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 xmlns="http://hl7.org/fhir">
<id value="e905f503-090c-45ab-b197-1b1d10998h2a"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-as-enrollment-bundle"/>
</meta>
<identifier>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="RI"/>
<display value="Resource identifier"/>
</coding>
</type>
<system value="http://vendor.com/ab"/>
<value value="316e9740-2c4d-4c5d-98b0-c68c84706807"/>
<assigner>
<display value="Alpha Beta"/>
</assigner>
</identifier>
<type value="message"/>
<timestamp value="2020-03-11T08:10:13-05:00"/>
<entry>
<fullUrl value="urn:uuid:eb5eb40b-78e8-4a52-903a-0348c1eac387"/>
<resource>
<MessageHeader>
<id value="fe0cc042-1a9a-4bfc-9989-aba61523366f"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-messageheader"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: MessageHeader</b><a name="fe0cc042-1a9a-4bfc-9989-aba61523366f"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource MessageHeader "fe0cc042-1a9a-4bfc-9989-aba61523366f" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-messageheader.html">UAPI MessageHeader</a></p></div><p><b>event</b>: 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')</p><h3>Destinations</h3><table class="grid"><tr><td>-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td>*</td><td>UAPI-ENR-V2.1</td><td><a href="https://test-us-e1.apis.roche.com/pharma-cmg-ehr-fhir-exp-test/v2/enrollment">https://test-us-e1.apis.roche.com/pharma-cmg-ehr-fhir-exp-test/v2/enrollment</a></td></tr></table><p><b>sender</b>: <a href="#Organization_01c31a2f-321d-4c6e-8349-206af8a88088">See above (urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088)</a></p><h3>Sources</h3><table class="grid"><tr><td>-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td>*</td><td>Vendor_AB</td><td><a href="http://vendor.com/fhir/enrollmentID/ENR-00001">http://vendor.com/fhir/enrollmentID/ENR-00001</a></td></tr></table><p><b>focus</b>: <a href="#List_4881c09f-657b-4262-afff-542b72880f99">See above (urn:uuid:b9604e41-5785-4a40-a4ac-a6112f22ef70)</a></p></div>
</text>
<eventCoding>
<system
value="http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-event-type"/>
<code value="enrollment-with-consent"/>
</eventCoding>
<destination>
<name value="UAPI-ENR-V2.1"/>
<endpoint
value="https://test-us-e1.apis.roche.com/pharma-cmg-ehr-fhir-exp-test/v2/enrollment"/>
</destination>
<sender>
<reference value="urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"/>
<type value="Organization"/>
</sender>
<source>
<name value="Vendor_AB"/>
<endpoint value="http://vendor.com/fhir/enrollmentID/ENR-00001"/>
</source>
<focus>
<reference value="urn:uuid:b9604e41-5785-4a40-a4ac-a6112f22ef70"/>
<type value="List"/>
</focus>
</MessageHeader>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:b9604e41-5785-4a40-a4ac-a6112f22ef70"/>
<resource>
<List>
<id value="4881c09f-657b-4262-afff-542b72880f99"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: List</b><a name="4881c09f-657b-4262-afff-542b72880f99"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource List "4881c09f-657b-4262-afff-542b72880f99" </p></div><p><b>status</b>: current</p><p><b>mode</b>: changes</p><p><b>title</b>: messageContext</p><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#Organization_01c31a2f-321d-4c6e-8349-206af8a88088">See above (urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#Practitioner_695d0991-5e03-46df-934a-85a28acd95c1">See above (urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#QuestionnaireResponse_5342779a-184f-42ba-ab44-3a8e02397he1">See above (urn:uuid:5342779a-184f-42ba-ab44-3a8e02397he1)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#Coverage_42b41bdb-1781-49aa-a091-78cdd92129df">See above (urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#Consent_1b53bfb2-1361-4906-acd8-35294d30273b">See above (urn:uuid:1b53bfb2-1361-4906-acd8-35294d30273b)</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="Bundle-caf568e0-21b6-40e4-b0b8-1fdddef30fd2.html#urn-uuid-45cf0b29-8c1d-4882-91e1-00bc28c06a52">urn:uuid:45cf0b29-8c1d-4882-91e1-00bc28c06a52</a></p></blockquote><blockquote><p><b>entry</b></p><p><b>item</b>: <a href="#RelatedPerson_4db51d32-65c3-4f8c-959e-0155c6d14545">See above (urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545)</a></p></blockquote></div>
