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: Internal - UAPI AS Enrollment for MPS Redesign biPA Bundle Before (Ocrevus)
Profile: UAPI Bundle - AS Enrollment
Bundle 316b5e76-22a6-499a-a27d-c02d798000c9 of type message
Entry 1 - fullUrl = urn:uuid:2fa6bc10-aa73-4bec-b357-39839c736ab9
Resource MessageHeader:
Profile: UAPI MessageHeader
event: uapi-event-type enrollment-with-consent: enrollment-with-consent
Destinations
Name UAPI-ENR-V2.1 Sources
Name <MPS Practice Name>
Entry 2 - fullUrl = urn:uuid:b898769f-53d9-4453-a957-2683942af961
Resource List:
messageContext
Mode: Change List Status: Current
Entry 3 - fullUrl = urn:uuid:746db8d7-8660-4b59-bd2f-fc240bd181b4
Resource Patient:
Profile: UAPI Patient
Ryan Michaelson (official) Male, DoB: 1972-10-29 ( Patient internal identifier: 746db8d7-8660-4b59-bd2f-fc240bd181b4 (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: 316b5e76-22a6-499a-a27d-c02d798000c9; type = message; timestamp = 2022-11-11 08:10:13-0500
- Managing Organization: Bundle: identifier = Resource identifier: 316b5e76-22a6-499a-a27d-c02d798000c9; type = message; timestamp = 2022-11-11 08:10:13-0500
Entry 4 - fullUrl = urn:uuid:9edd9044-26ab-4639-b59c-be07d459e045
Resource Organization:
Profile: UAPI Organization
identifier:
http://mps.gene.com/sfdcid/0011P000019Y4bLQAS (use: usual, )type: Healthcare Provider
name: Healthstar Physicians
contact
telecom: ph: -unknown-
address: 420 W MORRIS BLVD MORRISTOWN TN 37813 US
contact
name: Luis McLean (Official)
telecom: ph: 4232002041(Work), fax: 4235862410(Work)
Entry 5 - fullUrl = urn:uuid:0eba1bbc-782a-4727-b186-03e3abe86648
Resource Practitioner:
Profile: UAPI Practitioner
identifier:
http://mps.gene.com/prescriberid/PRES-31448 (use: official, )name: MARISSA CRUZ (Official)
Entry 6 - fullUrl = urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df
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:4db51d32-65c3-4f8c-959e-0155c6d14545
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:680fa043-5770-4ca9-84e7-5b1acacc1657
Resource QuestionnaireResponse:
LinkID Text Definition Answer 680fa043-5770-4ca9-84e7-5b1acacc1657
Questionnaire:https://dev.gene.com/fhir/uapi/fhirapi/Questionnaire/1234 authorization
Authorization # 34567890 Household size 11 Onsite Pharmacy Name (Optional) Onst Superfarm Preferred Specialty Pharmacy (Optional) Special Phmcy Site of Treatment Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500 Do not contact patient No Ok to leave a detailed message? Yes Annual household income $125,001 - $150,000 Onsite Pharmacy? Yes Is prior authorization in place? Yes Place of Service Infusion Center Is this a Prescription plan? Yes Re-verify benefits at PA expiration Yes Specialty Pharmacy? Yes TCPA Consent Provided? No Ok to send a text message? Yes Documentation for this format
Entry 9 - fullUrl = urn:uuid:bc20c5ea-f639-4221-ab61-ce75c5e64aba
Resource Condition:
code: Type 1 diab with mild nonp rtnop with macular edema, r eye
Entry 10 - fullUrl = urn:uuid:1b53bfb2-1361-4906-acd8-35294d30273b
Resource Consent:
Profile: UAPI Consent
status: Active
category: Patient Authorization Signature
Entry 11 - fullUrl = urn:uuid:cb626b8a-4e0e-484b-b4fb-1f48fd318418
Resource Provenance:
Profile: UAPI Provenance
Provenance for Bundle: identifier = Resource identifier: da5e1572-cc88-4e4d-9899-e3553f680d87; type = message; timestamp = 2020-03-11 08:10:13-0500
Summary
Recorded 2021-01-07 06:49:41+0000 Agents
who Bundle: identifier = Resource identifier: 316b5e76-22a6-499a-a27d-c02d798000c9; type = message; timestamp = 2022-11-11 08:10:13-0500
Entry 12 - fullUrl = urn:uuid:212c57ad-45cd-4882-87e7-8415ded3db05
Resource ServiceRequest:
Profile: UAPI ServiceRequest
status: Active
intent: Order
code: Benefit Investigation / Prior Authorization
Entry 13 - fullUrl = urn:uuid:8ae8ca14-1d93-45d1-bfd0-f6dcbc1fede8
Resource MedicationRequest:
Profile: UAPI MedicationRequest
status: Active
intent: Order
courseOfTherapyType: Subsequent Dose
note:
Every 6 months
dosageInstruction
text: String (up to 50 characters)
DoseAndRates
Dose[x] 600 mg dispenseRequest
numberOfRepeatsAllowed: 1
ExpectedSupplyDurations
Value Unit 2 300 mg vial(s)
Entry 14 - fullUrl = urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f
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 15 - fullUrl = urn:uuid:45cf0b29-8c1d-4882-91e1-00bc28c06a52
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-