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 (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.1.0. For a full list of available versions, see the Directory of published versions

ValueSet: Drug tier of medication in health plan

Summary

Defining URL:http://hl7.org/fhir/us/davinci-drug-formulary/ValueSet/DrugTierVS
Version:1.0.1
Name:DrugTierVS
Title:Drug tier of medication in health plan
Status:Active as of 2020-12-21T16:49:28+00:00
Definition:

The drug tier of a particular medication in a health plan. The base set are examples. Each plan may have its own controlled vocabulary.

Publisher:HL7 Pharmacy Working Group
Source Resource:XML / JSON / Turtle

References

Logical Definition (CLD)

 

Expansion

This value set contains 9 concepts

Expansion based on Codes for medication drug tiers in health plans v1.0.1 (CodeSystem)

All codes from system http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS

CodeDisplayDefinition
genericGeneric: Commonly prescribed generic drugs that cost more than drugs in the ‘preferred generic’ tier.
preferred-genericPreferred Generic: Commonly prescribed generic drugs.
non-preferred-genericNon-preferred Generic: Generic drugs that cost more than drugs in ‘generic’ tier.
specialtySpecialty: 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.
brandBrand: Brand name drugs that cost more than ‘preferred brand’ drugs.
preferred-brandPreferred Brand: Brand name drugs
non-preferred-brandNon-preferred Brand: Brand name drugs that cost more than ‘brand’ drugs.
zero-cost-share-preventativeZero cost-share preventative: Preventive medications and products available at no cost.
medical-serviceMedical Service: Drugs that must be administered by a clinician or in a facility and may be covered under a medical benefit.

Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
Source The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code