generated: '2026-07-18'
method: derived
source: openapi/clover-health-fhir-openapi-original.yml
# Entity-relationship graph derived from the FHIR R4 resources exposed by the
# Clover Health Formulary and Provider Directory API and their standard FHIR
# reference fields. Relationships reflect FHIR reference semantics.
entities:
  - name: List
    domain: formulary
    id_read: /formulary/api/List/{id}
    description: A curated FHIR List resource grouping covered drugs (formulary tier list).
  - name: MedicationKnowledge
    domain: formulary
    id_read: /formulary/api/MedicationKnowledge/{id}
    description: Drug coverage, tier, and utilization-management detail for a covered medication.
  - name: InsurancePlan
    domain: provider-directory
    id_read: /providerdirectory/api/InsurancePlan/{id}
    description: A Clover Health insurance plan (Medicare Advantage) offered in a service area.
  - name: Organization
    domain: provider-directory
    id_read: /providerdirectory/api/Organization/{id}
    description: A healthcare organization, group, or facility.
  - name: OrganizationAffiliation
    domain: provider-directory
    id_read: /providerdirectory/api/OrganizationAffiliation/{id}
    description: A relationship/affiliation between two organizations in the network.
  - name: Practitioner
    domain: provider-directory
    id_read: /providerdirectory/api/Practitioner/{id}
    description: An individual healthcare provider (doctor, nurse, clinician).
  - name: PractitionerRole
    domain: provider-directory
    id_read: /providerdirectory/api/PractitionerRole/{id}
    description: The role, location, and services a practitioner provides for an organization.
  - name: Location
    domain: provider-directory
    id_read: /providerdirectory/api/Location/{id}
    description: A physical place where services are provided.
  - name: HealthcareService
    domain: provider-directory
    id_read: /providerdirectory/api/HealthcareService/{id}
    description: A service offered by an organization at a location.
  - name: Endpoint
    domain: provider-directory
    id_read: /providerdirectory/api/Endpoint/{id}
    description: A technical connection endpoint for electronic exchange with an organization.
relationships:
  - from: PractitionerRole
    to: Practitioner
    type: belongs_to
    via: practitioner
  - from: PractitionerRole
    to: Organization
    type: belongs_to
    via: organization
  - from: PractitionerRole
    to: Location
    type: has_many
    via: location
  - from: PractitionerRole
    to: HealthcareService
    type: has_many
    via: healthcareService
  - from: PractitionerRole
    to: Endpoint
    type: has_many
    via: endpoint
  - from: OrganizationAffiliation
    to: Organization
    type: belongs_to
    via: organization
  - from: OrganizationAffiliation
    to: Organization
    type: belongs_to
    via: participatingOrganization
  - from: OrganizationAffiliation
    to: HealthcareService
    type: has_many
    via: healthcareService
  - from: OrganizationAffiliation
    to: Location
    type: has_many
    via: location
  - from: Organization
    to: Organization
    type: belongs_to
    via: partOf
  - from: Organization
    to: Endpoint
    type: has_many
    via: endpoint
  - from: Location
    to: Organization
    type: belongs_to
    via: managingOrganization
  - from: Location
    to: Endpoint
    type: has_many
    via: endpoint
  - from: HealthcareService
    to: Organization
    type: belongs_to
    via: providedBy
  - from: HealthcareService
    to: Location
    type: has_many
    via: location
  - from: HealthcareService
    to: Endpoint
    type: has_many
    via: endpoint
  - from: InsurancePlan
    to: Organization
    type: belongs_to
    via: ownedBy
  - from: InsurancePlan
    to: Organization
    type: belongs_to
    via: administeredBy
  - from: InsurancePlan
    to: Location
    type: has_many
    via: coverageArea
  - from: List
    to: MedicationKnowledge
    type: has_many
    via: entry.item