openapi: 3.0.0
info:
  title: Real Prior Authorization API
  description: FHIR Prior Authorization APIs (CDS, DTR, PAS)
  version: 1.0.0
servers:
- url: https://sandbox-apigw.optum.com
paths:
  /oihub/fhirpriorauth/v1/health-check:
    get:
      summary: Health Check
      description: Performs a health check to validate the availability and operational status of the
        FHIR Prior Auth.
      operationId: healthCheck
      security:
      - oAuth:
        - read_healthcheck
      tags:
      - HealthCheck
      responses:
        '200':
          description: Service is healthy - If the API engine is working correctly and if the entry points
            are accessible, the API operating status response shows "OK".
        '500':
          description: 'Service is unhealthy

            - **Note:** If you receive a response other than 200 OK, the health check failed. Please submit
            a ticket with Optum.

            '
  /oihub/fhirpriorauth/v1/fhirpa/R4/{payerId}/{lob}/Questionnaire/$next-question:
    post:
      operationId: getNextQuestion
      tags:
      - NextQuestion
      security:
      - oAuth:
        - read_healthcheck
      parameters:
      - name: payerId
        in: path
        required: true
        schema:
          type: string
          example: '87726'
      - name: lob
        in: path
        required: true
        schema:
          type: string
          example: bh
      - name: x-optum-consumer-correlation-id
        in: header
        schema:
          type: string
          description: Unique transaction identifier
          example: uuid-123
      - name: environment
        in: header
        schema:
          type: string
          description: Environment name
          example: sandbox
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/NextQuestionRequest'
            example:
              resourceType: QuestionnaireResponse
              id: 62b12331-3b16-4345-a1a6-6e60b236e6a5
              meta:
                profile:
                - http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse-adapt
              contained:
              - resourceType: Questionnaire
                id: '12345'
                meta:
                  profile:
                  - http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-adapt
                extension:
                - url: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-questionnaireAdaptive
                  valueBoolean: true
                name: Questionnaire name
                title: Questionnaire title
                status: active
                date: '2025-07-03T00:00:00-05:00'
                description: Questionnaire description
              extension:
              - url: http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-context
                valueReference:
                  reference: Coverage/CoverageExample
              questionnaire: '#12345'
              status: in-progress
              subject:
                reference: Patient/anonymous
              authored: '2025-11-04T12:12:59.7131+00:00'
      responses:
        '200':
          description: Successful response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/NextQuestionResponse'
              example:
                resourceType: QuestionnaireResponse
                meta:
                  profile:
                  - http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse-adapt
                contained:
                - resourceType: Questionnaire
                  id: '12345'
                  meta:
                    profile:
                    - http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-adapt
                  extension:
                  - url: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-questionnaireAdaptive
                    valueBoolean: true
                  name: Questionnaire name
                  title: Questionnaire title
                  status: active
                  date: '2025-07-03T05:00:00+00:00'
                  description: Questionnaire description
                  item:
                  - id: '1264854090'
                    extension:
                    - url: http://hl7.org/fhir/StructureDefinition/questionnaire-supportLink
                      valueUri: https://apimarketplace.uhcprovider.com/DTR_DOC_REF_API
                    linkId: '1'
                    text: 'Choose one:'
                    type: choice
                    required: true
                    repeats: false
                    answerOption:
                    - valueCoding:
                        code: '1'
                        display: Age ≥ 50
                    - valueCoding:
                        code: '2'
                        display: Age < 50
                extension:
                - url: http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-context
                  valueReference:
                    reference: Coverage/CoverageExample
                questionnaire: '#12345'
                status: in-progress
                subject:
                  reference: Patient/anonymous
                authored: '2025-11-04T12:12:59.7131+00:00'
        '400':
          description: Bad Request
          content:
            application/json:
              example:
                message: Bad Request
                statusCode: 400
        '401':
          description: UnAuthorized
          content:
            application/json:
              example:
                message: UnAuthorized
                statusCode: 401
        '406':
          description: Not Acceptable
          content:
            application/json:
              example:
                message: Not Acceptable
                statusCode: 406
        '500':
          description: Internal Server Error
          content:
            application/json:
              example:
                message: Internal server error
                statusCode: 500
  /oihub/fhirpriorauth/v1/fhirpa/R4/{payerId}/{lob}/Claim/$submit-attachment:
    post:
      operationId: submitAttachment
      tags:
      - SubmitAttachment
      security:
      - oAuth:
        - read_healthcheck
      parameters:
      - name: payerId
        in: path
        required: true
        schema:
          type: string
          example: '87726'
      - name: lob
        in: path
        required: true
        schema:
          type: string
          example: pa
      - name: environment
        in: header
        schema:
          type: string
          example: sandbox
      - name: reference-srn
        in: header
        required: true
        schema:
          type: string
          description: Reference SRN for prior authorization
          example: '123456789'
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/AttachmentRequest'
            example:
              parameter:
              - name: TrackingId
                valueIdentifier:
                  system: http://example.org/cdex/acn
                  value: '123456'
              - name: AttachTo
                valueCode: preauthorization
              - name: PayerId
                valueIdentifier:
                  system: http://example.org/cdex/payer-ids
                  value: '123456'
              - name: OrganizationId
                valueIdentifier:
                  system: http://hl7.org/fhir/sid/us-npi
                  value: '123456'
              - name: ProviderId
                valueIdentifier:
                  system: http://hl7.org/fhir/sid/us-npi
                  value: '123456'
              - name: MemberId
                valueIdentifier:
                  system: http://example.org/cdex/member-ids
                  value: '123456'
              - name: Attachment
                part:
                - name: Content
                  resource:
                    content:
                    - attachment:
                        contentType: application/pdf
                        creation: '2025-11-05T10:25:00-05:00'
                        data: PHN0c
                        url: attachment_url
                        title: History and Physical data
                    date: '2025-11-05T10:30:00-05:00'
                    id: docref-hp-002
                    resourceType: DocumentReference
                    status: current
              resourceType: Parameters
      responses:
        '200':
          description: Successful response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/AttachmentResponse'
              example:
                id: '23345435456574'
                issue:
                - code: informational
                  details:
                    text: AttachmentsacceptedandassociatedwiththereferencedpriorauthorizationforDocumentReferenceID:DocumentReference/docref-hp-002
                  diagnostics: TrackingId=123456;ReferenceSRN=AL26082223;AttachTo=preauthorization;AttachmentTransactionId=98ef77d2-798f-45b7-9925-ba59856574dc
                  location:
                  - Parameters.Attachment.part.Content/DocumentReference/docref-hp-002
                  severity: information
                meta:
                  lastUpdated: '2026-01-09T11:49:17.146+00:00'
                  versionId: '1'
                resourceType: OperationOutcome
                text:
                  div: <divxmlns="http://www.w3.org/1999/xhtml"><p>AttachmentsassociatedwithTrackingId=123456andReferenceId=AL26082223isprocessed.Totalnumberofattachments=1.Pleasereferto'issue'sectionfordetails.</p></div>
                  status: generated
        '400':
