Universal API Implementation Guide - Local Development build (v1.1.20) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
Example Bundle: External - UAPI AS Enrollment: Enspryng
Profile: UAPI Bundle - AS Enrollment
Bundle 05c47586-a4e8-4ab2-9dff-51f73ff6bda3 of type message
Entry 1 - fullUrl = urn:uuid:0a3b3ee3-e107-4ad5-bad4-25c565d23a5f
Resource MessageHeader:
Profile: UAPI MessageHeader
event: uapi-event-type enrollment-with-consent: enrollment-with-consent
Destinations
Name UAPI-ENR-V2.1 Sources
Name Vendor_AB
Entry 2 - fullUrl = urn:uuid:9b194fb4-b32e-4ffe-a81c-30775f6ee74a
Resource List:
messageContext
Mode: Change List Status: Current
Entry 3 - fullUrl = urn:uuid:1b315218-49b7-4264-816e-05d4b92ecbaa
Resource Patient:
Profile: UAPI Patient
Ryan Michaelson (official) Male, DoB: 1972-10-29 ( Patient internal identifier: 6bcd8467-0473-4836-9128-2e7972f23177 (use: official, ))
Contact Detail
- ph: 1231231234(Home)
- ph: 1234561234(Mobile)
- bobster83@example.com
- 1234 Main St San Francisco CA 94105 US
Language: English (preferred) Links:
- General Practitioner: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500
- Managing Organization: Bundle: identifier = Resource identifier: 05c47586-a4e8-4ab2-9dff-51f73ff6bda3; type = message; timestamp = 2020-03-11 08:10:13-0500
Entry 4 - fullUrl = urn:uuid:e69e5e73-0723-4f42-bfdd-b69f181160bf
Resource Organization:
Profile: UAPI Organization
identifier:
http://vendor.com/ab/HOSP-12345 (use: usual, )type: Healthcare Provider
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 - fullUrl = urn:uuid:78ef1b71-b14a-44a1-a1e8-c9c9efcc157c
Resource Practitioner:
Profile: UAPI Practitioner
identifier: Provider number/1922071448 (use: official, ), Tax ID number/00000000 (use: official, ), National provider identifier/1639285034 (use: official, )
name: MARISSA CRUZ (Official)
Entry 6 - fullUrl = urn:uuid:2722d5ae-1658-4d7f-8f64-de1299a1fb7f
Resource Coverage:
Profile: UAPI Coverage
status: Active
type: health insurance plan policy
subscriberId: 4353
Classes
Type Value Name Group 12344frgr Group Number order: 1
network: Dakotacare
Entry 7 - fullUrl = urn:uuid:0ec0f18c-5869-4d10-9752-79ea39e1f7ac
Resource RelatedPerson:
Profile: UAPI RelatedPerson
relationship: significant other
name: Bob Paul Smith (Official)
telecom: ph: 1234567890(Mobile)
birthDate: 1972-10-29
Entry 8 - fullUrl = urn:uuid:090e5caf-fdbd-4a67-8535-2983a3868f41
Resource Condition:
code: Neuromyelitis optica [Devic]
Entry 9 - fullUrl = urn:uuid:7ec5069e-799f-413a-a0d2-d107acdfad3d
Resource Consent:
Profile: UAPI Consent
status: Active
category: Patient Authorization Signature
provision
Entry 10 - fullUrl = urn:uuid:3f640e58-2f13-4d07-9356-8bc2ee64054d
Resource ServiceRequest:
Profile: UAPI ServiceRequest
status: Active
intent: Order
code: Benefit Investigation / Prior Authorization
Entry 11 - fullUrl = urn:uuid:ccd28c58-83e7-4657-b06a-53c8cc4ac94f
Resource ServiceRequest:
Profile: UAPI ServiceRequest
status: Active
intent: Order
code: Copay
Entry 12 - fullUrl = urn:uuid:d62fabac-5a26-41d8-bc86-3c029ca6b553
Resource MedicationRequest:
Profile: UAPI MedicationRequest
status: Active
intent: Order
courseOfTherapyType: Maintenance Dose
note:
Inject 120 mg
dosageInstruction
text: Inject 120mg SQ every 4 weeks
timing: Once per 4 weeks
DoseAndRates
Dose[x] 120 mg dispenseRequest
numberOfRepeatsAllowed: 123
ExpectedSupplyDurations
Value Unit System Code 1 mo http://unitsofmeasure.org mo
Entry 13 - fullUrl = urn:uuid:e551b51b-0646-4b23-b1ac-9ec623756ec6
Resource Organization:
Profile: UAPI Organization
identifier:
http://vendor.com/ab/PAY-111 (use: usual, )type: Insurance Company
name: Dakotacare
Contacts
Telecom ph: 8778472862(Work)
Entry 14 - fullUrl = urn:uuid:ce9ee2f1-3ebd-47d3-afd4-ad6a6bb21bc9
Resource QuestionnaireResponse:
LinkID Text Definition Answer ce9ee2f1-3ebd-47d3-afd4-ad6a6bb21bc9
Questionnaire:https://dev.gene.com/fhir/uapi/fhirapi/Questionnaire/1234 authorization
Authorization # #3456789 Other Medications XXX Has the patient started prescribed ENSPRYNG (satralizumab-mwge)? No Drug Allergies? No Known Dispensing Through: Buy and Bill Ok to leave a detailed message? No Do not contact patient Yes Site of Treatment 606bbb19-fe37-4847-b6bb-1cdac172c3ecIs this a Prescription plan? No Has treatment started? Yes Is prior authorization in place? Yes TCPA Consent Provided? Yes Co-pay program Commercial Insurance Yes Place of Service Infusion Center Documentation for this format
Entry 15 - fullUrl = urn:uuid:606bbb19-fe37-4847-b6bb-1cdac172c3ec
Resource Organization:
Profile: UAPI Organization
identifier:
http://SOT.com/ab/Infusion Site Id (use: usual, )type: Site of Treatment
name: Infusion Centre
contact
telecom: ph: 8882704882(Work), fax: 8179974042(Work)
address: 8 Ranoldo Terrace Cherry Hill NJ 08034 US
contact
name: Venus Yardav (Official)
telecom: ph: -unknown-