pa_id (optional — enables PA lifecycle tracking on the orchestrator)
payer · Availity/NovoLogix
organization
name
coverage
plan
planProductName
plan (PBM)
formName
rxBin
rxPcn
rxGroup
patient
firstName
lastName
gender
dateOfBirth
memberId
middleInitial
heightCm
weightKg
secondaryPhone
memberId
zip
state
address1
city
providers.requesting · Availity/NovoLogix
npi
name
address (row match)
contactNpi (ad_req)
contactName (MD Office Contact Name)
contactPhone (MD Office Contact Phone)
contactFax
contactEmail
providers.servicing · Availity/NovoLogix
copy requesting → servicing
npi
contactName (Rendering Contact Name)
contactPhone
contactFax
providers.prescriber · CoverMyMeds
npi
firstName
lastName
address1
city
state
zip
phone
fax
diagnosis
primary
authorization
priority
service
ndcCode
drugName
dateOfServiceFrom
quantity
quantityQualifier
daysSupply
dawBrandOnly
placeOfService
placeOfDispense
drugSelectionDecision
dateOfServiceTo
frequencyDays
refills
sig
canonical payload — live
{}
orchestrator endpoints
:5500 · click to call
CLIENT
AGENT PROTOCOL · token-gated · reference only
response
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import JSON payload
Paste the payload you send to the orchestrator — bare priorAuthorization, the full {context, priorAuthorization} wrapper, or a whole job. Fields auto-populate and the portal flips to match.