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 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

DrugTierCS


<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="usdf-DrugTierCS"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
<p><b>DrugTierCS CodeSystem</b></p>
<p>The drug tier of a particular medication in a health plan.  Base set are examples.  Each plan may have its own controlled vocabulary.</p>
</div>
  </text>
  <url
       value="http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS"/>
  <version value="1.0.0"/>
  <name value="DrugTierCS"/>
  <title value="Drug Tier CS"/>
  <status value="draft"/>
  <date value="2020-01-17T00:00:00+00:00"/>
  <publisher value="HL7 Pharmacy WG"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/medication/"/>
    </telecom>
  </contact>
  <description
               value="The drug tier of a particular medication in a health plan.  Base set are examples.  Each plan may have its own controlled vocabulary."/>
  <caseSensitive value="true"/>
  <content value="complete"/>
  <count value="9"/>
  <concept>
    <code value="generic"/>
    <display value="Generic"/>
    <definition
                value="Commonly prescribed generic drugs that cost more than drugs in the ‘preferred generic’ tier."/>
  </concept>
  <concept>
    <code value="preferred-generic"/>
    <display value="Preferred Generic"/>
    <definition value="Commonly prescribed generic drugs."/>
  </concept>
  <concept>
    <code value="non-preferred-generic"/>
    <display value="Non-preferred Generic"/>
    <definition
                value="Generic drugs that cost more than drugs in ‘generic’ tier."/>
  </concept>
  <concept>
    <code value="specialty"/>
    <display value="Specialty"/>
    <definition
                value="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."/>
  </concept>
  <concept>
    <code value="brand"/>
    <display value="Brand"/>
    <definition
                value="Brand name drugs that cost more than ‘preferred brand’ drugs."/>
  </concept>
  <concept>
    <code value="preferred-brand"/>
    <display value="Preferred Brand"/>
    <definition value="Brand name drugs"/>
  </concept>
  <concept>
    <code value="non-preferred-brand"/>
    <display value="Non-preferred Brand"/>
    <definition value="Brand name drugs that cost more than ‘brand’ drugs."/>
  </concept>
  <concept>
    <code value="zero-cost-share-preventive"/>
    <display value="Zero cost-share preventive"/>
    <definition
                value="Preventive medications and products available at no cost."/>
  </concept>
  <concept>
    <code value="medical-service"/>
    <display value="Medical Service"/>
    <definition
                value="Drugs that must be administered by a clinician or in a facility and may be covered under a medical benefit."/>
  </concept>
</CodeSystem>