description: A description of the drug tiers used by the formulary and how those tiers implement copay and coinsurance amounts. Drug tiers do not have any inherent meaning that is consistent across all formularies. Rather, each tier is defined using this element.
package_name: hl7.fhir.us.davinci
derivation: constraint
name: DrugTierDefinition
type: Extension
elements:
  extension:
    array: true
    min: 2
    index: 0
    slicing:
      slices:
        drugTierID:
          match: {}
          schema:
            isModifier: false
            index: 1
            type: Extension
            elements:
              extension: {index: 2}
              url:
                type: uri
                pattern: {type: Uri, value: drugTierID}
                index: 3
              valueCodeableConcept:
                type: CodeableConcept
                binding: {strength: extensible, valueSet: 'http://hl7.org/fhir/us/Davinci-drug-formulary/ValueSet/usdf-DrugTierVS'}
                index: 4
            _required: true
            extensions: {}
            base: {max: '*', min: 0, path: Element.extension}
            required: [valueCodeableConcept]
            isSummary: false
        mailOrder:
          match: {}
          schema:
            isModifier: false
            index: 5
            type: Extension
            elements:
              extension: {index: 6}
              url:
                type: uri
                pattern: {type: Uri, value: mailOrder}
                index: 7
              valueBoolean: {type: boolean, index: 8}
            _required: true
            extensions: {}
            base: {max: '*', min: 0, path: Element.extension}
            required: [valueBoolean]
            isSummary: false
        costSharing:
          match: {}
          schema:
            isModifier: false
            type: Extension
            array: true
            base: {max: '*', min: 0, path: Element.extension}
            isSummary: false
            index: 9
            extensions:
              pharmacyType:
                isModifier: false
                index: 11
                type: Extension
                elements:
                  extension: {index: 12}
                  url:
                    type: uri
                    pattern: {type: Uri, value: pharmacyType}
                    index: 13
                  valueCodeableConcept:
                    type: CodeableConcept
                    binding: {strength: extensible, valueSet: 'http://hl7.org/fhir/us/Davinci-drug-formulary/ValueSet/usdf-PharmacyTypeVS'}
                    index: 14
                _required: true
                extensions: {}
                url: null
                base: {max: '*', min: 0, path: Element.extension}
                required: [valueCodeableConcept]
                isSummary: false
              copayAmount:
                isModifier: false
                index: 15
                type: Extension
                elements:
                  extension: {index: 16}
                  url:
                    type: uri
                    pattern: {type: Uri, value: copayAmount}
                    index: 17
                  valueMoney: {type: Money, index: 18}
                _required: true
                extensions: {}
                url: null
                base: {max: '*', min: 0, path: Element.extension}
                required: [valueMoney]
                isSummary: false
              copayOption:
                isModifier: false
                index: 19
                type: Extension
                elements:
                  extension: {index: 20}
                  url:
                    type: uri
                    pattern: {type: Uri, value: copayOption}
                    index: 21
                  valueCodeableConcept:
                    type: CodeableConcept
                    binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/Davinci-drug-formulary/ValueSet/usdf-CopayOptionVS'}
                    index: 22
                _required: true
                extensions: {}
                url: null
                base: {max: '*', min: 0, path: Element.extension}
                required: [valueCodeableConcept]
                isSummary: false
              coinsuranceRate:
                isModifier: false
                index: 23
                type: Extension
                elements:
                  extension: {index: 24}
                  url:
                    type: uri
                    pattern: {type: Uri, value: coinsuranceRate}
                    index: 25
                  valueDecimal: {type: decimal, index: 26}
                _required: true
                extensions: {}
                url: null
                base: {max: '*', min: 0, path: Element.extension}
                required: [valueDecimal]
                isSummary: false
              coinsuranceOption:
                isModifier: false
                index: 27
                type: Extension
                elements:
                  extension: {index: 28}
                  url:
                    type: uri
                    pattern: {type: Uri, value: coinsuranceOption}
                    index: 29
                  valueCodeableConcept:
                    type: CodeableConcept
                    binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/Davinci-drug-formulary/ValueSet/usdf-CoinsuranceOptionVS'}
                    index: 30
                _required: true
                extensions: {}
                url: null
                base: {max: '*', min: 0, path: Element.extension}
                required: [valueCodeableConcept]
                isSummary: false
            elements:
              extension:
                array: true
                min: 5
                index: 10
                slicing:
                  slices:
                    pharmacyType:
                      match: {}
                      schema:
                        isModifier: false
                        index: 11
                        type: Extension
                        elements:
                          extension: {index: 12}
                          url:
                            type: uri
                            pattern: {type: Uri, value: pharmacyType}
                            index: 13
                          valueCodeableConcept:
