BestRx APIs
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  1. Realtime Data Feed Specification
  • Introduction - BestRx APIs
  • Patient API
    • Overview
    • Error Codes
    • Add Patient
      POST
    • Update Patient
      POST
    • Get Patient
      POST
    • Submit Charge Account Payment
      POST
  • Drug API
    • Overview
    • Error Codes
    • Get Drug Information
      POST
  • Prescription API
    • Overview
    • Error Codes
    • Submit Rx Transfer Request
      POST
    • Return to Stock
      POST
    • Save Rx Signature
      POST
  • Refill API
    • Overview
    • Error Codes
    • GetPatientProfile
      POST
    • Send Refill Request
      POST
  • BestPOS API
    • Overview
    • Error Codes
    • Create POS Transaction
      POST
    • Get POS Transaction Status
      POST
    • Get Item Details
      POST
  • Delivery/Shipping Provider API
    • Overview
    • Error Codes
    • Address Validation
    • Create Order
    • Update Order Status
    • Cancel Order
  • Realtime Data Feed Specification
    • Overview
    • Patient Update Callback
    • E-Prescription Notification Callback
    • Prescription Update Callback
  1. Realtime Data Feed Specification

Prescription Update Callback

INFO
Used to sync prescription data in BestRx with a TPP’s external environment. BestRx sends data to TPP each time a prescription performs relevant workflow steps in the BestRx system.

