Centene Provider RTR - FHIR PDEX Directory API
The Provider RTR FHIR Payer Data Exchange (PDEX) Directory API delivers provider directory data between payers and authorized external partners using HL7 FHIR PDEX profiles.
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OpenAPI Specification
{
"components": {
"parameters": {
"_count": {
"description": "The number of resources to return in a single page.",
"in": "query",
"name": "_count",
"schema": {
"type": "integer"
}
},
"_id": {
"description": "*Query by the resource's logical assignment id. For example, get {{base}}/{{resource}}?_id=[id value]. For further information please visit http://hl7.org/fhir/R4/search.html#id*",
"in": "query",
"name": "_id",
"schema": {
"type": "string"
}
},
"_lastUpdated": {
"description": "*Search by the LastUpdated Date. This is the date when the content of the resource was last updated by the source creating the record. For example, {{base}}/{{resource}}?_lastUpdated=[meta.lastUpdated value]. The value can be prefixed for more flexible searching. For example {{base}}/{{resource}}?_lastUpdated=lt2023-11-22. The available prefixes are: 'eq' for equal, 'ne' for not equal, 'le' for less than or equal, 'lt' for less than, 'ge' for greater than or equal, 'gt' for greater than, 'sa' for starts after, 'ap' for approximately equal, 'eb' for ends before. For further information please visit http://hl7.org/fhir/r4/search.html#lastUpdated*",
"in": "query",
"name": "_lastUpdated",
"schema": {
"type": "string"
}
},
"_next": {
"description": "*The default value for total results in all profiles is 200. _next will appear under link array only when rendered data records count is >200 , with a unique id . Clicking that link will help to navigate to next page. For further information please visit https://confluence.centene.com/pages/viewpage.action?spaceKey=PR&title=Documentation+on+how+FHIR+Pagination+works*",
"in": "query",
"name": "_next",
"schema": {
"type": "string"
}
},
"_page": {
"description": "*This parameter shows the next page number. For further information please visit https://confluence.centene.com/pages/viewpage.action?spaceKey=PR&title=Documentation+on+how+FHIR+Pagination+works*",
"in": "query",
"name": "_page",
"schema": {
"type": "string"
}
},
"_profile": {
"description": "*Find resources where the profile value equals a URI for the FHIR Profile. This will equal the URI representing the FHIR implementation of the resource. Each resource can have their own profile URI. For example, {{base}}/{{resource}}?_profile=[meta.profile value]. For further information please visit http://hl7.org/fhir/r4/search.html#profile*",
"in": "query",
"name": "_profile",
"schema": {
"type": "string"
}
},
"_profile_exact": {
"description": "*Find resources where the profile value equals a URI for the FHIR Profile. This will equal the URI representing the FHIR implementation of the resource. Each resource can have their own profile URI. For example, {{base}}/{{resource}}?_profile=[meta.profile value]. For further information please visit http://hl7.org/fhir/r4/search.html#profile*",
"in": "query",
"name": "_profile",
"schema": {
"type": "string"
}
},
"_source": {
"description": "*User can get all the records of the source provided. _source will be equal to the value of meta.source within the body. The source will be the entity that created the content for the resource json document. For example, {{base}}/{{resource}}?_source=[meta.source value]. For further information please visit http://hl7.org/fhir/r4/search.html#source*",
"in": "query",
"name": "_source",
"schema": {
"type": "string"
}
},
"active": {
"description": "*Find profiles that are currently marked as 'active'*",
