Coverage

The Coverage resource allows the retrieval of Medical 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 by Product

Coverage for a specific Plan and Product

Coverage for a specific Controller and Product

Coverage for a specific MCO and Product


Coverage by Product


Request Url
GET Medical/v1/Coverage


URI Parameters

NameDescription Type Required / Optional
ProductId

The Id of the Product

integer

Required

IndicationId

The Id of the Indication

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: 1)

integer

Optional

SummaryUseFormTrakControllerExclusions

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

boolean

Default value is False


Resource Description of Response Object

MedicalCoverageResponse
NameDescription Type Required / Optional
ControllerCoverages

Collection of MedicalCoverage

Optional

PlanCoverages

Collection of MedicalPlanCoverage

Optional

SummaryCoverages

Collection of MedicalUnifiedTierCoverageModel

Optional


Available Response Formats & Sample Data

{
  "ControllerCoverages": [
    {
      "ProductId": 1,
      "Product": "sample string 2",
      "MonthId": 3,
      "ControllerId": 4,
      "Controller": "sample string 5",
      "IndicationId": 6,
      "MedicalUnifiedTier": {
        "MedicalUnifiedTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "Lives": 7,
      "PlanCount": 8
    },
    {
      "ProductId": 1,
      "Product": "sample string 2",
      "MonthId": 3,
      "ControllerId": 4,
      "Controller": "sample string 5",
      "IndicationId": 6,
      "MedicalUnifiedTier": {
        "MedicalUnifiedTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "Lives": 7,
      "PlanCount": 8
    }
  ],
  "PlanCoverages": [
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "ControllerId": 6,
      "IndicationId": 7,
      "PANoteId": 1,
      "STNoteId": 1,
      "Lives": 8,
      "IsCovered": true,
      "PA": true,
      "ST": true,
      "MedicalUnifiedTierId": 9,
      "BuyAndBillType": "sample string 10",
      "MedicalPolicy": true,
      "Specialty": true,
      "SpecialtyPharmacyNoteId": 1,
      "FormularyId": 11,
      "MedicalGroupId": 12
    },
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "ControllerId": 6,
      "IndicationId": 7,
      "PANoteId": 1,
      "STNoteId": 1,
      "Lives": 8,
      "IsCovered": true,
      "PA": true,
      "ST": true,
      "MedicalUnifiedTierId": 9,
      "BuyAndBillType": "sample string 10",
      "MedicalPolicy": true,
      "Specialty": true,
      "SpecialtyPharmacyNoteId": 1,
      "FormularyId": 11,
      "MedicalGroupId": 12
    }
  ],
  "SummaryCoverages": [
    {
      "MedicalUnifiedTierId": 1,
      "Percentage": 2,
      "Lives": 3,
      "PlanCount": 4
    },
    {
      "MedicalUnifiedTierId": 1,
      "Percentage": 2,
      "Lives": 3,
      "PlanCount": 4
    }
  ]
}
<CoveragesResponseModel xmlns:i="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://api.mmitnetwork.com/medical/coverages">
  <ControllerCoverages>
    <CoverageModel>
