AR - CA - CO - CT - DE - DC - FM - FL - GA - GU - HI - ID - IL - IN - IA - KS - KY - LA - ME - MD - MA - MI - MN - MS - MO - MT - NE - NV - NH - NJ - NM - NY - NC - ND - MP - OH - OK - OR - PW - PA - PR - RI - SC - SD - TN - TX - UT - VT - VI - VA - WA - WV - WI - WY - AB - BC - MB - NB - NF - NL - NS - NT - 'ON' - PE - QC - SK - YT - UM - '' errorMessage: enum: invalid state or province. maxLength: maximum length must be 2. type: invalid type, expected string. maxLength: 2 type: string streetLine1: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object identifier: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 30. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 30 type: string name: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object genderCode: enum: - '0' - '1' - '2' - '3' - '' errorMessage: enum: invalid Value, expected values are 0,1,2,3. maxLength: exceeds the maximum limit of 1. type: invalid type, expected string. maxLength: 1 type: string insurance: items: properties: binNumber: errorMessage: maxLength: exceeds the maximum limit of 6. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 6 pattern: ^[0-9]*$ type: string cardholder: properties: id: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 60. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 60 type: string name: properties: first: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 105. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 105 type: string last: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 105. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 105 type: string type: object type: object cmsPartDDefinedQualifiedFacility: enum: - Y - N - '' errorMessage: enum: invalid value, expected values are Y,N. maxLength: exceeds the maximum limit of 1. type: invalid type, expected string. maxLength: 1 type: string eligibilityClarificationCode: description: 0 - Not Specified, 1 - No Override, 2 - Override, 3 - Full Time Student, 4 - Disabled Dependent, 5 - Dependent Parent, 6 - Significant Other, 7 - Non-human, 8 - Third Party Liability - Patient also eligible with federal/state funded program, coordination of benefit restrictions apply. errorMessage: maxLength: exceeds the maximum limit of 1. pattern: invalid value, only 0 to 6 allowed. type: invalid type, expected string. maxLength: 1 pattern: ^[0-6]*$ type: string groupCode: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 45. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 45 type: string groupId: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 45. format: ncpdp-alphanumeric maxLength: 45 type: string homePlan: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 9. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 9 type: string medicaidAgencyNumber: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 45. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 45 type: string medicaidIdNumber: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 60. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 60 type: string medicaidIndicator: description: Two character State Postal Code indicating the state where Medicaid coverage exists. errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 6. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 6 type: string medigapId: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 60. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 60 type: string patientRelationshipCode: errorMessage: maxLength: exceeds the maximum limit of 1. pattern: invalid value, only 0 to 4 allowed. type: invalid type, expected string. maxLength: 1 pattern: ^[0-4]*$ type: string personCode: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 9. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 9 type: string planId: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 24. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 24 type: string processorControlNumber: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 30. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 30 type: string providerAcceptAssignmentIndicator: description: Code indicating whether the provider accepts assignment. Y - Assigned, N - Not Assigned errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 3. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 3 type: string type: object type: array isPregnant: description: Code indicating the patient as pregnant or non-pregnant. 1 - Not pregnant, 2 - Pregnant enum: - Y - N - '' errorMessage: enum: invalid value, expected values are Y,N. maxLength: exceeds the maximum limit of 1. type: invalid type, expected string. maxLength: 1 type: string isSmoker: description: Code indicating the patient as a smoker or non-smoker. 1 - Non Smoker, 2 - Smoker enum: - Y - N - '' errorMessage: enum: invalid value, expected values are Y,N. maxLength: exceeds the maximum limit of 1. type: invalid type, expected string. maxLength: 1 type: string name: properties: first: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 105. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 105 type: string last: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 105. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 105 type: string type: object patientId: errorMessage: minItems: must have at least one item. items: properties: code: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number value: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object minItems: 1 type: array primaryCareProvider: properties: name: properties: last: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 105. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 105 type: string type: object providerId: errorMessage: minItems: must have at least one item. items: properties: code: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number value: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object minItems: 1 type: array type: object residence: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 2 pattern: ^[0-9]*$ type: string sexCode: enum: - '0' - '1' - '2' - '' errorMessage: enum: invalid Value, expected values are 0,1,2. maxLength: exceeds the maximum limit of 1. type: invalid type, expected string. maxLength: 1 type: string telephoneNumber: errorMessage: format: invalid phone number. type: invalid type, expected string. example: '7799886576' format: nanp-phone-number type: string workersCompensation: properties: billingEntityTypeIndicator: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid Value, only numeric are allowed. type: invalid type, expected string. maxLength: 2 pattern: ^[0-9]*$ type: string carrierId: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 30. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 30 type: string claimOrReferenceId: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string dateOfInjury: errorMessage: format: invalid date. type: invalid type. example: '2023-10-01' format: rxn-date type: string employer: properties: address: properties: cityName: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 60. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 60 type: string postalCode: errorMessage: format: invalid postal code. maxLength: exceeds the maximum limit of 15 type: invalid type, expected string. format: zip-or-postal-code maxLength: 15 type: string stateProvinceCode: enum: - AL - AK - AZ - AR - CA - CO - CT - DE - DC - FM - FL - GA - GU - HI - ID - IL - IN - IA - KS - KY - LA - ME - MD - MA - MI - MN - MS - MO - MT - NE - NV - NH - NJ - NM - NY - NC - ND - MP - OH - OK - OR - PW - PA - PR - RI - SC - SD - TN - TX - UT - VT - VI - VA - WA - WV - WI - WY - AB - BC - MB - NB - NF - NL - NS - NT - 'ON' - PE - QC - SK - YT - UM - '' errorMessage: enum: invalid state or province. maxLength: maximum length must be 2. type: invalid type, expected string. maxLength: 2 streetLine1: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 60. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 60 type: string type: object contact: properties: name: properties: first: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string last: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object type: object name: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string telephoneNumber: errorMessage: format: invalid phone number. type: invalid type, expected string. example: '7799886576' format: nanp-phone-number type: string type: object payTo: properties: address: properties: cityName: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 60. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 60 type: string postalCode: errorMessage: format: invalid postal code. maxLength: maximum length must be 15. type: invalid type, expected string. format: zip-or-postal-code maxLength: 15 type: string stateProvinceCode: enum: - AL - AK - AZ - AR - CA - CO - CT - DE - DC - FM - FL - GA - GU - HI - ID - IL - IN - IA - KS - KY - LA - ME - MD - MA - MI - MN - MS - MO - MT - NE - NV - NH - NJ - NM - NY - NC - ND - MP - OH - OK - OR - PW - PA - PR - RI - SC - SD - TN - TX - UT - VT - VI - VA - WA - WV - WI - WY - AB - BC - MB - NB - NF - NL - NS - NT - 'ON' - PE - QC - SK - YT - UM - '' errorMessage: enum: invalid state or province. maxLength: maximum length must be 2. type: invalid type, expected string. type: string streetLine1: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object name: properties: first: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 210. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 210 type: string last: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 210. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 210 type: string type: object serviceIdentifier: errorMessage: minItems: must have at least one item. type: invalid type, expected array. items: properties: code: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number value: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object minItems: 1 type: array type: object productId: errorMessage: minItems: must have at least one item. items: properties: code: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number value: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object minItems: 1 type: array type: object type: object PatientSegment: properties: dateOfBirth: $ref: '#/components/schemas/NcpdpDateType' empty: type: boolean patientFirstName: $ref: '#/components/schemas/NcpdpAlphaNumericType' patientIdCount: $ref: '#/components/schemas/NcpdpCountType' patientIdGroupings: items: $ref: '#/components/schemas/PatientIdGrouping' type: array patientLastName: $ref: '#/components/schemas/NcpdpAlphaNumericType' present: type: boolean type: object PatientV1: properties: dateOfBirth: format: date type: string name: $ref: '#/components/schemas/NameV1' type: object PayerIdentifier: properties: bankInformationNumber: type: string healthIndustryNumber: type: string nationalAssociationOfInsuranceCommissioners: type: string nationalPayerID: type: string other: type: string type: object PayerOrHealthPlanIdGrouping: properties: empty: type: boolean payerOrHealthPlanId: $ref: '#/components/schemas/NcpdpAlphaNumericType' payerOrHealthPlanIdQualifier: $ref: '#/components/schemas/NcpdpAlphaNumericType' present: type: boolean type: object Payment: properties: coordinationOfBenefits: items: $ref: '#/components/schemas/CoordinationOfBenefitsItem' type: array type: object PayToIdentifier: properties: federalTaxID: type: string nationalProviderIdentifier: type: string type: object PercentageSalesTax: properties: noPercentageSalesTaxAmountSubmitted: maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string percentageSalesTaxAmountSubmitted: maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string positivePercentageSalesTaxAmountSubmitted: maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string type: object Pharmacy: properties: providerIdentifier: $ref: '#/components/schemas/ProviderIdentifier' type: object PharmacyV1: properties: professionalProvider: properties: providerId: errorMessage: minItems: must have at least one item. type: invalid type, expected array. items: properties: code: description: 1 - Drug Enforcement Administration (DEA), 2 - State License, 3 - Social Security Number (SSN), 4 - Name, 5 - National Provider Identifier (NPI), 6 - Health Industry Number (HIN), 7 - State Issued, 8 - Other errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number value: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object minItems: 1 type: array type: object serviceProviderId: errorMessage: minItems: must have at least one item. type: invalid type, expected array. items: properties: code: description: Code qualifying the service Provider. 1 - National Provider Identifier (NPI), 2 - Blue Cross, 3 - Blue Shield, 4 - Medicare, 5 - Medicaid, 6 - UPIN (Unique Physician/Practitioner Identification Number), 7 - NCPDP Provider Identification Number (National Council for Prescription Drug Programs Provider Identification Number), 8 - State License, 9 - TRICARE, 10 - Health Industry Number (HIN), 11 - Federal Tax ID, 12 - Drug Enforcement Administration (DEA) Number, 13 - State Issued, 14 - Plan Specific, 15 - HCIdea, 16 - Combat Methamphetamine Epidemic Act (CMEA) Certificate ID, 17 - Foreign Prescriber Identifier, 18 - No Prescriber Required, 99 - Other errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number value: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object minItems: 1 type: array type: object PhoneNumber: properties: countryCode: format: int32 type: integer countryCodeSource: enum: - FROM_NUMBER_WITH_PLUS_SIGN - FROM_NUMBER_WITH_IDD - FROM_NUMBER_WITHOUT_PLUS_SIGN - FROM_DEFAULT_COUNTRY - UNSPECIFIED type: string extension: type: string italianLeadingZero: type: boolean nationalNumber: format: int64 type: integer numberOfLeadingZeros: format: int32 type: integer preferredDomesticCarrierCode: type: string rawInput: type: string type: object PreferredProductGrouping: properties: preferredProductCostShareIncentive: type: number preferredProductDescription: type: string preferredProductId: $ref: '#/components/schemas/CompoundProductIdentifier' preferredProductIncentive: type: number type: object PreferredProductGroupingV1: properties: costShareIncentive: type: number description: type: string incentive: type: number productId: $ref: '#/components/schemas/IdentifierV1' type: object Prescriber: properties: prescriberCityAddress: type: string prescriberFirstName: type: string prescriberIdentifier: $ref: '#/components/schemas/PrescriberIdentifier' prescriberLastName: type: string prescriberStateOrProvinceAddress: type: string prescriberStreetAddress: type: string prescriberTelephoneNumber: $ref: '#/components/schemas/PhoneNumber' prescriberZipOrPostalZone: type: string primaryCareProviderIdentifier: $ref: '#/components/schemas/PrimaryCareProviderIdentifier' primaryCareProviderLastName: type: string type: object PrescriberIdentifier: properties: blueCross: type: string blueShield: type: string champus: type: string deaNumber: type: string federalTaxId: type: string hcid: type: string healthIndustryNumber: type: string medicaid: type: string medicare: type: string ncpdpIdentifier: type: string npi: type: string other: type: string planSpecific: type: string stateIssued: type: string stateLicense: type: string upin: type: string type: object PrescriptionOrServiceReferenceNumberIdentifier: properties: nonPrescriptionProduct: type: string rxBilling: type: string serviceBilling: type: string type: object PrescriptionV1: properties: compoundCode: description: Code indicating whether or not the prescription is a compound. 0 - Not Specified, 1 - Not a Compound, 2 - Compound errorMessage: maxLength: exceeds the maximum limit of 1. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 1 pattern: ^[0-9]*$ type: string compoundType: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 6. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 6 type: string datePrescriptionWritten: errorMessage: format: invalid date. type: invalid type, expected string. example: '2023-10-01' format: rxn-date type: string dispensedTransaction: properties: alternateId: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 60. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 60 type: string associated: properties: prescriptionReferenceNumber: errorMessage: maxLength: exceeds the maximum limit of 12. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 12 pattern: ^[0-9]*$ type: string referenceDate: errorMessage: format: invalid date. type: invalid type, expected string. example: '2023-10-01' format: rxn-date type: string type: object authorization: properties: idSubmitted: errorMessage: maxLength: exceeds the maximum limit of 11. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 11 pattern: ^[0-9]*$ type: string intermediaryId: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 33. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 33 type: string intermediaryTypeId: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 2 pattern: ^[0-9]*$ type: string typeCode: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 2 pattern: ^[0-9]*$ type: string type: object daysSupply: errorMessage: maxLength: exceeds the maximum limit of 3. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 3 pattern: ^[0-9]*$ type: string daysSupplyIntendedToBeDispensed: errorMessage: maxLength: exceeds the maximum limit of 3. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 3 pattern: ^[0-9]*$ type: string delayReasonCode: description: Code to specify the reason that submission of the transactions has been delayed. 1 - Proof of eligibility unknown or unavailable, 2 - Litigation, 3 - Authorization delays, 4 - Delay in certifying provider, 5 - Delay in supplying billing forms, 6 - Delay in delivery of custom-made appliances, 7 - Third party processing delay, 8 - Delay in eligibility determination, 9 - Original claims rejected or denied due to a reason unrelated to the billing limitation rules, 10 - Administration delay in the prior approval process, 11 - Other, 12 - Received late with no exceptions, 13 - Substantial damage by fire, etc. to provider records, 14 - Theft, sabotage/other willful acts by employee errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 2 pattern: ^[0-9]*$ type: string dispenseAsWrittenProductSelectionCode: description: Code indicating product selection determination. 0 - No Product Selection Indicated, 1 - Substitution Not Allowed by Prescriber, 2 - Substitution Allowed - Patient Requested Product Dispensed, 3 - Substitution Allowed - Pharmacist Selected Product Dispensed, 4 - Substitution Allowed - Generic Drug or Interchangeable Biosimilar Not in Stock, 5 - Substitution Allowed - Brand Drug or Reference Product Dispensed as a Generic or interchangeable biosimilar, 6 Override, 7 - Substitution Not Allowed - Brand Drug or Reference Product Mandated by Law, 8 - Substitution Allowed - Generic Drug or Interchangeable Biosimilar Not Available in Marketplace, 9 - Substitution Allowed By Prescriber but Plan Requests Brand or Reference Product, 9 - Substitution Allowed By Prescriber but Plan Requests Brand or Reference Product, A - Multi-payer Brand/Reference Product Formulary Conflict errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 3. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 3 type: string dispensedItemDetail: properties: dosageFormDescription: description: Dosage form of the complete compound mixture. 01 - Capsule, 02 - Ointment, 03 - Cream, 04 - Suppository, 05 - Powder, 06 - Emulsion, 07 - Liquid, 10 - Tablet, 11 - Solution, 12 - Suspension, 13 - Lotion, 14 - Shampoo, 15 - Elixir, 16 - Syrup, 17 - Lozenge, 18 - Enema errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 6. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 6 item: items: properties: basisOfCostDetermination: description: Code indicating the method by which Ingredient Cost Submitted (409-D9) was calculated. 0 - Default, 1 - AWP (Average Wholesale Price), 2 - Local Wholesaler, 3 - Direct, 4 - EAC (Estimated Acquisition Cost), 5 - Acquisition, 6 - MAC (Maximum Allowable Cost), 7 - Usual & Customary, 8 - 340B/Disproportionate Share Pricing/Public Health Service, 9 - Other, 10 - ASP (Average Sales Price), 11 - AMP (Average Manufacturer Price), 12 - WAC (Wholesale Acquisition Cost), 13 - Special Patient Pricing, 14 - Cost basis on unreportable quantities., 15 - Free product or no associated cost., 16 - Nominal Price, 17 - Federal Supply Schedule errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 6. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 6 type: string cost: errorMessage: maxLength: exceeds the maximum limit of 13. pattern: invalid cost. type: invalid type, expected string. maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string itemQuantity: errorMessage: maxLength: exceeds the maximum limit of 10. pattern: invalid quantity. type: invalid type, expected string. maxLength: 11 pattern: ^(\d{1,7}(?:[.]\d{1,3})?)?$ type: string modifierCodes: items: description: 'Identifies special circumstances related to the dispensing/payment of the product as identified in the Compound Product ID. ' errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 6. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 6 type: string type: array productServiceIdentifier: properties: productId: errorMessage: minItems: must have at least one item. type: invalid type, expected array. items: properties: code: description: Code qualifying the value in Product/Service ID. 1 - Universal Product Code (UPC), 2 - Health Related Item (HRI), 3 - National Drug Code (NDC), 4 - Health Industry Business Communications Council (HIBCC), 5 - Department of Defense (DOD), 6 - Drug Use Review/ Professional Pharmacy Service (DUR/PPS), 7 - Current Procedural Terminology (CPT4), 8 - Current Procedural Terminology (CPT5), 9 - Healthcare Common Procedure Coding System (HCPCS), 10 - Pharmacy Practice Activity Classification (PPAC), 11 - National Pharmaceutical Product Interface Code (NAPPI), 12 - Global Trade Identification Number (GTIN), 13 - Drug Identification Number (DIN), 14 - Medi Span's Generic Product Identifier (GPI), 15 - First DataBank Formulation ID (GCN), 16 - Truven/Micromedex Generic Formulation Code (GFC), 17 - Medi Span's Drug Descriptor ID (DDID), 18 - First DataBank SmartKey, 19 - Truven/Micromedex Generic Master (GM), 28 - First DataBank Medication Name ID (FDB Med Name ID), 29 - First DataBank Routed Medication ID (FDB Routed Med ID), 30 - First DataBank Routed Dosage Form ID (FDB Routed Dosage Form Med ID), 31 - First DataBank Medication ID (FDB MedID), 32 - First DataBank Clinical Formulation ID Sequence Number (GCN_SEQNO), 33 - First DataBank Ingredient List ID (HICL_SEQNO), 34 - Universal Product Number (UPN), 35 - Logical Observation Identifier Names and Codes (LOINC), 36 - Representative National Drug Code (NDC), 37 - American Hospital Formulary Service (AHFS), 38 - RxNorm Semantic Clinical Drug (SCD), 39 - RxNorm Semantic Branded Drug (SBD), 40 - RxNorm Generic Package (GPCK), 41 - RxNorm Branded Package (BPCK), 42 - Gold Standard Marketed Product Identifier (MPid), 43 - Gold Standard Product Identifier (ProdID), 44 - Gold Standard Specific Product Identifier (SPID), 45 - Device Identifier (DI), 99 - Other errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number value: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object minItems: 1 type: array type: object type: object type: array type: object dispensingStatus: description: Code indicating the quantity dispensed is a partial fill or the completion of a partial fill. P - Partial Fill, C - Completion of Partial Fill errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 3. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 3 type: string dur: items: properties: coAgentProductId: errorMessage: minItems: must have at least one item. type: invalid type, expected array. items: properties: code: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number value: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object minItems: 1 type: array durOrPpsLevelOfEffort: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 2 pattern: ^[0-9]*$ type: string professionalServiceCode: description: Code identifying pharmacist intervention when a conflict code has been identified or service has been rendered. 00 - No intervention, AS - Patient assessment, AS - Patient assessment, CC - Coordination of care, DE - Dosing evaluation/determination, DP - Dosage evaluated, FE - Formulary enforcement, GP - Generic product selection, GP - Generic product selection, M0 - Prescriber consulted, M0 - Prescriber consulted, MA - Medication administration, MB - Medication benefit outweighs risk, MB - Overriding benefit, MP - Patient will be monitored, MR - Medication review, NM - Non-Medication Counseling, PA - Previous patient tolerance, PE - Patient education/instruction, PE - Patient education/instruction, PH - Patient medication history, PM - Patient monitoring, PM - Patient monitoring, P0 - Patient consulted, P0 - Patient consulted, PT - Perform laboratory test, R0 - Pharmacist consulted other source, R0 - Pharmacist consulted other source, RT - Recommend laboratory test, SC - Self-care consultation, SC - Self-care consultation, SW - Literature search/review, TC - Payer/processor consulted, TH - Therapeutic product interchang, UA - Unavailable to Confirm Medication Delivery Device Method and Patient Requires Immediate Access errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 6. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 6 type: string reasonForServiceCode: description: Code identifying the type of utilization conflict detected by the prescriber or the pharmacist or the reason for the pharmacist's professional service. AD - Additional Drug Needed, AN - Prescription Authentication, AR - Adverse Drug Reaction, AT - Additive Toxicity, CD - Chronic Disease Management, CH - Call Help Desk, CS - Patient Complaint/Symptom, DA - Drug-Allergy, DC - Drug-Disease (Inferred), DD - Drug-Drug Interaction, DF - Drug-Food Interaction, DI - Drug Incompatibility, DI - Drug Incompatibility, DL - Drug-Lab Conflict, DM - Apparent Drug Misuse, DP - Partial Lot Drug Recall Warning, DR - Dose Range Conflict, DS - Tobacco Use, ED - Patient Education/Instruction, ER - Overuse, EX - Excessive Quantity, HC - High Cumulative Dose, HD - High Dose, IC - Iatrogenic Condition, IC - Iatrogenic Condition, ID - Ingredient Duplication, LD - Low Dose, LK - Lock In Recipient, LR - Underuse, MC - Drug-Disease (Reported), MD - Medication Delivery Device Method Required, MN - Insufficient Duration, MP - Poly-Pharmacy Detected, MS - Missing Information/Clarification, MX - Excessive Duration, NA - Drug Not Available, NC - Non-covered Drug Purchase, ND - New Disease/Diagnosis, NF - Non-Formulary Drug, NN - Unnecessary Drug, NP - New Patient Processing, NR - Lactation/Nursing Interaction, NS - Insufficient Quantity, OH - Alcohol Conflict, PA - Drug-Age, PA - Drug-Age, PC - Patient Question/Concern, PG - Drug-Pregnancy, PH - Preventive Health Care, PN - Prescriber Consultation, PP - Plan Protocol, PR - Prior Adverse Reaction, PS - Product Selection Opportunity, RE - Suspected Environmental Risk, RF - Health Provider Referral, SC - Suboptimal Compliance, SD - Suboptimal Drug/Indication, SE - Side Effect, SF - Suboptimal Dosage Form, SR - Suboptimal Regimen, SX - Drug-Gender, TD - Therapeutic Duplication, TD - Therapeutic, TN - Laboratory Test Needed, TP - Payer/Processor Question, UD - Duplicate Drug errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 6. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 6 type: string resultOfServiceCode: description: Action taken by a pharmacist or prescriber in response to a conflict or the result of a pharmacist's professional service. 00 - Not Specified, 1A - Dispensed As Is, False Positive, 1B - Dispensed Prescription As Is, 1C - Dispensed, With Different Dose, 1D - Dispensed, With Different Directions, 1E - Dispensed, With Different Drug, 1F - Dispensed, With Different Quantity, 1G - Dispensed, With Prescriber Approval, 1H - Brand-to-Generic Change, 1J - Rx-to-OTC Change, 1K - Dispensed with Different Dosage Form, 2A - Prescription Not Dispensed, 2B - Not Dispensed, Directions Clarified, 3A - Recommendation Accepted, 3B - Recommendation Not Accepted, 3C - Discontinued Drug, 3D - Regimen Changed, 3E - Therapy Changed, 3F - Therapy Changed-cost increased acknowledged, 3G - Drug Therapy Unchanged, 3H - Follow-Up/Report, 3J - Patient Referral, 3K - Instructions Understood, 3M - Compliance Aid Provided, 3N - Medication Administered, 4A - Prescribed With Acknowledgments, 4B - Dispensed, Palliative Care, 4C - Dispensed, Hospice, 4D - Dispensed, Cancer Treatment, 4E - Dispensed, Chronic Pain, 4F - Dispensed, Exempt Per Prescriber, 4G - Dispensed, Surgery/Trauma, 4H - Dispensed, Hospital Admission/Discharge, 4J - Dispensed, Patient is Not Opioid Naive, 4K - Prescriber Specialty Exemption-Oncology Or Non-Hospice Palliative Care, 4L - Prescriber Specialty Exemption - Hospice, 4M - Dispensed, Sex Assigned at Birth is Male, 4N - Dispensed, Sex Assigned at Birth is Female, 4P - Dispensed, Sex Assigned at Birth is Unknown, 4Q - Dispensed, Sex Assigned at Birth is Intersex, 4R - Dispensed, Sickle Cell Disease, 5A - DME Pump Delivery Device Method, 5B - Non-DME or Disposable Delivery Device Method, 5C - Unknown Delivery Device Method and Immediate Access Required errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 6. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 6 type: string type: object type: array fillNumber: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 2 pattern: ^[0-9]*$ type: string levelOfService: description: Coding indicating the type of service the provider rendered. 0 - Not Specified, 1 - Patient Consultation, 2 - Home Delivery, 3 - Emergency, 4 - 24 Hour Service, 5 - Patient Consultation regarding generic product selection, 6 - In-Home Service, 7 - Medical at home with special pharmacy services identical to Long Term Care errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 2 pattern: ^[0-9]*$ type: string patientAssignmentIndicator: description: Code to indicate a patient's choice on assignment of benefits. Y - Patient assigns benefits, N - Patient does not assign benefits errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 3. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 3 type: string payment: properties: coordinationOfBenefits: items: properties: benefitStageAmount: errorMessage: minItems: must have at least one item. type: invalid type, expected array. items: properties: code: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number value: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object minItems: 1 type: array internalControlNumber: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string otherPayerAmountPaid: errorMessage: minItems: must have at least one item. type: invalid type, expected array. items: properties: code: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number value: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object minItems: 1 type: array otherPayerCoverageType: description: Code identifying the type or order of processing associated with the Other Payer ID. 01 - Primary (First), 02 - Secondary (Second), 03 Tertiary (Third), 04 - Quaternary (Fourth) errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 6. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 6 type: string otherPayerDate: errorMessage: format: invalid date. type: invalid type, expected string. example: '2023-10-01' format: rxn-date type: string otherPayerId: description: ' Other Payer ID Qualifier. 1 - Standard Unique Health Plan Identifier (01), 2 - Health Industry Number (HIN) (02), 3 - Bank Information Number (BIN) Card Issuer ID or Bank IDNumber assigned by ANSI used for network routing. (03), 4 - National Association of Insurance Commissioners (NAIC) (04), 5 - Medicare Carrier Number (05), 7 - Medicare Number (1C), 8 - Medicaid Number (1D), 99 - other' errorMessage: minItems: must have at least one item. type: invalid type, expected array. items: properties: code: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number value: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object minItems: 1 type: array otherPayerPatientResponsibilityAmount: errorMessage: minItems: must have at least one item. type: invalid type, expected array. items: properties: code: description: 'Code qualifying the Other Payer-Patient Responsibility Amount. 1 - Amount Applied to Periodic Deductible as reported by previous payer., 2 - Amount Attributed to Product Selection/Brand Drug as reported by previous payer., 3 - Amount Attributed to Percentage Tax as reported by previous payer., 4 - Amount Exceeding Periodic Benefit Maximum as reported by previous payer., 5 - Amount of Copay as reported by previous payer., 6 - Patient Pay Amount (505-F5) as reported by previous payer., 7 - Amount of Coinsurance as reported by previous payer., 8 - Amount Attributed to Product Selection/Non-Preferred Formulary Selection as reported by previous payer., 9 - Amount Attributed to Health Plan Assistance Amount as reported by previous payer., 10 - Amount Attributed to Provider Network Selection as reported by previous payer., 11 - Amount Attributed to Product Selection/Brand Non-Preferred Formulary Selection as reported by previous payer., 12 - Amount Attributed to Coverage Gap that was to be collected from the patient due to a coverage gap as reported by previous payer., 13 - Amount Attributed to Processor Fee as reported by previous payer., 14 - Amount Attributed to Grace Period as reported by previous payer., 15 - Amount Attributed to Catastrophic Benefit as reported by previous payer., 16 - Amount Attributed to Unbalanced Patient Pay Response Received from Previous Payer. The dollar amount representing the difference between the Patient Pay Amount (505-F5) and the sum of the reported Patient Pay Component Amounts (C93-KN)., 17 - Amount attributed to Regulatory Fee as reported by previous payer., 18 - Amount Attributed to Spend Down as Reported by Previous Payer., ' errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number value: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object minItems: 1 type: array otherPayerRejectCodes: items: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 9. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 9 type: string type: array type: object type: array type: object pricing: properties: basisOfCostDetermination: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 6. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 6 type: string dispensingFeeSubmitted: errorMessage: maxLength: exceeds the maximum limit of 13. pattern: invalid amount. type: invalid type, expected string. maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string flatSalesTaxAmountSubmitted: errorMessage: maxLength: exceeds the maximum limit of 13. pattern: invalid amount. type: invalid type, expected string. maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string grossAmountDue: errorMessage: maxLength: exceeds the maximum limit of 13. pattern: invalid amount. type: invalid type, expected string. maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string incentiveAmountSubmitted: errorMessage: maxLength: exceeds the maximum limit of 13. pattern: invalid amount. type: invalid type, expected string. maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string ingredientCostSubmitted: errorMessage: maxLength: exceeds the maximum limit of 13. pattern: invalid amount. type: invalid type, expected string. maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string medicaidPaidAmount: errorMessage: maxLength: exceeds the maximum limit of 13. pattern: invalid amount. type: invalid type, expected string. maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string otherAmountClaimedSubmitted: errorMessage: minItems: must have at least one item. type: invalid type, expected array. items: properties: code: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number value: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object minItems: 1 type: array patientPaidAmountSubmitted: properties: currentTPSubmitCopay: errorMessage: maxLength: exceeds the maximum limit of 13. pattern: invalid amount. type: invalid type, expected string. maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string previousTPFinalCopay: errorMessage: maxLength: exceeds the maximum limit of 13. pattern: invalid amount. type: invalid type, expected string. maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string type: object percentageSalesTax: properties: noPercentageSalesTaxAmountSubmitted: errorMessage: maxLength: exceeds the maximum limit of 13. pattern: invalid amount. type: invalid type, expected string. maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string percentageSalesTaxAmountSubmitted: errorMessage: maxLength: exceeds the maximum limit of 13. pattern: invalid amount. type: invalid type, expected string. maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string positivePercentageSalesTaxAmountSubmitted: errorMessage: maxLength: exceeds the maximum limit of 13. pattern: invalid amount. type: invalid type, expected string. maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string type: object percentageSalesTaxBasisSubmitted: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 6. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 6 type: string percentageSalesTaxRateSubmitted: errorMessage: maxLength: exceeds the maximum limit of 10. pattern: invalid amount. type: invalid type, expected string. maxLength: 10 pattern: ^-?(\d{1,3}(?:[.]\d{1,6})?)?