Root Fields#

Field NameTypeNotes
APIKeystringOptional field that can be used for authentication purposes. It’s up to the third party partner whether this field will be required or not.
PharmacyNumberstringNumber to help identify the pharmacy the data is coming from. By default BestRx will send the NPI number, but that can be changed if requested by the receiving partner.
PharmacyNumber_AltstringAn alternate pharmacy identifier can be provided if needed. Most integrations will not need this value.
transaction_idstringUnique identifier for the particular fill of the prescription. This value should be used when considering whether to add a new record or update an existing one.
transaction_datestringDate transaction is sent in YYYY-MM-DD format. This value is sent as the UTC date.
transaction_timestringTime transaction is sent in HH:MM:SS (24 hour) format. This value is sent as the UTC time.
transaction_time_fractionstringTime fraction transaction is sent, with 7 decimal places
rx_numberstringPrescription number
patient_idintegerUnique identifier of the patient in the BestRx system.
patient_last_namestringPatient’s last name
patient_first_namestringPatient’s first name
patient_middle_namestringPatient’s middle name
patient_prefixstringPrefix to patient’s name (ie Mr. Mrs., etc)
patient_suffixstringSuffix to patient’s name (ie Jr, III, etc)
patient_address1stringPatient street address line 1
patient_address2stringPatient street address line 2 ( ie Unit Number or other identifying info)
patient_citystringPatient’s city portion of address
patient_statestringPatient’s state portion of address
patient_zipstringPatient’s zip code
patient_home_phonestringPatient’s home phone number
patient_cell_phonestringPatient’s cell phone number
patient_work_phonestringPatient’s work phone number
patient_dobstringPatient date of birth in YYYY-MM-DD format
patient_genderstringPatient’s gender (M/F/N) **N=Non-Binary
patient_emailstringPatient’s email address
patient_grouparrayArray of groups that the patient is linked to. This is a repeating field. Please refer to the Groups section of this document for more info.
family_emailstringFamily’s shared email address
patient_short_remarkstringShort remark relating to the patient
patient_remarkstringLong remark relating to the patient
family_remarkstringShared remark relating to entire family
patient_shipto_organizationstringShip To organization name
patient_shipto_last_namestringShip To last name
patient_shipto_first_namestringShip To first name
patient_shipto_careofstringShip To “care of” name
patient_shipto_address1stringShip To street address line 1
patient_shipto_address2stringShip To street address line 2
patient_shipto_citystringShip To City
patient_shipto_statestringShip To state
patient_shipto_zipstringShip To zip code
patient_shipto_phonestringPhone number related to the Ship To Address
is_deactivatedbooleanIndicated whether the prescription was deactivated by the pharmacy (true/false)
transferred_outbooleanIndicates whether the prescription was transferred out to another pharmacy (true/false)
transferred_pharmacystringName of the pharmacy the prescription was transferred to
transferred_pharmacy_address1stringAddress line 1 of the pharmacy the prescription was transferred to
transferred_pharmacy_address2stringAddress line 2 of the pharmacy the prescription was transferred to
transferred_pharmacy_citystringCity of the pharmacy the prescription was transferred to
transferred_pharmacy_statestringState of the pharmacy the prescription was transferred to
transferred_pharmacy_zipstringZip code of the pharmacy the prescription was transferred to
transferred_pharmacy_phonestringPhone number of the pharmacy the prescription was transferred to
transferred_pharmacy_faxstringFax number
transferred_pharmacy_ncpdpstringNCPDP number of the pharmacy the prescription was transferred to
transferred_pharmacy_npistringNPI number of the pharmacy the prescription was transferred to
transferred_pharmacy_deastringDEA number of the pharmacy the prescription was transferred to
transfer_datestringThe date the prescription was transferred
transfer_contact_namestringThe contact name of the person at the pharmacy the prescription was transferred to
transfer_rph_initialsstringInitials of the pharmacist at your pharmacy that handled the transfer
transfer_rph_user_idstringBestRx User ID of the pharmacist at your pharmacy that handled the transfer
transfer_rph_last_namestringLast Name of the pharmacist at your pharmacy that handled the transfer
transfer_rph_first_namestringFirst Name of the pharmacist at your pharmacy that handled the transfer
transferfrom_pharmacyobjectInformation about the pharmacy that transferred the prescription to this pharmacy. Please see the Pharmacy Info section for more details
