BestRx Medical Billing API
by bestrxdevs

BestRx Medical Billing API

https://developer.bestrxconnect.com/TestMedicalBilling

https://developer.bestrxconnect.com/TestMedicalBilling
Operations
Pharmacy
POST - GetAccessToken
POST /Pharmacy/GetAccessToken
POST - SendPatientData
POST /Pharmacy/SendPatientData
GET - GetLogInfo
GET /Pharmacy/GetLogInfo
POST - GetUserAuthToken
POST /Pharmacy/GetUserAuthToken
GET - GetListOfUsers
GET /Pharmacy/GetListOfUsers
POST - GetAccessToken
POST /Pharmacy/GetAccessToken

This endpoint is used to get auth token.

Request headers

Authorization
string optional

Basic Auth

Request body

application/json
text/json
application/xml
text/xml
application/x-www-form-urlencoded
PharmacyTokenRequest
Example: 
{
    "PharmacyUniqueId": "",
    "IsEncrypted": true
}

Responses

200 200

OK

Body
application/json
text/json
application/xml
text/xml
ResponseGenericInfo[PharmacyAuthTokenResponse]
Examples: 
{
    "Data": {
        "AuthToken": "",
        "ExpirationTime": "",
        "RefreshToken": ""
    },
    "IsValid": true,
    "Messages": [
        {
            "MessageCode": "",
            "Message": "",
            "MessageType": "Warning"
        }
    ]
}
Example with response data

{
    "Data": {
        "AuthToken": "eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJ1bmlxdWVfbmFtZSI6IlBoYXJtYWN5IiwibmJmIjoxNjEzMDU5MDQ5LCJleHAiOjE2MTMxNDU0NDksImlhdCI6MTYxMzA1OTA0OSwiaXNzIjoiQXV0aFNydmMiLCJhdWQiOiJNZWRpY2FsQmlsbGluZyJ9.9mBQOzL-WlRIF8e4R6w3LA75JCrfyGMZIv4No_nua1Q",
        "ExpirationTime": "2021-02-12 15:57:29.000",
        "RefreshToken": "eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJ1bmlxdWVfbmFtZSI6IlBoYXJtYWN5IiwibmJmIjoxNjEzMDU5MDQ5LCJleHAiOjE2MTMxNDU0NDksImlhdCI6MTYxMzA1OTA0OSwiaXNzIjoiQXV0aFNydmMiLCJhdWQiOiJNZWRpY2FsQmlsbGluZyJ9.9mBQOzL-WlRIF8e4R6w3LA75JCrfyGMZIv4No_nua1Q"
    },
    "IsValid": true,
    "Messages": []
}
POST - SendPatientData
POST /Pharmacy/SendPatientData

This endpoint is used to send patient data.

Request headers

Authorization
string optional

Basic Auth

Request body

application/json
text/json
application/xml
text/xml
application/x-www-form-urlencoded
SendPatientDataRequest
Example: 
{
    "patientInfo": {
        "PatientAutoID": 1,
        "PharmacyID": 1,
        "PatientRecno": 1,
        "FamilyRecno": 1,
        "FamilyAutoID": 1,
        "First_Name": "",
        "Middle_Name": "",
        "Last_Name": "",
        "DOB": "",
        "Gender": "",
        "Suffix": "",
        "HomePhone": "",
        "CellPhone": "",
        "WorkPhone": "",
        "Email": "",
        "Remarks": "",
        "familyInfo": {
            "FamilyAutoID": 1,
            "PharmacyID": 1,
            "FamilyRecno": 1,
            "Family_First_Name": "",
            "Family_Last_Name": "",
            "Address1": "",
            "Address2": "",
            "City": "",
            "State": "",
            "Zip_Code": "",
            "HomePhoneNo": "",
            "Remarks": ""
        },
        "listPharmacyInsurances": [
            {
                "PatPharmInsuranceAutoID": 1,
                "PharmacyID": 1,
                "PatientAutoID": 1,
                "PatientRecno": 1,
                "InsuranceRecno": 1,
                "SeqNo": 1,
                "CardID": "",
                "GroupID": "",
                "PrimaryIndicator": "",
                "CardHolderName": "",
                "Relation": "",
                "insuranceInfo": {
                    "InsuranceAutoId": 1,
                    "PharmacyID": 1,
                    "InsuranceRecno": 1,
                    "Bin": "",
                    "PCN": "",
                    "PlanName": "",
                    "PlanCode": "",
                    "PhoneNo": "",
                    "Address1": "",
                    "Address2": "",
                    "City": "",
                    "State": "",
                    "Zip_Code": "",
                    "FaxNo": "",
                    "NCPDPVersion": "",
                    "CashIndicator": "",
                    "ProviderIDQualifier": "",
                    "Remarks": ""
                }
            }
        ],
        "listClinicalInsurances": [
            {
                "PatClinicalInsuranceAutoID": 1,
                "PatClinicalInsuranceRecno": 1,
                "PharmacyID": 1,
                "PatientAutoID": 1,
                "SeqNo": 1,
                "PayerAutoID": 1,
                "PayerID": "",
                "PayerName": "",
                "MemberID": "",
                "GroupID": "",
                "PrimaryIndicator": "",
                "CardHolderName": "",
                "Relation": "",
                "SubscriberLastName": "",
                "SubscriberFirstName": "",
                "SubscriberMiddleName": "",
                "SubscriberSuffix": "",
                "SubscriberAddr1": "",
                "SubscriberAddr2": "",
                "SubscriberCity": "",
                "SubscriberState": "",
                "SubscriberZipCode": "",
                "SubscriberPhone": "",
                "SubscriberDOB": "",
                "LastEligibilityCheckDate": "",
                "LastMBSubmittedDate": "",
                "Gender": "",
                "LastEligibilityResponse": {
                    "TransactionID": "",
                    "CorrelationID": "",
                    "Status": "",
                    "PreAuthReqd": "",
                    "InPlanNetworkInd": "",
                    "FreeText": "",
                    "ErrorDescr": "",
                    "CreatedDate": ""
                }
            }
        ]
    },
    "insuranceInfo": [
        {
            "InsuranceAutoId": 1,
            "PharmacyID": 1,
            "InsuranceRecno": 1,
            "Bin": "",
            "PCN": "",
            "PlanName": "",
            "PlanCode": "",
            "PhoneNo": "",
            "Address1": "",
            "Address2": "",
            "City": "",
            "State": "",
            "Zip_Code": "",
            "FaxNo": "",
            "NCPDPVersion": "",
            "CashIndicator": "",
            "ProviderIDQualifier": "",
            "Remarks": ""
        }
    ],
    "patientInsuranceInfo": [
        {
            "PatPharmInsuranceAutoID": 1,
            "PharmacyID": 1,
            "PatientAutoID": 1,
            "PatientRecno": 1,
            "InsuranceRecno": 1,
            "SeqNo": 1,
            "CardID": "",
            "GroupID": "",
            "PrimaryIndicator": "",
            "CardHolderName": "",
            "Relation": "",
            "insuranceInfo": {
                "InsuranceAutoId": 1,
                "PharmacyID": 1,
                "InsuranceRecno": 1,
                "Bin": "",
                "PCN": "",
                "PlanName": "",
                "PlanCode": "",
                "PhoneNo": "",
                "Address1": "",
                "Address2": "",
                "City": "",
                "State": "",
                "Zip_Code": "",
                "FaxNo": "",
                "NCPDPVersion": "",
                "CashIndicator": "",
                "ProviderIDQualifier": "",
                "Remarks": ""
            }
        }
    ]
}

