{
  "resourceType" : "Bundle",
  "id" : "bundle-chargeback-adjudicated",
  "type" : "message",
  "timestamp" : "2026-04-24T15:02:00Z",
  "entry" : [{
    "fullUrl" : "urn:uuid:77777777-7777-4777-8777-777777777777",
    "resource" : {
      "resourceType" : "MessageHeader",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"MessageHeader_null\"> </a><p class=\"res-header-id\"><b>Generated Narrative: MessageHeader </b></p><p><b>event</b>: events: 340b.chargeback.adjudicated (340b.chargeback.adjudicated)</p><h3>Sources</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Endpoint</b></td></tr><tr><td style=\"display: none\">*</td><td>urn:system:manufacturer-77</td></tr></table><p><b>focus</b>: <a href=\"Bundle-bundle-chargeback-adjudicated.html#urn-uuid-88888888-8888-4888-8888-888888888888\">ClaimResponse: extension = tx-1002,corr-9001; status = active; type = Pharmacy; use = claim; created = 2026-04-24; outcome = complete; disposition = Approved</a></p></div>"
      },
      "eventCoding" : {
        "system" : "https://exchange.example.org/events",
        "code" : "340b.chargeback.adjudicated"
      },
      "source" : {
        "endpoint" : "urn:system:manufacturer-77"
      },
      "focus" : [{
        "reference" : "urn:uuid:88888888-8888-4888-8888-888888888888"
      }]
    }
  },
  {
    "fullUrl" : "urn:uuid:88888888-8888-4888-8888-888888888888",
    "resource" : {
      "resourceType" : "ClaimResponse",
      "id" : "cr-340b-1001",
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ClaimResponse_cr-340b-1001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ClaimResponse cr-340b-1001</b></p><a name=\"cr-340b-1001\"> </a><a name=\"hccr-340b-1001\"> </a><p><b>340B Exchange Transaction ID Extension</b>: tx-1002</p><p><b>340B Correlation ID Extension</b>: corr-9001</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>: Claim</p><p><b>patient</b>: <a href=\"Bundle-bundle-chargeback-adjudicated.html#urn-uuid-33333333-3333-4333-8333-333333333333\">Pat Example  (no stated gender), DoB Unknown</a></p><p><b>created</b>: 2026-04-24</p><p><b>insurer</b>: <a href=\"Bundle-bundle-chargeback-adjudicated.html#urn-uuid-55555555-5555-4555-8555-555555555555\">Organization Example Manufacturer 77</a></p><p><b>request</b>: <a href=\"https://example.org/fhir/Claim/claim-340b-1001\">https://example.org/fhir/Claim/claim-340b-1001</a></p><p><b>outcome</b>: Processing Complete</p><p><b>disposition</b>: Approved</p><blockquote><p><b>item</b></p><p><b>itemSequence</b>: 1</p><blockquote><p><b>adjudication</b></p><p><b>category</b>: <span title=\"Codes:\">allowed</span></p><h3>Amounts</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Value</b></td><td><b>Currency</b></td></tr><tr><td style=\"display: none\">*</td><td>125.42</td><td>United States dollar</td></tr></table></blockquote></blockquote></div>"
      },
      "extension" : [{
        "url" : "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-exchange-transaction-id",
        "valueString" : "tx-1002"
      },
      {
        "url" : "https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-correlation-id",
        "valueString" : "corr-9001"
      }],
      "status" : "active",
      "type" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/claim-type",
          "code" : "pharmacy"
        }]
      },
      "use" : "claim",
      "patient" : {
        "reference" : "urn:uuid:33333333-3333-4333-8333-333333333333"
      },
      "created" : "2026-04-24",
      "insurer" : {
        "reference" : "urn:uuid:55555555-5555-4555-8555-555555555555"
      },
      "request" : {
        "reference" : "https://example.org/fhir/Claim/claim-340b-1001"
      },
      "outcome" : "complete",
      "disposition" : "Approved",
      "item" : [{
        "itemSequence" : 1,
        "adjudication" : [{
          "category" : {
            "text" : "allowed"
          },
          "amount" : {
            "value" : 125.42,
            "currency" : "USD"
          }
        }]
      }]
    }
  },
  {
    "fullUrl" : "urn:uuid:33333333-3333-4333-8333-333333333333",
    "resource" : {
      "resourceType" : "Patient",
      "id" : "p-001",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Patient_p-001\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Patient p-001</b></p><a name=\"p-001\"> </a><a name=\"hcp-001\"> </a><p style=\"border: 1px #661aff solid; background-color: #e6e6ff; padding: 10px;\">Pat Example  (no stated gender), DoB Unknown</p><hr/></div>"
      },
      "name" : [{
        "family" : "Example",
        "given" : ["Pat"]
      }]
    }
  },
  {
    "fullUrl" : "urn:uuid:55555555-5555-4555-8555-555555555555",
    "resource" : {
      "resourceType" : "Organization",
      "id" : "manufacturer-77",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"Organization_manufacturer-77\"> </a><p class=\"res-header-id\"><b>Generated Narrative: Organization manufacturer-77</b></p><a name=\"manufacturer-77\"> </a><a name=\"hcmanufacturer-77\"> </a><p><b>name</b>: Example Manufacturer 77</p></div>"
      },
      "name" : "Example Manufacturer 77"
    }
  }]
}