Coverage

The Coverage resource allows the retrieval of Formulary Coverage information for any number of Products. The coverage information is grouped by the Controller and is accompanied by a winning status and percentage. The plans or controllers can also be filtered by a number of parameters.


Coverage for a specific Plan and Product

Alternative Coverage for a specific Plan and Product

Coverage for a specific Controller and Product

Coverage for a specific MCO and Product

Alternative Coverage for a specific Controller and Product

Alternative Coverage for a specific MCO and Product

Coverage by Product


Coverage for a specific Plan and Product


Request Url
GET Formulary/v1/Coverage/Plan


URI Parameters

NameDescription Type Required / Optional
ProductId

The Id of the Product

integer

Required

PlanId

The Id of the Plan

integer

Required

LivesTypeId

The Id to override the types of lives to shown (Default: 4)

integer

Optional


Resource Description of Response Object

PlanCoveragesResponse
NameDescription Type Required / Optional
PlanCoverages

Collection of PlanCoverage

Optional


Available Response Formats & Sample Data

{
  "PlanCoverages": [
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "ControllerId": 6,
      "NoteId": 1,
      "NotesAvailable": 7,
      "Lives": 8,
      "DrugListTierId": 64,
      "FormularyTierId": 10,
      "FormularyUnifiedTierId": 11,
      "UnifiedTierId": 12,
      "PromotionalTierId": 1,
      "IsGeneric": true,
      "PriorAuthorization": true,
      "StepTherapy": true,
      "QuantityLimit": true,
      "SpecialtyPharmacy": true,
      "ConditionalPriorAuthorization": true,
      "DurableMedicalEquipment": true,
      "MedicalBenefit": true,
      "OverTheCounter": true,
      "Variance": true,
      "StateCarveOut": true,
      "FormularyId": 24
    },
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "ControllerId": 6,
      "NoteId": 1,
      "NotesAvailable": 7,
      "Lives": 8,
      "DrugListTierId": 64,
      "FormularyTierId": 10,
      "FormularyUnifiedTierId": 11,
      "UnifiedTierId": 12,
      "PromotionalTierId": 1,
      "IsGeneric": true,
      "PriorAuthorization": true,
      "StepTherapy": true,
      "QuantityLimit": true,
      "SpecialtyPharmacy": true,
      "ConditionalPriorAuthorization": true,
      "DurableMedicalEquipment": true,
      "MedicalBenefit": true,
      "OverTheCounter": true,
      "Variance": true,
      "StateCarveOut": true,
      "FormularyId": 24
    }
  ]
}
<PlanCoveragesResponse xmlns:i="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://api.mmitnetwork.com/formulary/coverages">
  <PlanCoverages>
    <PlanCoverage>
      <ChannelId>3</ChannelId>
      <ConditionalPriorAuthorization>true</ConditionalPriorAuthorization>
      <ControllerId>6</ControllerId>
      <DrugListTierId>64</DrugListTierId>
      <DurableMedicalEquipment>true</DurableMedicalEquipment>
      <FormularyId>24</FormularyId>
      <FormularyTierId>10</FormularyTierId>
      <FormularyUnifiedTierId>11</FormularyUnifiedTierId>
      <IsGeneric>true</IsGeneric>
      <Lives>8</Lives>
      <MedicalBenefit>true</MedicalBenefit>
      <MonthId>5</MonthId>
      <NoteId>1</NoteId>
      <NotesAvailable>7</NotesAvailable>
      <OverTheCounter>true</OverTheCounter>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <PriorAuthorization>true</PriorAuthorization>
      <ProductId>4</ProductId>
      <PromotionalTierId>1</PromotionalTierId>
      <QuantityLimit>true</QuantityLimit>
      <SpecialtyPharmacy>true</SpecialtyPharmacy>
      <StateCarveOut>true</StateCarveOut>
      <StepTherapy>true</StepTherapy>
      <UnifiedTierId>12</UnifiedTierId>
      <Variance>true</Variance>
    </PlanCoverage>
    <PlanCoverage>
      <ChannelId>3</ChannelId>
      <ConditionalPriorAuthorization>true</ConditionalPriorAuthorization>
      <ControllerId>6</ControllerId>
      <DrugListTierId>64</DrugListTierId>
      <DurableMedicalEquipment>true</DurableMedicalEquipment>
      <FormularyId>24</FormularyId>
      <FormularyTierId>10</FormularyTierId>
      <FormularyUnifiedTierId>11</FormularyUnifiedTierId>
      <IsGeneric>true</IsGeneric>
      <Lives>8</Lives>
      <MedicalBenefit>true</MedicalBenefit>
      <MonthId>5</MonthId>
      <NoteId>1</NoteId>
      <NotesAvailable>7</NotesAvailable>
      <OverTheCounter>true</OverTheCounter>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <PriorAuthorization>true</PriorAuthorization>
      <ProductId>4</ProductId>
      <PromotionalTierId>1</PromotionalTierId>
      <QuantityLimit>true</QuantityLimit>
      <SpecialtyPharmacy>true</SpecialtyPharmacy>
      <StateCarveOut>true</StateCarveOut>
      <StepTherapy>true</StepTherapy>
      <UnifiedTierId>12</UnifiedTierId>
      <Variance>true</Variance>
    </PlanCoverage>
  </PlanCoverages>
</PlanCoveragesResponse>

Build Request


NameDescription Input Value Type Required / Optional
ProductId

The Id of the Product

integer

Required

PlanId

The Id of the Plan

integer

Required

LivesTypeId

The Id to override the types of lives to shown (Default: 4)

integer

Optional





Request URL

GET Formulary/v1/Coverage/Plan?ProductId=ProductId&PlanId=PlanId&LivesTypeId=LivesTypeId

Status

Response Details

            
            

Alternative Coverage for a specific Plan and Product


Request Url
GET Formulary/v1/Coverage/Plan/Alternatives


URI Parameters

NameDescription Type Required / Optional
ProductId

The Id of the Product to return alternatives for

integer

Required

PlanId

The Id of the Plan

integer

Required

DrugTypeId

The DrugTypeId of the Product to be returned

byte

Optional

Options

Enter "CoveredOnly" to return only covered alternatives.

Collection of string

Optional

LivesTypeId

The Id to override the types of lives to shown (Default: 4)

integer

Optional


Resource Description of Response Object

AlternativePlanCoveragesResponse
NameDescription Type Required / Optional
PlanCoverages

