This page is part of the Consumer Real-time Pharmacy Benefit Check (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions 
XML Format: ValueSet-carin-rtpbc-coverage-summary-value-set
Raw xml
<ValueSet xmlns="http://hl7.org/fhir"> <id value="carin-rtpbc-coverage-summary-value-set"/> <meta> <lastUpdated value="2019-12-08T05:00:00.000+00:00"/> </meta> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><h2>CARIN RTPBC Coverage Summary Value Set</h2><div><p>This value set contains a set of coverage outcomes that may apply to a prescription product and pharmacy combination evaluated in the Real-time Pharmacy Benefit Check (RTPBC) process.</p> </div><p>This value set includes codes from the following code systems:</p><ul><li>Include these codes as defined in <a href="CodeSystem-carin-rtpbc-coverage-summary-code-system.html"><code>http://hl7.org/fhir/us/carin/CodeSystem/rtpbc-coverage-summary</code></a><table class="none"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td></tr><tr><td><a href="CodeSystem-carin-rtpbc-coverage-summary-code-system.html#carin-rtpbc-coverage-summary-code-system-covered">covered</a></td><td>Covered</td><td>Covered</td></tr><tr><td><a href="CodeSystem-carin-rtpbc-coverage-summary-code-system.html#carin-rtpbc-coverage-summary-code-system-prior-auth">prior-auth</a></td><td>Prior authorization required</td><td>Covered with restriction: Prior authorization required</td></tr><tr><td><a href="CodeSystem-carin-rtpbc-coverage-summary-code-system.html#carin-rtpbc-coverage-summary-code-system-step-therapy">step-therapy</a></td><td>Step therapy applies</td><td>Covered with restriction: Step therapy applies</td></tr><tr><td><a href="CodeSystem-carin-rtpbc-coverage-summary-code-system.html#carin-rtpbc-coverage-summary-code-system-quantity-limit">quantity-limit</a></td><td>Quantity limits apply</td><td>Covered with restriction: Quantity limits apply</td></tr><tr><td><a href="CodeSystem-carin-rtpbc-coverage-summary-code-system.html#carin-rtpbc-coverage-summary-code-system-other-restriction">other-restriction</a></td><td>Other restriction applies</td><td>Covered with restriction: Other restriction applies</td></tr><tr><td><a href="CodeSystem-carin-rtpbc-coverage-summary-code-system.html#carin-rtpbc-coverage-summary-code-system-not-covered">not-covered</a></td><td>Not covered</td><td>Not covered</td></tr></table></li></ul></div> </text> <url value="http://hl7.org/fhir/us/carin/ValueSet/rtpbc-coverage-summary"/> <version value="0.1.0"/> <name value="CarinRtbpcCoverageSummaryValueSet"/> <title value="CARIN RTPBC Coverage Summary Value Set"/> <status value="active"/> <experimental value="false"/> <date value="2019-12-08T05:00:00+00:00"/> <description value="This value set contains a set of coverage outcomes that may apply to a prescription product and pharmacy combination evaluated in the Real-time Pharmacy Benefit Check (RTPBC) process."/> <jurisdiction> <coding> <system value="urn:iso:std:iso:3166"/> <code value="US"/> <display value="United States of America"/> </coding> </jurisdiction> <compose> <include> <system value="http://hl7.org/fhir/us/carin/CodeSystem/rtpbc-coverage-summary"/> <concept> <code value="covered"/> <display value="Covered"/> </concept> <concept> <code value="prior-auth"/> <display value="Prior authorization required"/> </concept> <concept> <code value="step-therapy"/> <display value="Step therapy applies"/> </concept> <concept> <code value="quantity-limit"/> <display value="Quantity limits apply"/> </concept> <concept> <code value="other-restriction"/> <display value="Other restriction applies"/> </concept> <concept> <code value="not-covered"/> <display value="Not covered"/> </concept> </include> </compose> </ValueSet>