bill_statusstringCoded value for the Billing Status of the prescription. Please refer to Appendix A for a list of bill status codes and their descriptions.
bill_status_textstringText Description for the billing status of this prescription.
workflow_statusstringCoded value for the Workflow Status of the prescription. Please refer to Appendix B for a list of workflow statuses and their descriptions.
workflow_status_textstringText Description for the workflow status of the prescription
workflow_queuesarrayArray of workflow queues the prescription is in. This is a repeating field. Please refer to the Workflow Queues section of this document for more info.
fill_numberstringFill Number of the prescription (1 = original, 2 = first refill, 3 = second refill, etc).
fill_datestringDate the prescription was filled. Also knows as Date of Service. Value will be in YYYY-MM-DD format.
fill_timestringTime prescription was entered into the system. Value will be in HH:MM:SS (24 hour) format.
picked_upstringIndicates if the prescription was picked up (true/false)
deliveredstringIndicates if the prescription was delivered (true/false)
qty_orderedstringQuantity that the doctor prescribed for each fill
qty_filledstringQuantity that was dispensed for this fill
days_supplystringDays supply dispensed for this fill
refills_authorizedstringNumber of refills authorized by the doctor
refills_remainingstringNumber of refills that are remaining for this prescription. This could be a decimal value if there were partial fills involved.
refill_numberstringRefill number of the prescription (0 = original, 1 = first refill, 2 = second refill, etc).
refill_exp_datestringLatest date at which the prescription can still be refilled.
item_upc_codestringFor OTC items, the UPC code of the item
drug_ndcstringThe NDC of the dispensed drug.
drug_ndc_10digitstringThe NDC of the dispensed drug in 10-digit format without dashes.
drug_ndc_10digit_formattedstringThe NDC of the dispensed drug in 10-digit format with dashes.
drug_gpistringThe GPI of the dispensed drug. The GPI allows you to check if drugs with different NDC’s are therapeutically equivalent or related.Please see Appendix C for more info about GPI values.
drug_namestringThe name of the dispensed drug
drug_strengthstringThe strength of the drug (ie “20 MG”)
drug_mfgstringThe manufacturer of the drug
drug_schedulestringThe DEA control schedule of the dispensed drug.
drug_is_genericstringIndicates if the drug is generic (true/false)
drug_brand_namestringFor generic drugs, the brand drug name
drug_package_sizestringThe package size of the drug when purchased from the drug wholesaler
drug_formstringThe form that the drug comes in. Ex: Tablet, Capsule, Gram, ML, etc.
drug_colorstringThe color of the drug
drug_shapestringThe shape of the drug
drug_front_imprintstringThe imprint or markings on the front of the drug
drug_back_imprintstringThe imprint or markings on the back of the drug
drug_misc_infostringMiscellaneous info that can help with identifying the drug
lot_numberstringLot number of the dispensed drug
lot_exp_datestringLot expiration date of the dispensed drug (YYYY-MM-DD)
retailstringThe amount the pharmacy normally would charge for this prescription if the patient was to pay cash. Also knows as Usual & Customary Charges.
billedstringAmount that was billed to the insurance.
payersarrayArray of insurance payers linked to this prescription. This is a repeating field. Please refer to the Payers section of this document for more info.
coststringThe acquisition cost of this drug for the quantity dispensed.
patient_amount_duestringThe total amount that the patient is responsible for this prescription. This includes all copays, deductibles, coinsurances, etc from all of the patient’s insurances that have been billed.
due_from_insurancestringThe total amount due from insurance from all of the patient’s insurances that have been billed.
total_paidstringThe total amount the pharmacy can expect to receive for the prescription. This includes anything the insurance will pay as well as anything the patient will pay.
marginstringThe profit margin made on this prescription. Essentially it will be the same as total_paid - cost.
margin_percentstringProfit margin percentage
(100 * ((total_paid - cost) / cost)
is340bstringIndicates if it’s a 340B prescription (true/false)
dispense_as_writtenstring“true” or “false” value indicating DAW
daw_codestringDAW code of the prescription
date_rx_writtenstringDate the doctor wrote the prescription
signaturestringThe SIG directions of the prescription (ie TAKE 1 TABLET DAILY)
dosage_infoarrayArray of dosage info linked to this prescription. This is a repeating field. Please refer to the Dosage Info section of this document for more info.
rx_sourcestringHow the prescription reached the pharmacy 1 = Written 2 = Telephone 3 = Electronic 4 = Fax 5 = Generated by Pharmacy or Transferred to Pharmacy