Collection of PlanCoverage

Optional

Products

Collection of Product

Optional


Available Response Formats & Sample Data

{
  "PlanCoverages": [
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "ControllerId": 6,
      "NoteId": 1,
      "NotesAvailable": 7,
      "Lives": 8,
      "DrugListTierId": 64,
      "FormularyTierId": 10,
      "FormularyUnifiedTierId": 11,
      "UnifiedTierId": 12,
      "PromotionalTierId": 1,
      "IsGeneric": true,
      "PriorAuthorization": true,
      "StepTherapy": true,
      "QuantityLimit": true,
      "SpecialtyPharmacy": true,
      "ConditionalPriorAuthorization": true,
      "DurableMedicalEquipment": true,
      "MedicalBenefit": true,
      "OverTheCounter": true,
      "Variance": true,
      "StateCarveOut": true,
      "FormularyId": 24
    },
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "ControllerId": 6,
      "NoteId": 1,
      "NotesAvailable": 7,
      "Lives": 8,
      "DrugListTierId": 64,
      "FormularyTierId": 10,
      "FormularyUnifiedTierId": 11,
      "UnifiedTierId": 12,
      "PromotionalTierId": 1,
      "IsGeneric": true,
      "PriorAuthorization": true,
      "StepTherapy": true,
      "QuantityLimit": true,
      "SpecialtyPharmacy": true,
      "ConditionalPriorAuthorization": true,
      "DurableMedicalEquipment": true,
      "MedicalBenefit": true,
      "OverTheCounter": true,
      "Variance": true,
      "StateCarveOut": true,
      "FormularyId": 24
    }
  ],
  "Products": [
    {
      "ProductId": 1,
      "TherapeuticClassId": 2,
      "TherapeuticClass": "sample string 3",
      "Drug": {
        "DrugId": 1,
        "DrugTypeId": 64,
        "Name": "sample string 3",
        "Description": "sample string 4",
        "Brand": "sample string 5",
        "IsGeneric": true,
        "OverTheCounter": true,
        "IsOwner": true,
        "Logo": "sample string 8",
        "ImportantSafetyInformation": "sample string 9",
        "Rank": 64
      },
      "DisplayName": "sample string 4"
    },
    {
      "ProductId": 1,
      "TherapeuticClassId": 2,
      "TherapeuticClass": "sample string 3",
      "Drug": {
        "DrugId": 1,
        "DrugTypeId": 64,
        "Name": "sample string 3",
        "Description": "sample string 4",
        "Brand": "sample string 5",
        "IsGeneric": true,
        "OverTheCounter": true,
        "IsOwner": true,
        "Logo": "sample string 8",
        "ImportantSafetyInformation": "sample string 9",
        "Rank": 64
      },
      "DisplayName": "sample string 4"
    }
  ]
}
<AlternativePlanCoveragesResponse xmlns:i="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://api.mmitnetwork.com/formulary/coverages">
  <PlanCoverages>
    <PlanCoverage>
      <ChannelId>3</ChannelId>
      <ConditionalPriorAuthorization>true</ConditionalPriorAuthorization>
      <ControllerId>6</ControllerId>
      <DrugListTierId>64</DrugListTierId>
      <DurableMedicalEquipment>true</DurableMedicalEquipment>
      <FormularyId>24</FormularyId>
      <FormularyTierId>10</FormularyTierId>
      <FormularyUnifiedTierId>11</FormularyUnifiedTierId>
      <IsGeneric>true</IsGeneric>
      <Lives>8</Lives>
      <MedicalBenefit>true</MedicalBenefit>
      <MonthId>5</MonthId>
      <NoteId>1</NoteId>
      <NotesAvailable>7</NotesAvailable>
      <OverTheCounter>true</OverTheCounter>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <PriorAuthorization>true</PriorAuthorization>
      <ProductId>4</ProductId>
      <PromotionalTierId>1</PromotionalTierId>
      <QuantityLimit>true</QuantityLimit>
      <SpecialtyPharmacy>true</SpecialtyPharmacy>
      <StateCarveOut>true</StateCarveOut>
      <StepTherapy>true</StepTherapy>
      <UnifiedTierId>12</UnifiedTierId>
      <Variance>true</Variance>
    </PlanCoverage>
    <PlanCoverage>
      <ChannelId>3</ChannelId>
      <ConditionalPriorAuthorization>true</ConditionalPriorAuthorization>
      <ControllerId>6</ControllerId>
      <DrugListTierId>64</DrugListTierId>
      <DurableMedicalEquipment>true</DurableMedicalEquipment>
      <FormularyId>24</FormularyId>
      <FormularyTierId>10</FormularyTierId>
      <FormularyUnifiedTierId>11</FormularyUnifiedTierId>
      <IsGeneric>true</IsGeneric>
      <Lives>8</Lives>
      <MedicalBenefit>true</MedicalBenefit>
      <MonthId>5</MonthId>
      <NoteId>1</NoteId>
      <NotesAvailable>7</NotesAvailable>
      <OverTheCounter>true</OverTheCounter>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <PriorAuthorization>true</PriorAuthorization>
      <ProductId>4</ProductId>
      <PromotionalTierId>1</PromotionalTierId>
      <QuantityLimit>true</QuantityLimit>
      <SpecialtyPharmacy>true</SpecialtyPharmacy>
      <StateCarveOut>true</StateCarveOut>
      <StepTherapy>true</StepTherapy>
      <UnifiedTierId>12</UnifiedTierId>
      <Variance>true</Variance>
    </PlanCoverage>
  </PlanCoverages>
  <Products xmlns:d2p1="http://api.mmitnetwork.com/formulary/products">
    <d2p1:Product>
      <d2p1:DisplayName>sample string 4</d2p1:DisplayName>
      <d2p1:Drug>
        <d2p1:Brand>sample string 5</d2p1:Brand>
        <d2p1:Description>sample string 4</d2p1:Description>
        <d2p1:DrugId>1</d2p1:DrugId>
        <d2p1:DrugTypeId>64</d2p1:DrugTypeId>
        <d2p1:ImportantSafetyInformation>sample string 9</d2p1:ImportantSafetyInformation>
        <d2p1:IsGeneric>true</d2p1:IsGeneric>
        <d2p1:IsOwner>true</d2p1:IsOwner>
        <d2p1:Logo>sample string 8</d2p1:Logo>
        <d2p1:Name>sample string 3</d2p1:Name>
        <d2p1:OverTheCounter>true</d2p1:OverTheCounter>
        <d2p1:Rank>64</d2p1:Rank>
      </d2p1:Drug>
      <d2p1:ProductId>1</d2p1:ProductId>
      <d2p1:TherapeuticClass>sample string 3</d2p1:TherapeuticClass>
      <d2p1:TherapeuticClassId>2</d2p1:TherapeuticClassId>
    </d2p1:Product>
    <d2p1:Product>
      <d2p1:DisplayName>sample string 4</d2p1:DisplayName>
      <d2p1:Drug>
        <d2p1:Brand>sample string 5</d2p1:Brand>
        <d2p1:Description>sample string 4</d2p1:Description>
        <d2p1:DrugId>1</d2p1:DrugId>
        <d2p1:DrugTypeId>64</d2p1:DrugTypeId>
        <d2p1:ImportantSafetyInformation>sample string 9</d2p1:ImportantSafetyInformation>
        <d2p1:IsGeneric>true</d2p1:IsGeneric>
        <d2p1:IsOwner>true</d2p1:IsOwner>
        <d2p1:Logo>sample string 8</d2p1:Logo>
        <d2p1:Name>sample string 3</d2p1:Name>
        <d2p1:OverTheCounter>true</d2p1:OverTheCounter>
        <d2p1:Rank>64</d2p1:Rank>
      </d2p1:Drug>
      <d2p1:ProductId>1</d2p1:ProductId>
      <d2p1:TherapeuticClass>sample string 3</d2p1:TherapeuticClass>
      <d2p1:TherapeuticClassId>2</d2p1:TherapeuticClassId>
    </d2p1:Product>
  </Products>
</AlternativePlanCoveragesResponse>

Build Request


NameDescription Input Value Type Required / Optional
ProductId

The Id of the Product to return alternatives for

integer

Required

PlanId

The Id of the Plan

integer

Required

DrugTypeId

The DrugTypeId of the Product to be returned

byte

Optional

Options

Enter "CoveredOnly" to return only covered alternatives.

Collection of string

Optional

LivesTypeId

The Id to override the types of lives to shown (Default: 4)

integer

Optional





Request URL

GET Formulary/v1/Coverage/Plan/Alternatives?ProductId=ProductId&PlanId=PlanId&DrugTypeId=DrugTypeId&Options=Options&LivesTypeId=LivesTypeId

Status

Response Details

            
            

Coverage for a specific Controller and Product


Request Url
GET Formulary/v1/Coverage/Controller


URI Parameters

NameDescription Type Required / Optional
ProductId

The Id of the Product

integer

Required

ControllerId

The Id of the Controller/Parent

integer

Required

BenefitDesignId

The Id of the BenefitDesign used as a Plan filter the response

integer

Optional

ChannelId

The Id of the Channel used as a Plan filter the response

Collection of integer

Optional

PlanTypeId

The Id of the PlanType used as a Plan filter the response

integer

Optional

StateId

The US State Id where the Plan(s) are covered

string

Optional

CBSAId

The CBSA(Service Area) Id where the Plan is covered

integer

Optional

TerritoryId

The Territory Id where the Plan is covered

integer

Optional

Options

Enter "PlanCoverages" to include Plan level coverage in addition to Controller coverage.

Collection of string

Optional

LivesTypeId

The Id to override the types of lives to shown (Default: 4)

integer

Optional


Resource Description of Response Object

ControllerCoveragesResponse
NameDescription Type Required / Optional
ControllerCoverages

