Plans

The Plans resource allows for the retrieval of Plan information. One or more plans may be returned based on the given filters. Note that a plan may be ending (see the EndDate field), and it may also be slated to start in the future (see the EffectiveDate field).


Plans Search (using filter criteria)


Plans Search (using filter criteria)


Request Url
GET Formulary/v1/Plans


URI Parameters

NameDescription Type Required / Optional
Name

The name contained within the Plan Name

string

Optional

ControllerId

The id of the Controller of the Plan

integer

Optional

MCOId

The id of the Managed Care Organization

integer

Optional

PlanId

The Id of the Plan

integer

Optional

PayerId

The id of the Payer of the Plan

integer

Optional

PBMId

The id of the PBM of the Plan

integer

Optional

RxBin

The RxBin that matches the Plan. Can be used in conjunction with RxPCN and RxGroup

string

Optional

RxPCN

The RxPCN that matches the Plan. Can be used in conjunction with RxBin and RxGroup

string

Optional

RxGroup

The RxGroup that matches the Plan. Can be used in conjunction with RxBin and RxPCN

string

Optional

MedicareContractId

The CMSContractId that is assigned to the Plan. Should be used in conjunction with CMSPlanId

string

Optional

MedicarePlanId

The CMSPlanId that is assigned to the Plan. Should be used in conjunction with CMSContractId

integer

Optional

BenefitDesignId

The BenefitDesignId of the Plan

integer

Optional

ChannelId

The ChannelId of the Plan

Collection of integer

Optional

PlanTypeId

The PlanTypeId of the Plan

integer

Optional

StateId

The US State where the Plan is serviced

string

Optional

CBSAId

The CBSA Id (Core Based Statistical Area) where the Plan is serviced

integer

Optional

TerritoryId

The Territory Id where the Plan is covered

integer

Optional

FormularyId

The FormularyId of the Plan.

integer

Optional

LivesTypeId

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

integer

Optional

MedicalGroupId

The MedicalGroupId of the Plan.

integer

Optional


Resource Description of Response Object

PlansResponse
NameDescription Type Required / Optional
Plans

Collection of Plan

Optional


Available Response Formats & Sample Data

{
  "Plans": [
    {
      "PlanId": 1,
      "Name": "sample string 2",
      "MonthId": 3,
      "National": true,
      "PayerId": 1,
      "Payer": "sample string 4",
      "Lives": 5,
      "ControllerId": 6,
      "Controller": "sample string 7",
      "MCOId": 8,
      "MCO": "sample string 9",
      "Formulary": "sample string 10",
      "PBMId": 1,
      "PBM": "sample string 11",
      "PBMTypeId": 64,
      "PBMType": "sample string 12",
      "BenefitDesignId": 64,
      "BenefitDesign": "sample string 14",
      "PlanTypeId": 64,
      "ChannelId": 16,
      "Address": {
        "Address1": "sample string 1",
        "Address2": "sample string 2",
        "City": "sample string 3",
        "StateId": "sample string 4",
        "Zip": "sample string 5",
        "Phone": "sample string 6",
        "PriorAuthPhone": "sample string 7",
        "PriorAuthFax": "sample string 8",
        "MemberPhone": "sample string 9"
      },
      "FormularyId": 17,
      "MedicalGroupID": 18
    },
    {
      "PlanId": 1,
      "Name": "sample string 2",
      "MonthId": 3,
      "National": true,
      "PayerId": 1,
      "Payer": "sample string 4",
      "Lives": 5,
      "ControllerId": 6,
      "Controller": "sample string 7",
      "MCOId": 8,
      "MCO": "sample string 9",
      "Formulary": "sample string 10",
      "PBMId": 1,
      "PBM": "sample string 11",
      "PBMTypeId": 64,
      "PBMType": "sample string 12",
      "BenefitDesignId": 64,
      "BenefitDesign": "sample string 14",
      "PlanTypeId": 64,
      "ChannelId": 16,
      "Address": {
        "Address1": "sample string 1",
        "Address2": "sample string 2",
        "City": "sample string 3",
        "StateId": "sample string 4",
        "Zip": "sample string 5",
        "Phone": "sample string 6",
        "PriorAuthPhone": "sample string 7",
        "PriorAuthFax": "sample string 8",
        "MemberPhone": "sample string 9"
      },
      "FormularyId": 17,
      "MedicalGroupID": 18
    }
  ]
}
<PlansResponse xmlns:i="http://www.w3.org/2001/XMLSchema-instance" xmlns="http://api.mmitnetwork.com/formulary/plans">
  <Plans>
    <Plan>
      <Address>
        <Address1>sample string 1</Address1>
        <Address2>sample string 2</Address2>
        <City>sample string 3</City>
        <MemberPhone>sample string 9</MemberPhone>
        <Phone>sample string 6</Phone>
        <PriorAuthFax>sample string 8</PriorAuthFax>
        <PriorAuthPhone>sample string 7</PriorAuthPhone>
        <StateId>sample string 4</StateId>
        <Zip>sample string 5</Zip>
      </Address>
      <BenefitDesign>sample string 14</BenefitDesign>
      <BenefitDesignId>64</BenefitDesignId>
      <ChannelId>16</ChannelId>
      <Controller>sample string 7</Controller>
      <ControllerId>6</ControllerId>
      <Formulary>sample string 10</Formulary>
      <FormularyId>17</FormularyId>
      <Lives>5</Lives>
      <MCO>sample string 9</MCO>
      <MCOId>8</MCOId>
      <MedicalGroupID>18</MedicalGroupID>
      <MonthId>3</MonthId>
      <Name>sample string 2</Name>
      <National>true</National>
      <PBM>sample string 11</PBM>
      <PBMId>1</PBMId>
      <PBMType>sample string 12</PBMType>
      <PBMTypeId>64</PBMTypeId>
      <Payer>sample string 4</Payer>
      <PayerId>1</PayerId>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
    </Plan>
    <Plan>
      <Address>
        <Address1>sample string 1</Address1>
        <Address2>sample string 2</Address2>
        <City>sample string 3</City>
        <MemberPhone>sample string 9</MemberPhone>
        <Phone>sample string 6</Phone>
        <PriorAuthFax>sample string 8</PriorAuthFax>
        <PriorAuthPhone>sample string 7</PriorAuthPhone>
        <StateId>sample string 4</StateId>
        <Zip>sample string 5</Zip>
      </Address>
      <BenefitDesign>sample string 14</BenefitDesign>
      <BenefitDesignId>64</BenefitDesignId>
      <ChannelId>16</ChannelId>
      <Controller>sample string 7</Controller>
      <ControllerId>6</ControllerId>
      <Formulary>sample string 10</Formulary>
      <FormularyId>17</FormularyId>
      <Lives>5</Lives>
      <MCO>sample string 9</MCO>
      <MCOId>8</MCOId>
      <MedicalGroupID>18</MedicalGroupID>
      <MonthId>3</MonthId>
      <Name>sample string 2</Name>
      <National>true</National>
      <PBM>sample string 11</PBM>
      <PBMId>1</PBMId>
      <PBMType>sample string 12</PBMType>
      <PBMTypeId>64</PBMTypeId>
      <Payer>sample string 4</Payer>
      <PayerId>1</PayerId>
      <PlanId>1</PlanId>
      <PlanTypeId>64</PlanTypeId>
    </Plan>
  </Plans>
</PlansResponse>

