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

: External - UAPI Response to Copay Enrollment - success - JSON Representation

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{
  "resourceType" : "Bundle",
  "id" : "uapi-copay-response-1",
  "meta" : {
    "profile" : [
      "https://fhir.developer.gene.com/StructureDefinition/uapi-bundle-query-response"
    ]
  },
  "identifier" : {
    "use" : "usual",
    "system" : "http://connectiverx.com/requestId",
    "value" : "86a42a99-663b-48b8-8fd9-c1afdbca5b98"
  },
  "type" : "message",
  "timestamp" : "2023-01-11T08:10:17-05:00",
  "entry" : [
    {
      "fullUrl" : "urn:uuid:410f399f-e309-4bc9-be19-8ab330e40397",
      "resource" : {
        "resourceType" : "MessageHeader",
        "id" : "410f399f-e309-4bc9-be19-8ab330e40397",
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MessageHeader</b><a name=\"410f399f-e309-4bc9-be19-8ab330e40397\"> </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 \"410f399f-e309-4bc9-be19-8ab330e40397\" </p></div><p><b>event</b>: Enrollment Response (Details: http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-event-type code enrollment-response = 'enrollment-response', stated as 'Enrollment Response')</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>Genentech-FHIR-DEV</td><td><a href=\"https://fhir.developer.gene.com/$process-message\">https://fhir.developer.gene.com/$process-message</a></td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td>-</td><td><b>Identifier</b></td><td><b>Code</b></td></tr><tr><td>*</td><td>1-63c61a26-4965b3a156f488da6e0800ed</td><td>ok</td></tr></table><p><b>focus</b>: <a href=\"#Parameters_09cdac62-7c6b-48e6-8738-00f270280ba1\">See above (urn:uuid:09cdac62-7c6b-48e6-8738-00f270280ba1)</a></p></div>"
        },
        "eventCoding" : {
          "system" : "http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-event-type",
          "code" : "enrollment-response",
          "display" : "Enrollment Response"
        },
        "source" : {
          "name" : "Genentech-FHIR-DEV",
          "endpoint" : "https://fhir.developer.gene.com/$process-message"
        },
        "response" : {
          "identifier" : "1-63c61a26-4965b3a156f488da6e0800ed",
          "code" : "ok"
        },
        "focus" : [
          {
            "reference" : "urn:uuid:09cdac62-7c6b-48e6-8738-00f270280ba1"
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:09cdac62-7c6b-48e6-8738-00f270280ba1",
      "resource" : {
        "resourceType" : "Parameters",
        "id" : "09cdac62-7c6b-48e6-8738-00f270280ba1",
        "parameter" : [
          {
            "name" : "responder-patient",
            "valueReference" : {
              "reference" : "urn:uuid:b3d46ea3-62e6-4171-b818-d64712edfe55"
            }
          },
          {
            "name" : "search-result",
            "valueReference" : {
              "reference" : "urn:uuid:aecbb129-9a73-4b59-9d66-ff5cdb3f3164"
            }
          }
        ]
      }
    },
    {
      "fullUrl" : "urn:uuid:2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9",
      "resource" : {
        "resourceType" : "Patient",
        "id" : "2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9",
        "meta" : {
          "profile" : [
            "https://fhir.developer.gene.com/StructureDefinition/uapi-patient"
          ]
        },
        "text" : {
          "status" : "generated",
          "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: Patient</b><a name=\"2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9\"> </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 \"2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9\" </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: ca3c6274-e70b-45cf-a65a-30e8386d50bb(use: USUAL), Patient internal identifier: 8132413049(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>managingOrganization</b>: <a href=\"Bundle-caf568e0-21b6-40e4-b0b8-1fdddef30fd2.html#urn-uuid-01c31a2f-321d-4c6e-8349-206af8a88088\">urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088</a></p></div>"
        },
        "identifier" : [
          {
            "use" : "usual",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "PI",
                  "display" : "Patient internal identifier"
                }
              ]
            },
            "system" : "http://gene.com/patientmaster",
            "value" : "ca3c6274-e70b-45cf-a65a-30e8386d50bb",
            "assigner" : {
              "display" : "Genentech Patient Master"
            }
          },
          {
            "use" : "usual",
            "type" : {
              "coding" : [
                {
                  "system" : "http://terminology.hl7.org/CodeSystem/v2-0203",
                  "code" : "PI",
                  "display" : "Patient internal identifier"
                }
              ]
            },
            "system" : "http://connectiverx.com/confirmationId",
            "value" : "8132413049",
            "assigner" : {
              "display" : "CRX"
            }
          }
        ],
        "name" : [
          {
            "use" : "official",
            "family" : "Michaelson",
            "given" : [
              "Ryan"
            ]
          }
        ],
        "telecom" : [
          {
            "system" : "phone",
            "value" : "1231231234",
            "use" : "home",
            "rank" : 1
          },
          {
            "system" : "phone",
            "value" : "1234561234",
            "use" : "mobile",
            "rank" : 2
          },
          {
            "system" : "email",
            "value" : "bobster83@example.com",
            "use" : "home",
            "rank" : 3
          }
        ],
        "gender" : "male",
        "birthDate" : "1972-10-29",
        "address" : [
          {
            "line" : [
              "1234 Main St"
            ],
            "city" : "San Francisco",
            "state" : "CA",
            "postalCode" : "94105",
            "country" : "US"
          }
        ],
        "communication" : [
