Consumer Real-Time Pharmacy Benefit Check FHIR IG
2.0.0 - CI Build United States of America flag

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

Extension: RTPBC benefitRestriction Extension

Official URL: http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-benefitRestriction Version: 2.0.0
Standards status: Trial-use Maturity Level: 1 Computable Name: RtpbcExtensionBenefitRestriction

This extension conveys benefit restrictions that may apply to a prescription product and pharmacy combination.

Context of Use

This extension enables a real-time pharmacy benefit check responder to indicate one or more benefit restrictions that apply to:

  • the requested medication and pharmacy
  • an alternative medication and pharmacy

Values conveyed in this extension are defined in the RTPBC Benefit Restriction value set.


Usage info

Usages:

You can also check for usages in the FHIR IG Statistics

Formal Views of Extension Content

Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension Benefit restriction.
... extension 0..0
... url 1..1 uri "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-benefitRestriction"
... value[x] 1..1 Coding Value of extension
Binding: RTPBC Benefit Restriction Value Set (extensible)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension Benefit restriction.
... id 0..1 string Unique id for inter-element referencing
... extension 0..0
... url 1..1 uri "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-benefitRestriction"

doco Documentation for this format

This structure is derived from Extension

Summary

Simple Extension with the type Coding: This extension conveys benefit restrictions that may apply to a prescription product and pharmacy combination.

Maturity: 1

Differential View

This structure is derived from Extension

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension Benefit restriction.
... extension 0..0
... url 1..1 uri "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-benefitRestriction"
... value[x] 1..1 Coding Value of extension
Binding: RTPBC Benefit Restriction Value Set (extensible)

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraints    Filter: Filtersdoco
.. Extension 0..* Extension Benefit restriction.
... id 0..1 string Unique id for inter-element referencing
... extension 0..0
... url 1..1 uri "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-benefitRestriction"

doco Documentation for this format

This structure is derived from Extension

Summary

Simple Extension with the type Coding: This extension conveys benefit restrictions that may apply to a prescription product and pharmacy combination.

Maturity: 1

 

Other representations of profile: CSV, Excel, Schematron

Terminology Bindings

PathConformanceValueSetURI
Extension.value[x]extensibleRtbpcBenefitRestrictionValueSet(a valid code from RTPBC Benefit Restriction Code System)
http://hl7.org/fhir/us/carin-rtpbc/ValueSet/rtpbc-benefit-restriction
From this IG

Constraints

IdGradePath(s)DetailsRequirements
ele-1error**ALL** elementsAll FHIR elements must have a @value or children
: hasValue() or (children().count() > id.count())
ext-1error**ALL** extensionsMust have either extensions or value[x], not both
: extension.exists() != value.exists()