rph_initialsstringInitials of the registered pharmacist that filled or verified the prescription
tech_initialsstringInitials of the technician that helped to fill the prescription
rx_serial_numberstringThe serial number of the prescription from the doctor’s prescription pad
submission_clar_codestringSubmission Clarification Code used to override a reject during insurance billing
other_coverage_codestringOther Coverage Code used to bill insurance to a secondary or tertiary payer
horizon_graveyard_codestringCodified reason a prescription was not filled. Only used for pharmacies that report data to Horizon
diagnosisarrayArray of diagnosis code linked to this prescription. This is a repeating field. Please refer to the Diagnosis section of this document for more info.
doctor_idintegerUnique identifier of the prescriber in the BestRx system.
doctor_last_namestringPrescriber’s last name
doctor_first_namestringPrescriber’s first name
doctor_middle_namestringPrescriber’s middle name
doctor_prefixstringPrefix to prescriber’s name (ie Mr. Mrs., etc)
doctor_suffixstringSuffix to prescriber’s name (ie MD, DO, etc)
doctor_npistringPrescriber’s NPI number
doctor_deastringPrescriber’s DEA number
doctor_state_licnostringPrescriber's State License number
doctor_dps_nostringPrescriber's DPS number
doctor_medicaid_nostringPrescriber's Medicaid number
doctor_upinstringPrescriber's UPIN number
doctor_address1stringPrescriber’s street address line 1
doctor_address2stringPrescriber’s street address line 1 (ie Suite Number or other identifying info)
doctor_citystringPrescriber’s city portion of the address
doctor_statestringPrescriber’s state portion of the address
doctor_zipstringPrescriber’s zip code
doctor_phonestringPrescriber’s office phone number
doctor_faxstringPrescriber’s fax number
doctor_emailstringPrescriber’s email address
doctor_remarkstringRemarks associated with the prescribers
doctor_profession_codestringPrescriber's Profession Code
doctor_profession_descstringPrescriber's Profession Code Description
doctor_ama_specialty_codestringPrescriber's AMA Specialty Code
doctor_ama_groupingstringPrescriber's AMA Grouping
doctor_ama_classificationstringPrescriber's AMA Classification
doctor_ama_specializationstringPrescriber's AMA Specialization
doctor_surescripts_service_levelstringThe service levels that this prescriber is enabled for with Surescripts. Possible values are New, Refill, Change, RxFill, Cancel, MedHistory, Eligibility, Resupply, Census, CCR, Controlled Substances, RxFill Indicator Change, Long Term Care, CI Message, CI Event, ePA, RLE, Medication Adherence, High Risk Medication, Missing Medication, PDC, MmpocMpiSearch, Disposition Request, Disposition Acknowledgement, Patient Med Benefit Check, and Specialty Patient Onboard
next_refill_datestringDate that the next refill is due for the prescription
drug_therapeutic_classstringTherapeutic class of the drug (at this time this field will not be populated)
prescribed_drugstringDrug that was prescribed by the doctor
filled_bystringThe person at the pharmacy that “filled’ the prescription
erx_message_idstringMessage ID from the e-prescription message
erx_prescriber_order_nostringPrescriber Order Number from the e-prescription message
rx_remarkstringRemarks associated with the prescription
erx_pharmacy_remarkstringPharmacy related remarks related to the e-prescription message for this prescription
erx_prescriber_remarkstringPrescriber related remarks related to the e-prescription message for this prescription
erx_drug_notesstringThe medication notes sent by the prescriber in the e-prescription message for this prescription
written_date_remarkstringRemarks related to the written date for this prescription (ie why was prescription filled after normal allowable time after written date)
inactivate_rx_remarkstringRemarks related to explaining why a prescription was deactivated
shipping_providerstringShipping provider used to ship prescription to patient. Current support values are “FedEx”, “UPS” and “USPS”.
shipping_tracking_numberstringTracking number of shipment the prescription was a part of
dispense_usingstringLets you know what type of packing the prescription will use (ie Safety Caps, Easy Caps, Bubble Packs, Pouch, etc)
is_medsync_shortfillbooleanIndicates if this is a MedSync short fill
claim_reject_infoarrayArray of reject codes and descriptions associated with the claim transmittal. This is a repeating field. Please refer to the Claim Reject Info section of this document for more info.
pbm_messagestringMessage sent from the PBM in the NCPDP field 504-F4
claim_additional_messagesarrayArray of messages sent back in the NCPDP field 526-FQ. This is a repeating field. Please refer to the Claim Additional Messages section of this document for more info.