Build Request


NameDescription Input Value Type Required / Optional
Name

The name contained within the Plan Name

string

Optional

ControllerId

The id of the Controller of the Plan

integer

Optional

MCOId

The id of the Managed Care Organization

integer

Optional

PlanId

The Id of the Plan

integer

Optional

PayerId

The id of the Payer of the Plan

integer

Optional

PBMId

The id of the PBM of the Plan

integer

Optional

RxBin

The RxBin that matches the Plan. Can be used in conjunction with RxPCN and RxGroup

string

Optional

RxPCN

The RxPCN that matches the Plan. Can be used in conjunction with RxBin and RxGroup

string

Optional

RxGroup

The RxGroup that matches the Plan. Can be used in conjunction with RxBin and RxPCN

string

Optional

MedicareContractId

The CMSContractId that is assigned to the Plan. Should be used in conjunction with CMSPlanId

string

Optional

MedicarePlanId

The CMSPlanId that is assigned to the Plan. Should be used in conjunction with CMSContractId

integer

Optional

BenefitDesignId

The BenefitDesignId of the Plan

integer

Optional

ChannelId

The ChannelId of the Plan

Collection of integer

Optional

PlanTypeId

The PlanTypeId of the Plan

integer

Optional

StateId

The US State where the Plan is serviced

string

Optional

CBSAId

The CBSA Id (Core Based Statistical Area) where the Plan is serviced

integer

Optional

TerritoryId

The Territory Id where the Plan is covered

integer

Optional

FormularyId

The FormularyId of the Plan.

integer

Optional

LivesTypeId

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

integer

Optional

MedicalGroupId

The MedicalGroupId of the Plan.

integer

Optional





Request URL

GET Formulary/v1/Plans?Name=Name&ControllerId=ControllerId&MCOId=MCOId&PlanId=PlanId&PayerId=PayerId&PBMId=PBMId&RxBin=RxBin&RxPCN=RxPCN&RxGroup=RxGroup&MedicareContractId=MedicareContractId&MedicarePlanId=MedicarePlanId&BenefitDesignId=BenefitDesignId&ChannelId=ChannelId&PlanTypeId=PlanTypeId&StateId=StateId&CBSAId=CBSAId&TerritoryId=TerritoryId&FormularyId=FormularyId&LivesTypeId=LivesTypeId&MedicalGroupId=MedicalGroupId

Status

Response Details