"in": "query",
"name": "active",
"schema": {
"type": "boolean"
}
},
"address": {
"description": "*Search by address line values that start with the search term and return the matching resources. This search will span all applicable address lines. For example, {{base}}/{{resource}}?address=[address.city/address.state/address.country/address.postalCode value]*. For further information please visit http://hl7.org/fhir/r4/search.html#address*",
"in": "query",
"name": "address",
"schema": {
"type": "string"
}
},
"address_contains": {
"description": "*Search by address line values that contain the search term and return the matching resources. This search will span all applicable address lines. For example, {{base}}/{{resource}}?address:contains=[address.city/address.state/address.country/address.postalCode value]*. For further information please visit http://hl7.org/fhir/r4/search.html#address*",
"in": "query",
"name": "address:contains",
"schema": {
"type": "string"
}
},
"address_exact": {
"description": "*Search by address line values that exactly match the search term and return the matching resources. This search will span all applicable address lines. For example, {{base}}/{{resource}}?address:exact=[address.city/address.state/address.country/address.postalCode value]*. For further information please visit http://hl7.org/fhir/r4/search.html#address*",
"in": "query",
"name": "address:exact",
"schema": {
"type": "string"
}
},
"email": {
"description": "*The value in an email contact*",
"in": "query",
"name": "email",
"schema": {
"type": "string"
}
},
"endpoint": {
"description": "*Technical endpoints providing access to electronic services operated for the resource*",
"in": "query",
"name": "endpoint",
"schema": {
"type": "string"
}
},
"identifier": {
"description": "*External identifier for this item*",
"in": "query",
"name": "identifier",
"schema": {
"type": "string"
}
},
"identifier_of_type": {
"description": "*External identifier type*",
"in": "query",
"name": "identifier:of-type",
"schema": {
"type": "string"
}
},
"identifier_text": {
"description": "*External identifier type text for this item*",
"in": "query",
"name": "identifier:text",
"schema": {
"type": "string"
}
},
"location": {
"description": "*The location of the resource*",
"in": "query",
"name": "location",
"schema": {
"type": "string"
}
},
"name": {
"description": "*Search by the resource's name value and return the matching resources. For example, {{base}}/{{resource}}?name=[name value]. For further information please visit http://hl7.org/fhir/r4/search.html#name*",
"in": "query",
"name": "name",
"schema": {
"type": "string"
}
},
"name_contains": {
"description": "*Search by the resource's name with an partial match for the value and return the matching resources. For example, {{base}}/{{resource}}?name:contains=[name value]. For further information please visit http://hl7.org/fhir/r4/search.html#name:contains*",
"in": "query",
"name": "name:contains",
"schema": {
"type": "string"
}
},
"name_exact": {
"description": "*Search by the resource's name with an exact match for the value and return only the matching resources. For example, {{base}}/{{resource}}?name:exact=[name value]. For further information please visit http://hl7.org/fhir/r4/search.html#name:exact*",
"in": "query",
"name": "name:exact",
"schema": {
"type": "string"
}
},
"phone": {
"description": "*The value in an phone contact*",
"in": "query",
"name": "phone",
"schema": {
"type": "string"
}
},
"providedByOrganization": {
