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

Resource Profile: RtpbcResponseClaimResponse - Mappings

Mappings for the rtpbc-response-claimresponse resource profile.

Mappings for Workflow Pattern (http://hl7.org/fhir/workflow)

RtpbcResponseClaimResponse
ClaimResponseEvent
   identifierEvent.identifier
   statusEvent.status
   createdEvent.occurrence[x]
   insurerEvent.performer
   requestEvent.basedOn
   dispositionEvent.note

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

RtpbcResponseClaimResponse
ClaimResponse
   identifierFiveWs.identifier
   statusFiveWs.status
   typeFiveWs.class
   subTypeFiveWs.class
   useFiveWs.class
   patientFiveWs.subject[x], FiveWs.subject
   createdFiveWs.recorded
   requestorFiveWs.source
   requestFiveWs.why[x]
   addItem
      providerFiveWs.source
      serviced[x]FiveWs.done[x]
      location[x]FiveWs.where[x]

Mappings for RIM Mapping (http://hl7.org/v3)

RtpbcResponseClaimResponse
ClaimResponseEntity. Role, or Act
   textAct.text?
   containedN/A
   extensionN/A
   modifierExtensionN/A
   identifier
      idn/a
      extensionn/a
      useRole.code or implied by context
      typeRole.code or implied by context
      systemII.root or Role.id.root
      valueII.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
      periodRole.effectiveTime or implied by context
      assignerII.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
   type
      idn/a
      extensionn/a
      codingunion(., ./translation)
         idn/a
         extensionn/a
         system./codeSystem
         version./codeSystemVersion
         code./code
         displayCV.displayName
         userSelectedCD.codingRationale
      text./originalText[mediaType/code="text/plain"]/data
   insurer
      idn/a
      extensionn/a
      referenceN/A
      typeN/A
      identifier.identifier
         idn/a
         extensionn/a
         useRole.code or implied by context
         typeRole.code or implied by context
         systemII.root or Role.id.root
         valueII.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
         periodRole.effectiveTime or implied by context
         assignerII.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
      displayN/A
   request
      idn/a
      extensionn/a
      referenceN/A
      typeN/A
      identifier.identifier
         idn/a
         extensionn/a
         useRole.code or implied by context
         typeRole.code or implied by context
         systemII.root or Role.id.root
         valueII.extension or II.root if system indicates OID or GUID (Or Role.id.extension or root)
         periodRole.effectiveTime or implied by context
         assignerII.assigningAuthorityName but note that this is an improper use by the definition of the field. Also Role.scoper
      displayN/A
   item
      idn/a
      modifierExtensionN/A
      adjudication
         idn/a
         extensionn/a
         modifierExtensionN/A
         amount
            idn/a
            extensionn/a
      detail
         idn/a
         extensionn/a
         modifierExtensionN/A
         subDetail
            idn/a
            extensionn/a
            modifierExtensionN/A
   addItem
      idn/a
      modifierExtensionN/A
      provider
         idn/a
         extensionn/a
         referenceN/A
         typeN/A
         identifier.identifier
         displayN/A
      productOrService
         idn/a
         extensionn/a
         codingunion(., ./translation)
            idn/a
            extensionn/a
            system./codeSystem
            version./codeSystemVersion
            code./code
            displayCV.displayName
            userSelectedCD.codingRationale
         text./originalText[mediaType/code="text/plain"]/data
      modifier24.C, 24.D mods
      programCode24.H
      serviced[x]24.A
      location[x]24.B
      quantity24.G
         idn/a
         extensionn/a
         valuePQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
         unitPQ.unit
         systemCO.codeSystem, PQ.translation.codeSystem
         codePQ.code, MO.currency, PQ.translation.code
      net24.F
      adjudication
         idn/a
         extensionn/a
         modifierExtensionN/A
         amount
            idn/a
            extensionn/a
      detail
         idn/a
         extensionn/a
         modifierExtensionN/A
         modifier24.C, 24.D mods
         quantity24.G
         net24.F
         subDetail
            idn/a
            extensionn/a
            modifierExtensionN/A
            modifier24.C, 24.D mods
            quantity24.G
            net24.F
   total
      idn/a
      extensionn/a
      modifierExtensionN/A
   payment
      idn/a
      extensionn/a
      modifierExtensionN/A
   processNote
      idn/a
      extensionn/a
      modifierExtensionN/A
   insuranceCoverage
      idn/a
      extensionn/a
      modifierExtensionN/A
   error
      idn/a
      extensionn/a
      modifierExtensionN/A
      code
         idn/a
         extensionn/a
         codingunion(., ./translation)
            idn/a
            extensionn/a
            system./codeSystem
            version./codeSystemVersion
            code./code
            displayCV.displayName
            userSelectedCD.codingRationale
         text./originalText[mediaType/code="text/plain"]/data