GET api/Claims/GetClaimDetails?ClaimNo={ClaimNo}&CompanyId={CompanyId}

Request Information

URI Parameters

Name	Description	Type	Additional information
ClaimNo		string	Required
CompanyId		Company	None.

Body Parameters

None.

Request Formats

text/json, application/json

Sample:

Request sample for request 

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{
  "MemberId": "sample string 1",
  "ProviderId": "sample string 2",
  "ClaimNo": "sample string 3",
  "CompanyId": 0,
  "DateOfServiceRangeStart": "2026-06-03T09:19:53.2483705-07:00",
  "DateOfServiceRangeEnd": "2026-06-03T09:19:53.2483705-07:00",
  "IncludeEncounters": true,
  "ProviderNPI": "sample string 5"
}

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text/xml, application/xml

Sample:

Request sample for request 

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<ClaimRequestDTO xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.DTOs.Claims" xmlns:i="http://www.w3.org/2001/XMLSchema-instance">
  <ClaimNo>sample string 3</ClaimNo>
  <CompanyId>None</CompanyId>
  <DateOfServiceRangeEnd>2026-06-03T09:19:53.2483705-07:00</DateOfServiceRangeEnd>
  <DateOfServiceRangeStart>2026-06-03T09:19:53.2483705-07:00</DateOfServiceRangeStart>
  <IncludeEncounters>true</IncludeEncounters>
  <MemberId>sample string 1</MemberId>
  <ProviderId>sample string 2</ProviderId>
  <ProviderNPI>sample string 5</ProviderNPI>
</ClaimRequestDTO>

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Response Information

Resource Description

IHttpActionResult

None.

Response Formats

text/json, application/json

Sample:


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{
  "ClaimNo": "sample string 1",
  "CompanyId": 0,
  "Details": [
    {
      "LineItem": 1,
      "LineFlag": "sample string 2",
      "DateOfServiceEnd": "2026-06-03T09:19:53.2639943-07:00",
      "DateOfServiceStart": "2026-06-03T09:19:53.2639943-07:00",
      "ProcedureCode": {
        "Code": "sample string 1",
        "Description": "sample string 2"
      },
      "Quantity": 3.0,
      "AmountDetail": {
        "Paid": "sample string 1",
        "Billed": "sample string 2",
        "Contract": "sample string 3",
        "Net": "sample string 4"
      },
      "MemberCostSharingDetail": {
        "CoInsurance": 1.0,
        "CoPay": 1.0,
        "Deductible": 1.0
      },
      "Capitated": true,
      "AdjustmentCode": [
        {
          "Code": "sample string 1",
          "Description": "sample string 2"
        },
        {
          "Code": "sample string 1",
          "Description": "sample string 2"
        }
      ],
      "EFTNumber": "sample string 5",
      "StatusDetail": {
        "Code": "sample string 1",
        "Description": "sample string 2",
        "FromDate": "2026-06-03T09:19:53.2639943-07:00",
        "ToDate": "2026-06-03T09:19:53.2639943-07:00",
        "Notes": "sample string 3"
      }
    },
    {
      "LineItem": 1,
      "LineFlag": "sample string 2",
      "DateOfServiceEnd": "2026-06-03T09:19:53.2639943-07:00",
      "DateOfServiceStart": "2026-06-03T09:19:53.2639943-07:00",
      "ProcedureCode": {
        "Code": "sample string 1",
        "Description": "sample string 2"
      },
      "Quantity": 3.0,
      "AmountDetail": {
        "Paid": "sample string 1",
        "Billed": "sample string 2",
        "Contract": "sample string 3",
        "Net": "sample string 4"
      },
      "MemberCostSharingDetail": {
        "CoInsurance": 1.0,
        "CoPay": 1.0,
        "Deductible": 1.0
      },
      "Capitated": true,
      "AdjustmentCode": [
        {
          "Code": "sample string 1",
          "Description": "sample string 2"
        },
        {
          "Code": "sample string 1",
          "Description": "sample string 2"
        }
      ],
      "EFTNumber": "sample string 5",
      "StatusDetail": {
        "Code": "sample string 1",
        "Description": "sample string 2",
        "FromDate": "2026-06-03T09:19:53.2639943-07:00",
        "ToDate": "2026-06-03T09:19:53.2639943-07:00",
        "Notes": "sample string 3"
      }
    }
  ],
  "ConfirmationNumber": "sample string 2",
  "Notes": "sample string 3",
  "ProcessingStatusList": [
    {
      "StatusCode": "sample string 1",
      "StatusDescription": "sample string 2"
    },
    {
      "StatusCode": "sample string 1",
      "StatusDescription": "sample string 2"
    }
  ]
}

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text/xml, application/xml

Sample:


