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 to a Pricing Source

Format(s):

Example RTPBC submitted to a pricing source

In this example:

  • the patient information is referenced to a Patient resource
  • the requested medication is Prozac 10mg capsule, 60 capsules (included in the Claim.item composite and referenced to a MedicationRequest resource)
  • the prescriber's identifying information is referenced to a Practitioner resource
  • the requested pharmacy referenced to an Organization resource
  • a Coverage resource is not referenced
claim

Narrative view

Generated Narrative

id: rtpbc-claim-03-price-source

meta:

identifier: id: rtpbc-03

status: active

type: Pharmacy

use: predetermination

patient: Generated Summary: id: rtpbc-patient-03; Patient internal identifier: 30455; Jane Doe ; gender: female; birthDate: 1975-12-05

created: Nov 1, 2019 4:20:54 PM

provider: Generated Summary: id: rtpbc-organization-03; id: 0999017; active; Retail; name: Hometown Drug; ph: 6081234567

priority: Normal

prescription: Generated Summary: id: rtpbc-medicationrequest-03; status: draft; intent: proposal; reported; PROzac 10 MG Oral Capsule; authoredOn: 2019-11-01

CareTeams

-SequenceProvider
*1Generated Summary: id: rtpbc-practitioner-03; id: 1234567890; Johnson

Insurances

-SequenceFocalCoverage
*1true

Items

-SequenceCareTeamSequenceProductOrServiceQuantity
*11PROzac 10 MG Oral Capsule60 {Each}