HL7.FHIR.US.DAVINCI-DRUG-FORMULARY\Codes for medication drug tiers in health plans

DaVinci Payer Data Exchange (PDex) US Drug Formulary
1.1.0 - STU 1.1

This page is part of the US Drug Formulary (v1.1.0: STU 1) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions

CodeSystem: Codes for medication drug tiers in health plans

Summary

Defining URL:

http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS

Version:

1.1.0

Name:

DrugTierCS

Title:

Codes for medication drug tiers in health plans

Status:

Active as of 2021-10-15T15:46:55+00:00

Definition:

Codes to represent the drug tier of a particular medication in a health plan. Base set are examples. Each plan may have its own controlled vocabulary.

Publisher:

HL7 Pharmacy Working Group

Content:

Complete: All the concepts defined by the code system are included in the code system resource

Source Resource:

XML / JSON / Turtle

This Code system is referenced in the content logical definition of the following value sets:

DrugTierVS

This code system http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS defines the following codes:

Code	Display	Definition
generic	Generic	Commonly prescribed generic drugs that cost more than drugs in the ‘preferred generic’ tier.
preferred-generic	Preferred Generic	Commonly prescribed generic drugs.
non-preferred-generic	Non-preferred Generic	Generic drugs that cost more than drugs in ‘generic’ tier.
specialty	Specialty	Drugs used to treat complex conditions like cancer and multiple sclerosis. They can be generic or brand name, and are typically the most expensive drugs on the formulary.
brand	Brand	Brand name drugs that cost more than ‘preferred brand’ drugs.
preferred-brand	Preferred Brand	Brand name drugs
non-preferred-brand	Non-preferred Brand	Brand name drugs that cost more than ‘brand’ drugs.
zero-cost-share-preventative	Zero cost-share preventative	Preventive medications and products available at no cost.
medical-service	Medical Service	Drugs that must be administered by a clinician or in a facility and may be covered under a medical benefit.