Consumer Real-Time Pharmacy Benefit Check FHIR IG
2.0.0-ballot - STU 2 Ballot

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-ballot 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: RTPBC Request MessageHeader

Official URL: http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-messageheader | Version: 2.0.0-ballot | Highlight text changes?
Standards status: Trial-use Active as of 2020-05-23 | Maturity Level: 2 | Computable Name: RtpbcRequestMessageHeader

This profile constrains a MessageHeader resource for use in a Real-time Pharmacy Benefit Check (RTPBC) request bundle

This profile constrains the MessageHeader resource for use in a real-time pharmacy benefit check (RTPBC) request bundle. ﻿ An example instance is included in this full request message example

Usages:

- Use this Profile: RTPBC Request Bundle

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MessageHeader |  | 0..* | MessageHeader | A resource that describes a message that is exchanged between systems
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for event[x] | Σ | 1..1 | Coding | Code for the event this message represents or link to event definition Slice: Unordered, Closed by type:$this Binding: MessageEvent (example): One of the message events defined as part of this version of FHIR.
event[x]:eventCoding | S Σ | 1..1 | Coding | Code for the event this message represents or link to event definition Binding: MessageEvent (example): One of the message events defined as part of this version of FHIR. Required Pattern: At least the following
source | Σ | 1..1 | BackboneElement | Message source application
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
endpoint | Σ | 1..1 | url | Actual message source address or id
Slices for focus | Σ | 1..* | Reference(Resource) | The actual content of the message Slice: Unordered, Open by profile:$this
focus:rtpbc-request | S Σ | 1..1 | Reference(Claim) {b} | The actual content of the message
definition | S Σ | 1..1 | canonical(MessageDefinition) | Link to the definition for this message Fixed Value: http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MessageHeader.event[x] | Base | example | MessageEvent | 📍4.0.1 | FHIR Std.
MessageHeader.event[x]:eventCoding | Base | example | MessageEvent | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MessageHeader | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MessageHeader | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MessageHeader | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MessageHeader |  | 0..* | MessageHeader | A resource that describes a message that is exchanged between systems
Slices for event[x] |  | 1..1 | Coding | Code for the event this message represents or link to event definition Slice: Unordered, Open by type:$this
event[x]:eventCoding | S | 1..1 | Coding | Code for the event this message represents or link to event definition Required Pattern: At least the following
Slices for focus |  | 1..* | Reference(Resource) | The actual content of the message Slice: Unordered, Open by profile:$this
focus:rtpbc-request | S | 1..1 | Reference(Claim) {b} | The actual content of the message
definition | S | 1..1 | canonical(MessageDefinition) | Link to the definition for this message Fixed Value: http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MessageHeader |  | 0..* | MessageHeader | A resource that describes a message that is exchanged between systems
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for event[x] | Σ | 1..1 | Coding | Code for the event this message represents or link to event definition Slice: Unordered, Closed by type:$this Binding: MessageEvent (example): One of the message events defined as part of this version of FHIR.
event[x]:eventCoding | S Σ | 1..1 | Coding | Code for the event this message represents or link to event definition Binding: MessageEvent (example): One of the message events defined as part of this version of FHIR. Required Pattern: At least the following
destination | Σ | 0..* | BackboneElement | Message destination application(s)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
name | Σ | 0..1 | string | Name of system
target | Σ | 0..1 | Reference(Device) | Particular delivery destination within the destination
endpoint | Σ | 1..1 | url | Actual destination address or id
receiver | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Intended "real-world" recipient for the data
sender | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Real world sender of the message
enterer | Σ | 0..1 | Reference(Practitioner | PractitionerRole) | The source of the data entry
author | Σ | 0..1 | Reference(Practitioner | PractitionerRole) | The source of the decision
source | Σ | 1..1 | BackboneElement | Message source application
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
name | Σ | 0..1 | string | Name of system
software | Σ | 0..1 | string | Name of software running the system
version | Σ | 0..1 | string | Version of software running
contact | Σ | 0..1 | ContactPoint | Human contact for problems
endpoint | Σ | 1..1 | url | Actual message source address or id
responsible | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Final responsibility for event
reason | Σ | 0..1 | CodeableConcept | Cause of event Binding: ExampleMessageReasonCodes (example): Reason for event occurrence.
response | Σ | 0..1 | BackboneElement | If this is a reply to prior message
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
identifier | Σ | 1..1 | id | Id of original message
code | Σ | 1..1 | code | ok | transient-error | fatal-error Binding: ResponseType (required): The kind of response to a message.
details | Σ | 0..1 | Reference(OperationOutcome) | Specific list of hints/warnings/errors
Slices for focus | Σ | 1..* | Reference(Resource) | The actual content of the message Slice: Unordered, Open by profile:$this
focus:rtpbc-request | S Σ | 1..1 | Reference(Claim) {b} | The actual content of the message
definition | S Σ | 1..1 | canonical(MessageDefinition) | Link to the definition for this message Fixed Value: http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MessageHeader.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MessageHeader.event[x] | Base | example | MessageEvent | 📍4.0.1 | FHIR Std.
MessageHeader.event[x]:eventCoding | Base | example | MessageEvent | 📍4.0.1 | FHIR Std.
MessageHeader.reason | Base | example | Example Message Reason Codes | 📍4.0.1 | FHIR Std.
MessageHeader.response.​code | Base | required | ResponseType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MessageHeader | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MessageHeader | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MessageHeader | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Summary

