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-bundle-request-price-source

Raw xml | Download

    <Bundle xmlns="http://hl7.org/fhir">
      <id value="rtpbc-bundle-request-price-source"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-bundle"/>
      </meta>
      <language value="en"/>
      <type value="message"/>
      <timestamp value="2019-11-15T13:10:13-05:00"/>
      <entry>
        <fullUrl
                 value="http://example.org/my-app/MessageHeader/rtpbc-messageheader-request-03"/>
        <resource>
          <MessageHeader>
            <id value="rtpbc-messageheader-request-03"/>
            <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-03"> </a><p class="res-header-id"><b>Generated Narrative: MessageHeader rtpbc-messageheader-request-03</b></p><a name="rtpbc-messageheader-request-03"> </a><a name="hcrtpbc-messageheader-request-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-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="Claim-rtpbc-claim-03.html">Claim: identifier = rtpbc-03; status = active; type = Pharmacy; use = predetermination; created = 2019-11-01 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="Claim/rtpbc-claim-03"/>
            </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-03"/>
        <resource>
          <Claim>
            <id value="rtpbc-claim-03"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-claim"/>
            </meta>
            <language value="en"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Claim_rtpbc-claim-03"> </a><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"/><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>
            </text>
            <identifier>
              <value value="rtpbc-03"/>
            </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-03"/>
            </patient>
            <created value="2019-11-01T11:20:54-05:00"/>
            <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-03"/>
            </prescription>
            <careTeam>
              <sequence value="1"/>
              <provider>🔗
                <reference value="Practitioner/rtpbc-practitioner-03"/>
              </provider>
            </careTeam>
            <insurance>
              <sequence value="1"/>
              <focal value="true"/>
              <coverage>
                <identifier>
                  <value value="GOODPRICING"/>
                </identifier>
              </coverage>
            </insurance>
            <item>
              <sequence value="1"/>
              <careTeamSequence value="1"/>
              <productOrService>
                <coding>
                  <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
                  <code value="205535"/>
                  <display value="fluoxetine 10 MG Oral Capsule [Prozac]"/>
                </coding>
              </productOrService>
              <quantity>
                <value value="60"/>
                <unit value="{Each}"/>
              </quantity>
            </item>
          </Claim>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/my-app/Patient/rtpbc-patient-03"/>
        <resource>
          <Patient>
            <id value="rtpbc-patient-03"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-patient"/>
            </meta>
            <language value="en"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Patient_rtpbc-patient-03"> </a><p class="res-header-id"><b>Generated Narrative: Patient rtpbc-patient-03</b></p><a name="rtpbc-patient-03"> </a><a name="hcrtpbc-patient-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-patient.html">RTPBC Patient</a></p></div><p style="border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;">Jane Doe  Female, DoB: 1975-12-05 ( Patient internal identifier: 30455)</p><hr/><table class="grid"><tr><td style="background-color: #f3f5da" title="Ways to contact the Patient">Contact Detail</td><td colspan="3">100 Oak Court Madison WI 53510 US </td></tr></table></div>
            </text>
            <identifier>
              <type>
                <coding>
                  <system value="http://terminology.hl7.org/CodeSystem/v2-0203"/>
                  <code value="PI"/>
                  <display value="Patient internal identifier"/>
                </coding>
                <text value="Patient internal identifier"/>
              </type>
              <system value="http://example.org/MyPatientApp"/>
              <value value="30455"/>
            </identifier>
            <name>
              <family value="Doe"/>
              <given value="Jane"/>
            </name>
            <gender value="female"/>
            <birthDate value="1975-12-05"/>
            <address>
              <line value="100 Oak Court"/>
              <city value="Madison"/>
              <state value="WI"/>
              <postalCode value="53510"/>
