# RTPBC benefitRestriction Extension - Consumer Real-Time Pharmacy Benefit Check FHIR IG v2.0.0-ballot

## Extension: RTPBC benefitRestriction Extension 

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](ValueSet-rtpbc-benefit-restriction.md) value set.

**Usage info**

**Usages:**

* Use this Extension: [RTPBC Non-PHI Response Using ClaimResponse](StructureDefinition-rtpbc-response-claimresponse-non-phi.md) and [RTPBC Response Using ClaimResponse](StructureDefinition-rtpbc-response-claimresponse.md)
* Examples for this Extension: [Bundle/rtpbc-bundle-response-01](Bundle-rtpbc-bundle-response-01.md), [ClaimResponse/rtpbc-claim-response-01](ClaimResponse-rtpbc-claim-response-01.md) and [ClaimResponse/rtpbc-claim-response-not-covered](ClaimResponse-rtpbc-claim-response-not-covered.md)

You can also check for [usages in the FHIR IG Statistics](https://packages2.fhir.org/xig/hl7.fhir.us.carin-rtpbc|current/StructureDefinition/rtpbc-benefitRestriction)

### Formal Views of Extension Content

 [Description Differentials, Snapshots, and other representations](http://build.fhir.org/ig/FHIR/ig-guidance/readingIgs.html#structure-definitions). 

 

Other representations of profile: [CSV](../StructureDefinition-rtpbc-benefitRestriction.csv), [Excel](../StructureDefinition-rtpbc-benefitRestriction.xlsx), [Schematron](../StructureDefinition-rtpbc-benefitRestriction.sch) 



## Resource Content

```json
{
  "resourceType" : "StructureDefinition",
  "id" : "rtpbc-benefitRestriction",
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "phx"
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
    "valueInteger" : 1
  },
  {
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
    "valueCode" : "trial-use",
    "_valueCode" : {
      "extension" : [{
        "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
        "valueCanonical" : "http://hl7.org/fhir/us/carin-rtpbc/ImplementationGuide/hl7.fhir.us.carin-rtpbc"
      }]
    }
  }],
  "url" : "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-benefitRestriction",
  "version" : "2.0.0-ballot",
  "name" : "RtpbcExtensionBenefitRestriction",
  "title" : "RTPBC benefitRestriction Extension",
  "status" : "active",
  "experimental" : false,
  "date" : "2020-05-23T00:00:00-05:00",
  "publisher" : "HL7 International / Pharmacy",
  "contact" : [{
    "name" : "HL7 International / Pharmacy",
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/medication"
    }]
  },
  {
    "name" : "Frank McKinney",
    "telecom" : [{
      "system" : "email",
      "value" : "fm@frankmckinney.com"
    }]
  }],
  "description" : "This extension conveys benefit restrictions that may apply to a prescription product and pharmacy combination.",
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "US",
      "display" : "United States of America"
    }]
  }],
  "fhirVersion" : "4.0.1",
  "mapping" : [{
    "identity" : "rim",
    "uri" : "http://hl7.org/v3",
    "name" : "RIM Mapping"
  }],
  "kind" : "complex-type",
  "abstract" : false,
  "context" : [{
    "type" : "element",
    "expression" : "ClaimResponse.item"
  },
  {
    "type" : "element",
    "expression" : "ClaimResponse.addItem"
  }],
  "type" : "Extension",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Extension",
  "derivation" : "constraint",
  "differential" : {
    "element" : [{
      "id" : "Extension",
      "path" : "Extension",
      "short" : "Benefit restriction.",
      "definition" : "Benefit restrictions that may apply to a prescription product and pharmacy combination."
    },
    {
      "id" : "Extension.extension",
      "path" : "Extension.extension",
      "max" : "0"
    },
    {
      "id" : "Extension.url",
      "path" : "Extension.url",
      "fixedUri" : "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-benefitRestriction"
    },
    {
      "id" : "Extension.value[x]",
      "path" : "Extension.value[x]",
      "min" : 1,
      "type" : [{
        "code" : "Coding"
      }],
      "binding" : {
        "strength" : "extensible",
        "valueSet" : "http://hl7.org/fhir/us/carin-rtpbc/ValueSet/rtpbc-benefit-restriction"
      }
    }]
  }
}

```
