DaVinci Payer Data Exchange (PDex) US Drug Formulary
2.0.0 - STU 2 US

This page is part of the US Drug Formulary (v2.0.0: STU 2) based on FHIR 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

ValueSet: Pharmacy benefit types

Official URL: http://hl7.org/fhir/us/davinci-drug-formulary/ValueSet/PharmacyBenefitTypeVS Version: 2.0.0
Active as of 2022-08-25 Computable Name: PharmacyBenefitTypeVS

Pharmacy benefit types. Each payer will have its own controlled vocabulary.

References

Logical Definition (CLD)

 

Expansion

This value set contains 8 concepts

Expansion based on Codes for pharmacy benefit types v2.0.0 (CodeSystem)

All codes in this table are from the system http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS-TEMPORARY-TRIAL-USE

CodeDisplayDefinition
  1-month-in-retail1 month in network retail1 Month Supply via in-network retail pharmacy.
  1-month-out-retail1 month out of network retail1 Month Supply via out-of-network retail pharmacy.
  1-month-in-mail1 month in network mail order1 Month Supply via in-network mail order pharmacy.
  1-month-out-mail1 month out of network mail order1 Month Supply via out-of-network mail order pharmacy.
  3-month-in-retail3 month in network retail3 Month Supply via in-network retail pharmacy.
  3-month-out-retail3 month out of network retail3 Month Supply via out-of-network retail pharmacy.
  3-month-in-mail3 month in network mail order3 Month Supply via in-network mail order pharmacy.
  3-month-out-mail3 month out of network mail order3 Month Supply via out-of-network mail order pharmacy.

Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code