Consumer Real-Time Pharmacy Benefit Check FHIR IG, published by HL7 International / Pharmacy. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/carin-rtpbc/ and changes regularly. See the Directory of published versions
: RTPBC Patient Pay Type Code System - TTL Representation
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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:CodeSystem ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "rtpbc-patient-pay-type"] ; #
fhir:meta [
fhir:lastUpdated [ fhir:v "2019-12-08T00:00:00-05:00"^^xsd:dateTime ]
] ; #
fhir:text [
fhir:status [ fhir:v "generated" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: CodeSystem rtpbc-patient-pay-type</b></p><a name=\"rtpbc-patient-pay-type\"> </a><a name=\"hcrtpbc-patient-pay-type\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Last updated: 2019-12-08 00:00:00-0500</p></div><p>This case-insensitive code system <code>http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type</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\">deductible<a name=\"rtpbc-patient-pay-type-deductible\"> </a></td><td>Deductible</td><td>Amount to be collected from a patient to be applied to a periodic deductible</td></tr><tr><td style=\"white-space:nowrap\">coinsurance<a name=\"rtpbc-patient-pay-type-coinsurance\"> </a></td><td>Per prescription coinsurance</td><td>Amount to be collected from a patient to satisfy a per prescription coinsurance</td></tr><tr><td style=\"white-space:nowrap\">copay<a name=\"rtpbc-patient-pay-type-copay\"> </a></td><td>Copay</td><td>Amount to be collected from the patient to satisfy a per prescription copay</td></tr><tr><td style=\"white-space:nowrap\">tax<a name=\"rtpbc-patient-pay-type-tax\"> </a></td><td>Tax</td><td>Amount to be collected from the patient for sales tax</td></tr><tr><td style=\"white-space:nowrap\">cash-price<a name=\"rtpbc-patient-pay-type-cash-price\"> </a></td><td>Full product cash price</td><td>Full product cash price before discounts or coupons</td></tr><tr><td style=\"white-space:nowrap\">coupon-discount<a name=\"rtpbc-patient-pay-type-coupon-discount\"> </a></td><td>Coupon discount amount</td><td>Coupon discount reducing the amount to be collected from the patient</td></tr><tr><td style=\"white-space:nowrap\">member-discount<a name=\"rtpbc-patient-pay-type-member-discount\"> </a></td><td>Member discount amount</td><td>Member discount reducing the amount to be collected from the patient</td></tr><tr><td style=\"white-space:nowrap\">other-discount<a name=\"rtpbc-patient-pay-type-other-discount\"> </a></td><td>Other discount amount</td><td>Other discount reducing the amount to be collected from the patient</td></tr><tr><td style=\"white-space:nowrap\">other-cost<a name=\"rtpbc-patient-pay-type-other-cost\"> </a></td><td>Other cost</td><td>Other amount to be collected from the patient</td></tr><tr><td style=\"white-space:nowrap\">eligible<a name=\"rtpbc-patient-pay-type-eligible\"> </a></td><td>Eligible amount</td><td>Amount that is considered for adjudication</td></tr><tr><td style=\"white-space:nowrap\">total<a name=\"rtpbc-patient-pay-type-total\"> </a></td><td>Total patient responsibility</td><td>Amount equalling the total patient responsibility for a prescription product's cost</td></tr></table></div>"^^rdf:XMLLiteral
] ; #
fhir:extension ( [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ] ;
fhir:value [
a fhir:code ;
fhir:v "phx" ]
] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"^^xsd:anyURI ] ;
fhir:value [
a fhir:integer ;
fhir:v 4 ;
( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ] ;
fhir:value [
a fhir:canonical ;
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/ImplementationGuide/hl7.fhir.us.carin-rtpbc"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/carin-rtpbc/ImplementationGuide/hl7.fhir.us.carin-rtpbc> ] ] ) ]
