FHIR Profile Summary

Following is a comprehensive list of all FHIR profiles that are used in the messages. Each profile provides details on fields, datatypes, field values and highlights whether or not the fields are supported. Usage notes and CPHA3 mappings are also documented within each profile.



Common Header Profiles Profile Link
Bundle Bundle Profile
MessageHeaderRequest Profile for MessageHeaderRequest
MessageHeaderResponse Profile for MessageHeaderResponse
Claims
Claim for Medication Dispense Claim for Medication Dispense
Claim - Professional Services ProfessionalServicesClaim
Dispense Profile-Dispense Information
Prescription Profile - Prescription Information
Medication Profile -Medication Details
Patient Profile for Patient
Pharmacy Organization Profile for Pharmacy
Coverage Profile for Coverage
Prior Coverage Profile for Prior Coverage
ClaimResponse Profile Claim Response
Prior Claim Response Profile for Prior Adjudication Details
Prior Payor Response Prior Claim Response Details
Reversal Profile
Reversal Request,Parameters IN Reveral Parameters:IN
Reversal Response, Parameters OUT Reversal Parameters: OUT
Daily Totals & Details
Request Daily Totals & Adjudication Details Totals and Details:Parameters:IN
Daily Totals Response Totals:Parameters:OUT
Adjudication Details Response Details:ParametersOUT

Future - Not in Scope for MVP
Provenance for Prior Payor Response Provenance
Clinical Issues Detected Profile for Detected Issue
Claim Response -Error Profile for Error Response