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

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## ValueSet: Qualifier of copay amount

Summary

Defining URL: | http://hl7.org/fhir/us/davinci-drug-formulary/ValueSet/CopayOptionVS
Version: | 1.1.0
Name: | CopayOptionVS
Title: | Qualifier of copay amount
Status: | Active as of 2021-10-15T15:46:55+00:00
Definition: | Qualifier of copay amount
Publisher: | HL7 Pharmacy Working Group
Source Resource: | XML / JSON / Turtle

References

- Drug Tier Definition

### Logical Definition (CLD)

- Include all codes defined in `http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-CopayOptionCS`

### Expansion

This value set contains 6 concepts

Expansion based on Codes for qualifier of copay amount v1.1.0 (CodeSystem)

All codes in this table are from the system `http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-CopayOptionCS`

Code | Display | Definition
after-deductible | After Deductible | 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).
before-deductible | Before Deductible | 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).
no-charge | No Charge | No cost sharing is charged (this indicates that this benefit is not subject to the deductible).
no-charge-after-deductible | No Charge After Deductible | 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).
charge | Charge | 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).
not-applicable | Not Applicable | Deductible is not applicable: Zero-deductible cost sharing represented by a co-pay value of 'Not applicable' and co-insurance value of 'No charge'.

Explanation of the columns that may appear on this page:

Level | A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
Source | The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code | The code (used as the code in the resource instance)
Display | The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition | An explanation of the meaning of the concept
Comments | Additional notes about how to use the code