Consumer Real-Time Pharmacy Benefit Check FHIR IG
2.0.0 - CI Build
Consumer Real-Time Pharmacy Benefit Check FHIR IG
2.0.0 - CI Build
Consumer Real-Time Pharmacy Benefit Check FHIR IG, published by HL7 International / Pharmacy. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/carin-rtpbc/ and changes regularly. See the Directory of published versions
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:Bundle ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "rtpbc-bundle-request-non-phi-1"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-bundle-non-phi"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-bundle-non-phi> ] )
] ; #
fhir:language [ fhir:v "en"] ; #
fhir:type [ fhir:v "message"] ; #
fhir:timestamp [ fhir:v "2025-11-15T13:10:13-05:00"^^xsd:dateTime] ; #
fhir:entry ( [
fhir:fullUrl [
fhir:v "http://example.org/my-app/MessageHeader/rtpbc-messageheader-request-non-phi-1"^^xsd:anyURI ;
fhir:l <http://example.org/my-app/MessageHeader/rtpbc-messageheader-request-non-phi-1> ] ;
( fhir:resource <http://example.org/my-app/MessageHeader/rtpbc-messageheader-request-non-phi-1> )
] [
fhir:fullUrl [
fhir:v "http://example.org/my-app/Claim/rtpbc-claim-non-phi-1"^^xsd:anyURI ;
fhir:l <http://example.org/my-app/Claim/rtpbc-claim-non-phi-1> ] ;
( fhir:resource <http://example.org/my-app/Claim/rtpbc-claim-non-phi-1> )
] [
fhir:fullUrl [
fhir:v "http://example.org/my-app/Patient/rtpbc-patient-non-phi-1"^^xsd:anyURI ;
fhir:l <http://example.org/my-app/Patient/rtpbc-patient-non-phi-1> ] ;
( fhir:resource <http://example.org/my-app/Patient/rtpbc-patient-non-phi-1> )
] [
fhir:fullUrl [
fhir:v "http://example.org/my-app/MedicationRequest/rtpbc-medicationrequest-non-phi-1"^^xsd:anyURI ;
fhir:l <http://example.org/my-app/MedicationRequest/rtpbc-medicationrequest-non-phi-1> ] ;
( fhir:resource <http://example.org/my-app/MedicationRequest/rtpbc-medicationrequest-non-phi-1> )
] [
fhir:fullUrl [
fhir:v "http://example.org/my-app/Organization/rtpbc-organization-03"^^xsd:anyURI ;
fhir:l <http://example.org/my-app/Organization/rtpbc-organization-03> ] ;
( fhir:resource <http://example.org/my-app/Organization/rtpbc-organization-03> )
] ) . #
<http://example.org/my-app/MessageHeader/rtpbc-messageheader-request-non-phi-1> a fhir:MessageHeader ;
fhir:id [ fhir:v "rtpbc-messageheader-request-non-phi-1"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-messageheader"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-messageheader> ] )
] ; #
fhir:language [ fhir:v "en"] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_rtpbc-messageheader-request-non-phi-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader rtpbc-messageheader-request-non-phi-1</b></p><a name=\"rtpbc-messageheader-request-non-phi-1\"> </a><a name=\"hcrtpbc-messageheader-request-non-phi-1\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-request-messageheader.html\">RTPBC Request MessageHeader</a></p></div><p><b>event</b>: <a href=\"CodeSystem-rtpbc-event-type.html#rtpbc-event-type-rtpbc-request\">RTPBC Event Type Code System: rtpbc-request</a> (RTPBC Request)</p><h3>Sources</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td style=\"display: none\">*</td><td>MyPatientApp</td><td><a href=\"http://example.org/MyPatientApp\">http://example.org/MyPatientApp</a></td></tr></table><p><b>focus</b>: <a href=\"Bundle-rtpbc-bundle-request-non-phi-1.html#http-//example.org/my-app/Claim/rtpbc-claim-non-phi-1\">Claim: identifier = rtpbc-non-phi-1; status = active; type = Pharmacy; use = predetermination; created = 2025-11-01 11:20:54-0500; priority = Normal</a></p><p><b>definition</b>: <a href=\"MessageDefinition-rtpbc-request.html\">RTPBC Request Message Definition</a></p></div>"^^rdf:XMLLiteral ]
] ; #
fhir:event [
a fhir:Coding ;
fhir:system [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type> ] ;
fhir:code [ fhir:v "rtpbc-request" ] ;
fhir:display [ fhir:v "RTPBC Request" ]
] ; #
fhir:source [
fhir:name [ fhir:v "MyPatientApp" ] ;
fhir:endpoint [
fhir:v "http://example.org/MyPatientApp"^^xsd:anyURI ;
fhir:l <http://example.org/MyPatientApp> ]
] ; #
fhir:focus ( [
fhir:l <http://example.org/my-app/Claim/rtpbc-claim-non-phi-1> ;
fhir:reference [ fhir:v "http://example.org/my-app/Claim/rtpbc-claim-non-phi-1" ]
] ) ; #
fhir:definition [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request>
] . #
<http://example.org/my-app/Claim/rtpbc-claim-non-phi-1> a fhir:Claim ;