</text>
<status value="current"/>
<mode value="changes"/>
<title value="messageContext"/>
<entry>
<item>
<reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<type value="Patient"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"/>
<type value="Organization"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"/>
<type value="Practitioner"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:5342779a-184f-42ba-ab44-3a8e02397he1"/>
<type value="QuestionnaireResponse"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df"/>
<type value="Coverage"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:1b53bfb2-1361-4906-acd8-35294d30273b"/>
<type value="Consent"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:45cf0b29-8c1d-4882-91e1-00bc28c06a52"/>
<type value="Organization"/>
</item>
</entry>
<entry>
<item>
<reference value="urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545"/>
<type value="RelatedPerson"/>
</item>
</entry>
</List>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<resource>
<Patient>
<id value="fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-patient"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Patient</b><a name="fc2e5a72-c363-4616-ae00-4ad25cbcb45c"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Patient "fc2e5a72-c363-4616-ae00-4ad25cbcb45c" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-patient.html">UAPI Patient</a></p></div><p><b>identifier</b>: Patient internal identifier: 6bcd8467-0473-4836-9128-2e7972f23177(use: USUAL)</p><p><b>name</b>: Ryan Michaelson (OFFICIAL)</p><p><b>telecom</b>: ph: 1231231234(HOME), ph: 1234561234(MOBILE), <a href="mailto:bobster83@example.com">bobster83@example.com</a></p><p><b>gender</b>: male</p><p><b>birthDate</b>: 1972-10-29</p><p><b>address</b>: 1234 Main St San Francisco CA 94105 US </p><h3>Communications</h3><table class="grid"><tr><td>-</td><td><b>Language</b></td><td><b>Preferred</b></td></tr><tr><td>*</td><td>English <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-v3-ietf3066.html">Tags for the Identification of Languages</a>#en)</span></td><td>true</td></tr></table><p><b>generalPractitioner</b>: <a href="#Practitioner_695d0991-5e03-46df-934a-85a28acd95c1">See above (urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1)</a></p><p><b>managingOrganization</b>: <a href="#Organization_01c31a2f-321d-4c6e-8349-206af8a88088">See above (urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088)</a></p></div>
</text>
<identifier>
<use value="usual"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="PI"/>
<display value="Patient internal identifier"/>
</coding>
</type>
<system value="http://vendor.com/ab"/>
<value value="6bcd8467-0473-4836-9128-2e7972f23177"/>
<assigner>
<display value="AB Vendor"/>
</assigner>
</identifier>
<name>
<use value="official"/>
<family value="Michaelson"/>
<given value="Ryan"/>
</name>
<telecom>
<system value="phone"/>
<value value="1231231234"/>
<use value="home"/>
<rank value="1"/>
</telecom>
<telecom>
<system value="phone"/>
<value value="1234561234"/>
<use value="mobile"/>
<rank value="2"/>
</telecom>
<telecom>
<system value="email"/>
<value value="bobster83@example.com"/>
<use value="home"/>
<rank value="3"/>
</telecom>
<gender value="male"/>
<birthDate value="1972-10-29"/>
<address>
<line value="1234 Main St"/>
<city value="San Francisco"/>
<state value="CA"/>
<postalCode value="94105"/>
<country value="US"/>
</address>
<communication>
<language>
<coding>
<system value="urn:ietf:bcp:47"/>
<code value="en"/>
<display value="English"/>
</coding>
</language>
<preferred value="true"/>
</communication>
<generalPractitioner>
<reference value="urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"/>
</generalPractitioner>
<managingOrganization>
<reference value="urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"/>
</managingOrganization>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"/>
<resource>
<Organization>
