Universal API Implementation Guide
1.1.19 - ci-build
Universal API Implementation Guide - Local Development build (v1.1.19). See the Directory of published versions
Bundle 316b5e76-22a6-499a-a27d-c02d798000c9 of type message
Entry 1 - Full URL = urn:uuid:2fa6bc10-aa73-4bec-b357-39839c736ab9
Resource MessageHeader:
Generated Narrative: MessageHeader
Resource MessageHeader "2fa6bc10-aa73-4bec-b357-39839c736ab9"
Profile: UAPI MessageHeader
Texts
- Div * <div></div> event: enrollment-with-consent (Details: http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-event-type code enrollment-with-consent = 'enrollment-with-consent', stated as 'null')
Destinations
- Name Endpoint * UAPI-ENR-V2.0 https://test-us-e1.apis.roche.com/pharma-cmg-ehr-fhir-exp-test/v2/enrollment sender: See above (urn:uuid:9edd9044-26ab-4639-b59c-be07d459e045)
Sources
- Name Endpoint * <MPS Practice Name> http://mps.gene.com
Entry 2 - Full URL = urn:uuid:b898769f-53d9-4453-a957-2683942af961
Resource List:
messageContext
Mode: Change List Status: Current
Entry 3 - Full URL = urn:uuid:746db8d7-8660-4b59-bd2f-fc240bd181b4
Resource Patient:
Ryan Michaelson (OFFICIAL) Male, DoB: 1972-10-29 ( Patient internal identifier: 746db8d7-8660-4b59-bd2f-fc240bd181b4(use: OFFICIAL))
Entry 4 - Full URL = urn:uuid:9edd9044-26ab-4639-b59c-be07d459e045
Resource Organization:
Generated Narrative: Organization
Resource Organization "9edd9044-26ab-4639-b59c-be07d459e045"
Profile: UAPI Organization
Texts
- Div * <div></div> identifier: id: 0011P000019Y4bLQAS(use: USUAL)
type: Healthcare Provider (OrganizationType#prov)
name: Healthstar Physicians
contact
telecom: ph: -unknown-
address: 420 W MORRIS BLVD MORRISTOWN TN 37813 US
contact
name: Luis McLean (OFFICIAL)
telecom: ph: 4232002041(WORK), fax: 4235862410(WORK)
Entry 5 - Full URL = urn:uuid:0eba1bbc-782a-4727-b186-03e3abe86648
Resource Practitioner:
Generated Narrative: Practitioner
Resource Practitioner "0eba1bbc-782a-4727-b186-03e3abe86648"
Profile: UAPI Practitioner
Texts
- Div * <div></div> identifier: id: PRES-31448(use: OFFICIAL)
name: MARISSA CRUZ (OFFICIAL)
Entry 6 - Full URL = urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df
Resource Coverage:
Resource Coverage "42b41bdb-1781-49aa-a091-78cdd92129df"
Profile: UAPI Coverage
Texts
- Div * <div></div> status: ACTIVE
type: health insurance plan policy (ActCode#HIP)
subscriber: See above (urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545)
subscriberId: id: 4353
beneficiary: See above (urn:uuid:746db8d7-8660-4b59-bd2f-fc240bd181b4)
Classes
- Type Value Name * Group (Coverage Class Codes#group) id: 12344frgr Group Number order: 1
network: Dakotacare
Entry 7 - Full URL = urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545
Resource RelatedPerson:
Generated Narrative: RelatedPerson
Resource RelatedPerson "4db51d32-65c3-4f8c-959e-0155c6d14545"
Profile: UAPI RelatedPerson
Texts
- Div * <div></div> patient: See above (urn:uuid:746db8d7-8660-4b59-bd2f-fc240bd181b4)
relationship: significant other (RoleCode#SIGOTHR)
name: Bob Paul Smith (OFFICIAL)
telecom: +33 (237) 998327
birthDate: 1972-10-29
Entry 8 - Full URL = urn:uuid:680fa043-5770-4ca9-84e7-5b1acacc1657
Resource QuestionnaireResponse:
LinkId Text Definition Answer 680fa043-5770-4ca9-84e7-5b1acacc1657
QuestionnaireResponse authorization
Authorization # household-size
Household size opn-optional
Onsite Pharmacy Name (Optional) preferred-sp-optional
Preferred Specialty Pharmacy (Optional) site-of-treatment
