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

## Extension: RTPBC relatedCoverage Extension

Official URL: http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-relatedCoverage | Version: 2.0.0-ballot | Highlight text changes?
Standards status: Trial-use Active as of 2026-02-17 | Maturity Level: 1 | Computable Name: RtpbcExtensionRelatedCoverage

This extension conveys the coverage associated with an RTPBC Response item or addItem

Context of Use

This extension may be used on the following element(s)

- Element ID: `ClaimResponse.item`
- Element ID: `ClaimResponse.addItem`

This extension provides coverage information related to an RTPBC response entry conveyed in a Claim.item or Claim.addItem element. It's content is a reference to a Coverage resource which might, for example, contain identifiers needed to adjudicate a discount card.

Usage info

Usages:

- Use this Extension: RTPBC Non-PHI Response Using ClaimResponse and RTPBC Response Using ClaimResponse
- Examples for this Extension: Bundle/rtpbc-bundle-response-discount-card and ClaimResponse/rtpbc-claim-response-discount-card

You can also check for usages in the FHIR IG Statistics

### Formal Views of Extension Content

Description Differentials, Snapshots, and other representations.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Related Coverage.
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-relatedCoverage"
value[x] |  | 1..1 | Reference(RTPBC Coverage | RTPBC Coverage - Non-PHI) | Value of extension
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Related Coverage.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-relatedCoverage"
value[x] |  | 1..1 | Reference(RTPBC Coverage | RTPBC Coverage - Non-PHI) | Value of extension
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Description | Expression
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

Simple Extension with the type Reference: This extension conveys the coverage associated with an RTPBC Response item or addItem

Maturity: 1

Differential ViewDifferential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Related Coverage.
extension |  | 0..0 |  | Extension
url |  | 1..1 | uri | "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-relatedCoverage"
value[x] |  | 1..1 | Reference(RTPBC Coverage | RTPBC Coverage - Non-PHI) | Value of extension
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
Extension |  | 0..* | Extension | Related Coverage.
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..0 |  | Extension Slice: Unordered, Open by value:url
url |  | 1..1 | uri | "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-relatedCoverage"
value[x] |  | 1..1 | Reference(RTPBC Coverage | RTPBC Coverage - Non-PHI) | Value of extension
Documentation for this format

#### Constraints

Id | Grade | Path(s) | Description | Expression
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

Simple Extension with the type Reference: This extension conveys the coverage associated with an RTPBC Response item or addItem

Maturity: 1

Other representations of profile: CSV, Excel, Schematron