"description": "*Search for a resource provided by the referenced organization and return the matching resources. The value should passed to the parameter should be the logical _id for the organization desired. For example, {{base}}/{{resource}}?organization=[providedBy.reference value]. For further information please visit http://hl7.org/fhir/r4/search.html#organization*",
"in": "query",
"name": "organization",
"schema": {
"type": "string"
}
},
"role": {
"description": "*Role code for the resource*",
"in": "query",
"name": "role",
"schema": {
"type": "string"
}
},
"role_text": {
"description": "*Role code text for the resource*",
"in": "query",
"name": "role:text",
"schema": {
"type": "string"
}
},
"service": {
"description": "*Search for a resource providing the specified service and return the matching resources. The value should passed to the parameter should be the logical _id for the HealthcareService desired. For example, {{base}}/{{resource}}?service=[service.reference value]. For further information please visit http://hl7.org/fhir/r4/search.html#service*",
"in": "query",
"name": "service",
"schema": {
"type": "string"
}
},
"specialty": {
"description": "*The specialty code of the service provided by this resource.*",
"in": "query",
"name": "specialty",
"schema": {
"type": "string"
}
},
"specialty_text": {
"description": "*The specialty code description of the service provided by this resource.*",
"in": "query",
"name": "specialty:text",
"schema": {
"type": "string"
}
},
"telecom": {
"description": "*The value of any kind of contact*",
"in": "query",
"name": "telecom",
"schema": {
"type": "string"
}
},
"type": {
"description": "*Type code*",
"in": "query",
"name": "type",
"schema": {
"type": "string"
}
},
"type_text": {
"description": "*Type code text*",
"in": "query",
"name": "type:text",
"schema": {
"type": "string"
}
}
},
"schemas": {
"APIErrorResponse": {
"properties": {
"CorrelationID": {
"type": "object"
},
"Details": {
"type": "string"
},
"Message": {
"type": "string"
},
"StatusCode": {
"format": "int64",
"type": "integer"
}
},
"type": "object",
"x-go-package": "gitlab.centene.com/rtr/provider-rtr/interoperability/apis/fhir-pdex-plan-net-api/response"
},
"Address": {
"properties": {
"city": {
"type": "string",
"x-go-name": "City"
},
"country": {
"type": "string",
"x-go-name": "Country"
},
"district": {
"type": "string",
"x-go-name": "District"
},
"extension": {
"items": {
"$ref": "#/components/schemas/Extension"
},
"type": "array",
"x-go-name": "Extension"
},
"id": {
"type": "string",
"x-go-name": "ID"
},
"line": {
"items": {
"type": "string"
},
"type": "array",
"x-go-name": "Line"
},
"period": {
"$ref": "#/components/schemas/Period"
},
"postalCode": {
"type": "string",
"x-go-name": "PostalCode"
},
"state": {
"type": "string",
"x-go-name": "State"
},
"text": {
"type": "string",
"x-go-name": "Text"
},
"type": {
"type": "string",
"x-go-name": "Type"
},
"use": {
"type": "string",
"x-go-name": "Use"
}
},
"type": "object",
"x-go-package": "gitlab.centene.com/rtr/provider-rtr/interoperability/apis/fhir-pdex-plan-net-api/models/shared"
},
"Attachment": {
"properties": {
"contentType": {
"type": "string",
"x-go-name": "ContentType"
},
"creation": {
"type": "string",
"x-go-name": "Creation"
},
"data": {
"type": "string",
"x-go-name": "Data"
},
"hash": {
"type": "string",
"x-go-name": "Hash"
},
"language": {
"type": "string",
"x-go-name": "Language"
},
"size": {
"format": "int64",
"type": "integer",
"x-go-name": "Size"
},
"title": {
"type": "string",
"x-go-name": "Title"
},
"url": {
"type": "string",
"x-go-name": "URL"
}
},
"type": "object",
"x-go-package": "gitlab.centene.com/rtr/provider-rtr/interoperability/apis/fhir-pdex-plan-net-api/models/shared"
},
"AvailableTime": {
"properties": {
"allDay": {
"type": "boolean",
"x-go-name": "AllDay"
},
"availableEndTime": {