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<ClaimDetailsResponseDTO xmlns="http://schemas.datacontract.org/2004/07/AHC.WebServices.WebAPI.DTOs.Claims" xmlns:i="http://www.w3.org/2001/XMLSchema-instance">
  <ProcessingStatusList xmlns="http://schemas.datacontract.org/2004/07/AHC.Core.Web.DTOs" xmlns:a="http://schemas.datacontract.org/2004/07/AHC.Core">
    <a:ProcessingStatus>
      <a:StatusCode>sample string 1</a:StatusCode>
      <a:StatusDescription>sample string 2</a:StatusDescription>
    </a:ProcessingStatus>
    <a:ProcessingStatus>
      <a:StatusCode>sample string 1</a:StatusCode>
      <a:StatusDescription>sample string 2</a:StatusDescription>
    </a:ProcessingStatus>
  </ProcessingStatusList>
  <ConfirmationNumber xmlns="http://schemas.datacontract.org/2004/07/AHC.Core.Web.DTOs">sample string 2</ConfirmationNumber>
  <EstimatedFulfillmentDate xmlns="http://schemas.datacontract.org/2004/07/AHC.Core.Web.DTOs">2026-06-03T09:19:53.2796107-07:00</EstimatedFulfillmentDate>
  <Notes xmlns="http://schemas.datacontract.org/2004/07/AHC.Core.Web.DTOs">sample string 3</Notes>
  <ClaimNo>sample string 1</ClaimNo>
  <CompanyId>None</CompanyId>
  <Details>
    <ClaimServiceLineDetail>
      <AdjustmentCode>
        <CodeDescription>
          <Code>sample string 1</Code>
          <Description>sample string 2</Description>
        </CodeDescription>
        <CodeDescription>
          <Code>sample string 1</Code>
          <Description>sample string 2</Description>
        </CodeDescription>
      </AdjustmentCode>
      <AmountDetail>
        <Billed>sample string 2</Billed>
        <Contract>sample string 3</Contract>
        <Net>sample string 4</Net>
        <Paid>sample string 1</Paid>
      </AmountDetail>
      <Capitated>true</Capitated>
      <DateOfServiceEnd>2026-06-03T09:19:53.2796107-07:00</DateOfServiceEnd>
      <DateOfServiceStart>2026-06-03T09:19:53.2796107-07:00</DateOfServiceStart>
      <EFTNumber>sample string 5</EFTNumber>
      <LineFlag>sample string 2</LineFlag>
      <LineItem>1</LineItem>
      <MemberCostSharingDetail>
        <CoInsurance>1</CoInsurance>
        <CoPay>1</CoPay>
        <Deductible>1</Deductible>
      </MemberCostSharingDetail>
      <ProcedureCode>
        <Code>sample string 1</Code>
        <Description>sample string 2</Description>
      </ProcedureCode>
      <Quantity>3</Quantity>
      <StatusDetail>
        <Code>sample string 1</Code>
        <Description>sample string 2</Description>
        <FromDate>2026-06-03T09:19:53.2796107-07:00</FromDate>
        <Notes>sample string 3</Notes>
        <ToDate>2026-06-03T09:19:53.2796107-07:00</ToDate>
      </StatusDetail>
    </ClaimServiceLineDetail>
    <ClaimServiceLineDetail>
      <AdjustmentCode>
        <CodeDescription>
          <Code>sample string 1</Code>
          <Description>sample string 2</Description>
        </CodeDescription>
        <CodeDescription>
          <Code>sample string 1</Code>
          <Description>sample string 2</Description>
        </CodeDescription>
      </AdjustmentCode>
      <AmountDetail>
        <Billed>sample string 2</Billed>
        <Contract>sample string 3</Contract>
        <Net>sample string 4</Net>
        <Paid>sample string 1</Paid>
      </AmountDetail>
      <Capitated>true</Capitated>
      <DateOfServiceEnd>2026-06-03T09:19:53.2796107-07:00</DateOfServiceEnd>
      <DateOfServiceStart>2026-06-03T09:19:53.2796107-07:00</DateOfServiceStart>
      <EFTNumber>sample string 5</EFTNumber>
      <LineFlag>sample string 2</LineFlag>
      <LineItem>1</LineItem>
      <MemberCostSharingDetail>
        <CoInsurance>1</CoInsurance>
        <CoPay>1</CoPay>
        <Deductible>1</Deductible>
      </MemberCostSharingDetail>
      <ProcedureCode>
        <Code>sample string 1</Code>
        <Description>sample string 2</Description>
      </ProcedureCode>
      <Quantity>3</Quantity>
      <StatusDetail>
        <Code>sample string 1</Code>
        <Description>sample string 2</Description>
        <FromDate>2026-06-03T09:19:53.2796107-07:00</FromDate>
        <Notes>sample string 3</Notes>
        <ToDate>2026-06-03T09:19:53.2796107-07:00</ToDate>
      </StatusDetail>
    </ClaimServiceLineDetail>
  </Details>
</ClaimDetailsResponseDTO>

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