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

: Codes for qualifier of copay amount - TTL Representation

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

 a fhir:CodeSystem;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "usdf-CopayOptionCS"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This code system http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-CopayOptionCS defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">after-deductible<a name=\"usdf-CopayOptionCS-after-deductible\"> </a></td><td>After Deductible</td><td>The 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).</td></tr><tr><td style=\"white-space:nowrap\">before-deductible<a name=\"usdf-CopayOptionCS-before-deductible\"> </a></td><td>Before Deductible</td><td>The 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).</td></tr><tr><td style=\"white-space:nowrap\">no-charge<a name=\"usdf-CopayOptionCS-no-charge\"> </a></td><td>No Charge</td><td>No cost sharing is charged (this indicates that this benefit is not subject to the deductible).</td></tr><tr><td style=\"white-space:nowrap\">no-charge-after-deductible<a name=\"usdf-CopayOptionCS-no-charge-after-deductible\"> </a></td><td>No Charge After Deductible</td><td>The 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).</td></tr><tr><td style=\"white-space:nowrap\">charge<a name=\"usdf-CopayOptionCS-charge\"> </a></td><td>Charge</td><td>The 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).</td></tr><tr><td style=\"white-space:nowrap\">not-applicable<a name=\"usdf-CopayOptionCS-not-applicable\"> </a></td><td>Not Applicable</td><td>Deductible is not applicable: Zero-deductible cost sharing represented by a co-pay value of 'Not applicable' and co-insurance value of 'No charge'.</td></tr><tr><td style=\"white-space:nowrap\">deductible-waived<a name=\"usdf-CopayOptionCS-deductible-waived\"> </a></td><td>Deductible Waived</td><td>The consumer pays the copay with deductible requirement waived.</td></tr></table></div>"
  ];
  fhir:CodeSystem.url [ fhir:value "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-CopayOptionCS"];
  fhir:CodeSystem.version [ fhir:value "1.2.0"];
  fhir:CodeSystem.name [ fhir:value "CopayOptionCS"];
  fhir:CodeSystem.title [ fhir:value "Codes for qualifier of copay amount"];
  fhir:CodeSystem.status [ fhir:value "active"];
  fhir:CodeSystem.date [ fhir:value "2021-12-03T18:37:11+00:00"^^xsd:dateTime];
  fhir:CodeSystem.publisher [ fhir:value "HL7 Pharmacy Working Group"];
  fhir:CodeSystem.contact [
     fhir:index 0;
     fhir:ContactDetail.name [ fhir:value "HL7 Pharmacy Working Group" ];
     fhir:ContactDetail.telecom [
       fhir:index 0;
       fhir:ContactPoint.system [ fhir:value "url" ];
       fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/medication" ]     ], [
       fhir:index 1;
       fhir:ContactPoint.system [ fhir:value "email" ];
       fhir:ContactPoint.value [ fhir:value "pharmacy@lists.HL7.org" ]     ]
  ];
  fhir:CodeSystem.description [ fhir:value "Codes for qualifier of copay amount"];
  fhir:CodeSystem.jurisdiction [
     fhir:index 0;
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ];
       fhir:Coding.code [ fhir:value "US" ]     ]
  ];
  fhir:CodeSystem.caseSensitive [ fhir:value "true"^^xsd:boolean];
  fhir:CodeSystem.content [ fhir:value "complete"];
  fhir:CodeSystem.count [ fhir:value "7"^^xsd:nonNegativeInteger];
  fhir:CodeSystem.concept [
     fhir:index 0;
     fhir:CodeSystem.concept.code [ fhir:value "after-deductible" ];
     fhir:CodeSystem.concept.display [ fhir:value "After Deductible" ];
     fhir:CodeSystem.concept.definition [ fhir:value "The 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)." ]
  ], [
     fhir:index 1;
     fhir:CodeSystem.concept.code [ fhir:value "before-deductible" ];
     fhir:CodeSystem.concept.display [ fhir:value "Before Deductible" ];
     fhir:CodeSystem.concept.definition [ fhir:value "The 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)." ]
  ], [
     fhir:index 2;
     fhir:CodeSystem.concept.code [ fhir:value "no-charge" ];
     fhir:CodeSystem.concept.display [ fhir:value "No Charge" ];
     fhir:CodeSystem.concept.definition [ fhir:value "No cost sharing is charged (this indicates that this benefit is not subject to the deductible)." ]
  ], [
     fhir:index 3;
     fhir:CodeSystem.concept.code [ fhir:value "no-charge-after-deductible" ];
     fhir:CodeSystem.concept.display [ fhir:value "No Charge After Deductible" ];
     fhir:CodeSystem.concept.definition [ fhir:value "The 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)." ]
  ], [
     fhir:index 4;
     fhir:CodeSystem.concept.code [ fhir:value "charge" ];
     fhir:CodeSystem.concept.display [ fhir:value "Charge" ];
     fhir:CodeSystem.concept.definition [ fhir:value "The 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)." ]
  ], [
     fhir:index 5;
     fhir:CodeSystem.concept.code [ fhir:value "not-applicable" ];
     fhir:CodeSystem.concept.display [ fhir:value "Not Applicable" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Deductible is not applicable: Zero-deductible cost sharing represented by a co-pay value of 'Not applicable' and co-insurance value of 'No charge'." ]
  ], [
     fhir:index 6;
     fhir:CodeSystem.concept.code [ fhir:value "deductible-waived" ];
     fhir:CodeSystem.concept.display [ fhir:value "Deductible Waived" ];
     fhir:CodeSystem.concept.definition [ fhir:value "The consumer pays the copay with deductible requirement waived." ]
  ].

# - ontology header ------------------------------------------------------------

 a owl:Ontology;
  owl:imports fhir:fhir.ttl.