<id value="01c31a2f-321d-4c6e-8349-206af8a88088"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-organization"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Organization</b><a name="01c31a2f-321d-4c6e-8349-206af8a88088"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Organization "01c31a2f-321d-4c6e-8349-206af8a88088" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-organization.html">UAPI Organization</a></p></div><p><b>identifier</b>: id: HOSP-12345(use: USUAL)</p><p><b>type</b>: Healthcare Provider <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R4B/codesystem-organization-type.html">OrganizationType</a>#prov)</span></p><p><b>name</b>: Mid Atlantic Retina</p><p><b>telecom</b>: <a href="mailto:mar@example.com">mar@example.com</a></p><p><b>address</b>: 8 Ranoldo Terrace Cherry Hill NJ 08034 US </p><h3>Contacts</h3><table class="grid"><tr><td>-</td><td><b>Name</b></td><td><b>Telecom</b></td></tr><tr><td>*</td><td>Venus Yardav (OFFICIAL)</td><td>ph: 8882704882(WORK), fax: 8179974042(WORK)</td></tr></table></div>
</text>
<identifier>
<use value="usual"/>
<system value="http://vendor.com/ab"/>
<value value="HOSP-12345"/>
<assigner>
<display value="AB Vendor"/>
</assigner>
</identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="prov"/>
<display value="Healthcare Provider"/>
</coding>
</type>
<name value="Mid Atlantic Retina"/>
<telecom>
<system value="email"/>
<value value="mar@example.com"/>
</telecom>
<address>
<line value="8 Ranoldo Terrace"/>
<city value="Cherry Hill"/>
<state value="NJ"/>
<postalCode value="08034"/>
<country value="US"/>
</address>
<contact>
<name>
<use value="official"/>
<family value="Yardav"/>
<given value="Venus"/>
</name>
<telecom>
<system value="phone"/>
<value value="8882704882"/>
<use value="work"/>
<rank value="1"/>
</telecom>
<telecom>
<system value="fax"/>
<value value="8179974042"/>
<use value="work"/>
<rank value="2"/>
</telecom>
</contact>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"/>
<resource>
<Practitioner>
<id value="695d0991-5e03-46df-934a-85a28acd95c1"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-practitioner"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Practitioner</b><a name="695d0991-5e03-46df-934a-85a28acd95c1"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Practitioner "695d0991-5e03-46df-934a-85a28acd95c1" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-practitioner.html">UAPI Practitioner</a></p></div><p><b>identifier</b>: Provider identifier: 1922071448(use: OFFICIAL), Tax ID number: 00000000(use: OFFICIAL), National provider identifier: 1639285034(use: OFFICIAL)</p><p><b>name</b>: MARISSA CRUZ (OFFICIAL)</p></div>
</text>
<identifier>
<use value="official"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="PRN"/>
<display value="Provider identifier"/>
</coding>
</type>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="1922071448"/>
<assigner>
<display value="Centers for Medicare & Medicaid Services"/>
</assigner>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="TAX"/>
<display value="Tax ID number"/>
</coding>
</type>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="00000000"/>
</identifier>
<identifier>
<use value="official"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
<code value="NPI"/>
<display value="National provider identifier"/>
</coding>
</type>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="1639285034"/>
</identifier>
<name>
<use value="official"/>
<family value="CRUZ"/>
<given value="MARISSA"/>
</name>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df"/>
<resource>
<Coverage>
<id value="42b41bdb-1781-49aa-a091-78cdd92129df"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-coverage"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Coverage</b><a name="42b41bdb-1781-49aa-a091-78cdd92129df"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Coverage "42b41bdb-1781-49aa-a091-78cdd92129df" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-coverage.html">UAPI Coverage</a></p></div><p><b>status</b>: active</p><p><b>type</b>: health insurance plan policy <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-v3-ActCode.html">ActCode</a>#HIP)</span></p><p><b>subscriber</b>: <a href="#RelatedPerson_4db51d32-65c3-4f8c-959e-0155c6d14545">See above (urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545)</a></p><p><b>subscriberId</b>: 4353</p><p><b>beneficiary</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p><p><b>payor</b>: <a href="#Organization_d3637025-883d-4678-9e0a-1d243a338f9f">See above (urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f)</a></p><h3>Classes</h3><table class="grid"><tr><td>-</td><td><b>Type</b></td><td><b>Value</b></td><td><b>Name</b></td></tr><tr><td>*</td><td>Group <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R4B/codesystem-coverage-class.html">Coverage Class Codes</a>#group)</span></td><td>12344frgr</td><td>Group Number</td></tr></table><p><b>order</b>: 1</p><p><b>network</b>: Dakotacare</p></div>
