FHIR IG analytics| Package | hl7.fhir.us.carin-rtpbc |
| Resource Type | Bundle |
| Id | Bundle-rtpbc-bundle-request-03.json |
| FHIR Version | R4 |
No resources found
No resources found
No narrative content found in resource
FHIR
FHIRsmith{
"resourceType": "Bundle",
"id": "rtpbc-bundle-request-03",
"meta": {
"profile": [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-bundle"
]
},
"language": "en",
"type": "message",
"timestamp": "2019-11-15T13:10:13-05:00",
"entry": [
{
"fullUrl": "http://example.org/my-app/MessageHeader/rtpbc-messageheader-request-03a",
"resource": {
"resourceType": "MessageHeader",
"id": "rtpbc-messageheader-request-03a",
"meta": {
"profile": [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-messageheader"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_rtpbc-messageheader-request-03a\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader rtpbc-messageheader-request-03a</b></p><a name=\"rtpbc-messageheader-request-03a\"> </a><a name=\"hcrtpbc-messageheader-request-03a\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-request-messageheader.html\">RTPBC Request MessageHeader</a></p></div><p><b>event</b>: <a href=\"CodeSystem-rtpbc-event-type.html#rtpbc-event-type-rtpbc-request\">RTPBC Event Type Code System: rtpbc-request</a> (RTPBC Request)</p><h3>Sources</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Name</b></td><td><b>Endpoint</b></td></tr><tr><td style=\"display: none\">*</td><td>MyPatientApp</td><td><a href=\"http://example.org/MyPatientApp\">http://example.org/MyPatientApp</a></td></tr></table><p><b>focus</b>: <a href=\"Bundle-rtpbc-bundle-request-03.html#http-//example.org/my-app/Claim/rtpbc-claim-03a\">Claim: identifier = rtpbc-03a; status = active; type = Pharmacy; use = predetermination; created = 2019-11-01 11:20:54-0500; priority = Normal</a></p><p><b>definition</b>: <a href=\"MessageDefinition-rtpbc-request.html\">RTPBC Request Message Definition</a></p></div>"
},
"eventCoding": {
"system": "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-event-type",
"code": "rtpbc-request",
"display": "RTPBC Request"
},
"source": {
"name": "MyPatientApp",
"endpoint": "http://example.org/MyPatientApp"
},
"focus": [
{
"reference": "http://example.org/my-app/Claim/rtpbc-claim-03a"
}
],
"definition": "http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request"
}
},
{
"fullUrl": "http://example.org/my-app/Claim/rtpbc-claim-03a",
"resource": {
"resourceType": "Claim",
"id": "rtpbc-claim-03a",
"meta": {
"profile": [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-claim"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_rtpbc-claim-03a\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim rtpbc-claim-03a</b></p><a name=\"rtpbc-claim-03a\"> </a><a name=\"hcrtpbc-claim-03a\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-request-claim.html\">RTPBC Request Using Claim</a></p></div><p><b>identifier</b>: rtpbc-03a</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.html\">Jane Doe Female, DoB: 1975-12-05 ( Patient internal identifier: 30455)</a></p><p><b>created</b>: 2019-11-01 11:20:54-0500</p><p><b>provider</b>: <a href=\"Organization-rtpbc-organization-03.html\">Organization Hometown Drug</a></p><p><b>priority</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}\">Normal</span></p><p><b>prescription</b>: <a href=\"MedicationRequest-rtpbc-medicationrequest-03.html\">MedicationRequest: status = draft; intent = proposal; reported[x] = true; medication[x] = fluoxetine 10 MG Oral Capsule [Prozac]; authoredOn = 2019-11-01</a></p><h3>CareTeams</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Provider</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><a href=\"Practitioner-rtpbc-practitioner-03.html\">Practitioner Johnson </a></td></tr></table><h3>Insurances</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>Focal</b></td><td><b>Coverage</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>true</td><td><a href=\"Coverage-rtpbc-coverage-01.html\">Coverage: status = active; subscriberId = 121212; relationship = Self</a></td></tr></table><h3>Items</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>CareTeamSequence</b></td><td><b>ProductOrService</b></td><td><b>Quantity</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td>1</td><td><span title=\"Codes:{http://www.nlm.nih.gov/research/umls/rxnorm 205535}\">fluoxetine 10 MG Oral Capsule [Prozac]</span></td><td>60 {Each}</td></tr></table></div>"
},
"identifier": [
{
"value": "rtpbc-03a"
}
],
"status": "active",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy",
"display": "Pharmacy"
}
]
},
"use": "predetermination",
"patient": {
"reference": "Patient/rtpbc-patient-03"
},
"created": "2019-11-01T11:20:54-05:00",
