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 biPA Bundle Before
Bundle b17e292b-aef1-4e64-90c2-2d01f809041a of type message
Entry 1 - fullUrl = urn:uuid:eb5eb40b-78e8-4a52-903a-0348c1eac387
Resource MessageHeader:
Generated Narrative: MessageHeader
ResourceMessageHeader "eb5eb40b-78e8-4a52-903a-0348c1eac387"
Profile: UAPI MessageHeader
event: enrollment-with-consent (Details: uapi-event-type code enrollment-with-consent = 'enrollment-with-consent', stated as 'null')
Destinations
Name Endpoint UAPI-ENR-V2.1 https://test-us-e1.apis.roche.com/pharma-cmg-ehr-fhir-exp-test/v2/enrollment sender: See on this page: urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088
Sources
Name Endpoint Vendor_AB http://vendor.com/fhir/enrollmentID/ENR-00001 focus: See on this page: urn:uuid:584681db-df12-4038-bc82-7c438b06e63b
Entry 2 - fullUrl = urn:uuid:584681db-df12-4038-bc82-7c438b06e63b
Resource List:
messageContext
Mode: Change List Status: Current
Entry 3 - fullUrl = urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c
Resource Patient:
Anonymous Patient Male, DoB: 1972-10-29 ( Patient internal identifier: 6bcd8467-0473-4836-9128-2e7972f23177 (use: official))
Entry 4 - fullUrl = urn:uuid:01c31a2f-321d-4c6e-8349-206af8a88088
Resource Organization:
Generated Narrative: Organization
ResourceOrganization "01c31a2f-321d-4c6e-8349-206af8a88088"
Profile: UAPI Organization
identifier:
http://vendor.com/ab/HOSP-12345 (use: usual)type: Healthcare Provider (Organization type#prov)
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:695d0991-5e03-46df-934a-85a28acd95c1
Resource Practitioner:
Generated Narrative: Practitioner
ResourcePractitioner "695d0991-5e03-46df-934a-85a28acd95c1"
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:42b41bdb-1781-49aa-a091-78cdd92129df
Resource Coverage:
ResourceCoverage "42b41bdb-1781-49aa-a091-78cdd92129df"
Profile: UAPI Coverage
status: ACTIVE
type: health insurance plan policy (ActCode#HIP)
subscriber: See on this page: urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545
subscriberId: 4353
beneficiary: See on this page: urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c
Classes
Type Value Name Group (Coverage Class Codes#group) 12344frgr Group Number order: 1
network: Dakotacare
Entry 7 - fullUrl = urn:uuid:4db51d32-65c3-4f8c-959e-0155c6d14545
Resource RelatedPerson:
Generated Narrative: RelatedPerson
ResourceRelatedPerson "4db51d32-65c3-4f8c-959e-0155c6d14545"
Profile: UAPI RelatedPerson
patient: See on this page: urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c
relationship: significant other (RoleCode#SIGOTHR)
name: Bob Paul Smith (Official)
telecom: ph: 1234567890(MOBILE)
birthDate: 1972-10-29
Entry 8 - fullUrl = urn:uuid:9b0e2985-1430-4767-a698-57172fac4e32
Resource QuestionnaireResponse:
LinkId Text Definition Answer 9b0e2985-1430-4767-a698-57172fac4e32
QuestionnaireResponse authorization
Authorization # Date of Treatment Household size Onsite Pharmacy Name (Optional) Preferred Specialty Pharmacy (Optional) Confirmed positive for anaplastic lymphoma kinase (ALK)? Metastatic non-small cell lung cancer (NSCLC)? Do not contact patient Ok to leave a detailed message? Has treatment started? Annual household income Onsite Pharmacy? Is prior authorization in place? Is this a Prescription plan? Re-verify benefits at PA expiration Site of Treatment Specialty Pharmacy? TCPA Consent Provided? Ok to send a text message? Documentation for this format
Entry 9 - fullUrl = urn:uuid:62c47600-fbc1-422f-8fb7-118464fee7b9
Resource Condition:
Generated Narrative: Condition
ResourceCondition "62c47600-fbc1-422f-8fb7-118464fee7b9"
code: Malignant neoplasm of unspecified main bronchus (International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)#C34.00)
subject: See on this page: urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c
Entry 10 - fullUrl = urn:uuid:1b53bfb2-1361-4906-acd8-35294d30273b
Resource Consent:
ResourceConsent "1b53bfb2-1361-4906-acd8-35294d30273b"
Profile: UAPI Consent
status: ACTIVE
category: Patient Authorization Signature (LOINC#59284-0)
Entry 11 - fullUrl = urn:uuid:d3637025-883d-4678-9e0a-1d243a338f9f
Resource Organization:
Generated Narrative: Organization
ResourceOrganization "d3637025-883d-4678-9e0a-1d243a338f9f"
Profile: UAPI Organization
identifier:
http://vendor.com/ab/PAY-111 (use: usual)type: Insurance Company (Organization type#ins)
name: Dakotacare
Contacts
Telecom ph: 8778472862(WORK)
Entry 12 - fullUrl = urn:uuid:21b30e89-e799-484a-abcd-8c25c0b2599b
Resource Consent:
ResourceConsent "21b30e89-e799-484a-abcd-8c25c0b2599b"
Profile: UAPI Consent
status: ACTIVE
category: Prescriber Signature (LOINC#59284-0)
Entry 13 - fullUrl = urn:uuid:3cb05f30-9842-4651-a17d-930d7170bedf
Resource Provenance:
Provenance for See on this page: urn:uuid:21b30e89-e799-484a-abcd-8c25c0b2599b
Summary
Recorded 2022-02-07 09:49:39+0000 Agents
who See on this page: urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1
Entry 14 - fullUrl = urn:uuid:df610b38-2561-423c-b17a-36364f5a82c1
Resource MedicationRequest:
Generated Narrative: MedicationRequest
ResourceMedicationRequest "df610b38-2561-423c-b17a-36364f5a82c1"
Profile: UAPI MedicationRequest
status: ACTIVE
intent: ORDER
subject: See on this page: urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c
requester: See on this page: urn:uuid:695d0991-5e03-46df-934a-85a28acd95c1
insurance: See on this page: urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df
note: 600 mg twice a day
dosageInstruction
dispenseRequest
numberOfRepeatsAllowed: 3
ExpectedSupplyDurations
Value Unit System Code 1 mo Unified Code for Units of Measure (UCUM) mo
Entry 15 - fullUrl = urn:uuid:212c57ad-45cd-4882-87e7-8415ded3db05
Resource ServiceRequest:
Generated Narrative: ServiceRequest
ResourceServiceRequest "212c57ad-45cd-4882-87e7-8415ded3db05"
Profile: UAPI ServiceRequest
status: ACTIVE
intent: ORDER
code: Benefit Investigation / Prior Authorization (UAPI Code System - Service Request Type#bipa)
subject: See on this page: urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c