Responses

200 200

OK

Body
application/json
text/json
application/xml
text/xml
ResponseGenericInfo[SendPatientDataResponse]
Examples: 
{
    "Data": {
        "PatientRecno": 1,
        "PatientAutoNo": 1
    },
    "IsValid": true,
    "Messages": [
        {
            "MessageCode": "",
            "Message": "",
            "MessageType": "Success"
        }
    ]
}
Example with response data

{
    "Data": {
        "PatientRecno": 1011,
        "PatientAutoNo": 111
    },
    "IsValid": true,
    "Messages": []
}
GET - GetLogInfo
GET /Pharmacy/GetLogInfo

This endpoint is used to get log information.

Request parameters

LogId
integer int64 required
strType
string required

Request headers

Authorization
string optional

Basic Auth

Request body

Responses

200 200

OK

Body
application/json
text/json
application/xml
text/xml
ResponseGenericInfo[Object]
Examples: 
{
    "Data": {},
    "IsValid": true,
    "Messages": [
        {
            "MessageCode": "",
            "Message": "",
            "MessageType": "Unknown"
        }
    ]
}
Example with response data

{
    "Data": {},
    "IsValid": true,
    "Messages": []
}
POST - GetUserAuthToken
POST /Pharmacy/GetUserAuthToken

This endpoint is used to get user auth token.

Request headers

Authorization
string optional

Basic Auth

Request body

application/json
text/json
application/xml
text/xml
application/x-www-form-urlencoded
PharmacyUserAuthTokenRequest
Example: 
{
    "userId": 1
}

Responses

200 200

OK

Body
application/json
text/json
application/xml
text/xml
ResponseGenericInfo[PharmacyUserAuthTokenResponse]
Examples: 
{
    "Data": {
        "AuthToken": "",
        "ExpirationTime": ""
    },
    "IsValid": true,
    "Messages": [
        {
            "MessageCode": "",
            "Message": "",
            "MessageType": "Information"
        }
    ]
}
Example with response data
{
    "Data": {
        "AuthToken": "eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJ1bmlxdWVfbmFtZSI6IlBoYXJtYWN5IiwibmJmIjoxNjEzMDU5MDQ5LCJleHAiOjE2MTMxNDU0NDksImlhdCI6MTYxMzA1OTA0OSwiaXNzIjoiQXV0aFNydmMiLCJhdWQiOiJNZWRpY2FsQmlsbGluZyJ9.9mBQOzL-WlRIF8e4R6w3LA75JCrfyGMZIv4No_nua1Q",
        "ExpirationTime": "2021-02-12 15:57:29.000"
    },
    "IsValid": true,
    "Messages": []
}
GET - GetListOfUsers
GET /Pharmacy/GetListOfUsers

This endpoint is used to get list of users.

Request headers

Authorization
string optional

Basic Auth

Request body

Responses

200 200

OK

Body
application/json
text/json
application/xml
text/xml
ResponseGenericInfo[List[UserInfo]]
Examples: 
{
    "Data": [
        {
            "UserId": 1,
            "UserLastName": "",
            "UserFirstName": "",
            "UserName": "",
            "Password": "",
            "PIN": "",
            "EmailId": "",
            "IsActive": true,
            "Address1": "",
            "Address2": "",
            "City": "",
            "State": "",
            "ZipCode": "",
            "NPI": "",
            "HomePhone": "",
            "Fax": "",
            "CellPhone": "",
            "LastSyncDate": ""
        }
    ],
    "IsValid": true,
    "Messages": [
        {
            "MessageCode": "",
            "Message": "",
            "MessageType": "Information"
        }
    ]
}
Example with response data

{
    "Data": [
        {
            "UserId": 1,
            "UserLastName": "Micheal",
            "UserFirstName": "Test",
            "UserName": "Test123",
            "Password": "",
            "PIN": "123",
            "EmailId": "Test123@gmail.com",
            "IsActive": true,
            "Address1": "Joe brook",
            "Address2": "Micheal street",
            "City": "IL",
            "State": "",
            "ZipCode": "353456",
            "NPI": "5N201167",
            "HomePhone": "",
            "Fax": "4353535356",
            "CellPhone": "4643453567",
            "LastSyncDate": ""
        },
        {
            "UserId": 2,
            "UserLastName": "John",
            "UserFirstName": "Doe",
            "UserName": "John222",
            "Password": "",
            "PIN": "123",
            "EmailId": "JohnDoe123@gmail.com",
            "IsActive": true,
            "Address1": "gravyard street",
            "Address2": "Near brooklyn cafe",
            "City": "IL",
            "State": "",
            "ZipCode": "353456",
            "NPI": "5N201167",
            "HomePhone": "",
            "Fax": "6453535356",
            "CellPhone": "545454455",
            "LastSyncDate": ""
        }
    ],
    "IsValid": true,
    "Messages": [
        {
            "MessageCode": "",
            "Message": "",
            "MessageType": "Unknown"
        }
    ]
}
RHRxMB
PSOT - CheckEligibility
POST /RxMB/CheckEligibility
POST - GetRxMBEligibility
POST /RxMB/GetRxMBEligibility
POST - ClinicalDocumentation
POST /RxMB/ClinicalDocumentation
POST - SubmitClaim
POST /RxMB/SubmitClaim
PSOT - CheckEligibility
POST /RxMB/CheckEligibility

This endpoint is used to check eligibility of Rx.

