Example non-PHI RTPBC request

No personally-identifiable information is contained in this example. This profile is used when requesting information from RTPBC responders that do not require patient information to return the desired information--such as cash price data sources. Note the following data population:

• the bundle does not contain Patient, MedicationRequest, Practitioner or Coverage resources
• medication details are specified in the Claim resource
• a preferred pharmacy ZIP code is given (in an extension within the Claim.provider element) rather than a specific pharmacy
• the Claim contains a 'masked' Data Absent Reason for the patient element and insurance.coverage element, and careTeam is not populated

Example data content

to be added...

Bundle rtpbc-bundle-request-non-phi-1 of type message

Entry 1 - fullUrl = http://example.org/my-app/MessageHeader/rtpbc-messageheader-request-non-phi-1

Resource MessageHeader:

Language: en

Profile: RTPBC Non-PHI Request MessageHeader

event: RTPBC Event Type Code System: rtpbc-request-non-phi (RTPBC Non-PHI Request)

Sources

-	Name
*	MyPatientApp

focus: Claim: identifier = rtpbc-non-phi-1; status = active; type = Pharmacy; use = predetermination; created = 2025-11-01 11:20:54-0500; priority = Normal

definition: RTPBC Non-PHI Request Message Definition

Entry 2 - fullUrl = http://example.org/my-app/Claim/rtpbc-claim-non-phi-1

Resource Claim:

Language: en

Profile: RTPBC Request Using Claim - Non-PHI

identifier: rtpbc-non-phi-1

status: Active

type: Pharmacy

use: Predetermination

patient: ?rref?

created: 2025-11-01 11:20:54-0500

provider: Pharmacies in ZIP Code 55401 (Preferred pharmacy postal code: 55401)

priority: Normal

Insurances

-	Sequence	Focal	Coverage
*	1	false	?rref?

Items

-	Sequence	ProductOrService	Quantity
*	1	Prozac 10mg Capsule	60 {Each}