DaVinci Payer Data Exchange (PDex) US Drug Formulary
1.0.1 - STU 1.0.1

This page is part of the US Drug Formulary (v1.0.1: STU 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 medication drug tiers in health plans

Summary

Defining URL:http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS
Version:1.0.1
Name:DrugTierCS
Title:Codes for medication drug tiers in health plans
Status:Active as of 2020-12-21T16:49:28+00:00
Definition:

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.

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-DrugTierCS defines the following codes:

CodeDisplay
generic Generic: Commonly prescribed generic drugs that cost more than drugs in the ‘preferred generic’ tier.
preferred-generic Preferred Generic: Commonly prescribed generic drugs.
non-preferred-generic Non-preferred Generic: Generic drugs that cost more than drugs in ‘generic’ tier.
specialty Specialty: 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.
brand Brand: Brand name drugs that cost more than ‘preferred brand’ drugs.
preferred-brand Preferred Brand: Brand name drugs
non-preferred-brand Non-preferred Brand: Brand name drugs that cost more than ‘brand’ drugs.
zero-cost-share-preventative Zero cost-share preventative: Preventive medications and products available at no cost.
medical-service Medical Service: Drugs that must be administered by a clinician or in a facility and may be covered under a medical benefit.