API Reference
Claim Policy Holder / Medical ID
GET

/api/v2/policy_holder/{policy_holder_id}/claims/{claim_medical_id}

policy_holder_id*
claim_medical_id*
curl --request GET \
  --url https://app.tpastream.com/api/v2/policy_holder/{policy_holder_id}/claims/{claim_medical_id}
{
  "data": {
    "amount_allowed": 0,
    "amount_billed": 0,
    "amount_not_covered": 0,
    "amount_paid": 0,
    "amount_paid_other": 0,
    "check_date": "2022-10-25",
    "check_number": "string",
    "claim_medical_lines": [
      {
        "amount_allowed": 0,
        "amount_billed": 0,
        "amount_not_covered": 0,
        "amount_paid": 0,
        "amount_paid_other": 0,
        "coinsurance_patient": 0,
        "copayment": 0,
        "date_of_service": {
          "bounds": "string",
          "end": "2022-10-25",
          "start": "2022-10-25"
        },
        "days_supply": 0,
        "diagnosis_code": "string",
        "discount": 0,
        "id": 0,
        "national_drug_code": "string",
        "patient_responsibility": 0,
        "prescription_type_id": 0,
        "prescription_type_str": "string",
        "procedure_code": "string",
        "procedure_name": "string",
        "quantity": 0,
        "reduction": 0,
        "total_patient_responsibility": 0,
        "uuid": "3fa85f64-5717-4562-b3fc-2c963f66afa6",
        "vendor_system_id": "string"
      }
    ],
    "coinsurance_patient": 0,
    "computed_amount_allowed": 0,
    "computed_amount_billed": 0,
    "computed_amount_paid": 0,
    "computed_coinsurance_patient": 0,
    "computed_copayment": 0,
    "computed_patient_responsibility": 0,
    "computed_reduction": 0,
    "copayment": 0,
    "createddate": "2022-10-25T17:44:38.776Z",
    "dataobject_id": 0,
    "date_column": "2022-10-25T17:44:38.776Z",
    "date_of_service": {
      "bounds": "string",
      "end": "2022-10-25",
      "start": "2022-10-25"
    },
    "discount": 0,
    "eob_date": "2022-10-25",
    "group_name": "string",
    "group_number": "string",
    "id": 0,
    "incurred_value": 0,
    "is_incomplete": true,
    "last_updated_status": "2022-10-25T17:44:38.776Z",
    "members": [
      {
        "email": "string",
        "employer": {
          "id": 0,
          "name": "string"
        },
        "first_name": "string",
        "id": 0,
        "last_name": "string",
        "system_key": {
          "employee_navigator": "281BX1",
          "wex_healthcloud": "CO11B"
        }
      }
    ],
    "modifieddate": "2022-10-25T17:44:38.776Z",
    "network": "IN",
    "patient_account_number": "string",
    "patient_name": "string",
    "patient_payer_number": "string",
    "patient_responsibility": 0,
    "policy_holder": {
      "first_name": "string",
      "id": 0,
      "last_name": "string"
    },
    "processed_on": "2022-10-25",
    "recrawl_requested": true,
    "reduction": 0,
    "remarks": "string",
    "service_provider": "string",
    "service_provider_address": "string",
    "service_provider_billing_address": "string",
    "service_provider_billing_name": "string",
    "service_provider_billing_npi_number": 0,
    "service_provider_billing_number": "string",
    "service_provider_billing_phone": "string",
    "service_provider_npi_number": 0,
    "service_provider_number": "string",
    "status": "In Process",
    "type": {
      "name": "medical",
      "type_id": 1
    },
    "uuid": "3fa85f64-5717-4562-b3fc-2c963f66afa6",
    "vendor_system_id": "string"
  }
}

‚Äč
Path Parameters

policy_holder_idrequired
integer
claim_medical_idrequired
integer