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 - XML Representation

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="uapi-copay-response-1"/>
  <meta>
    <profile
             value="https://fhir.developer.gene.com/StructureDefinition/uapi-bundle-query-response"/>
  </meta>
  <identifier>
    <use value="usual"/>
    <system value="http://connectiverx.com/requestId"/>
    <value value="86a42a99-663b-48b8-8fd9-c1afdbca5b98"/>
  </identifier>
  <type value="message"/>
  <timestamp value="2023-01-11T08:10:17-05:00"/>
  <entry>
    <fullUrl value="urn:uuid:410f399f-e309-4bc9-be19-8ab330e40397"/>
    <resource>
      <MessageHeader>
        <id value="410f399f-e309-4bc9-be19-8ab330e40397"/>
        <text>
          <status value="generated"/>
          <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>
        </text>
        <eventCoding>
          <system
                  value="http://terminology.gene.com/fhir/usix/uapi/CodeSystem/uapi-event-type"/>
          <code value="enrollment-response"/>
          <display value="Enrollment Response"/>
        </eventCoding>
        <source>
          <name value="Genentech-FHIR-DEV"/>
          <endpoint value="https://fhir.developer.gene.com/$process-message"/>
        </source>
        <response>
          <identifier value="1-63c61a26-4965b3a156f488da6e0800ed"/>
          <code value="ok"/>
        </response>
        <focus>
          <reference value="urn:uuid:09cdac62-7c6b-48e6-8738-00f270280ba1"/>
        </focus>
      </MessageHeader>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:09cdac62-7c6b-48e6-8738-00f270280ba1"/>
    <resource>
      <Parameters>
        <id value="09cdac62-7c6b-48e6-8738-00f270280ba1"/>
        <parameter>
          <name value="responder-patient"/>
          <valueReference>
            <reference value="urn:uuid:b3d46ea3-62e6-4171-b818-d64712edfe55"/>
          </valueReference>
        </parameter>
        <parameter>
          <name value="search-result"/>
          <valueReference>
            <reference value="urn:uuid:aecbb129-9a73-4b59-9d66-ff5cdb3f3164"/>
          </valueReference>
        </parameter>
      </Parameters>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9"/>
    <resource>
      <Patient>
        <id value="2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9"/>
        <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="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>
        </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://gene.com/patientmaster"/>
          <value value="ca3c6274-e70b-45cf-a65a-30e8386d50bb"/>
          <assigner>
            <display value="Genentech Patient Master"/>
          </assigner>
        </identifier>
        <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://connectiverx.com/confirmationId"/>
          <value value="8132413049"/>
          <assigner>
            <display value="CRX"/>
          </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>
        <managingOrganization>
          <reference value="urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088"/>
        </managingOrganization>
      </Patient>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:b1fc009a-3710-49d8-81ad-cfa8e4a979fb"/>
    <resource>
      <Bundle>
        <id value="b1fc009a-3710-49d8-81ad-cfa8e4a979fb"/>
        <meta>
          <profile
                   value="https://fhir.developer.gene.com/StructureDefinition/uapi-bundle-search-result"/>
        </meta>
        <type value="searchset"/>
        <total value="1"/>
        <link>
          <relation value="self"/>
          <url
               value="ExplanationOfBenefit?patient=xyz&amp;_include=ExplanationOfBenefit:coverage"/>
        </link>
        <entry>
          <fullUrl value="urn:uuid:4822ddcc-2ce7-4b43-b6af-4f3435ce5a6d"/>
          <resource>
            <ExplanationOfBenefit>
              <id value="4822ddcc-2ce7-4b43-b6af-4f3435ce5a6d"/>
              <identifier>
                <use value="usual"/>
                <system value="http://connectiverx.com/enrollmentId"/>
                <value value="45d1b98c-587c-ed11-8279-d6b6a2da4722"/>
              </identifier>
              <status value="active"/>
              <type>
                <coding>
                  <code value="pharmacy"/>
                </coding>
              </type>
              <use value="predetermination"/>
              <patient>
                <reference
                           value="urn:uuid:2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9"/>
              </patient>
              <created value="2023-02-07T08:10:13-05:00"/>
              <insurer>
                <reference
                           value="urn:uuid:d02db104-a75c-433f-8764-9778c2e20626"/>
              </insurer>
              <provider>
                <reference
                           value="urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1"/>
              </provider>
              <outcome value="complete"/>
              <insurance>
                <focal value="true"/>
                <coverage>
                  <reference
                             value="urn:uuid:597540c9-6248-466e-81e0-58e78f15454e"/>
                </coverage>
              </insurance>
            </ExplanationOfBenefit>
          </resource>
          <search>
            <mode value="match"/>
          </search>
        </entry>
        <entry>
          <fullUrl value="urn:uuid:597540c9-6248-466e-81e0-58e78f15454e"/>
          <resource>
            <Coverage>
              <id value="597540c9-6248-466e-81e0-58e78f15454e"/>
              <meta>
                <profile
                         value="https://fhir.developer.gene.com/StructureDefinition/uapi-coverage"/>
              </meta>
              <extension
                         url="https://fhir.developer.gene.com/StructureDefinition/IssuedDate">
                <valueDate value="2023-01-01"/>
              </extension>
              <status value="active"/>
              <type>
                <coding>
                  <system
                          value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
                  <code value="pay"/>
                  <display value="Pay"/>
                </coding>
              </type>
              <subscriber>
                <reference
                           value="urn:uuid:2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9"/>
                <type value="Patient"/>
              </subscriber>
              <subscriberId value="EYE00044117"/>
              <beneficiary>
                <reference
                           value="urn:uuid:2c5aa62c-b6cd-49d2-ad9f-3128a69a32a9"/>
                <type value="Patient"/>
              </beneficiary>
              <period>
                <start value="2023-01-01"/>
                <end value="2023-12-31"/>
              </period>
              <payor>
                <reference
                           value="urn:uuid:d02db104-a75c-433f-8764-9778c2e20626"/>
                <type value="Organization"/>
              </payor>
              <class>
                <type>
                  <coding>
                    <system
                            value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
                    <code value="rxbin"/>
                    <display value="RX BIN"/>
                  </coding>
                </type>
                <value value="600426"/>
                <name value="BIN"/>
              </class>
              <class>
                <type>
                  <coding>
                    <system
                            value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
                    <code value="rxpcn"/>
                    <display value="RX PCN"/>
                  </coding>
                </type>
                <value value="54"/>
                <name value="PCN"/>
              </class>
              <class>
                <type>
                  <coding>
                    <system
                            value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
                    <code value="group"/>
                    <display value="Group"/>
                  </coding>
                </type>
                <value value="EC38517002"/>
                <name value="Group Number"/>
              </class>
              <class>
                <type>
                  <coding>
                    <system
                            value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
                    <code value="plan"/>
                    <display value="Plan"/>
                  </coding>
                </type>
                <value value="Vabysmo-Drug"/>
                <name value="Ophthalmology Co Pay program"/>
              </class>
              <order value="1"/>
              <network value="Genentech"/>
            </Coverage>
          </resource>
          <search>
            <mode value="include"/>
          </search>
        </entry>
      </Bundle>
    </resource>
  </entry>
</Bundle>