DaVinci Payer Data Exchange (PDex) US Drug Formulary
2.1.0 - STU2.1
US
DaVinci Payer Data Exchange (PDex) US Drug Formulary
2.1.0 - STU2.1
US
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
| Official URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyItem | Version: 2.1.0 | ||||
| Standards status: Trial-use | Computable Name: FormularyItem | ||||
| Other Identifiers: OID:2.25.74595174031514506193398850787025340071.42.9 | |||||
A resource that describes a drug's relationship to a drug plan, including drug tier, prior authorization requirements, and more. The set of FormularyItem resources associated with a particular drug plan represents the drug plans formulary.
Usages:
You can also check for usages in the FHIR IG Statistics
Description Differentials, Snapshots, and other representations.
| Path | Status | Usage | ValueSet | Version | Source |
| Basic.code | Base | example | Basic Resource Types | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | Basic | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | Basic | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
|
| dom-4 | error | Basic | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated |
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
|
| dom-5 | error | Basic | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | Basic | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
| Path | Status | Usage | ValueSet | Version | Source |
| Basic.meta.security | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std. |
| Basic.meta.tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std. |
| Basic.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| Basic.code | Base | example | Basic Resource Types | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | Basic | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | Basic | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
|
| dom-4 | error | Basic | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated |
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
|
| dom-5 | error | Basic | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | Basic | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
Summary
Mandatory: 5 elements(1 nested mandatory element)
Must-Support: 10 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Key Elements View
| Name | Flags | Card. | Type | Description & Constraints Filter:   |
|---|---|---|---|---|
  Basic |
0..* | Basic | Resource for non-supported content | |
  meta |
Σ | 0..1 | Meta | Metadata about the resource |
   lastUpdated |
SΣ | 1..1 | instant | When the resource version last changed |
 implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created |
 Slices for extension |
4..* | Extension | Extension Slice: Unordered, Open by value:url | |
  extension:usdf-FormularyReference-extension |
S | 1..1 | Reference(Formulary) | Formulary Reference URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyReference-extension |
| extension:usdf-AvailabilityStatus-extension |
S | 1..1 | code | Availability Status URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-AvailabilityStatus-extension Binding: PublicationStatus (required) |
| extension:usdf-AvailabilityPeriod-extension |
S | 0..1 | Period | Availability Period URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-AvailabilityPeriod-extension |
| extension:usdf-PharmacyBenefitType-extension |
S | 1..* | CodeableConcept | Pharmacy Benefit Type URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PharmacyBenefitType-extension Binding: Pharmacy benefit types (extensible) |
| extension:usdf-DrugTierID-extension |
S | 1..1 | CodeableConcept | Drug Tier ID URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierID-extension Binding: Drug tier of medication in health plan (extensible) |
| extension:usdf-PriorAuthorization-extension |
S | 0..1 | boolean | Prior Authorization URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorization-extension |
| extension:usdf-PriorAuthorizationNewStartsOnly-extension |
0..1 | boolean | Prior Authorization New Starts Only URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorizationNewStartsOnly-extension | |
| extension:usdf-StepTherapyLimit-extension |
S | 0..1 | boolean | Step Therapy Limit URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-StepTherapyLimit-extension |
| extension:usdf-StepTherapyLimitNewStartsOnly-extension |
0..1 | boolean | Step Therapy Limit New Starts Only URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-StepTherapyLimitNewStartsOnly-extension | |
| extension:usdf-QuantityLimit-extension |
S | 0..1 | boolean | Quantity Limit URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-QuantityLimit-extension |
| extension:usdf-QuantityLimitDetail-extension |
0..1 | (Complex) | Quantity Limit Detail URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-QuantityLimitDetail-extension | |
 extension:usdf-AdditionalCoverageInformation-extension |
0..1 | markdown | Additional Coverage Information URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-AdditionalCoverageInformation-extension | |
 modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored |
| code |
?!Σ | 1..1 | CodeableConcept | Kind of Resource Binding: BasicResourceTypes (example): Codes for identifying types of resources not yet defined by FHIR. Required Pattern: At least the following |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
 coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
| id |
0..1 | string | Unique id for inter-element referencing | |
| extension |
0..* | Extension | Additional content defined by implementations | |
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS | |
| version |
0..1 | string | Version of the system - if relevant | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: formulary-item | |
| display |
0..1 | string | Representation defined by the system | |
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |
| text |
0..1 | string | Plain text representation of the concept | |
 subject |
SΣ | 1..1 | Reference(Formulary Drug) | Identifies the focus of this resource |
| Documentation for this format | ||||
| Path | Status | Usage | ValueSet | Version | Source |
| Basic.code | Base | example | Basic Resource Types | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | Basic | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | Basic | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
|
| dom-4 | error | Basic | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated |
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
|
| dom-5 | error | Basic | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | Basic | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
Differential View
| Name | Flags | Card. | Type | Description & Constraints Filter: |
|---|---|---|---|---|
| Basic |
0..* | Basic | Resource for non-supported content | |
 meta |
||||
| lastUpdated |
S | 1..1 | instant | When the resource version last changed |
| Slices for extension |
4..* | Extension | Extension Slice: Unordered, Open by value:url | |
| extension:usdf-FormularyReference-extension |
S | 1..1 | Reference(Formulary) | Formulary Reference URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyReference-extension |
| extension:usdf-AvailabilityStatus-extension |
S | 1..1 | code | Availability Status URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-AvailabilityStatus-extension Binding: PublicationStatus (required) |
| extension:usdf-AvailabilityPeriod-extension |
S | 0..1 | Period | Availability Period URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-AvailabilityPeriod-extension |
| extension:usdf-PharmacyBenefitType-extension |
S | 1..* | CodeableConcept | Pharmacy Benefit Type URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PharmacyBenefitType-extension Binding: Pharmacy benefit types (extensible) |
| extension:usdf-DrugTierID-extension |
S | 1..1 | CodeableConcept | Drug Tier ID URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierID-extension Binding: Drug tier of medication in health plan (extensible) |
| extension:usdf-PriorAuthorization-extension |
S | 0..1 | boolean | Prior Authorization URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorization-extension |
| extension:usdf-PriorAuthorizationNewStartsOnly-extension |
0..1 | boolean | Prior Authorization New Starts Only URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorizationNewStartsOnly-extension | |
| extension:usdf-StepTherapyLimit-extension |
S | 0..1 | boolean | Step Therapy Limit URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-StepTherapyLimit-extension |
| extension:usdf-StepTherapyLimitNewStartsOnly-extension |
0..1 | boolean | Step Therapy Limit New Starts Only URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-StepTherapyLimitNewStartsOnly-extension | |
| extension:usdf-QuantityLimit-extension |
S | 0..1 | boolean | Quantity Limit URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-QuantityLimit-extension |
| extension:usdf-QuantityLimitDetail-extension |
0..1 | (Complex) | Quantity Limit Detail URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-QuantityLimitDetail-extension | |
| extension:usdf-AdditionalCoverageInformation-extension |
0..1 | markdown | Additional Coverage Information URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-AdditionalCoverageInformation-extension | |
| code |
1..1 | CodeableConcept | Kind of Resource Required Pattern: At least the following | |
 coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |
 system |
1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS | |
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: formulary-item | |
| subject |
S | 1..1 | Reference(Formulary Drug) | Identifies the focus of this resource |
| Documentation for this format | ||||
Snapshot ViewView
| Name | Flags | Card. | Type | Description & Constraints Filter: | ||||
|---|---|---|---|---|---|---|---|---|
| Basic |
0..* | Basic | Resource for non-supported content | |||||
| id |
Σ | 0..1 | id | Logical id of this artifact | ||||
| meta |
Σ | 0..1 | Meta | Metadata about the resource | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url | |||||
| versionId |
Σ | 0..1 | id | Version specific identifier | ||||
| lastUpdated |
SΣ | 1..1 | instant | When the resource version last changed | ||||
| source |
Σ | 0..1 | uri | Identifies where the resource comes from | ||||
| profile |
Σ | 0..* | canonical(StructureDefinition) | Profiles this resource claims to conform to | ||||
| security |
Σ | 0..* | Coding | Security Labels applied to this resource Binding: All Security Labels (extensible): Security Labels from the Healthcare Privacy and Security Classification System. | ||||
| tag |
Σ | 0..* | Coding | Tags applied to this resource Binding: CommonTags (example): Codes that represent various types of tags, commonly workflow-related; e.g. "Needs review by Dr. Jones". | ||||
| implicitRules |
?!Σ | 0..1 | uri | A set of rules under which this content was created | ||||
| language |
0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
| |||||
| text |
0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements | |||||
| contained |
0..* | Resource | Contained, inline Resources | |||||
| Slices for extension |
4..* | Extension | Extension Slice: Unordered, Open by value:url | |||||
