| Field | Type | Length | Short Description | Description |
|---|---|---|---|---|
| CorrelationId | string | 36 | Correlation ID | Correlation identifier for tracking the transaction end-to-end |
| Error | string | Variable | Error message, if any | Error message describing why the request could not be processed, if applicable |
| RequestId | string | 50 | Echoed correlation ID | Echoes the RequestId supplied on the request |
| ResponseId | string | 36 | Unique response ID | Unique identifier generated for this response |
| PayIndicator | boolean | true/false | Pay/deny flag | Indicates whether the claim should be paid (true) or denied (false) |
| MemberPolicyInformation | Policy Information (single object) | object | Matched policy details | Policy details used to determine the pay/deny outcome |
| memberPolicyInformation. Bin | string | variable | Carrier Bank ID Number | Bank Identification Number for the pharmacy benefit/carrier |
| memberPolicyInformation. CarrierName | string | variable | Carrier name | Name of the insurance carrier providing coverage |
| memberPolicyInformation. CoverageType | Type | variable | Coverage type code | Code identifying the type of coverage |
| memberPolicyInformation. CoverageTypeDesc | string | variable | Coverage type description | Description of the coverage type |
| memberPolicyInformation. CoverageTypeGrp | string | variable | Coverage type group | Group/category the coverage type belongs to |
| memberPolicyInformation. GroupName | string | variable | Benefit group name | Name of the employer/benefit group associated with the policy |
| memberPolicyInformation. GroupNumber | string | variable | Benefit group number | Number identifying the employer/benefit group associated with the policy |
| memberPolicyInformation. OhiEffectiveDate | DateOnly | 10 | OHI effective date | Date the other health insurance (OHI) coverage became effective |
| memberPolicyInformation. OhiTerminationDate | DateOnly | 10 | OHI termination date | Date the other health insurance (OHI) coverage terminated |
| memberPolicyInformation. OrderOfBenefits | int | up to 10 digits | Benefit order/primacy rank | Numeric order used to determine primacy of benefits |
| memberPolicyInformation. PayerName | string | variable | Payer name | Name of the payer responsible for the policy |
| memberPolicyInformation. Pcn | string | variable | Processor Control Number | Processor Control Number used for pharmacy claims routing |
| memberPolicyInformation. PolicyHolderFirstName | string | 128 | Policyholder's first name | First Name of the policyholder for this policy |
| memberPolicyInformation. PolicyHolderMiddleName | string | 128 | Policyholder's middle name | Middle Name of the policyholder for this policy |
| memberPolicyInformation. PolicyHolderLastName | string | 128 | Policyholder's last name | Last Name of the policyholder for this policy |
| memberPolicyInformation. PolicyId | string | 255 | Policy ID | Unique identifier for the policy |
| memberPolicyInformation. PolicyPersonCode | string | variable | Policy person code | Code identifying the covered person's role on the policy |
| memberPolicyInformation. Relationship | string | variable | Member's relationship to policyholder | Relationship of the Member to the policyholder |
| memberPolicyInformation. SubGroupNumber | string | variable | Benefit sub-group number | Number identifying the sub-group associated with the policy |