</text>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
<code value="HIP"/>
<display value="health insurance plan policy"/>
</coding>
</type>
<subscriber>
<reference value="urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545"/>
<type value="RelatedPerson"/>
</subscriber>
<subscriberId value="4353"/>
<beneficiary>
<reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<type value="Patient"/>
</beneficiary>
<payor>
<reference value="urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f"/>
<type value="Organization"/>
</payor>
<class>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="group"/>
<display value="Group"/>
</coding>
</type>
<value value="12344frgr"/>
<name value="Group Number"/>
</class>
<order value="1"/>
<network value="Dakotacare"/>
</Coverage>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545"/>
<resource>
<RelatedPerson>
<id value="4db51d32-65c3-4f8c-959e-0155c6d14545"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-relatedPerson"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: RelatedPerson</b><a name="4db51d32-65c3-4f8c-959e-0155c6d14545"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource RelatedPerson "4db51d32-65c3-4f8c-959e-0155c6d14545" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-relatedPerson.html">UAPI RelatedPerson</a></p></div><p><b>patient</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p><p><b>relationship</b>: significant other <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-v3-RoleCode.html">RoleCode</a>#SIGOTHR)</span></p><p><b>name</b>: Bob Paul Smith (OFFICIAL)</p><p><b>telecom</b>: <a href="tel:+33(237)998327">+33 (237) 998327</a></p><p><b>birthDate</b>: 1972-10-29</p></div>
</text>
<patient>
<reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<type value="Patient"/>
</patient>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-RoleCode"/>
<code value="SIGOTHR"/>
<display value="significant other"/>
</coding>
</relationship>
<name>
<use value="official"/>
<family value="Smith"/>
<given value="Bob Paul"/>
</name>
<telecom>
<system value="phone"/>
<value value="+33 (237) 998327"/>
<use value="mobile"/>
</telecom>
<birthDate value="1972-10-29"/>
</RelatedPerson>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:5342779a-184f-42ba-ab44-3a8e02397he1"/>
<resource>
<QuestionnaireResponse>
<id value="5342779a-184f-42ba-ab44-3a8e02397he1"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: QuestionnaireResponse</b><a name="5342779a-184f-42ba-ab44-3a8e02397he1"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource QuestionnaireResponse "5342779a-184f-42ba-ab44-3a8e02397he1" </p></div><p><b>questionnaire</b>: <a href="https://dev.gene.com/fhir/uapi/fhirapi/Questionnaire/1234">https://dev.gene.com/fhir/uapi/fhirapi/Questionnaire/1234</a></p><p><b>status</b>: completed</p><p><b>subject</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p><blockquote><p><b>item</b></p><p><b>linkId</b>: detailed-message</p><p><b>text</b>: Ok to leave a detailed message?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Yes</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: household-size</p><p><b>text</b>: Household size (including you)</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>3</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: household-income-amount</p><p><b>text</b>: Annual household income amount</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>$75,000</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: tcpa-consent</p><p><b>text</b>: TCPA Consent Provided?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Yes</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: hemlibra-weight-kg</p><p><b>text</b>: Weight (kg)</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>80</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: hemlibra-12-months-or-more-since-hemlibra-injection</p><p><b>text</b>: Has it been 12 months or more since the patient's last HEMLIBRA injection?