          description: Bad Request
          content:
            application/json:
              example:
                message: Bad Request
                statusCode: 400
        '401':
          description: UnAuthorized
          content:
            application/json:
              example:
                message: UnAuthorized
                statusCode: 401
        '406':
          description: Not Acceptable
          content:
            application/json:
              example:
                message: Not Acceptable
                statusCode: 406
        '500':
          description: Internal Server Error
          content:
            application/json:
              example:
                message: Internal server error
                statusCode: 500
  /oihub/fhirpriorauth/v1/fhirpa/R4/{payerId}/{lob}/document-reference:
    get:
      operationId: getDocumentReference
      tags:
      - DocumentReference
      security:
      - oAuth:
        - read_healthcheck
      parameters:
      - name: payerId
        in: path
        required: true
        schema:
          type: string
          example: '87726'
      - name: lob
        in: path
        required: true
        schema:
          type: string
          example: ph
      - name: queryContext
        in: query
        schema:
          type: string
          example: 5a6rra55-e00a-45y8-5tya-123454037c7c
      - name: _query
        in: query
        schema:
          type: string
          example: notes
      - name: noteType
        in: query
        schema:
          type: string
          example: COMMENT_NOTE
      - name: reference
        in: query
        schema:
          type: string
          example: '5'
      - name: questionnaire
        in: query
        schema:
          type: string
          example: '12345'
      - name: x-optum-consumer-correlation-id
        in: header
        schema:
          type: string
          example: uuid-123
      - name: environment
        in: header
        schema:
          type: string
          example: sandbox
      responses:
        '200':
          description: Successful response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/DocumentReferenceResponse'
              example:
                resourceType: Bundle
                id: 35c45r6y-123e-4fgh-b1c3-b949rt46r67y
                meta:
                  lastUpdated: '2025-11-12T02:18:46.123-06:00'
                type: searchset
                total: 1
                entry:
                - resource:
                    resourceType: DocumentReference
                    id: '1'
                    status: current
                    category:
                    - coding:
                      - code: QUESTION_NOTE
                        display: QuestionNote
                    content:
                    - attachment:
                        contentType: text/html
                        data: Base64encodedstring
                        title: QuestionNote
        '400':
          description: Bad Request
          content:
            application/json:
              example:
                message: Bad Request
                statusCode: 400
        '401':
          description: UnAuthorized
          content:
            application/json:
              example:
                message: UnAuthorized
                statusCode: 401
        '406':
          description: Not Acceptable
          content:
            application/json:
              example:
                message: Not Acceptable
                statusCode: 406
        '500':
          description: Internal Server Error
          content:
            application/json:
              example:
                message: Internal server error
                statusCode: 500
  /oihub/fhirpriorauth/v1/fhirpa/R4/{payerId}/{lob}/Claim/$inquire:
    post:
      operationId: inquireClaim
      tags:
      - Inquiry
      security:
      - oAuth:
        - read_healthcheck
      parameters:
      - name: payerId
        in: path
        required: true
        schema:
          type: string
          example: '87726'
      - name: lob
        in: path
        required: true
        schema:
          type: string
          example: bh
      - name: x-optum-consumer-correlation-id
        in: header
        schema:
          type: string
          description: Unique transaction identifier
          example: uuid-123
      - name: environment
        in: header
        schema:
          type: string
          description: Environment
          example: sandbox
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/InquireRequest'
            example:
              resourceType: Bundle
              id: pas-inquiry-request-bundle-example
              type: collection
              entry:
              - resource:
                  resourceType: Claim
                  id: claim-inquiry-example
                  contained:
                  - resourceType: Organization
                    id: requestor-organization-tin
                    identifier:
                    - system: http://hl7.org/fhir/sid/us-tin
                      value: '123456789'
                    name: Requestor Organization
                  - resourceType: Practitioner
                    id: facilityName
                    name:
                    - family: Medical Center
                  - resourceType: PractitionerRole
                    id: primary-role
                    practitioner:
                      reference: '#facilityName'
                  identifier:
                  - system: http://example.org/claim-ids
                    value: A123456789
                  meta:
                    profile:
                    - http://hl7.org/fhir/us/davinci-pas/STU2/StructureDefinition/profile-claim-inquiry
                  status: active
                  type:
                    coding:
                    - system: http://terminology.hl7.org/CodeSystem/claim-type
                      code: professional
                      display: Professional
                  patient:
                    reference: '#example'
                  use: preauthorization
                  created: '2023-10-05T08:30:00Z'
                  provider:
                    reference: '#requestor-organization-tin'
                    display: Requestor Organization
                  careTeam:
                  - provider:
                      reference: '#primary-role'
                    responsible: true
      responses:
        '200':
          description: Successful response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/InquireResponse'
              example:
                resourceType: Bundle
                entry:
                - resource:
                    resourceType: ClaimResponse
                    meta:
                      profile:
                      - https://hl7.org/fhir/us/davinci-pas/StructureDefinition-profile-claiminquiryresponse.html
                      tag:
                      - system: http://optum.com/fhir/wm/system/2021/07/resourceid
                        code: 8uj6vtuJ72g6wzEt46kqwjD+zY91vjtc3xBp0QTV0ZQd7vqimNYhpHtwnWeWUqLexvrvEVO+4rgK80Os00k+jrPw=
                      - system: COLLECTION_BASED_FHIR_METHODS_SHOULD_IMPLEMENT_PAGING_SYSTEM_NAME
                        code: CollectionBasedFhirMethods(mostlikely@Search)shouldbepaged.PleaseelevatethisissuetoyourBAifyouareseeingthismessage.
                        display: XXXCOLLECTION_BASED_FHIR_METHODS_SHOULD_IMPLEMENT_PAGINGXXX.XXXCOLLECTION_BASED_FHIR_METHODS_SHOULD_IMPLEMENT_PAGINGXXX.XXXCOLLECTION_BASED_FHIR_METHODS_SHOULD_IMPLEMENT_PAGINGXXX.XXXCOLLECTION_BASED_FHIR_METHODS_SHOULD_IMPLEMENT_PAGINGXXX.XXXCOLLECTION_BASED_FHIR_METHODS_SHOULD_IMPLEMENT_PAGINGXXX.XXXCOLLECTION_BASED_FHIR_METHODS_SHOULD_IMPLEMENT_PAGINGXXX.XXXCOLLECTION_BASED_FHIR_METHODS_SHOULD_IMPLEMENT_PAGINGXXX.
                    contained:
                    - resourceType: Patient
                      id: patientClaimReference
                      language: English
                      identifier:
                      - system: https://www.uhc.com/member-resources/your-member-id-card
                        value: '#memberId'
                      name:
                      - text: memberfullname
                        family: memberlastname
                        given:
                        - memberfirstname
                      telecom:
                      - system: phone
                        value: '#memberphone'
                      gender: membergender
                      communication:
                      - language:
                          coding:
                          - display: English
                      generalPractitioner:
                      - reference: '#practitionerReference'
                    - resourceType: Practitioner
                      id: practitionerReference
                      name:
                      - text: '#Practitioner'
                    - resourceType: Organization
                      id: organizationInsurerReference
                      meta:
                        profile:
                        - https://hl7.org/fhir/us/davinci-pas/STU2/StructureDefinition-profile-insurer
                      active: true
                      type:
                      - coding:
                        - system: https://hl7.org/fhir/R4/codesystem-organization-type.html#organization-type-pay
                          code: payer
                          display: Payer
                        text: Ahealthcarepayer.