fhir:id [ fhir:v "rtpbc-claim-non-phi-1"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-claim-non-phi"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-claim-non-phi> ] )
] ; #
fhir:language [ fhir:v "en"] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_rtpbc-claim-non-phi-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim rtpbc-claim-non-phi-1</b></p><a name=\"rtpbc-claim-non-phi-1\"> </a><a name=\"hcrtpbc-claim-non-phi-1\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-request-claim-non-phi.html\">RTPBC Request Using Claim - Non-PHI</a></p></div><p><b>identifier</b>: rtpbc-non-phi-1</p><p><b>status</b>: Active</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/claim-type pharmacy}\">Pharmacy</span></p><p><b>use</b>: Predetermination</p><p><b>patient</b>: <a href=\"Patient-rtpbc-patient-non-phi-1.html\">Anonymous Patient (no stated gender), DoB Unknown</a></p><p><b>created</b>: 2025-11-01 11:20:54-0500</p><p><b>provider</b>: <a href=\"Organization-rtpbc-organization-03.html\">Organization Hometown Drug</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><p><b>prescription</b>: <a href=\"MedicationRequest-rtpbc-medicationrequest-non-phi-1.html\">MedicationRequest: status = draft; intent = proposal; reported[x] = true; medication[x] = ; authoredOn = 2025-11-01</a></p><h3>CareTeams</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>Masked</td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td>Masked</td></tr></table><h3>Items</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>CareTeamSequence</b></td><td><b>ProductOrService</b></td><td><b>Quantity</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>1</td><td><span title=\"Codes:\">Prozac 10mg Capsule</span></td><td>60 {Each}</td></tr></table></div>"^^rdf:XMLLiteral ]
] ; #
fhir:identifier ( [
fhir:value [ fhir:v "rtpbc-non-phi-1" ]
] ) ; #
fhir:status [ fhir:v "active"] ; #
fhir:type [
( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/claim-type> ] ;
fhir:code [ fhir:v "pharmacy" ] ;
fhir:display [ fhir:v "Pharmacy" ] ] )
] ; #
fhir:use [ fhir:v "predetermination"] ; #
fhir:patient [
fhir:l fhir:Patient/rtpbc-patient-non-phi-1 ;
fhir:reference [ fhir:v "Patient/rtpbc-patient-non-phi-1" ]
] ; #
fhir:created [ fhir:v "2025-11-01T11:20:54-05:00"^^xsd:dateTime] ; #
fhir:provider [
fhir:l fhir:Organization/rtpbc-organization-03 ;
fhir:reference [ fhir:v "Organization/rtpbc-organization-03" ]
] ; #
fhir:priority [
( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/processpriority"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/processpriority> ] ;
fhir:code [ fhir:v "normal" ] ;
fhir:display [ fhir:v "Normal" ] ] )
] ; #
fhir:prescription [
fhir:l fhir:MedicationRequest/rtpbc-medicationrequest-non-phi-1 ;
fhir:reference [ fhir:v "MedicationRequest/rtpbc-medicationrequest-non-phi-1" ]
] ; #
fhir:careTeam ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:provider [
( fhir:extension [
fhir:url [
fhir:v "http://hl7.org/fhir/StructureDefinition/data-absent-reason"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/StructureDefinition/data-absent-reason> ] ;
fhir:value [
a fhir:Code ;
fhir:v "masked" ] ] ) ;
fhir:display [ fhir:v "Masked" ] ]
] ) ; #
fhir:insurance ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
fhir:focal [ fhir:v true ] ;
fhir:coverage [
( fhir:extension [
fhir:url [
fhir:v "http://hl7.org/fhir/StructureDefinition/data-absent-reason"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/StructureDefinition/data-absent-reason> ] ;
fhir:value [
a fhir:Code ;
fhir:v "masked" ] ] ) ;
fhir:display [ fhir:v "Masked" ] ]
] ) ; #
fhir:item ( [
fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
( fhir:careTeamSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ;
fhir:productOrService [
fhir:text [ fhir:v "Prozac 10mg Capsule" ] ] ;
fhir:quantity [
fhir:value [ fhir:v "60"^^xsd:decimal ] ;
fhir:unit [ fhir:v "{Each}" ] ]
] ) . #
<http://example.org/my-app/Patient/rtpbc-patient-non-phi-1> a fhir:Patient ;
fhir:id [ fhir:v "rtpbc-patient-non-phi-1"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-patient-non-phi"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-patient-non-phi> ] )
] ; #