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Yes</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: hemlibra-started-prescribed-hemlibra-emicizumab</p><p><b>text</b>: Has the patient started prescribed HEMLIBRA® (emicizumab)?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Yes</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: hemlibra-hemophilia-a</p><p><b>text</b>: Does your patient have Hemophilia A</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>With Inhibitors</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: contact-patient</p><p><b>text</b>: Do not contact patient</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Yes</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: prescription-plan</p><p><b>text</b>: Is this a Prescription plan?</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Yes</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: enroll-in-br</p><p><b>text</b>: Enroll Patient in Benefits Reverification</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Yes</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: preferred-sp-optional</p><p><b>text</b>: Preferred Specialty Pharmacy (Optional)</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Optional Specialty Pharmacy</td></tr></table></blockquote><blockquote><p><b>item</b></p><p><b>linkId</b>: opn-optional</p><p><b>text</b>: Onsite Pharmacy Name (Optional)</p><h3>Answers</h3><table class="grid"><tr><td>-</td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Onsite Pharmacy Name</td></tr></table></blockquote></div>
</text>
<questionnaire
value="https://dev.gene.com/fhir/uapi/fhirapi/Questionnaire/1234"/>
<status value="completed"/>
<subject>
<reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<type value="Patient"/>
</subject>
<item>
<linkId value="detailed-message"/>
<text value="Ok to leave a detailed message?"/>
<answer>
<valueString value="Yes"/>
</answer>
</item>
<item>
<linkId value="household-size"/>
<text value="Household size (including you)"/>
<answer>
<valueString value="3"/>
</answer>
</item>
<item>
<linkId value="household-income-amount"/>
<text value="Annual household income amount"/>
<answer>
<valueString value="$75,000"/>
</answer>
</item>
<item>
<linkId value="tcpa-consent"/>
<text value="TCPA Consent Provided?"/>
<answer>
<valueString value="Yes"/>
</answer>
</item>
<item>
<linkId value="hemlibra-weight-kg"/>
<text value="Weight (kg)"/>
<answer>
<valueString value="80"/>
</answer>
</item>
<item>
<linkId
value="hemlibra-12-months-or-more-since-hemlibra-injection"/>
<text
value="Has it been 12 months or more since the patient's last HEMLIBRA injection?"/>
<answer>
<valueString value="Yes"/>
</answer>
</item>
<item>
<linkId value="hemlibra-started-prescribed-hemlibra-emicizumab"/>
<text
value="Has the patient started prescribed HEMLIBRA® (emicizumab)?"/>
<answer>
<valueString value="Yes"/>
</answer>
</item>
<item>
<linkId value="hemlibra-hemophilia-a"/>
<text value="Does your patient have Hemophilia A"/>
<answer>
<valueString value="With Inhibitors"/>
</answer>
</item>
<item>
<linkId value="contact-patient"/>
<text value="Do not contact patient"/>
<answer>
<valueString value="Yes"/>
</answer>
</item>
<item>
<linkId value="prescription-plan"/>
<text value="Is this a Prescription plan?"/>
<answer>
<valueString value="Yes"/>
</answer>
</item>
<item>
<linkId value="enroll-in-br"/>
<text value="Enroll Patient in Benefits Reverification"/>
<answer>
<valueString value="Yes"/>
</answer>
</item>
<item>
<linkId value="preferred-sp-optional"/>
<text value="Preferred Specialty Pharmacy (Optional)"/>
<answer>
<valueString value="Optional Specialty Pharmacy"/>
</answer>
</item>
<item>
<linkId value="opn-optional"/>
<text value="Onsite Pharmacy Name (Optional)"/>
<answer>
<valueString value="Onsite Pharmacy Name"/>
</answer>
</item>
</QuestionnaireResponse>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:1b53bfb2-1361-4906-acd8-35294d30273b"/>
<resource>
<Consent>
