Claim Search

post

https://clientuatgateway.rxsense.com/core/api/claim/search

Search for claims using multiple criteria. At least one search criterion must be provided. For certain searches, date ranges and/or IsHierarchySP=true are required. At least one of ShowTestClaim, ShowBatchClaim, or ShowRealClaim must be true.

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Body Params

FetchAllRecords

boolean

Defaults to false

Flag to fetch all records without pagination. Default: false.

RxStartDate

date-time | null

Start of date range for claim's date of service. Required for some search types.

RxEndDate

date-time | null

End of date range for claim's date of service. Required for some search types.

ClaimId

integer

Claim identifier.

RxNumber

string

Prescription number.

NPI

string

National Provider Identifier.

NABP

string

National Association of Boards of Pharmacy ID.

DrugName

string

Name of the drug.

Ndc

string

National Drug Code of the drug.

Gpi

string

Generic Product Identifier of the drug.

FirstName

string

Member's first name.

LastName

string

Member's last name.

Dob

date-time

Member's date of birth.

GroupNumber

string

Number of the Group.

MemberId

integer

Unique identifier for the Member.

GroupId

integer

Unique identifier for the Group.

MemberNumber

string

Member's card number.

MemberCardIdentityID

integer

Identifier for the member card identity.

MemberIdentifier

string

Future parameter: contains either MemberCardIdentityID or MemberUlid.

PharmacyName

string

Name of the Pharmacy.

PharmacyZip

integer

ZIP code of the Pharmacy.

OrganizationNumber

string

Number of the Organization.

OrganizationName

string

Name of the Organization.

CarrierNumber

string

Number of the Carrier.

CarrierName

string

Name of the Carrier.

AccountNumber

string

Number of the Account.

AccountName

string

Name of the Account.

BenefitGroupNumber

string

Number of the Benefit Group.

BenefitGroupName

string

Name of the Benefit Group.

GroupName

string

Name of the Group.

RxTransactionStartDate

date-time

Start date for the prescription transaction.

RxTransactionEndDate

date-time

End date for the prescription transaction.

PharmacyChainName

string

Name of the Pharmacy Chain.

PharmacyChainCode

string

Code of the Pharmacy Chain.

IsChainCodeNameSP

boolean

Flag to enable search by chain code or name. Required with chain searches.

PageNumber

integer

Page number for paginated results.

PageSize

integer

Number of records per page.

ShowTestClaim

boolean

Defaults to false

Flag to include test claims. Default: false.

ShowBatchClaim

boolean

Flag to include batch claims.

ShowRealClaim

boolean

Defaults to true

Flag to include real claims. Default: true.

IsHierarchySP

boolean

Indicates if search should be done based on Hierarchy criteria. Required with hierarchy searches.

Headers

X-Api-Key

string

required

Unique API Key provided by RxSense.

Responses

400

Bad request.

401

Unauthorized.

200Claim search results.