POST api/petmedclaimsubmission

Request Information

URI Parameters

None.

Body Parameters

Name	Type	Additional information
DateOfService	date	Required
ServiceProviderId	string	Required
MemberID	string	Required String length: inclusive between 1 and 20
GroupId	string	Required Matching regular expression pattern: ^(COSTCO)$
PetDob	date	Required
PetGender	integer	Required Range: inclusive between 0 and 2
PetName	string	Required String length: inclusive between 1 and 20
MemberLastName	string	Required String length: inclusive between 1 and 30
MemberStreetAddress	string	String length: inclusive between 0 and 30
MemberCity	string	String length: inclusive between 0 and 30
MemberStateCode	string	String length: inclusive between 0 and 2
MemberZip	string	String length: inclusive between 0 and 5
PrescriberIdQualifier	string	Required Matching regular expression pattern: ^(1\|12)$
PrescriberId	string	Required
PrescriberFirstName	string	String length: inclusive between 0 and 20
PrescriberLastName	string	String length: inclusive between 0 and 30
PrescriberStreetAddress1	string	String length: inclusive between 0 and 40
PrescriberStreetAddress2	string	String length: inclusive between 0 and 40
PrescriberCity	string	String length: inclusive between 0 and 20
PrescriberStateCode	string	String length: inclusive between 0 and 2
PrescriberZip	string	String length: inclusive between 0 and 5
RxNumber	string	Required Matching regular expression pattern: ^[0-9]*$ String length: inclusive between 1 and 12
FillNumber	byte	Required Range: inclusive between 0 and 99
DaysSupply	integer	Required Range: inclusive between 1 and 999
DatePrescriptionWritten	date	Required
RefillsAuthorized	byte	Required Range: inclusive between 0 and 99
NDC	string	Required String length: inclusive between 11 and 19
QuantityDispensed	decimal number	Required

Request Formats

application/json, text/json, application/json-patch+json

Sample:

{
  "dateOfService": "2024-12-03T10:43:29.8768686-06:00",
  "serviceProviderId": "sample string 2",
  "memberID": "sample string 3",
  "groupId": "sample string 4",
  "petDob": "2024-12-03T10:43:29.8768686-06:00",
  "petGender": 6,
  "petName": "sample string 7",
  "memberLastName": "sample string 8",
  "memberStreetAddress": "sample string 9",
  "memberCity": "sample string 10",
  "memberStateCode": "sample string 11",
  "memberZip": "sample string 12",
  "prescriberIdQualifier": "sample string 13",
  "prescriberId": "sample string 14",
  "prescriberFirstName": "sample string 15",
  "prescriberLastName": "sample string 16",
  "prescriberStreetAddress1": "sample string 17",
  "prescriberStreetAddress2": "sample string 18",
  "prescriberCity": "sample string 19",
  "prescriberStateCode": "sample string 20",
  "prescriberZip": "sample string 21",
  "rxNumber": "sample string 22",
  "fillNumber": 64,
  "daysSupply": 24,
  "datePrescriptionWritten": "2024-12-03T10:43:29.8778686-06:00",
  "refillsAuthorized": 64,
  "ndc": "sample string 27",
  "quantityDispensed": 28.0
}

application/x-www-form-urlencoded

Sample:

Sample not available.

Response Information

Resource Description

PetMedClaimSubmissionResponseModel

Name	Type	Additional information
ResponseStatus	string	None.
PatientPayAmount	decimal number	None.
ClaimNo	integer	None.
RejectReason	Collection of RejectReason	None.

Response Formats

application/json, text/json, application/json-patch+json

Sample:

{
  "responseStatus": "sample string 1",
  "patientPayAmount": 2.0,
  "claimNo": 3,
  "rejectReason": [
    {
      "code": "sample string 1",
      "reason": "sample string 2",
      "additionalReason": "sample string 3"
    },
    {
      "code": "sample string 1",
      "reason": "sample string 2",
      "additionalReason": "sample string 3"
    }
  ]
}