"provider": {
"reference": "Organization/rtpbc-organization-03"
},
"priority": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal",
"display": "Normal"
}
]
},
"prescription": {
"reference": "MedicationRequest/rtpbc-medicationrequest-03"
},
"careTeam": [
{
"sequence": 1,
"provider": {
"reference": "Practitioner/rtpbc-practitioner-03"
}
}
],
"insurance": [
{
"sequence": 1,
"focal": true,
"coverage": {
"reference": "Coverage/rtpbc-coverage-01"
}
}
],
"item": [
{
"sequence": 1,
"careTeamSequence": [
1
],
"productOrService": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "205535",
"display": "fluoxetine 10 MG Oral Capsule [Prozac]"
}
]
},
"quantity": {
"value": 60,
"unit": "{Each}"
}
}
]
}
},
{
"fullUrl": "http://example.org/my-app/Patient/rtpbc-patient-03",
"resource": {
"resourceType": "Patient",
"id": "rtpbc-patient-03",
"meta": {
"profile": [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-patient"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_rtpbc-patient-03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient rtpbc-patient-03</b></p><a name=\"rtpbc-patient-03\"> </a><a name=\"hcrtpbc-patient-03\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-patient.html\">RTPBC Patient</a></p></div><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Jane Doe Female, DoB: 1975-12-05 ( Patient internal identifier: 30455)</p><hr/><table class=\"grid\"><tr><td style=\"background-color: #f3f5da\" title=\"Ways to contact the Patient\">Contact Detail</td><td colspan=\"3\">100 Oak Court Madison WI 53510 US </td></tr></table></div>"
},
"identifier": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"code": "PI",
"display": "Patient internal identifier"
}
],
"text": "Patient internal identifier"
},
"system": "http://example.org/MyPatientApp",
"value": "30455"
}
],
"name": [
{
"family": "Doe",
"given": [
"Jane"
]
}
],
"gender": "female",
"birthDate": "1975-12-05",
"address": [
{
"line": [
"100 Oak Court"
],
"city": "Madison",
"state": "WI",
"postalCode": "53510",
"country": "US"
}
]
}
},
{
"fullUrl": "http://example.org/my-app/Coverage/rtpbc-coverage-01",
"resource": {
"resourceType": "Coverage",
"id": "rtpbc-coverage-01",
"meta": {
"profile": [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-coverage"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Coverage_rtpbc-coverage-01\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Coverage rtpbc-coverage-01</b></p><a name=\"rtpbc-coverage-01\"> </a><a name=\"hcrtpbc-coverage-01\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-coverage.html\">RTPBC Coverage</a></p></div><p><b>status</b>: Active</p><p><b>subscriberId</b>: 121212</p><p><b>beneficiary</b>: <a href=\"Patient-rtpbc-patient-03.html\">Jane Doe Female, DoB: 1975-12-05 ( Patient internal identifier: 30455)</a></p><p><b>relationship</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/subscriber-relationship self}\">Self</span></p><p><b>payor</b>: Identifier: Pharmacy Plans US</p><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class rxbin}\">RX BIN</span></p><p><b>value</b>: BIN001</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class rxpcn}\">RX PCN</span></p><p><b>value</b>: PCN002</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class rxgroup}\">RX Group</span></p><p><b>value</b>: GROUP0001</p></blockquote><blockquote><p><b>class</b></p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/coverage-class rxid}\">RX Id</span></p><p><b>value</b>: MEMBER000001</p></blockquote></div>"
},
"status": "active",
"subscriberId": "121212",
"beneficiary": {
"reference": "Patient/rtpbc-patient-03"
},
"relationship": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
"code": "self"
}
]
},
"payor": [
{
"identifier": {
"value": "Pharmacy Plans US"
}
}
],
"class": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "rxbin"
}
]
},
"value": "BIN001"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "rxpcn"
}
]
},
"value": "PCN002"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "rxgroup"
}
]
},
"value": "GROUP0001"
},
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"code": "rxid"
}
]
},
"value": "MEMBER000001"
}
]
}
},
{
"fullUrl": "http://example.org/my-app/MedicationRequest/rtpbc-medicationrequest-03",
"resource": {
"resourceType": "MedicationRequest",
"id": "rtpbc-medicationrequest-03",
"meta": {
