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: RtpbcResponseClaimResponse - Mappings

Page standards status: Trial-use Maturity Level: 4

Mappings for the rtpbc-response-claimresponse 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
.. ClaimResponse
Event
  • Entity. Role
  • or Act
... id
... meta
... implicitRules
... language
... text
Act.text?
... contained
N/A
... extension
N/A
... modifierExtension
N/A
... identifier
Event.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
Event.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
FiveWs.subject
... created
Event.occurrence[x]
FiveWs.recorded
... insurer
Event.performer
.... id
n/a
.... extension
n/a
.... reference
N/A
.... type
N/A
.... identifier
.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
.... display
N/A
... requestor
FiveWs.source
... request
Event.basedOn
FiveWs.why[x]
.... id
n/a
.... extension
n/a
.... reference
N/A
.... type
N/A
.... identifier
.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
.... display
N/A
... outcome
... disposition
Event.note
... preAuthRef
... preAuthPeriod
... payeeType
... item
.... id
n/a
.... Slices for extension
..... extension:benefitRestriction
.... modifierExtension
N/A
.... itemSequence
.... noteNumber
.... adjudication
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... category
..... reason
..... amount
...... id
n/a
...... extension
n/a
...... value
...... currency
..... value
.... detail
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... detailSequence
..... noteNumber
..... adjudication
..... subDetail
...... id
n/a
...... extension
n/a
...... modifierExtension
N/A
...... subDetailSequence
...... noteNumber
...... adjudication
... addItem
.... id
n/a
.... Slices for extension
..... extension:isAlternative
..... extension:benefitRestriction
.... modifierExtension
N/A
.... itemSequence
.... detailSequence
.... subdetailSequence
.... provider
FiveWs.source
..... id
n/a
..... extension
n/a
..... reference
N/A
..... type
N/A
..... identifier
.identifier
..... display
N/A
.... 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
  • 24.C
  • 24.D mods
.... programCode
24.H
.... serviced[x]
FiveWs.done[x]
24.A
.... location[x]
FiveWs.where[x]
24.B
.... quantity
24.G
..... 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
24.F
.... bodySite
.... subSite
.... noteNumber
.... adjudication
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... category
..... reason
..... amount
...... id
n/a
...... extension
n/a
...... value
...... currency
..... value
.... detail
..... id
n/a
..... extension
n/a
..... modifierExtension
N/A
..... productOrService
..... modifier
  • 24.C
  • 24.D mods
..... quantity
24.G
..... unitPrice
..... factor
..... net
24.F
..... noteNumber
..... adjudication
..... subDetail
...... id
n/a
...... extension
n/a
...... modifierExtension
N/A
...... productOrService
...... modifier
  • 24.C
  • 24.D mods
...... quantity
24.G
...... unitPrice
...... factor
...... net
24.F
...... noteNumber
...... adjudication
... adjudication
... total
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... category
.... amount
... payment
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... type
.... adjustment
.... adjustmentReason
.... date
.... amount
.... identifier
... fundsReserve
... formCode
... form
... processNote
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... number
.... type
.... text
.... language
... communicationRequest
... insurance
Coverage
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... sequence
.... focal
.... coverage
.... businessArrangement
.... claimResponse
... error
.... id
n/a
.... extension
n/a
.... modifierExtension
N/A
.... itemSequence
.... detailSequence
.... subDetailSequence
.... code
..... 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

doco Documentation for this format