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

Table of Contents

Page standards status: Informative
.. 0 Table of Contents
... 1 Home
... 2 Reading this IG
... 3 Conformance Expectations
... 4 Project and Participants
... 5 Background
... 6 Specification
... 7 Privacy, Safety, and Security
... 8 Search Parameters
... 9 Queries
... 10 Artifacts Summary
.... 10.1 US Drug Formulary Server Capability Statement
.... 10.2 Basic-code
.... 10.3 Basic-drug-tier
.... 10.4 Basic-formulary
.... 10.5 Basic-lastupdated
.... 10.6 Basic-period
.... 10.7 Basic-pharmacy-benefit-type
.... 10.8 Basic-status
.... 10.9 Basic-subject
.... 10.10 InsurancePlan-coverage-area
.... 10.11 InsurancePlan-coverage-type
.... 10.12 InsurancePlan-formulary-coverage
.... 10.13 InsurancePlan-identifier
.... 10.14 InsurancePlan-lastupdated
.... 10.15 InsurancePlan-name
.... 10.16 InsurancePlan-period
.... 10.17 InsurancePlan-status
.... 10.18 InsurancePlan-type
.... 10.19 MedicationKnowledge-code
.... 10.20 MedicationKnowledge-doseform
.... 10.21 MedicationKnowledge-drug-name
.... 10.22 MedicationKnowledge-lastupdated
.... 10.23 MedicationKnowledge-status
.... 10.24 Formulary
.... 10.25 Formulary Bulk Data Graph Definition
.... 10.26 Formulary Drug
.... 10.27 Formulary Item
.... 10.28 Insurance Plan Coverage
.... 10.29 Insurance Plan Location
.... 10.30 Payer Insurance Plan
.... 10.31 Payer Insurance Plan Bulk Data Graph Definition
.... 10.32 Additional Coverage Information
.... 10.33 Availability Period
.... 10.34 Availability Status
.... 10.35 Drug Tier ID
.... 10.36 Formulary Reference
.... 10.37 Pharmacy Benefit Type
.... 10.38 Prior Authorization
.... 10.39 Prior Authorization New Starts Only
.... 10.40 Quantity Limit
.... 10.41 Quantity Limit Detail
.... 10.42 Step Therapy Limit
.... 10.43 Step Therapy Limit New Starts Only
.... 10.44 Benefit type of cost
.... 10.45 Drug tier of medication in health plan
.... 10.46 Insurance item type
.... 10.47 Non-Pack Semantic Drug Codes
.... 10.48 Pharmacy benefit types
.... 10.49 Qualifier for coinsurance rate
.... 10.50 Qualifier of copay amount
.... 10.51 Semantic Drug Codes
.... 10.52 Semantic Drug Form Group Codes
.... 10.53 Type of plan contact
.... 10.54 Codes for benefit type of cost
.... 10.55 Codes for insurance item type
.... 10.56 Codes for medication drug tiers in health plans
.... 10.57 Codes for pharmacy benefit types
.... 10.58 Codes for type of plan contact
.... 10.59 Codes qualifying the type of cost share amount
.... 10.60 acme-payer
.... 10.61 example
.... 10.62 FormularyD1002
.... 10.63 FormularyD3001
.... 10.64 FormularyD3002
.... 10.65 FormularyD3004t
.... 10.66 FormularyDrug-1000091
.... 10.67 FormularyDrug-1049640
.... 10.68 FormularyDrug-1541228
.... 10.69 FormularyDrug-209459
.... 10.70 FormularyDrug-284520
.... 10.71 FormularyGraphDefinition
.... 10.72 FormularyItem-D1002-1000091
.... 10.73 FormularyItem-D1002-1049640
.... 10.74 FormularyItem-D1002-209459
.... 10.75 FormularyItem-D1002-284520
.... 10.76 FormularyItem-D3001-1000091
.... 10.77 FormularyItem-D3002-1000091
.... 10.78 FormularyItem-D3004t-1049640
.... 10.79 InsurancePlanCoverageExample
.... 10.80 PayerInsurancePlanA1002
.... 10.81 PayerInsurancePlanA3001
.... 10.82 PayerInsurancePlanA3002
.... 10.83 PayerInsurancePlanA3004t
.... 10.84 PayerInsurancePlanGraphDefinition
.... 10.85 StateOfCTLocation
.... 10.86 UnitedStatesLocation
... 11 Downloads
... 12 Change Notes
... 13 US Drug Formulary ImplementationGuide Resource