haau3 FHIR Implementation Guide (HFIG)
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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

CodeSystem: Pharmacy Benefits Processing Code

Official URL: https://haau3.com/fhir/CodeSystem/pharmacy-benefits-processing-code Version: 1.0.0
Active as of 2026-10-20 Computable Name: PharmacyBenefitsProcessingCodeCS

Why a pharmacy benefit check could not be answered. Carried in ClaimResponse.error.code when a request was read and no connected source could answer it, and in OperationOutcome.issue.details when the sources asked did not answer.

This Code system is referenced in the content logical definition of the following value sets:

This case-sensitive code system https://haau3.com/fhir/CodeSystem/pharmacy-benefits-processing-code defines the following codes:

CodeDisplayDefinition
no-responder-for-coverage No responder for this coverage The request carried the member's coverage, and no insurer or pharmacy benefit manager this service connects to answers for that coverage's payer. Nothing is said about whether the medication is covered. Carried in ClaimResponse.error.code.
no-price-source No price source returned a price The request carried no patient details, and no price source this service connects to returned a price for the product, quantity and place asked about. No price is estimated in its place. Carried in ClaimResponse.error.code.
source-not-available-to-caller Source not available to this caller A source that could answer the request is connected, but its terms do not make it available to the organization that sent the request, so nothing from it is returned. Carried in ClaimResponse.error.code.
source-unavailable Source did not answer The sources asked did not answer in time, or answered with an error, so no answer could be given. Carried in OperationOutcome.issue.details on a 503; the request may be sent again later.