Universal API Implementation Guide
1.1.20 - ci-build
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
| Product | ACTION | FDA Approved | FDA Approved Date |
Description |
|---|---|---|---|---|
| Susvimo | Line Extension | Yes | 04/28/2025 | New indication for Diabetic Retinopathy (DR) added to Copay questionnaires Refer to 07/03/2025 Copay Updates |
| Evrysdi | Line Extension | Yes | 02/11/2025 | New indication for Evrysdi tablet added to AS/GPF questionnaires Refer to 2/14/2025 Copay Updates |
| Susvimo | Line Extension | Yes | 02/04/2025 | New indication for Diabetic Macular Edema (DME) added to Copay questionnaires Updated indication verbiage for Age-related Macular Degneration (AMD) Refer to 2/28/2025 Copay Updates |
| Itovebi | New product | Yes | 10/10/2024 | pronounced eye-TOVE-bee Effective 1/31/25: AS/GPF enrollments via UAPI is available for Itovebi. Effective 11/25/24: Copay enrollment via UAPI is available for Itovebi. Click HERE to learn more about Itovebi. |
| Ocrevus Zunovo | New product | Yes | 9/13/2024 | Effective 10/7/24: Copay enrollment will be available for Ocrevus Zunovo. Effective 10/21/24: AS/GPF enrollment will be available via UAPI for Ocrevus Zunovo. Click HERE to learn more about Ocrevus Zunovo. |
| Tecentriq Hybreza | New product | Yes | 9/12/2024 | Effective 9/25/24: AS/GPF enrollments will be available via UAPI for Tecentriq Hybreza. Effective 10/11/24: Copay enrollment will be available via UAPI for Tecentriq Hybreza. Click HERE to learn more about Tecentriq Hybreza. |
| PiaSky | New product | Yes | 6/20/2024 | Updated 10/28/2024: PiaSky Copay enrollment API deployed on 10/25/2024 Updated 10/22/2024:PiaSky Copay questionnaires are now available in test/stage environments There are no plans at this time to have Access Solutions/Patient Foundation enrollment API for PiaSky. |
| Gavreto | Removal from GNE product list | - | - | Effective 6/15/24: Gavreto Copay enrollments will no longer be accepted. |
| Gavreto | Removal from GNE product list | - | - | Effective 6/17/24: Gavreto enrollments for Access Solutions and Genentech Patient Foundation services will no longer be accepted via UAPI. |
| Date IG Page Updated |
IG Page | Update Description |
|---|---|---|
| 6/24/2025 | Testing page | Updated Testing page under GPF and AS Enrollments |
| 4/4/2025 | Artifacts Summary | Uploaded sample Itovebi GPF Enrollment bundle |
| 2/21/2025 | Copay Value Sets | Added table for Master Group Numbers found on Copay Response bundles |
| 2/19/2025 | Status Update Mapping page | Added "Inconclusive" as possible Patient Foundation Eligibility Status |
| 2/3/2025< | Copay Eligibility Questions | Updated Terms & Conditions under linkId: "agree-to-copay-program-terms" and linkId: "agree-to-admin-copay-program-terms" |
| 11/22/2024 | Copay Value Sets | Added Itovebi brandIds to value set list |
| 10/29/2024 | Testing page | Added Added weekend availability for testing environments. |
| 10/28/2024 | Copay Eligibility Questions page | Under "Inserting Product, Brand, Program Phone Number in Questionnaire Text" section: -added PiaSky brand & customer support# -added example questionnaire text to be updated for brand and phone number |
| 10/17/2024 | Sample Starter MedicationRequest for Ocrevus Zunovo | added Example Ocrevus Zunovo prescription for Starter SR enrollment |
| 10/17/2024 | Sample GPF MedicationRequest for Ocrevus Zunovo | added Example Ocrevus Zunovo prescription for GPF enrollment |
| 10/17/2024 | Sample GPF MedicationRequest for Tecentriq Hybreza | added Example Tecentriq Hybreza prescription for GPF enrollment |
| 10/16/2024 | Combination Therapies: AS/GPF and Copay enrollments | removed Combo Therapies section under Services Offered page and added new Combo Therapies page |
| 10/2/2024 | Copay Value Sets | added BrandIds for Tecentriq Hybreza and Ocrevus Zunovo |
| 9/27/2024 | Products Specific page | added Ocrevus Zunovo and Tecentriq Hybreza (SRs and prescription tables) |
| 9/27/2024 | Services Offered page | updated products that have Starter Program |
| 9/26/2024 | Copay Eligibility Questions page | updated list of common Copay questionnaires to include Ocrevus/Ocrevus "What form of Ocrevus" questionnaire; added Copay Customer Support Phone# table for each brand |
| 7/8/2024 | Copay Value Set page | added PiaSky brandIds |
| 7/8/2024 | Products Specific page | removed Gavreto prescription table |
| 7/8/2024 | Copay Value Set page | removed Gavreto from Copay and brandId tables |
| 6/15/2024 | Questionnaire page | added section on multi-select feature |
| May 2024 | Status Update Mapping page | added Status Query Response tables for BIPA and GPF |
| May 2024 | Questionnaire page | added a section on the new extension, where enableWhenExpression replaces enableWhen/enableBehavior for complex questions with "and/or" criteria. |
Code change released into production on 4/19/24
Clients utilizing Questionnaire feature dynamically will need to be able to accept this code change.
