UnitedHealth Group Clinical Data API

openapi: 3.1.0
info:
  title: UnitedHealth Group Optum Clinical Data API
  description: The UnitedHealth Group interoperability APIs provide FHIR R4-compliant access to healthcare data including patient records, claims history, provider directories, and formulary information in compliance with CMS Interoperability and Patient Access final rule (CMS-9115-F). Operates under the Optum platform serving UnitedHealthcare, UHC Medicare & Retirement, UHC Community & State, and Optum health services. Enables third-party applications and partners to access member health data using HL7 FHIR R4 standards for interoperable health data exchange.
  version: R4
  contact:
    name: UnitedHealth Group Interoperability
    url: https://www.uhc.com/legal/interoperability-apis
  license:
    name: UnitedHealth Group API Terms of Use
    url: https://www.uhc.com/legal/terms-of-use
servers:
- url: https://api.uhc.com/fhir/R4
  description: UnitedHealth Group FHIR R4 Production
security:
- bearerAuth: []
tags:
- name: Clinical Data
  description: FHIR R4 clinical data including conditions, observations, and medications
paths:
  /Condition:
    get:
      operationId: listConditions
      summary: UnitedHealth Group List Member Conditions
      description: Retrieve FHIR R4 Condition resources for a member representing active and historical health conditions, diagnoses, and clinical problems as reflected in claims data and clinical records available through the Patient Access API.
      tags:
      - Clinical Data
      x-microcks-operation:
        dispatcher: SCRIPT
        dispatcherRules: return 'DEFAULT';
      parameters:
      - name: patient
        in: query
        required: true
        description: Patient resource ID
        schema:
          type: string
      - name: clinical-status
        in: query
        required: false
        description: Condition clinical status filter
        schema:
          type: string
          enum:
          - active
          - recurrence
          - relapse
          - inactive
          - remission
          - resolved
      - name: _count
        in: query
        required: false
        description: Maximum number of results
        schema:
          type: integer
          default: 20
      responses:
        '200':
          description: FHIR Bundle of Condition resources
          content:
            application/fhir+json:
              schema:
                $ref: '#/components/schemas/FHIRBundle'
        '401':
          description: Unauthorized
        '403':
          description: Forbidden
        '429':
          description: Too many requests
components:
  schemas:
    FHIRBundle:
      type: object
      description: FHIR R4 Bundle resource containing a collection of FHIR resources returned from UnitedHealth Group interoperability API search operations
      properties:
        resourceType:
          type: string
          enum:
          - Bundle
          description: FHIR resource type identifier
        id:
          type: string
          description: Unique Bundle ID
        meta:
          type: object
          description: Bundle metadata
          properties:
            lastUpdated:
              type: string
              format: date-time
        type:
          type: string
          enum:
          - searchset
          - collection
          description: Bundle type
        total:
          type: integer
          description: Total number of matching resources
        link:
          type: array
          description: Pagination and navigation links
          items:
            type: object
            properties:
              relation:
                type: string
                enum:
                - self
                - next
                - previous
                - first
                - last
              url:
                type: string
                format: uri
        entry:
          type: array
          description: Bundle entries containing FHIR resources
          items:
            type: object
            properties:
              fullUrl:
                type: string
                format: uri
              resource:
                type: object
                description: The embedded FHIR resource
              search:
                type: object
                properties:
                  mode:
                    type: string
                    enum:
                    - match
                    - include
                    - outcome
  securitySchemes:
    bearerAuth:
      type: http
      scheme: bearer
      description: OAuth 2.0 Bearer token obtained via authorization code flow
externalDocs:
  description: UnitedHealth Group Interoperability APIs
  url: https://www.uhc.com/legal/interoperability-apis