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FHIR IG Statistics: CodeSystem/usdf-CostShareOptionCS-TEMPORARY-TRIAL-USE

Packagehl7.fhir.us.davinci-drug-formulary
TypeCodeSystem
Idusdf-CostShareOptionCS-TEMPORARY-TRIAL-USE
FHIR VersionR4
Sourcehttp://hl7.org/fhir/us/davinci-drug-formulary/https://build.fhir.org/ig/HL7/davinci-pdex-formulary/CodeSystem-usdf-CostShareOptionCS-TEMPORARY-TRIAL-USE.html
URLhttp://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-CostShareOptionCS-TEMPORARY-TRIAL-USE
Version2.1.0
Statusactive
Date2025-02-26T01:23:59+00:00
NameCostShareOptionCS
TitleCodes qualifying the type of cost share amount
Realmus
Authorityhl7
DescriptionCodes for qualifier of copay amount
Contentcomplete

Resources that use this resource

ValueSet
CoinsuranceOptionVSQualifier for coinsurance rate
CopayOptionVSQualifier of copay amount

Resources that this resource uses

No resources found


Narrative

Note: links and images are rebased to the (stated) source

Generated Narrative: CodeSystem usdf-CostShareOptionCS-TEMPORARY-TRIAL-USE

This case-sensitive code system http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-CostShareOptionCS-TEMPORARY-TRIAL-USE defines the following codes:

CodeDisplayDefinition
after-deductible After DeductibleThe consumer first pays the deductible, and after the deductible is met, the consumer is responsible only for the cost-share amount (this indicates that this benefit is subject to the deductible).
before-deductible Before DeductibleThe consumer first pays the cost share amount, and any net remaining allowed charges accrue to the deductible (this indicates that this benefit is subject to the deductible).
no-charge No ChargeNo cost sharing is charged (this indicates that this benefit is not subject to the deductible).
no-charge-after-deductible No Charge After DeductibleThe consumer first pays the deductible, and after the deductible is met, no cost share amount is charged (this indicates that this benefit is subject to the deductible).
charge ChargeThe consumer always pays just the cost share amount and the issuer pays the remainder of allowed charges (this indicates that this benefit is not subject to the deductible).
coinsurance-not-applicable Coinsurance Not ApplicableThe consumer pays only a copay. Note: When using Not Applicable for coinsurance, Not Applicable cannot also be used for copay (unless the drug tier type is Medical Service Drugs).
copay-not-applicable Copay Not ApplicableDeductible is not applicable: Zero-deductible cost sharing represented by a co-pay value of 'Not applicable' and co-insurance value of 'No charge'.
deductible-waived Deductible WaivedThe consumer pays the cost share amount with deductible requirement waived.

Source

{
  "resourceType": "CodeSystem",
  "id": "usdf-CostShareOptionCS-TEMPORARY-TRIAL-USE",
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "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-CostShareOptionCS-TEMPORARY-TRIAL-USE",
  "identifier": [
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.25.74595174031514506193398850787025340071.16.2"
    }
  ],
  "version": "2.1.0",
  "name": "CostShareOptionCS",
  "title": "Codes qualifying the type of cost share amount",
  "status": "active",
  "experimental": false,
  "date": "2025-02-26T01:23:59+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": "Codes for qualifier of copay amount",
  "jurisdiction": [
    {
      "coding": [
        {
          "system": "urn:iso:std:iso:3166",
          "code": "US"
        }
      ]
    }
  ],
  "caseSensitive": true,
  "content": "complete",
  "count": 8,
  "concept": [
    {
      "code": "after-deductible",
      "display": "After Deductible",
      "definition": "The consumer first pays the deductible, and after the deductible is met, the consumer is responsible only for the cost-share amount (this indicates that this benefit is subject to the deductible)."
    },
    {
      "code": "before-deductible",
      "display": "Before Deductible",
      "definition": "The consumer first pays the cost share amount, and any net remaining allowed charges accrue to the deductible (this indicates that this benefit is subject to the deductible)."
    },
    {
      "code": "no-charge",
      "display": "No Charge",
      "definition": "No cost sharing is charged (this indicates that this benefit is not subject to the deductible)."
    },
    {
      "code": "no-charge-after-deductible",
      "display": "No Charge After Deductible",
      "definition": "The consumer first pays the deductible, and after the deductible is met, no cost share amount is charged (this indicates that this benefit is subject to the deductible)."
    },
    {
      "code": "charge",
      "display": "Charge",
      "definition": "The consumer always pays just the cost share amount and the issuer pays the remainder of allowed charges (this indicates that this benefit is not subject to the deductible)."
    },
    {
      "code": "coinsurance-not-applicable",
      "display": "Coinsurance Not Applicable",
      "definition": "The consumer pays only a copay. Note: When using Not Applicable for coinsurance, Not Applicable cannot also be used for copay (unless the drug tier type is Medical Service Drugs)."
    },
    {
      "code": "copay-not-applicable",
      "display": "Copay Not Applicable",
      "definition": "Deductible is not applicable: Zero-deductible cost sharing represented by a co-pay value of 'Not applicable' and co-insurance value of 'No charge'."
    },
    {
      "code": "deductible-waived",
      "display": "Deductible Waived",
      "definition": "The consumer pays the cost share amount with deductible requirement waived."
    }
  ]
}