$ type: string professionalServiceFeeSubmitted: errorMessage: maxLength: exceeds the maximum limit of 13. pattern: invalid amount. type: invalid type, expected string. maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string usualAndCustomaryCharge: errorMessage: maxLength: exceeds the maximum limit of 13. pattern: invalid amount. type: invalid type, expected string. maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string type: object procedureModifierCodes: items: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 6. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 6 type: string type: array quantityDispensed: errorMessage: maxLength: exceeds the maximum limit of 10. pattern: invalid quantity. type: invalid type, expected string. maxLength: 11 pattern: ^(\d{1,7}(?:[.]\d{1,3})?)?$ type: string quantityIntendedToBeDispensed: errorMessage: maxLength: exceeds the maximum limit of 10. pattern: invalid quantity. type: invalid type, expected string. maxLength: 11 pattern: ^(\d{0,7}(\.?\d{1,3}+))*$ type: string specialPackagingIndicator: description: Code indicating the type of dispensing dose. 0 - Not Specified, 1 - Not Unit Dose, 2 - Manufacturer Unit Dose, 3 - Pharmacy Unit Dose, 4 - Pharmacy Unit Dose Patient Compliance Packaging, 5 - Pharmacy Multi-drug Patient Compliance Packaging, 6 - Remote Device Unit Dose, 7 - Remote Device Multi-drug Compliance, 8 - Manufacturer Unit of Use Package (not unit dose) errorMessage: maxLength: exceeds the maximum limit of 1. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 1 pattern: ^[0-9]*$ type: string submissionClarificationCodes: description: 'Code indicating that the pharmacist is clarifying the submission.0 - Not Specified, 1 - No Override, 2 - Other Override, 3 - Vacation Supply, 4 - Lost/Damaged Prescription, 5 - Therapy Change, 6 - Continuation Dose After Starter Dose, 6 - Starter Dose, 7 - Medically Necessary, 8 - Process Compound For Approved Ingredients, 9 - Encounters, 10 - Meets Plan Limitations, 11 - Certification on File, 12 - DME Replacement Indicator, 13 - Payer-Recognized Emergency/Disaster Assistance Request, 14 - Long Term Care Leave of Absence, 15 - Long Term Care Replacement Medication, 16 - Long Term Care Emergency box (kit) or automated dispensing machine, 17 - Long Term Care Emergency supply remainder, 18 - Long Term Care Patient Admit/Readmit Indicator, 19 - Split Billing, 20 - 340B, 21 - LTC dispensing: 14 days or less not applicable, 22 - LTC dispensing: 7 days, 23 - LTC dispensing: 4 days, 24 - LTC dispensing: 3 days, 25 - LTC dispensing: 2 days, 26 - LTC dispensing: 1 day, 27 - LTC dispensing: 4-3 days, 28 - LTC dispensing: 2-2-3 days, 29 - LTC dispensing: daily and 3-day weekend, 30 - LTC dispensing: Per shift dispensing, 31 - LTC dispensing: Per med pass dispensing, 32 - LTC dispensing: PRN on demand, 33 - LTC dispensing: 7 day or less cycle not otherwise represented, 34 - LTC dispensing: 14 days dispensing, 35 - LTC dispensing: 8-14 day dispensing method not listed above, 36 - LTC dispensing: dispensed outside short cycle, 42 - Prescriber ID Submitted is valid and prescribing requirements have been validated., 42 - Prescriber ID Submitted is valid and prescribing requirements have been validated., 42 - Prescriber ID Submitted is valid and prescribing requirements have been validated., 43 - Prescriber''s DEA is active with DEA Authorized Prescriptive Right., 44 - For prescriber ID submitted, associated prescriber DEA recently licensed or re-activated, 45 - Prescriber''s DEA is a valid Hospital DEA with Suffix and has prescriptive authority for this drug DEA Schedule, 46 - Prescriber''s DEA has prescriptive authority for this drug DEA Schedule, 47 - Other Shortened Days Supply, 48 - Dispensed Subsequent to a Shortened Days Supply Dispensing, 49 - Prescriber does not currently have an active Type 1 NPI, 50 - Prescriber''s active Medicare Fee For Service enrollment status has been validated, 51 - Pharmacy''s active Medicare Fee For Service enrollment status has been validated, 52 - Prescriber''s state license with prescriptive authority has been validated, 53 - Prescriber NPI active and valid, 54 - CMS Other Authorized Prescriber (OAP), 55 - Prescriber Enrollment in State Medicaid Program has been validated., 56 - Pharmacy Enrollment in State Medicaid Program has been validated., 57 - Discharge Medication, 58 - Nominal Price, 59 - Federal Supply Schedule, 60 - Long Term Care Same Drug Strength and Dosage Form with Multiple Dosing Directions, 61 - Synchronization Fill - Shortened Days Supply, 62 - Shortened Days Supply of Same Drug, Strength and Dosage Form with Multiple NDCs Dispensed, 63 - Mail Order Delay - Shortened Days Supply, 64 - Trial Fill - Shortened Days Supply, 65 - Individual Patient Emergency RX Fill Request., 99 - Other' items: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 2 pattern: ^[0-9]*$ type: string type: array transactionReferenceNumber: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 30. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 30 type: string unitOfMeasure: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 6. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 6 type: string type: object narrativeMessage: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 600. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 600 type: string numberOfRefillsAuthorized: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 2 pattern: ^[0-9]*$ type: string originallyPrescribedQuantity: errorMessage: maxLength: exceeds the maximum limit of 10. pattern: invalid quantity. type: invalid type, expected string. maxLength: 11 pattern: ^(\d{1,7}(?:[.]\d{1,3})?)?$ type: string otherCoverageCode: errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 2 pattern: ^[0-9]*$ type: string prescriber: properties: address: properties: cityName: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 60. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 60 type: string postalCode: errorMessage: format: invalid postal code. maxLength: maximum length must be 15. type: invalid type, expected string. format: zip-or-postal-code maxLength: 15 type: string stateProvinceCode: enum: - AL - AK - AZ - AR - CA - CO - CT - DE - DC - FM - FL - GA - GU - HI - ID - IL - IN - IA - KS - KY - LA - ME - MD - MA - MI - MN - MS - MO - MT - NE - NV - NH - NJ - NM - NY - NC - ND - MP - OH - OK - OR - PW - PA - PR - RI - SC - SD - TN - TX - UT - VT - VI - VA - WA - WV - WI - WY - AB - BC - MB - NB - NF - NL - NS - NT - 'ON' - PE - QC - SK - YT - UM - '' errorMessage: enum: invalid state or province. maxLength: maximum length must be 2. type: invalid type, expected string. type: string streetLine1: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object name: properties: first: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string last: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object serviceProviderId: errorMessage: minItems: must have at least one item. type: invalid type, expected array. items: properties: code: description: Code qualifying the service Provider. 1 - National Provider Identifier (NPI), 2 - Blue Cross, 3 - Blue Shield, 4 - Medicare, 5 - Medicaid, 6 - UPIN (Unique Physician/Practitioner Identification Number), 7 - NCPDP Provider Identification Number (National Council for Prescription Drug Programs Provider Identification Number), 8 - State License, 9 - TRICARE, 10 - Health Industry Number (HIN), 11 - Federal Tax ID, 12 - Drug Enforcement Administration (DEA) Number, 13 - State Issued, 14 - Plan Specific, 15 - HCIdea, 16 - Combat Methamphetamine Epidemic Act (CMEA) Certificate ID, 17 - Foreign Prescriber Identifier, 18 - No Prescriber Required, 99 - Other errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number value: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object minItems: 1 type: array telephoneNumber: errorMessage: format: invalid phone number. type: invalid type, expected string. example: '7799886576' format: nanp-phone-number type: string type: object prescriptionOriginCode: description: Code indicating the origin of the prescription. 0 - Not Known, 1 - Written, 2 - Telephone, 3 - Electronic, 4 - Facsimile, 5 - Pharmacy errorMessage: maxLength: exceeds the maximum limit of 1. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 1 pattern: ^[0-9]*$ type: string prescriptionServiceReferenceNumberId: errorMessage: minItems: must have at least one item. type: invalid type, expected array. items: properties: code: description: Indicates the type of billing submitted. 1 - Rx Billing, 2 - Service Billing, 3 - Non Prescription Product errorMessage: maxLength: exceeds the maximum limit of 2. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected number. maximum: 99 minimum: 0 type: number value: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object minItems: 1 type: array quantityPrescribed: errorMessage: maxLength: exceeds the maximum limit of 10. pattern: invalid quantity. type: invalid type, expected string. maxLength: 11 pattern: ^(\d{1,7}(?:[.]\d{1,3})?)?$ type: string routeOfAdministration: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 33. format: ncpdp-alphanumeric maxLength: 33 type: string scheduledPrescriptionIdNumber: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 36. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 36 type: string type: object Pricing: properties: basisOfCostDetermination: description: Code indicating the method by which Ingredient Cost Submitted (409-D9) was calculated. 0 - Default, 1 - AWP (Average Wholesale Price), 2 - Local Wholesaler, 3 - Direct, 4 - EAC (Estimated Acquisition Cost), 5 - Acquisition, 6 - MAC (Maximum Allowable Cost), 7 - Usual & Customary, 8 - 340B/Disproportionate Share Pricing/Public Health Service, 9 - Other, 10 - ASP (Average Sales Price), 11 - AMP (Average Manufacturer Price), 12 - WAC (Wholesale Acquisition Cost), 13 - Special Patient Pricing, 14 - Cost basis on unreportable quantities., 15 - Free product or no associated cost., 16 - Nominal Price, 17 - Federal Supply Schedule format: ncpdp-alphanumeric maxLength: 6 type: string dispensingFeeSubmitted: maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string flatSalesTaxAmountSubmitted: maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string grossAmountDue: maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string incentiveAmountSubmitted: maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string ingredientCostSubmitted: maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string medicaidPaidAmount: maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string otherAmountClaimedSubmitted: items: $ref: '#/components/schemas/OtherAmountClaimedSubmitted' type: array patientPaidAmountSubmitted: $ref: '#/components/schemas/PatientPaidAmountSubmitted' percentageSalesTax: $ref: '#/components/schemas/PercentageSalesTax' percentageSalesTaxBasisSubmitted: format: ncpdp-alphanumeric maxLength: 6 type: string percentageSalesTaxRateSubmitted: maxLength: 10 pattern: ^-?(\d{1,3}(?:[.]\d{1,6})?)?$ type: string professionalServiceFeeSubmitted: maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string usualAndCustomaryCharge: maxLength: 13 pattern: ^-?(\d{1,6}(?:[.]\d{1,6})?)?$ type: string type: object PricingSegment: properties: accumulatedDeductibleAmount: $ref: '#/components/schemas/NcpdpDecimalType' amountAppliedToPeriodicDeductible: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true amountAttributedToCoverageGap: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true amountAttributedToProcessorFee: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true amountAttributedToProductSelectionOrBrandDrug: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true amountAttributedToProductSelectionOrBrandNonPreferredFormularySelection: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true amountAttributedToProductSelectionOrNonPreferredFormularySelection: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true amountAttributedToProviderNetworkSelection: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true amountAttributedToSalesTax: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true amountExceedingPeriodicBenefitMaximum: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true amountOfCoinsurance: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true amountOfCopay: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true basisOfCalculationCoinsurance: $ref: '#/components/schemas/NcpdpCodeType' basisOfCalculationCopay: $ref: '#/components/schemas/NcpdpCodeType' basisOfCalculationDispensingFee: $ref: '#/components/schemas/NcpdpCodeType' basisOfCalculationFlatSalesTax: $ref: '#/components/schemas/NcpdpCodeType' deprecated: true basisOfCalculationPercentageSalesTax: $ref: '#/components/schemas/NcpdpCodeType' deprecated: true basisOfCalculationPercentageTax: $ref: '#/components/schemas/NcpdpCodeType' basisOfCalculationRegulatoryFee: $ref: '#/components/schemas/NcpdpCodeType' basisOfReimbursementDetermination: $ref: '#/components/schemas/NcpdpCodeType' benefitStageCount: $ref: '#/components/schemas/NcpdpCountType' deprecated: true benefitStageGroupings: deprecated: true items: $ref: '#/components/schemas/BenefitStageGrouping' type: array benefitStageIndicatorCount: $ref: '#/components/schemas/NcpdpCountType' benefitStageIndicators: items: $ref: '#/components/schemas/NcpdpCountType' type: array dispensingFeeContractedOrReimbursableAmount: $ref: '#/components/schemas/NcpdpDecimalType' dispensingFeePaid: $ref: '#/components/schemas/NcpdpDecimalType' empty: type: boolean estimatedGenericSavings: $ref: '#/components/schemas/NcpdpDecimalType' flatSalesTaxAmountPaid: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true healthPlanFundedAssistanceAmount: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true incentiveAmountPaid: $ref: '#/components/schemas/NcpdpDecimalType' ingredientCostContractedOrReimbursableAmount: $ref: '#/components/schemas/NcpdpDecimalType' ingredientCostPaid: $ref: '#/components/schemas/NcpdpDecimalType' otherAmountPaidCount: $ref: '#/components/schemas/NcpdpCountType' otherAmountPaidGroupings: items: $ref: '#/components/schemas/OtherAmountPaidGrouping' type: array otherPayerAmountRecognized: $ref: '#/components/schemas/NcpdpDecimalType' patientPayAmount: $ref: '#/components/schemas/NcpdpDecimalType' patientPayComponentCount: $ref: '#/components/schemas/NcpdpCountType' patientPayComponentGroupings: items: $ref: '#/components/schemas/PatientPayComponentGrouping' type: array patientRegulatoryFeeAmount: $ref: '#/components/schemas/NcpdpDecimalType' patientSalesTaxAmount: $ref: '#/components/schemas/NcpdpDecimalType' percentageSalesTaxAmountPaid: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true percentageSalesTaxBasisPaid: $ref: '#/components/schemas/NcpdpCodeType' deprecated: true percentageSalesTaxRatePaid: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true percentageTaxAmountPaid: $ref: '#/components/schemas/NcpdpDecimalType' percentageTaxBasisPaid: $ref: '#/components/schemas/NcpdpCodeType' percentageTaxExemptIndicator: $ref: '#/components/schemas/NcpdpCodeType' percentageTaxRatePaid: $ref: '#/components/schemas/NcpdpDecimalType' planSalesTaxAmount: $ref: '#/components/schemas/NcpdpDecimalType' deprecated: true present: type: boolean professionalServiceFeeContractedOrReimbursementAmount: $ref: '#/components/schemas/NcpdpDecimalType' professionalServiceFeePaid: $ref: '#/components/schemas/NcpdpDecimalType' regulatoryFeeCount: $ref: '#/components/schemas/NcpdpCountType' regulatoryFeeGroupings: items: $ref: '#/components/schemas/RegulatoryFeeGrouping' type: array remainingBenefitAmount: $ref: '#/components/schemas/NcpdpDecimalType' remainingDeductibleAmount: $ref: '#/components/schemas/NcpdpDecimalType' spendingAccountAmountRemaining: $ref: '#/components/schemas/NcpdpDecimalType' taxExemptIndicator: $ref: '#/components/schemas/NcpdpCodeType' deprecated: true totalAmountPaid: $ref: '#/components/schemas/NcpdpDecimalType' type: object PricingV1: properties: accumulatedDeductibleAmount: type: number amountAppliedToPeriodicDeductible: type: number amountAttributedToCoverageGap: type: number amountAttributedToProcessorFee: type: number amountAttributedToProductSelectionOrBrandDrug: type: number amountAttributedToProductSelectionOrBrandNonPrefferedFormularySelection: type: number amountAttributedToProductSelectionOrNonPrefferedFormularySelection: type: number amountAttributedToProviderNetwork: type: number amountAttributedToSalesTax: type: number amountExceedingPeriodicBenefitMaximum: type: number amountOfCoinsurance: type: number amountOfCopay: type: number basisOfCalculationCoinsurance: type: string basisOfCalculationCopay: type: string basisOfCalculationDispensingFee: type: string basisOfCalculationFlatSalesTax: type: string basisOfCalculationPercentageSalesTax: type: string basisOfReimbursementDetermination: type: string benefitStage: items: $ref: '#/components/schemas/CodeValuePairV1' type: array dispensingFeeContractedOrReimbursableAmount: type: number dispensingFeePaid: type: number estimatedGenericSavings: type: number flatSalesTaxAmountPaid: type: number healthPlanFundedAssistanceAmount: type: number incentiveAmountPaid: type: number ingredientCostContractedOrReimbursableAmount: type: number ingredientCostPaid: type: number otherAmountPaid: items: $ref: '#/components/schemas/CodeValuePairV1' type: array otherPayerAmountRecognized: type: number patientPayAmount: type: number patientRegulatoryFeeAmount: type: number patientSalesTaxAmount: type: number percentageSalesTaxAmountPaid: type: number percentageSalesTaxBasisPaid: type: string percentageSalesTaxRatePaid: type: number percentageTaxExemptIndicator: type: string planSalesTaxAmount: type: number professionalServiceFeePaid: type: number remainingBenefitAmount: type: number remainingDeductibleAmount: type: number spendingAccountAmountRemaining: type: number totalAmountPaid: type: number type: object PrimaryCareProviderIdentifier: properties: blueCross: type: string blueShield: type: string champus: type: string deaNumber: type: string federalTaxId: type: string hcid: type: string healthIndustryNumber: type: string medicaid: type: string medicare: type: string ncpdpIdentifier: type: string npi: type: string other: type: string planSpecific: type: string stateIssued: type: string stateLicense: type: string upin: type: string type: object PriorAuthorization: properties: authorizationNumber: format: ncpdp-alphanumeric maxLength: 60 type: string authorizedRepresentativeCityAddress: type: string authorizedRepresentativeFirstName: type: string authorizedRepresentativeLastName: type: string authorizedRepresentativeStateOrProvinceAddress: type: string authorizedRepresentativeStreetAddress: type: string authorizedRepresentativeZipOrPostalCode: type: string basisOfRequest: description: Code describing the reason for prior authorization request. ME - Medical Exception, PR - Plan Requirement, PL - Increase Plan Limitation format: ncpdp-alphanumeric maxLength: 6 type: string priorAuthorizationIdAssigned: type: string priorAuthorizationRequestPeriodBeginDate: type: string priorAuthorizationRequestPeriodEndDate: type: string priorAuthorizationSupportingDocumentation: type: string requestType: description: Code identifying type of prior authorization request. 