Example RTPBC request bundle submitted to a pricing source

In this example:

• the client is a patient application
• the server is a medication pricing source vendor
• the request is submitted as a Bundle containing a Claim and supporting resources, as the single parameter to the processor's $process-message operation

Content:

• the patient's name is Jane Doe, date of birth is 1975-12-05, and address is 100 Oak Court, Madison, WI 53510
• the requested medication is Prozac 10mg capsule, 60 capsules, for a 30 day supply (reflected in the Claim and MedicationRequest resources)
• the prescriber's identifying information is captured in the Practitioner resource
• the requested pharmacy is Hometown Drug (reflected in the Organization resource)
• a Coverage resource is not sent in the bundle, as it is not needed by the pricing source

Bundle rtpbc-bundle-request-03-price-source of type message

Entry 1 - fullUrl = http://example.org/my-app/MessageHeader/rtpbc-messageheader-request-03

Resource MessageHeader:

Profile: RTPBC Request MessageHeader

event: RTPBC Event Type Code System rtpbc-request: RTPBC Request

Sources

-	Name
*	MyPatientApp

focus: Claim: identifier = rtpbc-03; status = active; type = Pharmacy; use = predetermination; created = 2019-11-01 11:20:54-0500; priority = Normal

definition: RTPBC Request Message Definition

Entry 2 - fullUrl = http://example.org/my-app/Claim/rtpbc-claim-03

Resource Claim:

Profile: RTPBC Request Using Claim

identifier: rtpbc-03

status: Active

type: Pharmacy

use: Predetermination

patient: Jane Doe Female, DoB: 1975-12-05 ( Patient internal identifier: 30455)

created: 2019-11-01 11:20:54-0500

provider: Organization Hometown Drug

priority: Normal

prescription: MedicationRequest: status = draft; intent = proposal; reported[x] = true; medication[x] = PROzac 10 MG Oral Capsule; authoredOn = 2019-11-01

CareTeams

-	Sequence	Provider
*	1	Practitioner Johnson

Insurances

-	Sequence	Focal	Coverage
*	1	true	Identifier: GOODPRICING

Items

-	Sequence	CareTeamSequence	ProductOrService	Quantity
*	1	1	PROzac 10 MG Oral Capsule	60 {Each}

Entry 3 - fullUrl = http://example.org/my-app/Patient/rtpbc-patient-03

Resource Patient:

Profile: RTPBC Patient

Jane Doe Female, DoB: 1975-12-05 ( Patient internal identifier: 30455)

---

Contact Detail

100 Oak Court Madison WI 53510 US

Entry 4 - fullUrl = http://example.org/my-app/MedicationRequest/rtpbc-medicationrequest-03

Resource MedicationRequest:

Profile: RTPBC Medication Request

status: Draft

intent: Proposal

subject: Jane Doe Female, DoB: 1975-12-05 ( Patient internal identifier: 30455)

authoredOn: 2019-11-01

requester: Practitioner Johnson

DosageInstructions

-	Text
*	Take 2 capsules once a day

dispenseRequest

quantity: 60 {Each}

ExpectedSupplyDurations

-	Value	Unit	System	Code
*	30	days	http://unitsofmeasure.org	d

Substitutions

-	Allowed[x]
*	false

Entry 5 - fullUrl = http://example.org/my-app/Practitioner/rtpbc-practitioner-03

Resource Practitioner:

Profile: US Core Practitioner Profile

identifier: United States National Provider Identifier/1234567890

name: Johnson

Entry 6 - fullUrl = http://example.org/my-app/Organization/rtpbc-organization-03

Resource Organization:

Profile: RTPBC Pharmacy Organization

identifier: United States National Provider Identifier/9876543210

active: true

type: Retail

name: Hometown Drug

Contacts

-	Telecom	Address
*	ph: 6081234567	900 9th Street Madison WI 53535 US