DaVinci Payer Data Exchange (PDex) US Drug Formulary
2.0.0 - STU 2 United States of America flag

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

ValueSet: Drug tier of medication in health plan

Official URL: http://hl7.org/fhir/us/davinci-drug-formulary/ValueSet/DrugTierVS Version: 2.0.0
Active as of 2022-08-25 Computable Name: DrugTierVS

The drug tier of a particular medication in a health plan. The base set are examples. Each plan may have its own controlled vocabulary.


Logical Definition (CLD)



This value set contains 9 concepts

Expansion based on Codes for medication drug tiers in health plans v2.0.0 (CodeSystem)

All codes in this table are from the system http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE

  genericGenericCommonly prescribed generic drugs that cost more than drugs in the ‘preferred generic’ tier.
  preferred-genericPreferred GenericCommonly prescribed generic drugs.
  non-preferred-genericNon-preferred GenericGeneric drugs that cost more than drugs in ‘generic’ tier.
  specialtySpecialtyDrugs 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.
  brandBrandBrand name drugs that cost more than ‘preferred brand’ drugs.
  preferred-brandPreferred BrandBrand name drugs
  non-preferred-brandNon-preferred BrandBrand name drugs that cost more than ‘brand’ drugs.
  zero-cost-share-preventativeZero cost-share preventativePreventive medications and products available at no cost.
  medical-serviceMedical ServiceDrugs that must be administered by a clinician or in a facility and may be covered under a medical benefit.

Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code