{ "description": "This code system defines a set of benefit restrictions that may apply to a prescription product and pharmacy combination evaluated in the Real-time Pharmacy Benefit Check (RTPBC) process.", "_filename": "CodeSystem-rtpbc-benefit-restriction.json", "package_name": "hl7.fhir.us.carin-rtpbc", "date": "2020-05-23T00:00:00-05:00", "publisher": "HL7 International - Pharmacy", "jurisdiction": [ { "coding": [ { "code": "US", "system": "urn:iso:std:iso:3166", "display": "United States of America" } ] } ], "content": "complete", "name": "RtpbcBenefitRestrictionCodeSystem", "type": null, "experimental": "false", "resourceType": "CodeSystem", "title": "RTPBC Benefit Restriction Code System", "package_version": "1.0.0", "status": "active", "id": "6f61b4c2-1dde-4c00-8689-ac6dbee01694", "kind": null, "url": "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-benefit-restriction", "concept": [ { "code": "covered", "display": "Covered", "definition": "Covered" }, { "code": "prior-auth", "display": "Prior authorization required", "definition": "Covered with restriction: Prior authorization required" }, { "code": "step-therapy", "display": "Step therapy applies", "definition": "Covered with restriction: Step therapy applies" }, { "code": "quantity-limit", "display": "Quantity limit applies", "definition": "Covered with restriction: Quantity limit applies" }, { "code": "pharmacy-restriction", "display": "Pharmacy restriction applies", "definition": "Covered with restriction: Pharmacy restriction applies" }, { "code": "other-restriction", "display": "Other restriction applies", "definition": "Covered with restriction: Other restriction applies" }, { "code": "not-covered", "display": "Not covered", "definition": "Not covered" } ], "caseSensitive": false, "version": "1.0.0", "contact": [ { "name": "HL7 International - Pharmacy", "telecom": [ { "value": "http://www.hl7.org/Special/committees/medication", "system": "url" } ] }, { "name": "Frank McKinney", "telecom": [ { "value": "frank.mckinney@pocp.com", "system": "email" } ] } ] }