DaVinci Payer Data Exchange (PDex) US Drug Formulary
1.1.0 - STU 1.1

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## : Codes for qualifier of copay amount - XML Representation

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    <CodeSystem xmlns="http://hl7.org/fhir">
      <id value="usdf-CopayOptionCS"/>
      <text>
        <status value="generated"/>
        <div xmlns="http://www.w3.org/1999/xhtml"><p>This code system http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-CopayOptionCS defines the following codes:</p><table class="codes"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style="white-space:nowrap">after-deductible<a name="usdf-CopayOptionCS-after-deductible"> </a></td><td>After Deductible</td><td>The consumer first pays the deductible, and after the deductible is met, the consumer is responsible only for the copay (this indicates that this benefit is subject to the deductible).</td></tr><tr><td style="white-space:nowrap">before-deductible<a name="usdf-CopayOptionCS-before-deductible"> </a></td><td>Before Deductible</td><td>The consumer first pays the copay, and any net remaining allowed charges accrue to the deductible (this indicates that this benefit is subject to the deductible).</td></tr><tr><td style="white-space:nowrap">no-charge<a name="usdf-CopayOptionCS-no-charge"> </a></td><td>No Charge</td><td>No cost sharing is charged (this indicates that this benefit is not subject to the deductible).</td></tr><tr><td style="white-space:nowrap">no-charge-after-deductible<a name="usdf-CopayOptionCS-no-charge-after-deductible"> </a></td><td>No Charge After Deductible</td><td>The consumer first pays the deductible, and after the deductible is met, no copayment is charged (this indicates that this benefit is subject to the deductible).</td></tr><tr><td style="white-space:nowrap">charge<a name="usdf-CopayOptionCS-charge"> </a></td><td>Charge</td><td>The consumer always pays just the copay and the issuer pays the remainder of allowed charges (this indicates that this benefit is not subject to the deductible).</td></tr><tr><td style="white-space:nowrap">not-applicable<a name="usdf-CopayOptionCS-not-applicable"> </a></td><td>Not Applicable</td><td>Deductible is not applicable: Zero-deductible cost sharing represented by a co-pay value of 'Not applicable' and co-insurance value of 'No charge'.</td></tr></table></div>
      </text>
      <url
           value="http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-CopayOptionCS"/>
      <version value="1.1.0"/>
      <name value="CopayOptionCS"/>
      <title value="Codes for qualifier of copay amount"/>
      <status value="active"/>
      <date value="2021-10-15T15:46:55+00:00"/>
      <publisher value="HL7 Pharmacy Working Group"/>
      <contact>
        <name value="HL7 Pharmacy Working Group"/>
        <telecom>
          <system value="url"/>
          <value value="http://www.hl7.org/Special/committees/medication"/>
        </telecom>
        <telecom>
          <system value="email"/>
          <value value="pharmacy@lists.HL7.org"/>
        </telecom>
      </contact>
      <description value="Codes for qualifier of copay amount"/>
      <jurisdiction>
        <coding>
          <system value="urn:iso:std:iso:3166"/>
          <code value="US"/>
        </coding>
      </jurisdiction>
      <content value="complete"/>
      <count value="6"/>
      <concept>
        <code value="after-deductible"/>
        <display value="After Deductible"/>
        <definition
                    value="The consumer first pays the deductible, and after the deductible is met, the consumer is responsible only for the copay (this indicates that this benefit is subject to the deductible)."/>
      </concept>
      <concept>
        <code value="before-deductible"/>
        <display value="Before Deductible"/>
        <definition
                    value="The consumer first pays the copay, and any net remaining allowed charges accrue to the deductible (this indicates that this benefit is subject to the deductible)."/>
      </concept>
      <concept>
        <code value="no-charge"/>
        <display value="No Charge"/>
        <definition
                    value="No cost sharing is charged (this indicates that this benefit is not subject to the deductible)."/>
      </concept>
      <concept>
        <code value="no-charge-after-deductible"/>
        <display value="No Charge After Deductible"/>
        <definition
                    value="The consumer first pays the deductible, and after the deductible is met, no copayment is charged (this indicates that this benefit is subject to the deductible)."/>
      </concept>
      <concept>
        <code value="charge"/>
        <display value="Charge"/>
        <definition
                    value="The consumer always pays just the copay and the issuer pays the remainder of allowed charges (this indicates that this benefit is not subject to the deductible)."/>
      </concept>
      <concept>
        <code value="not-applicable"/>
        <display value="Not Applicable"/>
        <definition
                    value="Deductible is not applicable: Zero-deductible cost sharing represented by a co-pay value of &#39;Not applicable&#39; and co-insurance value of &#39;No charge&#39;."/>
      </concept>
    </CodeSystem>