Request headers

Authorization
string optional

Basic Auth

Request body

application/json
text/json
application/xml
text/xml
application/x-www-form-urlencoded
CheckEligibilityRequest
Example: 
{
    "PatientAutoID": 1,
    "SeqNo": 1
}

Responses

200 200

OK

Body
application/json
text/json
application/xml
text/xml
ResponseGenericInfo[EligibilityResponse]
Examples: 
{
    "Data": {
        "eligSubmitterTransactionId": "",
        "claimSubmittersId": "",
        "correlationId": "",
        "status": "",
        "requiresPreAuth": "",
        "inPlanNetworkIndicator": "",
        "info": [
            ""
        ],
        "errors": [
            {
                "Source": "",
                "ReasonCodes": "",
                "ReasonCodeDesc": "",
                "BestRxCodeDesc": ""
            }
        ]
    },
    "IsValid": true,
    "Messages": [
        {
            "MessageCode": "",
            "Message": "",
            "MessageType": "Warning"
        }
    ]
}
Example with response data

{
    "Data": {
        "eligSubmitterTransactionId": "a0455b31-2c5b-4f8c-a4e6-028bc8c66bd6",
        "claimSubmittersId": "",
        "correlationId": "165c29e3-6f0e-4a20-a822-e0e6a933c10e",
        "status": "ACTIVE",
        "requiresPreAuth": "N",
        "inPlanNetworkIndicator": "N",
        "info": [
            ""
        ],
        "errors": [
            {
                "Source": "",
                "ReasonCodes": "",
                "ReasonCodeDesc": "",
                "BestRxCodeDesc": ""
            }
        ]
    },
    "IsValid": true,
    "Messages": []
}
POST - GetRxMBEligibility
POST /RxMB/GetRxMBEligibility

This endpoint is used to get RX MB Eligibility.

Request parameters

userRecno
integer int32 required

Request headers

Authorization
string optional

Basic Auth

Request body

application/json
text/json
application/xml
text/xml
application/x-www-form-urlencoded
EligibilityRequest
Example: 
{
    "context": {
        "productCode": "",
        "storeNpi": "",
        "release": "",
        "submitterNpi": ""
    },
    "clearingHouseIndicator": "",
    "eligSubmitterTransactionId": "00000000-0000-0000-0000-000000000000",
    "claimSubmittersId": "",
    "submittedDate": "",
    "patientRelationshipToSubscriber": "",
    "billingOrganization": {
        "payToName": "",
        "orgId": ""
    },
    "subscriber": {
        "lastName": "",
        "firstName": "",
        "middleName": "",
        "suffix": "",
        "memberId": "",
        "dob": "",
        "gender": "",
        "street": "",
        "addrLine2": "",
        "city": "",
        "state": "",
        "zipCode": "",
        "phone": ""
    },
    "dependent": {
        "lastName": "",
        "firstName": "",
        "middleName": "",
        "suffix": "",
        "memberId": "",
        "dob": "",
        "gender": "",
        "street": "",
        "addrLine2": "",
        "city": "",
        "state": "",
        "zipCode": ""
    },
    "payer": {
        "name": "",
        "address": {
            "addrLine1": "",
            "addrLine2": "",
            "city": "",
            "state": "",
            "zipCode": ""
        },
        "id": "",
        "type": "",
        "priorAuthNum": 1
    }
}

Responses

200 200

OK

Body
application/json
text/json
application/xml
text/xml
ResponseGenericInfo[EligibilityResponse]
Example: 
Example with response data

{
    "Data": {
        "eligSubmitterTransactionId": "a0455b31-2c5b-4f8c-a4e6-028bc8c66bd6",
        "claimSubmittersId": "",
        "correlationId": "165c29e3-6f0e-4a20-a822-e0e6a933c10e",
        "status": "ACTIVE",
        "requiresPreAuth": "N",
        "inPlanNetworkIndicator": "N",
        "info": [
            ""
        ],
        "errors": [
            {
                "Source": "",
                "ReasonCodes": "",
                "ReasonCodeDesc": "",
                "BestRxCodeDesc": ""
            }
        ]
    },
    "IsValid": true,
    "Messages": []
}
POST - ClinicalDocumentation
POST /RxMB/ClinicalDocumentation

This endpoint is used to provide a clinical documentation info.

Request parameters

requestAutoID
integer int64 required
userRecno
integer int32 required

Request headers

Authorization
string optional

Basic Auth

Request body

application/json
text/json
application/xml
text/xml
application/x-www-form-urlencoded
CliniDocRequest
Example: 
{
    "clearingHouseIndicator": "",
    "context": {
        "productCode": "",
        "storeNpi": "",
        "release": "",
        "submitterNpi": ""
    },
    "transactionId": "00000000-0000-0000-0000-000000000000",
    "claimSubmittersId": "",
    "submittedDate": "",
    "subscriber": {
        "lastName": "",
        "firstName": "",
        "middleName": "",
        "suffix": "",
        "memberId": "",
        "dob": "",
        "gender": "",
        "street": "",
        "addrLine2": "",
        "city": "",
        "state": "",
        "zipCode": "",
        "phone": ""
    },
    "patientRelationshipToSubscriber": "",
    "dependent": {
        "lastName": "",
        "firstName": "",
        "middleName": "",
        "suffix": "",
        "memberId": "",
        "dob": "",
        "gender": "",
        "street": "",
        "addrLine2": "",
        "city": "",
        "state": "",
        "zipCode": ""
    },
    "referringProvider": {
        "npi": "",
        "lastName": "",
        "firstName": "",
        "middleName": "",
        "suffix": "",
        "otherId": ""
    },
    "renderingProvider": {
        "npi": "",
        "lastName": "",
        "firstName": "",
        "middleName": "",
        "otherId": "",
        "code": ""
    },
    "serviceLocation": {
        "name": "",
        "facilityType": "",
        "state": "",
        "zipCode": ""
    },
    "services": [
        {
            "serviceId": "",
            "hcpcsProcedureCode": "",
            "dateOfService": "",
            "icd10Code": [
                ""
            ]
        }
    ]
}

Responses

200 200

OK

Body
application/json
text/json
application/xml
text/xml
ResponseGenericInfo[CliniDocResponse]
Examples: 
{
    "Data": {
        "ClinicalDocAutoId": "",
        "transactionId": "",
        "claimSubmittersId": "",
        "correlationId": "",
        "status": "",
        "clinicalDoc": {
            "status": "",
            "claimNotes": [
                ""
            ],
            "viewToken": "",
            "url": "",
            "encounterId": "",
            "nonceId": ""
        },
        "errors": [
            {
                "Source": "",
                "ReasonCodes": "",
                "ReasonCodeDesc": "",
                "BestRxCodeDesc": ""
            }
        ]
    },
    "IsValid": true,
    "Messages": [
        {
            "MessageCode": "",
            "Message": "",
            "MessageType": "Unknown"
        }
    ]
}
Example with response data

{
    "Data": {
        "ClinicalDocAutoId": "10007",
        "transactionId": "d0007587-eb0d-4670-aa7b-e798a65f0436",
        "claimSubmittersId": "40553976-cd6a-4f88-b7f2-1d97888c345b",
        "correlationId": "892b14a3-7ed6-4168-8207-d47249a6fea8",
        "status": "",
        "clinicalDoc": {
            "status": "ERROR",
            "claimNotes": [
                "An Encounter may not be created with a Pharmacy NPI that is not listed "
            ],
            "viewToken": "",
            "url": "http://127.0.0.1",
            "encounterId": "832a2739-5bdd-4eed-b3d2-f7f7e59ad573",
            "nonceId": "2b551b21-f01a-4b3a-b73e-e6e5eba43882"
        },
        "errors": [
            {
                "Source": "",
                "ReasonCodes": "",
                "ReasonCodeDesc": "",
                "BestRxCodeDesc": ""
            }
        ]
    },
    "IsValid": true,
    "Messages": []
}
POST - SubmitClaim
POST /RxMB/SubmitClaim

This endpoint is used to submit a claim.