                      name: UnitedHealthcare
                    - resourceType: Organization
                      id: organizationRequestorReference
                      identifier:
                      - system: https://hl7.org/fhir/sid/us-tin
                        value: '123456789'
                      active: true
                      name: MEDICALCENTER
                      telecom:
                      - system: phone
                        value: 123-456-7890
                      address:
                      - line:
                        - address1
                        city: address2
                        state: AZ
                        postalCode: postalcode
                      contact:
                      - telecom:
                        - system: phone
                          value: 123-456-7890
                        address:
                          text: address
                    identifier:
                    - system: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-identifier
                      value: A123456789
                    status: active
                    type:
                      coding:
                      - system: https://hl7.org/fhir/R4/valueset-claim-type.html
                        code: professional
                    use: preauthorization
                    patient:
                      reference: '#patientClaimReference'
                    created: '2025-09-26T09:39:48.115+00:00'
                    insurer:
                      reference: '#organizationInsurerReference'
                    requestor:
                      reference: '#organizationRequestorReference'
                    outcome: complete
                    disposition: Open
                    preAuthPeriod:
                      start: '2025-04-11'
                      end: '2025-07-10'
                    item:
                    - extension:
                      - url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemTraceNumber
                        valueIdentifier:
                          value: A123456789
                      - url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthIssueDate
                        valueDate: '2025-04-11T06:48:28.407+00:00'
                      - url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-itemPreAuthPeriod
                        valuePeriod:
                          start: '2025-04-11'
                          end: '2025-07-10'
                      itemSequence: 1
                      adjudication:
                      - extension:
                        - url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-reviewActionCode
                          valueCodeableConcept:
                            coding:
                            - code: complete
                        category:
                          coding:
                          - system: http://terminology.hl7.org/CodeSystem/adjudication
                            code: submitted
                        reason:
                          coding:
                          - code: Covered/Approved
                  search:
                    mode: match
        '400':
          description: Bad Request
          content:
            application/json:
              example:
                message: Bad Request
                statusCode: 400
        '401':
          description: UnAuthorized
          content:
            application/json:
              example:
                message: UnAuthorized
                statusCode: 401
        '406':
          description: Not Acceptable
          content:
            application/json:
              example:
                message: Not Acceptable
                statusCode: 406
        '500':
          description: Internal Server Error
          content:
            application/json:
              example:
                message: Internal server error
                statusCode: 500
  /oihub/fhirpriorauth/v1/fhirpa/R4/{payerId}/{lob}/Questionnaire/$questionnaire-package:
    post:
      operationId: getQuestionnairePackage
      tags:
      - QuestionnairePackage
      security:
      - oAuth:
        - read_healthcheck
      parameters:
      - name: payerId
        in: path
        required: true
        schema:
          type: string
          example: '87726'
      - name: lob
        in: path
        required: true
        schema:
          type: string
          example: bh
      - name: x-optum-consumer-correlation-id
        in: header
        schema:
          type: string
          example: uuid-123
          description: Unique transaction identifier
      - name: environment
        in: header
        schema:
          type: string
          example: sandbox
          description: Environment name
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/QuestionnairePackageRequest'
            example:
              resourceType: Parameters
              parameter:
              - name: coverage
                resource:
                  resourceType: Coverage
                  id: CoverageExample
                  status: active
              - name: context
                valueString: 251110121553-uuid
      responses:
        '200':
          description: Successful response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/QuestionnairePackageResponse'
              example:
                resourceType: Parameters
                parameter:
                - name: PackageBundle
                  resource:
                    resourceType: Bundle
                    type: collection
                    entry:
                    - resource:
                        resourceType: Questionnaire
                        id: '12345'
                        meta:
                          profile:
                          - http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-adapt
                        extension:
                        - url: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-questionnaireAdaptive
                          valueBoolean: true
                        name: Questionnaire name
                        title: Questionnaire title
                        status: active
                        date: '2025-07-03T00:00:00-05:00'
                        description: Questionnaire description
                    - fullUrl: urn:uuid:dgh18567-f45b-4f7y-1234-f1475567a161
                      resource:
                        resourceType: QuestionnaireResponse
                        id: dgh18567-f45b-4f7y-1234-f1475567a161
                        meta:
                          profile:
                          - http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse-adapt
                        contained:
                        - resourceType: Questionnaire
                          id: '12345'
                          meta:
                            profile:
                            - http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-adapt
                          extension:
                          - url: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-questionnaireAdaptive
                            valueBoolean: true
                          name: Questionnaire name
                          title: Questionnaire title
                          status: active
                          date: '2025-07-03T00:00:00-05:00'
                          description: Questionnaire description
                        extension:
                        - url: http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-context
                          valueReference:
                            reference: Coverage/CoverageExample
                        questionnaire: '#12345'
                        status: in-progress
                        subject:
                          reference: Patient/anonymous
                        authored: '2025-11-11T19:49:42.5034+00:00'
        '400':
          description: Bad Request
          content:
            application/json:
              example:
                message: Bad Request
                statusCode: 400
        '401':
          description: UnAuthorized
          content:
            application/json:
              example:
                message: UnAuthorized
                statusCode: 401
        '406':
          description: Not Acceptable
          content:
            application/json:
              example:
                message: Not Acceptable
                statusCode: 406
        '500':
          description: Internal Server Error
          content:
            application/json:
              example:
                message: Internal server error
                statusCode: 500
  /oihub/fhirpriorauth/v1/cdsHooksServer/{payerId}/{lob}/api/cds-services/crd-order-sign:
    post:
      operationId: orderSign
      tags:
      - OrderSign
      security:
      - oAuth:
        - read_healthcheck
      parameters:
      - name: payerId
        in: path
        required: true
        schema:
          type: string
          example: '87726'
      - name: lob
        in: path
        required: true
        schema:
          type: string
          example: bh
      - name: x-optum-consumer-correlation-id
        in: header
        schema:
          type: string
          example: uuid-123
      - name: environment
        in: header
        schema:
          type: string
          example: sandbox
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/OrderSignRequest'
      responses:
        '200':
          description: Successful response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/OrderSignResponseWrapper'
              example:
                cards:
                - summary: Required
                  indicator: info
                  source:
                    label: UnitedHealthcarePriorAuthorizationRequirements
                    url: https://apimarketplace.uhcprovider.com/#/all-apis/prior-auth-api
                  uuid: uuid
                  detail: A9521DMESUP/ACCESS/SRV-COMPON/OTHHCPCS
                  links:
                  - label: CompleteDocumentation(DTR)
                    url: ''
                    type: absolute
                    appContext: f48ed17f-dc96-457d-8dc3-906a12f0a294
                systemActions: []
        '400':
          description: Bad Request
          content:
            application/json:
              example:
                message: Bad Request
                statusCode: 400
        '401':
          description: UnAuthorized
          content:
            application/json:
              example:
                message: UnAuthorized
                statusCode: 401
        '406':
          description: Not Acceptable
          content:
            application/json:
              example:
                message: Not Acceptable
                statusCode: 406
        '500':
          description: Internal Server Error
          content:
            application/json:
              example:
                message: Internal server error
                statusCode: 500
  /oihub/fhirpriorauth/v1/fhirpa/R4/{payerId}/{lob}/Claim/$submit:
    post:
      operationId: submitClaim
      tags:
      - Submit
      security:
      - oAuth:
        - read_healthcheck
      parameters:
      - name: payerId
        in: path
        required: true
        schema:
          type: string
          example: '87726'
      - name: lob
        in: path
        required: true
        schema:
          type: string
          example: bh
      - name: x-optum-consumer-correlation-id
        in: header
        schema:
          type: string
          description: Unique transaction identifier
          example: uuid-123
      - name: environment
        in: header
        schema:
          type: string
          description: Environment name
          example: sandbox
      requestBody:
        required: true
        content:
          application/json:
            schema:
              $ref: '#/components/schemas/SubmitRequest'
            example:
              resourceType: Bundle
              id: example-bundle-id
              type: collection
              entry:
              - resource:
                  resourceType: Claim
                  id: example-claim-id
                  contained:
                  - resourceType: DeviceRequest
                    id: device-request-1
                    status: active
                    intent: order
                    codeCodeableConcept:
                      coding:
                      - system: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets
                        code: E1223
                      text: Wheelchair
                    reasonCode:
                    - coding:
                      - system: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets
                        code: E1223
                      text: Wheelchair
                    note:
                    - text: No adverse events reported.
                    authoredOn: '2005-06-02'
                  - resourceType: Encounter
                    id: encounter-1
                    status: arrived
                    location:
                    - location:
                        reference: '#org-1'
                      period:
                        start: '2015-01-15'
                        end: '2016-01-15'
                    hospitalization:
                      destination:
                        reference: '#org-1'
                  - resourceType: ServiceRequest
                    id: service-request-1
                    status: active
                    intent: original-order
                    occurrenceTiming:
                      repeat:
                        periodUnit: min
                        durationUnit: min
                        frequency: 2
                        count: 2
                  - resourceType: Procedure
                    id: procedure-1
                    status: completed
                    basedOn:
                    - reference: '#service-request-1'
                    code:
                      coding:
                      - system: http://www.ama-assn.org/go/cpt
                        code: '22206'
                    subject:
                      reference: '#patient-1'
                    performedPeriod:
                      start: '2015-01-15'
                      end: '2016-01-15'
                    recorder:
                      reference: '#practitioner-1'
                    asserter:
                      reference: '#practitioner-1'
                    performer:
                    - actor:
                        reference: '#practitioner-1'
                    reasonCode:
                    - text: Generalized abdominal pain.
                    followUp:
                    - text: Follow up in 5 days.
                    note:
                    - text: Routine procedure.
