> ## Documentation Index > Fetch the complete documentation index at: https://simplex.sh/docs/llms.txt > Use this file to discover all available pages before exploring further. # Fill Prior Authorization > Fill a PA form for a pharmacy claim and return a signed PDF URL. `fill_pa` resolves the correct prior-authorization form for a `(bin, pcn, state)` tuple, stamps patient / prescriber / drug / clinical-answer data onto the template, merges any attached documents (e.g. chart notes) into a single fax-ready PDF, and uploads it to S3. The response includes a short-lived signed URL. Drug metadata (strength, quantity, day supply, route of administration) is assembled server-side from the `drug_slug` — callers should not pass it directly. Use [Search Drugs](/docs/prior-auth-sdk/search-drugs) to resolve a slug. The `clinical_questions` payload is the decision-tree answer set collected from the UI that renders [Get Clinical Questions](/docs/prior-auth-sdk/get-clinical-questions). It can be a flat `{question_id: value}` dict or the wrapped export shape `{"answers": {...}, "resolved": [...]}`. Chart-note attachments are required when the clinical answers imply them (Q1 weight-loss subprompt, Q4 chart notes submitted). If the backend rejects the request for a missing attachment it returns HTTP 400; the SDK raises `WorkflowError`. ## Parameters | Name | Type | Required | Description | | ------------------------- | --------------- | -------- | ---------------------------------------------------------------------------------------------------------- | | `bin` | string | yes | Pharmacy claim BIN (6 digits). | | `pcn` | string | yes | Processor control number from the patient's insurance card. | | `state` | string | yes | Two-letter USPS state code where the prescription will be filled. | | `member_id` | string | yes | Cardholder ID (302-C2). | | `drug_slug` | string | yes | Canonical drug identifier from [Search Drugs](/docs/prior-auth-sdk/search-drugs) (e.g. `"wegovy_4mg_tablets"`). | | `icd10_diagnosis` | string | yes | ICD-10 diagnosis code (e.g. `"E66.9"`). | | `patient` | object | yes | Patient demographics. See [PatientInfo](#patientinfo). | | `prescriber` | object | yes | Prescriber information. See [PrescriberInfo](#prescriberinfo). | | `group` | string | no | NCPDP Group ID (301-C1). Optional. | | `form_specific_questions` | object | no | Form-specific answers (e.g. `prescription_date`). Shape is form-dependent. | | `clinical_questions` | object or array | no | Decision-tree answers from the PA UI. | | `documents` | array | no | Files to merge into the filled PDF. Each entry may be a path string or a `(filename, bytes)` tuple. | ### PatientInfo | Field | Type | Description | | ------------ | ------ | ---------------------------------------------- | | `first_name` | string | Patient first name. | | `last_name` | string | Patient last name. | | `dob` | string | Date of birth as `MM/DD/YYYY` or `YYYY-MM-DD`. | | `id` | string | Member / cardholder ID. | | `address` | string | Street address (line 1). | | `city` | string | City. | | `state` | string | Two-letter USPS state code. | | `zip` | string | 5-digit ZIP. | | `home_phone` | string | Home phone number. | | `gender` | string | `"M"` or `"F"`. | ### PrescriberInfo | Field | Type | Description | | -------------- | ------ | ----------------------------------------- | | `first_name` | string | Prescriber first name. | | `last_name` | string | Prescriber last name. | | `npi` | string | National Provider Identifier (10 digits). | | `address` | string | Office address (line 1). | | `city` | string | City. | | `state` | string | Two-letter USPS state code. | | `zip` | string | 5-digit ZIP. | | `office_phone` | string | Office phone number. | ## Example ```python theme={null} from simplex import ( CaremarkGlobalPaFormQuestions, ClinicalAnswers, FillPaResponse, PatientInfo, PrescriberInfo, SimplexClient, SimplexError, ) client = SimplexClient() PATIENT: PatientInfo = { "first_name": "Jordan", "last_name": "WHITAKER", "dob": "1987-08-22", "id": "PSHP8839241076", "address": "4412 SE STEELE ST", "city": "PORTLAND", "state": "OR", "zip": "97206", "home_phone": "5035550142", "gender": "F", } PRESCRIBER: PrescriberInfo = { "first_name": "Evelyn", "last_name": "Harper", "npi": "1427389056", "address": "2130 NW Lovejoy St, Suite 400", "city": "Portland", "state": "OR", "zip": "97210", "office_phone": "5035550318", } FORM_SPECIFIC_QUESTIONS: CaremarkGlobalPaFormQuestions = { "prescription_date": "04/24/2026", } # Wrapped {answers, resolved} payload from the clinical-question UI. # `answers` drives form-fill decisions; `resolved` is preserved for audit. CLINICAL_ANSWERS: ClinicalAnswers = { "answers": { "indication_selector": "wm_adult_injection", "wm_adult_injection_phase": "initiation", "wm_adult_init_age_18_or_older": "18", "wm_adult_init_diet_and_activity": "yes", "wm_adult_init_6mo_wm_program": "yes", "wm_adult_init_bmi_branch": "bmi_ge_30", "wm_adult_init_bmi_value": "30", }, "resolved": [ { "question_id": "indication_selector", "prompt": "Which indication is this prior authorization for?", "answer_value": "wm_adult_injection", "answer_label": "Weight management (Adult) — Wegovy Injection", }, { "question_id": "wm_adult_init_bmi_value", "prompt": "What is the patient's baseline BMI (kg/m²)?", "answer_value": "30", "answer_label": "30 kg/m²", }, ], } # 1. Resolve drug_slug. match = client.search_drugs("wegovy 2.4mg auto-injectors")["matches"][0] # 2. Fill the PA. try: response: FillPaResponse = client.fill_pa( bin="004336", pcn="ADV", state="OR", member_id="PSHP8839241076", drug_slug=match["slug"], icd10_diagnosis="E66.9", patient=PATIENT, prescriber=PRESCRIBER, form_specific_questions=FORM_SPECIFIC_QUESTIONS, clinical_questions=CLINICAL_ANSWERS, documents=["chart_notes.pdf"], ) print(response["signed_url"]) except SimplexError as e: print(f"error: {e}") ``` ## Response ```json theme={null} { "succeeded": true, "form_id": "a2d18bab-8e4e-4873-b558-b65958b48400", "signed_url": "https://s3.us-west-1.amazonaws.com/simplex-prior-auth-submissions/a2d18bab-.../preview.pdf?...", "expires_at": "2026-04-25T06:15:18.958231+00:00" } ``` | Field | Description | | ------------ | ----------------------------------------------------------------------------------- | | `succeeded` | `true` when the form was filled and uploaded. | | `form_id` | UUID for the submission. Also appears in the signed URL. | | `signed_url` | Short-lived HTTPS URL where the filled PDF can be downloaded. Valid for \~24 hours. | | `expires_at` | ISO-8601 timestamp when `signed_url` expires. |