Collection of Coverage

Optional

PlanCoverages

Collection of PlanCoverage

Optional

SummaryCoverages

Collection of UnifiedTierCoverage

Optional

Statement

string

Optional


Available Response Formats & Sample Data

{
  "ControllerCoverages": [
    {
      "ProductId": 1,
      "MonthId": 3,
      "ControllerId": 4,
      "DrugListTier": {
        "DrugListTierId": 64,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "UnifiedTier": {
        "UnifiedTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "PromotionalTier": {
        "PromotionalTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "Lives": 6,
      "PlanCount": 7
    },
    {
      "ProductId": 1,
      "MonthId": 3,
      "ControllerId": 4,
      "DrugListTier": {
        "DrugListTierId": 64,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "UnifiedTier": {
        "UnifiedTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "PromotionalTier": {
        "PromotionalTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "Lives": 6,
      "PlanCount": 7
    }
  ],
  "PlanCoverages": [
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "ControllerId": 6,
      "NoteId": 1,
      "NotesAvailable": 7,
      "Lives": 8,
      "DrugListTierId": 64,
      "FormularyTierId": 10,
      "FormularyUnifiedTierId": 11,
      "UnifiedTierId": 12,
      "PromotionalTierId": 1,
      "IsGeneric": true,
      "PriorAuthorization": true,
      "StepTherapy": true,
      "QuantityLimit": true,
      "SpecialtyPharmacy": true,
      "ConditionalPriorAuthorization": true,
      "DurableMedicalEquipment": true,
      "MedicalBenefit": true,
      "OverTheCounter": true,
      "Variance": true,
      "StateCarveOut": true,
      "FormularyId": 24
    },
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "ControllerId": 6,
      "NoteId": 1,
      "NotesAvailable": 7,
      "Lives": 8,
      "DrugListTierId": 64,
      "FormularyTierId": 10,
      "FormularyUnifiedTierId": 11,
      "UnifiedTierId": 12,
      "PromotionalTierId": 1,
      "IsGeneric": true,
      "PriorAuthorization": true,
      "StepTherapy": true,
      "QuantityLimit": true,
      "SpecialtyPharmacy": true,
      "ConditionalPriorAuthorization": true,
      "DurableMedicalEquipment": true,
      "MedicalBenefit": true,
      "OverTheCounter": true,
      "Variance": true,
      "StateCarveOut": true,
      "FormularyId": 24
    }
  ],
  "SummaryCoverages": [
    {
      "UnifiedTierId": 1,
      "Percentage": 2,
      "Lives": 3,
      "PlanCount": 4
    },
    {
      "UnifiedTierId": 1,
      "Percentage": 2,
      "Lives": 3,
      "PlanCount": 4
    }
  ],
  "Statement": "sample string 1"
}
<ControllerCoveragesResponse xmlns:i="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://api.mmitnetwork.com/formulary/coverages">
  <ControllerCoverages>
    <Coverage>
      <ControllerId>4</ControllerId>
      <DrugListTier>
        <DrugListTierId>64</DrugListTierId>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
      </DrugListTier>
      <Lives>6</Lives>
      <MonthId>3</MonthId>
      <PlanCount>7</PlanCount>
      <ProductId>1</ProductId>
      <PromotionalTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <PromotionalTierId>1</PromotionalTierId>
      </PromotionalTier>
      <UnifiedTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <UnifiedTierId>1</UnifiedTierId>
      </UnifiedTier>
    </Coverage>
    <Coverage>
      <ControllerId>4</ControllerId>
      <DrugListTier>
        <DrugListTierId>64</DrugListTierId>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
      </DrugListTier>
      <Lives>6</Lives>
      <MonthId>3</MonthId>
      <PlanCount>7</PlanCount>
      <ProductId>1</ProductId>
      <PromotionalTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <PromotionalTierId>1</PromotionalTierId>
      </PromotionalTier>
      <UnifiedTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <UnifiedTierId>1</UnifiedTierId>
      </UnifiedTier>
    </Coverage>
  </ControllerCoverages>
  <PlanCoverages>
    <PlanCoverage>
      <ChannelId>3</ChannelId>
      <ConditionalPriorAuthorization>true</ConditionalPriorAuthorization>
      <ControllerId>6</ControllerId>
      <DrugListTierId>64</DrugListTierId>
      <DurableMedicalEquipment>true</DurableMedicalEquipment>
      <FormularyId>24</FormularyId>
      <FormularyTierId>10</FormularyTierId>
      <FormularyUnifiedTierId>11</FormularyUnifiedTierId>
      <IsGeneric>true</IsGeneric>
      <Lives>8</Lives>
      <MedicalBenefit>true</MedicalBenefit>
      <MonthId>5</MonthId>
      <NoteId>1</NoteId>
      <NotesAvailable>7</NotesAvailable>
      <OverTheCounter>true</OverTheCounter>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <PriorAuthorization>true</PriorAuthorization>
      <ProductId>4</ProductId>
      <PromotionalTierId>1</PromotionalTierId>
      <QuantityLimit>true</QuantityLimit>
      <SpecialtyPharmacy>true</SpecialtyPharmacy>
      <StateCarveOut>true</StateCarveOut>
      <StepTherapy>true</StepTherapy>
      <UnifiedTierId>12</UnifiedTierId>
      <Variance>true</Variance>
    </PlanCoverage>
    <PlanCoverage>
      <ChannelId>3</ChannelId>
      <ConditionalPriorAuthorization>true</ConditionalPriorAuthorization>
      <ControllerId>6</ControllerId>
      <DrugListTierId>64</DrugListTierId>
      <DurableMedicalEquipment>true</DurableMedicalEquipment>
      <FormularyId>24</FormularyId>
      <FormularyTierId>10</FormularyTierId>
      <FormularyUnifiedTierId>11</FormularyUnifiedTierId>
      <IsGeneric>true</IsGeneric>
      <Lives>8</Lives>
      <MedicalBenefit>true</MedicalBenefit>
      <MonthId>5</MonthId>
      <NoteId>1</NoteId>
      <NotesAvailable>7</NotesAvailable>
      <OverTheCounter>true</OverTheCounter>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <PriorAuthorization>true</PriorAuthorization>
      <ProductId>4</ProductId>
      <PromotionalTierId>1</PromotionalTierId>
      <QuantityLimit>true</QuantityLimit>
      <SpecialtyPharmacy>true</SpecialtyPharmacy>
      <StateCarveOut>true</StateCarveOut>
      <StepTherapy>true</StepTherapy>
      <UnifiedTierId>12</UnifiedTierId>
      <Variance>true</Variance>
    </PlanCoverage>
  </PlanCoverages>
  <Statement>sample string 1</Statement>
  <SummaryCoverages>
    <UnifiedTierCoverage>
      <Lives>3</Lives>
      <Percentage>2</Percentage>
      <PlanCount>4</PlanCount>
      <UnifiedTierId>1</UnifiedTierId>
    </UnifiedTierCoverage>
    <UnifiedTierCoverage>
      <Lives>3</Lives>
      <Percentage>2</Percentage>
      <PlanCount>4</PlanCount>
      <UnifiedTierId>1</UnifiedTierId>
    </UnifiedTierCoverage>
  </SummaryCoverages>
</ControllerCoveragesResponse>

Build Request


NameDescription Input Value Type Required / Optional
ProductId

The Id of the Product

integer

Required

ControllerId

The Id of the Controller/Parent

integer

Required

BenefitDesignId

The Id of the BenefitDesign used as a Plan filter the response

integer

Optional

ChannelId

The Id of the Channel used as a Plan filter the response

Collection of integer

Optional

PlanTypeId

The Id of the PlanType used as a Plan filter the response

integer

Optional

StateId

The US State Id where the Plan(s) are covered

string

Optional

CBSAId

The CBSA(Service Area) Id where the Plan is covered

integer

Optional

TerritoryId

The Territory Id where the Plan is covered

integer

Optional

Options

Enter "PlanCoverages" to include Plan level coverage in addition to Controller coverage.

Collection of string

Optional

LivesTypeId

The Id to override the types of lives to shown (Default: 4)

integer

Optional





Request URL

GET Formulary/v1/Coverage/Controller?ProductId=ProductId&ControllerId=ControllerId&BenefitDesignId=BenefitDesignId&ChannelId=ChannelId&PlanTypeId=PlanTypeId&StateId=StateId&CBSAId=CBSAId&TerritoryId=TerritoryId&Options=Options&LivesTypeId=LivesTypeId

Status

Response Details

            
            

Coverage for a specific MCO and Product


Request Url
GET Formulary/v1/Coverage/MCO


URI Parameters

NameDescription Type Required / Optional
ProductId

The Id of the Product

integer

Required

MCOId

The Id of the MCO

integer

Required

BenefitDesignId

The Id of the BenefitDesign used as a Plan filter the response

integer

Optional

ChannelId

The Id of the Channel used as a Plan filter the response

Collection of integer

Optional

PlanTypeId

The Id of the PlanType used as a Plan filter the response

integer

Optional

StateId

The US State Id where the Plan(s) are covered

string

Optional

CBSAId

The CBSA(Service Area) Id where the Plan is covered

integer

Optional

TerritoryId

The Territory Id where the Plan is covered

integer

Optional

Options

Enter "PlanCoverages" to include Plan level coverage in addition to MCO coverage.

