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

CostSharing

Definitions for usdf-CostSharing-extension.

1. Extension:costsharing
Definition

Definition of the patients responsibility for a portion of the cost not covered by insurance for a particular pharmacy type within a drug tier

Control0..* This element is affected by the following invariants: ele-1
InvariantsDefined on this element
ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
2. Extension:costsharing.id
Definition

Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.

Control0..1
Typestring
3. Extension:costsharing.extension
Definition

May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.

Control5..*
TypeExtension
Alternate Namesextensions, user content
Comments

There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.

4. Extension:costsharing.extension:pharmacytype
Definition

A code that describes the network (in/out) status of a pharmacy, the duration of supply, and whether this is a mail order pharmacy.

Control1..1
TypeExtension(PharmacyType) (Extension Type: CodeableConcept)
5. Extension:costsharing.extension:copayamount
Definition

A standard, nominal fee charged for each prescription of a drug

Control1..1
TypeExtension(CopayAmount) (Extension Type: Money)
6. Extension:costsharing.extension:copayoption
Definition

A code that qualifies the copay amount

Control1..1
TypeExtension(CopayOption) (Extension Type: CodeableConcept)
7. Extension:costsharing.extension:coinsurancerate
Definition

A fee charged for each prescription of a drug, expressed as a percentage of that drug's overall cost

Control1..1
TypeExtension(CoInsuranceRate) (Extension Type: decimal)
8. Extension:costsharing.extension:coinsuranceoption
Definition

A code that qualifies the coinsurance rate

Control1..1
TypeExtension(CoinsuranceOption) (Extension Type: CodeableConcept)
9. Extension:costsharing.url
Definition

Source of the definition for the extension code - a logical name or a URL.

Control1..1
Typeuri
Comments

The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.

Fixed Valuehttp://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-CostSharing-extension
10. Extension:costsharing.value[x]
Definition

Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).

Control0..0
TypeChoice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage
[x] NoteSee Choice of Data Types for further information about how to use [x]