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BlazeSync

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BlazeSync

BlazeSync

medicare_tools/blazesync
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NPN

npnstringRequired

National Producer Number

Sunfire instance

sunfireInstanceEnumRequired

Select your Sunfire instance

Value options:

"https://www.sunfirematrix.com/app/blazesync/yourmedicare/[NPN]/2025/": string"https://www.sunfirematrix.com/app/blazesync/bbi/[NPN]/2025/": string"https://www.sunfirematrix.com/app/blazesync/mts/[NPN]/2025/": string"https://www.sunfirematrix.com/app/blazesync/gom/[NPN]/2025/": string"https://www.sunfirematrix.com/app/blazesync/ifg/[NPN]/2025/": string"https://www.sunfirematrix.com/app/blazesync/int/[NPN]/2025/": string"https://www.sunfirematrix.com/app/blazesync/jsa/[NPN]/2025/": string"https://www.sunfirematrix.com/app/blazesync/ncc/[NPN]/2025/": string"https://www.sunfirematrix.com/app/blazesync/pfs/[NPN]/2025/": string"https://www.sunfirematrix.com/app/blazesync/sma/[NPN]/2025/": string"https://www.sunfirematrix.com/app/blazesync/spa/[NPN]/2025/": string"https://www.sunfirematrix.com/app/blazesync/tbr/[NPN]/2025/": string"https://www.sunfirematrix.com/app/blazesync/uig/[NPN]/2025/": string

First Name

firstNamestringRequired

Your first name

Last Name

lastNamestringRequired

Your last name

Date of Birth

dateOfBirthstringRequired

Your date of birth (YYYY-MM-DD)

Email

emailstringRequired

Your email address

Phone Number

phoneNumberstringOptional

US phone number in format (XXX) XXX-XXXX

Street Address

address1stringOptional

Your street address

Street Address Line 2

Address2stringOptional

Additional address information

City

citystringOptional

Your city

State/Province

statestringOptional

Your state or province

Postal/Zip Code

zipCodestringRequired

Your postal or zip code

County

CountystringOptional

Your county

Doctor 1 First Name

doctor1FirstNamestringOptional

First name of doctor 1

Doctor 1 Last Name

doctor1LastNamestringOptional

Last name of doctor 1

Doctor 2 First Name

doctor2FirstNamestringOptional

First name of doctor 2

Doctor 2 Last Name

doctor2LastNamestringOptional

Last name of doctor 2

Doctor 3 First Name

doctor3FirstNamestringOptional

First name of doctor 3

Doctor 3 Last Name

doctor3LastNamestringOptional

Last name of doctor 3

Doctor 4 First Name

doctor4FirstNamestringOptional

First name of doctor 4

Doctor 4 Last Name

doctor4LastNamestringOptional

Last name of doctor 4

Doctor 5 First Name

doctor5FirstNamestringOptional

First name of doctor 5

Doctor 5 Last Name

doctor5LastNamestringOptional

Last name of doctor 5

Drug 1 Name

drug1NamestringOptional

Name of medication 1

Drug 1 Dosage

drug1DosagestringOptional

Dosage of medication 1

Drug 1 Refill Frequency

drug1RefillFrequencystringOptional

Refill frequency of medication 1

Drug 1 Quantity

drug1QuantitystringOptional

Quantity of medication 1

Drug 2 Name

drug2NamestringOptional

Name of medication 2

Drug 2 Dosage

drug2DosagestringOptional

Dosage of medication 2

Drug 2 Refill Frequency

drug2RefillFrequencystringOptional

Refill frequency of medication 2

Drug 2 Quantity

drug2QuantitystringOptional

Quantity of medication 2

Drug 3 Name

drug3NamestringOptional

Name of medication 3

Drug 3 Dosage

drug3DosagestringOptional

Dosage of medication 3

Drug 3 Refill Frequency

drug3RefillFrequencystringOptional

Refill frequency of medication 3

Drug 3 Quantity

drug3QuantitystringOptional

Quantity of medication 3

Drug 4 Name

drug4NamestringOptional

Name of medication 4

Drug 4 Dosage

drug4DosagestringOptional

Dosage of medication 4

Drug 4 Refill Frequency

drug4RefillFrequencystringOptional

Refill frequency of medication 4

Drug 4 Quantity

drug4QuantitystringOptional

Quantity of medication 4

Drug 5 Name

drug5NamestringOptional

Name of medication 5

Drug 5 Dosage

drug5DosagestringOptional

Dosage of medication 5

Drug 5 Refill Frequency

drug5RefillFrequencystringOptional

Refill frequency of medication 5

Drug 5 Quantity

drug5QuantitystringOptional

Quantity of medication 5

Drug 6 Name

drug6NamestringOptional

Name of medication 6

Drug 6 Dosage

drug6DosagestringOptional

Dosage of medication 6

Drug 6 Refill Frequency

drug6RefillFrequencystringOptional

Refill frequency of medication 6

Drug 6 Quantity

drug6QuantitystringOptional

Quantity of medication 6

Drug 7 Name

drug7NamestringOptional

Name of medication 7

Drug 7 Dosage

drug7DosagestringOptional

Dosage of medication 7

Drug 7 Refill Frequency

drug7RefillFrequencystringOptional

Refill frequency of medication 7

Drug 7 Quantity

drug7QuantitystringOptional

Quantity of medication 7

Drug 8 Name

drug8NamestringOptional

Name of medication 8

Drug 8 Dosage

drug8DosagestringOptional

Dosage of medication 8

Drug 8 Refill Frequency

drug8RefillFrequencystringOptional

Refill frequency of medication 8

Drug 8 Quantity

drug8QuantitystringOptional

Quantity of medication 8

Drug 9 Name

drug9NamestringOptional

Name of medication 9

Drug 9 Dosage

drug9DosagestringOptional

Dosage of medication 9

Drug 9 Refill Frequency

drug9RefillFrequencystringOptional

Refill frequency of medication 9

Drug 9 Quantity

drug9QuantitystringOptional

Quantity of medication 9

Drug 10 Name

drug10NamestringOptional

Name of medication 10

Drug 10 Dosage

drug10DosagestringOptional

Dosage of medication 10

Drug 10 Refill Frequency

drug10RefillFrequencystringOptional

Refill frequency of medication 10

Drug 10 Quantity

drug10QuantitystringOptional

Quantity of medication 10

Uses Pharmacy

usesPharmacyEnumRequired

Do you use a pharmacy to fill prescriptions?

Value options:

"Yes": string"No": string"Mail order": string

Default value of this property is "Yes"

Pharmacy Name

pharmacyNamestringOptional

Name of the pharmacy

Developer
Maintained by Community

Actor Metrics

  • 1 monthly user

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  • Created in Dec 2024

  • Modified 18 days ago

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