CARIN Consumer Realtime Pharmacy Benefit Check
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This page is part of the Consumer Real-time Pharmacy Benefit Check (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

SD.7 StructureDefinition-carin-rtpbc-pharmacy-organization

This profile represents a pharmacy as used in the real-time pharmacy benefit check (RTPBC) process.


The function of the Pharmacy resource in this exchange is to identify a pharmacy as either…

  • the patient’s preferred pharmacy, in the RTPBC request
  • or an alternative pharmacy for which information is being returned in the RTPBC response

The set of conveyed pharmacy information consists of…

  • identification of the pharmacy. The NCPDP Provider ID is the preferred identifier for this purpose because it specifies the individual pharmacy location. Alternatively, an organizational NPI may be used
  • the pharmacy name
  • the phone number
  • the pharmacy address

Must Support elements in this profile

Client systems

  • The pharmacy identifier and name MUST be populated with correct information in order for the processor to determine reliable cost and coverage information
  • Pharmacy phone and address SHOULD be populated to assist in identifying a particular pharmacy location, especially when identifying the pharmacy using an NPI

Responding systems

  • MUST consider pharmacy type and location when determining pricing, coverage, and alternative pharmacy options

SD.7.1 Formal Views of Profile Content

Description of Profiles, Differentials, and Snapshots.

The official URL for this profile is: http://hl7.org/fhir/us/carin/StructureDefinition/rtpbc-pharmacy

Published on Sun Dec 08 05:00:00 UTC 2019 as a active by CARIN Alliance.

This profile builds on Organization

Summary

Mandatory: 5 elements (2 nested mandatory elements)
Must-Support: 13 elements
Fixed Value: 1 element

Slices

This structure defines the following Slices:

  • The element Organization.identifier is sliced based on the value of pattern:$this
NameFlagsCard.TypeDescription & Constraintsdoco
.. Organization 0..*Organization
... identifier 1..*(Slice Definition)Pharmacy Identifier
Slice: Unordered, Open by pattern:$this
.... identifier:All Slices Content/Rules for all slices
..... system S1..1uri
..... value 1..1string
.... identifier:pharmacyNpi S0..1IdentifierPharmacy's organizational NPI
Required Pattern: At least the following
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
.... identifier:pharmacyNcpdpId S0..1IdentifierPharmacy's NCPDP ID
Required Pattern: At least the following
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://ncpdp.org/provider-id
..... system 0..1uri
... type 1..1CodeableConceptPharmacy Type
Binding: CARIN RTPBC Pharmacy Type Value Set (extensible)
... name S1..1stringPharmacy Name
... telecom S0..*ContactPointPharmacy Telephone
.... system S1..1codeFixed Value: phone
.... value S1..1string
... address S0..*AddressPharmacy Address
.... line S0..*string
.... city S0..1string
.... state S0..1stringBinding: CARIN RTPBC Two Letter State and Province Code Value Set (extensible)
.... postalCode S0..1string
.... country S0..1stringBinding: CARIN RTPBC Pharmacy Type Value Setf (required)

doco Documentation for this format
NameFlagsCard.TypeDescription & Constraintsdoco
.. Organization I0..*OrganizationA grouping of people or organizations with a common purpose
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI1..*(Slice Definition)Pharmacy Identifier
Slice: Unordered, Open by pattern:$this
.... identifier:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!ΣI0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
..... type ΣI0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible)
..... system SΣI1..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value ΣI1..1stringThe value that is unique
Example General: 123456
..... period ΣI0..1PeriodTime period when id is/was valid for use
..... assigner ΣI0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:pharmacyNpi SΣI0..1IdentifierPharmacy's organizational NPI

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... use0..1codeusual | official | temp | secondary | old (If known)
..... type0..1CodeableConceptDescription of identifier
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value0..1stringThe value that is unique
..... period0..1PeriodTime period when id is/was valid for use
..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:pharmacyNcpdpId SΣI0..1IdentifierPharmacy's NCPDP ID