"profile": [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-medicationrequest"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MedicationRequest_rtpbc-medicationrequest-03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MedicationRequest rtpbc-medicationrequest-03</b></p><a name=\"rtpbc-medicationrequest-03\"> </a><a name=\"hcrtpbc-medicationrequest-03\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-medicationrequest.html\">RTPBC Medication Request</a></p></div><p><b>status</b>: Draft</p><p><b>intent</b>: Proposal</p><p><b>reported</b>: true</p><p><b>medication</b>: <span title=\"Codes:{http://www.nlm.nih.gov/research/umls/rxnorm 205535}\">fluoxetine 10 MG Oral Capsule [Prozac]</span></p><p><b>subject</b>: <a href=\"Patient-rtpbc-patient-03.html\">Jane Doe Female, DoB: 1975-12-05 ( Patient internal identifier: 30455)</a></p><p><b>authoredOn</b>: 2019-11-01</p><p><b>requester</b>: <a href=\"Practitioner-rtpbc-practitioner-03.html\">Practitioner Johnson </a></p><h3>DosageInstructions</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Text</b></td></tr><tr><td style=\"display: none\">*</td><td>Take 2 capsules once a day</td></tr></table><blockquote><p><b>dispenseRequest</b></p><p><b>quantity</b>: 60 {Each}</p><h3>ExpectedSupplyDurations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Unit</b></td><td><b>System</b></td><td><b>Code</b></td></tr><tr><td style=\"display: none\">*</td><td>30</td><td>days</td><td><a href=\"http://terminology.hl7.org/5.5.0/CodeSystem-v3-ucum.html\">http://unitsofmeasure.org</a></td><td>d</td></tr></table><p><b>performer</b>: <a href=\"Organization-rtpbc-organization-03.html\">Organization Hometown Drug</a></p></blockquote><h3>Substitutions</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Allowed[x]</b></td></tr><tr><td style=\"display: none\">*</td><td>false</td></tr></table></div>"
},
"status": "draft",
"intent": "proposal",
"reportedBoolean": true,
"medicationCodeableConcept": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "205535",
"display": "fluoxetine 10 MG Oral Capsule [Prozac]"
}
]
},
"subject": {
"reference": "Patient/rtpbc-patient-03"
},
"authoredOn": "2019-11-01",
"requester": {
"reference": "Practitioner/rtpbc-practitioner-03"
},
"dosageInstruction": [
{
"text": "Take 2 capsules once a day"
}
],
"dispenseRequest": {
"quantity": {
"value": 60,
"unit": "{Each}"
},
"expectedSupplyDuration": {
"value": 30,
"unit": "days",
"system": "http://unitsofmeasure.org",
"code": "d"
},
"performer": {
"reference": "Organization/rtpbc-organization-03"
}
},
"substitution": {
"allowedBoolean": false
}
}
},
{
"fullUrl": "http://example.org/my-app/Practitioner/rtpbc-practitioner-03",
"resource": {
"resourceType": "Practitioner",
"id": "rtpbc-practitioner-03",
"meta": {
"profile": [
"http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Practitioner_rtpbc-practitioner-03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Practitioner rtpbc-practitioner-03</b></p><a name=\"rtpbc-practitioner-03\"> </a><a name=\"hcrtpbc-practitioner-03\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"http://hl7.org/fhir/us/core/STU8.0.1/StructureDefinition-us-core-practitioner.html\">US Core Practitioner Profile</a></p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.5.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/1234567893</p><p><b>name</b>: Johnson </p></div>"
},
"identifier": [
{
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "1234567893"
}
],
"name": [
{
"family": "Johnson"
}
]
}
},
{
"fullUrl": "http://example.org/my-app/Organization/rtpbc-organization-03",
"resource": {
"resourceType": "Organization",
"id": "rtpbc-organization-03",
"meta": {
"profile": [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-pharmacy-organization"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_rtpbc-organization-03\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization rtpbc-organization-03</b></p><a name=\"rtpbc-organization-03\"> </a><a name=\"hcrtpbc-organization-03\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\"/><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-rtpbc-pharmacy-organization.html\">RTPBC Pharmacy Organization</a></p></div><p><b>identifier</b>: <a href=\"http://terminology.hl7.org/5.5.0/NamingSystem-npi.html\" title=\"National Provider Identifier\">United States National Provider Identifier</a>/9876543213</p><p><b>active</b>: true</p><p><b>type</b>: <span title=\"Codes:{http://terminology.hl7.org/CodeSystem/NCPDPPharmacyType R}\">Retail</span></p><p><b>name</b>: Hometown Drug</p><p><b>telecom</b>: ph: 6081234567</p><p><b>address</b>: 900 9th Street Madison WI 53535 US </p></div>"
},
"identifier": [
{
"system": "http://hl7.org/fhir/sid/us-npi",
"value": "9876543213"
}
],
"active": true,
"type": [
{
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/NCPDPPharmacyType",
"code": "R",
"display": "Retail"
}
]
}
],
"name": "Hometown Drug",
"telecom": [
{
"system": "phone",
"value": "6081234567"
}
],
"address": [
{
"line": [
"900 9th Street"
],
"city": "Madison",
"state": "WI",
"postalCode": "53535",
"country": "US"
}
]
}
}
]
}