Collection of string

Optional

LivesTypeId

The Id to override the types of lives to shown (Default: 4)

integer

Optional


Resource Description of Response Object

McoCoveragesResponse
NameDescription Type Required / Optional
MCOCoverages

Collection of McoCoverage

Optional

PlanCoverages

Collection of PlanMcoCoverage

Optional

SummaryCoverages

Collection of UnifiedTierCoverage

Optional

Statement

string

Optional


Available Response Formats & Sample Data

{
  "MCOCoverages": [
    {
      "ProductId": 1,
      "MonthId": 3,
      "MCOId": 4,
      "MCO": "sample string 5",
      "DrugListTier": {
        "DrugListTierId": 64,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "UnifiedTier": {
        "UnifiedTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "PromotionalTier": {
        "PromotionalTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "Lives": 6,
      "PlanCount": 7
    },
    {
      "ProductId": 1,
      "MonthId": 3,
      "MCOId": 4,
      "MCO": "sample string 5",
      "DrugListTier": {
        "DrugListTierId": 64,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "UnifiedTier": {
        "UnifiedTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "PromotionalTier": {
        "PromotionalTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "Lives": 6,
      "PlanCount": 7
    }
  ],
  "PlanCoverages": [
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "MCOId": 6,
      "MCO": "sample string 7",
      "NoteId": 1,
      "NotesAvailable": 8,
      "Lives": 9,
      "DrugListTierId": 64,
      "FormularyTierId": 11,
      "FormularyUnifiedTierId": 12,
      "UnifiedTierId": 13,
      "PromotionalTierId": 1,
      "IsGeneric": true,
      "PriorAuthorization": true,
      "StepTherapy": true,
      "QuantityLimit": true,
      "SpecialtyPharmacy": true,
      "ConditionalPriorAuthorization": true,
      "DurableMedicalEquipment": true,
      "MedicalBenefit": true,
      "OverTheCounter": true,
      "Variance": true,
      "StateCarveOut": true,
      "FormularyId": 25
    },
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "MCOId": 6,
      "MCO": "sample string 7",
      "NoteId": 1,
      "NotesAvailable": 8,
      "Lives": 9,
      "DrugListTierId": 64,
      "FormularyTierId": 11,
      "FormularyUnifiedTierId": 12,
      "UnifiedTierId": 13,
      "PromotionalTierId": 1,
      "IsGeneric": true,
      "PriorAuthorization": true,
      "StepTherapy": true,
      "QuantityLimit": true,
      "SpecialtyPharmacy": true,
      "ConditionalPriorAuthorization": true,
      "DurableMedicalEquipment": true,
      "MedicalBenefit": true,
      "OverTheCounter": true,
      "Variance": true,
      "StateCarveOut": true,
      "FormularyId": 25
    }
  ],
  "SummaryCoverages": [
    {
      "UnifiedTierId": 1,
      "Percentage": 2,
      "Lives": 3,
      "PlanCount": 4
    },
    {
      "UnifiedTierId": 1,
      "Percentage": 2,
      "Lives": 3,
      "PlanCount": 4
    }
  ],
  "Statement": "sample string 1"
}
<McoCoveragesResponse xmlns:i="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://api.mmitnetwork.com/formulary/coverages">
  <MCOCoverages>
    <McoCoverage>
      <DrugListTier>
        <DrugListTierId>64</DrugListTierId>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
      </DrugListTier>
      <Lives>6</Lives>
      <MCO>sample string 5</MCO>
      <MCOId>4</MCOId>
      <MonthId>3</MonthId>
      <PlanCount>7</PlanCount>
      <ProductId>1</ProductId>
      <PromotionalTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <PromotionalTierId>1</PromotionalTierId>
      </PromotionalTier>
      <UnifiedTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <UnifiedTierId>1</UnifiedTierId>
      </UnifiedTier>
    </McoCoverage>
    <McoCoverage>
      <DrugListTier>
        <DrugListTierId>64</DrugListTierId>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
      </DrugListTier>
      <Lives>6</Lives>
      <MCO>sample string 5</MCO>
      <MCOId>4</MCOId>
      <MonthId>3</MonthId>
      <PlanCount>7</PlanCount>
      <ProductId>1</ProductId>
      <PromotionalTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <PromotionalTierId>1</PromotionalTierId>
      </PromotionalTier>
      <UnifiedTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <UnifiedTierId>1</UnifiedTierId>
      </UnifiedTier>
    </McoCoverage>
  </MCOCoverages>
  <PlanCoverages>
    <PlanMcoCoverage>
      <ChannelId>3</ChannelId>
      <ConditionalPriorAuthorization>true</ConditionalPriorAuthorization>
      <DrugListTierId>64</DrugListTierId>
      <DurableMedicalEquipment>true</DurableMedicalEquipment>
      <FormularyId>25</FormularyId>
      <FormularyTierId>11</FormularyTierId>
      <FormularyUnifiedTierId>12</FormularyUnifiedTierId>
      <IsGeneric>true</IsGeneric>
      <Lives>9</Lives>
      <MCO>sample string 7</MCO>
      <MCOId>6</MCOId>
      <MedicalBenefit>true</MedicalBenefit>
      <MonthId>5</MonthId>
      <NoteId>1</NoteId>
      <NotesAvailable>8</NotesAvailable>
      <OverTheCounter>true</OverTheCounter>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <PriorAuthorization>true</PriorAuthorization>
      <ProductId>4</ProductId>
      <PromotionalTierId>1</PromotionalTierId>
      <QuantityLimit>true</QuantityLimit>
      <SpecialtyPharmacy>true</SpecialtyPharmacy>
      <StateCarveOut>true</StateCarveOut>
      <StepTherapy>true</StepTherapy>
      <UnifiedTierId>13</UnifiedTierId>
      <Variance>true</Variance>
    </PlanMcoCoverage>
    <PlanMcoCoverage>
      <ChannelId>3</ChannelId>
      <ConditionalPriorAuthorization>true</ConditionalPriorAuthorization>
      <DrugListTierId>64</DrugListTierId>
      <DurableMedicalEquipment>true</DurableMedicalEquipment>
      <FormularyId>25</FormularyId>
      <FormularyTierId>11</FormularyTierId>
      <FormularyUnifiedTierId>12</FormularyUnifiedTierId>
      <IsGeneric>true</IsGeneric>
      <Lives>9</Lives>
      <MCO>sample string 7</MCO>
      <MCOId>6</MCOId>
      <MedicalBenefit>true</MedicalBenefit>
      <MonthId>5</MonthId>
      <NoteId>1</NoteId>
      <NotesAvailable>8</NotesAvailable>
      <OverTheCounter>true</OverTheCounter>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <PriorAuthorization>true</PriorAuthorization>
      <ProductId>4</ProductId>
      <PromotionalTierId>1</PromotionalTierId>
      <QuantityLimit>true</QuantityLimit>
      <SpecialtyPharmacy>true</SpecialtyPharmacy>
      <StateCarveOut>true</StateCarveOut>
      <StepTherapy>true</StepTherapy>
      <UnifiedTierId>13</UnifiedTierId>
      <Variance>true</Variance>
    </PlanMcoCoverage>
  </PlanCoverages>
  <Statement>sample string 1</Statement>
  <SummaryCoverages>
    <UnifiedTierCoverage>
      <Lives>3</Lives>
      <Percentage>2</Percentage>
      <PlanCount>4</PlanCount>
      <UnifiedTierId>1</UnifiedTierId>
    </UnifiedTierCoverage>
    <UnifiedTierCoverage>
      <Lives>3</Lives>
      <Percentage>2</Percentage>
      <PlanCount>4</PlanCount>
      <UnifiedTierId>1</UnifiedTierId>
    </UnifiedTierCoverage>
  </SummaryCoverages>
</McoCoveragesResponse>

Build Request


NameDescription Input Value Type Required / Optional
ProductId

The Id of the Product

integer

Required

MCOId

The Id of the MCO

integer

Required

BenefitDesignId

The Id of the BenefitDesign used as a Plan filter the response

integer

Optional

ChannelId

The Id of the Channel used as a Plan filter the response

Collection of integer

Optional

PlanTypeId

The Id of the PlanType used as a Plan filter the response

integer

Optional

StateId

The US State Id where the Plan(s) are covered

string

Optional

CBSAId

The CBSA(Service Area) Id where the Plan is covered

integer

Optional

TerritoryId

The Territory Id where the Plan is covered

integer

Optional

Options

Enter "PlanCoverages" to include Plan level coverage in addition to MCO coverage.

Collection of string

Optional

LivesTypeId

The Id to override the types of lives to shown (Default: 4)

integer

Optional





Request URL

GET Formulary/v1/Coverage/MCO?ProductId=ProductId&MCOId=MCOId&BenefitDesignId=BenefitDesignId&ChannelId=ChannelId&PlanTypeId=PlanTypeId&StateId=StateId&CBSAId=CBSAId&TerritoryId=TerritoryId&Options=Options&LivesTypeId=LivesTypeId

Status

Response Details

            
            

Alternative Coverage for a specific Controller and Product


Request Url
GET Formulary/v1/Coverage/Controller/Alternatives


URI Parameters

NameDescription Type Required / Optional
ProductId

The Id of the Product

integer

Required

ControllerId

The Id of the Controller/Parent

integer

Required

BenefitDesignId

The Id of the BenefitDesign used as a Plan filter the response

integer

Optional

ChannelId

The Id of the Channel used as a Plan filter the response

Collection of integer

Optional

PlanTypeId

The Id of the PlanType used as a Plan filter the response

integer

Optional

StateId

The US State Id where the Plan(s) are covered

string

Optional

CBSAId

The CBSA(Service Area) Id where the Plan is covered

integer

Optional

TerritoryId

The Territory Id where the Plan is covered

integer

Optional

DrugTypeId

The DrugTypeId of the Product to be returned

byte

Optional

Options

Enter "PlanCoverages" to include Plan level coverage in addition to Controller coverage.

