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

## : rtpbc-claim-03

Page standards status: Informative

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    @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:Claim ;
      fhir:nodeRole fhir:treeRoot ;
      fhir:id [ fhir:v "rtpbc-claim-03"] ; #
      fhir:meta [
        ( fhir:profile [
    fhir:v "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-claim"^^xsd:anyURI ;
    fhir:l <http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-claim>     ] )
      ] ; #
      fhir:language [ fhir:v "en"] ; #
      fhir:text [
    fhir:status [ fhir:v "generated" ] ;
    fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\" xml:lang=\"en\" lang=\"en\"><p class=\"res-header-id\"><b>Generated Narrative: Claim rtpbc-claim-03</b></p><a name=\"rtpbc-claim-03\"> </a><a name=\"hcrtpbc-claim-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\">Language: en</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-request-claim.html\">RTPBC Request Using Claim</a></p></div><p><b>identifier</b>: rtpbc-03</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-03.html\">Jane Doe  Female, DoB: 1975-12-05 ( Patient internal identifier: 30455)</a></p><p><b>created</b>: 2019-11-01 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-03.html\">MedicationRequest: status = draft; intent = proposal; reported[x] = true; medication[x] = fluoxetine 10 MG Oral Capsule [Prozac]; authoredOn = 2019-11-01</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><a href=\"Practitioner-rtpbc-practitioner-03.html\">Practitioner Johnson </a></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>Identifier: GOODPRICING</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:{http://www.nlm.nih.gov/research/umls/rxnorm 205535}\">fluoxetine 10 MG Oral Capsule [Prozac]</span></td><td>60 {Each}</td></tr></table></div>"^^rdf:XMLLiteral ]
      ] ; #
      fhir:identifier ( [
    fhir:value [ fhir:v "rtpbc-03" ]
      ] ) ; #
      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-03 ;
    fhir:reference [ fhir:v "Patient/rtpbc-patient-03" ]
      ] ; #
      fhir:created [ fhir:v "2019-11-01T11:20:54-05:00"^^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-03 ;
    fhir:reference [ fhir:v "MedicationRequest/rtpbc-medicationrequest-03" ]
      ] ; #
      fhir:careTeam ( [
    fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
    fhir:provider [
    fhir:l fhir:Practitioner/rtpbc-practitioner-03 ;
    fhir:reference [ fhir:v "Practitioner/rtpbc-practitioner-03" ]     ]
      ] ) ; #
      fhir:insurance ( [
    fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
    fhir:focal [ fhir:v true ] ;
    fhir:coverage [
    fhir:identifier [
    fhir:value [ fhir:v "GOODPRICING" ]       ]     ]
      ] ) ; #
      fhir:item ( [
    fhir:sequence [ fhir:v "1"^^xsd:positiveInteger ] ;
        ( fhir:careTeamSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ;
    fhir:productOrService [
          ( fhir:coding [
    fhir:system [
    fhir:v "http://www.nlm.nih.gov/research/umls/rxnorm"^^xsd:anyURI ;
    fhir:l <http://www.nlm.nih.gov/research/umls/rxnorm>         ] ;
    fhir:code [ fhir:v "205535" ] ;
    fhir:display [ fhir:v "fluoxetine 10 MG Oral Capsule [Prozac]" ]       ] )     ] ;
    fhir:quantity [
    fhir:value [ fhir:v "60"^^xsd:decimal ] ;
    fhir:unit [ fhir:v "{Each}" ]     ]
      ] ) . #