| extension:usdf-FormularyReference-extension |
S | 1..1 | Reference(Formulary) | Formulary Reference URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyReference-extension | ||||
| extension:usdf-AvailabilityStatus-extension |
S | 1..1 | code | Availability Status URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-AvailabilityStatus-extension Binding: PublicationStatus (required) | ||||
| extension:usdf-AvailabilityPeriod-extension |
S | 0..1 | Period | Availability Period URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-AvailabilityPeriod-extension | ||||
| extension:usdf-PharmacyBenefitType-extension |
S | 1..* | CodeableConcept | Pharmacy Benefit Type URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PharmacyBenefitType-extension Binding: Pharmacy benefit types (extensible) | ||||
| extension:usdf-DrugTierID-extension |
S | 1..1 | CodeableConcept | Drug Tier ID URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierID-extension Binding: Drug tier of medication in health plan (extensible) | ||||
| extension:usdf-PriorAuthorization-extension |
S | 0..1 | boolean | Prior Authorization URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorization-extension | ||||
| extension:usdf-PriorAuthorizationNewStartsOnly-extension |
0..1 | boolean | Prior Authorization New Starts Only URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorizationNewStartsOnly-extension | |||||
| extension:usdf-StepTherapyLimit-extension |
S | 0..1 | boolean | Step Therapy Limit URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-StepTherapyLimit-extension | ||||
| extension:usdf-StepTherapyLimitNewStartsOnly-extension |
0..1 | boolean | Step Therapy Limit New Starts Only URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-StepTherapyLimitNewStartsOnly-extension | |||||
| extension:usdf-QuantityLimit-extension |
S | 0..1 | boolean | Quantity Limit URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-QuantityLimit-extension | ||||
| extension:usdf-QuantityLimitDetail-extension |
0..1 | (Complex) | Quantity Limit Detail URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-QuantityLimitDetail-extension | |||||
| extension:usdf-AdditionalCoverageInformation-extension |
0..1 | markdown | Additional Coverage Information URL: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-AdditionalCoverageInformation-extension | |||||
| modifierExtension |
?! | 0..* | Extension | Extensions that cannot be ignored | ||||
| identifier |
Σ | 0..* | Identifier | Business identifier | ||||
| code |
?!Σ | 1..1 | CodeableConcept | Kind of Resource Binding: BasicResourceTypes (example): Codes for identifying types of resources not yet defined by FHIR. Required Pattern: At least the following | ||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| coding |
1..* | Coding | Code defined by a terminology system Fixed Value: (Complex) | |||||
| id |
0..1 | string | Unique id for inter-element referencing | |||||
| extension |
0..* | Extension | Additional content defined by implementations | |||||
| system |
1..1 | uri | Identity of the terminology system Fixed Value: http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS | |||||
| version |
0..1 | string | Version of the system - if relevant | |||||
| code |
1..1 | code | Symbol in syntax defined by the system Fixed Value: formulary-item | |||||
| display |
0..1 | string | Representation defined by the system | |||||
| userSelected |
0..1 | boolean | If this coding was chosen directly by the user | |||||
| text |
0..1 | string | Plain text representation of the concept | |||||
| subject |
SΣ | 1..1 | Reference(Formulary Drug) | Identifies the focus of this resource | ||||
| created |
Σ | 0..1 | date | When created | ||||
| author |
Σ | 0..1 | Reference(Practitioner | PractitionerRole | Patient | RelatedPerson | Organization) | Who created | ||||
| Documentation for this format | ||||||||
| Path | Status | Usage | ValueSet | Version | Source |
| Basic.meta.security | Base | extensible | SecurityLabels | 📍4.0.1 | FHIR Std. |
| Basic.meta.tag | Base | example | Common Tags | 📍4.0.1 | FHIR Std. |
| Basic.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std. |
| Basic.code | Base | example | Basic Resource Types | 📍4.0.1 | FHIR Std. |
| Id | Grade | Path(s) | Description | Expression |
| dom-2 | error | Basic | If the resource is contained in another resource, it SHALL NOT contain nested Resources |
contained.contained.empty()
|
| dom-3 | error | Basic | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource |
contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
|
| dom-4 | error | Basic | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated |
contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
|
| dom-5 | error | Basic | If a resource is contained in another resource, it SHALL NOT have a security label |
contained.meta.security.empty()
|
| dom-6 | best practice | Basic | A resource should have narrative for robust management |
text.`div`.exists()
|
| ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children |
hasValue() or (children().count() > id.count())
|
| ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both |
extension.exists() != value.exists()
|
Summary
Mandatory: 5 elements(1 nested mandatory element)
Must-Support: 10 elements
Structures
This structure refers to these other structures:
Extensions
This structure refers to these extensions:
Other representations of profile: CSV, Excel, Schematron
IG © 2025+ HL7 International / Pharmacy.
Package hl7.fhir.us.davinci-drug-formulary#2.1.0 based on FHIR 4.0.1.
Generated
2026-05-21
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