Consumer Real-Time Pharmacy Benefit Check FHIR IG
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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

: rtpbc-bundle-request-non-phi-1

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<Bundle xmlns="http://hl7.org/fhir">
  <id value="rtpbc-bundle-request-non-phi-1"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-bundle-non-phi"/>
  </meta>
  <language value="en"/>
  <type value="message"/>
  <timestamp value="2025-11-15T13:10:13-05:00"/>
  <entry>
    <fullUrl
             value="http://example.org/my-app/MessageHeader/rtpbc-messageheader-request-non-phi-1"/>
    <resource>
      <MessageHeader>
        <id value="rtpbc-messageheader-request-non-phi-1"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-messageheader"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="generated"/>
          <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>
        </text>
        <eventCoding>
          <system
                  value="http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type"/>
          <code value="rtpbc-request"/>
          <display value="RTPBC Request"/>
        </eventCoding>
        <source>
          <name value="MyPatientApp"/>
          <endpoint value="http://example.org/MyPatientApp"/>
        </source>
        <focus>
          <reference
                     value="http://example.org/my-app/Claim/rtpbc-claim-non-phi-1"/>
        </focus>
        <definition
                    value="http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request"/>
      </MessageHeader>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://example.org/my-app/Claim/rtpbc-claim-non-phi-1"/>
    <resource>
      <Claim>
        <id value="rtpbc-claim-non-phi-1"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-claim-non-phi"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="generated"/>
          <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>
        </text>
        <identifier>
          <value value="rtpbc-non-phi-1"/>
        </identifier>
        <status value="active"/>
        <type>
          <coding>
            <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
            <code value="pharmacy"/>
            <display value="Pharmacy"/>
          </coding>
        </type>
        <use value="predetermination"/>
        <patient>🔗 
          <reference value="Patient/rtpbc-patient-non-phi-1"/>
        </patient>
        <created value="2025-11-01T11:20:54-05:00"/>
        <provider>🔗 
          <reference value="Organization/rtpbc-organization-03"/>
        </provider>
        <priority>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/processpriority"/>
            <code value="normal"/>
            <display value="Normal"/>
          </coding>
        </priority>
        <prescription>🔗 
          <reference
                     value="MedicationRequest/rtpbc-medicationrequest-non-phi-1"/>
        </prescription>
        <careTeam>
          <sequence value="1"/>
          <provider>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
              <valueCode value="masked"/>
            </extension>
            <display value="Masked"/>
          </provider>
        </careTeam>
        <insurance>
          <sequence value="1"/>
          <focal value="true"/>
          <coverage>
            <extension
                       url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
              <valueCode value="masked"/>
            </extension>
            <display value="Masked"/>
          </coverage>
        </insurance>
        <item>
          <sequence value="1"/>
          <careTeamSequence value="1"/>
          <productOrService>
            <text value="Prozac 10mg Capsule"/>
          </productOrService>
          <quantity>
            <value value="60"/>
            <unit value="{Each}"/>
          </quantity>
        </item>
      </Claim>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://example.org/my-app/Patient/rtpbc-patient-non-phi-1"/>
    <resource>
      <Patient>
        <id value="rtpbc-patient-non-phi-1"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-patient-non-phi"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="generated"/>
          <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>
        </text>
        <address>
          <postalCode value="53510"/>
        </address>
      </Patient>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://example.org/my-app/MedicationRequest/rtpbc-medicationrequest-non-phi-1"/>
    <resource>
      <MedicationRequest>
        <id value="rtpbc-medicationrequest-non-phi-1"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-medicationrequest-non-phi"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="generated"/>
          <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>
        </text>
        <status value="draft"/>
        <intent value="proposal"/>
        <reportedBoolean value="true"/>
        <medicationCodeableConcept>
          <text value="Prozac 10mg Capsule"/>
        </medicationCodeableConcept>
        <subject>🔗 
          <reference value="Patient/rtpbc-patient-non-phi-1"/>
        </subject>
        <authoredOn value="2025-11-01"/>
        <dispenseRequest>
          <quantity>
            <value value="60"/>
            <unit value="{Each}"/>
          </quantity>
          <performer>🔗 
            <reference value="Organization/rtpbc-organization-03"/>
          </performer>
        </dispenseRequest>
      </MedicationRequest>
    </resource>
  </entry>
  <entry>
    <fullUrl
             value="http://example.org/my-app/Organization/rtpbc-organization-03"/>
    <resource>
      <Organization>
        <id value="rtpbc-organization-03"/>
        <meta>
          <profile
                   value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-pharmacy-organization"/>
        </meta>
        <language value="en"/>
        <text>
          <status value="generated"/>
          <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>
        </text>
        <identifier>
          <system value="http://hl7.org/fhir/sid/us-npi"/>
          <value value="9876543213"/>
        </identifier>
        <active value="true"/>
        <type>
          <coding>
            <system
                    value="http://terminology.hl7.org/CodeSystem/NCPDPPharmacyType"/>
            <code value="R"/>
            <display value="Retail"/>
          </coding>
        </type>
        <name value="Hometown Drug"/>
        <telecom>
          <system value="phone"/>
          <value value="6081234567"/>
        </telecom>
        <address>
          <line value="900 9th Street"/>
          <city value="Madison"/>
          <state value="WI"/>
          <postalCode value="53535"/>
          <country value="US"/>
        </address>
      </Organization>
    </resource>
  </entry>
</Bundle>