340B FHIR Exchange Implementation Guide
0.1.0-ballot - ci-build
340B FHIR Exchange Implementation Guide
0.1.0-ballot - ci-build
340B FHIR Exchange Implementation Guide - Local Development build (v0.1.0-ballot) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
<Bundle xmlns="http://hl7.org/fhir">
<id value="bundle-chargeback-submitted"/>
<meta>
<profile
value="https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-message-bundle"/>
</meta>
<identifier>
<system value="https://exchange.example.org/bundle-ids"/>
<value value="bundle-sub-1001"/>
</identifier>
<type value="message"/>
<timestamp value="2026-04-24T15:00:00Z"/>
<entry>
<fullUrl value="urn:uuid:11111111-1111-4111-8111-111111111111"/>
<resource>
<MessageHeader>
<text>
<status value="generated"/>
<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.submitted (340b.chargeback.submitted)</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:tpa-01</td></tr></table><p><b>focus</b>: <a href="Bundle-bundle-chargeback-submitted.html#urn-uuid-22222222-2222-4222-8222-222222222222">Claim: extension = tx-1001,corr-9001,1.2.0,https://exchange.example.org/chargeback#cb-1001; status = active; type = Pharmacy; use = claim; created = 2026-04-24; priority = Normal</a></p></div>
</text>
<eventCoding>
<system value="https://exchange.example.org/events"/>
<code value="340b.chargeback.submitted"/>
</eventCoding>
<source>
<endpoint value="urn:system:tpa-01"/>
</source>
<focus>
<reference value="urn:uuid:22222222-2222-4222-8222-222222222222"/>
</focus>
</MessageHeader>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:22222222-2222-4222-8222-222222222222"/>
<resource>
<Claim>
<id value="claim-340b-1001"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Claim_claim-340b-1001"> </a><p class="res-header-id"><b>Generated Narrative: Claim claim-340b-1001</b></p><a name="claim-340b-1001"> </a><a name="hcclaim-340b-1001"> </a><p><b>340B Exchange Transaction ID Extension</b>: tx-1001</p><p><b>340B Correlation ID Extension</b>: corr-9001</p><p><b>340B Rule Set Version Extension</b>: 1.2.0</p><p><b>340B Chargeback Reference Extension</b>: <code>https://exchange.example.org/chargeback</code>/cb-1001</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>provider</b>: <a href="Bundle-bundle-chargeback-submitted.html#urn-uuid-44444444-4444-4444-8444-444444444444">Organization Example Pharmacy 22</a></p><p><b>priority</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/processpriority normal}">Normal</span></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>true</td><td><a href="Bundle-bundle-chargeback-submitted.html#urn-uuid-66666666-6666-4666-8666-666666666666">Coverage: status = active</a></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></tr><tr><td style="display: none">*</td><td>1</td><td><span title="Codes:{http://example.org/drug-codes 00000-1111-22}">00000-1111-22</span></td></tr></table></div>
</text>
<extension
url="https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-exchange-transaction-id">
<valueString value="tx-1001"/>
</extension>
<extension
url="https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-correlation-id">
<valueString value="corr-9001"/>
</extension>
<extension
url="https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-rule-set-version">
<valueString value="1.2.0"/>
</extension>
<extension
url="https://exchange.example.org/fhir/ig/340b-exchange/StructureDefinition/340b-chargeback-reference">
<valueIdentifier>
<system value="https://exchange.example.org/chargeback"/>
<value value="cb-1001"/>
</valueIdentifier>
</extension>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/claim-type"/>
<code value="pharmacy"/>
</coding>
</type>
<use value="claim"/>
<patient>
<reference value="urn:uuid:33333333-3333-4333-8333-333333333333"/>
</patient>
<created value="2026-04-24"/>
<insurer>
<reference value="urn:uuid:55555555-5555-4555-8555-555555555555"/>
</insurer>
<provider>
<reference value="urn:uuid:44444444-4444-4444-8444-444444444444"/>
</provider>
<priority>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/processpriority"/>
<code value="normal"/>
</coding>
</priority>
<insurance>
<sequence value="1"/>
<focal value="true"/>
<coverage>
<reference value="urn:uuid:66666666-6666-4666-8666-666666666666"/>
</coverage>
</insurance>
<item>
<sequence value="1"/>
<productOrService>
<coding>
<system value="http://example.org/drug-codes"/>
<code value="00000-1111-22"/>
</coding>
</productOrService>
</item>
</Claim>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:33333333-3333-4333-8333-333333333333"/>
<resource>
<Patient>
<id value="p-001"/>
<text>
<status value="generated"/>
<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>
</text>
<name>
<family value="Example"/>
<given value="Pat"/>
</name>
</Patient>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:44444444-4444-4444-8444-444444444444"/>
<resource>
<Organization>
<id value="pharmacy-22"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Organization_pharmacy-22"> </a><p class="res-header-id"><b>Generated Narrative: Organization pharmacy-22</b></p><a name="pharmacy-22"> </a><a name="hcpharmacy-22"> </a><p><b>name</b>: Example Pharmacy 22</p></div>
</text>
<name value="Example Pharmacy 22"/>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:55555555-5555-4555-8555-555555555555"/>
<resource>
<Organization>
<id value="manufacturer-77"/>
<text>
<status value="generated"/>
<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>
</text>
<name value="Example Manufacturer 77"/>
</Organization>
</resource>
</entry>
<entry>
<fullUrl value="urn:uuid:66666666-6666-4666-8666-666666666666"/>
<resource>
<Coverage>
<id value="cov-001"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><a name="Coverage_cov-001"> </a><p class="res-header-id"><b>Generated Narrative: Coverage cov-001</b></p><a name="cov-001"> </a><a name="hccov-001"> </a><p><b>status</b>: Active</p><p><b>beneficiary</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>payor</b>: <a href="Bundle-bundle-chargeback-adjudicated.html#urn-uuid-55555555-5555-4555-8555-555555555555">Organization Example Manufacturer 77</a></p></div>
</text>
<status value="active"/>
<beneficiary>
<reference value="urn:uuid:33333333-3333-4333-8333-333333333333"/>
</beneficiary>
<payor>
<reference value="urn:uuid:55555555-5555-4555-8555-555555555555"/>
</payor>
</Coverage>
</resource>
</entry>
</Bundle>