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-phi",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-bundle|2.0.0-ballot"
]
},
"type" : "message",
"timestamp" : "2026-10-20T14:00:00Z",
"entry" : [
{
"fullUrl" : "https://app.example.test/fhir/MessageHeader/phi-request",
"resource" : {
"resourceType" : "MessageHeader",
"id" : "phi-request",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-messageheader|2.0.0-ballot"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_phi-request\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader phi-request</b></p><a name=\"phi-request\"> </a><a name=\"hcphi-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|2.0.0-ballot</code></p></div><p><b>event</b>: rtpbc-event-type: rtpbc-request (RTPBC 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-phi.html#Claim_phi-claim\">Claim: identifier = benefit-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</code></p></div>"
},
"eventCoding" : {
"system" : "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type",
"code" : "rtpbc-request",
"display" : "RTPBC Request"
},
"source" : {
"name" : "Example app",
"endpoint" : "https://app.example.test"
},
"focus" : [
{
"reference" : "Claim/phi-claim"
}
],
"definition" : "http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request"
}
},
{
"fullUrl" : "https://app.example.test/fhir/Claim/phi-claim",
"resource" : {
"resourceType" : "Claim",
"id" : "phi-claim",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-claim|2.0.0-ballot"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_phi-claim\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim phi-claim</b></p><a name=\"phi-claim\"> </a><a name=\"hcphi-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|2.0.0-ballot</code></p></div><p><b>identifier</b>: benefit-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>: <a href=\"Bundle-pharmacy-benefits-request-phi.html#Patient_phi-patient\">Mei Lin Female, DoB: 1958-03-14 ( https://app.example.test/patients#example-0001)</a></p><p><b>created</b>: 2026-10-20 14:00:00+0000</p><p><b>provider</b>: <a href=\"Bundle-pharmacy-benefits-request-phi.html#Organization_phi-pharmacy\">Example Pharmacy (Retail) (http://hl7.org/fhir/sid/us-npi#United States National Provider Identifier#2900000003)</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><p><b>prescription</b>: <a href=\"Bundle-pharmacy-benefits-request-phi.html#MedicationRequest_phi-prescription\">MedicationRequest: status = draft; intent = proposal; medication[x] = lisinopril 5 MG Oral Tablet; authoredOn = 2026-10-20</a></p><h3>CareTeams</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><a href=\"Bundle-pharmacy-benefits-request-phi.html#Practitioner_phi-prescriber\">Ada Okafor (http://hl7.org/fhir/sid/us-npi#United States National Provider Identifier#2900000011)</a></td></tr></table><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>true</td><td><a href=\"Bundle-pharmacy-benefits-request-phi.html#Coverage_phi-coverage\">Coverage: status = active; subscriberId = EX0000001; relationship = Self</a></td></tr></table><h3>Items</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>CareTeamSequence</b></td><td><b>ProductOrService</b></td><td><b>Quantity</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>1</td><td><span title=\"Codes:{http://www.nlm.nih.gov/research/umls/rxnorm 311354}\">lisinopril 5 MG Oral Tablet</span></td><td>30 {Each}<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code{Each} = '{Each}')</span></td></tr></table></div>"
},
"identifier" : [
{
"value" : "benefit-check-0001"
}
],
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/claim-type",
"code" : "pharmacy",
"display" : "Pharmacy"
}
]
},
"use" : "predetermination",
"patient" : {
"reference" : "Patient/phi-patient"
},
"created" : "2026-10-20T14:00:00Z",
"provider" : {
"reference" : "Organization/phi-pharmacy"
},
"priority" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/processpriority",
"code" : "normal",
"display" : "Normal"
}
]
},
"prescription" : {
"reference" : "MedicationRequest/phi-prescription"
},
"careTeam" : [
{
"sequence" : 1,
"provider" : {
"reference" : "Practitioner/phi-prescriber"
}
}
],
"insurance" : [
{
"sequence" : 1,
"focal" : true,
"coverage" : {
"reference" : "Coverage/phi-coverage"
}
}
],
"item" : [
{
"sequence" : 1,
"careTeamSequence" : [
1
],
"productOrService" : {
"coding" : [
