{
  "resourceType" : "Bundle",
  "id" : "rtpbc-bundle-request-non-phi-2",
  "meta" : {
    "profile" : ["http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-bundle-non-phi"]
  },
  "language" : "en",
  "type" : "message",
  "timestamp" : "2025-11-15T13:10:13-05:00",
  "entry" : [{
    "fullUrl" : "http://example.org/my-app/MessageHeader/rtpbc-messageheader-request-non-phi-2",
    "resource" : {
      "resourceType" : "MessageHeader",
      "id" : "rtpbc-messageheader-request-non-phi-2",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-messageheader-non-phi"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_rtpbc-messageheader-request-non-phi-2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader rtpbc-messageheader-request-non-phi-2</b></p><a name=\"rtpbc-messageheader-request-non-phi-2\"> </a><a name=\"hcrtpbc-messageheader-request-non-phi-2\"> </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-non-phi.html\">RTPBC Non-PHI Request MessageHeader</a></p></div><p><b>event</b>: <a href=\"CodeSystem-rtpbc-event-type.html#rtpbc-event-type-rtpbc-request-non-phi\">RTPBC Event Type Code System: rtpbc-request-non-phi</a> (RTPBC Non-PHI 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=\"Bundle-rtpbc-bundle-request-non-phi-2.html#http-//example.org/my-app/Claim/rtpbc-claim-non-phi-2\">Claim: identifier = rtpbc-claim-non-phi-2; status = active; type = Pharmacy; use = predetermination; created = 2025-11-01 11:20:54-0500; priority = Normal</a></p><p><b>definition</b>: <a href=\"MessageDefinition-rtpbc-request-non-phi.html\">RTPBC Non-PHI Request Message Definition</a></p></div>"
      },
      "eventCoding" : {
        "system" : "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type",
        "code" : "rtpbc-request-non-phi",
        "display" : "RTPBC Non-PHI Request"
      },
      "source" : {
        "name" : "MyPatientApp",
        "endpoint" : "http://example.org/MyPatientApp"
      },
      "focus" : [{
        "reference" : "http://example.org/my-app/Claim/rtpbc-claim-non-phi-2"
      }],
      "definition" : "http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request-non-phi"
    }
  },
  {
    "fullUrl" : "http://example.org/my-app/Claim/rtpbc-claim-non-phi-2",
    "resource" : {
      "resourceType" : "Claim",
      "id" : "rtpbc-claim-non-phi-2",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-claim-non-phi"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_rtpbc-claim-non-phi-2\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim rtpbc-claim-non-phi-2</b></p><a name=\"rtpbc-claim-non-phi-2\"> </a><a name=\"hcrtpbc-claim-non-phi-2\"> </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-non-phi.html\">RTPBC Request Using Claim - Non-PHI</a></p></div><p><b>identifier</b>: rtpbc-claim-non-phi-2</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>: ?rref?</p><p><b>created</b>: 2025-11-01 11:20:54-0500</p><p><b>provider</b>: <a href=\"Organization-rtpbc-organization-01.html\">Organization Hometown Drug</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><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>false</td><td>?rref?</td></tr></table><h3>Items</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>ProductOrService</b></td><td><b>Quantity</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://www.nlm.nih.gov/research/umls/rxnorm 205535}\">Prozac 10mg Capsule</span></td><td>60 {Each}</td></tr></table></div>"
      },
      "identifier" : [{
        "value" : "rtpbc-claim-non-phi-2"
      }],
      "status" : "active",
      "type" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
          "code" : "pharmacy",
          "display" : "Pharmacy"
        }]
      },
      "use" : "predetermination",
      "patient" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
          "valueCode" : "masked"
        }]
      },
      "created" : "2025-11-01T11:20:54-05:00",
      "provider" : {
        "reference" : "Organization/rtpbc-organization-01"
      },
      "priority" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/processpriority",
          "code" : "normal",
          "display" : "Normal"
        }]
      },
      "insurance" : [{
        "sequence" : 1,
        "focal" : false,
        "coverage" : {
          "extension" : [{
            "url" : "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
            "valueCode" : "masked"
          }]
        }
      }],
      "item" : [{
        "sequence" : 1,
        "productOrService" : {
          "coding" : [{
            "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code" : "205535",
            "display" : "fluoxetine 10 MG Oral Capsule [Prozac]"
          }],
          "text" : "Prozac 10mg Capsule"
        },
        "quantity" : {
          "value" : 60,
          "unit" : "{Each}"
        }
      }]
    }
  },
  {
    "fullUrl" : "http://example.org/my-app/Organization/rtpbc-organization-01",
    "resource" : {
      "resourceType" : "Organization",
      "id" : "rtpbc-organization-01",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-pharmacy-organization"]
      },
      "language" : "en",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_rtpbc-organization-01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization rtpbc-organization-01</b></p><a name=\"rtpbc-organization-01\"> </a><a name=\"hcrtpbc-organization-01\"> </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>"
      },
      "identifier" : [{
        "system" : "http://hl7.org/fhir/sid/us-npi",
        "value" : "9876543213"
      }],
      "active" : true,
      "type" : [{
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/NCPDPPharmacyType",
          "code" : "R",
          "display" : "Retail"
        }]
      }],
      "name" : "Hometown Drug",
      "telecom" : [{
        "system" : "phone",
        "value" : "6081234567"
      }],
      "address" : [{
        "line" : ["900 9th Street"],
        "city" : "Madison",
        "state" : "WI",
        "postalCode" : "53535",
        "country" : "US"
      }]
    }
  }]
}