Consumer Real-Time Pharmacy Benefit Check FHIR IG
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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 - XML Representation

Page standards status: Trial-use Maturity Level: 4

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="rtpbc-patient-pay-type"/>
  <meta>
    <lastUpdated value="2019-12-08T00:00:00-05:00"/>
  </meta>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="phx"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="4">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical
                        value="http://hl7.org/fhir/us/carin-rtpbc/ImplementationGuide/hl7.fhir.us.carin-rtpbc"/>
      </extension>
    </valueInteger>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="trial-use">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical
                        value="http://hl7.org/fhir/us/carin-rtpbc/ImplementationGuide/hl7.fhir.us.carin-rtpbc"/>
      </extension>
    </valueCode>
  </extension>
  <url
       value="http://hl7.org/fhir/us/carin-rtpbc/CodeSystem/rtpbc-patient-pay-type"/>
  <version value="2.0.0"/>
  <name value="RtpbcPatientPayTypeCodeSystem"/>
  <title value="RTPBC Patient Pay Type Code System"/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2020-05-23T00:00:00-05:00"/>
  <publisher value="HL7 International / Pharmacy"/>
  <contact>
    <name value="HL7 International / Pharmacy"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/medication"/>
    </telecom>
  </contact>
  <contact>
    <name value="Frank McKinney"/>
    <telecom>
      <system value="email"/>
      <value value="fm@frankmckinney.com"/>
    </telecom>
  </contact>
  <description
               value="This code system defines components of a patient's responsibility for a prescription product's cost."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <caseSensitive value="false"/>
  <content value="complete"/>
  <count value="11"/>
  <concept>
    <code value="deductible"/>
    <display value="Deductible"/>
    <definition
                value="Amount to be collected from a patient to be applied to a periodic deductible"/>
  </concept>
  <concept>
    <code value="coinsurance"/>
    <display value="Per prescription coinsurance"/>
    <definition
                value="Amount to be collected from a patient to satisfy a per prescription coinsurance"/>
  </concept>
  <concept>
    <code value="copay"/>
    <display value="Copay"/>
    <definition
                value="Amount to be collected from the patient to satisfy a per prescription copay"/>
  </concept>
  <concept>
    <code value="tax"/>
    <display value="Tax"/>
    <definition
                value="Amount to be collected from the patient for sales tax"/>
  </concept>
  <concept>
    <code value="cash-price"/>
    <display value="Full product cash price"/>
    <definition value="Full product cash price before discounts or coupons"/>
  </concept>
  <concept>
    <code value="coupon-discount"/>
    <display value="Coupon discount amount"/>
    <definition
                value="Coupon discount reducing the amount to be collected from the patient"/>
  </concept>
  <concept>
    <code value="member-discount"/>
    <display value="Member discount amount"/>
    <definition
                value="Member discount reducing the amount to be collected from the patient"/>
  </concept>
  <concept>
    <code value="other-discount"/>
    <display value="Other discount amount"/>
    <definition
                value="Other discount reducing the amount to be collected from the patient"/>
  </concept>
  <concept>
    <code value="other-cost"/>
    <display value="Other cost"/>
    <definition value="Other amount to be collected from the patient"/>
  </concept>
  <concept>
    <code value="eligible"/>
    <display value="Eligible amount"/>
    <definition value="Amount that is considered for adjudication"/>
  </concept>
  <concept>
    <code value="total"/>
    <display value="Total patient responsibility"/>
    <definition
                value="Amount equalling the total patient responsibility for a prescription product's cost"/>
  </concept>
</CodeSystem>