DaVinci Payer Data Exchange (PDex) US Drug Formulary | STU2 Ballot
1.2.0 - STU2 Ballot

This page is part of the US Drug Formulary (v1.2.0: STU 2 Ballot 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 qualifier of copay amount

Summary

Defining URL:http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-CopayOptionCS
Version:1.2.0
Name:CopayOptionCS
Title:Codes for qualifier of copay amount
Status:Active as of 12/3/21 6:37 PM
Definition:

Codes for qualifier of copay amount

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:

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

CodeDisplayDefinition
after-deductible After DeductibleThe consumer first pays the deductible, and after the deductible is met, the consumer is responsible only for the copay (this indicates that this benefit is subject to the deductible).
before-deductible Before DeductibleThe consumer first pays the copay, and any net remaining allowed charges accrue to the deductible (this indicates that this benefit is subject to the deductible).
no-charge No ChargeNo cost sharing is charged (this indicates that this benefit is not subject to the deductible).
no-charge-after-deductible No Charge After DeductibleThe consumer first pays the deductible, and after the deductible is met, no copayment is charged (this indicates that this benefit is subject to the deductible).
charge ChargeThe consumer always pays just the copay and the issuer pays the remainder of allowed charges (this indicates that this benefit is not subject to the deductible).
not-applicable Not ApplicableDeductible is not applicable: Zero-deductible cost sharing represented by a co-pay value of 'Not applicable' and co-insurance value of 'No charge'.
deductible-waived Deductible WaivedThe consumer pays the copay with deductible requirement waived.