Request parameters

requestAutoID
integer int64 required
userRecno
integer int32 required

Request headers

Authorization
string optional

Basic Auth

Request body

application/json
text/json
application/xml
text/xml
application/x-www-form-urlencoded
ClaimRequest

Responses

200 200

OK

Body
application/json
text/json
application/xml
text/xml
ResponseGenericInfo[ClaimResponse]
Examples: 
{
    "Data": {
        "claimID": 1,
        "transactionId": "",
        "claimSubmittersId": "",
        "correlationId": "",
        "status": "",
        "errors": [
            {
                "Source": "",
                "ReasonCodes": "",
                "ReasonCodeDesc": "",
                "BestRxCodeDesc": ""
            }
        ],
        "claimResponse": {
            "status": "",
            "claimNotes": [
                ""
            ],
            "viewToken": "",
            "url": "",
            "encounterId": "",
            "nonceId": ""
        }
    },
    "IsValid": true,
    "Messages": [
        {
            "MessageCode": "",
            "Message": "",
            "MessageType": "Unknown"
        }
    ]
}
Example with response data

{
    "Data": {
        "claimID": "10007",
        "transactionId": "d0007587-eb0d-4670-aa7b-e798a65f0436",
        "claimSubmittersId": "40553976-cd6a-4f88-b7f2-1d97888c345b",
        "correlationId": "892b14a3-7ed6-4168-8207-d47249a6fea8",
        "status": "",
         "errors": [
            {
                "Source": "",
                "ReasonCodes": "",
                "ReasonCodeDesc": "",
                "BestRxCodeDesc": ""
            }
        ]
        "claimResponse": {
            "status": "ERROR",
            "claimNotes": [
                "An Encounter may not be created with a Pharmacy NPI that is not listed "
            ],
            "viewToken": "",
            "url": "http://127.0.0.1",
            "encounterId": "832a2739-5bdd-4eed-b3d2-f7f7e59ad573",
            "nonceId": "2b551b21-f01a-4b3a-b73e-e6e5eba43882"
        },
    },
    "IsValid": true,
    "Messages": []
}
CHRxMB
POST - GetRxMBEligibility
POST /BestRxMedicalBilling.Service/CHRxMB/GetRxMBEligibility
POST - SubmitRxMBClaimValidation
POST /BestRxMedicalBilling.Service/CHRxMB/SubmitRxMBClaimValidation
POST - SubmitRxMBClaimSubmission
POST /BestRxMedicalBilling.Service/CHRxMB/SubmitRxMBClaimSubmission
POST - GetRxMBEligibility
POST /BestRxMedicalBilling.Service/CHRxMB/GetRxMBEligibility

Authentication

basic

This endpoint is used to get RX MB Eligibility from Change Health.

Request body

Object
controlNumber
string
Example:
b8e090f9-0c10-445e-8d9d-b58d5c0fa7dd
tradingPartnerServiceId
string
provider
Object
organizationName
string
Example:
BestRx Pharmacy
npi
string
Example:
0284232035
serviceProviderNumber
string
Example:
4555854
providerCode
string
Example:
4555854
referenceIdentification
string
providerName
string
entityIdentifier
string
entityType
string
providerType
unknown nullable
employerId
unknown nullable
firstName
unknown nullable
lastName
unknown nullable
middleName
unknown nullable
ssn
unknown nullable
address
unknown nullable
contactInformation
unknown nullable
subscriber
Object
memberId
unknown nullable
firstName
string
Example:
WINSTON
lastName
string
Example:
ADDINGTON
gender
string
Example:
M
dateOfBirth
string
Example:
20010202
ssn
string
idCard
string
entityIdentifier
unknown nullable
entityType
unknown nullable
relationToSubscriber
unknown nullable
insuredIndicator
unknown nullable
maintenanceTypeCode
unknown nullable
maintenanceReasonCode
unknown nullable
address
unknown nullable
paymentResponsibilityLevelCode
unknown nullable
policyNumber
unknown nullable
dependents
unknown nullable
encounter
Object
beginningDateOfService
string
Example:
20231111
endDateOfService
string
Example:
20261111
serviceTypeCodes
Array
Example: 
["96"]
string
Example:
96
show more

