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-phi"/>
<meta>
<profile
value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-bundle|2.0.0-ballot"/>
</meta>
<type value="message"/>
<timestamp value="2026-10-20T14:00:00Z"/>
<entry>
<fullUrl value="https://app.example.test/fhir/MessageHeader/phi-request"/>
<resource>
<MessageHeader>
<id value="phi-request"/>
<meta>
<profile
value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-messageheader|2.0.0-ballot"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<eventCoding>
<system
value="http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type"/>
<code value="rtpbc-request"/>
<display value="RTPBC Request"/>
</eventCoding>
<source>
<name value="Example app"/>
<endpoint value="https://app.example.test"/>
</source>
<focus>
<reference value="Claim/phi-claim"/>
</focus>
<definition
value="http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request"/>
</MessageHeader>
</resource>
</entry>
<entry>
<fullUrl value="https://app.example.test/fhir/Claim/phi-claim"/>
<resource>
<Claim>
<id value="phi-claim"/>
<meta>
<profile
value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-claim|2.0.0-ballot"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<value value="benefit-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>
<reference value="Patient/phi-patient"/>
</patient>
<created value="2026-10-20T14:00:00Z"/>
<provider>
<reference value="Organization/phi-pharmacy"/>
</provider>
<priority>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/processpriority"/>
<code value="normal"/>
<display value="Normal"/>
</coding>
</priority>
<prescription>
<reference value="MedicationRequest/phi-prescription"/>
</prescription>
<careTeam>
<sequence value="1"/>
<provider>
<reference value="Practitioner/phi-prescriber"/>
</provider>
</careTeam>
<insurance>
<sequence value="1"/>
<focal value="true"/>
<coverage>
<reference value="Coverage/phi-coverage"/>
</coverage>
</insurance>
<item>
<sequence value="1"/>
<careTeamSequence 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>
</productOrService>
<quantity>
<value value="30"/>
<unit value="{Each}"/>
<system value="http://unitsofmeasure.org"/>
<code value="{Each}"/>
</quantity>
</item>
</Claim>
</resource>
</entry>
<entry>
<fullUrl value="https://app.example.test/fhir/Patient/phi-patient"/>
<resource>
<Patient>
<id value="phi-patient"/>
<meta>
<profile
value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-patient|2.0.0-ballot"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<system value="https://app.example.test/patients"/>
<value value="example-0001"/>
</identifier>
<name>
<family value="Lin"/>
<given value="Mei"/>
</name>
<gender value="female"/>
<birthDate value="1958-03-14"/>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="https://app.example.test/fhir/Coverage/phi-coverage"/>
<resource>
<Coverage>
<id value="phi-coverage"/>
<meta>
<profile
value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-coverage|2.0.0-ballot"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="active"/>
<subscriberId value="EX0000001"/>
<beneficiary>
<reference value="Patient/phi-patient"/>
</beneficiary>
<relationship>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/subscriber-relationship"/>
<code value="self"/>
</coding>
</relationship>
<payor>
<identifier>
<system value="https://payers.example.test"/>
<value value="EXAMPLE-PAYER"/>
</identifier>
<display value="Example Health Plan"/>
</payor>
<class>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="rxbin"/>
</coding>
</type>
<value value="000000"/>
</class>
<class>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="rxpcn"/>
</coding>
</type>
<value value="EXAMPLE"/>
</class>
<class>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="rxgroup"/>
</coding>
</type>
<value value="EXGROUP01"/>
</class>
<class>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/coverage-class"/>
<code value="rxid"/>
</coding>
</type>
<value value="EX0000001"/>
</class>
</Coverage>
</resource>
</entry>
<entry>
<fullUrl
value="https://app.example.test/fhir/MedicationRequest/phi-prescription"/>
<resource>
<MedicationRequest>
<id value="phi-prescription"/>
<meta>
<profile
value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-medicationrequest|2.0.0-ballot"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<status value="draft"/>
<intent value="proposal"/>
<medicationCodeableConcept>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="311354"/>
<display value="lisinopril 5 MG Oral Tablet"/>
</coding>
</medicationCodeableConcept>
<subject>
<reference value="Patient/phi-patient"/>
</subject>
<authoredOn value="2026-10-20"/>
<requester>
<reference value="Practitioner/phi-prescriber"/>
</requester>
<dispenseRequest>
<quantity>
<value value="30"/>
<unit value="{Each}"/>
<system value="http://unitsofmeasure.org"/>
<code value="{Each}"/>
</quantity>
<expectedSupplyDuration>
<value value="30"/>
<unit value="days"/>
<system value="http://unitsofmeasure.org"/>
<code value="d"/>
</expectedSupplyDuration>
<performer>
<reference value="Organization/phi-pharmacy"/>
</performer>
</dispenseRequest>
<substitution>
<allowedBoolean value="true"/>
</substitution>
</MedicationRequest>
</resource>
</entry>
<entry>
<fullUrl
value="https://app.example.test/fhir/Practitioner/phi-prescriber"/>
<resource>
<Practitioner>
<id value="phi-prescriber"/>
<meta>
<profile
value="http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner|8.0.1"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="2900000011"/>
</identifier>
<name>
<family value="Okafor"/>
<given value="Ada"/>
<suffix value="MD"/>
</name>
</Practitioner>
</resource>
</entry>
<entry>
<fullUrl value="https://app.example.test/fhir/Organization/phi-pharmacy"/>
<resource>
<Organization>
<id value="phi-pharmacy"/>
<meta>
<profile
value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-pharmacy-organization|2.0.0-ballot"/>
</meta>
<text>
<status value="generated"/>
<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>
</text>
<identifier>
<system value="http://hl7.org/fhir/sid/us-npi"/>
<value value="2900000003"/>
</identifier>
<active value="true"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/NCPDPPharmacyType"/>
<code value="R"/>
<display value="Retail"/>
</coding>
</type>
<name value="Example Pharmacy"/>
<telecom>
<system value="phone"/>
<value value="305-555-0100"/>
</telecom>
<address>
<line value="100 Example Street"/>
<city value="Miami"/>
<state value="FL"/>
<postalCode value="33131"/>
<country value="US"/>
</address>
</Organization>
</resource>
</entry>
</Bundle>