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 Bundle: rtpbc-bundle-response-price-source

Language: en

Profile: RTPBC Response Bundle Non-PHI

Bundle rtpbc-bundle-response-price-source of type message

Entry 1 - fullUrl = http://example.org/my-app/MessageHeader/rtpbc-messageheader-response-price-source

Resource MessageHeader:

> Language: en

> Profile: RTPBC Non-PHI Response MessageHeader

> event: RTPBC Event Type Code System: rtpbc-response-non-phi (RTPBC Non-PHI Response)

> ### Sources

> - | Name
> * | GoodPricing

> ### Responses

> - | Identifier | Code
> * | rtpbc-messageheader-request-non-phi-1 | OK

> focus: ClaimResponse: identifier = rtpbc-response-price-source; status = active; type = Pharmacy; use = predetermination; created = 2025-11-15 13:10:13-0500; outcome = complete; disposition = Processed successfully

> definition: RTPBC Non-PHI Response Message Definition

Entry 2 - fullUrl = http://example.org/my-app/ClaimResponse/rtpbc-claim-response-price-source

Resource ClaimResponse:

> 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: complete

> disposition: Processed successfully

> > item

> > itemSequence: 1

> > noteNumber: 1

> > > adjudication

> > > category: Full product cash price

> > > ### Amounts

> > > - | Value | Currency
> > > * | 105 | USD

> > > adjudication

> > > category: Coupon discount amount

> > > ### Amounts

> > > - | Value | Currency
> > > * | -20 | USD

> > > adjudication

> > > category: Total patient responsibility

> > > ### Amounts

> > > - | Value | Currency
> > > * | 85 | USD

> > 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 | USD

> > > adjudication

> > > category: Coupon discount amount

> > > ### Amounts

> > > - | Value | Currency
> > > * | -10 | USD

> > > adjudication

> > > category: Total patient responsibility

> > > ### Amounts

> > > - | Value | Currency
> > > * | 40 | USD