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 
Definitions for usdf-DrugTierDefinition-extension.
| 1. Extension | |
| Definition | 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. |
| Control | 0..* This element is affected by the following invariants: ele-1 |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 2. Extension.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Control | 0..1 |
| Type | string |
| 3. Extension.extension | |
| Definition | An Extension |
| Control | 2..* |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 4. Extension.extension:drugTierID | |
| SliceName | drugTierID |
| Definition | A code that describes the coverage status of a drug in a health plan (e.g., preferred generic, specialty, etc.) |
| Control | 1..1 |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 5. Extension.extension:drugTierID.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Control | 0..1 |
| Type | string |
| 6. Extension.extension:drugTierID.extension | |
| Definition | An Extension |
| Control | 0..0 |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 7. Extension.extension:drugTierID.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Control | 1..1 |
| Type | uri |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | drugTierID |
| 8. Extension.extension:drugTierID.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 1..1 |
| Type | CodeableConcept |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Extension.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
|
| 9. Extension.extension:drugTierID.value[x]:valueCodeableConcept | |
| SliceName | valueCodeableConcept |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 1..1 |
| Binding | The codes SHALL be taken from Drug Tier VS; other codes may be used where these codes are not suitable |
| Type | CodeableConcept |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 10. Extension.extension:mailOrder | |
| SliceName | mailOrder |
| Definition | A Boolean indication of whether this drug tier supports a mail order pharmacy option |
| Control | 1..1 |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 11. Extension.extension:mailOrder.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Control | 0..1 |
| Type | string |
| 12. Extension.extension:mailOrder.extension | |
| Definition | An Extension |
| Control | 0..0 |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 13. Extension.extension:mailOrder.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Control | 1..1 |
| Type | uri |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | mailOrder |
| 14. Extension.extension:mailOrder.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 1..1 |
| Type | boolean |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Extension.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
|
| 15. Extension.extension:mailOrder.value[x]:valueBoolean | |
| SliceName | valueBoolean |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 1..1 |
| Type | boolean |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 16. Extension.extension:costSharing | |
| SliceName | costSharing |
| Definition | Definition of the patients responsibility for a portion of the cost not covered by insurance for a particular pharmacy type within a drug tier |
| Control | 0..* |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 17. Extension.extension:costSharing.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Control | 0..1 |
| Type | string |
| 18. Extension.extension:costSharing.extension | |
| Definition | An Extension |
| Control | 5..* |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 19. Extension.extension:costSharing.extension:pharmacyType | |
| SliceName | pharmacyType |
| Definition | A code that describes the network (in/out) status of a pharmacy, the duration of supply, and whether this is a mail order pharmacy. |
| Control | 1..1 |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 20. Extension.extension:costSharing.extension:pharmacyType.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Control | 0..1 |
| Type | string |
| 21. Extension.extension:costSharing.extension:pharmacyType.extension | |
| Definition | An Extension |
| Control | 0..0 |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 22. Extension.extension:costSharing.extension:pharmacyType.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Control | 1..1 |
| Type | uri |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | pharmacyType |
| 23. Extension.extension:costSharing.extension:pharmacyType.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 1..1 |
| Type | CodeableConcept |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Extension.extension.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
|
| 24. Extension.extension:costSharing.extension:pharmacyType.value[x]:valueCodeableConcept | |
| SliceName | valueCodeableConcept |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 1..1 |
| Binding | The codes SHALL be taken from Pharmacy Type VS; other codes may be used where these codes are not suitable |
| Type | CodeableConcept |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 25. Extension.extension:costSharing.extension:copayAmount | |
| SliceName | copayAmount |
| Definition | A standard, nominal fee charged for each prescription of a drug |
| Control | 1..1 |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 26. Extension.extension:costSharing.extension:copayAmount.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Control | 0..1 |
| Type | string |
| 27. Extension.extension:costSharing.extension:copayAmount.extension | |
| Definition | An Extension |
| Control | 0..0 |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 28. Extension.extension:costSharing.extension:copayAmount.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Control | 1..1 |
| Type | uri |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | copayAmount |
| 29. Extension.extension:costSharing.extension:copayAmount.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 1..1 |