      <Controller>sample string 5</Controller>
      <ControllerId>4</ControllerId>
      <IndicationId>6</IndicationId>
      <Lives>7</Lives>
      <MedicalUnifiedTier>
        <Lives>3</Lives>
        <MedicalUnifiedTierId>1</MedicalUnifiedTierId>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
      </MedicalUnifiedTier>
      <MonthId>3</MonthId>
      <PlanCount>8</PlanCount>
      <Product>sample string 2</Product>
      <ProductId>1</ProductId>
    </CoverageModel>
    <CoverageModel>
      <Controller>sample string 5</Controller>
      <ControllerId>4</ControllerId>
      <IndicationId>6</IndicationId>
      <Lives>7</Lives>
      <MedicalUnifiedTier>
        <Lives>3</Lives>
        <MedicalUnifiedTierId>1</MedicalUnifiedTierId>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
      </MedicalUnifiedTier>
      <MonthId>3</MonthId>
      <PlanCount>8</PlanCount>
      <Product>sample string 2</Product>
      <ProductId>1</ProductId>
    </CoverageModel>
  </ControllerCoverages>
  <PlanCoverages>
    <PlanCoverageModel>
      <BuyAndBillType>sample string 10</BuyAndBillType>
      <ChannelId>3</ChannelId>
      <ControllerId>6</ControllerId>
      <FormularyId>11</FormularyId>
      <IndicationId>7</IndicationId>
      <IsCovered>true</IsCovered>
      <Lives>8</Lives>
      <MedicalGroupId>12</MedicalGroupId>
      <MedicalPolicy>true</MedicalPolicy>
      <MedicalUnifiedTierId>9</MedicalUnifiedTierId>
      <MonthId>5</MonthId>
      <PA>true</PA>
      <PANoteId>1</PANoteId>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <ProductId>4</ProductId>
      <ST>true</ST>
      <STNoteId>1</STNoteId>
      <Specialty>true</Specialty>
      <SpecialtyPharmacyNoteId>1</SpecialtyPharmacyNoteId>
    </PlanCoverageModel>
    <PlanCoverageModel>
      <BuyAndBillType>sample string 10</BuyAndBillType>
      <ChannelId>3</ChannelId>
      <ControllerId>6</ControllerId>
      <FormularyId>11</FormularyId>
      <IndicationId>7</IndicationId>
      <IsCovered>true</IsCovered>
      <Lives>8</Lives>
      <MedicalGroupId>12</MedicalGroupId>
      <MedicalPolicy>true</MedicalPolicy>
      <MedicalUnifiedTierId>9</MedicalUnifiedTierId>
      <MonthId>5</MonthId>
      <PA>true</PA>
      <PANoteId>1</PANoteId>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <ProductId>4</ProductId>
      <ST>true</ST>
      <STNoteId>1</STNoteId>
      <Specialty>true</Specialty>
      <SpecialtyPharmacyNoteId>1</SpecialtyPharmacyNoteId>
    </PlanCoverageModel>
  </PlanCoverages>
  <SummaryCoverages>
    <MedicalUnifiedTierCoverageModel>
      <Lives>3</Lives>
      <MedicalUnifiedTierId>1</MedicalUnifiedTierId>
      <Percentage>2</Percentage>
      <PlanCount>4</PlanCount>
    </MedicalUnifiedTierCoverageModel>
    <MedicalUnifiedTierCoverageModel>
      <Lives>3</Lives>
      <MedicalUnifiedTierId>1</MedicalUnifiedTierId>
      <Percentage>2</Percentage>
      <PlanCount>4</PlanCount>
    </MedicalUnifiedTierCoverageModel>
  </SummaryCoverages>
</CoveragesResponseModel>