1 - Initial, 2 -Reauthorization, 3 - Deferred format: ncpdp-alphanumeric maxLength: 3 type: string type: object PriorAuthorizationSegment: properties: empty: type: boolean present: type: boolean priorAuthorizationDollarsAuthorized: $ref: '#/components/schemas/NcpdpDecimalType' priorAuthorizationEffectiveDate: $ref: '#/components/schemas/NcpdpDateType' priorAuthorizationExpirationDate: $ref: '#/components/schemas/NcpdpDateType' priorAuthorizationIdAssigned: $ref: '#/components/schemas/NcpdpAlphaNumericType' priorAuthorizationNumberAssigned: $ref: '#/components/schemas/NcpdpAlphaNumericType' deprecated: true priorAuthorizationNumberOfRefillsAuthorized: $ref: '#/components/schemas/NcpdpIntegerType' priorAuthorizationProcessedDate: $ref: '#/components/schemas/NcpdpDateType' priorAuthorizationQuantity: $ref: '#/components/schemas/NcpdpDecimalType' priorAuthorizationQuantityAccumulated: $ref: '#/components/schemas/NcpdpDecimalType' type: object PriorAuthorizationV1: properties: authorizationNumber: errorMessage: format: invalid value for authorizationNumber maxLength: exceeds the maximum limit of 60. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 60 type: string authorizedRepresentative: errorMessage: minProperties: must have at least one property. minProperties: 1 properties: address: errorMessage: minProperties: must have at least one address property. minProperties: 1 properties: cityName: errorMessage: format: invalid city name. maxLength: exceeds the maximum limit of 60. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 60 type: string postalCode: errorMessage: format: invalid postal code. maxLength: maximum length must be 15. type: invalid type, expected string. format: zip-or-postal-code maxLength: 15 type: string stateProvinceCode: enum: - AL - AK - AZ - AR - CA - CO - CT - DE - DC - FM - FL - GA - GU - HI - ID - IL - IN - IA - KS - KY - LA - ME - MD - MA - MI - MN - MS - MO - MT - NE - NV - NH - NJ - NM - NY - NC - ND - MP - OH - OK - OR - PW - PA - PR - RI - SC - SD - TN - TX - UT - VT - VI - VA - WA - WV - WI - WY - AB - BC - MB - NB - NF - NL - NS - NT - 'ON' - PE - QC - SK - YT - UM - '' errorMessage: enum: invalid state or province. maxLength: maximum length must be 2. type: invalid type, expected string. maxLength: 2 type: string streetLine1: errorMessage: format: invalid street line 1 value. maxLength: exceeds the maximum limit of 90. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 90 type: string type: object name: errorMessage: minProperties: must have at least one name property. minProperties: 1 properties: first: errorMessage: format: invalid first name maxLength: exceeds the maximum limit of 105. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 105 type: string last: errorMessage: format: invalid last name maxLength: exceeds the maximum limit of 105. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 105 type: string middle: errorMessage: format: invalid middle name maxLength: exceeds the maximum limit of 105. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 105 type: string prefix: errorMessage: format: invalid prefix value maxLength: exceeds the maximum limit of 9. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 9 type: string suffix: errorMessage: format: invalid suffix value maxLength: exceeds the maximum limit of 9. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 9 type: string type: object type: object basisOfRequest: description: Code describing the reason for prior authorization request. ME - Medical Exception, PR - Plan Requirement, PL - Increase Plan Limitation errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 6. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 6 type: string idAssigned: errorMessage: maxLength: exceeds the maximum limit of 11. pattern: invalid value for pAIdAssigned type: invalid type, expected string. maxLength: 11 pattern: ^[0-9]*$ type: string requestPeriodBeginDate: errorMessage: format: invalid date. type: invalid type, expected string. example: '2023-10-01' format: rxn-date type: string requestPeriodEndDate: errorMessage: format: invalid date. type: invalid type, expected string. example: '2023-10-01' format: rxn-date type: string requestType: description: Code identifying type of prior authorization request. 1 - Initial, 2 -Reauthorization, 3 - Deferred errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 3. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 3 type: string supportingDocumentation: errorMessage: format: invalid value for pASupportingDocumentation maxLength: exceeds the maximum limit of 1500. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 1500 type: string type: object ProcessorV1: properties: binNumber: errorMessage: maxLength: exceeds the maximum limit of 6. pattern: invalid value, only numeric characters are allowed. type: invalid type, expected string. maxLength: 6 pattern: ^[0-9]*$ type: string claimFormatCode: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 9. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 9 type: string groupCode: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 45. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 45 type: string processorControlNumber: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 30. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 30 type: string rems: enum: - Y - N - y - n errorMessage: enum: invalid Value, expected values are Y or N. maxLength: exceeds the maximum limit of 1. type: invalid type, expected string. maxLength: 1 type: string siteCode: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 240. type: invalid type, expected string or null. format: ncpdp-alphanumeric maxLength: 240 type: - string - 'null' softwareVendorId: errorMessage: format: invalid value, only printable characters are allowed. maxLength: exceeds the maximum limit of 30. type: invalid type, expected string. format: ncpdp-alphanumeric maxLength: 30 type: string transactionCount: enum: - '1' - '' errorMessage: enum: invalid value, only expected value is 1. maxLength: exceeds the maximum limit of 1. type: invalid type, expected string. maxLength: 1 type: string type: object ProductOrServiceIdentifier: properties: currentProceduralTerminologyFive: type: string currentProceduralTerminologyFour: type: string deviceIdentifier: type: string drugUseReviewOrProfessionalPharmacyService: type: string elsevierGoldStandardMarketedProductIdentifier: type: string elsevierGoldStandardProductIdentifier: type: string elsevierGoldStandardSpecificProductIdentifier: type: string firstDataBankClinicalFormulationIDSequenceNumber: type: string firstDataBankFormulationIdGCB: type: string firstDataBankFormulationIdGCN: type: string firstDataBankIngredientListID: type: string firstDataBankMedicationID: type: string firstDataBankMedicationNameID: type: string firstDataBankRoutedDosageFormID: type: string firstDataBankRoutedMedicationID: type: string globalTradeIdentificationNumber: type: string healthcareCommonProcedureCodingSystem: type: string healthIndustryBusinessCommunicationsCouncil: type: string healthRelatedItem: type: string nationalDrugCode: type: string nationalPharmaceuticalProductInterfaceCode: type: string notSpecified: type: string other: type: string pharmacyPracticeActivityClassification: type: string representativeNationalDrugCode: type: string universalProductCode: type: string universalProductNumber: type: string type: object ProviderIdentifier: properties: deaNumber: type: string healthIndustryNumber: type: string name: type: string npi: type: string other: type: string socialSecurityNumber: type: string stateIssued: type: string stateLicense: type: string type: object ProviderSegment: properties: dataSourceOfInvalidProviderDetermination: $ref: '#/components/schemas/NcpdpCodeType' empty: type: boolean present: type: boolean stateCodeForDataSourceOfInvalidProviderDetermination: $ref: '#/components/schemas/NcpdpCodeType' type: object Question: properties: alphanumericResponse: format: ncpdp-alphanumeric maxLength: 90 type: string dateResponse: example: '2023-10-01' format: rxn-date type: string dollarAmountResponse: maxLength: 16 pattern: ^-?(\d{1,9}(?:[.]\d{1,6})?)?$ type: string numberOrLetter: format: ncpdp-alphanumeric maxLength: 9 type: string numericResponse: maxLength: 11 pattern: ^[0-9]*$ type: string percentResponse: maxLength: 5 pattern: ^(\d{1,3}(?:[.]\d{1,2})?)?