Collection of string

Optional

LivesTypeId

The Id to override the types of lives to shown (Default: 4)

integer

Optional


Resource Description of Response Object

AlternativeControllerCoveragesResponse
NameDescription Type Required / Optional
ControllerCoverages

Collection of Coverage

Optional

PlanCoverages

Collection of PlanCoverage

Optional

Products

Collection of Product

Optional


Available Response Formats & Sample Data

{
  "ControllerCoverages": [
    {
      "ProductId": 1,
      "MonthId": 3,
      "ControllerId": 4,
      "DrugListTier": {
        "DrugListTierId": 64,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "UnifiedTier": {
        "UnifiedTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "PromotionalTier": {
        "PromotionalTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "Lives": 6,
      "PlanCount": 7
    },
    {
      "ProductId": 1,
      "MonthId": 3,
      "ControllerId": 4,
      "DrugListTier": {
        "DrugListTierId": 64,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "UnifiedTier": {
        "UnifiedTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "PromotionalTier": {
        "PromotionalTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "Lives": 6,
      "PlanCount": 7
    }
  ],
  "PlanCoverages": [
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "ControllerId": 6,
      "NoteId": 1,
      "NotesAvailable": 7,
      "Lives": 8,
      "DrugListTierId": 64,
      "FormularyTierId": 10,
      "FormularyUnifiedTierId": 11,
      "UnifiedTierId": 12,
      "PromotionalTierId": 1,
      "IsGeneric": true,
      "PriorAuthorization": true,
      "StepTherapy": true,
      "QuantityLimit": true,
      "SpecialtyPharmacy": true,
      "ConditionalPriorAuthorization": true,
      "DurableMedicalEquipment": true,
      "MedicalBenefit": true,
      "OverTheCounter": true,
      "Variance": true,
      "StateCarveOut": true,
      "FormularyId": 24
    },
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "ControllerId": 6,
      "NoteId": 1,
      "NotesAvailable": 7,
      "Lives": 8,
      "DrugListTierId": 64,
      "FormularyTierId": 10,
      "FormularyUnifiedTierId": 11,
      "UnifiedTierId": 12,
      "PromotionalTierId": 1,
      "IsGeneric": true,
      "PriorAuthorization": true,
      "StepTherapy": true,
      "QuantityLimit": true,
      "SpecialtyPharmacy": true,
      "ConditionalPriorAuthorization": true,
      "DurableMedicalEquipment": true,
      "MedicalBenefit": true,
      "OverTheCounter": true,
      "Variance": true,
      "StateCarveOut": true,
      "FormularyId": 24
    }
  ],
  "Products": [
    {
      "ProductId": 1,
      "TherapeuticClassId": 2,
      "TherapeuticClass": "sample string 3",
      "Drug": {
        "DrugId": 1,
        "DrugTypeId": 64,
        "Name": "sample string 3",
        "Description": "sample string 4",
        "Brand": "sample string 5",
        "IsGeneric": true,
        "OverTheCounter": true,
        "IsOwner": true,
        "Logo": "sample string 8",
        "ImportantSafetyInformation": "sample string 9",
        "Rank": 64
      },
      "DisplayName": "sample string 4"
    },
    {
      "ProductId": 1,
      "TherapeuticClassId": 2,
      "TherapeuticClass": "sample string 3",
      "Drug": {
        "DrugId": 1,
        "DrugTypeId": 64,
        "Name": "sample string 3",
        "Description": "sample string 4",
        "Brand": "sample string 5",
        "IsGeneric": true,
        "OverTheCounter": true,
        "IsOwner": true,
        "Logo": "sample string 8",
        "ImportantSafetyInformation": "sample string 9",
        "Rank": 64
      },
      "DisplayName": "sample string 4"
    }
  ]
}
<AlternativeControllerCoveragesResponse xmlns:i="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://api.mmitnetwork.com/formulary/coverages">
  <ControllerCoverages>
    <Coverage>
      <ControllerId>4</ControllerId>
      <DrugListTier>
        <DrugListTierId>64</DrugListTierId>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
      </DrugListTier>
      <Lives>6</Lives>
      <MonthId>3</MonthId>
      <PlanCount>7</PlanCount>
      <ProductId>1</ProductId>
      <PromotionalTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <PromotionalTierId>1</PromotionalTierId>
      </PromotionalTier>
      <UnifiedTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <UnifiedTierId>1</UnifiedTierId>
      </UnifiedTier>
    </Coverage>
    <Coverage>
      <ControllerId>4</ControllerId>
      <DrugListTier>
        <DrugListTierId>64</DrugListTierId>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
      </DrugListTier>
      <Lives>6</Lives>
      <MonthId>3</MonthId>
      <PlanCount>7</PlanCount>
      <ProductId>1</ProductId>
      <PromotionalTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <PromotionalTierId>1</PromotionalTierId>
      </PromotionalTier>
      <UnifiedTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <UnifiedTierId>1</UnifiedTierId>
      </UnifiedTier>
    </Coverage>
  </ControllerCoverages>
  <PlanCoverages>
    <PlanCoverage>
      <ChannelId>3</ChannelId>
      <ConditionalPriorAuthorization>true</ConditionalPriorAuthorization>
      <ControllerId>6</ControllerId>
      <DrugListTierId>64</DrugListTierId>
      <DurableMedicalEquipment>true</DurableMedicalEquipment>
      <FormularyId>24</FormularyId>
      <FormularyTierId>10</FormularyTierId>
      <FormularyUnifiedTierId>11</FormularyUnifiedTierId>
      <IsGeneric>true</IsGeneric>
      <Lives>8</Lives>
      <MedicalBenefit>true</MedicalBenefit>
      <MonthId>5</MonthId>
      <NoteId>1</NoteId>
      <NotesAvailable>7</NotesAvailable>
      <OverTheCounter>true</OverTheCounter>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <PriorAuthorization>true</PriorAuthorization>
      <ProductId>4</ProductId>
      <PromotionalTierId>1</PromotionalTierId>
      <QuantityLimit>true</QuantityLimit>
      <SpecialtyPharmacy>true</SpecialtyPharmacy>
      <StateCarveOut>true</StateCarveOut>
      <StepTherapy>true</StepTherapy>
      <UnifiedTierId>12</UnifiedTierId>
      <Variance>true</Variance>
    </PlanCoverage>
    <PlanCoverage>
      <ChannelId>3</ChannelId>
      <ConditionalPriorAuthorization>true</ConditionalPriorAuthorization>
      <ControllerId>6</ControllerId>
      <DrugListTierId>64</DrugListTierId>
      <DurableMedicalEquipment>true</DurableMedicalEquipment>
      <FormularyId>24</FormularyId>
      <FormularyTierId>10</FormularyTierId>
      <FormularyUnifiedTierId>11</FormularyUnifiedTierId>
      <IsGeneric>true</IsGeneric>
      <Lives>8</Lives>
      <MedicalBenefit>true</MedicalBenefit>
      <MonthId>5</MonthId>
      <NoteId>1</NoteId>
      <NotesAvailable>7</NotesAvailable>
      <OverTheCounter>true</OverTheCounter>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <PriorAuthorization>true</PriorAuthorization>
      <ProductId>4</ProductId>
      <PromotionalTierId>1</PromotionalTierId>
      <QuantityLimit>true</QuantityLimit>
      <SpecialtyPharmacy>true</SpecialtyPharmacy>
      <StateCarveOut>true</StateCarveOut>
      <StepTherapy>true</StepTherapy>
      <UnifiedTierId>12</UnifiedTierId>
      <Variance>true</Variance>
    </PlanCoverage>
  </PlanCoverages>
  <Products xmlns:d2p1="http://api.mmitnetwork.com/formulary/products">
    <d2p1:Product>
      <d2p1:DisplayName>sample string 4</d2p1:DisplayName>
      <d2p1:Drug>
        <d2p1:Brand>sample string 5</d2p1:Brand>
        <d2p1:Description>sample string 4</d2p1:Description>
        <d2p1:DrugId>1</d2p1:DrugId>
        <d2p1:DrugTypeId>64</d2p1:DrugTypeId>
        <d2p1:ImportantSafetyInformation>sample string 9</d2p1:ImportantSafetyInformation>
        <d2p1:IsGeneric>true</d2p1:IsGeneric>
        <d2p1:IsOwner>true</d2p1:IsOwner>
        <d2p1:Logo>sample string 8</d2p1:Logo>
        <d2p1:Name>sample string 3</d2p1:Name>
        <d2p1:OverTheCounter>true</d2p1:OverTheCounter>
        <d2p1:Rank>64</d2p1:Rank>
      </d2p1:Drug>
      <d2p1:ProductId>1</d2p1:ProductId>
      <d2p1:TherapeuticClass>sample string 3</d2p1:TherapeuticClass>
      <d2p1:TherapeuticClassId>2</d2p1:TherapeuticClassId>
    </d2p1:Product>
    <d2p1:Product>
      <d2p1:DisplayName>sample string 4</d2p1:DisplayName>
      <d2p1:Drug>
        <d2p1:Brand>sample string 5</d2p1:Brand>
        <d2p1:Description>sample string 4</d2p1:Description>
        <d2p1:DrugId>1</d2p1:DrugId>
        <d2p1:DrugTypeId>64</d2p1:DrugTypeId>
        <d2p1:ImportantSafetyInformation>sample string 9</d2p1:ImportantSafetyInformation>
        <d2p1:IsGeneric>true</d2p1:IsGeneric>
        <d2p1:IsOwner>true</d2p1:IsOwner>
        <d2p1:Logo>sample string 8</d2p1:Logo>
        <d2p1:Name>sample string 3</d2p1:Name>
        <d2p1:OverTheCounter>true</d2p1:OverTheCounter>
        <d2p1:Rank>64</d2p1:Rank>
      </d2p1:Drug>
      <d2p1:ProductId>1</d2p1:ProductId>
      <d2p1:TherapeuticClass>sample string 3</d2p1:TherapeuticClass>
      <d2p1:TherapeuticClassId>2</d2p1:TherapeuticClassId>
    </d2p1:Product>
  </Products>
</AlternativeControllerCoveragesResponse>