                  - resourceType: Location
                    id: location-1
                    name: Generic Location
                    managingOrganization:
                      reference: '#org-1'
                  - resourceType: Organization
                    id: org-1
                    name: Organization
                    identifier:
                    - system: http://example.org/sampleepisodeofcare-identifier
                      type:
                        coding:
                        - system: http://terminology.hl7.org/CodeSystem/v2-0203
                          code: TAX
                      value: '123'
                  - resourceType: Coverage
                    id: coverage-1
                    status: active
                    subscriberId: '000000000'
                    beneficiary:
                      reference: '#patient-1'
                    class:
                    - type:
                        coding:
                        - system: http://terminology.hl7.org/CodeSystem/coverage-class
                          code: group
                      value: GROUP1
                    relationship:
                      coding:
                      - system: http://terminology.hl7.org/CodeSystem/subscriber-relationship
                        code: self
                    payor:
                    - reference: '#org-2'
                  - resourceType: Patient
                    id: patient-1
                    gender: male
                  - resourceType: Organization
                    id: org-2
                    name: Organization
                  - resourceType: Organization
                    id: org-3
                    name: Insurer Organization
                  - resourceType: Practitioner
                    id: practitioner-1
                  - resourceType: PractitionerRole
                    id: role-1
                    practitioner:
                      reference: '#practitioner-1'
                    organization:
                      reference: '#org-2'
                  identifier:
                  - system: http://example.org/claim-ids
                    value: CLAIM000000
                  meta:
                    profile:
                    - http://hl7.org/fhir/us/davinci-pas/STU2/StructureDefinition/profile-claim-submit
                  status: active
                  type:
                    coding:
                    - system: http://terminology.hl7.org/CodeSystem/claim-type
                      code: professional
                      display: Professional
                  use: preauthorization
                  patient:
                    reference: '#patient-1'
                  created: '2023-10-05T08:30:00Z'
                  insurer:
                    reference: '#org-3'
                  provider:
                    reference: '#org-2'
                  priority:
                    coding:
                    - system: http://terminology.hl7.org/CodeSystem/processpriority
                      code: stat
                      display: Immediate
                  diagnosis:
                  - sequence: 1
                    diagnosisCodeableConcept:
                      coding:
                      - system: http://hl7.org/fhir/sid/icd-10-cm
                        code: S42.192A
                  procedure:
                  - sequence: 1
                    procedureReference:
                      reference: '#procedure-1'
                  insurance:
                  - sequence: 1
                    focal: true
                    coverage:
                      reference: '#coverage-1'
                  careTeam:
                  - extension:
                    - url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-careTeamClaimScope
                      valueBoolean: true
                    sequence: 1
                    provider:
                      reference: '#role-1'
                    role:
                      coding:
                      - system: http://terminology.hl7.org/CodeSystem/claimcareteamrole
                        code: primary
                  item:
                  - extension:
                    - url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-requestedService
                      valueReference:
                        reference: '#device-request-1'
                    - url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType
                      valueCodeableConcept:
                        coding:
                        - system: https://codesystem.x12.org/005010/1525
                          code: HS
                          display: Health Services Review
                    - url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType
                      valueCodeableConcept:
                        coding:
                        - system: https://codesystem.x12.org/005010/1322
                          code: I
                          display: Initial
                    sequence: 1
                    careTeamSequence:
                    - 1
                    procedureSequence:
                    - 1
                    category:
                      coding:
                      - system: https://codesystem.x12.org/005010/1365
                        code: '42'
                        display: Home Health Care
                    productOrService:
                      coding:
                      - system: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets
                        code: G0154
                    locationCodeableConcept:
                      coding:
                      - system: https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set
                        code: '20'
                  - extension:
                    - url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-serviceItemRequestType
                      valueCodeableConcept:
                        coding:
                        - system: https://codesystem.x12.org/005010/1525
                          code: HS
                          display: Health Services Review
                    - url: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-certificationType
                      valueCodeableConcept:
                        coding:
                        - system: https://codesystem.x12.org/005010/1322
                          code: I
                          display: Initial
                    sequence: 2
                    category:
                      coding:
                      - system: https://codesystem.x12.org/005010/1365
                        code: '42'
                        display: Home Health Care
                    productOrService:
                      coding:
                      - system: http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets
                        code: B4184
                    locationCodeableConcept:
                      coding:
                      - system: https://www.cms.gov/Medicare/Coding/place-of-service-codes/Place_of_Service_Code_Set
                        code: '20'
                    encounter:
                    - reference: '#encounter-1'
      responses:
        '200':
          description: Successful response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/SubmitResponse'
              example:
                resourceType: Bundle
                entry:
                - resource:
                    resourceType: ClaimResponse
                    meta:
                      profile:
                      - http://hl7.org/fhir/us/davinci-pas/StructureDefinition-profile-claimresponse-base.html
                      tag:
                      - system: system
                        code: code
                      - system: COLLECTION_BASED_FHIR_METHODS_SHOULD_IMPLEMENT_PAGING_SYSTEM_NAME
                        code: CollectionBasedFhirMethods(mostlikely@Search)shouldbepaged.PleaseelevatethisissuetoyourBAifyouareseeingthismessage.
                        display: XXXCOLLECTION_BASED_FHIR_METHODS_SHOULD_IMPLEMENT_PAGINGXXX.XXXCOLLECTION_BASED_FHIR_METHODS_SHOULD_IMPLEMENT_PAGINGXXX.XXXCOLLECTION_BASED_FHIR_METHODS_SHOULD_IMPLEMENT_PAGINGXXX.XXXCOLLECTION_BASED_FHIR_METHODS_SHOULD_IMPLEMENT_PAGINGXXX.XXXCOLLECTION_BASED_FHIR_METHODS_SHOULD_IMPLEMENT_PAGINGXXX.XXXCOLLECTION_BASED_FHIR_METHODS_SHOULD_IMPLEMENT_PAGINGXXX.XXXCOLLECTION_BASED_FHIR_METHODS_SHOULD_IMPLEMENT_PAGINGXXX.
                    contained:
                    - resourceType: Patient
                      id: patientClaimReference
                      identifier:
                      - system: https://www.uhc.com/member-resources/your-member-id-card
                        value: XXXXX4606
                      name:
                      - text: givenfamilyName
                        family: familyName
                        given:
                        - given
                      telecom:
                      - system: phone
                        value: 121-121-1212
                      gender: male
                      generalPractitioner:
                      - reference: '#practitionerReference'
                    - resourceType: Practitioner
                      id: practitionerReference
                    - resourceType: Organization
                      id: organizationInsurerReference
                      meta:
                        profile:
                        - https://hl7.org/fhir/us/davinci-pas/STU2/StructureDefinition-profile-insurer
                      active: true
                      type:
                      - coding:
                        - system: https://hl7.org/fhir/R4/codesystem-organization-type.html#organization-type-pay
                          code: payer
                          display: Payer
                        text: Ahealthcarepayer.
                      name: dummy
                    - resourceType: Organization
                      id: organizationRequestorReference
                      identifier:
                      - system: http://hl7.org/fhir/sid/us-tin
                        value: '123456789'
                      active: true
                      name: MERCYCENTER
                      telecom:
                      - system: phone
                        value: 123-456-7890
                      address:
                      - line:
                        - lineDR
                        city: city
                        state: AZ
                        postalCode: '12345'
                      contact:
                      - name:
                          text: MERCYCENTER
                        telecom:
                        - system: phone
                          value: 123-345-4567
                    identifier:
                    - system: http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-identifier
                      value: A00123456
                    status: draft
                    type:
                      coding:
                      - system: https://hl7.org/fhir/R4/valueset-claim-type.html
                        code: professional
                    use: preauthorization
                    patient:
                      reference: '#patientClaimReference'
                    created: '2025-11-21T16:47:20'
                    insurer:
                      reference: '#organizationInsurerReference'
                    requestor:
                      reference: '#organizationRequestorReference'
                    outcome: queued
                    disposition: Open
                    preAuthPeriod:
                      start: '2015-01-15'
                      end: '2016-01-15'
                    item:
                    - itemSequence: 1
                      adjudication:
                      - category:
                          coding:
                          - system: http://terminology.hl7.org/CodeSystem/adjudication
                            code: submitted
                  search:
                    mode: match
        '400':
          description: Bad Request
          content:
            application/json:
              example:
                message: Bad Request
                statusCode: 400
        '401':
          description: UnAuthorized
          content:
            application/json:
              example:
                message: UnAuthorized
                statusCode: 401
        '406':
          description: Not Acceptable
          content:
            application/json:
              example:
                message: Not Acceptable
                statusCode: 406
        '500':
          description: Internal Server Error
          content:
            application/json:
              example:
                message: Internal server error
                statusCode: 500
  /oihub/fhirpriorauth/v1/cdsHooksServer/{payerId}/{lob}/api/cds-services:
    get:
      operationId: getDiscovery
      tags:
      - Discovery
      security:
      - oAuth:
        - read_healthcheck
      parameters:
      - name: payerId
        in: path
        required: true
        schema:
          type: string
          example: '87726'
      - name: lob
        in: path
        required: true
        schema:
          type: string
          example: ph
      - name: x-optum-consumer-correlation-id
        in: header
        schema:
          type: string
          example: uuid-123
      - name: environment
        in: header
        schema:
          type: string
          example: sandbox
      responses:
        '200':
          description: Successful response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/DiscoveryResponse'
              example:
                services:
                - id: coverageRequirements-serviceRequest
                  hook: order-sign
                  title: United Health Care Order Sign Decision Support
                  description: Coverage Requirement Guidance related to orders being signed
                  prefetch:
                    claimResponse: ClaimResponse?patient={{%context.patientId}}
                    condition: Condition?patient={{%context.patientId}}
                    coverage: Coverage?patient={{%context.patientId}}&status=active
                    device: Device?patient={{%context.patientId}}
                    encounter: Encounter/{{%context.encounterId}}
                    location: Location?_id={{%context.locationId}}
                    patient: Patient/{{%context.patientId}}
                    practitioner: Practitioner/{{%context.userId}}
                    practitionerRole: PractitionerRole?practitioner={{%context.userId}}
                  usageRequirements: requirement-1, requirement-2
        '400':
          description: Bad Request
          content:
            application/json:
              example:
                message: Bad Request
                statusCode: 400
        '401':
          description: UnAuthorized
          content:
            application/json:
              example:
                message: UnAuthorized
                statusCode: 401
        '406':
          description: Not Acceptable
          content:
            application/json:
              example:
                message: Not Acceptable
                statusCode: 406
        '500':
          description: Internal Server Error
          content:
            application/json:
              example:
                message: Internal server error
                statusCode: 500
  /oihub/fhirpriorauth/v1/fhirpa/R4/{payerId}/{lob}/operation-definition/{operation}:
    get:
      operationId: getOperationDefinition
      tags:
      - OperationDefinition
      security:
      - oAuth:
        - read_healthcheck
      parameters:
      - name: payerId
        in: path
        required: true
        schema:
          type: string
          example: '87726'
      - name: lob
        in: path
        required: true
        schema:
          type: string
          example: ph
      - name: operation
        in: path
        required: true
        schema:
          type: string
          example: next-question
      - name: x-optum-consumer-correlation-id
        in: header
        schema:
          type: string
          example: uuid-123
      - name: environment
        in: header
        schema:
          type: string
          example: sandbox
      responses:
        '200':
          description: Successful response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/OperationDefinitionResponse'
              example:
                resourceType: OperationDefinition
                text:
                  status: generated
                  div: <div xmlns="http://www.w3.org/1999/xhtml">Operation</div>
                url: https://apimarketplace-stg.uhc.com/PriorAuth/v1/OperationDefinition/next-question
                name: Next-question
                status: active
                kind: operation
                affectsState: true
                code: next-question
                resource:
                - Questionnaire
                system: false
                type: true
                instance: false
        '400':
          description: Bad Request
          content:
            application/json:
              example:
                message: Bad Request
                statusCode: 400
        '401':
          description: UnAuthorized
          content:
            application/json:
              example:
                message: UnAuthorized
                statusCode: 401
        '406':
          description: Not Acceptable
          content:
            application/json:
              example:
                message: Not Acceptable
                statusCode: 406
        '500':
          description: Internal Server Error
          content:
            application/json:
              example:
                message: Internal server error
                statusCode: 500
  /oihub/fhirpriorauth/v1/fhirpa/R4/{payerId}/{lob}/pas/metadata:
    get:
      operationId: getPasCapabilityStatement
      tags:
      - PasCapabilityStatement
      security:
      - oAuth:
        - read_healthcheck
      parameters:
      - name: payerId
        in: path
        required: true
        schema:
          type: string
          example: '87726'
      - name: lob
        in: path
        required: true
        schema:
          type: string
          example: ph
      - name: x-optum-consumer-correlation-id
        in: header
        schema:
          type: string
          example: uuid-123
      - name: environment
        in: header
        schema:
          type: string
          example: sandbox
      responses:
        '200':
          description: Successful response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/PasCapabilityStatementResponse'
              example:
                resourceType: CapabilityStatement
                id: 69d03dab-fd65-4412-83ce-395ffe9856f3
                text:
                  status: generated
                  div: <div xmlns="http://www.w3.org/1999/xhtml">uhcpp-paan-pas-server</div>
                name: UHC PAAN FHIR Layer Exchange
                status: active
                date: '2026-04-23T16:34:36.237+00:00'
                publisher: UHC PAAN
                description: The CapabilityStatement resource documents the functionality implemented
                  from the HL7® FHIR® standard
                kind: instance
                software:
                  name: uhcpp-paan-pas-server
                  version: 8.8.0
                implementation:
                  description: uhcpp-paan-pas-server implementation
                  url: https://apimarketplace-stg.uhc.com/PriorAuth/v1
                fhirVersion: 4.0.1
                format:
                - application/fhir+xml
                - xml
                - application/fhir+json
                - json
                - application/x-turtle
                - ttl
                rest:
                - mode: server
                  resource:
                  - type: Claim
                    profile: http://hl7.org/fhir/StructureDefinition/Claim
                    searchInclude:
                    - '*'
                    operation:
                    - name: submit
                      definition: https://apimarketplace-stg.uhc.com/PriorAuth/v1/OperationDefinition/claim-submit
                    - name: inquire
                      definition: https://apimarketplace-stg.uhc.com/PriorAuth/v1/OperationDefinition/claim-inquire
                  - type: OperationDefinition
                    profile: http://hl7.org/fhir/StructureDefinition/OperationDefinition
                    interaction:
                    - code: read
                    searchInclude:
                    - '*'
                  operation:
                  - name: submit-attachment
                    definition: https://apimarketplace-stg.uhc.com/PriorAuth/v1/OperationDefinition/submit-attachment
        '400':
          description: Bad Request
          content:
            application/json:
              example:
                message: Bad Request
                statusCode: 400
        '401':
          description: UnAuthorized
          content:
            application/json:
              example:
                message: UnAuthorized
                statusCode: 401
        '406':
          description: Not Acceptable
          content:
            application/json:
              example:
                message: Not Acceptable
                statusCode: 406
        '500':
          description: Internal Server Error
          content:
            application/json:
              example:
                message: Internal server error
                statusCode: 500
  /oihub/fhirpriorauth/v1/fhirpa/R4/{payerId}/{lob}/dtr/metadata:
    get:
      operationId: getDtrCapabilityStatement
      tags:
      - DtrCapabilityStatement
      security:
      - oAuth:
        - read_healthcheck
      parameters:
      - name: payerId
        in: path
        required: true
        schema:
          type: string
          example: '87726'
      - name: lob
        in: path
        required: true
        schema:
          type: string
          example: ph
      - name: x-optum-consumer-correlation-id
        in: header
        schema:
          type: string
          example: uuid-123
      - name: environment
        in: header
        schema:
          type: string
          example: sandbox
      responses:
        '200':
          description: Successful response
          content:
            application/json:
              schema:
                $ref: '#/components/schemas/DtrCapabilityStatementResponse'
              example:
                resourceType: CapabilityStatement
                id: 13bed635-6cd2-47e6-9709-fdfefde25954
                text:
                  status: generated
                  div: <div xmlns="http://www.w3.org/1999/xhtml">uhcpp-paan-dtr-server</div>
                name: UHC PAAN FHIR Layer Exchange
                status: active
                date: '2026-04-23T16:34:56.081+00:00'
                publisher: UHC PAAN
                description: The CapabilityStatement resource documents the functionality implemented
                  from the HL7® FHIR® standard
                kind: instance
                software:
                  name: uhcpp-paan-dtr-server
                  version: 8.8.0
                implementation:
                  description: uhcpp-paan-dtr-server implementation
                  url: https://apimarketplace-stg.uhc.com/PriorAuth/v1
                fhirVersion: 4.0.1
                format:
                - application/fhir+xml
                - xml
                - application/fhir+json
                - json
                - application/x-turtle
                - ttl
                rest:
                - mode: server
                  resource:
                  - type: OperationDefinition
                    profile: http://hl7.org/fhir/StructureDefinition/OperationDefinition
                    interaction:
                    - code: read
                    searchInclude:
                    - '*'
                  - type: Questionnaire
                    profile: http://hl7.org/fhir/StructureDefinition/Questionnaire
                    searchInclude:
                    - '*'
                    operation:
                    - name: questionnaire-package
                      definition: https://apimarketplace-stg.uhc.com/PriorAuth/v1/OperationDefinition/questionnaire-package
                    - name: next-question
                      definition: https://apimarketplace-stg.uhc.com/PriorAuth/v1/OperationDefinition/next-question
                    - name: document-reference
                      definition: https://apimarketplace-stg.uhc.com/PriorAuth/v1/OperationDefinition/document-reference
        '400':
          description: Bad Request
          content:
            application/json:
              example:
                message: Bad Request
                statusCode: 400
        '401':
          description: UnAuthorized
          content:
            application/json:
              example:
                message: UnAuthorized
                statusCode: 401
        '406':
          description: Not Acceptable
          content:
            application/json:
              example:
                message: Not Acceptable
                statusCode: 406
        '500':
          description: Internal Server Error
          content:
            application/json:
              example:
                message: Internal server error
                statusCode: 500
components:
  securitySchemes:
    oAuth:
      type: oauth2
      description: This API uses OAuth 2 with the client_credentials grant flow.
