| Name | Flags | Card. | Type |
Description & Constraints
|
|---|---|---|---|---|
Claim
|
Claim | |||
id
|
S | 1.. | Unique Claim Resource Identifier | |
|
identifier
|
S | 1..1 | RTPBC request identifier | |
value
|
S | 1.. | Unique RTPBC request ID | |
|
status
|
S |
Request status Fixed Value: active |
||
|
type
|
S | Requested Service Type | ||
|
coding
|
S | 1..1 | ||
system
|
S | 1..1 | Fixed Value: http://terminology.hl7.org/CodeSystem/claim-type | |
|
code
|
S | 1..1 | Fixed Value: pharmacy | |
|
display
|
S | 1..1 | Fixed Value: Pharmacy | |
|
use
|
S |
Processing Mode Fixed Value: predetermination |
||
patient
|
S | Reference (RTPBC Patient) | Request Patient Information | |
|
reference
|
S | 1..1 | Patient Reference | |
|
created
|
S | Created DateTime | ||
|
provider
|
S | Reference (RTPBC Pharmacy Organization) | Preferred Pharmacy | |
|
reference
|
S | 1..1 | Reference to Pharmacy Organization | |
|
priority
|
S | Processing priority | ||
|
coding
|
S | 1..1 | ||
|
system
|
S | 1..1 | Fixed Value: http://terminology.hl7.org/CodeSystem/processpriority | |
|
code
|
S | 1..1 | Fixed Value: normal | |
|
display
|
S | 1..1 | Fixed Value: Normal | |
|
prescription
|
S | 1.. | Reference (RTPBC Medication Request) | Prescription Reference |
|
reference
|
S | 1.. | ||
|
careTeam
|
S | 1..1 | Prescriber | |
|
sequence
|
S | Fixed Value: 1 | ||
|
provider
|
S | 1..1 | Reference (US Core Practitioner Profile) | Prescriber |
|
reference
|
S | 1..1 | Prescriber Reference | |
|
insurance
|
S | 1..1 | Pharmacy Coverage | |
|
sequence
|
S | Fixed Value: 1 | ||
|
focal
|
S | Fixed Value: true | ||
|
coverage
|
S | 1..1 | Reference (RTPBC Coverage) | Pharmacy Coverage Reference |
|
reference
|
S | 0..1 | Pharmacy Coverage Reference | |
|
item
|
S | 1..1 | Max 1 item per request | |
|
sequence
|
S | Fixed Value: 1 | ||
|
careTeamSequence
|
S | 1..1 | Care Team Sequence ID Reference | |
|
productOrService
|
S |
Prescribed Product Binding: RTPBC Prescribable Product Code Value Set ( extensible ): RTPBC prescribable product codes (NDC11 and RxNorm) |
||
|
coding
|
S | 1..* | ||
|
system
|
S | 1.. | ||
|
code
|
S | 1.. | ||
|
display
|
S | 1.. | Product Description | |
|
quantity
|
S | 1.. | Prescribed Quantity | |
|
value
|
S | 1.. | Quantity in Billing Units | |
|
unit
|
S | 1.. |
Billing unit of measure Binding: RTPBC Billing Unit Value Set ( extensible ): Billing quantity unit of measure |
|
|
Documentation for this format
|
||||