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
A description of the drug tiers used by the formulary and how those tiers implement copay and coinsurance amounts. Drug tiers do not have any inherent meaning that is consistent across all formularies. Rather, each tier is defined using this element.
The official URL for this extension is:
http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierDefinition-extension
Status: active
Extension maintained by: HL7 Pharmacy Working Group
Context of Use
This extension may be used on the following element(s):
Usage info
Usage:
Description of Profiles, Differentials, Snapshots, and how the XML and JSON presentations work.
This structure is derived from Extension
This structure is derived from Extension
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Extension | 0..* | Extension | Extension | |
extension | 2..* | Extension | Extension | |
extension:drugTierID | 1..1 | Extension | Drug Tier ID | |
extension | 0..0 | |||
url | 1..1 | uri | "drugTierID" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: Drug tier of medication in health plan (extensible) | |
extension:mailOrder | 1..1 | Extension | Mail Order | |
extension | 0..0 | |||
url | 1..1 | uri | "mailOrder" | |
value[x] | 1..1 | boolean | Value of extension | |
extension:costSharing | 0..* | Extension | Extension | |
extension | 5..* | Extension | Extension | |
extension:pharmacyType | 1..1 | Extension | Pharmacy Type | |
extension | 0..0 | |||
url | 1..1 | uri | "pharmacyType" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: Type of pharmacies (extensible) | |
extension:copayAmount | 1..1 | Extension | Copay Amount | |
extension | 0..0 | |||
url | 1..1 | uri | "copayAmount" | |
value[x] | 1..1 | Money | Value of extension | |
extension:copayOption | 1..1 | Extension | Copay Options | |
extension | 0..0 | |||
url | 1..1 | uri | "copayOption" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: Qualifier of copay amount (required) | |
extension:coinsuranceRate | 1..1 | Extension | Co-Insurance Rate | |
extension | 0..0 | |||
url | 1..1 | uri | "coinsuranceRate" | |
value[x] | 1..1 | decimal | Value of extension | |
extension:coinsuranceOption | 1..1 | Extension | Co-Insurance Option | |
extension | 0..0 | |||
url | 1..1 | uri | "coinsuranceOption" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: Qualifier for coinsurance rate (required) | |
url | 1..1 | uri | "costSharing" | |
value[x] | 0..0 | |||
url | 1..1 | uri | "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierDefinition-extension" | |
value[x] | 0..0 | |||
Documentation for this format |
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Extension | 0..* | Extension | Extension | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 2..* | Extension | Extension Slice: Unordered, Open by value:url | |
extension:drugTierID | 1..1 | Extension | Drug Tier ID | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..0 | |||
url | 1..1 | uri | "drugTierID" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: Drug tier of medication in health plan (extensible) | |
extension:mailOrder | 1..1 | Extension | Mail Order | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..0 | |||
url | 1..1 | uri | "mailOrder" | |
value[x] | 1..1 | boolean | Value of extension | |
extension:costSharing | 0..* | Extension | Extension | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 5..* | Extension | Extension Slice: Unordered, Open by value:url | |
extension:pharmacyType | 1..1 | Extension | Pharmacy Type | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..0 | |||
url | 1..1 | uri | "pharmacyType" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: Type of pharmacies (extensible) | |
extension:copayAmount | 1..1 | Extension | Copay Amount | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..0 | |||
url | 1..1 | uri | "copayAmount" | |
value[x] | 1..1 | Money | Value of extension | |
extension:copayOption | 1..1 | Extension | Copay Options | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..0 | |||
url | 1..1 | uri | "copayOption" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: Qualifier of copay amount (required) | |
extension:coinsuranceRate | 1..1 | Extension | Co-Insurance Rate | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..0 | |||
url | 1..1 | uri | "coinsuranceRate" | |
value[x] | 1..1 | decimal | Value of extension | |
extension:coinsuranceOption | 1..1 | Extension | Co-Insurance Option | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..0 | |||
url | 1..1 | uri | "coinsuranceOption" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: Qualifier for coinsurance rate (required) | |
url | 1..1 | uri | "costSharing" | |
url | 1..1 | uri | "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierDefinition-extension" | |