Responses

201 Created
Body
Object
Data
Object
meta
Object
submitterId
unknown nullable
senderId
string
Example:
APIM_Marketplace_SBX_Native_sS4M0qQDqFk7b6Sy
billerId
unknown nullable
traceId
string
Example:
2798c461-43c6-ad05-f310-c1cb5e5bf303
applicationMode
string
Example:
sandbox
controlNumber
unknown nullable
reassociationKey
unknown nullable
tradingPartnerServiceId
unknown nullable
provider
unknown nullable
subscriber
unknown nullable
subscriberTraceNumbers
unknown nullable
payer
unknown nullable
planDateInformation
unknown nullable
planStatus
unknown nullable
benefitsInformation
unknown nullable
x12
unknown nullable
errors
Array
Object
field
string
Example:
provider.referenceIdentification
description
string
Example:
Invalid value. Item must not be blank value.
code
unknown nullable
followupAction
unknown nullable
location
unknown nullable
IsValid
boolean
Example:
true
Messages
Array of unknown
show more
200 OK
Body
Object
meta
Object
senderId
string
Example:
APIM_Marketplace_SBX_Native_sS4M0qQDqFk7b6Sy
applicationMode
string
Example:
sandbox
traceId
string
Example:
ef91843b-0d04-e2c6-c86a-20d5727b9916
controlNumber
string
Example:
123456789
reassociationKey
string
Example:
123456789
tradingPartnerServiceId
string
Example:
0
provider
Object
providerName
string
Example:
BestRx Pharmacy
entityIdentifier
string
Example:
Provider
entityType
string
Example:
Non-Person Entity
npi
string
Example:
0284232035
subscriber
Object
firstName
string
Example:
johnOne
lastName
string
Example:
doeOne
gender
string
Example:
M
entityIdentifier
string
Example:
Insured or Subscriber
entityType
string
Example:
Person
dateOfBirth
string
Example:
18800102
ssn
string
Example:
111111111
subscriberTraceNumbers
Array
Object
traceTypeCode
string
Example:
1
traceType
string
Example:
Current Transaction Trace Numbers
referenceIdentification
string
Example:
123456789
originatingCompanyIdentifier
string
Example:
9EMDEON999
payer
Object
entityIdentifier
string
Example:
Payer
entityType
string
Example:
Non-Person Entity
name
string
Example:
Unknown
payorIdentification
string
Example:
0
planInformation
Object
socialSecurityNumber
string
Example:
111111111
planDateInformation
Object
plan
string
Example:
20160818-20160818
planStatus
Array
Object
statusCode
string
Example:
1
status
string
Example:
Active Coverage
planDetails
string
Example:
QMB
serviceTypeCodes
Array
Example: 
["30"]
string
Example:
30
benefitsInformation
Array
Object
code
string
Example:
1
name
string
Example:
Active Coverage
coverageLevelCode
string
Example:
IND
coverageLevel
string
Example:
Individual
serviceTypeCodes
Array
Example: 
["30"]
string
Example:
30
serviceTypes
Array
Example: 
["Health Benefit Plan Coverage"]
string
Example:
Health Benefit Plan Coverage
insuranceTypeCode
string
Example:
QM
insuranceType
string
Example:
Qualified Medicare Beneficiary
planCoverage
string
Example:
QMB
benefitsDateInformation
Object
benefit
string
Example:
20160818-20160818
x12
string
Example:
ISA*00* *01*SomePwd *ZZ*EMDEON *ZZ*TPG00000 *231129*1154*^*00501*123456789*0*T*:~GS*HB*MTEXE*LLX1210001*20131015*2219*123456789*X*005010X279A1~ST*271*946380841*005010X279A1~BHT*0022*11*ef91843b-0d04-e2c6-c86a-20d5727b9916*20231129*1154~HL*1**20*1~NM1*PR*2*Unknown*****PI*0~HL*2*1*21*1~NM1*1P*2*BestRx Pharmacy*****XX*0284232035~HL*3*2*22*0~TRN*1*123456789*9EMDEON999*~NM1*IL*1*doeOne*johnOne***~REF*SY*111111111~DMG*D8*18800102*M~DTP*291*RD8*20160818-20160818~EB*1*IND*30*QM*QMB~DTP*292*RD8*20160818-20160818~EB*R*IND*30*MA*MEDICARE PART A~DTP*291*RD8*20160818-20160818~EB*R*IND*30*MB*MEDICARE PART B~DTP*291*RD8*20160818-20160818~SE*19*946380841~GE*1*123456789~IEA*1*123456789~
show more
POST - SubmitRxMBClaimValidation
POST /BestRxMedicalBilling.Service/CHRxMB/SubmitRxMBClaimValidation

Authentication

basic

This endpoint is used to get validatre RX MB Claim.

Request body

Object
pattientRecNo
integer
Example:
10091
pharmacyRecNo
string
Example:
1817
LoginUserUniqueId
string
Example:
cead5e6d-c05b-49b8-b38e-4c60e346d95c
claimRequest
Object required
controlNumber
string required
Example:
000000001
tradingPartnerServiceId
string required
Example:
9496
submitter
Object required
organizationName
string
Example:
REGIONAL PPO NETWORK
contactInformation
Object
name
string
Example:
SUBMITTER CONTACT INFO
phoneNumber
string
Example:
123456789
receiver
Object required
organizationName
string
Example:
EXTRA HEALTHY INSURANCE
subscriber
Object required
memberId
string
Example:
0000000001
paymentResponsibilityLevelCode
string
Example:
P
firstName
string
Example:
johnone
lastName
string
Example:
doeOne
gender
string
Example:
M
dateOfBirth
string
Example:
19800102
policyNumber
string
Example:
00001
address
Object
address1
string
Example:
123 address1
city
string
Example:
city1
state
string
Example:
wa
postalCode
string
Example:
981010000
dependent
Object
memberId
string
Example:
0000000002
paymentResponsibilityLevelCode
string
Example:
P
firstName
string
Example:
janeone
lastName
string
Example:
doeOne
gender
string
Example:
F
dateOfBirth
string
Example:
19800102
policyNumber
string
Example:
00002
relationshipToSubscriberCode
string
Example:
01
address
Object
address1
string
Example:
123 address1
city
string
Example:
city1
state
string
Example:
wa
postalCode
string
Example:
981010000
providers
Array required
Object
providerType
string
Example:
BillingProvider
npi
string
Example:
1760854442
employerId
string
Example:
123456789
organizationName
string
Example:
HAPPY DOCTORS GROUPPRACTICE
address
Object
address1
string
Example:
000 address1
city
string
Example:
city2
state
string
Example:
tn
postalCode
string
Example:
372030000
contactInformation
Object
name
string
Example:
janetwo doetwo
phoneNumber
string
Example:
0000000001
claimInformation
Object required
claimFilingCode
string
Example:
CI
patientControlNumber
string
Example:
12345
claimChargeAmount
string
Example:
28.75
placeOfServiceCode
string
Example:
11
claimFrequencyCode
string
Example:
1
signatureIndicator
string
Example:
Y
planParticipationCode
string
Example:
A
benefitsAssignmentCertificationIndicator
string
Example:
Y
releaseInformationCode
string
Example:
Y
claimSupplementalInformation
Object
repricedClaimNumber
string
Example:
00001
claimNumber
string
Example:
12345
healthCareCodeInformation
Array required
Object
diagnosisTypeCode
string
Example:
ABK
diagnosisCode
string
Example:
S93401A
serviceFacilityLocation
Object
organizationName
string
Example:
HAPPY DOCTORS GROUP
address
Object
address1
string
Example:
000 address1
city
string
Example:
city2
state
string
Example:
tn
postalCode
string
Example:
372030000
serviceLines
Array required
Object
serviceDate
string
Example:
20180514
professionalService
Object
procedureIdentifier
string
Example:
HC
lineItemChargeAmount
string
Example:
25
procedureCode
string
Example:
E0570
measurementUnit
string
Example:
UN
serviceUnitCount
string
Example:
1
compositeDiagnosisCodePointers
Object
diagnosisCodePointers
Array
Example: 
["1","2"]
string
Example:
1
show more

Responses

201 Created
Body
Object
Data
Object
status
unknown nullable
controlNumber
unknown nullable
tradingPartnerServiceId
unknown nullable
claimReference
unknown nullable
editStatus
unknown nullable
payer
unknown nullable
errors
Array
Object
field
string
Example:
billing
description
string
Example:
Please use predefined canned users for non-prod environments: organizationName was not predefined.
code
unknown nullable
followupAction
unknown nullable
location
unknown nullable
meta
Object
submitterId
string
Example:
999898
senderId
string
Example:
APIM_Marketplace_SBX_Native_sS4M0qQDqFk7b6Sy
billerId
string
Example:
009998
traceId
string
Example:
3a0bae97-4511-6ee0-b9b1-d8dec136a2ef
applicationMode
string
Example:
sandbox
IsValid
boolean
Messages
Array
Object
MessageCode
string
Example:
BADREQUEST
Message
string
Example:
Bad Request
MessageType
string
Example:
Error
show more
POST - SubmitRxMBClaimSubmission
POST /BestRxMedicalBilling.Service/CHRxMB/SubmitRxMBClaimSubmission

Authentication

basic

This endpoint is used to get Submit RX MB Claim.