"type": "string",
"x-go-name": "AvailableEndtime"
},
"availableStartTime": {
"type": "string",
"x-go-name": "AvailableStarttime"
},
"daysOfWeek": {
"items": {
"type": "string"
},
"type": "array",
"x-go-name": "DaysOfWeek"
}
},
"type": "object",
"x-go-package": "gitlab.centene.com/rtr/provider-rtr/interoperability/apis/fhir-pdex-plan-net-api/models/shared"
},
"Code": {
"properties": {
"coding": {
"items": {
"$ref": "#/components/schemas/Coding"
},
"type": "array",
"x-go-name": "Coding"
},
"extension": {
"items": {
"$ref": "#/components/schemas/Extension"
},
"type": "array",
"x-go-name": "Extension"
},
"id": {
"type": "string",
"x-go-name": "ID"
},
"text": {
"type": "string",
"x-go-name": "Text"
}
},
"type": "object",
"x-go-package": "gitlab.centene.com/rtr/provider-rtr/interoperability/apis/fhir-pdex-plan-net-api/models/shared"
},
"CodeableConcept": {
"properties": {
"coding": {
"items": {
"$ref": "#/components/schemas/Coding"
},
"type": "array",
"x-go-name": "Coding"
},
"text": {
"type": "string",
"x-go-name": "Text"
}
},
"type": "object",
"x-go-package": "gitlab.centene.com/rtr/provider-rtr/interoperability/apis/fhir-pdex-plan-net-api/models/shared"
},
"Coding": {
"properties": {
"code": {
"type": "string",
"x-go-name": "Code"
},
"display": {
"type": "string",
"x-go-name": "Display"
},
"system": {
"type": "string",
"x-go-name": "System"
}
},
"type": "object",
"x-go-package": "gitlab.centene.com/rtr/provider-rtr/interoperability/apis/fhir-pdex-plan-net-api/models/shared"
},
"Contact": {
"properties": {
"address": {
"$ref": "#/components/schemas/Address"
},
"id": {
"type": "string",
"x-go-name": "ID"
},
"name": {
"$ref": "#/components/schemas/HumanName"
},
"purpose": {
"$ref": "#/components/schemas/CodeableConcept"
},
"telecom": {
"items": {
"$ref": "#/components/schemas/Telecom"
},
"type": "array",
"x-go-name": "Telecom"
}
},
"type": "object",
"x-go-package": "gitlab.centene.com/rtr/provider-rtr/interoperability/apis/fhir-pdex-plan-net-api/models/shared"
},
"EndpointAPIResponse": {
"properties": {
"address": {
"type": "string",
"x-go-name": "Address"
},
"connectionType": {
"$ref": "#/components/schemas/Coding"
},
"contact": {
"items": {
"$ref": "#/components/schemas/Telecom"
},
"type": "array",
"x-go-name": "Contact"
},
"extension": {
"items": {
"$ref": "#/components/schemas/Extension"
},
"type": "array",
"x-go-name": "Extension"
},
"header": {
"items": {
"type": "string"
},
"type": "array",
"x-go-name": "Header"
},
"id": {
"type": "string",
"x-go-name": "ID"
},
"identifier": {
"items": {
"$ref": "#/components/schemas/Identifier"
},
"type": "array",
"x-go-name": "Identifier"
},
"language": {
"type": "string",
"x-go-name": "Language"
},
"managingOrganization": {
"$ref": "#/components/schemas/Reference"
},
"meta": {
"$ref": "#/components/schemas/Meta"
},
"name": {
"type": "string",
"x-go-name": "Name"
},
"payloadMimeType": {
"items": {
"type": "string"
},
"type": "array",
"x-go-name": "PayloadMimeType"
},
"payloadType": {
"items": {
"$ref": "#/components/schemas/Code"
},
"type": "array",
"x-go-name": "PayloadType"
},
"period": {
"$ref": "#/components/schemas/Period"
},
"resourceType": {
"type": "string",
"x-go-name": "ResourceType"
},
"status": {
"type": "string",
"x-go-name": "Status"
},
"text": {
"$ref": "#/components/schemas/Text"
}
},
"type": "object",
"x-go-name": "Endpoint",
"x-go-package": "gitlab.centene.com/rtr/provider-rtr/interoperability/apis/fhir-pdex-plan-net-api/models"
},
"Extension": {
"properties": {
"extension": {
"items": {
"properties": {
"url": {
"type": "string",
"x-go-name": "URL"
},
"valueAttachment": {
"$ref": "#/components/schemas/Attachment"
},
"valueBoolean": {
"type": "boolean",
"x-go-name": "ValueBoolean"
},
"valueCode": {
"type": "string",
"x-go-name": "ValueCode"
},
"valueCodeableConcept": {
"$ref": "#/components/schemas/CodeableConcept"
},
"valueDecimal": {
"format": "double",
"type": "number",
"x-go-name": "ValueDecimal"
},
"valueIdentifier": {
"$ref": "#/components/schemas/Identifier"
},
"valuePeriod": {
"$ref": "#/components/schemas/Period"
},
"valueReference": {
"$ref": "#/components/schemas/Reference"
},
"valueString": {
"type": "string",
"x-go-name": "ValueString"
},
"valueTime": {
"type": "string",
"x-go-name": "ValueTime"
},
"valueUri": {
"type": "string",
"x-go-name": "ValueURI"
}
},
"type": "object"
},
"type": "array",
"x-go-name": "Extension"
},
"url": {
"type": "string",
"x-go-name": "URL"
},
"valueAttachment": {
"$ref": "#/components/schemas/Attachment"
},
"valueBoolean": {
"type": "boolean",
"x-go-name": "ValueBoolean"
},
"valueCode": {
"type": "string",
"x-go-name": "ValueCode"
},
"valueCodeableConcept": {
"$ref": "#/components/schemas/CodeableConcept"
},
"valueDecimal": {
"format": "double",
"type": "number",
"x-go-name": "ValueDecimal"
},
"valueIdentifier": {
"$ref": "#/components/schemas/Identifier"
},
"valuePeriod": {
"$ref": "#/components/schemas/Period"
},
"valueReference": {
"$ref": "#/components/schemas/Reference"
},
"valueString": {
"type": "string",
"x-go-name": "ValueString"
},
"valueTime": {
"type": "string",
"x-go-name": "ValueTime"
},
"valueUri": {
"type": "string",
"x-go-name": "ValueURI"
}
},
"type": "object",
"x-go-package": "gitlab.centene.com/rtr/provider-rtr/interoperability/apis/fhir-pdex-plan-net-api/models/shared"
},
"HealthcareServiceAPIResponse": {
"properties": {
"active": {
"type": "boolean",
"x-go-name": "Active"
},
"appointmentRequired": {
"type": "boolean",
"x-go-name": "Appointmentrequired"
},
"availabilityExceptions": {
"type": "string",
"x-go-name": "AvailabilityExceptions"
},
"availableTime": {
"items": {
"$ref": "#/components/schemas/AvailableTime"
},
"type": "array",
"x-go-name": "AvailableTime"
},
"category": {
"items": {
"$ref": "#/components/schemas/Code"
},
"type": "array",
"x-go-name": "Category"
},
"characteristic": {
"items": {
"$ref": "#/components/schemas/Code"
},
"type": "array",
"x-go-name": "Characteristic"
},
"comment": {
"type": "string",
"x-go-name": "Comment"
},
"communication": {
"items": {
"$ref": "#/components/schemas/Code"
},
"type": "array",
"x-go-name": "Communication"
},
"coverageArea": {
"items": {
"$ref": "#/components/schemas/Reference"
},
"type": "array",
"x-go-name": "CoverageArea"
},
"eligibility": {
"items": {
"properties": {
"code": {
"$ref": "#/components/schemas/Code"
},
"comment": {
"type": "string",
"x-go-name": "Comment"
},
"id": {
"type": "string",
"x-go-name": "ID"
}
},
"type": "object"
},
"type": "array",
"x-go-name": "Eligibility"
},
"endpoint": {
"items": {
"$ref": "#/components/schemas/Reference"
},
"type": "array",
"x-go-name": "Endpoint"
},
"extension": {
"items": {
"$ref": "#/components/schemas/Extension"
},
"type": "array",
"x-go-name": "Extension"
},
"extraDetails": {
"type": "string",
"x-go-name": "ExtraDetails"
},
"id": {
"type": "string",
"x-go-name": "ID"
},
"identifier": {
"items": {
"$ref": "#/components/schemas/Identifier"
},
"type": "array",
"x-go-name": "Identifier"
},
"language": {
"type": "string",
"x-go-name": "Language"
},
"location": {
"items": {
"$ref": "#/components/schemas/Reference"
},
"type": "array",
"x-go-name": "Location"
},
"meta": {
"$ref": "#/components/schemas/Meta"
},
"name": {
"type": "string",
"x-go-name": "Name"
},
"notAvailable": {
"items": {
"$ref": "#/components/schemas/NotAvailable"
},
"type": "array",
"x-go-name": "NotAvailable"
},
"program": {
"items": {
"$ref": "#/components/schemas/Code"