              <country value="US"/>
            </address>
          </Patient>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://example.org/my-app/MedicationRequest/rtpbc-medicationrequest-03"/>
        <resource>
          <MedicationRequest>
            <id value="rtpbc-medicationrequest-03"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-medicationrequest"/>
            </meta>
            <language value="en"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="MedicationRequest_rtpbc-medicationrequest-03"> </a><p class="res-header-id"><b>Generated Narrative: MedicationRequest rtpbc-medicationrequest-03</b></p><a name="rtpbc-medicationrequest-03"> </a><a name="hcrtpbc-medicationrequest-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-medicationrequest.html">RTPBC Medication Request</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:{http://www.nlm.nih.gov/research/umls/rxnorm 205535}">fluoxetine 10 MG Oral Capsule [Prozac]</span></p><p><b>subject</b>: <a href="Patient-rtpbc-patient-03.html">Jane Doe  Female, DoB: 1975-12-05 ( Patient internal identifier: 30455)</a></p><p><b>authoredOn</b>: 2019-11-01</p><p><b>requester</b>: <a href="Practitioner-rtpbc-practitioner-03.html">Practitioner Johnson </a></p><h3>DosageInstructions</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Text</b></td></tr><tr><td style="display: none">*</td><td>Take 2 capsules once a day</td></tr></table><blockquote><p><b>dispenseRequest</b></p><p><b>quantity</b>: 60 {Each}</p><h3>ExpectedSupplyDurations</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Unit</b></td><td><b>System</b></td><td><b>Code</b></td></tr><tr><td style="display: none">*</td><td>30</td><td>days</td><td><a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-ucum.html">http://unitsofmeasure.org</a></td><td>d</td></tr></table><p><b>performer</b>: <a href="Organization-rtpbc-organization-03.html">Organization Hometown Drug</a></p></blockquote><h3>Substitutions</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Allowed[x]</b></td></tr><tr><td style="display: none">*</td><td>false</td></tr></table></div>
            </text>
            <status value="draft"/>
            <intent value="proposal"/>
            <reportedBoolean value="true"/>
            <medicationCodeableConcept>
              <coding>
                <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
                <code value="205535"/>
                <display value="fluoxetine 10 MG Oral Capsule [Prozac]"/>
              </coding>
            </medicationCodeableConcept>
            <subject>🔗
              <reference value="Patient/rtpbc-patient-03"/>
            </subject>
            <authoredOn value="2019-11-01"/>
            <requester>🔗
              <reference value="Practitioner/rtpbc-practitioner-03"/>
            </requester>
            <dosageInstruction>
              <text value="Take 2 capsules once a day"/>
            </dosageInstruction>
            <dispenseRequest>
              <quantity>
                <value value="60"/>
                <unit value="{Each}"/>
              </quantity>
              <expectedSupplyDuration>
                <value value="30"/>
                <unit value="days"/>
                <system value="http://unitsofmeasure.org"/>
                <code value="d"/>
              </expectedSupplyDuration>
              <performer>🔗
                <reference value="Organization/rtpbc-organization-03"/>
              </performer>
            </dispenseRequest>
            <substitution>
              <allowedBoolean value="false"/>
            </substitution>
          </MedicationRequest>
        </resource>
      </entry>
      <entry>
        <fullUrl
                 value="http://example.org/my-app/Practitioner/rtpbc-practitioner-03"/>
        <resource>
          <Practitioner>
            <id value="rtpbc-practitioner-03"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"/>
            </meta>
            <language value="en"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Practitioner_rtpbc-practitioner-03"> </a><p class="res-header-id"><b>Generated Narrative: Practitioner rtpbc-practitioner-03</b></p><a name="rtpbc-practitioner-03"> </a><a name="hcrtpbc-practitioner-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="http://hl7.org/fhir/us/core/STU8.0.1/StructureDefinition-us-core-practitioner.html">US Core Practitioner Profile</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>/1234567893</p><p><b>name</b>: Johnson </p></div>
            </text>
            <identifier>
              <system value="http://hl7.org/fhir/sid/us-npi"/>
              <value value="1234567893"/>
            </identifier>
            <name>
              <family value="Johnson"/>
            </name>
          </Practitioner>
        </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>