] [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"^^xsd:anyURI ] ;
fhir:value [
a fhir:code ;
fhir:v "trial-use" ;
( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom"^^xsd:anyURI ] ;
fhir:value [
a fhir:canonical ;
fhir:v "http://hl7.org/fhir/us/carin-rtpbc/ImplementationGuide/hl7.fhir.us.carin-rtpbc"^^xsd:anyURI ;
fhir:link <http://hl7.org/fhir/us/carin-rtpbc/ImplementationGuide/hl7.fhir.us.carin-rtpbc> ] ] ) ]
] ) ; #
fhir:url [ fhir:v "http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type"^^xsd:anyURI] ; #
fhir:version [ fhir:v "2.0.0"] ; #
fhir:name [ fhir:v "RtpbcPatientPayTypeCodeSystem"] ; #
fhir:title [ fhir:v "RTPBC Patient Pay Type Code System"] ; #
fhir:status [ fhir:v "active"] ; #
fhir:experimental [ fhir:v false] ; #
fhir:date [ fhir:v "2020-05-23T00:00:00-05:00"^^xsd:dateTime] ; #
fhir:publisher [ fhir:v "HL7 International / Pharmacy"] ; #
fhir:contact ( [
fhir:name [ fhir:v "HL7 International / Pharmacy" ] ;
( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/medication" ] ] )
] [
fhir:name [ fhir:v "Frank McKinney" ] ;
( fhir:telecom [
fhir:system [ fhir:v "email" ] ;
fhir:value [ fhir:v "fm@frankmckinney.com" ] ] )
] ) ; #
fhir:description [ fhir:v "This code system defines components of a patient's responsibility for a prescription product's cost."] ; #
fhir:jurisdiction ( [
( fhir:coding [
fhir:system [ fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ] ;
fhir:code [ fhir:v "US" ] ;
fhir:display [ fhir:v "United States of America" ] ] )
] ) ; #
fhir:caseSensitive [ fhir:v false] ; #
fhir:content [ fhir:v "complete"] ; #
fhir:count [ fhir:v "11"^^xsd:nonNegativeInteger] ; #
fhir:concept ( [
fhir:code [ fhir:v "deductible" ] ;
fhir:display [ fhir:v "Deductible" ] ;
fhir:definition [ fhir:v "Amount to be collected from a patient to be applied to a periodic deductible" ]
] [
fhir:code [ fhir:v "coinsurance" ] ;
fhir:display [ fhir:v "Per prescription coinsurance" ] ;
fhir:definition [ fhir:v "Amount to be collected from a patient to satisfy a per prescription coinsurance" ]
] [
fhir:code [ fhir:v "copay" ] ;
fhir:display [ fhir:v "Copay" ] ;
fhir:definition [ fhir:v "Amount to be collected from the patient to satisfy a per prescription copay" ]
] [
fhir:code [ fhir:v "tax" ] ;
fhir:display [ fhir:v "Tax" ] ;
fhir:definition [ fhir:v "Amount to be collected from the patient for sales tax" ]
] [
fhir:code [ fhir:v "cash-price" ] ;
fhir:display [ fhir:v "Full product cash price" ] ;
fhir:definition [ fhir:v "Full product cash price before discounts or coupons" ]
] [
fhir:code [ fhir:v "coupon-discount" ] ;
fhir:display [ fhir:v "Coupon discount amount" ] ;
fhir:definition [ fhir:v "Coupon discount reducing the amount to be collected from the patient" ]
] [
fhir:code [ fhir:v "member-discount" ] ;
fhir:display [ fhir:v "Member discount amount" ] ;
fhir:definition [ fhir:v "Member discount reducing the amount to be collected from the patient" ]
] [
fhir:code [ fhir:v "other-discount" ] ;
fhir:display [ fhir:v "Other discount amount" ] ;
fhir:definition [ fhir:v "Other discount reducing the amount to be collected from the patient" ]
] [
fhir:code [ fhir:v "other-cost" ] ;
fhir:display [ fhir:v "Other cost" ] ;
fhir:definition [ fhir:v "Other amount to be collected from the patient" ]
] [
fhir:code [ fhir:v "eligible" ] ;
fhir:display [ fhir:v "Eligible amount" ] ;
fhir:definition [ fhir:v "Amount that is considered for adjudication" ]
] [
fhir:code [ fhir:v "total" ] ;
fhir:display [ fhir:v "Total patient responsibility" ] ;
fhir:definition [ fhir:v "Amount equalling the total patient responsibility for a prescription product's cost" ]
] ) . #
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