      flows:
        clientCredentials:
          tokenUrl: /apip/auth/v2/token
          scopes:
            read_txn: read transactions
            create_txn: submit a new transaction request
            read_coveragediscovery: read coverage discovery tasks
            create_coveragediscovery: submit a new coverage discovery task
            read_healthcheck: check the status of the system
  schemas:
    NextQuestionRequest:
      type: object
      description: FHIR QuestionnaireResponse request containing current answers and context to fetch
        next adaptive question
      properties:
        resourceType:
          type: string
          description: FHIR resource type
          example: QuestionnaireResponse
        id:
          type: string
          description: Unique QuestionnaireResponse identifier
          example: 62b12331-3b16-4345-a1a6-6e60b236e6a5
        meta:
          $ref: '#/components/schemas/Meta'
        contained:
          type: array
          description: Contained Questionnaire resource
          items:
            $ref: '#/components/schemas/Questionnaire'
        extension:
          type: array
          description: FHIR extensions providing additional context
          items:
            $ref: '#/components/schemas/Extension'
        questionnaire:
          type: string
          description: Reference to Questionnaire
          example: '#12345'
        status:
          type: string
          description: QuestionnaireResponse status
          example: in-progress
        subject:
          $ref: '#/components/schemas/Reference'
        authored:
          type: string
          description: Date/time when response was authored
          example: '2025-11-04T12:12:59.7131+00:00'
    NextQuestionResponse:
      type: object
      description: FHIR QuestionnaireResponse response containing next adaptive question
      properties:
        resourceType:
          type: string
          example: QuestionnaireResponse
        meta:
          $ref: '#/components/schemas/Meta'
        contained:
          type: array
          description: Contained Questionnaire with next question items
          items:
            $ref: '#/components/schemas/Questionnaire'
        extension:
          type: array
          items:
            $ref: '#/components/schemas/Extension'
        questionnaire:
          type: string
          example: '#12345'
        status:
          type: string
          example: in-progress
        subject:
          $ref: '#/components/schemas/Reference'
        authored:
          type: string
          example: '2025-11-04T12:12:59.7131+00:00'
    Meta:
      type: object
      description: FHIR metadata
      properties:
        profile:
          type: array
          description: FHIR profile URLs
          items:
            type: string
            example: http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaireresponse-adapt
    Questionnaire:
      type: object
      description: FHIR Questionnaire resource
      properties:
        resourceType:
          type: string
          example: Questionnaire
        id:
          type: string
          example: '12345'
        meta:
          $ref: '#/components/schemas/Meta'
        extension:
          type: array
          description: Questionnaire extensions
          items:
            $ref: '#/components/schemas/ExtensionGeneric'
        name:
          type: string
          description: Questionnaire name
          example: Questionnaire name
        title:
          type: string
          description: Questionnaire title
          example: Questionnaire title
        status:
          type: string
          description: Questionnaire status
          example: active
        date:
          type: string
          description: Date of creation
          example: '2025-07-03T00:00:00-05:00'
        description:
          type: string
          description: Questionnaire description
          example: Questionnaire description
        item:
          type: array
          description: List of questions
          items:
            $ref: '#/components/schemas/Item'
    Item:
      type: object
      description: Questionnaire item (question)
      properties:
        id:
          type: string
          example: '1264854090'
        linkId:
          type: string
          example: '1'
        text:
          type: string
          example: 'Choose one:'
        type:
          type: string
          example: choice
        required:
          type: boolean
          example: true
        repeats:
          type: boolean
          example: false
        extension:
          type: array
          items:
            $ref: '#/components/schemas/ExtensionGeneric'
        answerOption:
          type: array
          items:
            $ref: '#/components/schemas/AnswerOption'
        item:
          type: array
          description: Nested child questions
          items:
            $ref: '#/components/schemas/Item'
    AnswerOption:
      type: object
      description: Answer choice option
      properties:
        valueCoding:
          $ref: '#/components/schemas/Coding'
    Coding:
      type: object
      description: Coding structure for answers
      properties:
        code:
          type: string
          example: '1'
        display:
          type: string
          example: Age ≥ 50
    Extension:
      type: object
      description: FHIR extension with Reference
      properties:
        url:
          type: string
          example: http://hl7.org/fhir/us/davinci-dtr/StructureDefinition/qr-context
        valueReference:
          $ref: '#/components/schemas/Reference'
    ExtensionGeneric:
      type: object
      description: Generic extension supporting multiple value types
      properties:
        url:
          type: string
          example: http://hl7.org/fhir/StructureDefinition/questionnaire-supportLink
        valueBoolean:
          type: boolean
          example: true
        valueUri:
          type: string
          example: https://apimarketplace.uhcprovider.com/DTR_DOC_REF_API
    Reference:
      type: object
      description: FHIR Reference
      properties:
        reference:
          type: string
          example: Patient/anonymous
    AttachmentRequest:
      type: object
      description: FHIR Parameters resource for attachment submission
      properties:
        resourceType:
          type: string
          example: Parameters
        parameter:
          type: array
          items:
            $ref: '#/components/schemas/Parameter'
    Parameter:
      type: object
      description: Parameter entry in Parameters resource
      properties:
        name:
          type: string
          example: TrackingId
        valueIdentifier:
          $ref: '#/components/schemas/Identifier'
        valueCode:
          type: string
          example: preauthorization
        part:
          type: array
          items:
            $ref: '#/components/schemas/ParameterPart'
    ParameterPart:
      type: object
      description: Nested parameter part (used for Attachment)
      properties:
        name:
          type: string
          example: Content
        resource:
          $ref: '#/components/schemas/DocumentReference'
    DocumentReference:
      type: object
      description: FHIR DocumentReference used inside attachment
      properties:
        resourceType:
          type: string
          example: DocumentReference
        id:
          type: string
          example: docref-hp-002
        status:
          type: string
          example: current
        date:
          type: string
          example: '2025-11-05T10:30:00-05:00'
        content:
          type: array
          items:
            $ref: '#/components/schemas/Content'
    Content:
      type: object
      properties:
        attachment:
          $ref: '#/components/schemas/Attachment'
    Attachment:
      type: object
      description: Attachment content details
      properties:
        contentType:
          type: string
          example: application/pdf
        creation:
          type: string
          example: '2025-11-05T10:25:00-05:00'
        data:
          type: string
          example: PHN0c
        url:
          type: string
          example: attachment_url
        title:
          type: string
          example: History and Physical data
    AttachmentResponse:
      type: object
      description: FHIR OperationOutcome response
      properties:
        resourceType:
          type: string
          example: OperationOutcome
        id:
          type: string
          example: '23345435456574'
        meta:
          $ref: '#/components/schemas/Meta'
        issue:
          type: array
          items:
            $ref: '#/components/schemas/Issue'
        text:
          $ref: '#/components/schemas/Narrative'
    Issue:
      type: object
      description: OperationOutcome issue details
      properties:
        severity:
          type: string
          example: information
        code:
          type: string
          example: informational
        details:
          type: object
          properties:
            text:
              type: string
              example: Attachments accepted and associated...