{
"system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
"code" : "311354",
"display" : "lisinopril 5 MG Oral Tablet"
}
]
},
"quantity" : {
"value" : 30,
"unit" : "{Each}",
"system" : "http://unitsofmeasure.org",
"code" : "{Each}"
}
}
]
}
},
{
"fullUrl" : "https://app.example.test/fhir/Patient/phi-patient",
"resource" : {
"resourceType" : "Patient",
"id" : "phi-patient",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-patient|2.0.0-ballot"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_phi-patient\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient phi-patient</b></p><a name=\"phi-patient\"> </a><a name=\"hcphi-patient\"> </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-patient|2.0.0-ballot</code></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Mei Lin Female, DoB: 1958-03-14 ( https://app.example.test/patients#example-0001)</p><hr/></div>"
},
"identifier" : [
{
"system" : "https://app.example.test/patients",
"value" : "example-0001"
}
],
"name" : [
{
"family" : "Lin",
"given" : [
"Mei"
]
}
],
"gender" : "female",
"birthDate" : "1958-03-14"
}
},
{
"fullUrl" : "https://app.example.test/fhir/Coverage/phi-coverage",
"resource" : {
"resourceType" : "Coverage",
"id" : "phi-coverage",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-coverage|2.0.0-ballot"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_phi-coverage\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage phi-coverage</b></p><a name=\"phi-coverage\"> </a><a name=\"hcphi-coverage\"> </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-coverage|2.0.0-ballot</code></p></div><p><b>status</b>: Active</p><p><b>subscriberId</b>: EX0000001</p><p><b>beneficiary</b>: <a href=\"Bundle-pharmacy-benefits-request-phi.html#Patient_phi-patient\">Mei Lin Female, DoB: 1958-03-14 ( https://app.example.test/patients#example-0001)</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>payor</b>: Example Health Plan (Identifier: <code>https://payers.example.test</code>/EXAMPLE-PAYER)</p><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class rxbin}\">RX BIN</span></p><p><b>value</b>: 000000</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class rxpcn}\">RX PCN</span></p><p><b>value</b>: EXAMPLE</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class rxgroup}\">RX Group</span></p><p><b>value</b>: EXGROUP01</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class rxid}\">RX Id</span></p><p><b>value</b>: EX0000001</p></blockquote></div>"
},
"status" : "active",
"subscriberId" : "EX0000001",
"beneficiary" : {
"reference" : "Patient/phi-patient"
},
"relationship" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
"code" : "self"
}
]
},
"payor" : [
{
"identifier" : {
"system" : "https://payers.example.test",
"value" : "EXAMPLE-PAYER"
},
"display" : "Example Health Plan"
}
],
"class" : [
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
"code" : "rxbin"
}
]
},
"value" : "000000"
},
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
"code" : "rxpcn"
}
]
},
"value" : "EXAMPLE"
},
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
"code" : "rxgroup"
}
]
},
"value" : "EXGROUP01"
},
{
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/coverage-class",
"code" : "rxid"
}
]
},
"value" : "EX0000001"
}
]
}
},
{
"fullUrl" : "https://app.example.test/fhir/MedicationRequest/phi-prescription",
"resource" : {
"resourceType" : "MedicationRequest",
"id" : "phi-prescription",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-medicationrequest|2.0.0-ballot"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MedicationRequest_phi-prescription\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MedicationRequest phi-prescription</b></p><a name=\"phi-prescription\"> </a><a name=\"hcphi-prescription\"> </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-medicationrequest|2.0.0-ballot</code></p></div><p><b>status</b>: Draft</p><p><b>intent</b>: Proposal</p><p><b>medication</b>: <span title=\"Codes:{http://www.nlm.nih.gov/research/umls/rxnorm 311354}\">lisinopril 5 MG Oral Tablet</span></p><p><b>subject</b>: <a href=\"Bundle-pharmacy-benefits-request-phi.html#Patient_phi-patient\">Mei Lin Female, DoB: 1958-03-14 ( https://app.example.test/patients#example-0001)</a></p><p><b>authoredOn</b>: 2026-10-20</p><p><b>requester</b>: <a href=\"Bundle-pharmacy-benefits-request-phi.html#Practitioner_phi-prescriber\">Ada