there are a few data elements listed as Boolean within the Formulary IG that have more than 2 values in our API.  The example I used was step therapy having three potential values in our formulary data source.  If we map the third value “Step Therapy Applies to New Starts Only” to “True” it will mis-leading to members.  Below are all of the data elements we found listed as Boolean which have more than 2 values on our data source (potential values are listed). 

Step Therapy:

    0 = No Step Therapy Applies

    1 = Step Therapy Applies

    2 = Step Therapy Applies to New Starts Only

Prior Authorization:

    0 = No Prior Authorization

    1 = Prior Authorization Applies

    2 = Prior Authorization Applies to New Starts Only

    3 = Part D vs. PartB Prior Authorization Only

Quantity Limit Type:

    0 = Quantity Limits Do Not Apply

    1 = Daily Quantity Limit

    2 = Quantity Limit Over Time