To accommodate scenarios involving an 'and/or' enableBehavior, we have restructured the following Access Solutions/GPF questionnaires. The enableWhen and enableBehavior settings have been replaced with an extension that contains new enableWhenExpression.
NOTE: The format of the questionnaireResponse does not change.
Refer to Questionnaire page for additional details
| Available in Test Environment |
Product | linkId | Comments |
|---|---|---|---|
| Yes | Actemra Intravenous Avastin Columvi Enspryng Gazyva Herceptin Herceptin Hylecta Kadcyla Lunsumio Ocrevus Perjeta Phesgo Polivy Rituxan for Immunology Rituxan for Oncology Rituxan Hycela Tecentriq Xolair |
"linkId": "site-of-treatment" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
| Yes | Susvimo | "linkId": "site-of-treatment" | extension with enableWhenExpression replaces enableWhen/enableBehavior includes Ambulatory Surgical Center |
| Yes | Actemra Intravenous Avastin Columvi Enspryng Gazyva Hemlibra Herceptin Herceptin Hylecta Kadcyla Lunsumio Ocrevus Perjeta Phesgo Polivy Rituxan for Immunology Rituxan for Oncology Rituxan Hycela Tecentriq Xolair |
"linkId": "site-of-treatment-2" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
| Yes | Susvimo | "linkId": "site-of-treatment-2" | extension with enableWhenExpression replaces enableWhen/enableBehavior includes Ambulatory Surgical Center |
| Yes | Ocrevus | "linkId": "indication-other" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
| Yes | Venclexta | "linkId": "dot" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
| Yes | Venclexta | "linkId": "pharmacy-phone-optional" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
| Yes | Venclexta | "linkId": "pharmacy-contact-person-optional" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
| Yes | Venclexta | "linkId": "opn-optional" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
| Yes | Venclexta Xolair |
"linkId": "authorization" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
| Yes | Venclexta Xolair |
"linkId": "preferred-sp-optional" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
| Yes | Xolair | "linkId": "xolair-weight-kg" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
| Yes | Xolair | "linkId": "xolair-ige-level-iuml" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
| Yes | Evrysdi | "linkId": "evrysdi-ftt" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
| Yes | Evrysdi | "linkId": "evrysdi-allergies" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
| Yes | Evrysdi | "linkId": "evrysdi-spinraza-last-dose" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
| Yes | Evrysdi | "linkId": "evrysdi-zolgensma-last-dose" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
| Yes | Evrysdi | "linkId": "evrysdi-other-therapy" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
| Yes | Evrysdi | "linkId": "evrysdi-other-therapy-last-dose" | extension with enableWhenExpression replaces enableWhen/enableBehavior |
"linkId: site-of-treatment" updated questionnaire structure
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "((%resource.repeat(item).where(linkId='applied-for-bipa').answer.value = true or %resource.repeat(item).where(linkId='applied-for-appeals').answer.value = true) and (%resource.repeat(item).where(linkId='pos').answer.value = 'Hospital Outpatient' or %resource.repeat(item).where(linkId='pos').answer.value = 'Infusion Center'))"
}
}
],
"linkId": "site-of-treatment",
"text": "Site of Treatment",
"type": "reference",
"required": true
}
"linkId: site-of-treatment" updated questionnaire structure (SUSVIMO)
