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Centene

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.

Documentation Provider Profile APIs.io OpenAPI GitHub

Centene Provider RTR - FHIR PDEX Directory API is one of 12 APIs that Centene publishes on the APIs.io network, described by a machine-readable OpenAPI specification.

Tagged areas include FHIR, PDEX, and Payer Data Exchange. The published artifact set on APIs.io includes API documentation and an OpenAPI specification.

This API exposes 18 operations across 18 paths, organized into 2 resource areas, and defines 33 schemas. It is described by OpenAPI 3.0.3, at version 1.2.

Requests are made against 2 base URLs: https://prod.api.centene.com/tst/prtc/external/fhir-pdex-plan-net/v1/, https://prod.api.centene.com/prtc/external/fhir-pdex-plan-net/v1/.

18 operations 18 paths 33 schemas 18 GET

Metadata

The identity and technical contract details declared by the specification.

Specification
OpenAPI 3.0.3
API Version
1.2
Base URL
https://prod.api.centene.com/prtc/external/fhir-pdex-plan-net/v1/
Authentication
OAuth 2.0
Contact
Provider_RTR_Support@centene.com
Resource Areas
2

Authentication & Security 1

Centene Provider RTR - FHIR PDEX Directory API declares 1 security scheme for authenticating requests. It supports OAuth 2.0 (oauth2) using the clientCredentials flow, exposing 1 scope. By default, every request must be authenticated.

Paths & Operations 18

Across 18 paths, the API surfaces 18 operations — 18 GET. They span 2 resource areas: FHIR-PDEX-Plan-Net-API, Utilities. Each is listed below with its method, path, parameters, and response codes.

FHIR-PDEX-Plan-Net-API 16
GET
/Endpoint
EndpointSearch 8 params → 200403500504
GET
/Endpoint/{_id}
EndpointById 1 param → 200403500504
GET
/HealthcareService
For further information about parameters please visit https://hl7.org/fhir/R4/healthcareservice.htmlsearch
HealthcareServiceSearch 30 params → 200403500504
GET
/HealthcareService/{_id}
For further information about parameters please visit https://hl7.org/fhir/R4/healthcareservice.htmlsearch
HealthcareServiceById 1 param → 200403500504
GET
/InsurancePlan
InsurancePlanSearch 21 params → 200403500504
GET
/InsurancePlan/{_id}
InsurancePlanById 1 param → 200403500504
GET
/Location
LocationSearch 35 params → 200403500504
GET
/Location/{_id}
LocationById 1 param → 200403500504
GET
/Organization
OrganizationSearch 23 params → 200403500504
GET
/Organization/{_id}
OrganizationById 1 param → 200403500504
GET
/OrganizationAffiliation
OrganizationAffiliationSearch 24 params → 200403500504
GET
/OrganizationAffiliation/{_id}
OrganizationAffiliationById 1 param → 200403500504
GET
/Practitioner
PractitionerSearch 20 params → 200403500504
GET
/Practitioner/{_id}
PractitionerById 1 param → 200403500504
GET
/PractitionerRole
practitionerRoleSearch 21 params → 200403500504
GET
/PractitionerRole/{_id}
practitionerRoleById 1 param → 200403500504
Utilities 2
GET
/health
Health Check
Health → 200403424500504
GET
/version
Version Information
Version → 200403500504

Schemas 33

The contract defines 33 schemas that model the data the API accepts and returns. The most detailed are HealthcareServiceAPIResponse (29 properties), LocationAPIResponse (22 properties), PractitionerRoleAPIResponse (20 properties), InsurancePlanAPIResponse (19 properties). Each schema is shown below with its type and property counts.

APIErrorResponse
object
4 properties
Address
object
12 properties
Attachment
object
8 properties
AvailableTime
object
4 properties
Code
object
4 properties
CodeableConcept
object
2 properties
Coding
object
3 properties
Contact
object
5 properties
EndpointAPIResponse
object
17 properties
Extension
object
13 properties
HealthcareServiceAPIResponse
object
29 properties
HumanName
object
7 properties
Identifier
object
7 properties
InsurancePlanAPIResponse
object
19 properties
Link
object
2 properties
LocationAPIResponse
object
22 properties
Meta
object
5 properties
Metadata
object
3 properties
NotAvailable
object
2 properties
OrganizationAPIResponse
object
17 properties
OrganizationAffiliationAPIResponse
object
17 properties
Period
object
2 properties
PractitionerAPIResponse
object
14 properties
PractitionerRoleAPIResponse
object
20 properties
Qualifiers
object
2 properties
Quantity
object
5 properties
Reference
object
2 properties
Response
object
2 properties
Telecom
object
7 properties
Text
object
2 properties
apiResponse
object
6 properties
healthResponse
object
Health response containing the status of the mongo database
4 properties
versionResponse
object
Version response containing build information of the current api
3 properties

Specification

The full machine-readable OpenAPI contract behind this narrative.

Source

centene-provider-rtr-fhir-pdex-openapi.json Raw ↑

Other APIs Centene publishes across the network.

Centene FHIR Patient Access API
AE Profile APIs.io
Centene FHIR Provider Directory API
AE Profile APIs.io
Centene Provider RTR Demographics API
AE Profile APIs.io
Centene Provider Carrier Entity Search (PCES) API
AE Profile APIs.io
Centene Provider Carrier Entity Search (PCES) Extract API
AE Profile APIs.io
Centene Provider Search Suggest API
AE Profile APIs.io
Centene Product Mapping V2 API
AE Profile APIs.io
Centene LWC EDI CORE Real Time Service
AE Profile APIs.io
Centene CCM Communication API
AE Profile APIs.io
Centene CCM SMS User Response Webhook
AE Profile APIs.io
Centene Healow Health API
AE Profile APIs.io
#FHIR#PDEX#Payer Data Exchange
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API Details
ID
centene:centene-fhir-pdex-rtr
Base URL
https://prod.api.centene.com/prtc/external/fhir-pdex-plan-net/v1/
Docs
https://partners.centene.com/apiDetail/6b5c0001-8b47-4f1c-864f-9193971f5c62
Provider
Centene
APIs.io →  GitHub →
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