{ "description": "Codes for qualifier of copay amount", "_filename": "CodeSystem-usdf-CostShareOptionCS-TEMPORARY-TRIAL-USE.json", "package_name": "hl7.fhir.us.davinci-drug-formulary", "date": "2022-08-25T13:09:53+00:00", "publisher": "HL7 Pharmacy Working Group", "jurisdiction": [ { "coding": [ { "code": "US", "system": "urn:iso:std:iso:3166" } ] } ], "content": "complete", "name": "CostShareOptionCS", "type": null, "experimental": null, "resourceType": "CodeSystem", "title": "Codes qualifying the type of cost share amount", "package_version": "2.0.0", "status": "active", "id": "6ec7e461-5c44-47ae-8afe-5bbac50b4e2c", "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": "2.0.0", "contact": [ { "name": "HL7 Pharmacy Working Group", "telecom": [ { "value": "http://www.hl7.org/Special/committees/medication", "system": "url" }, { "value": "pharmacy@lists.HL7.org", "system": "email" } ] } ] }