specification: FinOps Framework
specificationVersion: '1.0'
schema: https://www.finops.org/framework/
alignedWith:
  framework: FinOps Foundation Framework
  frameworkUrl: https://www.finops.org/framework/
  dataSpec: FOCUS
  dataSpecVersion: '1.3'
  dataSpecUrl: https://focus.finops.org/focus-specification/v1-3/
provider: CVS Health
providerId: cvs-health
publisherName: CVS Health Corporation
serviceCategory: Healthcare
created: '2026-05-04'
# Provenance stamped 2026-08-11: this artifact was written by the API Evangelist
# bulk sweep dated 2026-05-04, not harvested from the provider. See roadmap#35.
method: generated
modified: '2026-05-05'
reconciled: false
tags:
  - Healthcare
  - Pharmacy
  - Health Insurance
  - FHIR
  - FinOps
  - FOCUS
description: 'FOCUS-aligned FinOps for CVS Health: payer-mandated patient-access FHIR is no-cost; partner
  integrations (HL7 / NCPDP / EDI / FHIR) are contractual. Spend rolls up to the underlying healthcare
  product (PBM, plan, pharmacy), not API metering.'
sources:
  - https://www.cvshealth.com/
notes: No public API pricing. Reconcile against partner integration agreements for B2B costs.
principles:
  - name: Visibility
    description: Use partner-portal usage reports and EDI / NCPDP transaction logs to track integration
      activity; correlate with the relevant pharmacy / payer cost center.
  - name: Allocation
    description: Allocate to the consuming line of business (Pharmacy, Aetna, Caremark, MinuteClinic,
      Oak Street) via partner_id and integration_type tags.
  - name: Optimization
    description: Consolidate duplicate partner endpoints; prefer FHIR over EDI where supported; reuse
      tokens within their lifetime to reduce auth overhead.
  - name: Accountability
    description: Health-IT integration and compliance teams jointly own partner integrations; review
      quarterly for HIPAA, CMS rule, and 21st Century Cures Act compliance.
domains:
  - name: Understand Usage and Cost
    capabilities:
      - Allocation
      - Reporting and Analytics
  - name: Quantify Business Value
    capabilities:
      - Forecasting
      - Budgeting
  - name: Optimize Usage and Cost
    capabilities:
      - Workload Optimization
  - name: Manage the FinOps Practice
    capabilities:
      - Invoicing and Chargeback
billingModel:
  pricingCategory: Partner Contract
  billingFrequency: Per-Invoice
  billingCurrency: USD
  chargeCategories:
    - Usage
    - Purchase
    - Tax
    - Adjustment
  chargeFrequency: Recurring
focusColumns:
  ServiceName: CVS Health
  ServiceCategory: Healthcare
  ProviderName: CVS Health
  PublisherName: CVS Health Corporation
  InvoiceIssuerName: CVS Health Corporation
  PricingCategory: Partner Contract
  BillingCurrency: USD
  ChargeCategory: Usage
meters:
  - name: fhir_requests
    description: FHIR API calls under patient-access / partner agreements
    unit: request
    aggregation: sum
    dimensions:
      - app
      - resource_type
  - name: edi_transactions
    description: EDI healthcare transactions (270/271/834/835/837)
    unit: transaction
    aggregation: sum
    dimensions:
      - partner
      - transaction_type
  - name: ncpdp_claims
    description: Pharmacy claim transactions via NCPDP
    unit: claim
    aggregation: sum
    dimensions:
      - partner
      - line_of_business
  - name: api_requests
    description: API calls against CVS Health partner endpoints (not separately billed; observed for
      capacity)
    unit: request
    aggregation: sum
    dimensions:
      - api
      - partner
apis:
  - name: CVS Health Partner Integrations
    baseURL: ''
    tags:
      - EDI
      - FHIR
      - Healthcare
      - HL7
      - NCPDP
      - Partner Integration
      - Pharmacy
    serviceName: CVS Health Partner Integrations
    serviceCategory: API
unitEconomics:
  - name: Cost per FHIR Request
    metric: billed_cost / fhir_requests
  - name: Cost per EDI Transaction
    metric: billed_cost / edi_transactions
maintainers:
  - FN: Kin Lane
    email: kin@apievangelist.com