Pharmacy Info Fields#

Field NameTypeNotes
pharmacy_namestringName of the pharmacy
addressobjectContains address info of the pharmacy. Please see the Address Info section for more info.
phone_numberstringPhone Number of the pharmacy
fax_numberstringFax Number of the pharmacy
npistringNPI Number of the pharmacy
ncpdpstringNCPDP Number of the pharmacy
deastringDEA Number of the pharmacy

Address Info Fields#

Field NameTypeNotes
address1stringStreet Address Line 1
address2stringStreet Address Line 2
citystringCity component of address
statestringState component of address
zipcodestringZip Code component of address

Group Fields#

Field NameTypeNotes
group_codestringInternal code of the group in the BestRx system.
group_namestringName of the group.

Payer Fields#

Field NameTypeNotes
plan_seq_nostringThe sequence number of the plans associated with this prescription. This is the order in which the plans were billed for (1 = primary, 2 = secondary, etc).
plan_codestringThe code of the insurance plan. The code is assigned by the pharmacy and has no significance in terms of actual billing purposes.
plan_namestringThe name of the insurance plan
plan_binstringThe BIN of the insurance plan
plan_pcnstringThe Processor Control Number of the insurance plan
card_idstringThe patient’s Cardholder ID for this plan
groupstringThe patient’s Group Number for this plan
person_codestringThe patient’s Person Code for this plan
relation_codestringThe patient’s Relationship Code for this plan
plan_bill_statusstringCoded value for the Billing Status of this plan. Please refer to Appendix A for a list of bill status codes and their descriptions.
plan_bill_status_textstringText Description for the billing status of this plan.
cost_paidstringCost paid by insurance/payer
disp_fee_paidstringDispensing fee paid by insurance/payer
tax_paidstringTax paid by insurance/payer
discountstringDiscount applied to prescription
pat_pay_amountstringPatient pay amount after billing to insurance/payer
due_from_payerstringTotal amount that will be paid by this insurance/payer
applied_to_deductiblestringThe amount from this prescription that was applied to the patient’s deductible
accumulated_deductiblestringAmount met by the patient/family in a deductible plan
remaining_deductiblestringAmount not met by the patient/family in the deductible plan

Diagnosis Fields#

Field NameTypeNotes
qualifierstringQualifier indicating the type of diagnosis code  01 = ICD9  02 = ICD10
codestringDiagnosis code
descriptionstringDiagnosis description for code

Dosage Fields#

Field NameTypeNotes
dose_slotintegerDosage slot (ie sequence of dose during the day). Currently BestRx supports up to 6 slots, so you can expect a value of 1-6 here.
dose_timestringDosage time. This can include specific times (ie 8:00 AM or 7:00 PM) or can contain keywords (ie (MORNING, LUNCH, DINNER, BEDTIME).
dose_qtystringQuantity of the drug to take for this particular dose
dose_daysstringThe days of the week that this dose should be administered  “daily” = take every day  “every_other_day” = take every other day  “see_sig_instructions” = complicated instructions, so please look at signature field for more info  “1” = Sunday  “2” = Monday  “3” = Tuesday  “4” = Wednesday  “5” = Thursday  “6” = Friday  “7” = Saturday  Combination values also possible:  “1;2;3” = Sunday, Monday, Tuesday  “2;4;6” = Monday, Wednesday, Friday

Workflow Queues#

Field NameTypeNotes
queue_codeintegerInternal record number of the queue in the BestRx system.
queue_namestringName of the queue.

