haau3 FHIR Implementation Guide (HFIG)
1.0.0 - ci-build
haau3 FHIR Implementation Guide (HFIG)
1.0.0 - ci-build
haau3 FHIR Implementation Guide (HFIG) - Local Development build (v1.0.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
{
"resourceType" : "Bundle",
"id" : "pharmacy-benefits-request-non-phi",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-bundle-non-phi|2.0.0-ballot"
]
},
"type" : "message",
"timestamp" : "2026-10-20T14:00:00Z",
"entry" : [
{
"fullUrl" : "https://app.example.test/fhir/MessageHeader/non-phi-request",
"resource" : {
"resourceType" : "MessageHeader",
"id" : "non-phi-request",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-messageheader-non-phi|2.0.0-ballot"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_non-phi-request\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader non-phi-request</b></p><a name=\"non-phi-request\"> </a><a name=\"hcnon-phi-request\"> </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: <code>http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-messageheader-non-phi|2.0.0-ballot</code></p></div><p><b>event</b>: rtpbc-event-type: rtpbc-request-non-phi (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>Example app</td><td><a href=\"https://app.example.test\">https://app.example.test</a></td></tr></table><p><b>focus</b>: <a href=\"Bundle-pharmacy-benefits-request-non-phi.html#https-//app.example.test/fhir/Claim/non-phi-claim\">Claim: identifier = price-check-0001; status = active; type = Pharmacy; use = predetermination; created = 2026-10-20 14:00:00+0000; priority = Normal</a></p><p><b>definition</b>: <code>http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request-non-phi</code></p></div>"
},
"eventCoding" : {
"system" : "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type",
"code" : "rtpbc-request-non-phi",
"display" : "RTPBC Non-PHI Request"
},
"source" : {
"name" : "Example app",
"endpoint" : "https://app.example.test"
},
"focus" : [
{
"reference" : "https://app.example.test/fhir/Claim/non-phi-claim"
}
],
"definition" : "http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request-non-phi"
}
},
{
"fullUrl" : "https://app.example.test/fhir/Claim/non-phi-claim",
"resource" : {
"resourceType" : "Claim",
"id" : "non-phi-claim",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-claim-non-phi|2.0.0-ballot"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_non-phi-claim\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim non-phi-claim</b></p><a name=\"non-phi-claim\"> </a><a name=\"hcnon-phi-claim\"> </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: <code>http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-claim-non-phi|2.0.0-ballot</code></p></div><p><b>identifier</b>: price-check-0001</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>: 2026-10-20 14:00:00+0000</p><p><b>provider</b>: ?rref?</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 311354}\">lisinopril 5 mg tablet</span></td><td>30 {Each}<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code{Each} = '{Each}')</span></td></tr></table></div>"
},
"identifier" : [
{
"value" : "price-check-0001"
}
],
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claim-type",
"code" : "pharmacy",
"display" : "Pharmacy"
}
]
},
"use" : "predetermination",
"patient" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
"valueCode" : "masked"
}
]
},
"created" : "2026-10-20T14:00:00Z",
"provider" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-preferredPharmacyPostalCode",
"valueString" : "33131"
}
]
},
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/processpriority",
"code" : "normal",
"display" : "Normal"
}
]
},
"insurance" : [
{
"sequence" : 1,
"focal" : false,
"coverage" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
"valueCode" : "masked"
}
]
}
}
],
"item" : [
{
"sequence" : 1,
"productOrService" : {
"coding" : [
{
"system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
"code" : "311354",
"display" : "lisinopril 5 MG Oral Tablet"
}
],
"text" : "lisinopril 5 mg tablet"
},
"quantity" : {
"value" : 30,
"unit" : "{Each}",
"system" : "http://unitsofmeasure.org",
"code" : "{Each}"
}
}
]
}
}
]
}