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "((%resource.repeat(item).where(linkId='applied-for-bipa').answer.value = true or %resource.repeat(item).where(linkId='applied-for-appeals').answer.value = true) and (%resource.repeat(item).where(linkId='pos').answer.value = 'Hospital Outpatient' or %resource.repeat(item).where(linkId='pos').answer.value = 'Ambulatory Surgical Center'))"
}
}
],
"linkId": "site-of-treatment",
"text": "Site of Treatment",
"type": "reference",
"required": true
}
"linkId: site-of-treatment-2" updated questionnaire structure
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "((%resource.repeat(item).where(linkId='applied-for-pf').answer.value = true) and (%resource.repeat(item).where(linkId='pos').answer.value = 'Hospital Outpatient' or %resource.repeat(item).where(linkId='pos').answer.value = 'Infusion Center' or %resource.repeat(item).where(linkId='ship-to').answer.value = 'Site of Treatment'))"
}
}
],
"linkId": "site-of-treatment-2",
"text": "Third-party Site of Treatment",
"type": "reference",
"required": true
}
"linkId: site-of-treatment-2" updated questionnaire structure (SUSVIMO)
{
"extension": [
{
"url": "http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
"valueExpression": {
"language": "text/fhirpath",
"expression": "((%resource.repeat(item).where(linkId='applied-for-pf').answer.value = true) and (%resource.repeat(item).where(linkId='pos').answer.value = 'Hospital Outpatient' or %resource.repeat(item).where(linkId='pos').answer.value = 'Ambulatory Surgical Center' or %resource.repeat(item).where(linkId='ship-to').answer.value = 'Site of Treatment'))"
}
}
],
"linkId": "site-of-treatment-2",
"text": "Third-party Site of Treatment",
"type": "reference",
"required": true,
"repeats": false
}
"linkId: dot" updated questionnaire structure
{
"extension":[
{
"url":"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
"valueExpression":{
"language":"text/fhirpath",
"expression":"((%resource.repeat(item).where(linkId='applied-for-copay').answer.value = true or %resource.repeat(item).where(linkId='applied-for-starter').answer.value = true) and (%resource.repeat(item).where(linkId='has-treatment-started').answer.value = 'yes'))"
}
}
],
"linkId":"dot",
"text":"Date of Treatment",
"type":"date",
"required":true,
"repeats":false,
"answerOption":[
{
"valueString":"YYYY-MM-DD"
}
]
}
"linkId: pharmacy-phone-optional" updated questionnaire structure
{
"extension":[
{
"url":"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
"valueExpression":{
"language":"text/fhirpath",
"expression":"((%resource.repeat(item).where(linkId='applied-for-bipa').answer.value = true or %resource.repeat(item).where(linkId='applied-for-starter').answer.value = true) and (%resource.repeat(item).where(linkId='onsite-pharmacy').answer.value = 'yes' or %resource.repeat(item).where(linkId='specialty-pharmacy').answer.value = 'yes'))"
}
}
],
"linkId":"pharmacy-contact-person-optional",
"text":"Pharmacy Contact Person (Optional)",
"type":"string",
"required":false,
"repeats":false
}
"linkId: pharmacy-contact-person-optional" updated questionnaire structure
{
"extension":[
{
"url":"http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-enableWhenExpression",
"valueExpression":{
"language":"text/fhirpath",
"expression":"((%resource.repeat(item).where(linkId='applied-for-bipa').answer.value = true or %resource.repeat(item).where(linkId='applied-for-starter').answer.value = true) and (%resource.repeat(item).where(linkId='onsite-pharmacy').answer.value = 'yes' or %resource.repeat(item).where(linkId='specialty-pharmacy').answer.value = 'yes'))"
}
}
],
"linkId":"pharmacy-contact-person-optional",
"text":"Pharmacy Contact Person (Optional)",
"type":"string",
"required":false,
"repeats":false
}