Claim Reject Fields#

Field NameTypeNotes
reject_codestringRejection code sent for the claim in the NCPDP field 511-FB
reject_descriptionstringThe description associated with the Reject Code

Claim Additional Messages Fields#

Field NameTypeNotes
messagestringMessage sent back in this iteration of the NCPDP field 526-FQ

Appendix A - Billing Status Codes and Descriptions#

CodeDescription
0Paid-Cash
1Unbilled
2Hold
3Transmitted/Adjudicated
4Paid by Ins (ie Reconciled)
5Rejected
6Transferred Out to Another Pharmacy (just this particular fill, not the entire prescription)

Appendix B - Workflow Status Codes and Descriptions#

CodeDescription
-1Unspecified
0Entered into System
1Ready for Pickup
2Ready for Delivery
3Picked Up
4Out for Delivery
5Delivered
6Unable to Deliver
7Transferred Out to Another Pharmacy (just this particular fill, not the entire prescription)
8Ready for Shipping
9Shipped
10Shipment Delivery Confirmed
11Intake Complete
12PA Request Pending
13PA Request Sent
14PA Request Received
15Approved by Insurance
16Rejected by Insurance
17Label Printed
18Verified before Fill
19Filled
20Verified before Dispense
21Reversed from Insurance
22Returned to Stock
23Returned by Patient
24On Hold
25Delivery Cancelled
26Shipment Order Created
27Shipment Cancelled
28Shipment in Transit
29Shipment Delivered
30Delivery Order Created
31Shipment Exception
32Returned by Shipment Provider
33Queued
34Verified Data Entry

