DaVinci Payer Data Exchange (PDex) US Drug Formulary
2.1.0 - STU2.1 United States of America flag

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

Resource Profile: PayerInsurancePlan - Mappings

Page standards status: Trial-use

Mappings for the usdf-PayerInsurancePlan resource profile.

Mappings for FiveWs Pattern Mapping (http://hl7.org/fhir/fivews)

PayerInsurancePlan
InsurancePlan
   identifierFiveWs.identifier
   statusFiveWs.status
   typeFiveWs.class
   plan
      identifierFiveWs.identifier
   plan (drug-plan)
      identifierFiveWs.identifier

Mappings for RIM Mapping (http://hl7.org/v3)

PayerInsurancePlan
InsurancePlanEntity. Role, or Act
   meta
      idn/a
      extensionn/a
   textAct.text?
   containedN/A
   extensionN/A
   modifierExtensionN/A
   identifier.scopes[Role](classCode=IDENT)
   status.status
   type.code
   name.name
   alias.name
   contact.contactParty
      idn/a
      extensionn/a
      modifierExtensionN/A
      purpose./type
      name./name
         idn/a
         extensionn/a
         useunique(./use)
         text./formatted
         family./part[partType = FAM]
         given./part[partType = GIV]
         prefix./part[partType = PFX]
         suffix./part[partType = SFX]
         period./usablePeriod[type="IVL<TS>"]
      telecom./telecom
         idn/a
         extensionn/a
         system./scheme
         value./url
         useunique(./use)
         rankn/a
         period./usablePeriod[type="IVL<TS>"]
      address./addr
   endpointn/a
   coverage
      idn/a
      extensionn/a
      modifierExtensionN/A
      benefit
         idn/a
         extensionn/a
         modifierExtensionN/A
         limit
            idn/a
            extensionn/a
            modifierExtensionN/A
   coverage (drug-coverage)
      idn/a
      modifierExtensionN/A
      benefit
         idn/a
         extensionn/a
         modifierExtensionN/A
         limit
            idn/a
            extensionn/a
            modifierExtensionN/A
      benefit (drug-plan)
         idn/a
         extensionn/a
         modifierExtensionN/A
         limit
            idn/a
            extensionn/a
            modifierExtensionN/A
   plan
      idn/a
      extensionn/a
      modifierExtensionN/A
      identifier.scopes[Role](classCode=IDENT)
      generalCost
         idn/a
         extensionn/a
         modifierExtensionN/A
      specificCost
         idn/a
         extensionn/a
         modifierExtensionN/A
         benefit
            idn/a
            extensionn/a
            modifierExtensionN/A
            cost
               idn/a
               extensionn/a
               modifierExtensionN/A
               value
   plan (drug-plan)
      idn/a
      extensionn/a
      modifierExtensionN/A
      identifier.scopes[Role](classCode=IDENT)
      generalCost
         idn/a
         extensionn/a
         modifierExtensionN/A
      specificCost
         idn/a
         extensionn/a
         modifierExtensionN/A
         benefit
            idn/a
            extensionn/a
            modifierExtensionN/A
            cost
               idn/a
               extensionn/a
               modifierExtensionN/A
               value
            cost (copay)
               idn/a
               extensionn/a
               modifierExtensionN/A
               value
                  idn/a
                  extensionn/a
                  valuePQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
                  comparatorIVL properties
                  unitPQ.unit
                  systemCO.codeSystem, PQ.translation.codeSystem
                  codePQ.code, MO.currency, PQ.translation.code
            cost (coinsurance)
               idn/a
               extensionn/a
               modifierExtensionN/A
               value
                  idn/a
                  extensionn/a
                  valuePQ.value, CO.value, MO.value, IVL.high or IVL.low depending on the value
                  comparatorIVL properties
                  unitPQ.unit
                  systemCO.codeSystem, PQ.translation.codeSystem
                  codePQ.code, MO.currency, PQ.translation.code