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
<Bundle xmlns="http://hl7.org/fhir">
<id value="pharmacy-benefits-request-non-phi"/>
<meta>
<profile
value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-bundle-non-phi|2.0.0-ballot"/>
</meta>
<type value="message"/>
<timestamp value="2026-10-20T14:00:00Z"/>
<entry>
<fullUrl
value="https://app.example.test/fhir/MessageHeader/non-phi-request"/>
<resource>
<MessageHeader>
<id value="non-phi-request"/>
<meta>
<profile
value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-messageheader-non-phi|2.0.0-ballot"/>
</meta>
<text>
<status value="generated"/>
<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>
</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="Example app"/>
<endpoint value="https://app.example.test"/>
</source>
<focus>
<reference
value="https://app.example.test/fhir/Claim/non-phi-claim"/>
</focus>
<definition
value="http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request-non-phi"/>
</MessageHeader>
</resource>
</entry>
<entry>
<fullUrl value="https://app.example.test/fhir/Claim/non-phi-claim"/>
<resource>
<Claim>
<id value="non-phi-claim"/>
<meta>
<profile
value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-claim-non-phi|2.0.0-ballot"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<value value="price-check-0001"/>
</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="2026-10-20T14:00:00Z"/>
<provider>
<extension
url="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-preferredPharmacyPostalCode">
<valueString value="33131"/>
</extension>
</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="311354"/>
<display value="lisinopril 5 MG Oral Tablet"/>
</coding>
<text value="lisinopril 5 mg tablet"/>
</productOrService>
<quantity>
<value value="30"/>
<unit value="{Each}"/>
<system value="http://unitsofmeasure.org"/>
<code value="{Each}"/>
</quantity>
</item>
</Claim>
</resource>
</entry>
</Bundle>