Site of Treatment contact-patient
Do not contact patient detailed-message
Ok to leave a detailed message? household-income
Annual household income onsite-pharmacy
Onsite Pharmacy? pa-in-place
Is prior authorization in place? pos
Place of Service prescription-plan
Is this a Prescription plan? re-verify-benefits-at-pa-expiration
Re-verify benefits at PA expiration specialty-pharmacy
Specialty Pharmacy? tcpa-consent
TCPA Consent Provided? text-message
Ok to send a text message? Documentation for this format
Entry 9 - Full URL = urn:uuid:bc20c5ea-f639-4221-ab61-ce75c5e64aba
Resource Condition:
Generated Narrative: Condition
Resource Condition "bc20c5ea-f639-4221-ab61-ce75c5e64aba"
Texts
- Div * <div></div> code: Type 1 diab with mild nonp rtnop with macular edema, r eye (International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)#E10.3211)
subject: See above (urn:uuid:746db8d7-8660-4b59-bd2f-fc240bd181b4)
Entry 10 - Full URL = urn:uuid:1b53bfb2-1361-4906-acd8-35294d30273b
Resource Consent:
Resource Consent "1b53bfb2-1361-4906-acd8-35294d30273b"
Profile: UAPI Consent
Texts
- Div * <div></div> status: ACTIVE
category: Patient Authorization Signature (LOINC#59284-0)
Entry 11 - Full URL = urn:uuid:cb626b8a-4e0e-484b-b4fb-1f48fd318418
Resource Provenance:
Provenance for See above (urn:uuid:1b53bfb2-1361-4906-acd8-35294d30273b)
Summary
Recorded Jan 6, 2021, 10:49:41 PM Agents
who See above (urn:uuid:746db8d7-8660-4b59-bd2f-fc240bd181b4)
Entry 12 - Full URL = urn:uuid:212c57ad-45cd-4882-87e7-8415ded3db05
Resource ServiceRequest:
Generated Narrative: ServiceRequest
Resource ServiceRequest "212c57ad-45cd-4882-87e7-8415ded3db05"
Profile: UAPI ServiceRequest
Texts
- Div * <div></div> status: ACTIVE
intent: ORDER
code: Benefit Investigation / Prior Authorization (UAPI Code System - Service Request Type#bipa)
subject: See above (urn:uuid:746db8d7-8660-4b59-bd2f-fc240bd181b4)
Entry 13 - Full URL = urn:uuid:8ae8ca14-1d93-45d1-bfd0-f6dcbc1fede8
Resource MedicationRequest:
Generated Narrative: MedicationRequest
Resource MedicationRequest "8ae8ca14-1d93-45d1-bfd0-f6dcbc1fede8"
Profile: UAPI MedicationRequest
Texts
- Div * <div></div> status: ACTIVE
intent: ORDER
subject: See above (urn:uuid:746db8d7-8660-4b59-bd2f-fc240bd181b4)
requester: See above (urn:uuid:0eba1bbc-782a-4727-b186-03e3abe86648)
courseOfTherapyType: Subsequent Dose ()
insurance: See above (urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df)
note: Every 6 months
dispenseRequest
numberOfRepeatsAllowed: 1
ExpectedSupplyDurations
- Value Unit * 2 300 mg vial(s)
Entry 14 - Full URL = urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f
Resource Organization:
Generated Narrative: Organization
Resource Organization "d3637025-883d-4678-9e0a-1d243a338f9f"
Profile: UAPI Organization
Texts
- Div * <div></div> identifier: id: PAY-111(use: USUAL)
type: Insurance Company (OrganizationType#ins)
name: Dakotacare
Contacts
- Telecom * ph: 8778472862(WORK)
Entry 15 - Full URL = urn:uuid:45cf0b29-8c1d-4882-91e1-00bc28c06a52
Resource Organization:
Generated Narrative: Organization
Resource Organization "45cf0b29-8c1d-4882-91e1-00bc28c06a52"
Profile: UAPI Organization
Texts
- Div * <div></div> identifier: id: Infusion Site Id(use: USUAL)
type: Site of Treatment (OrganizationType#other)
name: Infusion Centre
contact
telecom: ph: 8882704882(WORK), fax: 8179974042(WORK)
address: 8 Ranoldo Terrace Cherry Hill NJ 08034 US
contact
name: Venus Yardav (OFFICIAL)
telecom: ph: -unknown-