# rtpbc-bundle-response-discount-card - Consumer Real-Time Pharmacy Benefit Check FHIR IG v2.0.0-ballot

## Example Bundle: rtpbc-bundle-response-discount-card



## Resource Content

```json
{
  "resourceType" : "Bundle",
  "id" : "rtpbc-bundle-response-discount-card",
  "meta" : {
    "profile" : ["http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-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-response-discount-card",
    "resource" : {
      "resourceType" : "MessageHeader",
      "id" : "rtpbc-messageheader-response-discount-card",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-messageheader-non-phi"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_rtpbc-messageheader-response-discount-card\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader rtpbc-messageheader-response-discount-card</b></p><a name=\"rtpbc-messageheader-response-discount-card\"> </a><a name=\"hcrtpbc-messageheader-response-discount-card\"> </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-response-messageheader-non-phi.html\">RTPBC Non-PHI Response MessageHeader</a></p></div><p><b>event</b>: <a href=\"CodeSystem-rtpbc-event-type.html#rtpbc-event-type-rtpbc-response-non-phi\">RTPBC Event Type Code System: rtpbc-response-non-phi</a> (RTPBC Non-PHI Response)</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>GoodPricing</td><td><a href=\"http://example.org/GoodPricing/fhir\">http://example.org/GoodPricing/fhir</a></td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Identifier</b></td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td>rtpbc-messageheader-request-non-phi-1</td><td>OK</td></tr></table><p><b>focus</b>: <a href=\"Bundle-rtpbc-bundle-response-discount-card.html#http-//example.org/my-app/ClaimResponse/rtpbc-claim-response-discount-card\">ClaimResponse: identifier = rtpbc-03-response-discount-card; status = active; type = Pharmacy; use = predetermination; created = 2025-11-15 13:10:13-0500; outcome = complete; disposition = Processed successfully</a></p><p><b>definition</b>: <a href=\"MessageDefinition-rtpbc-response-non-phi.html\">RTPBC Non-PHI Response Message Definition</a></p></div>"
      },
      "eventCoding" : {
        "system" : "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type",
        "code" : "rtpbc-response-non-phi",
        "display" : "RTPBC Non-PHI Response"
      },
      "source" : {
        "name" : "GoodPricing",
        "endpoint" : "http://example.org/GoodPricing/fhir"
      },
      "response" : {
        "identifier" : "rtpbc-messageheader-request-non-phi-1",
        "code" : "ok"
      },
      "focus" : [{
        "reference" : "http://example.org/my-app/ClaimResponse/rtpbc-claim-response-discount-card"
      }],
      "definition" : "http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-response-non-phi"
    }
  },
  {
    "fullUrl" : "http://example.org/my-app/ClaimResponse/rtpbc-claim-response-discount-card",
    "resource" : {
      "resourceType" : "ClaimResponse",
      "id" : "rtpbc-claim-response-discount-card",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-claimresponse-non-phi"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClaimResponse_rtpbc-claim-response-discount-card\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse rtpbc-claim-response-discount-card</b></p><a name=\"rtpbc-claim-response-discount-card\"> </a><a name=\"hcrtpbc-claim-response-discount-card\"> </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-response-claimresponse-non-phi.html\">RTPBC Non-PHI Response Using ClaimResponse</a></p></div><p><b>identifier</b>: rtpbc-03-response-discount-card</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>: 2025-11-15 13:10:13-0500</p><p><b>insurer</b>: ?rref?</p><p><b>request</b>: Identifier: rtpbc-01</p><p><b>outcome</b>: Processing Complete</p><p><b>disposition</b>: Processed successfully</p><blockquote><p><b>item</b></p><p><b>RTPBC relatedCoverage Extension</b>: <a href=\"Coverage-rtpbc-coverage-non-phi-01.html\">Coverage: status = active; subscriberId = ; relationship = Self</a></p><p><b>itemSequence</b>: 1</p><p><b>noteNumber</b>: 1</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary cash-price}\">Full product cash price</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>105</td><td>United States dollar</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary coupon-discount}\">Coupon discount amount</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>-20</td><td>United States dollar</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary total}\">Total patient responsibility</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>85</td><td>United States dollar</td></tr></table></blockquote></blockquote><blockquote><p><b>addItem</b></p><p><b>RTPBC isAlternative Extension</b>: true</p><p><b>RTPBC relatedCoverage Extension</b>: <a href=\"Coverage-rtpbc-coverage-non-phi-01.html\">Coverage: status = active; subscriberId = ; relationship = Self</a></p><p><b>itemSequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://www.nlm.nih.gov/research/umls/rxnorm 205535}\">fluoxetine 10 MG Oral Capsule [Prozac]</span></p><p><b>quantity</b>: 60 {Each}</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary cash-price}\">Full product cash price</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>50</td><td>United States dollar</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary coupon-discount}\">Coupon discount amount</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>-10</td><td>United States dollar</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary total}\">Total patient responsibility</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>40</td><td>United States dollar</td></tr></table></blockquote></blockquote></div>"
      },
      "identifier" : [{
        "value" : "rtpbc-03-response-discount-card"
      }],
      "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" : "2025-11-15T13:10:13-05:00",
