Elevance Health (formerly Anthem) is a Fortune 500 health benefits company serving members through Blue Cross and Blue Shield affiliated health plans across multiple states, offering medical, pharmacy, dental, vision and specialty insurance. Its entire public API surface is HL7 FHIR, published to satisfy the CMS Interoperability and Patient Access Final Rule: a member-consented Patient Access API (FHIR R4, CARIN Blue Button, SMART on FHIR), a read-only Provider Directory API (Da Vinci PDEX Plan Net) whose CapabilityStatement is readable with no credentials, a Formulary API (Da Vinci PDEX US Drug Formulary), and a legacy Patient360 FHIR DSTU2 endpoint running CareEvolution HIEBus. There is no OpenAPI, no SDK and no pricing — the contracts are the FHIR CapabilityStatements the servers publish about themselves. Elevance has committed in its own endpoint support document to shipping Payer-to-Payer, Prior Authorization and Provider Access APIs by 1 January 2027 under CMS-0057-F; none of the three exists today.
Elevance Health publishes 5 APIs on the APIs.io network, including Claims API, Conformance API, Coverage API, and 2 more. Tagged areas include Fortune 500, Healthcare, Health Insurance, FHIR, and Interoperability.
Elevance Health’s developer surface includes getting-started guide, signup flow, support, engineering blog, developer portal, authentication, documentation, and 26 more developer resources.
Regulatory Posture applies to this provider. Its tags matched the
Health regime, so
Regulatory Posture carries 15 points of the composite.
If this regime is wrong for your business, say so on your
provider repo — the
applicability map is public and we will correct it.
Create-or-Update Ergonomics does not apply to this provider. The published contracts declare
no write operations, and a read-only API cannot create-or-update. The facet is excluded from this provider's
denominator entirely — not scored zero. A reference or data API is not deficient for being unable to
upsert.
The six quality facets above are damped to 85 points between them,
because the conditional facet above carries the other
15. That is why each facet's contribution is shown against a damped
maximum: raising a quality facet moves the composite by 85% of its nominal
weight, not 100%. The full arithmetic is at apis.io/rating/.
The Patient Access API gives Elevance Health members, through an application they authorize, up to five years of their medical, pharmacy, dental and vision claims and clinical d...
The Provider Directory API exposes which practitioners and organizations are in-network for a given Elevance Health insurance plan. HL7 FHIR R4 conforming to Da Vinci PDEX Plan ...
The Formulary API publishes drug coverage for Elevance-affiliated Medicare, Medicaid and CHIP plans — covered drug lists, tier placement, pharmacy type and cost-sharing. HL7 FHI...
aid: elevance-health
name: Elevance Health
url: https://raw.githubusercontent.com/api-evangelist/elevance-health/refs/heads/main/apis.yml
description: 'Elevance Health (formerly Anthem) is a Fortune 500 health benefits company serving members through Blue Cross
and Blue Shield affiliated health plans across multiple states, offering medical, pharmacy, dental, vision and specialty
insurance. Its entire public API surface is HL7 FHIR, published to satisfy the CMS Interoperability and Patient Access Final
Rule: a member-consented Patient Access API (FHIR R4, CARIN Blue Button, SMART on FHIR), a read-only Provider Directory
API (Da Vinci PDEX Plan Net) whose CapabilityStatement is readable with no credentials, a Formulary API (Da Vinci PDEX US
Drug Formulary), and a legacy Patient360 FHIR DSTU2 endpoint running CareEvolution HIEBus. There is no OpenAPI, no SDK and
no pricing — the contracts are the FHIR CapabilityStatements the servers publish about themselves. Elevance has committed
in its own endpoint support document to shipping Payer-to-Payer, Prior Authorization and Provider Access APIs by 1 January
2027 under CMS-0057-F; none of the three exists today.'
