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 e905f503-090c-45ab-b197-5b1d10996xd1 of type message
Entry 1 - Full URL = urn:uuid:eb5eb40b-78e8-4a52-903a-0348c1eac387
Resource MessageHeader:
Generated Narrative: MessageHeader
Resource MessageHeader "05621068-0e0b-4bc3-a0d0-d21f9270bcfd"
Profile: UAPI MessageHeader
Texts
- Div * <div></div> event: enrollment-only (Details: http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-event-type code enrollment-only = 'enrollment-only', stated as 'null')
Destinations
- Name Endpoint * UAPI-ENR-V1.0 https://test-us-e1.apis.roche.com/pharma-cmg-ehr-fhir-exp-test/v1/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:584681db-df12-4038-bc82-7c438b06e63b)
Entry 2 - Full URL = urn:uuid:584681db-df12-4038-bc82-7c438b06e63b
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:5342779a-184f-42ba-ab44-3a8e02397he2
Resource QuestionnaireResponse:
LinkId Text Definition Answer 5342779a-184f-42ba-ab44-3a8e02397he2
QuestionnaireResponse hemlibra-weight-kg
Weight (kg) hemlibra-12-months-or-more-since-hemlibra-injection
Has it been 12 months or more since the patient's last HEMLIBRA injection? hemlibra-started-prescribed-hemlibra-emicizumab
Has the patient started prescribed HEMLIBRA® (emicizumab)? hemlibra-hemophilia-a
Does your patient have Hemophilia A contact-patient
Do not contact patient prescription-plan
Is this a Prescription plan? enroll-in-br
Enroll Patient in Benefits Reverification preferred-sp-optional
Preferred Specialty Pharmacy (Optional) opn-optional
Onsite Pharmacy Name (Optional) 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: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 11 - 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 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:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)
Entry 13 - Full URL = urn:uuid:1409c0e9-6b06-4de5-82e7-577516c866db
Resource ServiceRequest:
Generated Narrative: ServiceRequest
Resource ServiceRequest "1409c0e9-6b06-4de5-82e7-577516c866db"
Profile: UAPI ServiceRequest
Texts
- Div * <div></div> status: ACTIVE
intent: ORDER
code: Starter (UAPI Code System - Service Request Type#starter)
subject: See above (urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c)
Entry 14 - Full URL = 80addde0-ebdf-48fa-abf9-a72961769b6e
Resource MedicationRequest:
Generated Narrative: MedicationRequest
Resource MedicationRequest "80addde0-ebdf-48fa-abf9-a72961769b6e"
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)
courseOfTherapyType: Starter ()
insurance: See above (urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df)
note: 30-day Subsequent Dose (6mg/kg)
dispenseRequest
UAPI MedicationRequest Dispenser Instructions: 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)
UAPI MedicationRequest Dispense Quantity Detailed Breakdown
value: 1
value: 60mg vial(s)
UAPI MedicationRequest Dispense Quantity Detailed Breakdown
value: 1
value: 105mg vial(s)
UAPI MedicationRequest Dispense Quantity Detailed Breakdown
value: 1
value: 150mg vial(s)
UAPI MedicationRequest Dispense Quantity Detailed Breakdown
value: 1
value: 30mg vial(s)
numberOfRepeatsAllowed: 0
ExpectedSupplyDurations
- Value Unit System Code * 1 mo Unified Code for Units of Measure (UCUM) mo
Entry 15 - 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)