fhir:language [ fhir:v "en"] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_rtpbc-patient-non-phi-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient rtpbc-patient-non-phi-1</b></p><a name=\"rtpbc-patient-non-phi-1\"> </a><a name=\"hcrtpbc-patient-non-phi-1\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-patient-non-phi.html\">RTPBC Patient - Non-PHI</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Anonymous Patient (no stated gender), DoB Unknown</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\">53510 </td></tr></table></div>"^^rdf:XMLLiteral ]
] ; #
fhir:address ( [
fhir:postalCode [ fhir:v "53510" ]
] ) . #
<http://example.org/my-app/MedicationRequest/rtpbc-medicationrequest-non-phi-1> a fhir:MedicationRequest ;
fhir:id [ fhir:v "rtpbc-medicationrequest-non-phi-1"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-medicationrequest-non-phi"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-medicationrequest-non-phi> ] )
] ; #
fhir:language [ fhir:v "en"] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MedicationRequest_rtpbc-medicationrequest-non-phi-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MedicationRequest rtpbc-medicationrequest-non-phi-1</b></p><a name=\"rtpbc-medicationrequest-non-phi-1\"> </a><a name=\"hcrtpbc-medicationrequest-non-phi-1\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-medicationrequest-non-phi.html\">RTPBC Medication Request - Non-PHI</a></p></div><p><b>status</b>: Draft</p><p><b>intent</b>: Proposal</p><p><b>reported</b>: true</p><p><b>medication</b>: <span title=\"Codes:\">Prozac 10mg Capsule</span></p><p><b>subject</b>: <a href=\"Patient-rtpbc-patient-non-phi-1.html\">Anonymous Patient (no stated gender), DoB Unknown</a></p><p><b>authoredOn</b>: 2025-11-01</p><h3>DispenseRequests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Quantity</b></td><td><b>Performer</b></td></tr><tr><td style=\"display: none\">*</td><td>60 {Each}</td><td><a href=\"Organization-rtpbc-organization-03.html\">Organization Hometown Drug</a></td></tr></table></div>"^^rdf:XMLLiteral ]
] ; #
fhir:status [ fhir:v "draft"] ; #
fhir:intent [ fhir:v "proposal"] ; #
fhir:reported [
a fhir:Boolean ;
fhir:v true
] ; #
fhir:medication [
a fhir:CodeableConcept ;
fhir:text [ fhir:v "Prozac 10mg Capsule" ]
] ; #
fhir:subject [
fhir:l fhir:Patient/rtpbc-patient-non-phi-1 ;
fhir:reference [ fhir:v "Patient/rtpbc-patient-non-phi-1" ]
] ; #
fhir:authoredOn [ fhir:v "2025-11-01"^^xsd:date] ; #
fhir:dispenseRequest [
fhir:quantity [
fhir:value [ fhir:v "60"^^xsd:decimal ] ;
fhir:unit [ fhir:v "{Each}" ] ] ;
fhir:performer [
fhir:l fhir:Organization/rtpbc-organization-03 ;
fhir:reference [ fhir:v "Organization/rtpbc-organization-03" ] ]
] . #
<http://example.org/my-app/Organization/rtpbc-organization-03> a fhir:Organization ;
fhir:id [ fhir:v "rtpbc-organization-03"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-pharmacy-organization"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-pharmacy-organization> ] )
] ; #
fhir:language [ fhir:v "en"] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_rtpbc-organization-03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization rtpbc-organization-03</b></p><a name=\"rtpbc-organization-03\"> </a><a name=\"hcrtpbc-organization-03\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-pharmacy-organization.html\">RTPBC Pharmacy Organization</a></p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.5.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/9876543213</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/NCPDPPharmacyType R}\">Retail</span></p><p><b>name</b>: Hometown Drug</p><p><b>telecom</b>: ph: 6081234567</p><p><b>address</b>: 900 9th Street Madison WI 53535 US </p></div>"^^rdf:XMLLiteral ]
] ; #
fhir:identifier ( [
fhir:system [
fhir:v "http://hl7.org/fhir/sid/us-npi"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/sid/us-npi> ] ;
fhir:value [ fhir:v "9876543213" ]
] ) ; #
fhir:active [ fhir:v true] ; #
fhir:type ( [
( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/NCPDPPharmacyType"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/NCPDPPharmacyType> ] ;
fhir:code [ fhir:v "R" ] ;
fhir:display [ fhir:v "Retail" ] ] )
] ) ; #
fhir:name [ fhir:v "Hometown Drug"] ; #
fhir:telecom ( [
fhir:system [ fhir:v "phone" ] ;
fhir:value [ fhir:v "6081234567" ]
] ) ; #
fhir:address ( [
( fhir:line [ fhir:v "900 9th Street" ] ) ;
fhir:city [ fhir:v "Madison" ] ;
fhir:state [ fhir:v "WI" ] ;
fhir:postalCode [ fhir:v "53535" ] ;
fhir:country [ fhir:v "US" ]
] ) . #
IG © 2024+ HL7 International / Pharmacy.
Package hl7.fhir.us.carin-rtpbc#2.0.0 based on FHIR 4.0.1.
Generated
2025-12-16
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