Documentation for this format |
This structure is derived from Extension
Differential View
This structure is derived from Extension
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Extension | 0..* | Extension | Extension | |
extension | 2..* | Extension | Extension | |
extension:drugTierID | 1..1 | Extension | Drug Tier ID | |
extension | 0..0 | |||
url | 1..1 | uri | "drugTierID" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: Drug tier of medication in health plan (extensible) | |
extension:mailOrder | 1..1 | Extension | Mail Order | |
extension | 0..0 | |||
url | 1..1 | uri | "mailOrder" | |
value[x] | 1..1 | boolean | Value of extension | |
extension:costSharing | 0..* | Extension | Extension | |
extension | 5..* | Extension | Extension | |
extension:pharmacyType | 1..1 | Extension | Pharmacy Type | |
extension | 0..0 | |||
url | 1..1 | uri | "pharmacyType" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: Type of pharmacies (extensible) | |
extension:copayAmount | 1..1 | Extension | Copay Amount | |
extension | 0..0 | |||
url | 1..1 | uri | "copayAmount" | |
value[x] | 1..1 | Money | Value of extension | |
extension:copayOption | 1..1 | Extension | Copay Options | |
extension | 0..0 | |||
url | 1..1 | uri | "copayOption" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: Qualifier of copay amount (required) | |
extension:coinsuranceRate | 1..1 | Extension | Co-Insurance Rate | |
extension | 0..0 | |||
url | 1..1 | uri | "coinsuranceRate" | |
value[x] | 1..1 | decimal | Value of extension | |
extension:coinsuranceOption | 1..1 | Extension | Co-Insurance Option | |
extension | 0..0 | |||
url | 1..1 | uri | "coinsuranceOption" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: Qualifier for coinsurance rate (required) | |
url | 1..1 | uri | "costSharing" | |
value[x] | 0..0 | |||
url | 1..1 | uri | "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierDefinition-extension" | |
value[x] | 0..0 | |||
Documentation for this format |
Snapshot View
Name | Flags | Card. | Type | Description & Constraints |
---|---|---|---|---|
Extension | 0..* | Extension | Extension | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 2..* | Extension | Extension Slice: Unordered, Open by value:url | |
extension:drugTierID | 1..1 | Extension | Drug Tier ID | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..0 | |||
url | 1..1 | uri | "drugTierID" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: Drug tier of medication in health plan (extensible) | |
extension:mailOrder | 1..1 | Extension | Mail Order | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..0 | |||
url | 1..1 | uri | "mailOrder" | |
value[x] | 1..1 | boolean | Value of extension | |
extension:costSharing | 0..* | Extension | Extension | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 5..* | Extension | Extension Slice: Unordered, Open by value:url | |
extension:pharmacyType | 1..1 | Extension | Pharmacy Type | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..0 | |||
url | 1..1 | uri | "pharmacyType" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: Type of pharmacies (extensible) | |
extension:copayAmount | 1..1 | Extension | Copay Amount | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..0 | |||
url | 1..1 | uri | "copayAmount" | |
value[x] | 1..1 | Money | Value of extension | |
extension:copayOption | 1..1 | Extension | Copay Options | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..0 | |||
url | 1..1 | uri | "copayOption" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: Qualifier of copay amount (required) | |
extension:coinsuranceRate | 1..1 | Extension | Co-Insurance Rate | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..0 | |||
url | 1..1 | uri | "coinsuranceRate" | |
value[x] | 1..1 | decimal | Value of extension | |
extension:coinsuranceOption | 1..1 | Extension | Co-Insurance Option | |
id | 0..1 | string | Unique id for inter-element referencing | |
extension | 0..0 | |||
url | 1..1 | uri | "coinsuranceOption" | |
value[x] | 1..1 | CodeableConcept | Value of extension Binding: Qualifier for coinsurance rate (required) | |
url | 1..1 | uri | "costSharing" | |
url | 1..1 | uri | "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierDefinition-extension" | |
Documentation for this format |
Other representations of extension: Schematron
Path | Conformance | ValueSet |
Extension.extension:drugTierID.value[x] | extensible | DrugTierVS |
Extension.extension:costSharing.extension:pharmacyType.value[x] | extensible | PharmacyTypeVS |
Extension.extension:costSharing.extension:copayOption.value[x] | required | CopayOptionVS |
Extension.extension:costSharing.extension:coinsuranceOption.value[x] | required | CoinsuranceOptionVS |