<?xml version="1.0" encoding="UTF-8"?>

<Bundle xmlns="http://hl7.org/fhir">
  <id value="pharmacy-benefits-response-non-phi"/>
  <meta>
    <profile value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-bundle-non-phi|2.0.0-ballot"/>
  </meta>
  <type value="message"/>
  <timestamp value="2026-10-20T14:00:01Z"/>
  <entry>
    <fullUrl value="urn:uuid:cfe4fe76-8b70-4edc-af4b-7e2f8c25b3e8"/>
    <resource>
      <MessageHeader>
        <id value="cfe4fe76-8b70-4edc-af4b-7e2f8c25b3e8"/>
        <meta>
          <profile value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-messageheader-non-phi|2.0.0-ballot"/>
        </meta>
        <text>
          <status value="generated"/><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>
        </text>
        <eventCoding>
          <system value="http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type"/>
          <code value="rtpbc-response-non-phi"/>
          <display value="RTPBC Non-PHI Response"/>
        </eventCoding>
        <source>
          <name value="haau3 Pharmacy Benefits"/>
          <endpoint value="https://api.haau3.com/v1/fhir/r4"/>
        </source>
        <response>
          <identifier value="non-phi-request"/>
          <code value="ok"/>
        </response>
        <focus>
          <reference value="urn:uuid:a7fb50aa-3ca5-47a1-96f8-67ec1e95546e"/>
        </focus>
        <definition value="http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-response-non-phi"/>
      </MessageHeader>
    </resource>
  </entry>
  <entry>
    <fullUrl value="urn:uuid:a7fb50aa-3ca5-47a1-96f8-67ec1e95546e"/>
    <resource>
      <ClaimResponse>
        <id value="a7fb50aa-3ca5-47a1-96f8-67ec1e95546e"/>
        <meta>
          <profile value="http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-claimresponse-non-phi|2.0.0-ballot"/>
        </meta>
        <text>
          <status value="generated"/><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>
        </text>
        <identifier>
          <value value="a7fb50aa-3ca5-47a1-96f8-67ec1e95546e"/>
        </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="2026-10-20T14:00:01Z"/>
        <insurer>
          <extension url="http://hl7.org/fhir/StructureDefinition/data-absent-reason">
            <valueCode value="masked"/>
          </extension>
        </insurer>
        <request>
          <identifier>
            <value value="price-check-0001"/>
          </identifier>
        </request>
        <outcome value="error"/>
        <disposition value="No price source this service connects to returned a price for this request."/>
        <error>
          <code>
            <coding>
              <system value="https://haau3.com/fhir/CodeSystem/pharmacy-benefits-processing-code"/>
              <code value="no-price-source"/>
              <display value="No price source returned a price"/>
            </coding>
          </code>
        </error>
      </ClaimResponse>
    </resource>
  </entry>
</Bundle>