DaVinci Payer Data Exchange (PDex) US Drug Formulary, published by HL7 International / Pharmacy. This guide is not an authorized publication; it is the continuous build for version 2.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-pdex-formulary/ and changes regularly. See the Directory of published versions

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: Codes for benefit type of cost

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/usdf-BenefitCostTypeCS-TEMPORARY-TRIAL-USE> a fhir:CodeSystem ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "usdf-BenefitCostTypeCS-TEMPORARY-TRIAL-USE"] ;
  fhir:Resource.language [ fhir:value "en"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem usdf-BenefitCostTypeCS-TEMPORARY-TRIAL-USE</b></p><a name=\"usdf-BenefitCostTypeCS-TEMPORARY-TRIAL-USE\"> </a><a name=\"hcusdf-BenefitCostTypeCS-TEMPORARY-TRIAL-USE\"> </a><p>This case-sensitive code system <code>http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-BenefitCostTypeCS-TEMPORARY-TRIAL-USE</code> 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\">copay<a name=\"usdf-BenefitCostTypeCS-TEMPORARY-TRIAL-USE-copay\"> </a></td><td>Copay</td><td>A flat fee the member pays to fill the prescription.</td></tr><tr><td style=\"white-space:nowrap\">coinsurance<a name=\"usdf-BenefitCostTypeCS-TEMPORARY-TRIAL-USE-coinsurance\"> </a></td><td>Coinsurance</td><td>A percentage of the cost to fill the prescription, usually after the deductible has been met.</td></tr></table></div>"
  ] ;
  fhir:DomainResource.extension [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg" ] ;
     fhir:Extension.valueCode [ fhir:value "phx" ]
  ], [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status" ] ;
     fhir:Extension.valueCode [
       fhir:value "trial-use" ;
       fhir:Element.extension [
         fhir:index -1 ;
         fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom" ] ;
         fhir:Extension.valueCanonical [
           fhir:value "http://hl7.org/fhir/us/davinci-drug-formulary/ImplementationGuide/hl7.fhir.us.davinci-drug-formulary" ;
           fhir:link <http://hl7.org/fhir/us/davinci-drug-formulary/ImplementationGuide/hl7.fhir.us.davinci-drug-formulary>
         ]
       ]
     ]
  ] ;
  fhir:CodeSystem.url [ fhir:value "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-BenefitCostTypeCS-TEMPORARY-TRIAL-USE"] ;
  fhir:CodeSystem.identifier [
     fhir:index -1 ;
     fhir:Identifier.system [ fhir:value "urn:ietf:rfc:3986" ] ;
     fhir:Identifier.value [ fhir:value "urn:oid:2.25.74595174031514506193398850787025340071.16.1" ]
  ] ;
  fhir:CodeSystem.version [ fhir:value "2.1.0"] ;
  fhir:CodeSystem.name [ fhir:value "BenefitCostTypeCS"] ;
  fhir:CodeSystem.title [ fhir:value "Codes for benefit type of cost"] ;
  fhir:CodeSystem.status [ fhir:value "active"] ;
  fhir:CodeSystem.experimental [ fhir:value "false"^^xsd:boolean] ;
  fhir:CodeSystem.date [ fhir:value "2026-08-03T19:19:34+00:00"^^xsd:dateTime] ;
  fhir:CodeSystem.publisher [ fhir:value "HL7 International / Pharmacy"] ;
  fhir:CodeSystem.contact [
     fhir:index -1 ;
     fhir:ContactDetail.name [ fhir:value "HL7 International / Pharmacy" ] ;
     fhir:ContactDetail.telecom [
       fhir:index -1 ;
       fhir:ContactPoint.system [ fhir:value "url" ] ;
       fhir:ContactPoint.value [ fhir:value "http://www.hl7.org/Special/committees/medication" ]
     ], [
       fhir:index -1 ;
       fhir:ContactPoint.system [ fhir:value "email" ] ;
       fhir:ContactPoint.value [ fhir:value "pharmacy@lists.HL7.org" ]
     ]
  ] ;
  fhir:CodeSystem.description [ fhir:value "Types of out of pockets costs associated with the benefit"] ;
  fhir:CodeSystem.jurisdiction [
     fhir:index -1 ;
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ] ;
       fhir:Coding.code [ fhir:value "US" ]
     ]
  ] ;
  fhir:CodeSystem.caseSensitive [ fhir:value "true"^^xsd:boolean] ;
  fhir:CodeSystem.content [ fhir:value "complete"] ;
  fhir:CodeSystem.count [ fhir:value "2"^^xsd:nonNegativeInteger] ;
  fhir:CodeSystem.concept [
     fhir:index -1 ;
     fhir:CodeSystem.concept.code [ fhir:value "copay" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Copay" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "A flat fee the member pays to fill the prescription." ]
  ], [
     fhir:index -1 ;
     fhir:CodeSystem.concept.code [ fhir:value "coinsurance" ] ;
     fhir:CodeSystem.concept.display [ fhir:value "Coinsurance" ] ;
     fhir:CodeSystem.concept.definition [ fhir:value "A percentage of the cost to fill the prescription, usually after the deductible has been met." ]
  ] .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/CodeSystem/usdf-BenefitCostTypeCS-TEMPORARY-TRIAL-USE.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/CodeSystem/usdf-BenefitCostTypeCS-TEMPORARY-TRIAL-USE.ttl> .