Build Request


NameDescription Input Value Type Required / Optional
ProductId

The Id of the Product

integer

Required

IndicationId

The Id of the Indication

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: 1)

integer

Optional

SummaryUseFormTrakControllerExclusions

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

boolean

Default value is False





Request URL

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

Status

Response Details

            
            

Coverage for a specific Plan and Product


Request Url
GET Medical/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

IndicationId

The Id of the Indication

integer

Required

LivesTypeId

The Id to override the types of lives to shown (Default: 1)

integer

Optional


Resource Description of Response Object

MedicalPlanCoverageResponse
NameDescription Type Required / Optional
PlanCoverages

Collection of MedicalPlanCoverage

Optional


Available Response Formats & Sample Data

{
  "PlanCoverages": [
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "ControllerId": 6,
      "IndicationId": 7,
      "PANoteId": 1,
      "STNoteId": 1,
      "Lives": 8,
      "IsCovered": true,
      "PA": true,
      "ST": true,
      "MedicalUnifiedTierId": 9,
      "BuyAndBillType": "sample string 10",
      "MedicalPolicy": true,
      "Specialty": true,
      "SpecialtyPharmacyNoteId": 1,
      "FormularyId": 11,
      "MedicalGroupId": 12
    },
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "ControllerId": 6,
      "IndicationId": 7,
      "PANoteId": 1,
      "STNoteId": 1,
      "Lives": 8,
      "IsCovered": true,
      "PA": true,
      "ST": true,
      "MedicalUnifiedTierId": 9,
      "BuyAndBillType": "sample string 10",
      "MedicalPolicy": true,
      "Specialty": true,
      "SpecialtyPharmacyNoteId": 1,
      "FormularyId": 11,
      "MedicalGroupId": 12
    }
  ]
}
<PlanCoveragesResponseModel xmlns:i="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://api.mmitnetwork.com/medical/coverages">
  <PlanCoverages>
    <PlanCoverageModel>
      <BuyAndBillType>sample string 10</BuyAndBillType>
      <ChannelId>3</ChannelId>
      <ControllerId>6</ControllerId>
      <FormularyId>11</FormularyId>
      <IndicationId>7</IndicationId>
      <IsCovered>true</IsCovered>
      <Lives>8</Lives>
      <MedicalGroupId>12</MedicalGroupId>
      <MedicalPolicy>true</MedicalPolicy>
      <MedicalUnifiedTierId>9</MedicalUnifiedTierId>
      <MonthId>5</MonthId>
      <PA>true</PA>
      <PANoteId>1</PANoteId>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <ProductId>4</ProductId>
      <ST>true</ST>
      <STNoteId>1</STNoteId>
      <Specialty>true</Specialty>
      <SpecialtyPharmacyNoteId>1</SpecialtyPharmacyNoteId>
    </PlanCoverageModel>
    <PlanCoverageModel>
      <BuyAndBillType>sample string 10</BuyAndBillType>
      <ChannelId>3</ChannelId>
      <ControllerId>6</ControllerId>
      <FormularyId>11</FormularyId>
      <IndicationId>7</IndicationId>
      <IsCovered>true</IsCovered>
      <Lives>8</Lives>
      <MedicalGroupId>12</MedicalGroupId>
      <MedicalPolicy>true</MedicalPolicy>
      <MedicalUnifiedTierId>9</MedicalUnifiedTierId>
      <MonthId>5</MonthId>
      <PA>true</PA>
      <PANoteId>1</PANoteId>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <ProductId>4</ProductId>
      <ST>true</ST>
      <STNoteId>1</STNoteId>
      <Specialty>true</Specialty>
      <SpecialtyPharmacyNoteId>1</SpecialtyPharmacyNoteId>
    </PlanCoverageModel>
  </PlanCoverages>
</PlanCoveragesResponseModel>

Build Request


NameDescription Input Value Type Required / Optional
ProductId

The Id of the Product

integer

Required

PlanId

The Id of the Plan

integer

Required

IndicationId

The Id of the Indication

integer

Required

LivesTypeId

The Id to override the types of lives to shown (Default: 1)

integer

Optional





Request URL

GET Medical/v1/Coverage/Plan?ProductId=ProductId&PlanId=PlanId&IndicationId=IndicationId&LivesTypeId=LivesTypeId

Status

Response Details

            
            

Coverage for a specific Controller and Product


Request Url
GET Medical/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

IndicationId

The Id of the Indication

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. 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: 1)

integer

Optional

SummaryUseFormTrakControllerExclusions

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

boolean

Default value is False


Resource Description of Response Object

MedicalCoverageResponse
NameDescription Type Required / Optional
ControllerCoverages