Appendix C - GPI Information#

GPI Structure The 14-character GPI consists of seven subsets, each providing increasingly more specific information about drug products. Asterisks included in the drug product name refer to the position of the product within Wolters Kluwer Clinical Drug Information’s TCS. The asterisk before the name indicates the location is within the first three Record Types; the asterisk(s) after the name indicates the level of specificity. Record Types 1 through 3 will always contain asterisks; Record Type 5 will only contain asterisks for partial GPIs. These subsets are structured and identified below:
SubsetRecord TypeNumber of CharactersDescriptionExample
12-xx-xx-xx-xx-xx-12Drug GroupENDOCRINE AND METABOLIC AGENTS - MISC.*
12-34-xx-xx-xx-xx-24Drug ClassPosterior Pituitary Hormones**
12-34-56-xx-xx-xx-36Drug SubclassVasopressin**
12-34-56-78-xx-xx-68Drug Base NameDesmopressin
12-34-56-78-90-xx-xx410Drug Name/Drug Name ExtensionDesmopressin Acetate
12-34-56-78-90-12-xx712Drug Name and Dosage FormDesmopressin Acetate Tablet
12-34-56-78-90-12-34514Full GPI with Drug Strength and StrengthDesmopressin Acetate Tablet 0.1 MG
Subsets Drug Group The two-character Drug Group (first subset) classifies general drug products. These 99 Drug Groups include the Drug Classes frequently used in general market research and third-party prescription processing.
Examples include:
01 PENICILLINS
25 CONTRACEPTIVES
27 ANTIDIABETICS
36 ANTIHYPERTENSIVES
86 OPHTHALMIC AGENTS
Drug Class The four-character Drug Class (first and second subset) identifies specific therapeutic drug classes designed to accommodate more detailed market research. The Drug Class also serves as the structural base for most therapeutic drug monitoring applications (such as dosage screening and disease contraindication monitoring). For example, Drug Group 37, DIURETICS, includes the following Drug Classes:
Note: “99” in the second or third subset is used to identify multiple ingredient (combination) drug products.
37 DIURETICS
37-10 Carbonic Anhydrase Inhibitors*
37-20 Loop Diuretics*
37-30 Mercurial Diuretics*
37-40 Osmotic Diuretics*
37-50 Potassium Sparing Diuretics*
37-60 Thiazides and Thiazide-Like Diuretics*
37-90 Diuretics-Miscellaneous*
37-99 Diuretic Combinations*
Drug Subclass The six-character Drug Subclass (first through third subset) is used if further distinction is needed within a Drug Class. For example, the Drug Class 21-40, Antineoplastic - Hormonal Agents, includes the following Drug Subclasses:
21 ANTINEOPLASTICS AND ADJUNCTIVE THERAPIES
21-40 Antineoplastic - Hormonal and Related Agents*
21-40-20 Androgens - Antineoplastic**
21-40-22 Antiadrenals**
21-40-24 Antiandrogens**
21-40-26 Antiestrogens**
21-40-28 Aromatase Inhibitors**
21-40-30 Estrogens - Antineoplastic**
21-40-35 Estrogen Receptor Antagonist**
21-40-40 Progestins - Antineoplastic**
21-40-50 LHRH Analogs**
21-40-55 Gonadotropin Releasing Hormone (GnRH) Antagonists**
21-40-60 Androgen Biosynthesis Inhibitors**
Drug Base Name The eight-character Drug Base Name (first through fourth subset) designates the basic drug moiety. The Drug Base Name may represent the therapeutic class and not a specific moiety. This often occurs with combination products. For example, the Drug Subclass 30-04-20, Bisphosphonates, includes the following Drug Base Names:
30-04-20 Bisphosphonates***
30-04-20-10 Alendronate
30-04-20-40 Etidronate
30-04-20-48 Ibandronate
30-04-20-60 Pamidronate
30-04-20-65 Risedronate
30-04-20-70 Tiludronate
30-04-20-90 Zoledronic Acid
Drug Name and Drug Name Extension The 10-character Drug Name and Drug Name Extension (first through fifth subset) designates the specific drug and salt, when applicable. When no salt is present, the Drug Name and Drug Name Extension will be the same as the Drug Base Name. For example, Drug Base Name 22-10-00-20, Dexamethasone, includes the following Drug Names and Drug Name Extensions:
22-10-00-20- Dexamethasone
22-10-00-20-10 Dexamethasone Acetate
22-10-00-20-20 Dexamethasone Sodium Phosphate
For combination drug products, the fourth subset generally specifies the number
of active ingredient(s) in a multiple ingredient (combination) product. The fifth
subset designates the specific combination of ingredients in the drug product.
For example, Drug Subclass 43-99-30, Decongestant & Antihistamines, includes,
but is not limited to, the following combination drug products:
43-99-30 Decongestant & Antihistamine**
43-99-30-02-03 Acrivastine & Pseudoephedrine
43-99-30-02-05 Astemizole & Pseudoephedrine
43-99-30-02-10 Azatadine & Pseudoephedrine
43-99-30-02-25 Carbinoxamine & Phenylephrine
43-99-30-02-30 Chlorpheniramine & Phenylephrine
43-99-30-02-59 Loratadine & Pseudoephedrine
43-99-30-02-70 Promethazine & Phenylephrine
43-99-30-02-72 Promethazine & Pseudoephedrine
43-99-30-02-80 Triprolidine & Pseudoephedrine
43-99-30-03-05 Brompheniramine-Diphenhydramine-Phenylephrine
43-99-30-03-24 Chlorpheniramine-Pyrilamine & Phenylephrine
Drug Name and Dosage Form The 12-character Drug Name and Dosage Form (first through sixth subsets) designates the specific drug and its dosage form. For example, Drug Name and Drug Name Extension 67-40-60-70-10, Sumatriptan Succinate, includes the following Drug Name and Dosage Forms:
67-40-60-70-10 Sumatriptan Succinate
67-40-60-70-10-03 Sumatriptan Succinate Tablet
67-40-60-70-10-20 Sumatriptan Succinate Solution
67-40-60-70-10-62 Sumatriptan Succinate Device
67-40-60-70-10-64 Sumatriptan Succinate Kit
Full GPI with Drug Strength and Strength UOM The 13th and 14th characters (seventh subset) identify various strengths. For example, Drug Name and Dosage Form 37-20-00-30-00, Furosemide, includes the following:
37-20-00-30-00-03 Furosemide Tablet
37-20-00-30-00-03-05 Furosemide Tab 20 MG
37-20-00-30-00-03-10 Furosemide Tab 40 MG
37-20-00-30-00-03-15 Furosemide Tab 80 MG
37-20-00-30-00-20-05 Furosemide Inj 10 MG/ML
37-20-00-30-00-20-50 Furosemide Oral Soln 10 MG/ML
Note The seventh subset can also imply a route when the first twelve characters
of the GPI cannot define the route difference, as illustrated by the last two
rows in the table above. When strengths are not specified, the seventh subset may be “00”. For example, Drug Name 90-55-00-75, Hydrocortisone, includes the following
dosage forms without strengths:
90-55-00-75-00-29-00 Hydrocortisone Powder
90-55-00-75-10-29-00 Hydrocortisone Acetate Powder**
The 12-character Drug Name and Dosage Form (first through sixth subsets) designates the specific drug and its dosage form. For example, Drug Name and Drug Name Extension 67-40-60-70-10, Sumatriptan Succinate, includes the following Drug Name and Dosage Forms:
67-40-60-70-10 Sumatriptan Succinate
67-40-60-70-10-03 Sumatriptan Succinate Tablet
67-40-60-70-10-20 Sumatriptan Succinate Solution
67-40-60-70-10-62 Sumatriptan Succinate Device
67-40-60-70-10-64 Sumatriptan Succinate Kit

Example#

{
  "APIKey": "",
  "PharmacyNumber": "1234567890",
  "transaction_id": "888057520190315",
  "transaction_date": "2019-03-15",
  "transaction_time": "22:56:21",
  "rx_number": "8880575",
  "patient_id": 25731,
  "patient_last_name": "DOE",
  "patient_first_name": "JOHN",
  "patient_middle_name": "WAYNE",
  "patient_prefix": "",
  "patient_suffix": "",
  "patient_address1": "167 W GRAND AVE",
  "patient_address2": "UNIT 1408",
  "patient_city": "CHICAGO",
  "patient_state": "IL",
  "patient_zip": "60654",
  "patient_home_phone": "3129555555",
  "patient_cell_phone": "6304005555",
  "patient_work_phone": "6308935555",
  "patient_dob": "1980-04-23",
  "patient_gender": "M",
  "patient_email": "johndoe@email.com",
  "patient_group": [
      {
          "group_code": "1",
          "group_name": "Group Name One"
      },
      {
          "group_code": "3",
          "group_name": "Group Name Three"
      }
    ],
  "family_email": "",
  "patient_short_remark": "Test short remark",
  "patient_remark": "",
  "family_remark": "",
  "patient_shipto_organization": "",
  "patient_shipto_last_name": "",
  "patient_shipto_first_name": "",
  "patient_shipto_careof": "",
  "patient_shipto_address1": "",
  "patient_shipto_address2": "",
  "patient_shipto_city": "",
  "patient_shipto_state": "",
  "patient_shipto_zip": "",
  "patient_shipto_phone": "",
  "is_deactivated": false,
  "transferred_out": false,
  "transferred_pharmacy": "",
  "transferred_pharmacy_address1": "",
  "transferred_pharmacy_address2": "",
  "transferred_pharmacy_city": "",
  "transferred_pharmacy_state": "",
  "transferred_pharmacy_zip": "",
  "transferred_pharmacy_phone": "",
  "transferred_pharmacy_fax": "",
  "transferred_pharmacy_ncpdp": "",
  "transferred_pharmacy_npi": "",
  "transferred_pharmacy_dea": "",
  "bill_status": "3",
  "bill_status_text": "Transmitted",
  "workflow_status": "11",
  "workflow_status_text": "Approved by Insurance",
  "fill_number": "2",
  "fill_date": "2019-03-15",
  "fill_time": "22:50:46",
  "picked_up": "false",
  "delivered": "false",
  "qty_ordered": "30",
  "qty_filled": "30",
  "days_supply": "30",
  "refills_authorized": "5",
  "refills_remaining": "4",
  "refill_number": "1",
  "refill_exp_date": "2019-12-03",
  "item_upc_code": "",
  "drug_ndc": "43547036109",
  "drug_ndc_10digit": "4354736109",
  "drug_ndc_10digit_formatted": "43547-361-09",
  "drug_gpi": "36150040200330",
  "drug_name": "LOSARTAN 50MG TAB SOL",
  "drug_strength": "50 MG",
  "drug_schedule": "0",
  "drug_is_generic": "true",
  "drug_brand_name": "COZAAR 50 MG TABLET",
  "drug_package_size": "90",
  "drug_form": "EACH",
  "drug_color": "WHITE TO OFF WHITE",
  "drug_shape": "ROUND,CONVEX,BEVELED EDGE",
  "drug_front_imprint": "S",
  "drug_back_imprint": "11  2",
  "drug_misc_info": "Convex,White to off-white,Beveled edge",
  "lot_number": "",
  "lot_exp_date": "",
  "retail": "80.00",
  "billed": "75.38",
  "payers": [
    {
      "plan_seq_no": "1",
      "plan_code": "TESTREJ70",
      "plan_name": "TEST REJECTION CODE 70",
      "plan_bin": "330033",
      "plan_pcn": "REJ70",
      "card_id": "44444444",
      "group": "",
      "person_code": "",
      "relation_code": "",
      "plan_bill_status": "5",
      "plan_bill_status_text": "Rejected",
      "cost_paid": "0.00",
      "disp_fee_paid": "0.00",
      "tax_paid": "0.00",
      "discount": "0.00",
      "pat_pay_amount": "0.00",
      "due_from_payer": "0.00"
    },
    {
      "plan_seq_no": "2",
      "plan_code": "TESTCPAY50",
      "plan_name": "TEST COPAY 50",
      "plan_bin": "330033",
      "plan_pcn": "COPAY50",
      "card_id": "44444444",
      "group": "",
      "person_code": "",
      "relation_code": "",
      "plan_bill_status": "3",
      "plan_bill_status_text": "Transmitted",
      "cost_paid": "218.20",
      "disp_fee_paid": "0.00",
      "tax_paid": "0.00",
      "discount": "0.00",
      "pat_pay_amount": "50.00",
      "due_from_payer": "168.20"
    }
  ],
  "cost": "0.89",
  "patient_amount_due": "50.00",
  "due_from_insurance": "168.20",
  "total_paid": "218.20",
  "margin": "217.31",
  "margin_percent": "24416.85",
  "is340b": "true",
  "dispense_as_written": "false",
  "daw_code": "0",
  "date_rx_written": "2018-12-04",
  "signature": "TAKE 1 TABLET DAILY|TOME 1 TABLETA AL DIA",
  "dosage_info": [
    {
      "dose_slot": 1,
      "dose_time": "MORNING",
      "dose_qty": "1",
      "dose_days": "daily"
    }
  ],
  "rx_source": "1 - Written",
  "rph_initials": "HD",
  "tech_initials": "",
  "rx_serial_number": "",
  "submission_clar_code": "20",
  "other_coverage_code": "03",
  "horizon_graveyard_code": "",
  "diagnosis": [
    {
      "qualifier": "02",
      "code": "I10",
      "description": "Essential (primary) hypertension"
    },
    {
      "qualifier": "02",
      "code": "I27.0",
      "description": "Primary pulmonary hypertension"
    }
  ],
  "doctor_id": 4696,
  "doctor_last_name": "SMITH",
  "doctor_first_name": "MICHELLE",
  "doctor_middle_name": "",
  "doctor_prefix": "",
  "doctor_suffix": "",
  "doctor_npi": "1679856987",
  "doctor_dea": "MR2314019",
  "doctor_address1": "WEST CITY MEDICAL CENTER",
  "doctor_address2": "SECOND FLOOR",
  "doctor_city": "CHICAGO",
  "doctor_state": "IL",
  "doctor_zip": "60612",
  "doctor_phone": "7732229987",
  "doctor_fax": "7732229999",
  "doctor_email": "michellesmith@email.com",
  "doctor_remark": "",
  "next_refill_date": "2019-04-14",
  "drug_therapeutic_class": "",
  "prescribed_drug": "LOSARTAN 50MG TAB SOL",
  "filled_by": "",
  "erx_message_id": "",
  "erx_prescriber_order_no": "",
  "rx_remark": "",
  "erx_pharmacy_remark": "",
  "erx_prescriber_remark": "",
  "written_date_remark": "",
  "inactive_rx_remark": "",
  "shipping_provider": "",
  "shipping_tracking_number": "",
  "dispense_using": "Safety Caps",
  "is_medsync_shortfill": false,
  "claim_reject_info": [
    {
      "reject_code": "05",
      "reject_description": "M/I Service Provider Number"
    }
  ],
  "pbm_message": "",
  "claim_additional_messages": [
    {
      "message": "sample message text"
    },
    {
      "message": "more sample message text"
    }
  ]
}
Modified at 2025-03-21 18:46:51
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