                            type: CodeableConcept
                            binding: {strength: extensible, valueSet: 'http://hl7.org/fhir/us/Davinci-drug-formulary/ValueSet/usdf-PharmacyTypeVS'}
                            index: 14
                        _required: true
                        extensions: {}
                        base: {max: '*', min: 0, path: Element.extension}
                        required: [valueCodeableConcept]
                        isSummary: false
                    copayAmount:
                      match: {}
                      schema:
                        isModifier: false
                        index: 15
                        type: Extension
                        elements:
                          extension: {index: 16}
                          url:
                            type: uri
                            pattern: {type: Uri, value: copayAmount}
                            index: 17
                          valueMoney: {type: Money, index: 18}
                        _required: true
                        extensions: {}
                        base: {max: '*', min: 0, path: Element.extension}
                        required: [valueMoney]
                        isSummary: false
                    copayOption:
                      match: {}
                      schema:
                        isModifier: false
                        index: 19
                        type: Extension
                        elements:
                          extension: {index: 20}
                          url:
                            type: uri
                            pattern: {type: Uri, value: copayOption}
                            index: 21
                          valueCodeableConcept:
                            type: CodeableConcept
                            binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/Davinci-drug-formulary/ValueSet/usdf-CopayOptionVS'}
                            index: 22
                        _required: true
                        extensions: {}
                        base: {max: '*', min: 0, path: Element.extension}
                        required: [valueCodeableConcept]
                        isSummary: false
                    coinsuranceRate:
                      match: {}
                      schema:
                        isModifier: false
                        index: 23
                        type: Extension
                        elements:
                          extension: {index: 24}
                          url:
                            type: uri
                            pattern: {type: Uri, value: coinsuranceRate}
                            index: 25
                          valueDecimal: {type: decimal, index: 26}
                        _required: true
                        extensions: {}
                        base: {max: '*', min: 0, path: Element.extension}
                        required: [valueDecimal]
                        isSummary: false
                    coinsuranceOption:
                      match: {}
                      schema:
                        isModifier: false
                        index: 27
                        type: Extension
                        elements:
                          extension: {index: 28}
                          url:
                            type: uri
                            pattern: {type: Uri, value: coinsuranceOption}
                            index: 29
                          valueCodeableConcept:
                            type: CodeableConcept
                            binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/Davinci-drug-formulary/ValueSet/usdf-CoinsuranceOptionVS'}
                            index: 30
                        _required: true
                        extensions: {}
                        base: {max: '*', min: 0, path: Element.extension}
                        required: [valueCodeableConcept]
                        isSummary: false
              url:
                type: uri
                pattern: {type: Uri, value: costSharing}
                index: 31
              value:
                choices: []
                index: 33
  url:
    type: uri
    pattern: {type: Uri, value: 'http://hl7.org/fhir/us/Davinci-drug-formulary/StructureDefinition/usdf-DrugTierDefinition-extension'}
    index: 34
  value:
    choices: []
    index: 36
package_version: drug-formulary-1.0.0
extensions:
  drugTierID:
    isModifier: false
    index: 1
    type: Extension
    elements:
      extension: {index: 2}
      url:
        type: uri
        pattern: {type: Uri, value: drugTierID}
        index: 3
      valueCodeableConcept:
        type: CodeableConcept
        binding: {strength: extensible, valueSet: 'http://hl7.org/fhir/us/Davinci-drug-formulary/ValueSet/usdf-DrugTierVS'}
        index: 4
    _required: true
    extensions: {}
    url: null
    base: {max: '*', min: 0, path: Element.extension}
    required: [valueCodeableConcept]
    isSummary: false
  mailOrder:
    isModifier: false
    index: 5
    type: Extension
    elements:
      extension: {index: 6}
      url:
        type: uri
        pattern: {type: Uri, value: mailOrder}
        index: 7
      valueBoolean: {type: boolean, index: 8}
    _required: true
    extensions: {}
    url: null
    base: {max: '*', min: 0, path: Element.extension}
    required: [valueBoolean]
    isSummary: false
  costSharing:
    isModifier: false
    index: 9
    type: Extension
    array: true
    elements:
      extension:
        array: true
        min: 5
        index: 10
        slicing:
          slices:
            pharmacyType:
              match: {}
              schema:
                isModifier: false
                index: 11
                type: Extension
                elements:
                  extension: {index: 12}
                  url:
                    type: uri
                    pattern: {type: Uri, value: pharmacyType}
                    index: 13
                  valueCodeableConcept:
                    type: CodeableConcept
                    binding: {strength: extensible, valueSet: 'http://hl7.org/fhir/us/Davinci-drug-formulary/ValueSet/usdf-PharmacyTypeVS'}
                    index: 14
                _required: true
                extensions: {}
                base: {max: '*', min: 0, path: Element.extension}
