--- title: Message Examples slug: rtpb-providers/guide/message-examples docTags: createdAt: 2026-06-11T13:22:17.797Z --- :::hint{type="info"} **Note: **Examples are intended for schema illustration purposes only. The data supplied in the examples may not be clinically accurate. ::: ## RTPBRequest Example :::hint{type="info"} **Note: **This example includes diagnosis information. ::: ```xml 017010 IIN 0215COMM PCN 123456789 PY D00000000123597 D SomeGeneratedEHRId EligibilityIdObtainedFromEHR 2024-03-12T10:10:02.9587124Z 2233445566 WHITE MARY F 1935-10-01 MD 20850 Annapolis 123456789 00456140230 30 38 C48542 30 0 DiagnosisCode1 ABF DiagnosisCode2 LD 2256487127 JONES 0618097 2123112346 ELM STREET PHARMACY 3015550120 ``` ## RTPBResponse Example :::CodeblockTabs RTPBResponse Example ```xml                        D00000000123597         D                                 434257         IIN                       012345         PCN                        D00000000478396          PY                   SomeGeneratedId     RequestIdSentFromEHR     2024-03-12T10:10:02.9587124Z                                      Success                                                        00456401001                             Celexa 10mg Tablet                    30           38                        C28254                                                     R                            3412131               1234567890                          UNKNOWN                                   R             CC             U                            30               38                                C28254                                         30             703.39                            01               0.3                          40             3176.67                                                     M                            2623735               1234567890                          UNKNOWN                                   M             CR             U                            90               38                                C28254                                         90             766.26             0             3209.05                            9G                                         7X                                         608                                         MR                                         AJ                                                                  R                            0100949               1234567890                          UNKNOWN                                   D             CR             U                            90               38                                C28254                                         90                            7X                                                                                00185037101                             FirstAlternate                                 R                            3412131               1234567890                          UNKNOWN                                   R             CC             U                            30               38                                C28254                                         30             3.6                                                                   00378700110                             SecondAlternate                                 R                            3412131               1234567890                          UNKNOWN                                   R             CC             U                            30               38                                C28254                                         30             3.6                                    ``` ::: ## Affiliated Pharmacy Request Example ```xml                        S00000000000005         PY                       T00000001123020         PY                                 D00000000123597         D                 SomeGeneratedEHRId     EligibilityIdObtainedFromEHR     2024-03-12T10:10:02.9587124Z     2233445566                                      WHITE           MARY                             F                  1935-10-01         MD         20850             Annapolis                            123456789                                               00456140230                                        30           38                        C48542                             30         0                                  2256487127                  JONES                                  0618097           2123112346                  ELM STREET PHARMACY         3015550120                                                      1375426                                   2123112346                                        RED LAKE BAND OF CHIPPEWA INDIANS                             6122223333                         ```