<id value="1b53bfb2-1361-4906-acd8-35294d30273b"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-consent"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Consent</b><a name="1b53bfb2-1361-4906-acd8-35294d30273b"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Consent "1b53bfb2-1361-4906-acd8-35294d30273b" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-consent.html">UAPI Consent</a></p></div><p><b>status</b>: active</p><p><b>scope</b>: Privacy Consent <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R4B/codesystem-consent-scope.html">Consent Scope Codes</a>#patient-privacy)</span></p><p><b>category</b>: Patient Authorization Signature <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://loinc.org/">LOINC</a>#59284-0)</span></p><p><b>patient</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p><p><b>dateTime</b>: 2016-06-16 04:24:45+0000</p><p><b>performer</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p><p><b>policyRule</b>: HIPAA Authorization <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R4B/codesystem-consent-policy.html">Policy Codes</a>#hipaa-auth)</span></p><h3>Provisions</h3><table class="grid"><tr><td>-</td><td><b>Type</b></td></tr><tr><td>*</td><td>permit</td></tr></table></div>
</text>
<status value="active"/>
<scope>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/consentscope"/>
<code value="patient-privacy"/>
<display value="Privacy Consent"/>
</coding>
</scope>
<category>
<coding>
<system value="http://loinc.org"/>
<code value="59284-0"/>
<display value="Patient Authorization Signature"/>
</coding>
</category>
<patient>
<reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<type value="Patient"/>
</patient>
<dateTime value="2016-06-16T16:24:45Z"/>
<performer>
<reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<type value="Patient"/>
</performer>
<policyRule>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/consentpolicycodes"/>
<code value="hipaa-auth"/>
<display value="HIPAA Authorization"/>
</coding>
</policyRule>
<provision>
<type value="permit"/>
</provision>
</Consent>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:80addde0-ebdf-48fa-abf9-a72961769b6e"/>
<resource>
<MedicationRequest>
<id value="80addde0-ebdf-48fa-abf9-a72961769b6e"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-medicationrequest"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: MedicationRequest</b><a name="80addde0-ebdf-48fa-abf9-a72961769b6e"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource MedicationRequest "80addde0-ebdf-48fa-abf9-a72961769b6e" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-medicationrequest.html">UAPI MedicationRequest</a></p></div><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>medication</b>: Hemlibra <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-uapi-product-name.html">UAPI Code System - Product Names</a>#hemlibra)</span></p><p><b>subject</b>: <a href="#Patient_fc2e5a72-c363-4616-ae00-4ad25cbcb45c">See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)</a></p><p><b>requester</b>: <a href="#Practitioner_695d0991-5e03-46df-934a-85a28acd95c1">See above (urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1)</a></p><p><b>courseOfTherapyType</b>: Starter <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>insurance</b>: <a href="#Coverage_42b41bdb-1781-49aa-a091-78cdd92129df">See above (urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df)</a></p><p><b>note</b>: 30-day Subsequent Dose (6mg/kg)</p><blockquote><p><b>dosageInstruction</b></p><p><b>text</b>: String (up to 50 characters)</p></blockquote><blockquote><p><b>dispenseRequest</b></p><p><b>UAPI MedicationRequest Dispenser Instructions</b>: Dispense Instruction: Quantity 1 of 60 mg vial(s) and Quantity 1 of 105 mg vial(s) and Quantity 1 of 150 mg vial(s) and Quantity 1 of 30 mg vial(s)</p><blockquote><p><b>UAPI MedicationRequest Dispense Quantity Detailed Breakdown</b></p><p><b>value</b>: 1</p><p><b>value</b>: 60mg vial(s)</p></blockquote><blockquote><p><b>UAPI MedicationRequest Dispense Quantity Detailed Breakdown</b></p><p><b>value</b>: 1</p><p><b>value</b>: 105mg vial(s)</p></blockquote><blockquote><p><b>UAPI MedicationRequest Dispense Quantity Detailed Breakdown</b></p><p><b>value</b>: 1</p><p><b>value</b>: 150mg vial(s)</p></blockquote><blockquote><p><b>UAPI MedicationRequest Dispense Quantity Detailed Breakdown</b></p><p><b>value</b>: 1</p><p><b>value</b>: 30mg vial(s)</p></blockquote><p><b>numberOfRepeatsAllowed</b>: 0</p><h3>ExpectedSupplyDurations</h3><table class="grid"><tr><td>-</td><td><b>Value</b></td><td><b>Unit</b></td><td><b>System</b></td><td><b>Code</b></td></tr><tr><td>*</td><td>1</td><td>mo</td><td><a href="http://terminology.hl7.org/5.3.0/CodeSystem-v3-ucum.html">Unified Code for Units of Measure (UCUM)</a></td><td>mo</td></tr></table></blockquote></div>
