DaVinci Payer Data Exchange (PDex) US Drug Formulary
2.1.0 - STU 3 (ci-build) 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

Example Basic: FormularyItem-D3002-1000091

Page standards status: Informative

Generated Narrative: Basic FormularyItem-D3002-1000091

Last updated: 2021-08-22 18:36:03+0000

Profile: Formulary Item

Formulary Reference: InsurancePlan Sample Medicare Advantage Part D Formulary D3002

Availability Status: active

Pharmacy Benefit Type: 1 month in network retail

Pharmacy Benefit Type: 1 month in network mail order

Pharmacy Benefit Type: 3 month in network retail

Pharmacy Benefit Type: 3 month in network mail order

Drug Tier ID: Generic

Availability Period: 2021-01-01 --> 2021-12-31

Prior Authorization: false

Step Therapy Limit: true

Step Therapy Limit New Starts Only: true

Quantity Limit: true

code: Formulary Item

subject: MedicationKnowledge doxepin hydrochloride 50 MG/ML Topical Cream