DaVinci Payer Data Exchange (PDex) US Drug Formulary
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DaVinci Payer Data Exchange (PDex) US Drug Formulary, published by HL7 Pharmacy Working Group. This is not an authorized publication; it is the continuous build for version 2.0.0). 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

CodeSystem: Codes for medication drug tiers in health plans

Official URL: http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE Version: 2.0.0
Active as of 2022-08-25 Computable Name: DrugTierCS

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.

This Code system is referenced in the content logical definition of the following value sets:

This code system http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE defines the following codes:

CodeDisplayDefinition
generic GenericCommonly prescribed generic drugs that cost more than drugs in the ‘preferred generic’ tier.
preferred-generic Preferred GenericCommonly prescribed generic drugs.
non-preferred-generic Non-preferred GenericGeneric drugs that cost more than drugs in ‘generic’ tier.
specialty SpecialtyDrugs 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.
brand BrandBrand name drugs that cost more than ‘preferred brand’ drugs.
preferred-brand Preferred BrandBrand name drugs
non-preferred-brand Non-preferred BrandBrand name drugs that cost more than ‘brand’ drugs.
zero-cost-share-preventative Zero cost-share preventativePreventive medications and products available at no cost.
medical-service Medical ServiceDrugs that must be administered by a clinician or in a facility and may be covered under a medical benefit.