                required: [valueCodeableConcept]
                isSummary: false
            copayAmount:
              match: {}
              schema:
                isModifier: false
                index: 15
                type: Extension
                elements:
                  extension: {index: 16}
                  url:
                    type: uri
                    pattern: {type: Uri, value: copayAmount}
                    index: 17
                  valueMoney: {type: Money, index: 18}
                _required: true
                extensions: {}
                base: {max: '*', min: 0, path: Element.extension}
                required: [valueMoney]
                isSummary: false
            copayOption:
              match: {}
              schema:
                isModifier: false
                index: 19
                type: Extension
                elements:
                  extension: {index: 20}
                  url:
                    type: uri
                    pattern: {type: Uri, value: copayOption}
                    index: 21
                  valueCodeableConcept:
                    type: CodeableConcept
                    binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/Davinci-drug-formulary/ValueSet/usdf-CopayOptionVS'}
                    index: 22
                _required: true
                extensions: {}
                base: {max: '*', min: 0, path: Element.extension}
                required: [valueCodeableConcept]
                isSummary: false
            coinsuranceRate:
              match: {}
              schema:
                isModifier: false
                index: 23
                type: Extension
                elements:
                  extension: {index: 24}
                  url:
                    type: uri
                    pattern: {type: Uri, value: coinsuranceRate}
                    index: 25
                  valueDecimal: {type: decimal, index: 26}
                _required: true
                extensions: {}
                base: {max: '*', min: 0, path: Element.extension}
                required: [valueDecimal]
                isSummary: false
            coinsuranceOption:
              match: {}
              schema:
                isModifier: false
                index: 27
                type: Extension
                elements:
                  extension: {index: 28}
                  url:
                    type: uri
                    pattern: {type: Uri, value: coinsuranceOption}
                    index: 29
                  valueCodeableConcept:
                    type: CodeableConcept
                    binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/Davinci-drug-formulary/ValueSet/usdf-CoinsuranceOptionVS'}
                    index: 30
                _required: true
                extensions: {}
                base: {max: '*', min: 0, path: Element.extension}
                required: [valueCodeableConcept]
                isSummary: false
      url:
        type: uri
        pattern: {type: Uri, value: costSharing}
        index: 31
      value:
        choices: []
        index: 33
    extensions:
      pharmacyType:
        isModifier: false
        index: 11
        type: Extension
        elements:
          extension: {index: 12}
          url:
            type: uri
            pattern: {type: Uri, value: pharmacyType}
            index: 13
          valueCodeableConcept:
            type: CodeableConcept
            binding: {strength: extensible, valueSet: 'http://hl7.org/fhir/us/Davinci-drug-formulary/ValueSet/usdf-PharmacyTypeVS'}
            index: 14
        _required: true
        extensions: {}
        url: null
        base: {max: '*', min: 0, path: Element.extension}
        required: [valueCodeableConcept]
        isSummary: false
      copayAmount:
        isModifier: false
        index: 15
        type: Extension
        elements:
          extension: {index: 16}
          url:
            type: uri
            pattern: {type: Uri, value: copayAmount}
            index: 17
          valueMoney: {type: Money, index: 18}
        _required: true
        extensions: {}
        url: null
        base: {max: '*', min: 0, path: Element.extension}
        required: [valueMoney]
        isSummary: false
      copayOption:
        isModifier: false
        index: 19
        type: Extension
        elements:
          extension: {index: 20}
          url:
            type: uri
            pattern: {type: Uri, value: copayOption}
            index: 21
          valueCodeableConcept:
            type: CodeableConcept
            binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/Davinci-drug-formulary/ValueSet/usdf-CopayOptionVS'}
            index: 22
        _required: true
        extensions: {}
        url: null
        base: {max: '*', min: 0, path: Element.extension}
        required: [valueCodeableConcept]
        isSummary: false
      coinsuranceRate:
        isModifier: false
        index: 23
        type: Extension
        elements:
          extension: {index: 24}
          url:
            type: uri
            pattern: {type: Uri, value: coinsuranceRate}
            index: 25
          valueDecimal: {type: decimal, index: 26}
        _required: true
        extensions: {}
        url: null
        base: {max: '*', min: 0, path: Element.extension}
        required: [valueDecimal]
        isSummary: false
      coinsuranceOption:
        isModifier: false
        index: 27
        type: Extension
        elements:
          extension: {index: 28}
          url:
            type: uri
            pattern: {type: Uri, value: coinsuranceOption}
            index: 29
          valueCodeableConcept:
            type: CodeableConcept
            binding: {strength: required, valueSet: 'http://hl7.org/fhir/us/Davinci-drug-formulary/ValueSet/usdf-CoinsuranceOptionVS'}
            index: 30
        _required: true
        extensions: {}
        url: null
        base: {max: '*', min: 0, path: Element.extension}
        required: [valueCodeableConcept]
        isSummary: false
    url: null
    base: {max: '*', min: 0, path: Element.extension}
    isSummary: false
class: extension
kind: complex-type
url: http://hl7.org/fhir/us/Davinci-drug-formulary/StructureDefinition/usdf-DrugTierDefinition-extension
base: http://hl7.org/fhir/StructureDefinition/Extension
version: 1.0.0