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

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## : Codes for medication drug tiers in health plans - XML Representation

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    <CodeSystem xmlns="http://hl7.org/fhir">
      <id value="usdf-DrugTierCS"/>
      <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-DrugTierCS 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">generic<a name="usdf-DrugTierCS-generic"> </a></td><td>Generic</td><td>Commonly prescribed generic drugs that cost more than drugs in the ‘preferred generic’ tier.</td></tr><tr><td style="white-space:nowrap">preferred-generic<a name="usdf-DrugTierCS-preferred-generic"> </a></td><td>Preferred Generic</td><td>Commonly prescribed generic drugs.</td></tr><tr><td style="white-space:nowrap">non-preferred-generic<a name="usdf-DrugTierCS-non-preferred-generic"> </a></td><td>Non-preferred Generic</td><td>Generic drugs that cost more than drugs in ‘generic’ tier.</td></tr><tr><td style="white-space:nowrap">specialty<a name="usdf-DrugTierCS-specialty"> </a></td><td>Specialty</td><td>Drugs used to treat complex conditions like cancer and multiple sclerosis. They can be generic or brand name, and are typically the most expensive drugs on the formulary.</td></tr><tr><td style="white-space:nowrap">brand<a name="usdf-DrugTierCS-brand"> </a></td><td>Brand</td><td>Brand name drugs that cost more than ‘preferred brand’ drugs.</td></tr><tr><td style="white-space:nowrap">preferred-brand<a name="usdf-DrugTierCS-preferred-brand"> </a></td><td>Preferred Brand</td><td>Brand name drugs</td></tr><tr><td style="white-space:nowrap">non-preferred-brand<a name="usdf-DrugTierCS-non-preferred-brand"> </a></td><td>Non-preferred Brand</td><td>Brand name drugs that cost more than ‘brand’ drugs.</td></tr><tr><td style="white-space:nowrap">zero-cost-share-preventative<a name="usdf-DrugTierCS-zero-cost-share-preventative"> </a></td><td>Zero cost-share preventative</td><td>Preventive medications and products available at no cost.</td></tr><tr><td style="white-space:nowrap">medical-service<a name="usdf-DrugTierCS-medical-service"> </a></td><td>Medical Service</td><td>Drugs that must be administered by a clinician or in a facility and may be covered under a medical benefit.</td></tr></table></div>
      </text>
      <url
           value="http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS"/>
      <version value="1.1.0"/>
      <name value="DrugTierCS"/>
      <title value="Codes for medication drug tiers in health plans"/>
      <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 to represent the drug tier of a particular medication in a health plan.  Base set are examples.  Each plan may have its own controlled vocabulary."/>
      <jurisdiction>
        <coding>
          <system value="urn:iso:std:iso:3166"/>
          <code value="US"/>
        </coding>
      </jurisdiction>
      <content value="complete"/>
      <count value="9"/>
      <concept>
        <code value="generic"/>
        <display value="Generic"/>
        <definition
                    value="Commonly prescribed generic drugs that cost more than drugs in the ‘preferred generic’ tier."/>
      </concept>
      <concept>
        <code value="preferred-generic"/>
        <display value="Preferred Generic"/>
        <definition value="Commonly prescribed generic drugs."/>
      </concept>
      <concept>
        <code value="non-preferred-generic"/>
        <display value="Non-preferred Generic"/>
        <definition
                    value="Generic drugs that cost more than drugs in ‘generic’ tier."/>
      </concept>
      <concept>
        <code value="specialty"/>
        <display value="Specialty"/>
        <definition
                    value="Drugs used to treat complex conditions like cancer and multiple sclerosis. They can be generic or brand name, and are typically the most expensive drugs on the formulary."/>
      </concept>
      <concept>
        <code value="brand"/>
        <display value="Brand"/>
        <definition
                    value="Brand name drugs that cost more than ‘preferred brand’ drugs."/>
      </concept>
      <concept>
        <code value="preferred-brand"/>
        <display value="Preferred Brand"/>
        <definition value="Brand name drugs"/>
      </concept>
      <concept>
        <code value="non-preferred-brand"/>
        <display value="Non-preferred Brand"/>
        <definition value="Brand name drugs that cost more than ‘brand’ drugs."/>
      </concept>
      <concept>
        <code value="zero-cost-share-preventative"/>
        <display value="Zero cost-share preventative"/>
        <definition
                    value="Preventive medications and products available at no cost."/>
      </concept>
      <concept>
        <code value="medical-service"/>
        <display value="Medical Service"/>
        <definition
                    value="Drugs that must be administered by a clinician or in a facility and may be covered under a medical benefit."/>
      </concept>
    </CodeSystem>