Build Request


NameDescription Input Value Type Required / Optional
ProductId

The Id of the Product

integer

Required

ControllerId

The Id of the Controller/Parent

integer

Required

BenefitDesignId

The Id of the BenefitDesign used as a Plan filter the response

integer

Optional

ChannelId

The Id of the Channel used as a Plan filter the response

Collection of integer

Optional

PlanTypeId

The Id of the PlanType used as a Plan filter the response

integer

Optional

StateId

The US State Id where the Plan(s) are covered

string

Optional

CBSAId

The CBSA(Service Area) Id where the Plan is covered

integer

Optional

TerritoryId

The Territory Id where the Plan is covered

integer

Optional

DrugTypeId

The DrugTypeId of the Product to be returned

byte

Optional

Options

Enter "PlanCoverages" to include Plan level coverage in addition to Controller coverage.

Collection of string

Optional

LivesTypeId

The Id to override the types of lives to shown (Default: 4)

integer

Optional





Request URL

GET Formulary/v1/Coverage/Controller/Alternatives?ProductId=ProductId&ControllerId=ControllerId&BenefitDesignId=BenefitDesignId&ChannelId=ChannelId&PlanTypeId=PlanTypeId&StateId=StateId&CBSAId=CBSAId&TerritoryId=TerritoryId&DrugTypeId=DrugTypeId&Options=Options&LivesTypeId=LivesTypeId

Status

Response Details

            
            

Alternative Coverage for a specific MCO and Product


Request Url
GET Formulary/v1/Coverage/MCO/Alternatives


URI Parameters

NameDescription Type Required / Optional
ProductId

The Id of the Product

integer

Required

MCOId

The Id of the MCO

integer

Required

BenefitDesignId

The Id of the BenefitDesign used as a Plan filter the response

integer

Optional

ChannelId

The Id of the Channel used as a Plan filter the response

Collection of integer

Optional

PlanTypeId

The Id of the PlanType used as a Plan filter the response

integer

Optional

StateId

The US State Id where the Plan(s) are covered

string

Optional

CBSAId

The CBSA(Service Area) Id where the Plan is covered

integer

Optional

TerritoryId

The Territory Id where the Plan is covered

integer

Optional

DrugTypeId

The DrugTypeId of the Product to be returned

byte

Optional

Options

Enter "PlanCoverages" to include Plan level coverage in addition to Controller coverage.

Collection of string

Optional

LivesTypeId

The Id to override the types of lives to shown (Default: 4)

integer

Optional


Resource Description of Response Object

AlternativeMcoCoveragesResponse
NameDescription Type Required / Optional
McoCoverages

