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 Only
Bundle e905f503-090c-45ab-b197-5b1d10996xd1 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-only (Details: uapi-event-type code enrollment-only = 'enrollment-only', stated as 'null')
Destinations
Name Endpoint UAPI-ENR-V2.0 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:5342779a-184f-42ba-ab44-3a8e02397he2
Resource QuestionnaireResponse:
LinkId Text Definition Answer 5342779a-184f-42ba-ab44-3a8e02397he2
QuestionnaireResponse hemlibra-weight-kg
Weight (kg) Has it been 12 months or more since the patient's last HEMLIBRA injection? Has the patient started prescribed HEMLIBRA® (emicizumab)? Does your patient have Hemophilia A Do not contact patient Is this a Prescription plan? Enroll Patient in Benefits Reverification Preferred Specialty Pharmacy (Optional) Onsite Pharmacy Name (Optional) Documentation for this format
Entry 9 - fullUrl = urn:uuid:bc20c5ea-f639-4221-ab61-ce75c5e64aba
Resource Condition:
Generated Narrative: Condition
ResourceCondition "bc20c5ea-f639-4221-ab61-ce75c5e64aba"
code: Type 1 diab with mild nonp rtnop with macular edema, r eye (International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)#E10.3211)
subject: See on this page: urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c
Entry 10 - 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 11 - 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 12 - 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
Entry 13 - fullUrl = urn:uuid:1409c0e9-6b06-4de5-82e7-577516c866db
Resource ServiceRequest:
Generated Narrative: ServiceRequest
ResourceServiceRequest "1409c0e9-6b06-4de5-82e7-577516c866db"
Profile: UAPI ServiceRequest
status: ACTIVE
intent: ORDER
code: Starter (UAPI Code System - Service Request Type#starter)
subject: See on this page: urn:uuid:fc2e5a72-c363-4616-ae00-4ad25cbcb45c
Entry 14 - fullUrl = 80addde0-ebdf-48fa-abf9-a72961769b6e
Resource MedicationRequest:
Generated Narrative: MedicationRequest
ResourceMedicationRequest "80addde0-ebdf-48fa-abf9-a72961769b6e"
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
courseOfTherapyType: Subsequent Dose ()
insurance: See on this page: urn:uuid:42b41bdb-1781-49aa-a091-78cdd92129df
note: 6-mg/kg
dosageInstruction
dispenseRequest
UAPI MedicationRequest Dispenser Instructions: Dispense Instruction: Quantity 1 of 12 mg vial(s) and Quantity 1 of 30 mg vial(s)
UAPI MedicationRequest Dispense Quantity Detailed Breakdown
url
dispenseQuantityvalue: 1
url
dispenseUnitvalue: 12mg vial(s)
UAPI MedicationRequest Dispense Quantity Detailed Breakdown
url
dispenseQuantityvalue: 1
url
dispenseUnitvalue: 30mg vial(s)
numberOfRepeatsAllowed: 0
ExpectedSupplyDurations
Value Unit System Code 1 mo Unified Code for Units of Measure (UCUM) mo
Entry 15 - 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)