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

PriorAuthorization

{
  "resourceType" : "StructureDefinition",
  "id" : "usdf-PriorAuthorization-extension",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n  <p><b>PriorAuthorization Extension</b></p>\n  <p>A Boolean indication of whether the coverage plan imposes a prior authorization requirement on this drug.</p>\n</div>"
  },
  "url" : "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorization-extension",
  "version" : "1.0.0",
  "name" : "PriorAuthorization",
  "title" : "Prior Authorization",
  "status" : "draft",
  "date" : "2020-01-17T00:00:00+00:00",
  "publisher" : "HL7 Pharmacy WG",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/medication/"
        }
      ]
    }
  ],
  "description" : "A Boolean indication of whether the coverage plan imposes a prior authorization requirement on this drug.",
  "fhirVersion" : "4.0.1",
  "mapping" : [
    {
      "identity" : "rim",
      "uri" : "http://hl7.org/v3",
      "name" : "RIM Mapping"
    }
  ],
  "kind" : "complex-type",
  "abstract" : false,
  "context" : [
    {
      "type" : "element",
      "expression" : "*"
    }
  ],
  "type" : "Extension",
  "baseDefinition" : "http://hl7.org/fhir/StructureDefinition/Extension",
  "derivation" : "constraint",
  "snapshot" : {
    "element" : [
      {
        "id" : "Extension",
        "path" : "Extension",
        "short" : "PriorAuthorization",
        "definition" : "A Boolean indication of whether the coverage plan imposes a prior authorization requirement on this drug.",
        "min" : 0,
        "max" : "*",
        "base" : {
          "path" : "Extension",
          "min" : 0,
          "max" : "*"
        },
        "condition" : [
          "ele-1"
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key" : "ext-1",
            "severity" : "error",
            "human" : "Must have either extensions or value[x], not both",
            "expression" : "extension.exists() != value.exists()",
            "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), 'value')])",
            "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier" : false
      },
      {
        "id" : "Extension.id",
        "path" : "Extension.id",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "Unique id for inter-element referencing",
        "definition" : "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.",
        "min" : 0,
        "max" : "1",
        "base" : {
          "path" : "Element.id",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type",
                "valueUrl" : "string"
              }
            ],
            "code" : "http://hl7.org/fhirpath/System.String"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "n/a"
          }
        ]
      },
      {
        "id" : "Extension.extension",
        "path" : "Extension.extension",
        "slicing" : {
          "discriminator" : [
            {
              "type" : "value",
              "path" : "url"
            }
          ],
          "description" : "Extensions are always sliced by (at least) url",
          "rules" : "open"
        },
        "short" : "Extension",
        "definition" : "An Extension",
        "min" : 0,
        "max" : "0",
        "base" : {
          "path" : "Element.extension",
          "min" : 0,
          "max" : "*"
        },
        "type" : [
          {
            "code" : "Extension"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          },
          {
            "key" : "ext-1",
            "severity" : "error",
            "human" : "Must have either extensions or value[x], not both",
            "expression" : "extension.exists() != value.exists()",
            "xpath" : "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])",
            "source" : "http://hl7.org/fhir/StructureDefinition/Extension"
          }
        ],
        "isModifier" : false,
        "isSummary" : false
      },
      {
        "id" : "Extension.url",
        "path" : "Extension.url",
        "representation" : [
          "xmlAttr"
        ],
        "short" : "identifies the meaning of the extension",
        "definition" : "Source of the definition for the extension code - a logical name or a URL.",
        "comment" : "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.",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "Extension.url",
          "min" : 1,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "uri"
          }
        ],
        "fixedUri" : "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorization-extension",
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "Extension.value[x]",
        "path" : "Extension.value[x]",
        "slicing" : {
          "discriminator" : [
            {
              "type" : "type",
              "path" : "$this"
            }
          ],
          "ordered" : false,
          "rules" : "closed"
        },
        "short" : "Value of extension",
        "definition" : "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "Extension.value[x]",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "boolean"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      },
      {
        "id" : "Extension.value[x]:valueBoolean",
        "path" : "Extension.value[x]",
        "sliceName" : "valueBoolean",
        "short" : "Value of extension",
        "definition" : "Value of extension - must be one of a constrained set of the data types (see [Extensibility](http://hl7.org/fhir/R4/extensibility.html) for a list).",
        "min" : 1,
        "max" : "1",
        "base" : {
          "path" : "Extension.value[x]",
          "min" : 0,
          "max" : "1"
        },
        "type" : [
          {
            "code" : "boolean"
          }
        ],
        "constraint" : [
          {
            "key" : "ele-1",
            "severity" : "error",
            "human" : "All FHIR elements must have a @value or children",
            "expression" : "hasValue() or (children().count() > id.count())",
            "xpath" : "@value|f:*|h:div",
            "source" : "http://hl7.org/fhir/StructureDefinition/Element"
          }
        ],
        "isModifier" : false,
        "isSummary" : false,
        "mapping" : [
          {
            "identity" : "rim",
            "map" : "N/A"
          }
        ]
      }
    ]
  },
  "differential" : {
    "element" : [
      {
        "id" : "Extension",
        "path" : "Extension",
        "short" : "PriorAuthorization",
        "definition" : "A Boolean indication of whether the coverage plan imposes a prior authorization requirement on this drug.",
        "min" : 0,
        "max" : "*"
      },
      {
        "id" : "Extension.extension",
        "path" : "Extension.extension",
        "min" : 0,
        "max" : "0"
      },
      {
        "id" : "Extension.url",
        "path" : "Extension.url",
        "type" : [
          {
            "code" : "uri"
          }
        ],
        "fixedUri" : "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorization-extension"
      },
      {
        "id" : "Extension.valueBoolean",
        "path" : "Extension.valueBoolean",
        "min" : 1,
        "type" : [
          {
            "code" : "boolean"
          }
        ]
      }
    ]
  }
}