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
| LinkId | Text | Definition | Answer![]() |
|---|---|---|---|
![]() | QuestionnaireResponse | ||
![]() ![]() | Authorization # | #123456 | |
![]() ![]() | Date of Treatment | 2022-02-28 | |
![]() ![]() | Household size | 11 | |
![]() ![]() | Onsite Pharmacy Name (Optional) | Name of pharmacy | |
![]() ![]() | Preferred Specialty Pharmacy (Optional) | SP ... | |
![]() ![]() | Do not contact patient | Yes | |
![]() ![]() | Ok to leave a detailed message? | No | |
![]() ![]() | Has treatment started? | Yes | |
![]() ![]() | Annual household income | $100,001 - $125,000 | |
![]() ![]() | Onsite Pharmacy? | Yes | |
![]() ![]() | Is prior authorization in place? | Yes | |
![]() ![]() | Is this a Prescription plan? | Yes | |
![]() ![]() | Re-verify benefits at PA expiration | Yes | |
![]() ![]() | Metastatic non-small cell lung cancer (NSCLC)? | Yes | |
![]() ![]() | Positive for neurotropic tropomyosoin receptor kinase (NTRK) fusions without a known acquired resistance? | Yes | |
![]() ![]() | Positive for ROS1? | Yes | |
![]() ![]() | Ship to: | Practice | |
![]() ![]() | Specialty Pharmacy? | Yes | |
![]() ![]() | TCPA Consent Provided? | Yes | |
![]() ![]() | Ok to send a text message? | No | |
Documentation for this format | |||