Consumer Real-Time Pharmacy Benefit Check
1.0.0 - STU1

This page is part of the Consumer Real-time Pharmacy Benefit Check (v1.0.0: STU 1) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

RTPBC Request Bundle submitted to a pricing source

Format(s):

Example RTPBC request bundle submitted to a pricing source

In this example:

  • the client is a patient application
  • the server is a medication pricing source vendor
  • the request is submitted as a Bundle containing a Claim and supporting resources, as the single parameter to the processor's $process-message operation

Content:

  • the patient's name is Jane Doe, date of birth is 1975-12-05, and address is 100 Oak Court, Madison, WI 53510
  • the requested medication is Prozac 10mg capsule, 60 capsules, for a 30 day supply (reflected in the Claim and MedicationRequest resources)
  • the prescriber's identifying information is captured in the Practitioner resource
  • the requested pharmacy is Hometown Drug (reflected in the Organization resource)
  • a Coverage resource is not sent in the bundle, as it is not needed by the pricing source

bundle


Narrative view

Bundle rtpbc-bundle-request-03-price-source of type message


Entry 1 - Full URL = urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0a

Resource MessageHeader:


Entry 2 - Full URL = urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0b

Resource Claim:


Entry 3 - Full URL = urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0c

Resource Patient:


Entry 4 - Full URL = urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0e

Resource MedicationRequest:


Entry 5 - Full URL = urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0f

Resource Practitioner:


Entry 6 - Full URL = urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0g

Resource Organization: