Universal API Implementation Guide - Local Development build (v1.1.20) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions
CodeSystem: UAPI Code System - Benefit Type
Official URL : https://fhir.developer.gene.com/CodeSystem/uapi-benefit-type
Version :
1.1.20
Active
as of 2020-06-15
Computable Name : UapiCodeSystemBenefitType
Genentech Benefit Types Supported in UAPI
This Code system is referenced in the content logical definition of the following value sets:
Last updated: 2021-04-28 05:00:00+0000
This case-insensitive 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