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... use0..1codeusual | official | temp | secondary | old (If known)
..... type0..1CodeableConceptDescription of identifier
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://ncpdp.org/provider-id
..... value0..1stringThe value that is unique
..... period0..1PeriodTime period when id is/was valid for use
..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!ΣI0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
..... type ΣI0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible)
..... system ΣI0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value ΣI0..1stringThe value that is unique
Example General: 123456
..... period ΣI0..1PeriodTime period when id is/was valid for use
..... assigner ΣI0..1Reference(Organization)Organization that issued id (may be just text)
... active ?!ΣI0..1booleanWhether the organization's record is still in active use
... type ΣI1..1CodeableConceptPharmacy Type
Binding: CARIN RTPBC Pharmacy Type Value Set (extensible)
... name SΣI1..1stringPharmacy Name
... alias I0..*stringA list of alternate names that the organization is known as, or was known as in the past
... telecom SI0..*ContactPointPharmacy Telephone
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... system SΣI1..1codephone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required)
Fixed Value: phone
.... value SΣI1..1stringThe actual contact point details
.... use ?!ΣI0..1codehome | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required)
.... rank ΣI0..1positiveIntSpecify preferred order of use (1 = highest)
.... period ΣI0..1PeriodTime period when the contact point was/is in use
... address SI0..*AddressPharmacy Address
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!ΣI0..1codehome | work | temp | old | billing - purpose of this address
Binding: AddressUse (required)
Example General: home
.... type ΣI0..1codepostal | physical | both
Binding: AddressType (required)
Example General: both
.... text ΣI0..1stringText representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
.... line SΣI0..*stringStreet name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
.... city SΣI0..1stringName of city, town etc.
Example General: Erewhon
.... district ΣI0..1stringDistrict name (aka county)
Example General: Madison
.... state SΣI0..1stringSub-unit of country (abbreviations ok)
Binding: CARIN RTPBC Two Letter State and Province Code Value Set (extensible)
.... postalCode SΣI0..1stringPostal code for area
Example General: 9132
.... country SΣI0..1stringCountry (e.g. can be ISO 3166 2 or 3 letter code)
Binding: CARIN RTPBC Pharmacy Type Value Setf (required)
.... period ΣI0..1PeriodTime period when address was/is in use
Example General: {"start":"2010-03-23T00:00:00+00:00","end":"2010-07-01T00:00:00+00:00"}
... partOf ΣI0..1Reference(Organization)The organization of which this organization forms a part
... contact I0..*BackboneElementContact for the organization for a certain purpose
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... purpose I0..1CodeableConceptThe type of contact
Binding: ContactEntityType (extensible)
.... name I0..1HumanNameA name associated with the contact
.... telecom I0..*ContactPointContact details (telephone, email, etc.) for a contact
.... address I0..1AddressVisiting or postal addresses for the contact
... endpoint I0..*Reference(Endpoint)Technical endpoints providing access to services operated for the organization

doco Documentation for this format

Summary

Mandatory: 5 elements (2 nested mandatory elements)
Must-Support: 13 elements
Fixed Value: 1 element

Slices

This structure defines the following Slices:

  • The element Organization.identifier is sliced based on the value of pattern:$this

Differential View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Organization 0..*Organization
... identifier 1..*(Slice Definition)Pharmacy Identifier
Slice: Unordered, Open by pattern:$this
.... identifier:All Slices Content/Rules for all slices
..... system S1..1uri
..... value 1..1string
.... identifier:pharmacyNpi S0..1IdentifierPharmacy's organizational NPI
Required Pattern: At least the following
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
.... identifier:pharmacyNcpdpId S0..1IdentifierPharmacy's NCPDP ID
Required Pattern: At least the following
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://ncpdp.org/provider-id
..... system 0..1uri
... type 1..1CodeableConceptPharmacy Type
Binding: CARIN RTPBC Pharmacy Type Value Set (extensible)
... name S1..1stringPharmacy Name
... telecom S0..*ContactPointPharmacy Telephone
.... system S1..1codeFixed Value: phone
.... value S1..1string
... address S0..*AddressPharmacy Address
.... line S0..*string
.... city S0..1string
.... state S0..1stringBinding: CARIN RTPBC Two Letter State and Province Code Value Set (extensible)
.... postalCode S0..1string
.... country S0..1stringBinding: CARIN RTPBC Pharmacy Type Value Setf (required)

doco Documentation for this format

Snapshot View

NameFlagsCard.TypeDescription & Constraintsdoco
.. Organization I0..*OrganizationA grouping of people or organizations with a common purpose
... id Σ0..1stringLogical id of this artifact
... meta ΣI0..1MetaMetadata about the resource
... implicitRules ?!ΣI0..1uriA set of rules under which this content was created
... language I0..1codeLanguage of the resource content
Binding: CommonLanguages (preferred)
Max Binding: AllLanguages
... text I0..1NarrativeText summary of the resource, for human interpretation
... contained 0..*ResourceContained, inline Resources
... extension I0..*ExtensionAdditional content defined by implementations
... modifierExtension ?!I0..*ExtensionExtensions that cannot be ignored
... identifier ΣI1..*(Slice Definition)Pharmacy Identifier
Slice: Unordered, Open by pattern:$this
.... identifier:All Slices Content/Rules for all slices
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!ΣI0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
..... type ΣI0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible)
..... system SΣI1..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value ΣI1..1stringThe value that is unique
Example General: 123456
..... period ΣI0..1PeriodTime period when id is/was valid for use
..... assigner ΣI0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:pharmacyNpi SΣI0..1IdentifierPharmacy's organizational NPI

