{
  "description": "Codes for qualifier of copay amount",
  "_filename": "CodeSystem-usdf-CostShareOptionCS-TEMPORARY-TRIAL-USE.json",
  "package_name": "hl7.fhir.us.davinci-drug-formulary",
  "date": "2023-12-01T22:20:12+00:00",
  "publisher": "HL7 International / Pharmacy",
  "jurisdiction": [ {
    "coding": [ {
      "code": "US",
      "system": "urn:iso:std:iso:3166"
    } ]
  } ],
  "content": "complete",
  "name": "CostShareOptionCS",
  "type": null,
  "experimental": "false",
  "resourceType": "CodeSystem",
  "title": "Codes qualifying the type of cost share amount",
  "package_version": "2.0.1",
  "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"
      } ]
    }
  } ],
  "status": "active",
  "id": "5363d5f7-2df3-46a4-a519-06f9fd431881",
  "kind": null,
  "count": 8,
  "url": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-CostShareOptionCS-TEMPORARY-TRIAL-USE",
  "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."
  } ],
  "caseSensitive": true,
  "version": "2.0.1",
  "contact": [ {
    "name": "HL7 International / Pharmacy",
    "telecom": [ {
      "value": "http://www.hl7.org/Special/committees/medication",
      "system": "url"
    }, {
      "value": "pharmacy@lists.HL7.org",
      "system": "email"
    } ]
  } ]
}