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 medication drug tiers in health plans - 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-DrugTierCS"];
  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-DrugTierCS 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\">generic<a name=\"usdf-DrugTierCS-generic\"> </a></td><td>Generic</td><td>Commonly prescribed generic drugs that cost more than drugs in the ‘preferred generic’ tier.</td></tr><tr><td style=\"white-space:nowrap\">preferred-generic<a name=\"usdf-DrugTierCS-preferred-generic\"> </a></td><td>Preferred Generic</td><td>Commonly prescribed generic drugs.</td></tr><tr><td style=\"white-space:nowrap\">non-preferred-generic<a name=\"usdf-DrugTierCS-non-preferred-generic\"> </a></td><td>Non-preferred Generic</td><td>Generic drugs that cost more than drugs in ‘generic’ tier.</td></tr><tr><td style=\"white-space:nowrap\">specialty<a name=\"usdf-DrugTierCS-specialty\"> </a></td><td>Specialty</td><td>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.</td></tr><tr><td style=\"white-space:nowrap\">brand<a name=\"usdf-DrugTierCS-brand\"> </a></td><td>Brand</td><td>Brand name drugs that cost more than ‘preferred brand’ drugs.</td></tr><tr><td style=\"white-space:nowrap\">preferred-brand<a name=\"usdf-DrugTierCS-preferred-brand\"> </a></td><td>Preferred Brand</td><td>Brand name drugs</td></tr><tr><td style=\"white-space:nowrap\">non-preferred-brand<a name=\"usdf-DrugTierCS-non-preferred-brand\"> </a></td><td>Non-preferred Brand</td><td>Brand name drugs that cost more than ‘brand’ drugs.</td></tr><tr><td style=\"white-space:nowrap\">zero-cost-share-preventative<a name=\"usdf-DrugTierCS-zero-cost-share-preventative\"> </a></td><td>Zero cost-share preventative</td><td>Preventive medications and products available at no cost.</td></tr><tr><td style=\"white-space:nowrap\">medical-service<a name=\"usdf-DrugTierCS-medical-service\"> </a></td><td>Medical Service</td><td>Drugs that must be administered by a clinician or in a facility and may be covered under a medical benefit.</td></tr></table></div>"
  ];
  fhir:CodeSystem.url [ fhir:value "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS"];
  fhir:CodeSystem.version [ fhir:value "1.2.0"];
  fhir:CodeSystem.name [ fhir:value "DrugTierCS"];
  fhir:CodeSystem.title [ fhir:value "Codes for medication drug tiers in health plans"];
  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 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."];
  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 "9"^^xsd:nonNegativeInteger];
  fhir:CodeSystem.concept [
     fhir:index 0;
     fhir:CodeSystem.concept.code [ fhir:value "generic" ];
     fhir:CodeSystem.concept.display [ fhir:value "Generic" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Commonly prescribed generic drugs that cost more than drugs in the ‘preferred generic’ tier." ]
  ], [
     fhir:index 1;
     fhir:CodeSystem.concept.code [ fhir:value "preferred-generic" ];
     fhir:CodeSystem.concept.display [ fhir:value "Preferred Generic" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Commonly prescribed generic drugs." ]
  ], [
     fhir:index 2;
     fhir:CodeSystem.concept.code [ fhir:value "non-preferred-generic" ];
     fhir:CodeSystem.concept.display [ fhir:value "Non-preferred Generic" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Generic drugs that cost more than drugs in ‘generic’ tier." ]
  ], [
     fhir:index 3;
     fhir:CodeSystem.concept.code [ fhir:value "specialty" ];
     fhir:CodeSystem.concept.display [ fhir:value "Specialty" ];
     fhir:CodeSystem.concept.definition [ fhir:value "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." ]
  ], [
     fhir:index 4;
     fhir:CodeSystem.concept.code [ fhir:value "brand" ];
     fhir:CodeSystem.concept.display [ fhir:value "Brand" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Brand name drugs that cost more than ‘preferred brand’ drugs." ]
  ], [
     fhir:index 5;
     fhir:CodeSystem.concept.code [ fhir:value "preferred-brand" ];
     fhir:CodeSystem.concept.display [ fhir:value "Preferred Brand" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Brand name drugs" ]
  ], [
     fhir:index 6;
     fhir:CodeSystem.concept.code [ fhir:value "non-preferred-brand" ];
     fhir:CodeSystem.concept.display [ fhir:value "Non-preferred Brand" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Brand name drugs that cost more than ‘brand’ drugs." ]
  ], [
     fhir:index 7;
     fhir:CodeSystem.concept.code [ fhir:value "zero-cost-share-preventative" ];
     fhir:CodeSystem.concept.display [ fhir:value "Zero cost-share preventative" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Preventive medications and products available at no cost." ]
  ], [
     fhir:index 8;
     fhir:CodeSystem.concept.code [ fhir:value "medical-service" ];
     fhir:CodeSystem.concept.display [ fhir:value "Medical Service" ];
     fhir:CodeSystem.concept.definition [ fhir:value "Drugs that must be administered by a clinician or in a facility and may be covered under a medical benefit." ]
  ].

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

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