Sandbox Predefined Fields and Values

You can edit fields in the HTTP request body to see how the API works with changes to the data. For Sandbox use, you are limited to a specific set of values.

For Sandbox usage, all fields must have the correct predefined values to obtain a successful response. Inventing new PMI values or using real-world PMI values will result in errors.

Go to this page to see sample test responses

The following Eligibility JSON fields must have one of the listed predefined values shown below.

Field NameValues
controlNumber"000000001", "000000002", "000000003", "000000004", "123456789"
memberId"0000000000", "0000000001", "0000000002", "1234567890", "0000000004", "0000000005", "0000000006","0000000007", "123456789"
firstName"johnone", "johntwo", "janeone", "janetwo"
lastName"doeone", "doetwo"
middleName"middleone", "middletwo"
gender"m", "u", "f"
dateOfBirth"18800102", "18800101", "18160421", "19800101", "19800102", "20000101", "20000102"
ssn"000000000", "555443333", "111111111", "000000001", "891234567", "123456789"
groupNumber"0000000000", "1111111111", "1234567891", "0000000001", "0000000002", "0000000003", "0000000004", "0000000005"
address1"123 address1", "000 address1"
address2"apt 123", "apt 000", "123", "000"
city"city1", "city2"
state"wa", "tn"
postalCode"981010000", "372030000"
employerId"00000", "12345", "00001", "00002", "000000000", "123456789", "123456"
propertyCasualtyClaimNumber"00000", "12345", "00001", "00002"
patientControlNumber"00000", "12345", "00001", "00002"
priorAuthorizationNumber"00000", "12345", "00001", "00002"
referralNumber"00000", "12345", "00001", "00002"
repricedClaimNumber"00000", "12345", "00001", "00002"
investigationalDeviceExemptionNumber"00000", "12345", "00001", "00002"
claimNumber"00000", "12345", "00001", "00002"
name"johnone doeone", "johntwo doetwo", "janeone doeone", "janetwo doetwo", "submitter contact info"
phoneNumber"0000000000", "123456789", "0000000001", "0000000002"
faxNumber"0000000000", "123456789", "0000000001", "0000000002"
email"[email protected]", "[email protected]"
stateLicenseNumber"0000000", "0000001", "123456"
contractVersionIdentifier"111111", "222222", "123456"
priorAuthorizationNumber"00000", "12345", "00001", "00002"
referralNumber"00000", "12345", "00001", "00002"
claimControlNumber"00000", "12345", "00001", "00002"
cliaNumber"12D4567890", "00D0000001"
mammographyCertificationNumber"00000", "12345", "00001", "00002"
medicalRecordNumber"00000", "12345", "00001", "00002"
demoProjectIdentifier"00000", "12345", "00001", "00002"
carePlanOversightNumber"00000", "12345", "00001", "00002"
policyNumber"00000", "12345", "00001", "00002"
npi"1760854442", "1942788757"
organizationName"happy doctors group", "happy doctors grouppractice","extra healthy insurance", "regional ppo network"

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