{
  "resourceType" : "Bundle",
  "id" : "pharmacy-benefits-response-non-phi",
  "meta" : {
    "profile" : ["http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-bundle-non-phi|2.0.0-ballot"]
  },
  "type" : "message",
  "timestamp" : "2026-10-20T14:00:01Z",
  "entry" : [{
    "fullUrl" : "urn:uuid:cfe4fe76-8b70-4edc-af4b-7e2f8c25b3e8",
    "resource" : {
      "resourceType" : "MessageHeader",
      "id" : "cfe4fe76-8b70-4edc-af4b-7e2f8c25b3e8",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-messageheader-non-phi|2.0.0-ballot"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_cfe4fe76-8b70-4edc-af4b-7e2f8c25b3e8\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader cfe4fe76-8b70-4edc-af4b-7e2f8c25b3e8</b></p><a name=\"cfe4fe76-8b70-4edc-af4b-7e2f8c25b3e8\"> </a><a name=\"hccfe4fe76-8b70-4edc-af4b-7e2f8c25b3e8\"> </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-response-messageheader-non-phi|2.0.0-ballot</code></p></div><p><b>event</b>: rtpbc-event-type: rtpbc-response-non-phi (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>haau3 Pharmacy Benefits</td><td><a href=\"https://api.haau3.com/v1/fhir/r4\">https://api.haau3.com/v1/fhir/r4</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>non-phi-request</td><td>OK</td></tr></table><p><b>focus</b>: <a href=\"Bundle-pharmacy-benefits-response-non-phi.html#urn-uuid-a7fb50aa-3ca5-47a1-96f8-67ec1e95546e\">ClaimResponse: identifier = a7fb50aa-3ca5-47a1-96f8-67ec1e95546e; status = active; type = Pharmacy; use = predetermination; created = 2026-10-20 14:00:01+0000; outcome = error; disposition = No price source this service connects to returned a price for this request.</a></p><p><b>definition</b>: <code>http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-response-non-phi</code></p></div>"
      },
      "eventCoding" : {
        "system" : "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type",
        "code" : "rtpbc-response-non-phi",
        "display" : "RTPBC Non-PHI Response"
      },
      "source" : {
        "name" : "haau3 Pharmacy Benefits",
        "endpoint" : "https://api.haau3.com/v1/fhir/r4"
      },
      "response" : {
        "identifier" : "non-phi-request",
        "code" : "ok"
      },
      "focus" : [{
        "reference" : "urn:uuid:a7fb50aa-3ca5-47a1-96f8-67ec1e95546e"
      }],
      "definition" : "http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-response-non-phi"
    }
  },
  {
    "fullUrl" : "urn:uuid:a7fb50aa-3ca5-47a1-96f8-67ec1e95546e",
    "resource" : {
      "resourceType" : "ClaimResponse",
      "id" : "a7fb50aa-3ca5-47a1-96f8-67ec1e95546e",
      "meta" : {
        "profile" : ["http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-claimresponse-non-phi|2.0.0-ballot"]
      },
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClaimResponse_a7fb50aa-3ca5-47a1-96f8-67ec1e95546e\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse a7fb50aa-3ca5-47a1-96f8-67ec1e95546e</b></p><a name=\"a7fb50aa-3ca5-47a1-96f8-67ec1e95546e\"> </a><a name=\"hca7fb50aa-3ca5-47a1-96f8-67ec1e95546e\"> </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-response-claimresponse-non-phi|2.0.0-ballot</code></p></div><p><b>identifier</b>: a7fb50aa-3ca5-47a1-96f8-67ec1e95546e</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 14:00:01+0000</p><p><b>insurer</b>: ?rref?</p><p><b>request</b>: Identifier: price-check-0001</p><p><b>outcome</b>: Error</p><p><b>disposition</b>: No price source this service connects to returned a price for this request.</p><h3>Errors</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td><span title=\"Codes:{https://haau3.com/fhir/CodeSystem/pharmacy-benefits-processing-code no-price-source}\">No price source returned a price</span></td></tr></table></div>"
      },
      "identifier" : [{
        "value" : "a7fb50aa-3ca5-47a1-96f8-67ec1e95546e"
      }],
      "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" : "2026-10-20T14:00:01Z",
      "insurer" : {
        "extension" : [{
          "url" : "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
          "valueCode" : "masked"
        }]
      },
      "request" : {
        "identifier" : {
          "value" : "price-check-0001"
        }
      },
      "outcome" : "error",
      "disposition" : "No price source this service connects to returned a price for this request.",
      "error" : [{
        "code" : {
          "coding" : [{
            "system" : "https://haau3.com/fhir/CodeSystem/pharmacy-benefits-processing-code",
            "code" : "no-price-source",
            "display" : "No price source returned a price"
          }]
        }
      }]
    }
  }]
}