Universal API Implementation Guide - Local Development build (v1.1.19). See the Directory of published versions
CodeSystem: UAPI Code System - Benefit Type
| Official URL: https://fhir.developer.gene.com/CodeSystem/uapi-benefit-type
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Version:
1.1.19
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Active
as of 2020-06-15
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Responsible:
Genentech USIX
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Realm: 
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Computable Name: UapiCodeSystemBenefitType |
Genentech Benefit Types Supported in UAPI
This Code system is referenced in the content logical definition of the following value sets:
This code system https://fhir.developer.gene.com/CodeSystem/uapi-benefit-type defines the following codes:
| Code | Display |
| fullBI | Full BI |
| reverify | Reverify BI Information |
| dateEligibility | Eligibility Date Only |
| oSource | Other Source |
| triage | Triage |
| appeals | Appeals Support |
| deductible | deductible |
| OOPMax | OOP Max |
| doesIndDedApplyFamily | does ind ded apply to family |
| FamDedMetBefore | Must Fam Ded Be Met Before Bene Cov |
| OOPApply | Does OOP Apply |
| IndividualOOPFamily | Does Individual OOP Apply to Family |
| 100%Cov | 100% Cov only if Family OOP Met |
| InsurerCostShare | Insurer Cost Share % |
| PatientCostShare | Patient Cost Share % |
| DrugCo-Pay | Drug Co-Pay |
| SpecialistCo-Pay | Specialist Co-Pay |
| DeductibleApplyOOP | Does Deductible Apply to OOP |
| MaxBenefit/Year | Max Benefit/Year |
| MaxLifetimeAmount | Max Lifetime Amount |
| BuyBill | Buy and Bill |
| PlaceOfServiceCo-Pay | Place of Service Co-Pay |
| SpentDownAmount | Spent Down Amount |
| DrugTierLevel | Drug Tier Level |
| DeductibleApply | Does Deductible Apply? |
| PatientCostInitial | Patient Cost Share % **Initial Coverage Stage |
| DaysSupplyInitial | Day Supply **Initial Coverage Stage |
| DrugCopayInitial | Drug Copay **Initial Coverage Stage |
| PatientCostCatastrophic | Patient Cost Share % **Catastrophic Coverage Stage |
| DrugCopayCatastrophic | Drug Co-pay **Catastrophic Coverage Stage |
| CoverageGap | Coverage Gap |