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

## : rtpbc-bundle-request-non-phi-1

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    <Bundle xmlns="http://hl7.org/fhir">
      <id value="rtpbc-bundle-request-non-phi-1"/>
      <meta>
        <profile
                 value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-bundle-non-phi"/>
      </meta>
      <language value="en"/>
      <type value="message"/>
      <timestamp value="2025-11-15T13:10:13-05:00"/>
      <entry>
        <fullUrl
                 value="http://example.org/my-app/MessageHeader/rtpbc-messageheader-request-non-phi-1"/>
        <resource>
          <MessageHeader>
            <id value="rtpbc-messageheader-request-non-phi-1"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-messageheader-non-phi"/>
            </meta>
            <language value="en"/>
            <text>
              <status value="generated"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="MessageHeader_rtpbc-messageheader-request-non-phi-1"> </a><p class="res-header-id"><b>Generated Narrative: MessageHeader rtpbc-messageheader-request-non-phi-1</b></p><a name="rtpbc-messageheader-request-non-phi-1"> </a><a name="hcrtpbc-messageheader-request-non-phi-1"> </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-request-messageheader-non-phi.html">RTPBC Non-PHI Request MessageHeader</a></p></div><p><b>event</b>: <a href="CodeSystem-rtpbc-event-type.html#rtpbc-event-type-rtpbc-request-non-phi">RTPBC Event Type Code System: rtpbc-request-non-phi</a> (RTPBC Non-PHI Request)</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>MyPatientApp</td><td><a href="http://example.org/MyPatientApp">http://example.org/MyPatientApp</a></td></tr></table><p><b>focus</b>: <a href="Bundle-rtpbc-bundle-request-non-phi-1.html#http-//example.org/my-app/Claim/rtpbc-claim-non-phi-1">Claim: identifier = rtpbc-non-phi-1; status = active; type = Pharmacy; use = predetermination; created = 2025-11-01 11:20:54-0500; priority = Normal</a></p><p><b>definition</b>: <a href="MessageDefinition-rtpbc-request-non-phi.html">RTPBC Non-PHI Request Message Definition</a></p></div>
            </text>
            <eventCoding>
              <system
                      value="http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type"/>
              <code value="rtpbc-request-non-phi"/>
              <display value="RTPBC Non-PHI Request"/>
            </eventCoding>
            <source>
              <name value="MyPatientApp"/>
              <endpoint value="http://example.org/MyPatientApp"/>
            </source>
            <focus>
              <reference
                         value="http://example.org/my-app/Claim/rtpbc-claim-non-phi-1"/>
            </focus>
            <definition
                        value="http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request-non-phi"/>
          </MessageHeader>
        </resource>
      </entry>
      <entry>
        <fullUrl value="http://example.org/my-app/Claim/rtpbc-claim-non-phi-1"/>
        <resource>
          <Claim>
            <id value="rtpbc-claim-non-phi-1"/>
            <meta>
              <profile
                       value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-claim-non-phi"/>
            </meta>
            <language value="en"/>
            <text>
              <status value="extensions"/>
              <div xmlns="http://www.w3.org/1999/xhtml"><a name="Claim_rtpbc-claim-non-phi-1"> </a><p class="res-header-id"><b>Generated Narrative: Claim rtpbc-claim-non-phi-1</b></p><a name="rtpbc-claim-non-phi-1"> </a><a name="hcrtpbc-claim-non-phi-1"> </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-request-claim-non-phi.html">RTPBC Request Using Claim - Non-PHI</a></p></div><p><b>identifier</b>: rtpbc-non-phi-1</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>: 2025-11-01 11:20:54-0500</p><p><b>provider</b>: Pharmacies in ZIP Code 55401 (Preferred pharmacy postal code: 55401)</p><p><b>priority</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}">Normal</span></p><h3>Insurances</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style="display: none">*</td><td>1</td><td>false</td><td>?rref?</td></tr></table><h3>Items</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Sequence</b></td><td><b>ProductOrService</b></td><td><b>Quantity</b></td></tr><tr><td style="display: none">*</td><td>1</td><td><span title="Codes:{http://www.nlm.nih.gov/research/umls/rxnorm 205535}">Prozac 10mg Capsule</span></td><td>60 {Each}</td></tr></table></div>
            </text>
            <identifier>
              <value value="rtpbc-non-phi-1"/>
            </identifier>
            <status value="active"/>
            <type>
              <coding>
                <system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
                <code value="pharmacy"/>
                <display value="Pharmacy"/>
              </coding>
            </type>
            <use value="predetermination"/>
            <patient>
              <extension
                         url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
                <valueCode value="masked"/>
              </extension>
            </patient>
            <created value="2025-11-01T11:20:54-05:00"/>
            <provider>
              <extension
                         url="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-preferredPharmacyPostalCode">
                <valueString value="55401"/>
              </extension>
              <display value="Pharmacies in ZIP Code 55401"/>
            </provider>
            <priority>
              <coding>
                <system
                        value="http://terminology.hl7.org/CodeSystem/processpriority"/>
                <code value="normal"/>
                <display value="Normal"/>
              </coding>
            </priority>
            <insurance>
              <sequence value="1"/>
              <focal value="false"/>
              <coverage>
                <extension
                           url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
                  <valueCode value="masked"/>
                </extension>
              </coverage>
            </insurance>
            <item>
              <sequence value="1"/>
              <productOrService>
                <coding>
                  <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
                  <code value="205535"/>
                  <display value="fluoxetine 10 MG Oral Capsule [Prozac]"/>
                </coding>
                <text value="Prozac 10mg Capsule"/>
              </productOrService>
              <quantity>
                <value value="60"/>
                <unit value="{Each}"/>
              </quantity>
            </item>
          </Claim>
        </resource>
      </entry>
    </Bundle>