Collection of MedicalCoverage

Optional

PlanCoverages

Collection of MedicalPlanCoverage

Optional

SummaryCoverages

Collection of MedicalUnifiedTierCoverageModel

Optional


Available Response Formats & Sample Data

{
  "ControllerCoverages": [
    {
      "ProductId": 1,
      "Product": "sample string 2",
      "MonthId": 3,
      "ControllerId": 4,
      "Controller": "sample string 5",
      "IndicationId": 6,
      "MedicalUnifiedTier": {
        "MedicalUnifiedTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "Lives": 7,
      "PlanCount": 8
    },
    {
      "ProductId": 1,
      "Product": "sample string 2",
      "MonthId": 3,
      "ControllerId": 4,
      "Controller": "sample string 5",
      "IndicationId": 6,
      "MedicalUnifiedTier": {
        "MedicalUnifiedTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "Lives": 7,
      "PlanCount": 8
    }
  ],
  "PlanCoverages": [
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "ControllerId": 6,
      "IndicationId": 7,
      "PANoteId": 1,
      "STNoteId": 1,
      "Lives": 8,
      "IsCovered": true,
      "PA": true,
      "ST": true,
      "MedicalUnifiedTierId": 9,
      "BuyAndBillType": "sample string 10",
      "MedicalPolicy": true,
      "Specialty": true,
      "SpecialtyPharmacyNoteId": 1,
      "FormularyId": 11,
      "MedicalGroupId": 12
    },
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "ControllerId": 6,
      "IndicationId": 7,
      "PANoteId": 1,
      "STNoteId": 1,
      "Lives": 8,
      "IsCovered": true,
      "PA": true,
      "ST": true,
      "MedicalUnifiedTierId": 9,
      "BuyAndBillType": "sample string 10",
      "MedicalPolicy": true,
      "Specialty": true,
      "SpecialtyPharmacyNoteId": 1,
      "FormularyId": 11,
      "MedicalGroupId": 12
    }
  ],
  "SummaryCoverages": [
    {
      "MedicalUnifiedTierId": 1,
      "Percentage": 2,
      "Lives": 3,
      "PlanCount": 4
    },
    {
      "MedicalUnifiedTierId": 1,
      "Percentage": 2,
      "Lives": 3,
      "PlanCount": 4
    }
  ]
}
<CoveragesResponseModel xmlns:i="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://api.mmitnetwork.com/medical/coverages">
  <ControllerCoverages>
    <CoverageModel>
      <Controller>sample string 5</Controller>
      <ControllerId>4</ControllerId>
      <IndicationId>6</IndicationId>
      <Lives>7</Lives>
      <MedicalUnifiedTier>
        <Lives>3</Lives>
        <MedicalUnifiedTierId>1</MedicalUnifiedTierId>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
      </MedicalUnifiedTier>
      <MonthId>3</MonthId>
      <PlanCount>8</PlanCount>
      <Product>sample string 2</Product>
      <ProductId>1</ProductId>
    </CoverageModel>
    <CoverageModel>
      <Controller>sample string 5</Controller>
      <ControllerId>4</ControllerId>
      <IndicationId>6</IndicationId>
      <Lives>7</Lives>
      <MedicalUnifiedTier>
        <Lives>3</Lives>
        <MedicalUnifiedTierId>1</MedicalUnifiedTierId>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
      </MedicalUnifiedTier>
      <MonthId>3</MonthId>
      <PlanCount>8</PlanCount>
      <Product>sample string 2</Product>
      <ProductId>1</ProductId>
    </CoverageModel>
  </ControllerCoverages>
  <PlanCoverages>
    <PlanCoverageModel>
      <BuyAndBillType>sample string 10</BuyAndBillType>
      <ChannelId>3</ChannelId>
      <ControllerId>6</ControllerId>
      <FormularyId>11</FormularyId>
      <IndicationId>7</IndicationId>
      <IsCovered>true</IsCovered>
      <Lives>8</Lives>
      <MedicalGroupId>12</MedicalGroupId>
      <MedicalPolicy>true</MedicalPolicy>
      <MedicalUnifiedTierId>9</MedicalUnifiedTierId>
      <MonthId>5</MonthId>
      <PA>true</PA>
      <PANoteId>1</PANoteId>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <ProductId>4</ProductId>
      <ST>true</ST>
      <STNoteId>1</STNoteId>
      <Specialty>true</Specialty>
      <SpecialtyPharmacyNoteId>1</SpecialtyPharmacyNoteId>
    </PlanCoverageModel>
    <PlanCoverageModel>
      <BuyAndBillType>sample string 10</BuyAndBillType>
      <ChannelId>3</ChannelId>
      <ControllerId>6</ControllerId>
      <FormularyId>11</FormularyId>
      <IndicationId>7</IndicationId>
      <IsCovered>true</IsCovered>
      <Lives>8</Lives>
      <MedicalGroupId>12</MedicalGroupId>
      <MedicalPolicy>true</MedicalPolicy>
      <MedicalUnifiedTierId>9</MedicalUnifiedTierId>
      <MonthId>5</MonthId>
      <PA>true</PA>
      <PANoteId>1</PANoteId>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <ProductId>4</ProductId>
      <ST>true</ST>
      <STNoteId>1</STNoteId>
      <Specialty>true</Specialty>
      <SpecialtyPharmacyNoteId>1</SpecialtyPharmacyNoteId>
    </PlanCoverageModel>
  </PlanCoverages>
  <SummaryCoverages>
    <MedicalUnifiedTierCoverageModel>
      <Lives>3</Lives>
      <MedicalUnifiedTierId>1</MedicalUnifiedTierId>
      <Percentage>2</Percentage>
      <PlanCount>4</PlanCount>
    </MedicalUnifiedTierCoverageModel>
    <MedicalUnifiedTierCoverageModel>
      <Lives>3</Lives>
      <MedicalUnifiedTierId>1</MedicalUnifiedTierId>
      <Percentage>2</Percentage>
      <PlanCount>4</PlanCount>
    </MedicalUnifiedTierCoverageModel>
  </SummaryCoverages>
</CoveragesResponseModel>

