| Name | Description | Type | Additional information |
|---|---|---|---|
| PriorAuthorizationStatusType | PriorAuthorizationStatusType |
None. |
|
| ClosedReasonCodeId | PriorAuthorizationClosedReasonCodes |
None. |
|
| AuthorizationNumber | string |
None. |
|
| AuthorizationPeriodStart | date |
None. |
|
| AuthorizationPeriodEnd | date |
None. |
|
| PharmacyType | DoseSpotPharmacyTypes |
None. |
|
| Quantity | string |
None. |
|
| DaysSupply | string |
None. |
|
| NumberOfCycles | string |
None. |
|
| NumberOfRefills | string |
None. |
|
| Note | string |
None. |
|
| CanAppeal | boolean |
None. |