Request body

Object
pattientRecNo
integer
Example:
10091
pharmacyRecNo
string
Example:
1817
LoginUserUniqueId
string
Example:
cead5e6d-c05b-49b8-b38e-4c60e346d95c
claimRequest
Object required
controlNumber
string required
Example:
000000001
tradingPartnerServiceId
string required
Example:
9496
submitter
Object required
organizationName
string
Example:
REGIONAL PPO NETWORK
contactInformation
Object
name
string
Example:
SUBMITTER CONTACT INFO
phoneNumber
string
Example:
123456789
receiver
Object required
organizationName
string
Example:
EXTRA HEALTHY INSURANCE
subscriber
Object required
memberId
string
Example:
0000000001
paymentResponsibilityLevelCode
string
Example:
P
firstName
string
Example:
johnone
lastName
string
Example:
doeOne
gender
string
Example:
M
dateOfBirth
string
Example:
19800102
policyNumber
string
Example:
00001
address
Object
address1
string
Example:
123 address1
city
string
Example:
city1
state
string
Example:
wa
postalCode
string
Example:
981010000
dependent
Object
memberId
string
Example:
0000000002
paymentResponsibilityLevelCode
string
Example:
P
firstName
string
Example:
janeone
lastName
string
Example:
doeOne
gender
string
Example:
F
dateOfBirth
string
Example:
19800102
policyNumber
string
Example:
00002
relationshipToSubscriberCode
string
Example:
01
address
Object
address1
string
Example:
123 address1
city
string
Example:
city1
state
string
Example:
wa
postalCode
string
Example:
981010000
providers
Array required
Object
providerType
string
Example:
BillingProvider
npi
string
Example:
1760854442
employerId
string
Example:
123456789
organizationName
string
Example:
HAPPY DOCTORS GROUPPRACTICE
address
Object
address1
string
Example:
000 address1
city
string
Example:
city2
state
string
Example:
tn
postalCode
string
Example:
372030000
contactInformation
Object
name
string
Example:
janetwo doetwo
phoneNumber
string
Example:
0000000001
claimInformation
Object required
claimFilingCode
string
Example:
CI
patientControlNumber
string
Example:
12345
claimChargeAmount
string
Example:
28.75
placeOfServiceCode
string
Example:
11
claimFrequencyCode
string
Example:
1
signatureIndicator
string
Example:
Y
planParticipationCode
string
Example:
A
benefitsAssignmentCertificationIndicator
string
Example:
Y
releaseInformationCode
string
Example:
Y
claimSupplementalInformation
Object
repricedClaimNumber
string
Example:
00001
claimNumber
string
Example:
12345
healthCareCodeInformation
Array required
Object
diagnosisTypeCode
string
Example:
ABK
diagnosisCode
string
Example:
S93401A
serviceFacilityLocation
Object
organizationName
string
Example:
HAPPY DOCTORS GROUP
address
Object
address1
string
Example:
000 address1
city
string
Example:
city2
state
string
Example:
tn
postalCode
string
Example:
372030000
serviceLines
Array required
Object
serviceDate
string
Example:
20180514
professionalService
Object
procedureIdentifier
string
Example:
HC
lineItemChargeAmount
string
Example:
25
procedureCode
string
Example:
E0570
measurementUnit
string
Example:
UN
serviceUnitCount
string
Example:
1
compositeDiagnosisCodePointers
Object
diagnosisCodePointers
Array
Example: 
["1","2"]
string
Example:
1
show more

