DaVinci Payer Data Exchange (PDex) US Drug Formulary STU 1

DaVinci Payer Data Exchange (PDex) US Drug Formulary STU 1

This page is part of the US Drug Formulary (v1.0.0: 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

Drug Tier CS

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

This code system http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS defines the following codes:

Code	Display	Definition
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-preventive	Zero cost-share preventive	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.

Downloads: XML, JSON, Turtle

This code system is used by the following value sets: