For AI agents: the documentation index is at /docs/payerbox/llms.txt. A Markdown version of this page is available at /docs/payerbox/data-integration/uscdi/immunizations.md or by requesting it with the Accept: text/markdown header.
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Immunizations

Datasets

US Core 6.1.0 maps each USCDI element to FHIR.

DatasetUS Core 6.1.0 target profile(s)
immunizationsUS Core Immunization

immunizations

One row per administered (or refused) dose per patient. A member with three seasonal flu shots is three rows.

ColumnRequiredFormat / valuesExample
patient_identifierYespatient keyMRN-4471903
statusYescompleted, entered-in-error, not-done immunization-statuscompleted
status_reason_codeIf not-doneSNOMED CT or v3 ActReason code, with status_reason_system immunization-status-reasonPATOBJ patient objection
vaccine_codeYesCVX code, with vaccine_system; CVX if omitted CVX Vaccines Administered Vaccine Set140 influenza, seasonal, injectable, preservative free
occurrence_dateYesdatetime2025-10-02
performer_npiIf available10 digits1407006835
primary_sourceRecommendedtrue / falsetrue
  • vaccine_code is the one coded field with no fallback: a row without it cannot become an Immunization. Send vaccine_system as http://hl7.org/fhir/sid/cvx. US Core requires the CVX coding, so a row sourced from a billed claim that only carries an NDC should send that NDC with vaccine_system as http://hl7.org/fhir/sid/ndc; Payerbox crosswalks it to CVX.
  • status marks each row: completed for a dose that was given, not-done for one that was not, entered-in-error to retract a record that should never have existed.
  • status_reason_code belongs only on not-done rows: why the vaccine was not given — patient objection, medical precaution, out of stock, immunity, or a SNOMED CT refusal code. Send status_reason_system as http://terminology.hl7.org/CodeSystem/v3-ActReason or http://snomed.info/sct.
  • occurrence_date is the administration date (for not-done rows, the date the dose was due or refused). A date without a time is fine.
  • performer_npi identifies the administering practitioner and must match a row in practitioners.
  • primary_source is true when the record comes from the party that administered the vaccine, false for secondhand reports — member-reported doses or history imported from another system.

These resources are served by Patient Access, Provider Access, Payer-to-Payer, and Prior Auth.

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