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

Release 2024 Oct 11

Tecentriq Hybreza

Tecentriq Hybreza Copay Enrollment - Questionnaires

Questionnaires for Copay enrollments can be accessed by requesting Tecentriq Hybreza questionnaire definitions from the Genentech FHIR Server.

URL to Copay Questionnaire endpoint (test): https://test-us-e1.apis.roche.com/pharma-cmg-copay-exp-test/v1/questionnaire?name=Copay Tecentriq Hybreza
URL to Copay Questionnaire endpoint (stage): https://stage-us-e1.apis.roche.com/pharma-cmg-copay-exp-stage/v1/questionnaire?name=Copay Tecentriq Hybreza
URL to Copay Questionnaire endpoint (prod): https://prod-us-e1.apis.roche.com/pharma-cmg-copay-exp-prod/v1/questionnaire?name=Copay Tecentriq Hybreza

Tecentriq Hybreza Combo with Avastin, Cotellic & Zelboraf - Questionnaire Updates

Type	Available in QA (test) environment?	Product(s) impacted	linkId impacted (if applicable)	OLD	New	Comments
Update	Yes	Avastin	avastin-combo-adv-with-tecentriq	Text: Is the patient on AVASTIN in combination with TECENTRIQ® (atezolizumab) or TECENTRIQ HYBREZA™ (atezolizumab and hyaluronidase-tqjs)? Acceptable values: Yes-Tecentriq Yes-Tecentriq Hybreza No	Text: Is the patient on AVASTIN in combination with TECENTRIQ® (atezolizumab) or TECENTRIQ HYBREZA™ (atezolizumab and hyaluronidase-tqjs)? Acceptable values:Yes No
Update	Yes	Avastin	avastin-combo-hcc-with-tecentriq	Text: Is the patient on AVASTIN in combination with TECENTRIQ or TECENTRIQ HYBREZA™ (atezolizumab and hyaluronidase-tqjs) Acceptable values: Yes-Tecentriq Yes-Tecentriq Hybreza No	Text: Is the patient on AVASTIN in combination with TECENTRIQ or TECENTRIQ HYBREZA? Acceptable values:Yes No
Delete	Yes	Avastin	avastin-verify-combo-adv-with-tecentriq-hybreza	Can you please verify if the patient is on AVASTIN and TECENTRIQ HYBREZA for metastatic nonsquamous non-small cell lung cancer? Yes No enableWhen:avastin-combo-adv-with-tecentriq= "Yes-Tecentriq Hybreza"	-
Update	Yes	Avastin	avastin-verify-combo-adv-with-tecentriq	Can you please verify if the patient is on AVASTIN and TECENTRIQ for metastatic nonsquamous non-small cell lung cancer? enableWhen: avastin-combo-adv-with-tecentriq= 'Yes-Tecentriq'	Can you please verify that the patient is on AVASTIN and TECENTRIQ or TECENTRIQ HYBREZA for the treatment of metastatic nonsquamous non-small cell lung cancer (NSCLC)? enableWhen: avastin-combo-adv-with-tecentriq=Yes Acceptable values: Yes No Unsure
Update	Yes	Avastin	avastin-verify-combo-hcc-with-tecentriq	Can you please verify if the patient is on AVASTIN and TECENTRIQ for hepatocellular carcinoma (HCC)? enableWhenavastin-combo-hcc-with-tecentriq= "Yes-Tecentriq"	Can you please verify if the patient is on AVASTIN and TECENTRIQ or TECENTRIQ HYBREZA for hepatocellular carcinoma (HCC)? enableWhenavastin-combo-hcc-with-tecentriq= "Yes" Acceptable values:Yes No Unsure
Delete	Yes	Avastin	avastin-verify-combo-hcc-with-tecentriq-hybreza	Can you please verify if the patient is on AVASTIN and TECENTRIQ HYBREZA for hepatocellular carcinoma (HCC)? Yes No enableWhen:avastin-combo-hcc-with-tecentriq= "Yes-Tecentriq Hybreza"	-