Okafor (http://hl7.org/fhir/sid/us-npi#United States National Provider Identifier#2900000011)</a></p><blockquote><p><b>dispenseRequest</b></p><p><b>quantity</b>: 30 {Each}<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM code{Each} = '{Each}')</span></p><h3>ExpectedSupplyDurations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Unit</b></td><td><b>System</b></td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td>30</td><td>days</td><td><a href=\"http://hl7.org/fhir/uv/xver-r5.r4/0.1.0/CodeSystem-v3-ucum.html\">http://unitsofmeasure.org</a></td><td>d</td></tr></table><p><b>performer</b>: <a href=\"Bundle-pharmacy-benefits-request-phi.html#Organization_phi-pharmacy\">Example Pharmacy (Retail) (http://hl7.org/fhir/sid/us-npi#United States National Provider Identifier#2900000003)</a></p></blockquote><h3>Substitutions</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Allowed[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>true</td></tr></table></div>"
},
"status" : "draft",
"intent" : "proposal",
"medicationCodeableConcept" : {
"coding" : [
{
"system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
"code" : "311354",
"display" : "lisinopril 5 MG Oral Tablet"
}
]
},
"subject" : {
"reference" : "Patient/phi-patient"
},
"authoredOn" : "2026-10-20",
"requester" : {
"reference" : "Practitioner/phi-prescriber"
},
"dispenseRequest" : {
"quantity" : {
"value" : 30,
"unit" : "{Each}",
"system" : "http://unitsofmeasure.org",
"code" : "{Each}"
},
"expectedSupplyDuration" : {
"value" : 30,
"unit" : "days",
"system" : "http://unitsofmeasure.org",
"code" : "d"
},
"performer" : {
"reference" : "Organization/phi-pharmacy"
}
},
"substitution" : {
"allowedBoolean" : true
}
}
},
{
"fullUrl" : "https://app.example.test/fhir/Practitioner/phi-prescriber",
"resource" : {
"resourceType" : "Practitioner",
"id" : "phi-prescriber",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|8.0.1"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_phi-prescriber\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner phi-prescriber</b></p><a name=\"phi-prescriber\"> </a><a name=\"hcphi-prescriber\"> </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/core/StructureDefinition/us-core-practitioner|8.0.1</code></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Ada Okafor (http://hl7.org/fhir/sid/us-npi#United States National Provider Identifier#2900000011)</p><hr/></div>"
},
"identifier" : [
{
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "2900000011"
}
],
"name" : [
{
"family" : "Okafor",
"given" : [
"Ada"
],
"suffix" : [
"MD"
]
}
]
}
},
{
"fullUrl" : "https://app.example.test/fhir/Organization/phi-pharmacy",
"resource" : {
"resourceType" : "Organization",
"id" : "phi-pharmacy",
"meta" : {
"profile" : [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-pharmacy-organization|2.0.0-ballot"
]
},
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_phi-pharmacy\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization phi-pharmacy</b></p><a name=\"phi-pharmacy\"> </a><a name=\"hcphi-pharmacy\"> </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-pharmacy-organization|2.0.0-ballot</code></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Example Pharmacy (Retail) (http://hl7.org/fhir/sid/us-npi#United States National Provider Identifier#2900000003)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Record is active\">Active:</td><td colspan=\"3\">true</td></tr><tr><td style=\"background-color: #f3f5da\" title=\"The kind(s) of organization that this is\">Type:</td><td colspan=\"3\"><span title=\"Codes:{http://terminology.hl7.org/CodeSystem/NCPDPPharmacyType R}\">Retail</span></td></tr><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the organization\">Contact Detail</td><td colspan=\"3\"><ul><li>ph: 305-555-0100</li><li>100 Example Street Miami FL 33131 US </li></ul></td></tr></table></div>"
},
"identifier" : [
{
"system" : "http://hl7.org/fhir/sid/us-npi",
"value" : "2900000003"
}
],
"active" : true,
"type" : [
{
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/NCPDPPharmacyType",
"code" : "R",
"display" : "Retail"
}
]
}
],
"name" : "Example Pharmacy",
"telecom" : [
{
"system" : "phone",
"value" : "305-555-0100"
}
],
"address" : [
{
"line" : [
"100 Example Street"
],
"city" : "Miami",
"state" : "FL",
"postalCode" : "33131",
"country" : "US"
}
]
}
}
]
}