      "insurer" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
          "valueCode" : "masked"
        }]
      },
      "request" : {
        "identifier" : {
          "value" : "rtpbc-01"
        }
      },
      "outcome" : "complete",
      "disposition" : "Processed successfully",
      "item" : [{
        "extension" : [{
          "url" : "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-relatedCoverage",
          "valueReference" : {
            "reference" : "Coverage/rtpbc-coverage-non-phi-01"
          }
        }],
        "itemSequence" : 1,
        "noteNumber" : [1],
        "adjudication" : [{
          "category" : {
            "coding" : [{
              "system" : "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary",
              "code" : "cash-price",
              "display" : "Full product cash price"
            }]
          },
          "amount" : {
            "value" : 105,
            "currency" : "USD"
          }
        },
        {
          "category" : {
            "coding" : [{
              "system" : "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary",
              "code" : "coupon-discount",
              "display" : "Coupon discount amount"
            }]
          },
          "amount" : {
            "value" : -20,
            "currency" : "USD"
          }
        },
        {
          "category" : {
            "coding" : [{
              "system" : "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary",
              "code" : "total",
              "display" : "Total patient responsibility"
            }]
          },
          "amount" : {
            "value" : 85,
            "currency" : "USD"
          }
        }]
      }],
      "addItem" : [{
        "extension" : [{
          "url" : "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-isAlternative",
          "valueBoolean" : true
        },
        {
          "url" : "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-relatedCoverage",
          "valueReference" : {
            "reference" : "Coverage/rtpbc-coverage-non-phi-01"
          }
        }],
        "itemSequence" : [1],
        "productOrService" : {
          "coding" : [{
            "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code" : "205535",
            "display" : "fluoxetine 10 MG Oral Capsule [Prozac]"
          }]
        },
        "quantity" : {
          "value" : 60,
          "unit" : "{Each}"
        },
        "adjudication" : [{
          "category" : {
            "coding" : [{
              "system" : "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary",
              "code" : "cash-price",
              "display" : "Full product cash price"
            }]
          },
          "amount" : {
            "value" : 50,
            "currency" : "USD"
          }
        },
        {
          "category" : {
            "coding" : [{
              "system" : "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary",
              "code" : "coupon-discount",
              "display" : "Coupon discount amount"
            }]
          },
          "amount" : {
            "value" : -10,
            "currency" : "USD"
          }
        },
        {
          "category" : {
            "coding" : [{
              "system" : "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary",
              "code" : "total",
              "display" : "Total patient responsibility"
            }]
          },
          "amount" : {
            "value" : 40,
            "currency" : "USD"
          }
        }]
      }]
    }
  },
  {
    "fullUrl" : "http://example.org/my-app/Coverage/rtpbc-coverage-non-phi-01",
    "resource" : {
      "resourceType" : "Coverage",
      "id" : "rtpbc-coverage-non-phi-01",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-coverage-non-phi"]
      },
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_rtpbc-coverage-non-phi-01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage rtpbc-coverage-non-phi-01</b></p><a name=\"rtpbc-coverage-non-phi-01\"> </a><a name=\"hcrtpbc-coverage-non-phi-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-coverage-non-phi.html\">RTPBC Coverage - Non-PHI</a></p></div><p><b>status</b>: Active</p><p><b>subscriberId</b>: Absent because : masked</p><p><b>beneficiary</b>: ?rref?</p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>payor</b>: Identifier: Med Discounts</p><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class rxbin}\">RX BIN</span></p><p><b>value</b>: BIN001</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class rxpcn}\">RX PCN</span></p><p><b>value</b>: PCN002</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class rxgroup}\">RX Group</span></p><p><b>value</b>: GROUP0001</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class rxid}\">RX Id</span></p><p><b>value</b>: MEMBER000001</p></blockquote></div>"
      },
      "status" : "active",
      "_subscriberId" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
          "valueCode" : "masked"
        }]
      },
      "beneficiary" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
          "valueCode" : "masked"
        }]
      },
      "relationship" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
          "code" : "self"
        }]
      },
      "payor" : [{
        "identifier" : {
          "value" : "Med Discounts"
        }
      }],
      "class" : [{
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "rxbin"
          }]
        },
        "value" : "BIN001"
      },
      {
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "rxpcn"
          }]
        },
        "value" : "PCN002"
      },
      {
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "rxgroup"
          }]
        },
        "value" : "GROUP0001"
      },
      {
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
            "code" : "rxid"
          }]
        },
        "value" : "MEMBER000001"
      }]
    }
  }]
}

```