Update	Yes	Avastin	avastin-receive-copay-for-tecentriq	Does the patient wish to receive co-pay benefits for TECENTRIQ HYBREZA as well? enableWhen:avastin-verify-combo-hcc-with-tecentriq hybreza= Yes OR avastin-verify-combo-adv-with-tecentriq hybreza= Yes	Does the patient wish to receive co-pay benefits for TECENTRIQ or TECENTRIQ HYBREZA as well? enableWhen:avastin-verify-combo-hcc-with-tecentriq= Yes OR avastin-verify-combo-adv-with-tecentriq= Yes Acceptable values:Yes No
ADD	Yes	Avastin	avastin-select-tecentriq-product	-	Please select product below to receive co-pay benefits: Acceptable Values:TECENTRIQ TECENTRIQ HYBREZA enableWhen: avastin-receive-copay-for-tecentriq = Yes
Update	Yes	Cotellic	cotellic-combo-with-tecentriq	Text: Is the patient also taking TECENTRIQ or TECENTRIQ HYBREZA™ (atezolizumab and hyaluronidase-tqjs)? Acceptable values:Yes-Tecentriq Yes-Tecentriq Hybreza No	Text: Is the patient also taking TECENTRIQ or TECENTRIQ HYBREZA? Acceptable values:Yes No enableWhen: cotellic-receive-copay-for-zelboraf = Yes or No
Delete	Yes	Cotellic	cotellic-receive-copay-for-tecentriq-hybreza	Does the patient wish to receive co-pay benefits for TECENTRIQ HYBREZA as well? Yes No enableWhen:cotellic-combo-with-tecentriq = "Yes-Tecentriq Hybreza"	-
Update	Yes	Cotellic	cotellic-receive-copay-for-tecentriq	Does the patient wish to receive co-pay benefits for TECENTRIQ as well? enableWhen:cotellic-combo-with-tecentriq = Yes-Tecentriq	Does the patient wish to receive co-pay benefits for TECENTRIQ or TECENTRIQ HYBREZA as well? enableWhen:cotellic-combo-with-tecentriq =Yes
ADD	Yes	Cotellic	cotellic-select-tecentriq-product	Please select product below to receive co-pay benefits: Acceptable Values:TECENTRIQ, TECENTRIQ HYBREZA enableWhen: cotellic-receive-copay-for-tecentriq = Yes	-
Update	Yes	Zelboraf	zelboraf-combo-with-tecentriq	Text: Is the patient also taking TECENTRIQ® (atezolizumab) or TECENTRIQ HYBREZA ™ (atezolizumab and hyaluronidase-tqjs)? Acceptable values:Yes-Tecentriq Yes-Tecentriq Hybreza No	Text: Is the patient also taking TECENTRIQ® (atezolizumab) or TECENTRIQ HYBREZA ™ (atezolizumab and hyaluronidase-tqjs)? Acceptable values:Yes No enableWhen: If linkId: Zelboraf-receive-copay-for-cotellic = Yes or No
Update	Yes	Zelboraf	zelboraf-receive-copay-for-tecentriq	Text: Does the patient wish to receive Copay benefits for Tecentriq as well enableWhen:zelboraf-combo-with-tecentriq = Yes-Tecentriq	Text: Does the patient wish to receive co-pay benefits for TECENTRIQ or TECENTRIQ HYBREZA as well? enableWhen:zelboraf-combo-with-tecentriq = Yes
Delete	Yes	Zelboraf	zelboraf-receive-copay-for-tecentriq-hybreza	Does the patient wish to receive co-pay benefits for TECENTRIQ HYBREZA as well? Yes No enableWhen:zelboraf-combo-with-tecentriq = "Yes-Tecentriq Hybreza"	-
ADD	Yes	Zelboraf	zelboraf-select-tecentriq-product	-	Please select product below to receive co-pay benefits: Acceptable Values:TECENTRIQ TECENTRIQ HYBREZA enableWhen: zelboraf-receive-copay-for-tecentriq = Yes

Tecentriq Hybreza - BrandIds

Refer to brandIds table on Copay Value Set page

Tecentriq Hybreza - FDA Indications (ICD10)

FDA approved indications (ICD10 codes) can be found on the Access Solutions website for Tecentriq Hybreza