DaVinci Payer Data Exchange (PDex) US Drug Formulary
2.0.1 - STU 2 United States of America flag

This page is part of the US Drug Formulary (v2.0.1: STU 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: Codes for benefit type of cost - JSON Representation

Page standards status: Trial-use

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{
  "resourceType" : "CodeSystem",
  "id" : "usdf-BenefitCostTypeCS-TEMPORARY-TRIAL-USE",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This case-sensitive code system <code>http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-BenefitCostTypeCS-TEMPORARY-TRIAL-USE</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">copay<a name=\"usdf-BenefitCostTypeCS-TEMPORARY-TRIAL-USE-copay\"> </a></td><td>Copay</td><td>A flat fee the member pays to fill the prescription.</td></tr><tr><td style=\"white-space:nowrap\">coinsurance<a name=\"usdf-BenefitCostTypeCS-TEMPORARY-TRIAL-USE-coinsurance\"> </a></td><td>Coinsurance</td><td>A percentage of the cost to fill the prescription, usually after the deductible has been met.</td></tr></table></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "phx"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
      "valueCode" : "trial-use",
      "_valueCode" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
            "valueCanonical" : "http://hl7.org/fhir/us/davinci-drug-formulary/ImplementationGuide/hl7.fhir.us.davinci-drug-formulary"
          }
        ]
      }
    }
  ],
  "url" : "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-BenefitCostTypeCS-TEMPORARY-TRIAL-USE",
  "version" : "2.0.1",
  "name" : "BenefitCostTypeCS",
  "title" : "Codes for benefit type of cost",
  "status" : "active",
  "experimental" : false,
  "date" : "2023-12-01T22:20:12+00:00",
  "publisher" : "HL7 International / Pharmacy",
  "contact" : [
    {
      "name" : "HL7 International / Pharmacy",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/medication"
        },
        {
          "system" : "email",
          "value" : "pharmacy@lists.HL7.org"
        }
      ]
    }
  ],
  "description" : "Types of out of pockets costs associated with the benefit",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "caseSensitive" : true,
  "content" : "complete",
  "count" : 2,
  "concept" : [
    {
      "code" : "copay",
      "display" : "Copay",
      "definition" : "A flat fee the member pays to fill the prescription."
    },
    {
      "code" : "coinsurance",
      "display" : "Coinsurance",
      "definition" : "A percentage of the cost to fill the prescription, usually after the deductible has been met."
    }
  ]
}