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

## Example ClaimResponse: rtpbc-claim-response-price-source

Page standards status: Informative

Language: en

Profile: RTPBC Non-PHI Response Using ClaimResponse

identifier: rtpbc-response-price-source

status: Active

type: Pharmacy

use: Predetermination

patient: ?rref?

created: 2025-11-15 13:10:13-0500

insurer: ?rref?

request: Identifier: rtpbc-01

outcome: Processing Complete

disposition: Processed successfully

> item

> itemSequence: 1

> noteNumber: 1

> > adjudication

> > category: Full product cash price

> > ### Amounts

> > - | Value | Currency
> > * | 105 | United States dollar

> > adjudication

> > category: Coupon discount amount

> > ### Amounts

> > - | Value | Currency
> > * | -20 | United States dollar

> > adjudication

> > category: Total patient responsibility

> > ### Amounts

> > - | Value | Currency
> > * | 85 | United States dollar

> addItem

> RTPBC isAlternative Extension: true

> itemSequence: 1

> productOrService: fluoxetine 10 MG Oral Capsule [Prozac]

> quantity: 60 {Each}

> > adjudication

> > category: Full product cash price

> > ### Amounts

> > - | Value | Currency
> > * | 50 | United States dollar

> > adjudication

> > category: Coupon discount amount

> > ### Amounts

> > - | Value | Currency
> > * | -10 | United States dollar

> > adjudication

> > category: Total patient responsibility

> > ### Amounts

> > - | Value | Currency
> > * | 40 | United States dollar