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

IndicationId

The Id of the Indication

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. 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: 1)

integer

Optional

SummaryUseFormTrakControllerExclusions

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

boolean

Default value is False





Request URL

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

Status

Response Details

            
            

Coverage for a specific MCO and Product


Request Url
GET Medical/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

IndicationId

The Id of the Indication

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: 1)

integer

Optional

SummaryUseFormTrakControllerExclusions

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

boolean

Default value is False


Resource Description of Response Object

MedicalMcoCoverageResponse
NameDescription Type Required / Optional
McoCoverages

Collection of MedicalMcoCoverage

Optional

PlanMcoCoverages

Collection of MedicalPlanMcoCoverage

Optional

SummaryCoverages

Collection of MedicalUnifiedTierCoverageModel

Optional


Available Response Formats & Sample Data

{
  "McoCoverages": [
    {
      "ProductId": 1,
      "Product": "sample string 2",
      "MonthId": 3,
      "McoId": 4,
      "MCO": "sample string 5",
      "IndicationId": 6,
      "MedicalUnifiedTier": {
        "MedicalUnifiedTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "Lives": 7,
      "PlanCount": 8
    },
    {
      "ProductId": 1,
      "Product": "sample string 2",
      "MonthId": 3,
      "McoId": 4,
      "MCO": "sample string 5",
      "IndicationId": 6,
      "MedicalUnifiedTier": {
        "MedicalUnifiedTierId": 1,
        "Percentage": 2,
        "Lives": 3,
        "PlanCount": 4
      },
      "Lives": 7,
      "PlanCount": 8
    }
  ],
  "PlanMcoCoverages": [
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "McoId": 6,
      "Mco": "sample string 7",
      "IndicationId": 8,
      "PANoteId": 1,
      "STNoteId": 1,
      "Lives": 9,
      "IsCovered": true,
      "PA": true,
      "ST": true,
      "MedicalUnifiedTierId": 10,
      "BuyAndBillType": "sample string 11",
      "MedicalPolicy": true,
      "Specialty": true,
      "SpecialtyPharmacyNoteId": 1,
      "FormularyId": 12,
      "MedicalGroupId": 13
    },
    {
      "PlanId": 1,
      "PlanTypeId": 64,
      "ChannelId": 3,
      "ProductId": 4,
      "MonthId": 5,
      "McoId": 6,
      "Mco": "sample string 7",
      "IndicationId": 8,
      "PANoteId": 1,
      "STNoteId": 1,
      "Lives": 9,
      "IsCovered": true,
      "PA": true,
      "ST": true,
      "MedicalUnifiedTierId": 10,
      "BuyAndBillType": "sample string 11",
      "MedicalPolicy": true,
      "Specialty": true,
      "SpecialtyPharmacyNoteId": 1,
      "FormularyId": 12,
      "MedicalGroupId": 13
    }
  ],
  "SummaryCoverages": [
    {
      "MedicalUnifiedTierId": 1,
      "Percentage": 2,
      "Lives": 3,
      "PlanCount": 4
    },
    {
      "MedicalUnifiedTierId": 1,
      "Percentage": 2,
      "Lives": 3,
      "PlanCount": 4
    }
  ]
}
<McoCoveragesResponseModel xmlns:i="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://api.mmitnetwork.com/medical/coverages">
  <McoCoverages>
    <McoCoverageModel>
      <IndicationId>6</IndicationId>
      <Lives>7</Lives>
      <MCO>sample string 5</MCO>
      <McoId>4</McoId>
