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 Response Bundle returned by a pricing source - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:Bundle;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "rtpbc-bundle-response-03-price-source"];
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-bundle";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-bundle>     ]
  ];
  fhir:Bundle.type [ fhir:value "message"];
  fhir:Bundle.timestamp [ fhir:value "2019-11-15T13:10:15-05:00"^^xsd:dateTime];
  fhir:Bundle.entry [
     fhir:index 0;
     fhir:Bundle.entry.fullUrl [ fhir:value "urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0a" ];
     fhir:Bundle.entry.resource <urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0a>
  ], [
     fhir:index 1;
     fhir:Bundle.entry.fullUrl [ fhir:value "urn:uuid:61ebe359-bfdc-4613-8bf2-c5e3464805f0b" ];
     fhir:Bundle.entry.resource <urn:uuid:61ebe359-bfdc-4613-8bf2-c5e3464805f0b>
  ], [
     fhir:index 2;
     fhir:Bundle.entry.fullUrl [ fhir:value "urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0c" ];
     fhir:Bundle.entry.resource <urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0c>
  ], [
     fhir:index 3;
     fhir:Bundle.entry.fullUrl [ fhir:value "urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0d" ];
     fhir:Bundle.entry.resource <urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0d>
  ].

<urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0a> a fhir:MessageHeader;
  fhir:Resource.id [ fhir:value "rtpbc-messageheader-response-03"];
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-messageheader";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-messageheader>     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>id</b>: rtpbc-messageheader-response-03</p><p><b>meta</b>: </p><p><b>event</b>: <span title=\"{http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type rtpbc-response}\">RTPBC Response</span></p><h3>Sources</h3><table class=\"grid\"><tr><td>-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td>*</td><td>GoodPricing</td><td><a href=\"http://example.org/GoodPricing/fhir\">http://example.org/GoodPricing/fhir</a></td></tr></table><h3>Responses</h3><table class=\"grid\"><tr><td>-</td><td><b>Identifier</b></td><td><b>Code</b></td></tr><tr><td>*</td><td>rtpbc-messageheader-request-03</td><td>ok</td></tr></table><p><b>focus</b>: <a href=\"#ClaimResponse_rtpbc-claim-response-03-price-source\">See above (ClaimResponse/rtpbc-claim-response-03-price-source)</a></p><p><b>definition</b>: <a href=\"http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-response\">http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-response</a></p></div>"
  ];
  fhir:MessageHeader.eventCoding [
     fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type" ];
     fhir:Coding.code [ fhir:value "rtpbc-response" ];
     fhir:Coding.display [ fhir:value "RTPBC Response" ]
  ];
  fhir:MessageHeader.source [
     fhir:MessageHeader.source.name [ fhir:value "GoodPricing" ];
     fhir:MessageHeader.source.endpoint [ fhir:value "http://example.org/GoodPricing/fhir" ]
  ];
  fhir:MessageHeader.response [
     fhir:MessageHeader.response.identifier [ fhir:value "rtpbc-messageheader-request-03" ];
     fhir:MessageHeader.response.code [ fhir:value "ok" ]
  ];
  fhir:MessageHeader.focus [
     fhir:index 0;
     fhir:Reference.reference [ fhir:value "urn:uuid:61ebe359-bfdc-4613-8bf2-c5e3464805f0b" ]
  ];
  fhir:MessageHeader.definition [
     fhir:value "http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-response";
     fhir:link <http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-response>
  ].

<urn:uuid:61ebe359-bfdc-4613-8bf2-c5e3464805f0b> a fhir:ClaimResponse;
  fhir:Resource.id [ fhir:value "rtpbc-claim-response-03-price-source"];
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-claimresponse";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-response-claimresponse>     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>id</b>: rtpbc-claim-response-03-price-source</p><p><b>meta</b>: </p><p><b>identifier</b>: id: rtpbc-03-response-price-source</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=\"#Patient_rtpbc-patient-03\">See above (Patient/rtpbc-patient-03)</a></p><p><b>created</b>: Nov 1, 2019 4:20:59 PM</p><p><b>insurer</b>: <span></span></p><p><b>request</b>: <span></span></p><p><b>outcome</b>: complete</p><p><b>disposition</b>: Processed successfully</p><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 1</p><p><b>noteNumber</b>: 1</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes: {http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type cash-price}\">Full product cash price</span></p><p><b>amount</b>: </p></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes: {http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type coupon-discount}\">Coupon discount amount</span></p><p><b>amount</b>: </p></blockquote><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes: {http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type total}\">Total patient responsibility</span></p><p><b>amount</b>: </p></blockquote></blockquote><blockquote><p><b>addItem</b></p><p><b>itemSequence</b>: 1</p><p><b>provider</b>: <a href=\"#Organization_rtpbc-organization-03r\">See above (Organization/rtpbc-organization-03r)</a></p><p><b>productOrService</b>: <span title=\"Codes: {http://www.nlm.nih.gov/research/umls/rxnorm 205535}\">PROzac 10 MG Oral Capsule</span></p><p><b>quantity</b>: 60 {Each}</p><h3>Adjudications</h3><table class=\"grid\"><tr><td>-</td><td><b>Category</b></td><td><b>Amount</b></td></tr><tr><td>*</td><td><span title=\"Codes: {http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type cash-price}\">Full product cash price</span></td><td></td></tr><tr><td>*</td><td><span title=\"Codes: {http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type coupon-discount}\">Coupon discount amount</span></td><td></td></tr><tr><td>*</td><td><span title=\"Codes: {http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type total}\">Total patient responsibility</span></td><td></td></tr></table></blockquote></div>"