image: https://kinlane-images.s3.amazonaws.com/shared/apis-json/icons/elevance-health.png
tags:
- Fortune 500
- Healthcare
- Health Insurance
- FHIR
- Interoperability
- CMS Interoperability
- SMART on FHIR
- Da Vinci PDEX
- CARIN Blue Button
- Payer
- Provider Directory
- Formulary
- HL7
created: '2026-03-21'
modified: '2026-09-07'
specificationVersion: '0.23'
type: Index
position: Producing
access: 3rd-Party
deliveryModel:
model: saas
open_source: false
commercial: true
callable_host: true
label: Hosted service · you call their endpoint
confidence: high
source:
- fhir-capabilitystatement
- plans
- https://www.anthem.com/developers
generated: '2026-09-07'
method: probed
note: Live FHIR CapabilityStatements were retrieved from Elevance-controlled hosts, confirming a callable hosted service.
accessModel:
pricing: free
onboarding: approval-required
trial: true
try_now: false
public: false
label: Free, registration and approval required
confidence: high
source:
- plans
- authentication
- sandbox
- https://www.anthem.com/developers
generated: '2026-09-07'
method: searched
note: CMS-9115-F requires member data access to be free of charge, and Elevance publishes no price list of any kind. A self-service
sandbox with synthetic data exists, which is why trial is true; production access requires a request form, a documented
security risk analysis and an approval Elevance says can take several weeks, which is why onboarding is not self-serve.
apis:
- aid: elevance-health:patient-access
name: Elevance Health Patient Access API
description: 'The Patient Access API gives Elevance Health members, through an application they authorize, up to five years
of their medical, pharmacy, dental and vision claims and clinical data. It is HL7 FHIR R4 (4.0.1) against US Core 6.1.0
and the CARIN IG for Blue Button STU 2.1.0, authorized with SMART App Launch 2.2.0 and member consent. Production is tenanted:
there are thirteen brand-specific base URLs under totalview.healthos.elevancehealth.com/resources/registered/{Brand}/api/v1/fhir,
of which AnthemBlueCross is recorded here as the representative. The capability statement declares 27 resource types and
106 interactions, all read-only. A public sandbox with synthetic data is available on self-service registration; production
access requires an approval that Elevance says takes several weeks.'
humanURL: https://www.anthem.com/developers
baseURL: https://totalview.healthos.elevancehealth.com/resources/registered/AnthemBlueCross/api/v1/fhir
tags:
- FHIR
- Healthcare
- Health Insurance
- Patient Access
- Interoperability
properties:
- type: Documentation
url: https://totalview.healthos.elevancehealth.com/fhir/documentation
- type: DeveloperPortal
url: https://www.anthem.com/developers
- type: APIReference
url: https://www.anthem.com/content/dam/digital/developers-portal/Anthem-IOProviderDirectoryAndFormulary-API-Documentation.pdf
- type: Conformance
url: conformance/elevance-health-patient-access-capabilitystatement.json
- type: WellKnown
url: well-known/elevance-health-totalview-smart-configuration.json
- type: Sandbox
url: sandbox/elevance-health-sandbox.yml
- type: SignUp
url: https://www.anthem.com/developers/request-anthem-io
- aid: elevance-health:provider-directory
name: Elevance Health Provider Directory API
description: The Provider Directory API exposes which practitioners and organizations are in-network for a given Elevance
Health insurance plan. HL7 FHIR R4 conforming to Da Vinci PDEX Plan Net 1.1.0 and US Core STU 3.1.1, exposing HealthcareService,
InsurancePlan, Location, Organization, OrganizationAffiliation, Practitioner, PractitionerRole and Specimen — 25 interactions,
all read-only. Its CapabilityStatement is readable with no credentials at all, which makes it the only Elevance surface
an unattended agent can inspect before integrating; data access itself uses OAuth 2.0 client credentials issued by secure
email after registration.
humanURL: https://www.anthem.com/developers
tags:
- FHIR
- Provider Directory
- Healthcare
- Interoperability
properties:
- type: Documentation
url: https://totalview.healthos.elevancehealth.com/fhir/documentation
- type: APIReference
url: https://www.anthem.com/content/dam/digital/developers-portal/Anthem-IOProviderDirectoryAndFormulary-API-Documentation.pdf
- type: Conformance
url: conformance/elevance-health-provider-directory-capabilitystatement.json
- type: SignUp
url: https://www.anthem.com/developers/provider-directory-api-request
baseURL: https://totalview.healthos.elevancehealth.com/resources/unregistered/api/v1/fhir/cms_mandate/mcd/
- aid: elevance-health:formulary
name: Elevance Health Formulary API
description: The Formulary API publishes drug coverage for Elevance-affiliated Medicare, Medicaid and CHIP plans — covered
drug lists, tier placement, pharmacy type and cost-sharing. HL7 FHIR R4 conforming to Da Vinci PDEX US Drug Formulary
IG 2.0.1 STU2, carried on InsurancePlan (PayerInsurancePlan and Formulary), Basic (FormularyItem) and MedicationKnowledge
(FormularyDrug). Read-only, authorized with OAuth 2.0 client credentials. The endpoint returns HTTP 403 with an empty
body until an application is registered, so its capability statement could not be retrieved; the resource and search-parameter
set recorded here comes from the provider’s own endpoint support document rather than from the contract.
humanURL: https://www.anthem.com/developers
tags:
- FHIR
- Formulary
- Pharmacy
- Healthcare
- Interoperability
properties:
- type: Documentation
url: https://totalview.healthos.elevancehealth.com/fhir/documentation
- type: APIReference
url: https://www.anthem.com/content/dam/digital/developers-portal/Anthem-IOProviderDirectoryAndFormulary-API-Documentation.pdf
baseURL: https://totalview.healthos.elevancehealth.com/resources/unregistered/api/v1/fhir/cms_mandate/frmlry
- aid: elevance-health:elevance-health-claims-api
name: Elevance Health Claims API
description: The Claims API from Elevance Health — 3 operation(s) for claims.
humanURL: https://patient360c.anthem.com/P360Member/fhir/documentation
baseURL: https://patient360.anthem.com/P360Member/api/fhir
tags:
- Claims
properties:
- type: OpenAPI
url: openapi/elevance-health-claims-api-openapi.yml
- type: Overlay
url: overlays/elevance-health-claims-api-overlay.yaml
- type: Documentation
url: https://patient360c.anthem.com/P360Member/fhir/documentation
- type: Conformance
url: conformance/elevance-health-patient360-dstu2-conformance.xml
- aid: elevance-health:elevance-health-conformance-api
name: Elevance Health Conformance API
description: The Conformance API from Elevance Health — 1 operation(s) for conformance.
humanURL: https://patient360c.anthem.com/P360Member/fhir/documentation
baseURL: https://patient360.anthem.com/P360Member/api/fhir
tags:
- Conformance
properties:
- type: OpenAPI
url: openapi/elevance-health-conformance-api-openapi.yml
- type: Overlay
url: overlays/elevance-health-conformance-api-overlay.yaml
- type: Documentation
url: https://patient360c.anthem.com/P360Member/fhir/documentation
- type: Conformance
url: conformance/elevance-health-patient360-dstu2-conformance.xml
- aid: elevance-health:elevance-health-coverage-api
name: Elevance Health Coverage API
description: The Coverage API from Elevance Health — 2 operation(s) for coverage.
humanURL: https://patient360c.anthem.com/P360Member/fhir/documentation
baseURL: https://patient360.anthem.com/P360Member/api/fhir
tags:
- Coverage
properties:
- type: OpenAPI
url: openapi/elevance-health-coverage-api-openapi.yml
- type: Overlay
url: overlays/elevance-health-coverage-api-overlay.yaml
- type: Documentation
url: https://patient360c.anthem.com/P360Member/fhir/documentation
- type: Conformance
url: conformance/elevance-health-patient360-dstu2-conformance.xml
- aid: elevance-health:elevance-health-patient-api
name: Elevance Health Patient API
description: The Patient API from Elevance Health — 2 operation(s) for patient.
humanURL: https://patient360c.anthem.com/P360Member/fhir/documentation
baseURL: https://patient360.anthem.com/P360Member/api/fhir
tags:
- Patient
properties:
- type: OpenAPI
url: openapi/elevance-health-patient-api-openapi.yml
- type: Overlay
url: overlays/elevance-health-patient-api-overlay.yaml
- type: Documentation
url: https://patient360c.anthem.com/P360Member/fhir/documentation
- type: Conformance
url: conformance/elevance-health-patient360-dstu2-conformance.xml
- aid: elevance-health:elevance-health-provider-directory-api
name: Elevance Health Provider Directory API
description: The Provider Directory API from Elevance Health — 2 operation(s) for provider directory.
humanURL: https://patient360c.anthem.com/P360Member/fhir/documentation
baseURL: https://patient360.anthem.com/P360Member/api/fhir
tags:
- Provider Directory
properties:
- type: OpenAPI
url: openapi/elevance-health-provider-directory-api-openapi.yml
- type: Overlay
url: overlays/elevance-health-provider-directory-api-overlay.yaml
- type: Documentation
url: https://patient360c.anthem.com/P360Member/fhir/documentation
- type: Conformance
url: conformance/elevance-health-patient360-dstu2-conformance.xml
common:
- type: GettingStarted
url: https://www.anthem.com/developers
- type: SignUp
url: https://www.anthem.com/developers/request-anthem-io
- type: Support
url: https://www.anthem.com/contact-us
- type: Blog
url: https://www.anthem.com/blog
- type: Portal
url: https://www.anthem.com
- type: GitHubOrganization
url: https://github.com/openanthem
- type: CapabilityMap
url: capabilities/elevance-health-capability-edges.yml
name: Elevance Health Business Capability Map
- type: AgenticAccess
url: agentic-access/elevance-health-agentic-access.yml
- type: DomainSecurity
url: security/elevance-health-domain-security.yml
- type: Authentication
url: authentication/elevance-health-authentication.yml
- type: OAuthScopes
url: scopes/elevance-health-scopes.yml
- type: LinkedIn
url: https://www.linkedin.com/company/elevance-health
- type: Website
url: https://www.elevancehealth.com
- type: DeveloperPortal
url: https://www.anthem.com/developers
- type: Documentation
url: https://patient360c.anthem.com/P360Member/fhir/documentation
- type: Signup
url: https://www.anthem.com/developers/request-anthem-io
- type: Conformance
url: conformance/elevance-health-conformance.yml
- type: WellKnown
url: well-known/elevance-health-well-known.yml
- type: Conventions
url: conventions/elevance-health-conventions.yml
- type: ErrorCatalog
url: errors/elevance-health-problem-types.yml
- type: Lifecycle
url: lifecycle/elevance-health-lifecycle.yml
- type: ChangeLog
url: changelog/elevance-health-changelog.yml
- type: DataModel
url: data-model/elevance-health-data-model.yml
- type: Sandbox
url: sandbox/elevance-health-sandbox.yml
- type: Packages
url: packages/elevance-health-packages.yml
- type: Plans
url: plans/elevance-health-plans-pricing.yml
- type: RateLimits
url: rate-limits/elevance-health-rate-limits.yml
- type: LLMsTxt
url: llms/elevance-health-llms.txt
- type: AgentSkill
url: skills/_index.yml
- type: X-MCPServerCandidate
url: mcp/elevance-health-mcp.yml
- type: APIReference
url: https://www.anthem.com/content/dam/digital/developers-portal/Anthem-IOProviderDirectoryAndFormulary-API-Documentation.pdf
name: Interoperability API Endpoint Support Document (IO105 v15.0)
- type: TermsOfService
url: https://www.anthem.com/terms-of-use
- type: PrivacyPolicy
url: https://www.elevancehealth.com/privacy-policy
maintainers:
- FN: API Evangelist
email: info@apievangelist.com
x-enrichment:
date: '2026-09-07'
status: enriched
artifacts_added: 29
pass: local-v3
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