US Drug Formulary STU Ballot

This page is part of the US Drug Formulary (v0.1.0: STU 1 Draft) 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

Example: CoveragePlanV3004t

*** CoveragePlan Example #1 (Reference to MedicationKnowledge) ***

id: covplanV2001

Plan Name: Sample Gold Health Plan

Drug Product: (Generated Detail from id - formularydrugV1001): Acetaminophen 325 MG / Oxycodone Hydrochloride 5 MG Oral Tablet [Percocet]

Status: current

Drug Tier ID: Brand

Mail order: false

Pharmacy type: 1-MONTH-IN-RETAIL

Copay Amount: 20.0

Copay option: AFTER-DEDUCTIBLE

Coinsurance rate: 0.20

Coinsurance option: AFTER-DEDUCTIBLE