        diagnostics:
          type: string
          example: TrackingId=123456;ReferenceSRN=AL26082223...
        location:
          type: array
          items:
            type: string
            example: Parameters.Attachment.part.Content/DocumentReference/docref-hp-002
    Narrative:
      type: object
      properties:
        status:
          type: string
          example: generated
        div:
          type: string
          example: <div xmlns="http://www.w3.org/1999/xhtml">Operation</div>
    Identifier:
      type: object
      properties:
        system:
          type: string
          example: http://example.org/cdex/acn
        value:
          type: string
          example: '123456'
    DocumentReferenceResponse:
      type: object
      description: FHIR Bundle containing DocumentReference search results
      properties:
        resourceType:
          type: string
          example: Bundle
        id:
          type: string
          example: 35c45r6y-123e-4fgh-b1c3-b949rt46r67y
        meta:
          $ref: '#/components/schemas/Meta'
        type:
          type: string
          example: searchset
        total:
          type: integer
          example: 1
        entry:
          type: array
          items:
            $ref: '#/components/schemas/DocumentEntry'
    DocumentEntry:
      type: object
      description: Bundle entry containing DocumentReference
      properties:
        resource:
          $ref: '#/components/schemas/DocumentReference'
    CodeableConcept:
      type: object
      description: FHIR CodeableConcept
      properties:
        coding:
          type: array
          items:
            $ref: '#/components/schemas/Coding'
    InquireRequest:
      type: object
      description: FHIR Bundle for claim inquiry
      properties:
        resourceType:
          type: string
          example: Bundle
        id:
          type: string
          example: pas-inquiry-request-bundle-example
        type:
          type: string
          example: collection
        entry:
          type: array
          items:
            $ref: '#/components/schemas/Entry'
    InquireResponse:
      type: object
      description: FHIR Bundle with ClaimResponse
      properties:
        resourceType:
          type: string
          example: Bundle
        entry:
          type: array
          items:
            $ref: '#/components/schemas/ResponseEntry'
    Entry:
      type: object
      properties:
        resource:
          $ref: '#/components/schemas/Claim'
    ResponseEntry:
      type: object
      properties:
        resource:
          $ref: '#/components/schemas/ClaimResponse'
        search:
          type: object
          properties:
            mode:
              type: string
              example: match
    Claim:
      type: object
      description: FHIR Claim Inquiry Request
      properties:
        resourceType:
          type: string
          example: Claim
        id:
          type: string
        meta:
          $ref: '#/components/schemas/Meta'
        identifier:
          type: array
          items:
            $ref: '#/components/schemas/Identifier'
        status:
          type: string
          example: active
        type:
          $ref: '#/components/schemas/CodeableConcept'
        use:
          type: string
          example: preauthorization
        created:
          type: string
          example: '2023-10-05T08:30:00Z'
        patient:
          $ref: '#/components/schemas/Reference'
        provider:
          $ref: '#/components/schemas/Reference'
        careTeam:
          type: array
          items:
            $ref: '#/components/schemas/CareTeam'
    ClaimResponse:
      type: object
      description: FHIR ClaimResponse
      properties:
        resourceType:
          type: string
          example: ClaimResponse
        meta:
          $ref: '#/components/schemas/Meta'
        identifier:
          type: array
          items:
            $ref: '#/components/schemas/Identifier'
        status:
          type: string
          example: active
        type:
          $ref: '#/components/schemas/CodeableConcept'
        use:
          type: string
          example: preauthorization
        created:
          type: string
          example: '2025-09-26T09:39:48+00:00'
        patient:
          $ref: '#/components/schemas/Reference'
        insurer:
          $ref: '#/components/schemas/Reference'
        requestor:
          $ref: '#/components/schemas/Reference'
        outcome:
          type: string
          example: complete
        disposition:
          type: string
          example: Open
        preAuthPeriod:
          $ref: '#/components/schemas/Period'
        item:
          type: array
          items:
            $ref: '#/components/schemas/ResponseItem'
    ResponseItem:
      type: object
      properties:
        itemSequence:
          type: integer
          example: 1
        extension:
          type: array
          items:
            $ref: '#/components/schemas/Extension'
        adjudication:
          type: array
          items:
            $ref: '#/components/schemas/Adjudication'
    Adjudication:
      type: object
      properties:
        category:
          $ref: '#/components/schemas/CodeableConcept'
        reason:
          $ref: '#/components/schemas/CodeableConcept'
        extension:
          type: array
          items:
            $ref: '#/components/schemas/Extension'
    CareTeam:
      type: object
      properties:
        provider:
          $ref: '#/components/schemas/Reference'
        responsible:
          type: boolean
          example: true
    Period:
      type: object
      properties:
        start:
          type: string
          example: '2025-04-11'
        end:
          type: string
          example: '2025-07-10'
    QuestionnairePackageRequest:
      type: object
      description: FHIR Parameters request for Questionnaire Package
      properties:
        resourceType:
          type: string
          description: FHIR resource type
          example: Parameters
        parameter:
          type: array
          description: List of parameters
          items:
            $ref: '#/components/schemas/RequestParameter'
    RequestParameter:
      type: object
      description: Request parameter entry
      properties:
        name:
          type: string
          description: Parameter name
          example: coverage
        resource:
          $ref: '#/components/schemas/Coverage'
        valueString:
          type: string
          description: Context correlation ID
          example: 251110121553-uuid
    Coverage:
      type: object
      description: FHIR Coverage resource
      properties:
        resourceType:
          type: string
          example: Coverage
        id:
          type: string
          example: CoverageExample
        status:
          type: string
          description: Coverage status
          example: active
    QuestionnairePackageResponse:
      type: object
      description: FHIR Parameters response containing Questionnaire package bundle
      properties:
        resourceType:
          type: string
          example: Parameters
        parameter:
          type: array
          items:
            $ref: '#/components/schemas/ResponseParameter'
    ResponseParameter:
      type: object
      description: Response parameter entry
      properties:
        name:
          type: string
          description: Parameter name containing bundle
          example: PackageBundle
        resource:
          $ref: '#/components/schemas/Bundle'
    Bundle:
      type: object
      description: FHIR Bundle resource
      properties:
        resourceType:
          type: string
          example: Bundle
        type:
          type: string
          example: collection
        entry:
          type: array
          description: Bundle entries
          items:
            $ref: '#/components/schemas/Entry'
    OrderSignRequest:
      type: object
      description: CDS Hooks Order Sign Request payload
      properties:
        hook:
          type: string
          description: CDS Hooks hook name
          example: order-sign
        hookInstance:
          type: string
          description: Unique hook instance identifier
          example: serviceRequestCoverageRequirements
        fhirServer:
          type: string
          description: FHIR server base URL
          example: http://hooks.smarthealth.org:9121
        fhirAuthorization:
          $ref: '#/components/schemas/FhirAuthorization'
        context:
          $ref: '#/components/schemas/Context'
        prefetch:
          $ref: '#/components/schemas/Prefetch'
    FhirAuthorization:
      type: object
      description: FHIR authorization details
      properties:
        access_token:
          type: string
          description: Access token for FHIR server
          example: some-opaque-fhir-access-token
        token_type:
          type: string
          description: Token type
          example: Bearer
        expires_in:
          type: integer
          description: Token expiration time in seconds
          example: 300
        scope:
          type: string
          description: Authorized scope
          example: user/Patient.read user/DeviceRequest.read
        subject:
          type: string
          description: Subject identifier
          example: cds-service4
    Context:
      type: object
      description: CDS Hooks context information
      properties:
        userId:
          type: string
          description: User identifier
          example: Practitioner/1381234567
        patientId:
          type: string
          description: Patient identifier
          example: patient_id
        encounterId:
          type: string
          description: Encounter identifier
          example: encounter_id
        draftOrders:
          $ref: '#/components/schemas/Bundle'
    Prefetch:
      type: object
      properties:
        claimResponse:
          type: string
          example: ClaimResponse?patient={{%context.patientId}}
        condition:
          type: string
          example: Condition?patient={{%context.patientId}}
        coverage:
          type: string
          example: Coverage?patient={{%context.patientId}}&status=active
        device:
          type: string
          example: Device?patient={{%context.patientId}}
