Consumer Real-Time Pharmacy Benefit Check FHIR IG
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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:

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

Sources

-Name
*GoodPricing

Responses

-IdentifierCode
*rtpbc-messageheader-request-non-phi-1OK

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:

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

-ValueCurrency
*105USD

adjudication

category: Coupon discount amount

Amounts

-ValueCurrency
*-20USD

adjudication

category: Total patient responsibility

Amounts

-ValueCurrency
*85USD

addItem

RTPBC isAlternative Extension: true

itemSequence: 1

productOrService: fluoxetine 10 MG Oral Capsule [Prozac]

quantity: 60 {Each}

adjudication

category: Full product cash price

Amounts

-ValueCurrency
*50USD

adjudication

category: Coupon discount amount

Amounts

-ValueCurrency
*-10USD

adjudication

category: Total patient responsibility

Amounts

-ValueCurrency
*40USD