| Type | Money |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Extension.extension.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
|
| 30. Extension.extension:costSharing.extension:copayAmount.value[x]:valueMoney | |
| SliceName | valueMoney |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 1..1 |
| Type | Money |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 31. Extension.extension:costSharing.extension:copayOption | |
| SliceName | copayOption |
| Definition | A code that qualifies the copay amount |
| Control | 1..1 |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 32. Extension.extension:costSharing.extension:copayOption.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Control | 0..1 |
| Type | string |
| 33. Extension.extension:costSharing.extension:copayOption.extension | |
| Definition | An Extension |
| Control | 0..0 |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 34. Extension.extension:costSharing.extension:copayOption.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Control | 1..1 |
| Type | uri |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | copayOption |
| 35. Extension.extension:costSharing.extension:copayOption.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 1..1 |
| Type | CodeableConcept |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Extension.extension.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
|
| 36. Extension.extension:costSharing.extension:copayOption.value[x]:valueCodeableConcept | |
| SliceName | valueCodeableConcept |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 1..1 |
| Binding | The codes SHALL be taken from Copay Option VS |
| Type | CodeableConcept |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 37. Extension.extension:costSharing.extension:coinsuranceRate | |
| SliceName | coinsuranceRate |
| Definition | A fee charged for each prescription of a drug, expressed as a percentage of that drug's overall cost |
| Control | 1..1 |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 38. Extension.extension:costSharing.extension:coinsuranceRate.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Control | 0..1 |
| Type | string |
| 39. Extension.extension:costSharing.extension:coinsuranceRate.extension | |
| Definition | An Extension |
| Control | 0..0 |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 40. Extension.extension:costSharing.extension:coinsuranceRate.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Control | 1..1 |
| Type | uri |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | coinsuranceRate |
| 41. Extension.extension:costSharing.extension:coinsuranceRate.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 1..1 |
| Type | decimal |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Extension.extension.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
|
| 42. Extension.extension:costSharing.extension:coinsuranceRate.value[x]:valueDecimal | |
| SliceName | valueDecimal |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 1..1 |
| Type | decimal |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 43. Extension.extension:costSharing.extension:coinsuranceOption | |
| SliceName | coinsuranceOption |
| Definition | A code that qualifies the coinsurance rate |
| Control | 1..1 |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| 44. Extension.extension:costSharing.extension:coinsuranceOption.id | |
| Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. |
| Control | 0..1 |
| Type | string |
| 45. Extension.extension:costSharing.extension:coinsuranceOption.extension | |
| Definition | An Extension |
| Control | 0..0 |
| Type | Extension |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists()) |
| Slicing | This element introduces a set of slices on Extension.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators:
|
| 46. Extension.extension:costSharing.extension:coinsuranceOption.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Control | 1..1 |
| Type | uri |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | coinsuranceOption |
| 47. Extension.extension:costSharing.extension:coinsuranceOption.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 1..1 |
| Type | CodeableConcept |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| Slicing | This element introduces a set of slices on Extension.extension.extension.value[x]. The slices are unordered and Closed, and can be differentiated using the following discriminators:
|
| 48. Extension.extension:costSharing.extension:coinsuranceOption.value[x]:valueCodeableConcept | |
| SliceName | valueCodeableConcept |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 1..1 |
| Binding | The codes SHALL be taken from Coinsurance Option VS |
| Type | CodeableConcept |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 49. Extension.extension:costSharing.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Control | 1..1 |
| Type | uri |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | costSharing |
| 50. Extension.extension:costSharing.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 0..0 |
| Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
| 51. Extension.url | |
| Definition | Source of the definition for the extension code - a logical name or a URL. |
| Control | 1..1 |
| Type | uri |
| Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension. |
| Fixed Value | http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierDefinition-extension |
| 52. Extension.value[x] | |
| Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list). |
| Control | 0..0 |
| Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta |
| [x] Note | See Choice of Data Types for further information about how to use [x] |
| Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) |
©2020+
HL7 Pharmacy WG.
Package hl7.fhir.us.davinci-drug-formulary#1.0.0 based on FHIR 4.0.1.
Generated 2020-01-21.
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