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

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## Extension: DrugTierDefinition - Detailed Descriptions

Definitions for the usdf-DrugTierDefinition-extension extension.

1. Extension
Definition | 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.
Control | 0..* This element is affected by the following invariants: ele-1
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
2. Extension.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
3. Extension.extension
Definition | An Extension
Control | 2..*
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on Extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
4. Extension.extension:drugTierID
SliceName | drugTierID
Definition | An Extension
Control | 1..1
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
5. Extension.extension:drugTierID.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
6. Extension.extension:drugTierID.extension
Definition | An Extension
Control | 0..0
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on Extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
7. Extension.extension:drugTierID.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Control | 1..1
Type | uri
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Fixed Value | drugTierID
8. Extension.extension:drugTierID.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Control | 1..1
Binding | The codes SHALL be taken from Drug tier of medication in health plan; other codes may be used where these codes are not suitable
Type | CodeableConcept
[x] Note | See Choice of Data Types for further information about how to use [x]
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
9. Extension.extension:mailOrder
SliceName | mailOrder
Definition | An Extension
Control | 1..1
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
10. Extension.extension:mailOrder.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
11. Extension.extension:mailOrder.extension
Definition | An Extension
Control | 0..0
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on Extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
12. Extension.extension:mailOrder.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Control | 1..1
Type | uri
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Fixed Value | mailOrder
13. Extension.extension:mailOrder.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Control | 1..1
Type | boolean
[x] Note | See Choice of Data Types for further information about how to use [x]
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
14. Extension.extension:costSharing
SliceName | costSharing
Definition | An Extension
Control | 0..*
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
15. Extension.extension:costSharing.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
16. Extension.extension:costSharing.extension
Definition | An Extension
Control | 5..*
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on Extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
17. Extension.extension:costSharing.extension:pharmacyType
SliceName | pharmacyType
Definition | An Extension
Control | 1..1
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
18. Extension.extension:costSharing.extension:pharmacyType.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
19. Extension.extension:costSharing.extension:pharmacyType.extension
Definition | An Extension
Control | 0..0
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on Extension.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
20. Extension.extension:costSharing.extension:pharmacyType.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Control | 1..1
Type | uri
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Fixed Value | pharmacyType
21. Extension.extension:costSharing.extension:pharmacyType.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Control | 1..1
Binding | The codes SHALL be taken from Type of pharmacies; other codes may be used where these codes are not suitable
Type | CodeableConcept
[x] Note | See Choice of Data Types for further information about how to use [x]
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
22. Extension.extension:costSharing.extension:copayAmount
SliceName | copayAmount
Definition | An Extension
Control | 1..1
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
23. Extension.extension:costSharing.extension:copayAmount.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
24. Extension.extension:costSharing.extension:copayAmount.extension
Definition | An Extension
Control | 0..0
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on Extension.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
25. Extension.extension:costSharing.extension:copayAmount.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Control | 1..1
Type | uri
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Fixed Value | copayAmount
26. Extension.extension:costSharing.extension:copayAmount.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Control | 1..1
Type | Money
[x] Note | See Choice of Data Types for further information about how to use [x]
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
27. Extension.extension:costSharing.extension:copayOption
SliceName | copayOption
Definition | An Extension
Control | 1..1
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
28. Extension.extension:costSharing.extension:copayOption.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
29. Extension.extension:costSharing.extension:copayOption.extension
Definition | An Extension
Control | 0..0
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on Extension.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
30. Extension.extension:costSharing.extension:copayOption.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Control | 1..1
Type | uri
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Fixed Value | copayOption
31. Extension.extension:costSharing.extension:copayOption.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Control | 1..1
Binding | The codes SHALL be taken from Qualifier of copay amount
Type | CodeableConcept
[x] Note | See Choice of Data Types for further information about how to use [x]
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
32. Extension.extension:costSharing.extension:coinsuranceRate
SliceName | coinsuranceRate
Definition | An Extension
Control | 1..1
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
33. Extension.extension:costSharing.extension:coinsuranceRate.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
34. Extension.extension:costSharing.extension:coinsuranceRate.extension
Definition | An Extension
Control | 0..0
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on Extension.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
35. Extension.extension:costSharing.extension:coinsuranceRate.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Control | 1..1
Type | uri
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Fixed Value | coinsuranceRate
36. Extension.extension:costSharing.extension:coinsuranceRate.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Control | 1..1
Type | decimal
[x] Note | See Choice of Data Types for further information about how to use [x]
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
37. Extension.extension:costSharing.extension:coinsuranceOption
SliceName | coinsuranceOption
Definition | An Extension
Control | 1..1
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
38. Extension.extension:costSharing.extension:coinsuranceOption.id
Definition | Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.
Control | 0..1
Type | string
39. Extension.extension:costSharing.extension:coinsuranceOption.extension
Definition | An Extension
Control | 0..0
Type | Extension
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count())) ext-1: Must have either extensions or value[x], not both (: extension.exists() != value.exists())
Slicing | This element introduces a set of slices on Extension.extension.extension.extension. The slices are unordered and Open, and can be differentiated using the following discriminators: value @ url
40. Extension.extension:costSharing.extension:coinsuranceOption.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Control | 1..1
Type | uri
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Fixed Value | coinsuranceOption
41. Extension.extension:costSharing.extension:coinsuranceOption.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Control | 1..1
Binding | The codes SHALL be taken from Qualifier for coinsurance rate
Type | CodeableConcept
[x] Note | See Choice of Data Types for further information about how to use [x]
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
42. Extension.extension:costSharing.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Control | 1..1
Type | uri
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Fixed Value | costSharing
43. Extension.extension:costSharing.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Control | 0..0
Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
[x] Note | See Choice of Data Types for further information about how to use [x]
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))
44. Extension.url
Definition | Source of the definition for the extension code - a logical name or a URL.
Control | 1..1
Type | uri
Comments | The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
Fixed Value | http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierDefinition-extension
45. Extension.value[x]
Definition | Value of extension - must be one of a constrained set of the data types (see Extensibility for a list).
Control | 0..0
Type | Choice of: base64Binary, boolean, canonical, code, date, dateTime, decimal, id, instant, integer, markdown, oid, positiveInt, string, time, unsignedInt, uri, url, uuid, Address, Age, Annotation, Attachment, CodeableConcept, Coding, ContactPoint, Count, Distance, Duration, HumanName, Identifier, Money, Period, Quantity, Range, Ratio, Reference, SampledData, Signature, Timing, ContactDetail, Contributor, DataRequirement, Expression, ParameterDefinition, RelatedArtifact, TriggerDefinition, UsageContext, Dosage, Meta
[x] Note | See Choice of Data Types for further information about how to use [x]
Invariants | Defined on this element ele-1: All FHIR elements must have a @value or children (: hasValue() or (children().count() > id.count()))