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

Resource Profile: RtpbcRequestClaim - Mappings

Page standards status: Trial-use Maturity Level: 4

Mappings for the rtpbc-request-claim resource profile.

Mappings to Structures in this Implementation Guide

No Mappings Found

Mappings to other Structures

No Mappings Found

Other Mappings

NameWorkflow PatternFiveWs Pattern MappingRIM Mappingdoco
.. Claim
Request
  • Entity. Role
  • or Act
... id
... meta
... implicitRules
... language
... text
Act.text?
... contained
N/A
... extension
N/A
... modifierExtension
N/A
... identifier
Request.identifier
FiveWs.identifier
.... id
n/a
.... extension
n/a
.... use
Role.code or implied by context
.... type
Role.code or implied by context
.... system
II.root or Role.id.root
.... value
II.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
.... period
Role.effectiveTime or implied by context
.... assigner
II.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
... status
Request.status
FiveWs.status
... type
FiveWs.class
.... id
n/a
.... extension
n/a
.... coding
  • union(.
  • ./translation)
..... id
n/a
..... extension
n/a
..... system
./codeSystem
..... version
./codeSystemVersion
..... code
./code
..... display
CV.displayName
..... userSelected
CD.codingRationale
.... text
./originalText[mediaType/code="text/plain"]/data
... subType
FiveWs.class
... use
FiveWs.class
... patient
Request.subject
FiveWs.subject
.... id
n/a
.... extension
n/a
.... reference
N/A
.... type
N/A
.... identifier
.identifier
.... display
N/A
... billablePeriod
FiveWs.done[x]
... created
Request.authoredOn
FiveWs.recorded
... enterer
FiveWs.author
... insurer
Request.performer
... provider
Request.requester
FiveWs.source
.... id
n/a
.... extension
n/a
.... reference
N/A
.... type
N/A
.... identifier
.identifier
.... display
N/A
... priority
Request.priority
.... id
n/a
.... extension
n/a
.... coding
  • union(.
  • ./translation)
..... id
n/a
..... extension
n/a
..... system
./codeSystem
..... version
./codeSystemVersion
..... code
./code
..... display
CV.displayName
..... userSelected
CD.codingRationale
.... text
./originalText[mediaType/code="text/plain"]/data
... fundsReserve
... related
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... claim
Request.replaces
.... relationship
.... reference
... prescription
.... id
n/a
.... extension
n/a
.... reference
N/A
.... type
N/A
.... identifier
.identifier
.... display
N/A
... originalPrescription
... payee
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... type
.... party
... referral
FiveWs.cause
... facility
FiveWs.where[x]
... careTeam
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... sequence
.... provider
FiveWs.actor
..... id
n/a
..... extension
n/a
..... reference
N/A
..... type
N/A
..... identifier
.identifier
..... display
N/A
.... responsible
.... role
.... qualification
... supportingInfo
Request.supportingInfo
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... sequence
.... category
.... code
.... timing[x]
.... value[x]
.... reason
... diagnosis
Request.reasonReference
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... sequence
.... diagnosis[x]
.... type
.... onAdmission
.... packageCode
... procedure
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... sequence
.... type
.... date
.... procedure[x]
.... udi
... insurance
Coverage
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... sequence
.... focal
.... identifier
Request.identifier
FiveWs.identifier
.... coverage
..... id
n/a
..... extension
n/a
..... reference
N/A
..... type
N/A
..... identifier
.identifier
..... display
N/A
.... businessArrangement
.... preAuthRef
.... claimResponse
... accident
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... date
.... type
.... location[x]
... item
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... sequence
.... careTeamSequence
.... diagnosisSequence
.... procedureSequence
.... informationSequence
.... revenue
.... category
.... productOrService
..... id
n/a
..... extension
n/a
..... coding
  • union(.
  • ./translation)
...... id
n/a
...... extension
n/a
...... system
./codeSystem
...... version
./codeSystemVersion
...... code
./code
...... display
CV.displayName
...... userSelected
CD.codingRationale
..... text
./originalText[mediaType/code="text/plain"]/data
.... modifier
.... programCode
.... serviced[x]
FiveWs.done[x]
.... location[x]
FiveWs.where[x]
.... quantity
..... id
n/a
..... extension
n/a
..... value
  • PQ.value
  • CO.value
  • MO.value
  • IVL.high or IVL.low depending on the value
..... comparator
IVL properties
..... unit
PQ.unit
..... system
  • CO.codeSystem
  • PQ.translation.codeSystem
..... code
  • PQ.code
  • MO.currency
  • PQ.translation.code
.... unitPrice
.... factor
.... net
.... udi
.... bodySite
.... subSite
.... encounter
Request.context
.... detail
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... sequence
..... revenue
..... category
..... productOrService
..... modifier
..... programCode
..... quantity
..... unitPrice
..... factor
..... net
..... udi
..... subDetail
...... id
n/a
...... extension
n/a
...... modifierExtension
N/A
...... sequence
...... revenue
...... category
...... productOrService
...... modifier
...... programCode
...... quantity
...... unitPrice
...... factor
...... net
...... udi
... total

doco Documentation for this format