        encounter:
          type: string
          example: Encounter/{{%context.encounterId}}
        location:
          type: string
          example: Location?_id={{%context.locationId}}
        patient:
          type: string
          example: Patient/{{%context.patientId}}
        practitioner:
          type: string
          example: Practitioner/{{%context.userId}}
        practitionerRole:
          type: string
          example: PractitionerRole?practitioner={{%context.userId}}
    Patient:
      type: object
      description: FHIR Patient resource
      properties:
        resourceType:
          type: string
          description: Resource type
          example: Patient
        id:
          type: string
          description: Patient ID
          example: patient_id
    OrderSignResponseWrapper:
      type: object
      description: Wrapper for Order Sign response
      properties:
        cards:
          type: array
          description: List of CDS Hooks cards
          items:
            $ref: '#/components/schemas/Card'
        systemActions:
          type: array
          description: System actions returned by CDS service
          items:
            type: object
          example: []
    Card:
      type: object
      description: CDS Hooks card response
      properties:
        summary:
          type: string
          description: Short summary of the card
          example: Required
        indicator:
          type: string
          description: Severity indicator
          example: info
        detail:
          type: string
          description: Detailed description
          example: A9521DMESUP/ACCESS/SRV-COMPON/OTHHCPCS
        uuid:
          type: string
          description: Unique card identifier
          example: uuid
        source:
          $ref: '#/components/schemas/Source'
        links:
          type: array
          description: Links for additional actions or documentation
          items:
            $ref: '#/components/schemas/Link'
    Source:
      type: object
      description: Source information for the card
      properties:
        label:
          type: string
          description: Source label
          example: UnitedHealthcarePriorAuthorizationRequirements
        url:
          type: string
          description: Source URL
          example: https://apimarketplace.uhcprovider.com/#/all-apis/prior-auth-api
    Link:
      type: object
      description: Card action link
      properties:
        label:
          type: string
          description: Link label
          example: CompleteDocumentation(DTR)
        url:
          type: string
          description: Link URL
          example: ''
        type:
          type: string
          description: Link type
          example: absolute
        appContext:
          type: string
          description: Application context identifier
          example: f48ed17f-dc96-457d-8dc3-906a12f0a294
    SubmitRequest:
      type: object
      description: FHIR Bundle containing Claim submission request
      properties:
        resourceType:
          type: string
          example: Bundle
        id:
          type: string
          example: example-bundle-id
        type:
          type: string
          example: collection
        entry:
          type: array
          items:
            $ref: '#/components/schemas/Entry'
    SubmitResponse:
      type: object
      description: FHIR Bundle containing ClaimResponse
      properties:
        resourceType:
          type: string
          example: Bundle
        entry:
          type: array
          items:
            $ref: '#/components/schemas/ResponseEntry'
    ClaimItem:
      type: object
      description: Claim item
      properties:
        sequence:
          type: integer
          example: 1
        productOrService:
          $ref: '#/components/schemas/CodeableConcept'
        category:
          $ref: '#/components/schemas/CodeableConcept'
    DiscoveryResponse:
      type: object
      properties:
        services:
          type: array
          items:
            $ref: '#/components/schemas/DiscoveryService'
    DiscoveryService:
      type: object
      properties:
        id:
          type: string
          example: coverageRequirements-serviceRequest
        hook:
          type: string
          example: order-sign
        title:
          type: string
          example: United Health Care Order Sign Decision Support
        description:
          type: string
          example: Coverage Requirement Guidance related to orders being signed
        prefetch:
          $ref: '#/components/schemas/Prefetch'
        usageRequirements:
          type: string
          example: requirement-1, requirement-2
      required:
      - id
      - hook
      - title
    OperationDefinitionResponse:
      type: object
      properties:
        resourceType:
          type: string
          example: OperationDefinition
        text:
          $ref: '#/components/schemas/Narrative'
        url:
          type: string
          format: uri
          example: https://https://sandbox-apigw.optum.com//oihub/fhirpriorauth/v1/fhirpa/R4/{payerId}/{lob}/Questionnaire/$next-question
        name:
          type: string
          example: Next-question
        status:
          type: string
          example: active
        kind:
          type: string
          example: operation
        affectsState:
          type: boolean
          example: true
        code:
          type: string
          example: next-question
        resource:
          type: array
          items:
            type: string
          example:
          - Questionnaire
        system:
          type: boolean
          example: false
        type:
          type: boolean
          example: true
        instance:
          type: boolean
          example: false
    PasCapabilityStatementResponse:
      type: object
      properties:
        resourceType:
          type: string
          example: CapabilityStatement
        id:
          type: string
          example: 69d03dab-fd65-4412-83ce-395ffe9856f3
        text:
          $ref: '#/components/schemas/Narrative'
        name:
          type: string
          example: UHC PAAN FHIR Layer Exchange
        status:
          type: string
          example: active
        date:
          type: string
          format: date-time
          example: '2026-04-23T16:34:36.237+00:00'
        publisher:
          type: string
          example: UHC PAAN
        description:
          type: string
        kind:
          type: string
          example: instance
        software:
          $ref: '#/components/schemas/CapabilityStatementSoftware'
        implementation:
          $ref: '#/components/schemas/CapabilityStatementImplementation'
        fhirVersion:
          type: string
          example: 4.0.1
        format:
          type: array
          items:
            type: string
        rest:
          type: array
          items:
            $ref: '#/components/schemas/CapabilityStatementRest'
    CapabilityStatementSoftware:
      type: object
      properties:
        name:
          type: string
          example: uhcpp-paan-pas-server
        version:
          type: string
          example: 8.8.0
    CapabilityStatementImplementation:
      type: object
      properties:
        description:
          type: string
          example: uhcpp-paan-pas-server implementation
        url:
          type: string
          format: uri
          example: https://apimarketplace-stg.uhc.com/PriorAuth/v1
    CapabilityStatementRest:
      type: object
      properties:
        mode:
          type: string
          example: server
        resource:
          type: array
          items:
            $ref: '#/components/schemas/CapabilityStatementResource'
        operation:
          type: array
          items:
            $ref: '#/components/schemas/CapabilityStatementOperation'
    CapabilityStatementResource:
      type: object
      properties:
        type:
          type: string
          example: Claim
        profile:
          type: string
          format: uri
        searchInclude:
          type: array
          items:
            type: string
        interaction:
          type: array
          items:
            $ref: '#/components/schemas/CapabilityStatementInteraction'
        operation:
          type: array
          items:
            $ref: '#/components/schemas/CapabilityStatementOperation'
    CapabilityStatementInteraction:
      type: object
      properties:
        code:
          type: string
          example: read
    CapabilityStatementOperation:
      type: object
      properties:
        name:
          type: string
          example: submit
        definition:
          type: string
          format: uri
    DtrCapabilityStatementResponse:
      type: object
      properties:
        resourceType:
          type: string
          example: CapabilityStatement
        id:
          type: string
          example: 13bed635-6cd2-47e6-9709-fdfefde25954
        text:
          $ref: '#/components/schemas/Narrative'
        name:
          type: string
          example: UHC PAAN FHIR Layer Exchange
        status:
          type: string
          example: active
        date:
          type: string
          format: date-time
          example: '2026-04-23T16:34:56.081+00:00'
        publisher:
          type: string
          example: UHC PAAN
        description:
          type: string
          example: The CapabilityStatement resource documents the functionality implemented from the HL7®
            FHIR® standard
        kind:
          type: string
          example: instance
        software:
          $ref: '#/components/schemas/CapabilityStatementSoftware'
        implementation:
          $ref: '#/components/schemas/CapabilityStatementImplementation'
        fhirVersion:
          type: string
          example: 4.0.1
        format:
          type: array
          items:
            type: string
          example:
          - application/fhir+xml
          - xml
          - application/fhir+json
          - json
          - application/x-turtle
          - ttl
        rest:
          type: array
          items:
            $ref: '#/components/schemas/CapabilityStatementRest'
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