  ];
  fhir:ClaimResponse.identifier [
     fhir:index 0;
     fhir:Identifier.value [ fhir:value "rtpbc-03-response-price-source" ]
  ];
  fhir:ClaimResponse.status [ fhir:value "active"];
  fhir:ClaimResponse.type [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/claim-type" ];
       fhir:Coding.code [ fhir:value "pharmacy" ];
       fhir:Coding.display [ fhir:value "Pharmacy" ]     ]
  ];
  fhir:ClaimResponse.use [ fhir:value "predetermination"];
  fhir:ClaimResponse.patient [
     fhir:Reference.reference [ fhir:value "Patient/rtpbc-patient-03" ]
  ];
  fhir:ClaimResponse.created [ fhir:value "2019-11-01T11:20:59-05:00"^^xsd:dateTime];
  fhir:ClaimResponse.insurer [
     fhir:Reference.identifier [
       fhir:Identifier.value [ fhir:value "GoodPricing" ]     ]
  ];
  fhir:ClaimResponse.request [
     fhir:Reference.identifier [
       fhir:Identifier.value [ fhir:value "rtpbc-03" ]     ]
  ];
  fhir:ClaimResponse.outcome [ fhir:value "complete"];
  fhir:ClaimResponse.disposition [ fhir:value "Processed successfully"];
  fhir:ClaimResponse.item [
     fhir:index 0;
     fhir:ClaimResponse.item.itemSequence [ fhir:value "1"^^xsd:positiveInteger ];
     fhir:ClaimResponse.item.noteNumber [
       fhir:value "1"^^xsd:positiveInteger;
       fhir:index 0     ];
     fhir:ClaimResponse.item.adjudication [
       fhir:index 0;
       fhir:ClaimResponse.item.adjudication.category [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type" ];
           fhir:Coding.code [ fhir:value "cash-price" ];
           fhir:Coding.display [ fhir:value "Full product cash price" ]         ]       ];
       fhir:ClaimResponse.item.adjudication.amount [
         fhir:Money.value [ fhir:value "105.00"^^xsd:decimal ];
         fhir:Money.currency [ fhir:value "USD" ]       ]     ], [
       fhir:index 1;
       fhir:ClaimResponse.item.adjudication.category [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type" ];
           fhir:Coding.code [ fhir:value "coupon-discount" ];
           fhir:Coding.display [ fhir:value "Coupon discount amount" ]         ]       ];
       fhir:ClaimResponse.item.adjudication.amount [
         fhir:Money.value [ fhir:value "-20.00"^^xsd:decimal ];
         fhir:Money.currency [ fhir:value "USD" ]       ]     ], [
       fhir:index 2;
       fhir:ClaimResponse.item.adjudication.category [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type" ];
           fhir:Coding.code [ fhir:value "total" ];
           fhir:Coding.display [ fhir:value "Total patient responsibility" ]         ]       ];
       fhir:ClaimResponse.item.adjudication.amount [
         fhir:Money.value [ fhir:value "85.00"^^xsd:decimal ];
         fhir:Money.currency [ fhir:value "USD" ]       ]     ]
  ];
  fhir:ClaimResponse.addItem [
     fhir:index 0;
     fhir:Element.extension [
       fhir:index 0;
       fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-isAlternative" ];
       fhir:Extension.valueBoolean [ fhir:value "true"^^xsd:boolean ]     ];
     fhir:ClaimResponse.addItem.itemSequence [
       fhir:value "1"^^xsd:positiveInteger;
       fhir:index 0     ];
     fhir:ClaimResponse.addItem.provider [
       fhir:index 0;
       fhir:Reference.reference [ fhir:value "Organization/rtpbc-organization-03r" ]     ];
     fhir:ClaimResponse.addItem.productOrService [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://www.nlm.nih.gov/research/umls/rxnorm" ];
         fhir:Coding.code [ fhir:value "205535" ];
         fhir:Coding.display [ fhir:value "PROzac 10 MG Oral Capsule" ]       ]     ];
     fhir:ClaimResponse.addItem.quantity [
       fhir:Quantity.value [ fhir:value "60"^^xsd:decimal ];
       fhir:Quantity.unit [ fhir:value "{Each}" ]     ];
     fhir:ClaimResponse.addItem.adjudication [
       fhir:index 0;
       fhir:ClaimResponse.item.adjudication.category [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type" ];
           fhir:Coding.code [ fhir:value "cash-price" ];
           fhir:Coding.display [ fhir:value "Full product cash price" ]         ]       ];
       fhir:ClaimResponse.item.adjudication.amount [
         fhir:Money.value [ fhir:value "50.00"^^xsd:decimal ];
         fhir:Money.currency [ fhir:value "USD" ]       ]     ], [
       fhir:index 1;
       fhir:ClaimResponse.item.adjudication.category [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type" ];
           fhir:Coding.code [ fhir:value "coupon-discount" ];
           fhir:Coding.display [ fhir:value "Coupon discount amount" ]         ]       ];
       fhir:ClaimResponse.item.adjudication.amount [
         fhir:Money.value [ fhir:value "-10.00"^^xsd:decimal ];
         fhir:Money.currency [ fhir:value "USD" ]       ]     ], [
       fhir:index 2;
       fhir:ClaimResponse.item.adjudication.category [
         fhir:CodeableConcept.coding [
           fhir:index 0;
           fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type" ];
           fhir:Coding.code [ fhir:value "total" ];
           fhir:Coding.display [ fhir:value "Total patient responsibility" ]         ]       ];
       fhir:ClaimResponse.item.adjudication.amount [
         fhir:Money.value [ fhir:value "40.00"^^xsd:decimal ];
         fhir:Money.currency [ fhir:value "USD" ]       ]     ]
  ].

<urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0c> a fhir:Patient;
  fhir:Resource.id [ fhir:value "rtpbc-patient-03"];
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-patient";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-patient>     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>id</b>: rtpbc-patient-03</p><p><b>meta</b>: </p><p><b>identifier</b>: Patient internal identifier: 30455</p><p><b>name</b>: Jane Doe </p><p><b>gender</b>: female</p><p><b>birthDate</b>: 1975-12-05</p><p><b>address</b>: 100 Oak Court Madison WI 53510 US </p></div>"
  ];
  fhir:Patient.identifier [
     fhir:index 0;
     fhir:Identifier.type [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/v2-0203" ];
         fhir:Coding.code [ fhir:value "PI" ];
         fhir:Coding.display [ fhir:value "Patient internal identifier" ]       ];
       fhir:CodeableConcept.text [ fhir:value "Patient internal identifier" ]     ];
     fhir:Identifier.system [ fhir:value "http://example.org/MyPatientApp" ];
     fhir:Identifier.value [ fhir:value "30455" ]
  ];
  fhir:Patient.name [
     fhir:index 0;
     fhir:HumanName.family [ fhir:value "Doe" ];
     fhir:HumanName.given [
       fhir:value "Jane";
       fhir:index 0     ]
  ];
  fhir:Patient.gender [ fhir:value "female"];
  fhir:Patient.birthDate [ fhir:value "1975-12-05"^^xsd:date];
  fhir:Patient.address [
     fhir:index 0;
     fhir:Address.line [
       fhir:value "100 Oak Court";
       fhir:index 0     ];
     fhir:Address.city [ fhir:value "Madison" ];
     fhir:Address.state [ fhir:value "WI" ];
     fhir:Address.postalCode [ fhir:value "53510" ];
     fhir:Address.country [ fhir:value "US" ]
  ].

<urn:uuid:61ebe359-bfdc-4613-8bf2-c5e300945f0d> a fhir:Organization;
  fhir:Resource.id [ fhir:value "rtpbc-organization-03r"];
  fhir:Resource.meta [
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-pharmacy-organization";
       fhir:index 0;
       fhir:link <http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-pharmacy-organization>     ]
  ];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>id</b>: rtpbc-organization-03r</p><p><b>meta</b>: </p><p><b>identifier</b>: id: 1305460505</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes: {http://ncpdp.org/pharmacy-type R}\">Retail</span></p><p><b>name</b>: Corner Drug</p><p><b>telecom</b>: ph: 5551239999</p><p><b>address</b>: 123 Sycamore Road Madison WI 53510 US </p></div>"
  ];
  fhir:Organization.identifier [
     fhir:index 0;
     fhir:Identifier.system [ fhir:value "http://hl7.org/fhir/sid/us-npi" ];
     fhir:Identifier.value [ fhir:value "1305460505" ]
  ];
  fhir:Organization.active [ fhir:value "true"^^xsd:boolean];
  fhir:Organization.type [
     fhir:index 0;
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://ncpdp.org/pharmacy-type" ];
       fhir:Coding.code [ fhir:value "R" ];
       fhir:Coding.display [ fhir:value "Retail" ]     ]
  ];
  fhir:Organization.name [ fhir:value "Corner Drug"];
  fhir:Organization.telecom [
     fhir:index 0;
     fhir:ContactPoint.system [ fhir:value "phone" ];
     fhir:ContactPoint.value [ fhir:value "5551239999" ]
  ];
  fhir:Organization.address [
     fhir:index 0;
     fhir:Address.line [
       fhir:value "123 Sycamore Road";
       fhir:index 0     ];
     fhir:Address.city [ fhir:value "Madison" ];
     fhir:Address.state [ fhir:value "WI" ];
     fhir:Address.postalCode [ fhir:value "53510" ];
     fhir:Address.country [ fhir:value "US" ]
  ].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.