Collection of McoCoverage

Optional

PlanCoverages

Collection of PlanMcoCoverage

Optional

Products

Collection of Product

Optional


Available Response Formats & Sample Data

{
  "McoCoverages": [
    {
      "ProductId": 1,
      "MonthId": 3,
      "MCOId": 4,
      "MCO": "sample string 5",
      "DrugListTier": {
        "DrugListTierId": 64,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "UnifiedTier": {
        "UnifiedTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "PromotionalTier": {
        "PromotionalTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "Lives": 6,
      "PlanCount": 7
    },
    {
      "ProductId": 1,
      "MonthId": 3,
      "MCOId": 4,
      "MCO": "sample string 5",
      "DrugListTier": {
        "DrugListTierId": 64,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "UnifiedTier": {
        "UnifiedTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "PromotionalTier": {
        "PromotionalTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "Lives": 6,
      "PlanCount": 7
    }
  ],
  "PlanCoverages": [
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "MCOId": 6,
      "MCO": "sample string 7",
      "NoteId": 1,
      "NotesAvailable": 8,
      "Lives": 9,
      "DrugListTierId": 64,
      "FormularyTierId": 11,
      "FormularyUnifiedTierId": 12,
      "UnifiedTierId": 13,
      "PromotionalTierId": 1,
      "IsGeneric": true,
      "PriorAuthorization": true,
      "StepTherapy": true,
      "QuantityLimit": true,
      "SpecialtyPharmacy": true,
      "ConditionalPriorAuthorization": true,
      "DurableMedicalEquipment": true,
      "MedicalBenefit": true,
      "OverTheCounter": true,
      "Variance": true,
      "StateCarveOut": true,
      "FormularyId": 25
    },
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "MCOId": 6,
      "MCO": "sample string 7",
      "NoteId": 1,
      "NotesAvailable": 8,
      "Lives": 9,
      "DrugListTierId": 64,
      "FormularyTierId": 11,
      "FormularyUnifiedTierId": 12,
      "UnifiedTierId": 13,
      "PromotionalTierId": 1,
      "IsGeneric": true,
      "PriorAuthorization": true,
      "StepTherapy": true,
      "QuantityLimit": true,
      "SpecialtyPharmacy": true,
      "ConditionalPriorAuthorization": true,
      "DurableMedicalEquipment": true,
      "MedicalBenefit": true,
      "OverTheCounter": true,
      "Variance": true,
      "StateCarveOut": true,
      "FormularyId": 25
    }
  ],
  "Products": [
    {
      "ProductId": 1,
      "TherapeuticClassId": 2,
      "TherapeuticClass": "sample string 3",
      "Drug": {
        "DrugId": 1,
        "DrugTypeId": 64,
        "Name": "sample string 3",
        "Description": "sample string 4",
        "Brand": "sample string 5",
        "IsGeneric": true,
        "OverTheCounter": true,
        "IsOwner": true,
        "Logo": "sample string 8",
        "ImportantSafetyInformation": "sample string 9",
        "Rank": 64
      },
      "DisplayName": "sample string 4"
    },
    {
      "ProductId": 1,
      "TherapeuticClassId": 2,
      "TherapeuticClass": "sample string 3",
      "Drug": {
        "DrugId": 1,
        "DrugTypeId": 64,
        "Name": "sample string 3",
        "Description": "sample string 4",
        "Brand": "sample string 5",
        "IsGeneric": true,
        "OverTheCounter": true,
        "IsOwner": true,
        "Logo": "sample string 8",
        "ImportantSafetyInformation": "sample string 9",
        "Rank": 64
      },
      "DisplayName": "sample string 4"
    }
  ]
}
<AlternativeMcoCoveragesResponse xmlns:i="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://api.mmitnetwork.com/formulary/coverages">
  <McoCoverages>
    <McoCoverage>
      <DrugListTier>
        <DrugListTierId>64</DrugListTierId>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
      </DrugListTier>
      <Lives>6</Lives>
      <MCO>sample string 5</MCO>
      <MCOId>4</MCOId>
      <MonthId>3</MonthId>
      <PlanCount>7</PlanCount>
      <ProductId>1</ProductId>
      <PromotionalTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <PromotionalTierId>1</PromotionalTierId>
      </PromotionalTier>
      <UnifiedTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <UnifiedTierId>1</UnifiedTierId>
      </UnifiedTier>
    </McoCoverage>
    <McoCoverage>
      <DrugListTier>
        <DrugListTierId>64</DrugListTierId>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
      </DrugListTier>
      <Lives>6</Lives>
      <MCO>sample string 5</MCO>
      <MCOId>4</MCOId>
      <MonthId>3</MonthId>
      <PlanCount>7</PlanCount>
      <ProductId>1</ProductId>
      <PromotionalTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <PromotionalTierId>1</PromotionalTierId>
      </PromotionalTier>
      <UnifiedTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <UnifiedTierId>1</UnifiedTierId>
      </UnifiedTier>
    </McoCoverage>
  </McoCoverages>
  <PlanCoverages>
    <PlanMcoCoverage>
      <ChannelId>3</ChannelId>
      <ConditionalPriorAuthorization>true</ConditionalPriorAuthorization>
      <DrugListTierId>64</DrugListTierId>
      <DurableMedicalEquipment>true</DurableMedicalEquipment>
      <FormularyId>25</FormularyId>
      <FormularyTierId>11</FormularyTierId>
      <FormularyUnifiedTierId>12</FormularyUnifiedTierId>
      <IsGeneric>true</IsGeneric>
      <Lives>9</Lives>
      <MCO>sample string 7</MCO>
      <MCOId>6</MCOId>
      <MedicalBenefit>true</MedicalBenefit>
      <MonthId>5</MonthId>
      <NoteId>1</NoteId>
      <NotesAvailable>8</NotesAvailable>
      <OverTheCounter>true</OverTheCounter>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <PriorAuthorization>true</PriorAuthorization>
      <ProductId>4</ProductId>
      <PromotionalTierId>1</PromotionalTierId>
      <QuantityLimit>true</QuantityLimit>
      <SpecialtyPharmacy>true</SpecialtyPharmacy>
      <StateCarveOut>true</StateCarveOut>
      <StepTherapy>true</StepTherapy>
      <UnifiedTierId>13</UnifiedTierId>
      <Variance>true</Variance>
    </PlanMcoCoverage>
    <PlanMcoCoverage>
      <ChannelId>3</ChannelId>
      <ConditionalPriorAuthorization>true</ConditionalPriorAuthorization>
      <DrugListTierId>64</DrugListTierId>
      <DurableMedicalEquipment>true</DurableMedicalEquipment>
      <FormularyId>25</FormularyId>
      <FormularyTierId>11</FormularyTierId>
      <FormularyUnifiedTierId>12</FormularyUnifiedTierId>
      <IsGeneric>true</IsGeneric>
      <Lives>9</Lives>
      <MCO>sample string 7</MCO>
      <MCOId>6</MCOId>
      <MedicalBenefit>true</MedicalBenefit>
      <MonthId>5</MonthId>
      <NoteId>1</NoteId>
      <NotesAvailable>8</NotesAvailable>
      <OverTheCounter>true</OverTheCounter>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <PriorAuthorization>true</PriorAuthorization>
      <ProductId>4</ProductId>
      <PromotionalTierId>1</PromotionalTierId>
      <QuantityLimit>true</QuantityLimit>
      <SpecialtyPharmacy>true</SpecialtyPharmacy>
      <StateCarveOut>true</StateCarveOut>
      <StepTherapy>true</StepTherapy>
      <UnifiedTierId>13</UnifiedTierId>
      <Variance>true</Variance>
    </PlanMcoCoverage>
  </PlanCoverages>
  <Products xmlns:d2p1="http://api.mmitnetwork.com/formulary/products">
    <d2p1:Product>
      <d2p1:DisplayName>sample string 4</d2p1:DisplayName>
      <d2p1:Drug>
        <d2p1:Brand>sample string 5</d2p1:Brand>
        <d2p1:Description>sample string 4</d2p1:Description>
        <d2p1:DrugId>1</d2p1:DrugId>
        <d2p1:DrugTypeId>64</d2p1:DrugTypeId>
        <d2p1:ImportantSafetyInformation>sample string 9</d2p1:ImportantSafetyInformation>
        <d2p1:IsGeneric>true</d2p1:IsGeneric>
        <d2p1:IsOwner>true</d2p1:IsOwner>
        <d2p1:Logo>sample string 8</d2p1:Logo>
        <d2p1:Name>sample string 3</d2p1:Name>
        <d2p1:OverTheCounter>true</d2p1:OverTheCounter>
        <d2p1:Rank>64</d2p1:Rank>
      </d2p1:Drug>
      <d2p1:ProductId>1</d2p1:ProductId>
      <d2p1:TherapeuticClass>sample string 3</d2p1:TherapeuticClass>
      <d2p1:TherapeuticClassId>2</d2p1:TherapeuticClassId>
    </d2p1:Product>
    <d2p1:Product>
      <d2p1:DisplayName>sample string 4</d2p1:DisplayName>
      <d2p1:Drug>
        <d2p1:Brand>sample string 5</d2p1:Brand>
        <d2p1:Description>sample string 4</d2p1:Description>
        <d2p1:DrugId>1</d2p1:DrugId>
        <d2p1:DrugTypeId>64</d2p1:DrugTypeId>
        <d2p1:ImportantSafetyInformation>sample string 9</d2p1:ImportantSafetyInformation>
        <d2p1:IsGeneric>true</d2p1:IsGeneric>
        <d2p1:IsOwner>true</d2p1:IsOwner>
        <d2p1:Logo>sample string 8</d2p1:Logo>
        <d2p1:Name>sample string 3</d2p1:Name>
        <d2p1:OverTheCounter>true</d2p1:OverTheCounter>
        <d2p1:Rank>64</d2p1:Rank>
      </d2p1:Drug>
      <d2p1:ProductId>1</d2p1:ProductId>
      <d2p1:TherapeuticClass>sample string 3</d2p1:TherapeuticClass>
      <d2p1:TherapeuticClassId>2</d2p1:TherapeuticClassId>
    </d2p1:Product>
  </Products>
</AlternativeMcoCoveragesResponse>

Build Request


NameDescription Input Value Type Required / Optional
ProductId

The Id of the Product

integer

Required

MCOId

The Id of the MCO

integer

Required

BenefitDesignId

The Id of the BenefitDesign used as a Plan filter the response

integer

Optional

ChannelId

The Id of the Channel used as a Plan filter the response

Collection of integer

Optional

PlanTypeId

The Id of the PlanType used as a Plan filter the response

integer

Optional

StateId

The US State Id where the Plan(s) are covered

string

Optional

CBSAId

The CBSA(Service Area) Id where the Plan is covered

integer

Optional

TerritoryId

The Territory Id where the Plan is covered

integer

Optional

DrugTypeId

The DrugTypeId of the Product to be returned

byte

Optional

Options

Enter "PlanCoverages" to include Plan level coverage in addition to Controller coverage.

Collection of string

Optional

LivesTypeId

The Id to override the types of lives to shown (Default: 4)

integer

Optional





Request URL

GET Formulary/v1/Coverage/MCO/Alternatives?ProductId=ProductId&MCOId=MCOId&BenefitDesignId=BenefitDesignId&ChannelId=ChannelId&PlanTypeId=PlanTypeId&StateId=StateId&CBSAId=CBSAId&TerritoryId=TerritoryId&DrugTypeId=DrugTypeId&Options=Options&LivesTypeId=LivesTypeId

Status

Response Details

            
            

Coverage by Product


Request Url
GET Formulary/v1/Coverage


URI Parameters

NameDescription Type Required / Optional
ProductId

The Id of the Product

integer

Required

BenefitDesignId

The Id of the BenefitDesign used as a Plan filter the response

integer

Optional

ChannelId

The Id of the Channel used as a Plan filter the response

Collection of integer

Optional

PlanTypeId

The Id of the PlanType used as a Plan filter the response

integer

Optional

StateId

The US State Id where the Plan(s) are covered

string

Optional

CBSAId

The CBSA(Service Area) Id where the Plan is covered

integer

Optional

TerritoryId

The Territory Id where the Plan is covered

integer

Optional

Options

Enter "PlanCoverages" to include Plan level coverage in addition to Controller coverage. Enter "SummaryCoverages" to include a summary of all statuses in addition to Controller coverage.