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... use0..1codeusual | official | temp | secondary | old (If known)
..... type0..1CodeableConceptDescription of identifier
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://hl7.org/fhir/sid/us-npi
..... value0..1stringThe value that is unique
..... period0..1PeriodTime period when id is/was valid for use
..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
.... identifier:pharmacyNcpdpId SΣI0..1IdentifierPharmacy's NCPDP ID

Required Pattern: At least the following
..... id0..1stringUnique id for inter-element referencing
..... extension0..*ExtensionAdditional content defined by implementations
..... use0..1codeusual | official | temp | secondary | old (If known)
..... type0..1CodeableConceptDescription of identifier
..... system1..1uriThe namespace for the identifier value
Fixed Value: http://ncpdp.org/provider-id
..... value0..1stringThe value that is unique
..... period0..1PeriodTime period when id is/was valid for use
..... assigner0..1Reference(Organization)Organization that issued id (may be just text)
..... id 0..1stringUnique id for inter-element referencing
..... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
..... use ?!ΣI0..1codeusual | official | temp | secondary | old (If known)
Binding: IdentifierUse (required)
..... type ΣI0..1CodeableConceptDescription of identifier
Binding: Identifier Type Codes (extensible)
..... system ΣI0..1uriThe namespace for the identifier value
Example General: http://www.acme.com/identifiers/patient
..... value ΣI0..1stringThe value that is unique
Example General: 123456
..... period ΣI0..1PeriodTime period when id is/was valid for use
..... assigner ΣI0..1Reference(Organization)Organization that issued id (may be just text)
... active ?!ΣI0..1booleanWhether the organization's record is still in active use
... type ΣI1..1CodeableConceptPharmacy Type
Binding: CARIN RTPBC Pharmacy Type Value Set (extensible)
... name SΣI1..1stringPharmacy Name
... alias I0..*stringA list of alternate names that the organization is known as, or was known as in the past
... telecom SI0..*ContactPointPharmacy Telephone
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... system SΣI1..1codephone | fax | email | pager | url | sms | other
Binding: ContactPointSystem (required)
Fixed Value: phone
.... value SΣI1..1stringThe actual contact point details
.... use ?!ΣI0..1codehome | work | temp | old | mobile - purpose of this contact point
Binding: ContactPointUse (required)
.... rank ΣI0..1positiveIntSpecify preferred order of use (1 = highest)
.... period ΣI0..1PeriodTime period when the contact point was/is in use
... address SI0..*AddressPharmacy Address
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
Slice: Unordered, Open by value:url
.... use ?!ΣI0..1codehome | work | temp | old | billing - purpose of this address
Binding: AddressUse (required)
Example General: home
.... type ΣI0..1codepostal | physical | both
Binding: AddressType (required)
Example General: both
.... text ΣI0..1stringText representation of the address
Example General: 137 Nowhere Street, Erewhon 9132
.... line SΣI0..*stringStreet name, number, direction & P.O. Box etc.
This repeating element order: The order in which lines should appear in an address label
Example General: 137 Nowhere Street
.... city SΣI0..1stringName of city, town etc.
Example General: Erewhon
.... district ΣI0..1stringDistrict name (aka county)
Example General: Madison
.... state SΣI0..1stringSub-unit of country (abbreviations ok)
Binding: CARIN RTPBC Two Letter State and Province Code Value Set (extensible)
.... postalCode SΣI0..1stringPostal code for area
Example General: 9132
.... country SΣI0..1stringCountry (e.g. can be ISO 3166 2 or 3 letter code)
Binding: CARIN RTPBC Pharmacy Type Value Setf (required)
.... period ΣI0..1PeriodTime period when address was/is in use
Example General: {"start":"2010-03-23T00:00:00+00:00","end":"2010-07-01T00:00:00+00:00"}
... partOf ΣI0..1Reference(Organization)The organization of which this organization forms a part
... contact I0..*BackboneElementContact for the organization for a certain purpose
.... id 0..1stringUnique id for inter-element referencing
.... extension I0..*ExtensionAdditional content defined by implementations
.... modifierExtension ?!ΣI0..*ExtensionExtensions that cannot be ignored even if unrecognized
.... purpose I0..1CodeableConceptThe type of contact
Binding: ContactEntityType (extensible)
.... name I0..1HumanNameA name associated with the contact
.... telecom I0..*ContactPointContact details (telephone, email, etc.) for a contact
.... address I0..1AddressVisiting or postal addresses for the contact
... endpoint I0..*Reference(Endpoint)Technical endpoints providing access to services operated for the organization

doco Documentation for this format

Downloads: StructureDefinition: (XML, JSON), Schema: XML Schematron