$ type: string type: object RegulatoryFeeGrouping: properties: empty: type: boolean present: type: boolean regulatoryFeeAmountPaid: $ref: '#/components/schemas/NcpdpDecimalType' regulatoryFeeExemptIndicator: $ref: '#/components/schemas/NcpdpCodeType' regulatoryFeeTypeCode: $ref: '#/components/schemas/NcpdpCodeType' type: object RejectCodeGrouping: properties: empty: type: boolean present: type: boolean rejectCode: $ref: '#/components/schemas/NcpdpCodeType' rejectFieldOccurrenceIndicator: $ref: '#/components/schemas/NcpdpIntegerType' type: object RejectDetails: properties: rejectCode: type: string rejectFieldOccurrenceIndicator: format: int32 type: integer type: object RejectDetailsV1: properties: code: type: string fieldOccurrenceIndicator: format: int32 type: integer type: object ResponseIntermediaryAuthorizationGrouping: properties: empty: type: boolean intermediaryMessage: $ref: '#/components/schemas/NcpdpAlphaNumericType' present: type: boolean responseIntermediaryAuthorizationId: $ref: '#/components/schemas/NcpdpAlphaNumericType' responseIntermediaryAuthorizationTypeId: $ref: '#/components/schemas/NcpdpCodeType' type: object ResponseTransaction: properties: claim: $ref: '#/components/schemas/ClaimSegment' deprecated: true cobOrOtherPayers: $ref: '#/components/schemas/OtherPayersSegment' deprecated: true durOrPps: $ref: '#/components/schemas/DurOrPpsSegment' deprecated: true empty: type: boolean present: type: boolean pricing: $ref: '#/components/schemas/PricingSegment' deprecated: true priorAuthorization: $ref: '#/components/schemas/PriorAuthorizationSegment' deprecated: true status: $ref: '#/components/schemas/StatusSegment' deprecated: true type: object ServiceProviderIdentifier: properties: blueCross: type: string blueShield: type: string champus: type: string drugEnforcementAdministration: type: string federalTaxId: type: string hcidea: type: string healthIndustryNumber: type: string medicaid: type: string medicare: type: string nationalProviderIdentifier: type: string ncpdpProviderID: type: string planSpecific: type: string serviceOther: type: string stateIssued: type: string stateLicense: type: string upin: type: string type: object Standard: properties: transactionType: maxLength: 2 type: string type: type: string versionOrReleaseNumber: maxLength: 2 type: string type: object StandardV1: properties: transactionType: type: string versionOrReleaseNumber: type: string type: object Status: properties: additionalMessageInformation: items: $ref: '#/components/schemas/AdditionalMessageInformationGrouping' type: array additionalMessageInformationCount: type: string approvedMessageCode: items: type: string type: array approvedMessageCodeCount: type: string authorizationNumber: type: string helpDeskTelephoneNumber: $ref: '#/components/schemas/HelpDeskPhoneNumber' helpDeskTelephoneQualifier: type: string internalControlNumber: type: string rejectDetails: items: $ref: '#/components/schemas/RejectDetails' type: array transactionReferenceNumber: type: string transactionResponseStatus: type: string url: type: string type: object StatusSegment: properties: additionalMessageInformationCount: $ref: '#/components/schemas/NcpdpCountType' additionalMessageInformationGroupings: items: $ref: '#/components/schemas/AdditionalMessageInformationGrouping' type: array adjudicatedProgramType: $ref: '#/components/schemas/NcpdpCodeType' approvedMessageCodeCount: $ref: '#/components/schemas/NcpdpCountType' approvedMessageCodes: items: $ref: '#/components/schemas/NcpdpCodeType' type: array authorizationNumber: $ref: '#/components/schemas/NcpdpAlphaNumericType' empty: type: boolean helpDeskSupportTypeCount: $ref: '#/components/schemas/NcpdpCountType' helpDeskSupportTypeGroupings: items: $ref: '#/components/schemas/HelpDeskSupportTypeGrouping' type: array helpDeskTelephoneNumber: $ref: '#/components/schemas/NcpdpAlphaNumericType' deprecated: true helpDeskTelephoneNumberQualifier: $ref: '#/components/schemas/NcpdpCodeType' deprecated: true internalControlNumber: $ref: '#/components/schemas/NcpdpAlphaNumericType' nextAvailableFillDate: $ref: '#/components/schemas/NcpdpDateType' present: type: boolean reconciliationId: $ref: '#/components/schemas/NcpdpAlphaNumericType' rejectCodeGroupings: items: $ref: '#/components/schemas/RejectCodeGrouping' type: array rejectCount: $ref: '#/components/schemas/NcpdpCountType' transactionReferenceNumber: $ref: '#/components/schemas/NcpdpAlphaNumericType' transactionResponseStatus: $ref: '#/components/schemas/NcpdpCodeType' url: $ref: '#/components/schemas/NcpdpAlphaNumericType' deprecated: true type: object StatusV1: properties: additionalMessageInformation: items: $ref: '#/components/schemas/AdditionalMessageInformationGroupingV1' type: array additionalMessageInformationCount: type: string approvedMessageCode: items: type: string type: array approvedMessageCodeCount: type: string authorizationNumber: type: string helpDeskTelephone: $ref: '#/components/schemas/IdentifierV1' internalControlNumber: type: string rejectDetails: items: $ref: '#/components/schemas/RejectDetailsV1' type: array transactionReferenceNumber: type: string transactionResponseStatus: type: string url: type: string type: object TelecomRequest: properties: additionalDocumentation: $ref: '#/components/schemas/AdditionalDocumentation' claim: $ref: '#/components/schemas/Claim' clinical: $ref: '#/components/schemas/Clinical' compound: $ref: '#/components/schemas/Compound' coupon: $ref: '#/components/schemas/Coupon' dur: items: $ref: '#/components/schemas/DurItem' type: array facility: $ref: '#/components/schemas/Facility' insurance: $ref: '#/components/schemas/Insurance' narrative: $ref: '#/components/schemas/Narrative' patient: $ref: '#/components/schemas/Patient' payment: $ref: '#/components/schemas/Payment' pharmacy: $ref: '#/components/schemas/Pharmacy' prescriber: $ref: '#/components/schemas/Prescriber' pricing: $ref: '#/components/schemas/Pricing' priorAuthorization: $ref: '#/components/schemas/PriorAuthorization' telecomHeader: $ref: '#/components/schemas/Header' workersCompensation: $ref: '#/components/schemas/WorkersCompensation' type: object TelecomRequestV1: properties: additionalDocumentation: $ref: '#/components/schemas/AdditionalDocumentationV1' coupon: $ref: '#/components/schemas/CouponV1' header: $ref: '#/components/schemas/HeaderRequestV1' patient: $ref: '#/components/schemas/PatientRequestV1' pharmacy: $ref: '#/components/schemas/PharmacyV1' prescription: $ref: '#/components/schemas/PrescriptionV1' priorAuthorization: $ref: '#/components/schemas/PriorAuthorizationV1' processor: $ref: '#/components/schemas/ProcessorV1' type: object Transaction: properties: claim: $ref: '#/components/schemas/Claim' dur: $ref: '#/components/schemas/DurOrPps' payment: $ref: '#/components/schemas/CobOtherPayments' pricing: $ref: '#/components/schemas/Pricing' status: $ref: '#/components/schemas/Status' type: object TransactionV1: properties: dur: $ref: '#/components/schemas/DurOrPpsV1' payment: $ref: '#/components/schemas/CobOtherPaymentsV1' prescription: $ref: '#/components/schemas/ClaimV1' pricing: $ref: '#/components/schemas/PricingV1' status: $ref: '#/components/schemas/StatusV1' type: object WorkersCompensation: properties: billingEntityTypeIndicator: maxLength: 2 pattern: ^[0-9]*$ type: string carrierId: format: ncpdp-alphanumeric maxLength: 30 type: string claimOrReferenceId: format: ncpdp-alphanumeric maxLength: 90 type: string dateOfInjury: example: '2023-10-01' format: rxn-date type: string employerCityAddress: type: string employerContactName: type: string employerName: type: string employerStateOrProvinceAddress: type: string employerStreetAddress: type: string employerTelephoneNumber: $ref: '#/components/schemas/PhoneNumber' employerZipOrPostalCode: type: string genericEquivalentProductIdentifier: $ref: '#/components/schemas/GenericEquivalentProductIdentifier' payToCityAddress: type: string payToIdentifier: $ref: '#/components/schemas/PayToIdentifier' payToName: type: string payToStateOrProvinceAddress: type: string payToStreetAddress: type: string payToZipOrPostalCode: type: string type: object securitySchemes: oauth2_security: flows: clientCredentials: scopes: {} tokenUrl: https://idx-stage.linkhealth.com/auth/realms/developer-platform/protocol/openid-connect/token type: oauth2 externalDocs: description: Resource Docs url: https://springdoc.org/ info: description: API for Telecom Formatter title: Telecom Formatter API version: v1 openapi: 3.1.0 paths: /health/telecom-formatter: get: responses: '200': description: OK summary: Health check endpoint for the telecom-formatter tags: - HealthCheck /v1/formatDetails: post: description: This endpoint receives structured JSON data and transforms it into a formatted NCPDP (National Council for Prescription Drug Programs) string. operationId: formatDetails requestBody: content: application/json: schema: $ref: '#/components/schemas/TelecomRequestV1' description: Request to format details required: true responses: '200': content: '*/*': schema: $ref: '#/components/schemas/NCPDPRequestConverterV1Response' description: Successful Response '401': content: '*/*': schema: $ref: '#/components/schemas/NCPDPRequestConverterV1Response' description: Unauthorized summary: Format Details tags: - Telecom Format /v1/telecomFormatResponse: post: description: This endpoint converts a raw NCPDP telecom message string into a structured JSON format. It is primarily used to parse and interpret NCPDP D.0 or similar telecom transaction formats, making the data easier to consume for downstream systems. operationId: formatIncomingData requestBody: content: application/json: schema: $ref: '#/components/schemas/NcpdpFormatRequestData' description: Request to telecom format Response required: true responses: '200': content: '*/*': schema: $ref: '#/components/schemas/NCPDPResponseConverterV1Response' description: Successful '401': content: '*/*': schema: $ref: '#/components/schemas/NCPDPResponseConverterV1Response' description: Unauthorized summary: NCPDP Format Request Data tags: - Telecom Format security: - oauth2_security: [] servers: - description: Generated server url url: ' https://sandbox-apigw.optum.com/rxn/telecomformatter' tags: - description: API to format details received in a request name: Telecom Format x-readme: explorer-enabled: true proxy-enabled: true