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

: rtpbc-bundle-response-price-source

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:Bundle ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "rtpbc-bundle-response-price-source"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-bundle-non-phi"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-bundle-non-phi>     ] )
  ] ; # 
  fhir:language [ fhir:v "en"] ; # 
  fhir:type [ fhir:v "message"] ; # 
  fhir:timestamp [ fhir:v "2025-11-15T13:10:13-05:00"^^xsd:dateTime] ; # 
  fhir:entry ( [
fhir:fullUrl [
fhir:v "http://example.org/my-app/MessageHeader/rtpbc-messageheader-response-price-source"^^xsd:anyURI ;
fhir:l <http://example.org/my-app/MessageHeader/rtpbc-messageheader-response-price-source>     ] ;
    ( fhir:resource <http://example.org/my-app/MessageHeader/rtpbc-messageheader-response-price-source> )
  ] [
fhir:fullUrl [
fhir:v "http://example.org/my-app/ClaimResponse/rtpbc-claim-response-price-source"^^xsd:anyURI ;
fhir:l <http://example.org/my-app/ClaimResponse/rtpbc-claim-response-price-source>     ] ;
    ( fhir:resource <http://example.org/my-app/ClaimResponse/rtpbc-claim-response-price-source> )
  ] ) . # 

<http://example.org/my-app/MessageHeader/rtpbc-messageheader-response-price-source> a fhir:MessageHeader ;
  fhir:id [ fhir:v "rtpbc-messageheader-response-price-source"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-messageheader-non-phi"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-messageheader-non-phi>     ] )
  ] ; # 
  fhir:language [ fhir:v "en"] ; # 
  fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_rtpbc-messageheader-response-price-source\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader rtpbc-messageheader-response-price-source</b></p><a name=\"rtpbc-messageheader-response-price-source\"> </a><a name=\"hcrtpbc-messageheader-response-price-source\"> </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-response-messageheader-non-phi.html\">RTPBC Non-PHI Response MessageHeader</a></p></div><p><b>event</b>: <a href=\"CodeSystem-rtpbc-event-type.html#rtpbc-event-type-rtpbc-response-non-phi\">RTPBC Event Type Code System: rtpbc-response-non-phi</a> (RTPBC Non-PHI Response)</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>GoodPricing</td><td><a href=\"http://example.org/GoodPricing/fhir\">http://example.org/GoodPricing/fhir</a></td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Identifier</b></td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td>rtpbc-messageheader-request-non-phi-1</td><td>OK</td></tr></table><p><b>focus</b>: <a href=\"Bundle-rtpbc-bundle-response-price-source.html#http-//example.org/my-app/ClaimResponse/rtpbc-claim-response-price-source\">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</a></p><p><b>definition</b>: <a href=\"MessageDefinition-rtpbc-response-non-phi.html\">RTPBC Non-PHI Response Message Definition</a></p></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:event [
a fhir:Coding ;
fhir:system [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type>     ] ;
fhir:code [ fhir:v "rtpbc-response-non-phi" ] ;
fhir:display [ fhir:v "RTPBC Non-PHI Response" ]
  ] ; # 
  fhir:source [
fhir:name [ fhir:v "GoodPricing" ] ;
fhir:endpoint [
fhir:v "http://example.org/GoodPricing/fhir"^^xsd:anyURI ;
fhir:l <http://example.org/GoodPricing/fhir>     ]
  ] ; # 
  fhir:response [
fhir:identifier [ fhir:v "rtpbc-messageheader-request-non-phi-1" ] ;
fhir:code [ fhir:v "ok" ]
  ] ; # 
  fhir:focus ( [
fhir:l <http://example.org/my-app/ClaimResponse/rtpbc-claim-response-price-source> ;
fhir:reference [ fhir:v "http://example.org/my-app/ClaimResponse/rtpbc-claim-response-price-source" ]
  ] ) ; # 
  fhir:definition [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-response-non-phi"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-response-non-phi>
  ] . # 

