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

: FormularyItem-D1002-284520

Page standards status: Informative

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@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/Basic/FormularyItem-D1002-284520> a fhir:Basic ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:Resource.id [ fhir:value "FormularyItem-D1002-284520"] ;
  fhir:Resource.meta [
     fhir:Meta.lastUpdated [ fhir:value "2021-08-22T18:36:03.000+00:00"^^xsd:dateTime ] ;
     fhir:Meta.profile [
       fhir:value "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyItem" ;
       fhir:index -1 ;
       fhir:link <http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyItem>
     ]
  ] ;
  fhir:Resource.language [ fhir:value "en"] ;
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "extensions" ] ;
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: Basic FormularyItem-D1002-284520</b></p><a name=\"FormularyItem-D1002-284520\"> </a><a name=\"hcFormularyItem-D1002-284520\"> </a><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Last updated: 2021-08-22 18:36:03+0000</p><p style=\"margin-bottom: 0px\">Profile: <a href=\"StructureDefinition-usdf-FormularyItem.html\">Formulary Item</a></p></div><p><b>Formulary Reference</b>: <a href=\"InsurancePlan-FormularyD1002.html\">InsurancePlan Sample Medicare Advantage Part D Formulary D1002</a></p><p><b>Availability Status</b>: active</p><p><b>Pharmacy Benefit Type</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS-TEMPORARY-TRIAL-USE 3-month-out-retail}\">3 month out of network retail</span></p><p><b>Drug Tier ID</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE brand}\">Brand</span></p><p><b>Availability Period</b>: 2021-01-01 --&gt; 2021-12-31</p><p><b>Prior Authorization</b>: false</p><p><b>Step Therapy Limit</b>: false</p><p><b>Quantity Limit</b>: false</p><p><b>code</b>: <span title=\"Codes:{http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS formulary-item}\">Formulary Item</span></p><p><b>subject</b>: <a href=\"MedicationKnowledge-FormularyDrug-284520.html\">MedicationKnowledge tacrolimus 0.001 MG/MG Topical Ointment [Protopic]</a></p></div>"
  ] ;
  fhir:DomainResource.extension [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyReference-extension" ] ;
     fhir:Extension.valueReference [
       fhir:link <http://hl7.org/fhir/InsurancePlan/FormularyD1002> ;
       fhir:Reference.reference [ fhir:value "InsurancePlan/FormularyD1002" ]
     ]
  ], [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-AvailabilityStatus-extension" ] ;
     fhir:Extension.valueCode [ fhir:value "active" ]
  ], [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PharmacyBenefitType-extension" ] ;
     fhir:Extension.valueCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS-TEMPORARY-TRIAL-USE" ] ;
         fhir:Coding.code [ fhir:value "3-month-out-retail" ] ;
         fhir:Coding.display [ fhir:value "3 month out of network retail" ]
       ]
     ]
  ], [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierID-extension" ] ;
     fhir:Extension.valueCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index -1 ;
         fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS-TEMPORARY-TRIAL-USE" ] ;
         fhir:Coding.code [ fhir:value "brand" ] ;
         fhir:Coding.display [ fhir:value "Brand" ]
       ]
     ]
  ], [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-AvailabilityPeriod-extension" ] ;
     fhir:Extension.valuePeriod [
       fhir:Period.start [ fhir:value "2021-01-01"^^xsd:date ] ;
       fhir:Period.end [ fhir:value "2021-12-31"^^xsd:date ]
     ]
  ], [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorization-extension" ] ;
     fhir:Extension.valueBoolean [ fhir:value "false"^^xsd:boolean ]
  ], [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-StepTherapyLimit-extension" ] ;
     fhir:Extension.valueBoolean [ fhir:value "false"^^xsd:boolean ]
  ], [
     fhir:index -1 ;
     fhir:Extension.url [ fhir:value "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-QuantityLimit-extension" ] ;
     fhir:Extension.valueBoolean [ fhir:value "false"^^xsd:boolean ]
  ] ;
  fhir:Basic.code [
     fhir:CodeableConcept.coding [
       fhir:index -1 ;
       fhir:Coding.system [ fhir:value "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS" ] ;
       fhir:Coding.code [ fhir:value "formulary-item" ] ;
       fhir:Coding.display [ fhir:value "Formulary Item" ]
     ]
  ] ;
  fhir:Basic.subject [
     fhir:link <http://hl7.org/fhir/MedicationKnowledge/FormularyDrug-284520> ;
     fhir:Reference.reference [ fhir:value "MedicationKnowledge/FormularyDrug-284520" ]
  ] .

<http://hl7.org/fhir/InsurancePlan/FormularyD1002> a fhir:InsurancePlan .

<http://hl7.org/fhir/MedicationKnowledge/FormularyDrug-284520> a fhir:MedicationKnowledge .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/Basic/FormularyItem-D1002-284520.ttl> a owl:Ontology ;
  owl:imports fhir:fhir.ttl ;
  owl:versionIRI <http://build.fhir.org/Basic/FormularyItem-D1002-284520.ttl> .