FHIR IG analytics| Package | hl7.fhir.us.carin-rtpbc |
| Resource Type | Bundle |
| Id | Bundle-rtpbc-bundle-request-non-phi-1.json |
| FHIR Version | R4 |
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No resources found
No narrative content found in resource
FHIR
FHIRsmith{
"resourceType": "Bundle",
"id": "rtpbc-bundle-request-non-phi-1",
"meta": {
"profile": [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-bundle-non-phi"
]
},
"language": "en",
"type": "message",
"timestamp": "2025-11-15T13:10:13-05:00",
"entry": [
{
"fullUrl": "http://example.org/my-app/MessageHeader/rtpbc-messageheader-request-non-phi-1",
"resource": {
"resourceType": "MessageHeader",
"id": "rtpbc-messageheader-request-non-phi-1",
"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-non-phi-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader rtpbc-messageheader-request-non-phi-1</b></p><a name=\"rtpbc-messageheader-request-non-phi-1\"> </a><a name=\"hcrtpbc-messageheader-request-non-phi-1\"> </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-non-phi-1.html#http-//example.org/my-app/Claim/rtpbc-claim-non-phi-1\">Claim: identifier = rtpbc-non-phi-1; status = active; type = Pharmacy; use = predetermination; created = 2025-11-01 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-non-phi-1"
}
],
"definition": "http://hl7.org/fhir/us/carin-rtpbc/MessageDefinition/rtpbc-request"
}
},
{
"fullUrl": "http://example.org/my-app/Claim/rtpbc-claim-non-phi-1",
"resource": {
"resourceType": "Claim",
"id": "rtpbc-claim-non-phi-1",
"meta": {
"profile": [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-request-claim-non-phi"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Claim_rtpbc-claim-non-phi-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Claim rtpbc-claim-non-phi-1</b></p><a name=\"rtpbc-claim-non-phi-1\"> </a><a name=\"hcrtpbc-claim-non-phi-1\"> </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-non-phi.html\">RTPBC Request Using Claim - Non-PHI</a></p></div><p><b>identifier</b>: rtpbc-non-phi-1</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>: ?rref?</p><p><b>created</b>: 2025-11-01 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-non-phi-1.html\">MedicationRequest: status = draft; intent = proposal; reported[x] = true; medication[x] = ; authoredOn = 2025-11-01</a></p><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>false</td><td>?rref?</td></tr></table><h3>Items</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Sequence</b></td><td><b>ProductOrService</b></td><td><b>Quantity</b></td></tr><tr><td style=\"display: none\">*</td><td>1</td><td><span title=\"Codes:{http://www.nlm.nih.gov/research/umls/rxnorm 205535}\">Prozac 10mg Capsule</span></td><td>60 {Each}</td></tr></table></div>"
},
"identifier": [
{
"value": "rtpbc-non-phi-1"
}
],
"status": "active",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/claim-type",
"code": "pharmacy",
"display": "Pharmacy"
}
]
},
"use": "predetermination",
"patient": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
"valueCode": "masked"
}
]
},
"created": "2025-11-01T11:20:54-05:00",
"provider": {
"reference": "Organization/rtpbc-organization-03"
},
"priority": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/processpriority",
"code": "normal",
"display": "Normal"
}
]
},
"prescription": {
"reference": "MedicationRequest/rtpbc-medicationrequest-non-phi-1"
},
"insurance": [
{
"sequence": 1,
"focal": false,
"coverage": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
"valueCode": "masked"
}
]
}
}
],
"item": [
{
"sequence": 1,
"productOrService": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "205535",
"display": "fluoxetine 10 MG Oral Capsule [Prozac]"
}
],
"text": "Prozac 10mg Capsule"
},
"quantity": {
"value": 60,
"unit": "{Each}"
}
}
]
}
},
{
"fullUrl": "http://example.org/my-app/MedicationRequest/rtpbc-medicationrequest-non-phi-1",
"resource": {
"resourceType": "MedicationRequest",
"id": "rtpbc-medicationrequest-non-phi-1",
"meta": {
"profile": [
"http://hl7.org/fhir/us/carin-rtpbc/StructureDefinition/rtpbc-medicationrequest-non-phi"
]
},
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MedicationRequest_rtpbc-medicationrequest-non-phi-1\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MedicationRequest rtpbc-medicationrequest-non-phi-1</b></p><a name=\"rtpbc-medicationrequest-non-phi-1\"> </a><a name=\"hcrtpbc-medicationrequest-non-phi-1\"> </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-non-phi.html\">RTPBC Medication Request - Non-PHI</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:\">Prozac 10mg Capsule</span></p><p><b>subject</b>: ?rref?</p><p><b>authoredOn</b>: 2025-11-01</p><h3>DispenseRequests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Quantity</b></td><td><b>Performer</b></td></tr><tr><td style=\"display: none\">*</td><td>60 {Each}</td><td><a href=\"Organization-rtpbc-organization-03.html\">Organization Hometown Drug</a></td></tr></table></div>"
},
"status": "draft",
"intent": "proposal",
"reportedBoolean": true,
"medicationCodeableConcept": {
"text": "Prozac 10mg Capsule"
},
"subject": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/data-absent-reason",
"valueCode": "masked"
}
]
},
"authoredOn": "2025-11-01",
"dispenseRequest": {
"quantity": {
"value": 60,
"unit": "{Each}"
},
"performer": {
"reference": "Organization/rtpbc-organization-03"
}
}
}
},
{
"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"
}
]
}
}
]
}