Universal API Implementation Guide - Local Development build (v1.1.19). See the Directory of published versions
Example Bundle: External - UAPI AS Enrollment biPA CoPay Bundle Before (Cotellic)
Bundle ca5e6019-b4f7-41ae-a7f9-11903a8ab566 of type message
Entry 1 - Full URL = urn:uuid:eb5eb40b-78e8-4a52-903a-0348c1eac387
Resource MessageHeader:
Generated Narrative: MessageHeader
Resource MessageHeader "fe0cc042-1a9a-4bfc-9989-aba61523366f"
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-V2.1 https://test-us-e1.apis.roche.com/pharma-cmg-ehr-fhir-exp-test/v2/enrollment sender: See above (urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088)
Sources
- Name Endpoint * Vendor_AB http://vendor.com/fhir/enrollmentID/ENR-00001 focus: See above (urn:uuid:2758ea1a-0522-4190-9849-5e1719b1733d)
Entry 2 - Full URL = urn:uuid:2758ea1a-0522-4190-9849-5e1719b1733d
Resource List:
messageContext
Mode: Change List Status: Current
Entry 3 - Full URL = urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c
Resource Patient:
Ryan Michaelson (OFFICIAL) Male, DoB: 1972-10-29 ( Patient internal identifier: 6bcd8467-0473-4836-9128-2e7972f23177(use: USUAL))
Entry 4 - Full URL = urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088
Resource Organization:
Generated Narrative: Organization
Resource Organization "01c31a2f-321d-4c6e-8349-206af8a88088"
Profile: UAPI Organization
Texts
- Div * <div></div> identifier: id: HOSP-12345(use: USUAL)
type: Healthcare Provider (OrganizationType#prov)
name: Mid Atlantic Retina
contact
telecom: mar@example.com
address: 8 Ranoldo Terrace Cherry Hill NJ 08034 US
contact
name: Venus Yardav (OFFICIAL)
telecom: ph: 8882704882(WORK), fax: 8179974042(WORK)
Entry 5 - Full URL = urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1
Resource Practitioner:
Generated Narrative: Practitioner
Resource Practitioner "695d0991-5e03-46df-934a-85a28acd95c1"
Profile: UAPI Practitioner
Texts
- Div * <div></div> identifier: Provider identifier: 1922071448(use: OFFICIAL), Tax ID number: 00000000(use: OFFICIAL), National provider identifier: 1639285034(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:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)
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:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)
relationship: significant other (RoleCode#SIGOTHR)
name: Bob Paul Smith (OFFICIAL)
telecom: +33 (237) 998327
birthDate: 1972-10-29
Entry 8 - Full URL = urn:uuid:af15ccf2-4e36-400f-8e74-24fbcf29dfbd
Resource QuestionnaireResponse:
LinkId Text Definition Answer af15ccf2-4e36-400f-8e74-24fbcf29dfbd
QuestionnaireResponse authorization
Authorization # Date of Treatment Household size Line of therapy-other? Onsite Pharmacy Name (Optional) Preferred Specialty Pharmacy (Optional) Site of Treatment Do not contact patient Is Cotellic going to be used in combination with ZELBORAF® (vemurafenib)? Has the patient been confirmed positive for BRAF V600E? Has the patient been confirmed positive for BRAF V600K? Does the patient have unresectable/metastatic melanoma? Ok to leave a detailed message? Has treatment started? Annual household income Line of therapy? Onsite Pharmacy? Is prior authorization in place? Is this a Prescription plan? Re-verify benefits at PA expiration Specialty Pharmacy? TCPA Consent Provided? 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:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)
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)
dateTime: 2016-06-16 04:24:45+0000
Provisions
- Type * PERMIT
Entry 11 - Full URL = urn:uuid:21b30e89-e799-484a-abcd-8c25c0b2599b
Resource Consent:
Resource Consent "21b30e89-e799-484a-abcd-8c25c0b2599b"
Profile: UAPI Consent
Texts
- Div * <div></div> status: ACTIVE
category: Prescriber Signature (LOINC#59284-0)
Entry 12 - Full URL = urn:uuid:3cb05f30-9842-4651-a17d-930d7170bedf
Resource Provenance:
Provenance for See above (urn:uuid:21b30e89-e799-484a-abcd-8c25c0b2599b)
Summary
Recorded Feb 7, 2022, 1:49:39 AM Agents
who See above (urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1)
Entry 13 - 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:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)
Entry 14 - Full URL = urn:uuid:f71a66c4-f747-4b46-8adc-875a45f8ee7e
Resource ServiceRequest:
Generated Narrative: ServiceRequest
Resource ServiceRequest "f71a66c4-f747-4b46-8adc-875a45f8ee7e"
Profile: UAPI ServiceRequest
Texts
- Div * <div></div> status: ACTIVE
intent: ORDER
code: Copay (UAPI Code System - Service Request Type#copay)
subject: See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)
Entry 15 - Full URL = urn:uuid:2988979c-49e1-4a2e-a430-acbab6d525c8
Resource MedicationRequest:
Generated Narrative: MedicationRequest
Resource MedicationRequest "2988979c-49e1-4a2e-a430-acbab6d525c8"
Profile: UAPI MedicationRequest
Texts
- Div * <div></div> status: ACTIVE
intent: ORDER
subject: See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)
requester: See above (urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1)
insurance: See above (urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df)
note: 60 mg Daily
dispenseRequest
numberOfRepeatsAllowed: 12
ExpectedSupplyDurations
- Value Unit System Code * 3 mo Unified Code for Units of Measure (UCUM) mo
Entry 16 - 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 17 - 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-