Mandatory: 4 elements
Must-Support: 3 elements
Fixed: 1 element

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MessageHeader.event[x]
- The element 1 is sliced based on the value of MessageHeader.focus

Maturity: 2

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MessageHeader |  | 0..* | MessageHeader | A resource that describes a message that is exchanged between systems
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for event[x] | Σ | 1..1 | Coding | Code for the event this message represents or link to event definition Slice: Unordered, Closed by type:$this Binding: MessageEvent (example): One of the message events defined as part of this version of FHIR.
event[x]:eventCoding | S Σ | 1..1 | Coding | Code for the event this message represents or link to event definition Binding: MessageEvent (example): One of the message events defined as part of this version of FHIR. Required Pattern: At least the following
source | Σ | 1..1 | BackboneElement | Message source application
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
endpoint | Σ | 1..1 | url | Actual message source address or id
Slices for focus | Σ | 1..* | Reference(Resource) | The actual content of the message Slice: Unordered, Open by profile:$this
focus:rtpbc-request | S Σ | 1..1 | Reference(Claim) {b} | The actual content of the message
definition | S Σ | 1..1 | canonical(MessageDefinition) | Link to the definition for this message Fixed Value: http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MessageHeader.event[x] | Base | example | MessageEvent | 📍4.0.1 | FHIR Std.
MessageHeader.event[x]:eventCoding | Base | example | MessageEvent | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MessageHeader | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MessageHeader | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MessageHeader | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MessageHeader |  | 0..* | MessageHeader | A resource that describes a message that is exchanged between systems
Slices for event[x] |  | 1..1 | Coding | Code for the event this message represents or link to event definition Slice: Unordered, Open by type:$this
event[x]:eventCoding | S | 1..1 | Coding | Code for the event this message represents or link to event definition Required Pattern: At least the following
Slices for focus |  | 1..* | Reference(Resource) | The actual content of the message Slice: Unordered, Open by profile:$this
focus:rtpbc-request | S | 1..1 | Reference(Claim) {b} | The actual content of the message
definition | S | 1..1 | canonical(MessageDefinition) | Link to the definition for this message Fixed Value: http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request
Documentation for this format

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MessageHeader |  | 0..* | MessageHeader | A resource that describes a message that is exchanged between systems
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
Slices for event[x] | Σ | 1..1 | Coding | Code for the event this message represents or link to event definition Slice: Unordered, Closed by type:$this Binding: MessageEvent (example): One of the message events defined as part of this version of FHIR.
event[x]:eventCoding | S Σ | 1..1 | Coding | Code for the event this message represents or link to event definition Binding: MessageEvent (example): One of the message events defined as part of this version of FHIR. Required Pattern: At least the following
destination | Σ | 0..* | BackboneElement | Message destination application(s)
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
name | Σ | 0..1 | string | Name of system
target | Σ | 0..1 | Reference(Device) | Particular delivery destination within the destination
endpoint | Σ | 1..1 | url | Actual destination address or id
receiver | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Intended "real-world" recipient for the data
sender | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Real world sender of the message
enterer | Σ | 0..1 | Reference(Practitioner | PractitionerRole) | The source of the data entry
author | Σ | 0..1 | Reference(Practitioner | PractitionerRole) | The source of the decision
source | Σ | 1..1 | BackboneElement | Message source application
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
name | Σ | 0..1 | string | Name of system
software | Σ | 0..1 | string | Name of software running the system
version | Σ | 0..1 | string | Version of software running
contact | Σ | 0..1 | ContactPoint | Human contact for problems
endpoint | Σ | 1..1 | url | Actual message source address or id
responsible | Σ | 0..1 | Reference(Practitioner | PractitionerRole | Organization) | Final responsibility for event
reason | Σ | 0..1 | CodeableConcept | Cause of event Binding: ExampleMessageReasonCodes (example): Reason for event occurrence.
response | Σ | 0..1 | BackboneElement | If this is a reply to prior message
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
identifier | Σ | 1..1 | id | Id of original message
code | Σ | 1..1 | code | ok | transient-error | fatal-error Binding: ResponseType (required): The kind of response to a message.
details | Σ | 0..1 | Reference(OperationOutcome) | Specific list of hints/warnings/errors
Slices for focus | Σ | 1..* | Reference(Resource) | The actual content of the message Slice: Unordered, Open by profile:$this
focus:rtpbc-request | S Σ | 1..1 | Reference(Claim) {b} | The actual content of the message
definition | S Σ | 1..1 | canonical(MessageDefinition) | Link to the definition for this message Fixed Value: http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MessageHeader.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MessageHeader.event[x] | Base | example | MessageEvent | 📍4.0.1 | FHIR Std.
MessageHeader.event[x]:eventCoding | Base | example | MessageEvent | 📍4.0.1 | FHIR Std.
MessageHeader.reason | Base | example | Example Message Reason Codes | 📍4.0.1 | FHIR Std.
MessageHeader.response.​code | Base | required | ResponseType | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MessageHeader | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MessageHeader | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MessageHeader | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MessageHeader | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Summary

Mandatory: 4 elements
Must-Support: 3 elements
Fixed: 1 element

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MessageHeader.event[x]
- The element 1 is sliced based on the value of MessageHeader.focus

Maturity: 2

Other representations of profile: CSV, Excel, Schematron