<http://example.org/my-app/ClaimResponse/rtpbc-claim-response-price-source> a fhir:ClaimResponse ;
  fhir:id [ fhir:v "rtpbc-claim-response-price-source"] ; # 
  fhir:meta [
    ( fhir:profile [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-claimresponse-non-phi"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-claimresponse-non-phi>     ] )
  ] ; # 
  fhir:language [ fhir:v "en"] ; # 
  fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div [ fhir:v "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClaimResponse_rtpbc-claim-response-price-source\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse rtpbc-claim-response-price-source</b></p><a name=\"rtpbc-claim-response-price-source\"> </a><a name=\"hcrtpbc-claim-response-price-source\"> </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-response-claimresponse-non-phi.html\">RTPBC Non-PHI Response Using ClaimResponse</a></p></div><p><b>identifier</b>: rtpbc-response-price-source</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>: 2025-11-15 13:10:13-0500</p><p><b>insurer</b>: ?rref?</p><p><b>request</b>: Identifier: rtpbc-01</p><p><b>outcome</b>: Processing Complete</p><p><b>disposition</b>: Processed successfully</p><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 1</p><p><b>noteNumber</b>: 1</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary cash-price}\">Full product cash price</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>105</td><td>United States dollar</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary coupon-discount}\">Coupon discount amount</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>-20</td><td>United States dollar</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary total}\">Total patient responsibility</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>85</td><td>United States dollar</td></tr></table></blockquote></blockquote><blockquote><p><b>addItem</b></p><p><b>RTPBC isAlternative Extension</b>: true</p><p><b>itemSequence</b>: 1</p><p><b>productOrService</b>: <span title=\"Codes:{http://www.nlm.nih.gov/research/umls/rxnorm 205535}\">fluoxetine 10 MG Oral Capsule [Prozac]</span></p><p><b>quantity</b>: 60 {Each}</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary cash-price}\">Full product cash price</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>50</td><td>United States dollar</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary coupon-discount}\">Coupon discount amount</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>-10</td><td>United States dollar</td></tr></table></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:{http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary total}\">Total patient responsibility</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>40</td><td>United States dollar</td></tr></table></blockquote></blockquote></div>"^^rdf:XMLLiteral ]
  ] ; # 
  fhir:identifier ( [
fhir:value [ fhir:v "rtpbc-response-price-source" ]
  ] ) ; # 
  fhir:status [ fhir:v "active"] ; # 
  fhir:type [
    ( fhir:coding [
fhir:system [
fhir:v "http://terminology.hl7.org/CodeSystem/claim-type"^^xsd:anyURI ;
fhir:l <http://terminology.hl7.org/CodeSystem/claim-type>       ] ;
fhir:code [ fhir:v "pharmacy" ] ;
fhir:display [ fhir:v "Pharmacy" ]     ] )
  ] ; # 
  fhir:use [ fhir:v "predetermination"] ; # 
  fhir:patient [
    ( fhir:extension [
fhir:url [
fhir:v "http://hl7.org/fhir/StructureDefinition/data-absent-reason"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/StructureDefinition/data-absent-reason>       ] ;
fhir:value [
a fhir:Code ;
fhir:v "masked"       ]     ] )
  ] ; # 
  fhir:created [ fhir:v "2025-11-15T13:10:13-05:00"^^xsd:dateTime] ; # 
  fhir:insurer [
    ( fhir:extension [
fhir:url [
fhir:v "http://hl7.org/fhir/StructureDefinition/data-absent-reason"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/StructureDefinition/data-absent-reason>       ] ;
fhir:value [
a fhir:Code ;
fhir:v "masked"       ]     ] )
  ] ; # 
  fhir:request [
fhir:identifier [
fhir:value [ fhir:v "rtpbc-01" ]     ]
  ] ; # 
  fhir:outcome [ fhir:v "complete"] ; # 
  fhir:disposition [ fhir:v "Processed successfully"] ; # 
  fhir:item ( [
fhir:itemSequence [ fhir:v "1"^^xsd:positiveInteger ] ;
    ( fhir:noteNumber [ fhir:v "1"^^xsd:positiveInteger ] ) ;
    ( fhir:adjudication [
fhir:category [
        ( fhir:coding [
fhir:system [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary>           ] ;
fhir:code [ fhir:v "cash-price" ] ;
fhir:display [ fhir:v "Full product cash price" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "105"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary>           ] ;
fhir:code [ fhir:v "coupon-discount" ] ;
fhir:display [ fhir:v "Coupon discount amount" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "-20"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary>           ] ;
fhir:code [ fhir:v "total" ] ;
fhir:display [ fhir:v "Total patient responsibility" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "85"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]       ]     ] )
  ] ) ; # 
  fhir:addItem ( [
    ( fhir:extension [
fhir:url [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-isAlternative"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-isAlternative>       ] ;
fhir:value [
a fhir:Boolean ;
fhir:v true       ]     ] ) ;
    ( fhir:itemSequence [ fhir:v "1"^^xsd:positiveInteger ] ) ;
fhir:productOrService [
      ( fhir:coding [
fhir:system [
fhir:v "http://www.nlm.nih.gov/research/umls/rxnorm"^^xsd:anyURI ;
fhir:l <http://www.nlm.nih.gov/research/umls/rxnorm>         ] ;
fhir:code [ fhir:v "205535" ] ;
fhir:display [ fhir:v "fluoxetine 10 MG Oral Capsule [Prozac]" ]       ] )     ] ;
fhir:quantity [
fhir:value [ fhir:v "60"^^xsd:decimal ] ;
fhir:unit [ fhir:v "{Each}" ]     ] ;
    ( fhir:adjudication [
fhir:category [
        ( fhir:coding [
fhir:system [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary>           ] ;
fhir:code [ fhir:v "cash-price" ] ;
fhir:display [ fhir:v "Full product cash price" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "50"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary>           ] ;
fhir:code [ fhir:v "coupon-discount" ] ;
fhir:display [ fhir:v "Coupon discount amount" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "-10"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]       ]     ] [
fhir:category [
        ( fhir:coding [
fhir:system [
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary"^^xsd:anyURI ;
fhir:l <http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type-temporary>           ] ;
fhir:code [ fhir:v "total" ] ;
fhir:display [ fhir:v "Total patient responsibility" ]         ] )       ] ;
fhir:amount [
fhir:value [ fhir:v "40"^^xsd:decimal ] ;
fhir:currency [ fhir:v "USD" ]       ]     ] )
  ] ) . #