Responses

400 Bad Request
Body
Object
Data
Object
status
unknown nullable
controlNumber
unknown nullable
tradingPartnerServiceId
unknown nullable
claimReference
unknown nullable
editStatus
unknown nullable
payer
unknown nullable
errors
Array
Object
field
string
Example:
submitter
description
string
Example:
Please use predefined canned users for non-prod environments: organizationName was not predefined.
code
unknown nullable
followupAction
unknown nullable
location
unknown nullable
meta
Object
submitterId
string
Example:
999898
senderId
string
Example:
APIM_Marketplace_SBX_Native_sS4M0qQDqFk7b6Sy
billerId
string
Example:
009998
traceId
string
Example:
9b5c0b5c-3528-2633-64e6-4edf64db1769
applicationMode
string
Example:
sandbox
IsValid
boolean
Messages
Array
Object
MessageCode
string
Example:
BADREQUEST
Message
string
Example:
Bad Request
MessageType
string
Example:
Error
show more
200 OK
Body
Object
status
string
Example:
SUCCESS
controlNumber
string
Example:
000000001
tradingPartnerServiceId
string
Example:
9496
claimReference
Object
correlationId
string
Example:
231128R999898~1153539694937055
submitterId
string
Example:
009998999898
customerClaimNumber
string
Example:
b1c8935c-0f78-3dbd-c38c-cde8757b1727
patientControlNumber
string
Example:
12345
timeOfResponse
string
Example:
2023-11-28T04:36:48.251-06:00
claimType
string
Example:
PRO
formatVersion
string
Example:
5010
rhclaimNumber
string
Example:
2333255502701
meta
Object
submitterId
string
Example:
999898
senderId
string
Example:
APIM_Marketplace_SBX_Native_sS4M0qQDqFk7b6Sy
billerId
string
Example:
009998
traceId
string
Example:
b1c8935c-0f78-3dbd-c38c-cde8757b1727
applicationMode
string
Example:
sandbox
editStatus
string
Example:
SUCCESS
payer
Object
payerName
string
Example:
Unknown
payerID
string
Example:
9496
show more
Type Definitions
PharmacyTokenRequest
Object
PharmacyUniqueId
string required
IsEncrypted
boolean
ResponseGenericInfo[PharmacyAuthTokenResponse]
Object
Data
PharmacyAuthTokenResponse
IsValid
boolean
Messages
Array of MessageInfo
PharmacyAuthTokenResponse
Object
AuthToken
string
ExpirationTime
string date-time
RefreshToken
string
MessageInfo
Object
MessageCode
string
Message
string
MessageType
string
Enumeration:
Information
Warning
Error
Success
Unknown
SendPatientDataRequest
Object
patientInfo
PatientInfo
insuranceInfo
Array of PharmacyInsuranceInfo
patientInsuranceInfo
Array of PatPharmInsuranceInfo
PatientInfo
Object
PatientAutoID
integer int32
PharmacyID
integer int32 required
Min: 1
Max: 2,147,483,647
PatientRecno
integer int32 required
Min: 1
Max: 2,147,483,647
FamilyRecno
integer int32
Min: 0
Max: 2,147,483,647
FamilyAutoID
integer int32
Min: 0
Max: 2,147,483,647
First_Name
string required
Min length: 0
Max length: 1,000
Middle_Name
string
Min length: 0
Max length: 1,000
Last_Name
string required
Min length: 0
Max length: 1,000
DOB
string date-time
Gender
string
Min length: 0
Max length: 1
Suffix
string
Min length: 0
Max length: 10
HomePhone
string
Min length: 0
Max length: 25
Pattern: ^\(?([0-9]{3})\)?[-. ]?([0-9]{3})[-. ]?([0-9]{4})$
CellPhone
string
Min length: 0
Max length: 25
Pattern: ^\(?([0-9]{3})\)?[-. ]?([0-9]{3})[-. ]?([0-9]{4})$
WorkPhone
string
Min length: 0
Max length: 25
Pattern: ^\(?([0-9]{3})\)?[-. ]?([0-9]{3})[-. ]?([0-9]{4})$
Email
string
Min length: 0
Max length: 1,000
Remarks
string
Min length: 0
Max length: 5,000
familyInfo
FamilyInfo
listPharmacyInsurances
Array of PatPharmInsuranceInfo
listClinicalInsurances
Array of PatClinicalInsuranceInfo
show more
PharmacyInsuranceInfo
Object
InsuranceAutoId
integer int32
PharmacyID
integer int32 required
Min: 1
Max: 2,147,483,647
InsuranceRecno
integer int32 required
Min: 1
Max: 2,147,483,647
Bin
string required
Min length: 0
Max length: 20
PCN
string
Min length: 0
Max length: 20
PlanName
string required
Min length: 0
Max length: 50
PlanCode
string required
Min length: 0
Max length: 50
PhoneNo
string
Min length: 0
Max length: 25
Pattern: ^\(?([0-9]{3})\)?[-. ]?([0-9]{3})[-. ]?([0-9]{4})$
Address1
string
Min length: 0
Max length: 1,000
Address2
string
Min length: 0
Max length: 1,000
City
string
Min length: 0
Max length: 250
State
string
Min length: 0
Max length: 2
Zip_Code
string
Min length: 0
Max length: 20
FaxNo
string
Min length: 0
Max length: 25
Pattern: ^\(?([0-9]{3})\)?[-. ]?([0-9]{3})[-. ]?([0-9]{4})$
NCPDPVersion
string
Min length: 0
Max length: 4
CashIndicator
string
Min length: 0
Max length: 1
ProviderIDQualifier
string
Min length: 0
Max length: 2
Remarks
string
Min length: 0
Max length: 5,000
show more
PatPharmInsuranceInfo
Object
PatPharmInsuranceAutoID
integer int64
PharmacyID
integer int32 required
Min: 1
Max: 2,147,483,647
PatientAutoID
integer int32
Min: 0
Max: 2,147,483,647
PatientRecno
integer int32 required
InsuranceRecno
integer int32 required
Min: 1
Max: 2,147,483,647
SeqNo
integer int32 required
Min: 1
Max: 2,147,483,647
CardID
string
Min length: 0
Max length: 50
GroupID
string
Min length: 0
Max length: 50
PrimaryIndicator
string
Min length: 0
Max length: 1
CardHolderName
string
Min length: 0
Max length: 1,000
Pattern: ^([A-Za-z ]+),([A-Za-z ]+)
Relation
string
Min length: 0
Max length: 2
insuranceInfo
PharmacyInsuranceInfo
show more
FamilyInfo
Object
FamilyAutoID
integer int32
PharmacyID
integer int32 required
Min: 1
Max: 2,147,483,647
FamilyRecno
integer int32 required
Min: 1
Max: 2,147,483,647
Family_First_Name
string required
Min length: 0
Max length: 1,000
Family_Last_Name
string required
Min length: 0
Max length: 1,000
Address1
string
Min length: 0
Max length: 1,000
Address2
string
Min length: 0
Max length: 1,000
City
string
Min length: 0
Max length: 250
State
string
Min length: 0
Max length: 2
Zip_Code
string
Min length: 0
Max length: 20
HomePhoneNo
string
Min length: 0
Max length: 25
Pattern: ^\(?([0-9]{3})\)?[-. ]?([0-9]{3})[-. ]?([0-9]{4})$
Remarks
string
Min length: 0
Max length: 5,000
show more
PatClinicalInsuranceInfo
Object
PatClinicalInsuranceAutoID
integer int64
PatClinicalInsuranceRecno
integer int32
PharmacyID
integer int32 required
Min: 1
Max: 2,147,483,647
PatientAutoID
integer int64 required
Min: 1
Max: 2,147,483,647
SeqNo
integer int32 required
Min: 1
Max: 2,147,483,647
PayerAutoID
integer int32 required
Min: 1
Max: 2,147,483,647
PayerID
string required
Min length: 0
Max length: 50
PayerName
string required
Min length: 0
Max length: 50
MemberID
string
Min length: 0
Max length: 50
GroupID
string
Min length: 0
Max length: 50
PrimaryIndicator
string
Min length: 0
Max length: 1
CardHolderName
string
Min length: 0
Max length: 1,000
Pattern: ^([A-Za-z ]+),([A-Za-z ]+)
Relation
string
Min length: 0
Max length: 2
SubscriberLastName
string
SubscriberFirstName
string
SubscriberMiddleName
string
SubscriberSuffix
string
SubscriberAddr1
string
SubscriberAddr2
string
SubscriberCity
string
SubscriberState
string
SubscriberZipCode
string
SubscriberPhone
string
SubscriberDOB
string date-time
LastEligibilityCheckDate
string date-time
LastMBSubmittedDate
string date-time
Gender
string
LastEligibilityResponse
EligibilityResponseLog
show more
EligibilityResponseLog
Object
TransactionID
string
CorrelationID
string
Status
string
PreAuthReqd
string
InPlanNetworkInd