Collection of string

Optional

LivesTypeId

The Id to override the types of lives to shown (Default: 4)

integer

Optional

SummaryUseFormTrakControllerExclusions

Set to true to exclude FormTrak excluded controllers (Default: false)

boolean

Default value is False


Resource Description of Response Object

ControllerCoveragesResponse
NameDescription Type Required / Optional
ControllerCoverages

Collection of Coverage

Optional

PlanCoverages

Collection of PlanCoverage

Optional

SummaryCoverages

Collection of UnifiedTierCoverage

Optional

Statement

string

Optional


Available Response Formats & Sample Data

{
  "ControllerCoverages": [
    {
      "ProductId": 1,
      "MonthId": 3,
      "ControllerId": 4,
      "DrugListTier": {
        "DrugListTierId": 64,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "UnifiedTier": {
        "UnifiedTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "PromotionalTier": {
        "PromotionalTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "Lives": 6,
      "PlanCount": 7
    },
    {
      "ProductId": 1,
      "MonthId": 3,
      "ControllerId": 4,
      "DrugListTier": {
        "DrugListTierId": 64,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "UnifiedTier": {
        "UnifiedTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "PromotionalTier": {
        "PromotionalTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "Lives": 6,
      "PlanCount": 7
    }
  ],
  "PlanCoverages": [
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "ControllerId": 6,
      "NoteId": 1,
      "NotesAvailable": 7,
      "Lives": 8,
      "DrugListTierId": 64,
      "FormularyTierId": 10,
      "FormularyUnifiedTierId": 11,
      "UnifiedTierId": 12,
      "PromotionalTierId": 1,
      "IsGeneric": true,
      "PriorAuthorization": true,
      "StepTherapy": true,
      "QuantityLimit": true,
      "SpecialtyPharmacy": true,
      "ConditionalPriorAuthorization": true,
      "DurableMedicalEquipment": true,
      "MedicalBenefit": true,
      "OverTheCounter": true,
      "Variance": true,
      "StateCarveOut": true,
      "FormularyId": 24
    },
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "ControllerId": 6,
      "NoteId": 1,
      "NotesAvailable": 7,
      "Lives": 8,
      "DrugListTierId": 64,
      "FormularyTierId": 10,
      "FormularyUnifiedTierId": 11,
      "UnifiedTierId": 12,
      "PromotionalTierId": 1,
      "IsGeneric": true,
      "PriorAuthorization": true,
      "StepTherapy": true,
      "QuantityLimit": true,
      "SpecialtyPharmacy": true,
      "ConditionalPriorAuthorization": true,
      "DurableMedicalEquipment": true,
      "MedicalBenefit": true,
      "OverTheCounter": true,
      "Variance": true,
      "StateCarveOut": true,
      "FormularyId": 24
    }
  ],
  "SummaryCoverages": [
    {
      "UnifiedTierId": 1,
      "Percentage": 2,
      "Lives": 3,
      "PlanCount": 4
    },
    {
      "UnifiedTierId": 1,
      "Percentage": 2,
      "Lives": 3,
      "PlanCount": 4
    }
  ],
  "Statement": "sample string 1"
}
<ControllerCoveragesResponse xmlns:i="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://api.mmitnetwork.com/formulary/coverages">
  <ControllerCoverages>
    <Coverage>
      <ControllerId>4</ControllerId>
      <DrugListTier>
        <DrugListTierId>64</DrugListTierId>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
      </DrugListTier>
      <Lives>6</Lives>
      <MonthId>3</MonthId>
      <PlanCount>7</PlanCount>
      <ProductId>1</ProductId>
      <PromotionalTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <PromotionalTierId>1</PromotionalTierId>
      </PromotionalTier>
      <UnifiedTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <UnifiedTierId>1</UnifiedTierId>
      </UnifiedTier>
    </Coverage>
    <Coverage>
      <ControllerId>4</ControllerId>
      <DrugListTier>
        <DrugListTierId>64</DrugListTierId>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
      </DrugListTier>
      <Lives>6</Lives>
      <MonthId>3</MonthId>
      <PlanCount>7</PlanCount>
      <ProductId>1</ProductId>
      <PromotionalTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <PromotionalTierId>1</PromotionalTierId>
      </PromotionalTier>
      <UnifiedTier>
        <Lives>3</Lives>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
        <UnifiedTierId>1</UnifiedTierId>
      </UnifiedTier>
    </Coverage>
  </ControllerCoverages>
  <PlanCoverages>
    <PlanCoverage>
      <ChannelId>3</ChannelId>
      <ConditionalPriorAuthorization>true</ConditionalPriorAuthorization>
      <ControllerId>6</ControllerId>
      <DrugListTierId>64</DrugListTierId>
      <DurableMedicalEquipment>true</DurableMedicalEquipment>
      <FormularyId>24</FormularyId>
      <FormularyTierId>10</FormularyTierId>
      <FormularyUnifiedTierId>11</FormularyUnifiedTierId>
      <IsGeneric>true</IsGeneric>
      <Lives>8</Lives>
      <MedicalBenefit>true</MedicalBenefit>
      <MonthId>5</MonthId>
      <NoteId>1</NoteId>
      <NotesAvailable>7</NotesAvailable>
      <OverTheCounter>true</OverTheCounter>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <PriorAuthorization>true</PriorAuthorization>
      <ProductId>4</ProductId>
      <PromotionalTierId>1</PromotionalTierId>
      <QuantityLimit>true</QuantityLimit>
      <SpecialtyPharmacy>true</SpecialtyPharmacy>
      <StateCarveOut>true</StateCarveOut>
      <StepTherapy>true</StepTherapy>
      <UnifiedTierId>12</UnifiedTierId>
      <Variance>true</Variance>
    </PlanCoverage>
    <PlanCoverage>
      <ChannelId>3</ChannelId>
      <ConditionalPriorAuthorization>true</ConditionalPriorAuthorization>
      <ControllerId>6</ControllerId>
      <DrugListTierId>64</DrugListTierId>
      <DurableMedicalEquipment>true</DurableMedicalEquipment>
      <FormularyId>24</FormularyId>
      <FormularyTierId>10</FormularyTierId>
      <FormularyUnifiedTierId>11</FormularyUnifiedTierId>
      <IsGeneric>true</IsGeneric>
      <Lives>8</Lives>
      <MedicalBenefit>true</MedicalBenefit>
      <MonthId>5</MonthId>
      <NoteId>1</NoteId>
      <NotesAvailable>7</NotesAvailable>
      <OverTheCounter>true</OverTheCounter>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <PriorAuthorization>true</PriorAuthorization>
      <ProductId>4</ProductId>
      <PromotionalTierId>1</PromotionalTierId>
      <QuantityLimit>true</QuantityLimit>
      <SpecialtyPharmacy>true</SpecialtyPharmacy>
      <StateCarveOut>true</StateCarveOut>
      <StepTherapy>true</StepTherapy>
      <UnifiedTierId>12</UnifiedTierId>
      <Variance>true</Variance>
    </PlanCoverage>
  </PlanCoverages>
  <Statement>sample string 1</Statement>
  <SummaryCoverages>
    <UnifiedTierCoverage>
      <Lives>3</Lives>
      <Percentage>2</Percentage>
      <PlanCount>4</PlanCount>
      <UnifiedTierId>1</UnifiedTierId>
    </UnifiedTierCoverage>
    <UnifiedTierCoverage>
      <Lives>3</Lives>
      <Percentage>2</Percentage>
      <PlanCount>4</PlanCount>
      <UnifiedTierId>1</UnifiedTierId>
    </UnifiedTierCoverage>
  </SummaryCoverages>
</ControllerCoveragesResponse>

Build Request


NameDescription Input Value Type Required / Optional
ProductId

The Id of the Product

integer

Required

BenefitDesignId

The Id of the BenefitDesign used as a Plan filter the response

integer

Optional

ChannelId

The Id of the Channel used as a Plan filter the response

Collection of integer

Optional

PlanTypeId

The Id of the PlanType used as a Plan filter the response

integer

Optional

StateId

The US State Id where the Plan(s) are covered

string

Optional

CBSAId

The CBSA(Service Area) Id where the Plan is covered

integer

Optional

TerritoryId

The Territory Id where the Plan is covered

integer

Optional

Options

Enter "PlanCoverages" to include Plan level coverage in addition to Controller coverage. Enter "SummaryCoverages" to include a summary of all statuses in addition to Controller coverage.

Collection of string

Optional

LivesTypeId

The Id to override the types of lives to shown (Default: 4)

integer

Optional

SummaryUseFormTrakControllerExclusions

Set to true to exclude FormTrak excluded controllers (Default: false)

boolean

Default value is False





Request URL

GET Formulary/v1/Coverage?ProductId=ProductId&BenefitDesignId=BenefitDesignId&ChannelId=ChannelId&PlanTypeId=PlanTypeId&StateId=StateId&CBSAId=CBSAId&TerritoryId=TerritoryId&Options=Options&LivesTypeId=LivesTypeId&SummaryUseFormTrakControllerExclusions=SummaryUseFormTrakControllerExclusions

Status

Response Details