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This page is part of the CARIN Digital Insurance Card (v1.1.0: STU1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: C4DIC Extended Copay Type - JSON Representation

Active as of 2024-04-16

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{
  "resourceType" : "CodeSystem",
  "id" : "C4DICExtendedCopayTypeCS",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This case-sensitive code system <code>http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCopayTypeCS</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td></tr><tr><td style=\"white-space:nowrap\">FamOutDed<a name=\"C4DICExtendedCopayTypeCS-FamOutDed\"> </a></td><td>Family Out of Network Deductible</td></tr><tr><td style=\"white-space:nowrap\">FamInDed<a name=\"C4DICExtendedCopayTypeCS-FamInDed\"> </a></td><td>Family In Network Deductible</td></tr><tr><td style=\"white-space:nowrap\">FamRxOutDed<a name=\"C4DICExtendedCopayTypeCS-FamRxOutDed\"> </a></td><td>Family Pharmacy Out of Network Deductible</td></tr><tr><td style=\"white-space:nowrap\">FamRxInDed<a name=\"C4DICExtendedCopayTypeCS-FamRxInDed\"> </a></td><td>Family Pharmacy In Network Deductible</td></tr><tr><td style=\"white-space:nowrap\">FamOutMax<a name=\"C4DICExtendedCopayTypeCS-FamOutMax\"> </a></td><td>Family Out of Network Out of Pocket Maximum</td></tr><tr><td style=\"white-space:nowrap\">FamInMax<a name=\"C4DICExtendedCopayTypeCS-FamInMax\"> </a></td><td>Family In Network Out of Pocket Maximum</td></tr><tr><td style=\"white-space:nowrap\">FamRxOutMax<a name=\"C4DICExtendedCopayTypeCS-FamRxOutMax\"> </a></td><td>Family Pharmacy Out of Network Out of Pocket Maximum</td></tr><tr><td style=\"white-space:nowrap\">FamRxInMax<a name=\"C4DICExtendedCopayTypeCS-FamRxInMax\"> </a></td><td>Family Pharmacy In Network Out of Pocket Maximum</td></tr><tr><td style=\"white-space:nowrap\">IndOutDed<a name=\"C4DICExtendedCopayTypeCS-IndOutDed\"> </a></td><td>Invidual Out of Network Deductible</td></tr><tr><td style=\"white-space:nowrap\">IndInDed<a name=\"C4DICExtendedCopayTypeCS-IndInDed\"> </a></td><td>Individual In Network Deductible</td></tr><tr><td style=\"white-space:nowrap\">IndRxOutDed<a name=\"C4DICExtendedCopayTypeCS-IndRxOutDed\"> </a></td><td>Individual Pharmacy Out of Network Deductible</td></tr><tr><td style=\"white-space:nowrap\">IndRxInDed<a name=\"C4DICExtendedCopayTypeCS-IndRxInDed\"> </a></td><td>Individual Pharmacy In Network Deductible</td></tr><tr><td style=\"white-space:nowrap\">IndOutMax<a name=\"C4DICExtendedCopayTypeCS-IndOutMax\"> </a></td><td>Individual Out of Network Out of Pocket Maximum</td></tr><tr><td style=\"white-space:nowrap\">IndInMax<a name=\"C4DICExtendedCopayTypeCS-IndInMax\"> </a></td><td>Individual In Network Out of Pocket Maximum</td></tr><tr><td style=\"white-space:nowrap\">IndRxOutMax<a name=\"C4DICExtendedCopayTypeCS-IndRxOutMax\"> </a></td><td>Individual Pharmacy Out of Network Out of Pocket Maximum</td></tr><tr><td style=\"white-space:nowrap\">IndRxInMax<a name=\"C4DICExtendedCopayTypeCS-IndRxInMax\"> </a></td><td>Individual Pharmacy In Network Out of Pocket Maximum</td></tr><tr><td style=\"white-space:nowrap\">rx<a name=\"C4DICExtendedCopayTypeCS-rx\"> </a></td><td>Prescription</td></tr></table></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "claims"
    }
  ],
  "url" : "http://hl7.org/fhir/us/insurance-card/CodeSystem/C4DICExtendedCopayTypeCS",
  "version" : "1.1.0",
  "name" : "C4DICExtendedCopayTypeCS",
  "title" : "C4DIC Extended Copay Type",
  "status" : "active",
  "experimental" : false,
  "date" : "2024-04-16T17:37:30+00:00",
  "publisher" : "HL7 International / Payer/Provider Information Exchange Work Group",
  "contact" : [
    {
      "name" : "HL7 International / Payer/Provider Information Exchange Work Group",
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://www.hl7.org/Special/committees/claims"
        },
        {
          "system" : "email",
          "value" : "pie@lists.HL7.org"
        }
      ]
    }
  ],
  "description" : "This code system includes an extended set of Copay Type codes.",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "copyright" : "This CodeSystem is not copyrighted.",
  "caseSensitive" : true,
  "content" : "complete",
  "count" : 17,
  "concept" : [
    {
      "code" : "FamOutDed",
      "display" : "Family Out of Network Deductible"
    },
    {
      "code" : "FamInDed",
      "display" : "Family In Network Deductible"
    },
    {
      "code" : "FamRxOutDed",
      "display" : "Family Pharmacy Out of Network Deductible"
    },
    {
      "code" : "FamRxInDed",
      "display" : "Family Pharmacy In Network Deductible"
    },
    {
      "code" : "FamOutMax",
      "display" : "Family Out of Network Out of Pocket Maximum"
    },
    {
      "code" : "FamInMax",
      "display" : "Family In Network Out of Pocket Maximum"
    },
    {
      "code" : "FamRxOutMax",
      "display" : "Family Pharmacy Out of Network Out of Pocket Maximum"
    },
    {
      "code" : "FamRxInMax",
      "display" : "Family Pharmacy In Network Out of Pocket Maximum"
    },
    {
      "code" : "IndOutDed",
      "display" : "Invidual Out of Network Deductible"
    },
    {
      "code" : "IndInDed",
      "display" : "Individual In Network Deductible"
    },
    {
      "code" : "IndRxOutDed",
      "display" : "Individual Pharmacy Out of Network Deductible"
    },
    {
      "code" : "IndRxInDed",
      "display" : "Individual Pharmacy In Network Deductible"
    },
    {
      "code" : "IndOutMax",
      "display" : "Individual Out of Network Out of Pocket Maximum"
    },
    {
      "code" : "IndInMax",
      "display" : "Individual In Network Out of Pocket Maximum"
    },
    {
      "code" : "IndRxOutMax",
      "display" : "Individual Pharmacy Out of Network Out of Pocket Maximum"
    },
    {
      "code" : "IndRxInMax",
      "display" : "Individual Pharmacy In Network Out of Pocket Maximum"
    },
    {
      "code" : "rx",
      "display" : "Prescription"
    }
  ]
}