Pharmacy API Solutions

PokitDok's Pharmacy APIs inspire intelligent medication decisions by providing real-time insight into a patient's prescription benefits. They allow access to formulary and benefit information in real-time, offering transparency into prescription drug cost and coverage. With a clear view into out-of-pocket costs, patients are more likely to adhere to their prescribed medications and follow their provider's instructions.

PokitDok's streamlined approach to pharmacy benefits offers insight into a complex process, complete with vast cost and time saving potential

PokitDok Pharmacy Illustration

This information, while available to patients and providers, has been locked away in hard to read formulary lists or descriptions of benefit coverage. While there have been recent improvements in the ability to display this information, it is generally unavailable in real-time or with streamlined access or user experience in mind.

PokitDok Pharmacy Illustration
PokitDok Pharmacy Illustration

PokitDok's Pharmacy APIs streamline access to this information electronically and in real-time, making it easy to enhance existing systems or create new applications. By revealing this information instantly, PokitDok powers the ability to make better treatment plan decisions with respect to patient coverage and drug cost.

Companies ranging from pharmacy benefit managers and insurance companies, to self-insured employers, hospital and health systems, brokers, and TPAs can use PokitDok's Pharmacy APIs to:

  • Look up formulary and benefit information in real-time
  • Offer better utilization of medications covered by the insurance formulary
  • Provide insights into what prescriptions are covered, increasing medication adherence
  • Reduce phone calls inquiring about pharmacy benefits and associated cost of overhead
  • Give a competitive advantage by offering a formulary lookup tool
  • Reduce the likelihood of 30-day readmissions by ensuring that discharge medications are covered by insurance

PokitDok's Pharmacy APIs are currently deployed for Medicare Part D and Medicare Advantage plans. Access to commercial pharmacy benefits is available for certain groups such as employers, brokers, and health plans.

Plan Number
Plan Number
Plan Number
In-Network Pharmacy API

Once a provider issues a prescription, taking into consideration a member's plan coverage and formulary, this API assists the patient in finding an in-network pharmacy close and convenient to them.

Plan Number
Plans API

Utilizing basic demographic information,this API can return data including: premium, deductible, initial coverage limit, and copay/coinsurance for all drug tiers, as well as retail and mail order coverage. The data provides deep information on a prescription drug coverage plan.

Plan Number
Formulary API

This API returns the total cost of the drug (30 and 90 day supply, fulfilled via retail pharmacy or mail order), what the out of pocket cost will be and how much the insurer will pay. Find out drug tier, if the drug requires prior authorization or step therapy, and quantity limits. Request pharmacy plan information such as premium, deductible, initial coverage limit, copay/ coinsurance as well as retail and mail order coverage. This information guides providers to make drug prescription decisions based on real-time member coverage information.

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