      <MedicalUnifiedTier>
        <Lives>3</Lives>
        <MedicalUnifiedTierId>1</MedicalUnifiedTierId>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
      </MedicalUnifiedTier>
      <MonthId>3</MonthId>
      <PlanCount>8</PlanCount>
      <Product>sample string 2</Product>
      <ProductId>1</ProductId>
    </McoCoverageModel>
    <McoCoverageModel>
      <IndicationId>6</IndicationId>
      <Lives>7</Lives>
      <MCO>sample string 5</MCO>
      <McoId>4</McoId>
      <MedicalUnifiedTier>
        <Lives>3</Lives>
        <MedicalUnifiedTierId>1</MedicalUnifiedTierId>
        <Percentage>2</Percentage>
        <PlanCount>4</PlanCount>
      </MedicalUnifiedTier>
      <MonthId>3</MonthId>
      <PlanCount>8</PlanCount>
      <Product>sample string 2</Product>
      <ProductId>1</ProductId>
    </McoCoverageModel>
  </McoCoverages>
  <PlanMcoCoverages>
    <PlanMcoCoverageModel>
      <BuyAndBillType>sample string 11</BuyAndBillType>
      <ChannelId>3</ChannelId>
      <FormularyId>12</FormularyId>
      <IndicationId>8</IndicationId>
      <IsCovered>true</IsCovered>
      <Lives>9</Lives>
      <Mco>sample string 7</Mco>
      <McoId>6</McoId>
      <MedicalGroupId>13</MedicalGroupId>
      <MedicalPolicy>true</MedicalPolicy>
      <MedicalUnifiedTierId>10</MedicalUnifiedTierId>
      <MonthId>5</MonthId>
      <PA>true</PA>
      <PANoteId>1</PANoteId>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <ProductId>4</ProductId>
      <ST>true</ST>
      <STNoteId>1</STNoteId>
      <Specialty>true</Specialty>
      <SpecialtyPharmacyNoteId>1</SpecialtyPharmacyNoteId>
    </PlanMcoCoverageModel>
    <PlanMcoCoverageModel>
      <BuyAndBillType>sample string 11</BuyAndBillType>
      <ChannelId>3</ChannelId>
      <FormularyId>12</FormularyId>
      <IndicationId>8</IndicationId>
      <IsCovered>true</IsCovered>
      <Lives>9</Lives>
      <Mco>sample string 7</Mco>
      <McoId>6</McoId>
      <MedicalGroupId>13</MedicalGroupId>
      <MedicalPolicy>true</MedicalPolicy>
      <MedicalUnifiedTierId>10</MedicalUnifiedTierId>
      <MonthId>5</MonthId>
      <PA>true</PA>
      <PANoteId>1</PANoteId>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
      <ProductId>4</ProductId>
      <ST>true</ST>
      <STNoteId>1</STNoteId>
      <Specialty>true</Specialty>
      <SpecialtyPharmacyNoteId>1</SpecialtyPharmacyNoteId>
    </PlanMcoCoverageModel>
  </PlanMcoCoverages>
  <SummaryCoverages>
    <MedicalUnifiedTierCoverageModel>
      <Lives>3</Lives>
      <MedicalUnifiedTierId>1</MedicalUnifiedTierId>
      <Percentage>2</Percentage>
      <PlanCount>4</PlanCount>
    </MedicalUnifiedTierCoverageModel>
    <MedicalUnifiedTierCoverageModel>
      <Lives>3</Lives>
      <MedicalUnifiedTierId>1</MedicalUnifiedTierId>
      <Percentage>2</Percentage>
      <PlanCount>4</PlanCount>
    </MedicalUnifiedTierCoverageModel>
  </SummaryCoverages>
</McoCoveragesResponseModel>

Build Request


NameDescription Input Value Type Required / Optional
ProductId

The Id of the Product

integer

Required

MCOId

The Id of the MCO

integer

Required

IndicationId

The Id of the Indication

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: 1)

integer

Optional

SummaryUseFormTrakControllerExclusions

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

boolean

Default value is False





Request URL

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

Status

Response Details