</text>
<status value="active"/>
<intent value="order"/>
<medicationCodeableConcept>
<coding>
<system
value="https://fhir.developer.gene.com/CodeSystem/uapi-product-name"/>
<code value="hemlibra"/>
<display value="Hemlibra"/>
</coding>
</medicationCodeableConcept>
<subject>
<reference value="urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c"/>
<type value="Patient"/>
</subject>
<requester>
<reference value="urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"/>
<type value="Practitioner"/>
</requester>
<courseOfTherapyType>
<text value="Starter"/>
</courseOfTherapyType>
<insurance>
<reference value="urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df"/>
<type value="Coverage"/>
</insurance>
<note>
<text value="30-day Subsequent Dose (6mg/kg)"/>
</note>
<dosageInstruction>
<text value="String (up to 50 characters)"/>
<doseAndRate>
<doseQuantity>
<value value="6"/>
<unit value="mg/kg"/>
</doseQuantity>
</doseAndRate>
</dosageInstruction>
<dispenseRequest>
<extension
url="https://fhir.developer.gene.com/StructureDefinition/dispenser-instruction">
<valueAnnotation>
<text
value="Dispense Instruction: Quantity 1 of 60 mg vial(s) and Quantity 1 of 105 mg vial(s) and Quantity 1 of 150 mg vial(s) and Quantity 1 of 30 mg vial(s)"/>
</valueAnnotation>
</extension>
<extension
url="https://fhir.developer.gene.com/StructureDefinition/dispense-quantity-detail">
<extension url="dispenseQuantity">
<valueQuantity>
<value value="1"/>
</valueQuantity>
</extension>
<extension url="dispenseUnit">
<valueString value="60mg vial(s)"/>
</extension>
</extension>
<extension
url="https://fhir.developer.gene.com/StructureDefinition/dispense-quantity-detail">
<extension url="dispenseQuantity">
<valueQuantity>
<value value="1"/>
</valueQuantity>
</extension>
<extension url="dispenseUnit">
<valueString value="105mg vial(s)"/>
</extension>
</extension>
<extension
url="https://fhir.developer.gene.com/StructureDefinition/dispense-quantity-detail">
<extension url="dispenseQuantity">
<valueQuantity>
<value value="1"/>
</valueQuantity>
</extension>
<extension url="dispenseUnit">
<valueString value="150mg vial(s)"/>
</extension>
</extension>
<extension
url="https://fhir.developer.gene.com/StructureDefinition/dispense-quantity-detail">
<extension url="dispenseQuantity">
<valueQuantity>
<value value="1"/>
</valueQuantity>
</extension>
<extension url="dispenseUnit">
<valueString value="30mg vial(s)"/>
</extension>
</extension>
<numberOfRepeatsAllowed value="0"/>
<expectedSupplyDuration>
<value value="1"/>
<unit value="mo"/>
<system value="http://unitsofmeasure.org"/>
<code value="mo"/>
</expectedSupplyDuration>
</dispenseRequest>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f"/>
<resource>
<Organization>
<id value="d3637025-883d-4678-9e0a-1d243a338f9f"/>
<meta>
<profile
value="https://fhir.developer.gene.com/StructureDefinition/uapi-organization"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Organization</b><a name="d3637025-883d-4678-9e0a-1d243a338f9f"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Organization "d3637025-883d-4678-9e0a-1d243a338f9f" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-uapi-organization.html">UAPI Organization</a></p></div><p><b>identifier</b>: id: PAY-111(use: USUAL)</p><p><b>type</b>: Insurance Company <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R4B/codesystem-organization-type.html">OrganizationType</a>#ins)</span></p><p><b>name</b>: Dakotacare</p><p><b>telecom</b>: ph: 8778472862(WORK)</p></div>
</text>
<identifier>
<use value="usual"/>
<system value="http://vendor.com/ab"/>
<value value="PAY-111"/>
<assigner>
<display value="AB Vendor"/>
</assigner>
</identifier>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/organization-type"/>
<code value="ins"/>
</coding>
</type>
<name value="Dakotacare"/>
<telecom>
<system value="phone"/>
<value value="8778472862"/>
<use value="work"/>
<rank value="1"/>
</telecom>
</Organization>
</resource>
</entry>
</Bundle>
IG © 2021+ . Package gene.com.fhir.uapi#1.1.19 based on FHIR 4.3.0. Generated 2024-02-19
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