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Optum

Optum Pharmacy Solutions API

Pharmacy network services: a formatting rule API and telecom formatter for NCPDP-style pharmacy claim formatting, and a submitter API for managing pharmacy network submitters.

Documentation Provider Profile APIs.io OpenAPI GitHub

This API exposes 4 operations across 4 paths, organized into 2 resource areas, and defines 20 schemas. It is described by OpenAPI 3.1.0, at version v1.

Requests are made against a single base URL, https://sandbox-apigw.optum.com/rxn/formattingrules.

4 operations 4 paths 20 schemas 1 GET1 PATCH2 POST

Metadata

The identity and technical contract details declared by the specification.

Specification
OpenAPI 3.1.0
API Version
v1
Base URL
https://apigw.optum.com/pharmacynetwork/
Authentication
OAuth 2.0
Resource Areas
2

Authentication & Security 1

Optum Pharmacy Solutions API declares 1 security scheme for authenticating requests. It supports OAuth 2.0 (oauth2_security) using the clientCredentials flow. By default, every request must be authenticated.

Paths & Operations 4

Across 4 paths, the API surfaces 4 operations — 1 GET, 1 PATCH, 2 POST. They span 2 resource areas: Payersheet, HealthCheck. Each is listed below with its method, path, parameters, and response codes.

Payersheet 3

API to process Payersheet information

POST
/v1/standards-based-messaging/services/payer-sheet-service/telecomFormat/fetch
Fetch Claim Format
getClaimFormat body → 200
POST
/v1/standards-based-messaging/services/payer-sheet-service/telecomFormat/save
Save Claim Format
saveClaimFormat 1 param → 200
PATCH
/v1/standards-based-messaging/services/payer-sheet-service/telecomFormat/update
Update Claim Format
updateClaimFormat 1 param → 200
HealthCheck 1
GET
/health/formatting-rules
Health check endpoint for the formatting rule engine
→ 200

Schemas 20

The contract defines 20 schemas that model the data the API accepts and returns. The most detailed are ClaimFormat (17 properties), JsonSegmentField (16 properties), JsonClaimFormat (15 properties), GetClaimFormatRequest (12 properties). Each schema is shown below with its type and property counts.

ClaimFormat
object
17 properties
FieldGroup
object
8 properties
GetClaimFormatRequest
object
12 properties
GetClaimFormatResponse
object
1 property
JsonClaimFormat
object
15 properties
JsonClaimFormatWrapper
object
1 property
JsonFieldGroup
object
5 properties
JsonSegment
object
4 properties
JsonSegmentField
object
16 properties
JsonSegmentFieldQualifier
object
3 properties
JsonTransmission
object
4 properties
N1
object
4 properties
Prereq
object
1 property
Prereqs
object
1 property
SaveClaimFormatRequest
object
1 property
Segment
object
7 properties
SegmentField
object
6 properties
SegmentGroup
object
2 properties
Transmission
object
5 properties
UpdateClaimFormatRequest
object
1 property

Specification

The full machine-readable OpenAPI contract behind this narrative.

Source

optum-formatting-rule-api-openapi.yml Raw ↑
#Pharmacy#NCPDP#Formatting#Submitter
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API Details
ID
optum:optum-pharmacy-solutions-api
Base URL
https://apigw.optum.com/pharmacynetwork/
Docs
https://developer.optum.com/pharmacysolutions
Provider
Optum
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