          {
            "language" : {
              "coding" : [
                {
                  "system" : "urn:ietf:bcp:47",
                  "code" : "en",
                  "display" : "English"
                }
              ]
            },
            "preferred" : true
          }
        ],
        "managingOrganization" : {
          "reference" : "urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"
        }
      }
    },
    {
      "fullUrl" : "urn:uuid:b1fc009a-3710-49d8-81ad-cfa8e4a979fb",
      "resource" : {
        "resourceType" : "Bundle",
        "id" : "b1fc009a-3710-49d8-81ad-cfa8e4a979fb",
        "meta" : {
          "profile" : [
            "https://fhir.developer.gene.com/StructureDefinition/uapi-bundle-search-result"
          ]
        },
        "type" : "searchset",
        "total" : 1,
        "link" : [
          {
            "relation" : "self",
            "url" : "ExplanationOfBenefit?patient=xyz&_include=ExplanationOfBenefit:coverage"
          }
        ],
        "entry" : [
          {
            "fullUrl" : "urn:uuid:4822ddcc-2ce7-4b43-b6af-4f3435ce5a6d",
            "resource" : {
              "resourceType" : "ExplanationOfBenefit",
              "id" : "4822ddcc-2ce7-4b43-b6af-4f3435ce5a6d",
              "identifier" : [
                {
                  "use" : "usual",
                  "system" : "http://connectiverx.com/enrollmentId",
                  "value" : "45d1b98c-587c-ed11-8279-d6b6a2da4722"
                }
              ],
              "status" : "active",
              "type" : {
                "coding" : [
                  {
                    "code" : "pharmacy"
                  }
                ]
              },
              "use" : "predetermination",
              "patient" : {
                "reference" : "urn:uuid:2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9"
              },
              "created" : "2023-02-07T08:10:13-05:00",
              "insurer" : {
                "reference" : "urn:uuid:d02db104-a75c-433f-8764-9778c2e20626"
              },
              "provider" : {
                "reference" : "urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"
              },
              "outcome" : "complete",
              "insurance" : [
                {
                  "focal" : true,
                  "coverage" : {
                    "reference" : "urn:uuid:597540c9-6248-466e-81e0-58e78f15454e"
                  }
                }
              ]
            },
            "search" : {
              "mode" : "match"
            }
          },
          {
            "fullUrl" : "urn:uuid:597540c9-6248-466e-81e0-58e78f15454e",
            "resource" : {
              "resourceType" : "Coverage",
              "id" : "597540c9-6248-466e-81e0-58e78f15454e",
              "meta" : {
                "profile" : [
                  "https://fhir.developer.gene.com/StructureDefinition/uapi-coverage"
                ]
              },
              "extension" : [
                {
                  "url" : "https://fhir.developer.gene.com/StructureDefinition/IssuedDate",
                  "valueDate" : "2023-01-01"
                }
              ],
              "status" : "active",
              "type" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
                    "code" : "pay",
                    "display" : "Pay"
                  }
                ]
              },
              "subscriber" : {
                "reference" : "urn:uuid:2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9",
                "type" : "Patient"
              },
              "subscriberId" : "EYE00044117",
              "beneficiary" : {
                "reference" : "urn:uuid:2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9",
                "type" : "Patient"
              },
              "period" : {
                "start" : "2023-01-01",
                "end" : "2023-12-31"
              },
              "payor" : [
                {
                  "reference" : "urn:uuid:d02db104-a75c-433f-8764-9778c2e20626",
                  "type" : "Organization"
                }
              ],
              "class" : [
                {
                  "type" : {
                    "coding" : [
                      {
                        "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code" : "rxbin",
                        "display" : "RX BIN"
                      }
                    ]
                  },
                  "value" : "600426",
                  "name" : "BIN"
                },
                {
                  "type" : {
                    "coding" : [
                      {
                        "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code" : "rxpcn",
                        "display" : "RX PCN"
                      }
                    ]
                  },
                  "value" : "54",
                  "name" : "PCN"
                },
                {
                  "type" : {
                    "coding" : [
                      {
                        "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code" : "group",
                        "display" : "Group"
                      }
                    ]
                  },
                  "value" : "EC38517002",
                  "name" : "Group Number"
                },
                {
                  "type" : {
                    "coding" : [
                      {
                        "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
                        "code" : "plan",
                        "display" : "Plan"
                      }
                    ]
                  },
                  "value" : "Vabysmo-Drug",
                  "name" : "Ophthalmology Co Pay program"
                }
              ],
              "order" : 1,
              "network" : "Genentech"
            },
            "search" : {
              "mode" : "include"
            }
          }
        ]
      }
    }
  ]
}