string
FreeText
string
ErrorDescr
string
CreatedDate
string date-time
ResponseGenericInfo[SendPatientDataResponse]
Object
Data
SendPatientDataResponse
IsValid
boolean
Messages
Array of MessageInfo
SendPatientDataResponse
Object
PatientRecno
integer int32
PatientAutoNo
integer int32
ResponseGenericInfo[Object]
Object
Data
Object
IsValid
boolean
Messages
Array of MessageInfo
PharmacyUserAuthTokenRequest
Object
userId
integer int32
ResponseGenericInfo[PharmacyUserAuthTokenResponse]
Object
Data
PharmacyUserAuthTokenResponse
IsValid
boolean
Messages
Array of MessageInfo
PharmacyUserAuthTokenResponse
Object
AuthToken
string
ExpirationTime
string date-time
ResponseGenericInfo[List[UserInfo]]
Object
Data
Array of UserInfo
IsValid
boolean
Messages
Array of MessageInfo
UserInfo
Object
UserId
integer int32 required
UserLastName
string
UserFirstName
string
UserName
string
Password
string
PIN
string
EmailId
string
IsActive
boolean
Address1
string
Address2
string
City
string
State
string
ZipCode
string
NPI
string
HomePhone
string
Fax
string
CellPhone
string
LastSyncDate
string date-time
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CheckEligibilityRequest
Object
PatientAutoID
integer int64 required
Min: 1
Max: 2,147,483,647
SeqNo
integer int32 required
Min: 1
Max: 2,147,483,647
ResponseGenericInfo[EligibilityResponse]
Object
Data
EligibilityResponse
IsValid
boolean
Messages
Array of MessageInfo
EligibilityResponse
Object
eligSubmitterTransactionId
string
claimSubmittersId
string
correlationId
string
status
string
requiresPreAuth
string
inPlanNetworkIndicator
string
info
Array of string
errors
Array of ErrorList
ErrorList
Object
Source
string
ReasonCodes
string
ReasonCodeDesc
string
BestRxCodeDesc
string
EligibilityRequest
Object
context
Context
clearingHouseIndicator
string
eligSubmitterTransactionId
string uuid
Example:
00000000-0000-0000-0000-000000000000
claimSubmittersId
string
submittedDate
string
patientRelationshipToSubscriber
string
billingOrganization
Billingorganization
subscriber
Subscriber
dependent
Dependent
payer
Payer
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Context
Object
productCode
string
storeNpi
string
release
string
submitterNpi
string
Billingorganization
Object
payToName
string
orgId
string
Subscriber
Object
lastName
string
firstName
string
middleName
string
suffix
string
memberId
string
dob
string
gender
string
street
string
addrLine2
string
city
string
state
string
zipCode
string
phone
string
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Dependent
Object
lastName
string
firstName
string
middleName
string
suffix
string
memberId
string
dob
string
gender
string
street
string
addrLine2
string
city
string
state
string
zipCode
string
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Payer
Object
name
string
address
Address
id
string
type
string
priorAuthNum
integer int32
Address
Object
addrLine1
string
addrLine2
string
city
string
state
string
zipCode
string
CliniDocRequest
Object
clearingHouseIndicator
string
context
Context
transactionId
string uuid
Example:
00000000-0000-0000-0000-000000000000
claimSubmittersId
string
submittedDate
string
subscriber
Subscriber
patientRelationshipToSubscriber
string
dependent
Dependent
referringProvider
Referringprovider
renderingProvider
Renderingprovider
serviceLocation
Servicelocation
services
Array of Service
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Referringprovider
Object
npi
string
lastName
string
firstName
string
middleName
string
suffix
string
otherId
string
Renderingprovider
Object
npi
string
lastName
string
firstName
string
middleName
string
otherId
string
code
string
Servicelocation
Object
name
string
facilityType
string
state
string
zipCode
string
Service
Object
serviceId
string
hcpcsProcedureCode
string
dateOfService
string
icd10Code
Array of string
ResponseGenericInfo[CliniDocResponse]
Object
Data
CliniDocResponse
IsValid
boolean
Messages
Array of MessageInfo
CliniDocResponse
Object
ClinicalDocAutoId
string
transactionId
string
claimSubmittersId
string
correlationId
string
status
string
clinicalDoc
Clinicaldoc
errors
Array of ErrorList
Clinicaldoc
Object
status
string
claimNotes
Array of string
viewToken
string
url
string
encounterId
string
nonceId
string
ClaimRequest
Object
context
Context
billingOrganization
ClaimBillingOrganization
subscriber
ClaimSubscriber
clearinghouseIndicator
string
payer
Payer
referringProvider
ClaimReferringProvider
renderingProvider
ClaimRenderingProvider
serviceLocation
ClaimServiceLocation
claim
RxMBClaim
services
Array of ClaimService
patientRelationshipToSubscriber
string
dependent
Dependent
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ClaimBillingOrganization
Object
entityTypeQual
integer int32
name
Name
address
Address
contact
Contact
orgId
string
taxIdQual
string
taxId
string
ClaimSubscriber
Object
name
Name
address
Address
dob
string
gender
string
idCodeQual
string
memberId
string
planPriority
string
phone
string
pregnancyIndicator
string
ClaimReferringProvider
Object
npi
string
name
Name
otherIdQual
string
ReferringProvider
string
ClaimRenderingProvider
Object
code
string
entityTypeQual
integer int32
npi
integer int64
name
Name
ClaimServiceLocation
Object
facilityType
string
name
string
address
Address
storeNpi
string
otherIdQual
string
otherId
string
RxMBClaim
Object
freqTypeCode
integer int32
amountAlreadyPaid
number float
benefitsAssignment
string
cashIndicator
integer int32
cliaNumber
integer int32
conditionOnsetDate
string
diagnosisCode
Array of string
initTreatmentDate
string
lastSeenDate
string
medRcdNum
integer int32
monetaryAmount
number float
noteDesc
string
patientConsent
string
providerSignatureOnFile
string
submittedDate
string
lastMenstrualDate
string date-time
submittersId
integer int32
transactionId
string uuid
Example:
00000000-0000-0000-0000-000000000000
vendorId
string
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ClaimService
Object
serviceId
integer int32
serviceDesc
string
amountToBillForService
number float
associationOfProductServiceToDiagnosis
Array
integer int32
cashPrice
number float
dateOfService
string
drugQtyDispensed
integer int32
drugUnitMeasure
string
emergencyIndicator
string
epsdtInvolvementIndicator
string
facilityType
string
familyPlanningIndicator
string
procedureCodeQual
string
hcpcsProcedureCode
string
procedureModifier
string
procedureModifier2
string
procedureModifier3
string
procedureModifier4
string
ndcNumber
string
negotiatedRate
number float
quantityOfServiceOrProductPerformed
number float
rxQual
string
rxNumber
string
rxDateWritten
string
unitOfMeasurementCode
string
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Name
Object
first
string
last
string
middle
string
sufix
string
Contact
Object
name
string
telephone
string
email
string
telephoneExt
string
ResponseGenericInfo[ClaimResponse]
Object
Data
ClaimResponse
IsValid
boolean
Messages
Array of MessageInfo
ClaimResponse
Object
claimID
integer int64
transactionId
string
claimSubmittersId
string
correlationId
string
status
string
errors
Array of ErrorList
claimResponse
Claim
Claim
Object
status
string
claimNotes
Array of string
viewToken
string
url
string
encounterId
string
nonceId
string