},
"type": "array",
"x-go-name": "Program"
},
"providedBy": {
"$ref": "#/components/schemas/Reference"
},
"referralMethod": {
"items": {
"$ref": "#/components/schemas/Code"
},
"type": "array",
"x-go-name": "ReferralMethod"
},
"resourceType": {
"type": "string",
"x-go-name": "ResourceType"
},
"serviceProvisionCode": {
"items": {
"$ref": "#/components/schemas/Code"
},
"type": "array",
"x-go-name": "ServiceProvisionCode"
},
"specialty": {
"items": {
"$ref": "#/components/schemas/Code"
},
"type": "array",
"x-go-name": "Specialty"
},
"telecom": {
"items": {
"$ref": "#/components/schemas/Telecom"
},
"type": "array",
"x-go-name": "Telecom"
},
"text": {
"$ref": "#/components/schemas/Text"
},
"type": {
"items": {
"$ref": "#/components/schemas/Code"
},
"type": "array",
"x-go-name": "Type"
}
},
"type": "object",
"x-go-name": "HealthcareService",
"x-go-package": "gitlab.centene.com/rtr/provider-rtr/interoperability/apis/fhir-pdex-plan-net-api/models"
},
"HumanName": {
"properties": {
"family": {
"type": "string",
"x-go-name": "Family"
},
"given": {
"items": {
"type": "string"
},
"type": "array",
"x-go-name": "Given"
},
"period": {
"$ref": "#/components/schemas/Period"
},
"prefix": {
"items": {
"type": "string"
},
"type": "array",
"x-go-name": "Prefix"
},
"suffix": {
"items": {
"type": "string"
},
"type": "array",
"x-go-name": "Suffix"
},
"text": {
"type": "string",
"x-go-name": "Text"
},
"use": {
"type": "string",
"x-go-name": "Use"
}
},
"type": "object",
"x-go-package": "gitlab.centene.com/rtr/provider-rtr/interoperability/apis/fhir-pdex-plan-net-api/models/shared"
},
"Identifier": {
"properties": {
"assigner": {
"$ref": "#/components/schemas/Reference"
},
"id": {
"type": "string",
"x-go-name": "ID"
},
"period": {
"$ref": "#/components/schemas/Period"
},
"system": {
"type": "string",
"x-go-name": "System"
},
"type": {
"$ref": "#/components/schemas/Code"
},
"use": {
"type": "string",
"x-go-name": "Use"
},
"value": {
"type": "string",
"x-go-name": "Value"
}
},
"type": "object",
"x-go-package": "gitlab.centene.com/rtr/provider-rtr/interoperability/apis/fhir-pdex-plan-net-api/models/shared"
},
"InsurancePlanAPIResponse": {
"properties": {
"administeredBy": {
"$ref": "#/components/schemas/Reference"
},
"alias": {
"items": {
"type": "string"
},
"type": "array",
"x-go-name": "Alias"
},
"contact": {
"items": {
"$ref": "#/components/schemas/Contact"
},
"type": "array",
"x-go-name": "Contact"
},
"coverage": {
"items": {
"properties": {
"benefit": {
"items": {
"properties": {
"id": {
"type": "string",
"x-go-name": "ID"
},
"limit": {
"items": {
"properties": {
"code": {
"$ref": "#/components/schemas/Code"
},
"value": {
"$ref": "#/components/schemas/Quantity"
}
},
"type": "object"
},
"type": "array",
"x-go-name": "Limit"
},
"type": {
"$ref": "#/components/schemas/Code"
}
},
"type": "object"
},
"type": "array",
"x-go-name": "Benefit"
},
"id": {
"type": "string",
"x-go-name": "ID"
},
"network": {
"items": {
"$ref": "#/components/schemas/Reference"
},
"type": "array",
"x-go-name": "Network"
},
"type": {
"$ref": "#/components/schemas/Code"
}
},
"type": "object"
},
"type": "array",
"x-go-name": "Coverage"
},
"coverageArea": {
"items": {
"$ref": "#/components/schemas/Reference"
},
"type": "array",
"x-go-name": "CoverageArea"
},
"endpoint": {
"items": {
"$ref": "#/components/schemas/Reference"
},
"type": "array",
"x-go-name": "Endpoint"
},
"id": {
"type": "string",
"x-go-name": "ID"
},
"identifier": {
"items": {
"$ref": "#/components/schemas/Identifier"
# --- truncated at 32 KB (128 KB total) ---
# Full source: https://raw.githubusercontent.com/api-evangelist/centene/refs/heads/main/openapi/centene-provider-rtr-fhir-pdex-openapi.json