API Reference
Claim Policy Holder ID
API Reference
Claim Policy Holder ID
GET
/
api
/
v2
/
policy_holder
/
{policy_holder_id}
/
claims
curl --request GET \
--url https://app.tpastream.com/api/v2/policy_holder/{policy_holder_id}/claims
{
"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": "2022-10-25T17:35:58.960Z",
"dataobject_id": 0,
"date_column": "2022-10-25T17:35:58.960Z",
"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": "2022-10-25T17:35:58.960Z",
"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": "2022-10-25T17:35:58.960Z",
"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"
},
"has_next": true,
"has_prev": true,
"next_num": 0,
"page": 0,
"pages": 0,
"per_page": 0,
"prev_num": 0,
"total": 0
}
{
"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": "2022-10-25T17:35:58.960Z",
"dataobject_id": 0,
"date_column": "2022-10-25T17:35:58.960Z",
"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": "2022-10-25T17:35:58.960Z",
"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": "2022-10-25T17:35:58.960Z",
"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"
},
"has_next": true,
"has_prev": true,
"next_num": 0,
"page": 0,
"pages": 0,
"per_page": 0,
"prev_num": 0,
"total": 0
}
curl --request GET \
--url https://app.tpastream.com/api/v2/policy_holder/{policy_holder_id}/claims
{
"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": "2022-10-25T17:35:58.960Z",
"dataobject_id": 0,
"date_column": "2022-10-25T17:35:58.960Z",
"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": "2022-10-25T17:35:58.960Z",
"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": "2022-10-25T17:35:58.960Z",
"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"
},
"has_next": true,
"has_prev": true,
"next_num": 0,
"page": 0,
"pages": 0,
"per_page": 0,
"prev_num": 0,
"total": 0
}