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 2.0.1 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

Queries

Page standards status: Informative

Anticipated Client Queries

Find All PayerInsurancePlans

PayerInsurancePlans may have any number of types found in the http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsuranceProductTypeCS CodeSystem. Each PayerInsurancePlan conformant to this IG will have ane or more memberPlan extensions that references a Formulary. From the PayerInsurancePlan memberPlan extension(s), it is possible to retrieve the Formulary resource(s).

  
    GET [base]/InsurancePlan?type=http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsuranceProductTypeCS|
  

Find All Insurance Plans with Drug Coverage

InsurancePlan with drug coverage can be search for with a `coverage.type` of `http://terminology.hl7.org/CodeSystem/v3-ActCode|DRUGPOL`.

  
    GET [base]/InsurancePlan?coverage-type=http://terminology.hl7.org/CodeSystem/v3-ActCode|DRUGPOL
  

Find All Formulary Resource

Formulary can be search for with a type of `http://terminology.hl7.org/CodeSystem/v3-ActCode|DRUGPOL`.

  
    GET [base]/InsurancePlan?type=http://terminology.hl7.org/CodeSystem/v3-ActCode|DRUGPOL
  

Find a Formulary by its Identifier

To find an Formulary for a with id 'D1002':

  
    GET [base]/InsurancePlan?type=http://terminology.hl7.org/CodeSystem/v3-ActCode|DRUGPOL&identifier=D1002
  

Find All PayerInsurancePlans by a Formulary

To find all PayerInsurancePlans that include a coverage with a specific formulary by id 'FormularyD1002':

  
    GET [base]/InsurancePlan?formulary-coverage=InsurancePlan/FormularyD1002
  

Find All PayerInsurancePlans by Coverage Area

To find all PayerInsurancePlans with a coverage area Location by id 'StateOfCTLocation':

  
    GET [base]/InsurancePlan?coverage-area=Location/StateOfCTLocation
  

Find All FormularyItems and FormularyDrugs in a Formulary

To find all FormularyItems and their respective FormularyDrugs in a Formulary with the id of 'FormularyD1002':

  
    GET [base]/Basic?code=http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS|formulary-item&formulary=InsurancePlan/FormularyD1002&_include=Basic:subject
  

Find All FormularyItems and FormularyDrugs in an Formulary by Drug Tier

To find all FormularyItems and their respective FormularyDrugs in a Formulary with the id of 'FormularyD1002' and a drug-tier of 'generic':

  
    GET [base]/Basic?code=http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS|formulary-item&formulary=InsurancePlan/FormularyD1002&drug-tier=http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS|generic&_include=Basic:subject
  

Find All FormularyItems and FormularyDrugs in a Formulary by Pharmacy Benefit Type

To find all FormularyItems and their respective FormularyDrugs in a Formulary with the id of 'FormularyD1002' and a pharmacy-benefit-type of '3-month-in-mail':

  
    GET [base]/Basic?code=http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS|formulary-item&formulary=InsurancePlan/FormularyD1002&pharmacy-benefit-type=http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS|3-month-in-mail&_include=Basic:subject
  

Find All FormularyItems and FormularyDrugs in a Formulary by Drug Name

To find all FormularyItems and their respective FormularyDrugs in a Formulary with the id of 'FormularyD1002' and a drug name of 'doxepin hydrochloride':

  
    GET [base]/Basic?code=http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS|formulary-item&formulary=InsurancePlan/FormularyD1002&subject:MedicationKnowledge.drug-name=doxepin%20hydrochloride&_include=Basic:subject
  

Find All FormularyItems and FormularyDrugs in a Formulary by Drug Code

To find all FormularyItems and their respective FormularyDrugs in a Formulary with the id of 'FormularyD1002' and a drug with the RxNorm code of '1000091':

  
    GET [base]/Basic?code=http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS|formulary-item&formulary=InsurancePlan/FormularyD1002&subject:MedicationKnowledge.code=http://www.nlm.nih.gov/research/umls/rxnorm|1000091&_include=Basic:subject
  

Find All FormularyItems and Covering Formulary Resources by Drug Code

To find all FormularyItems and the Formulary resources that include them for the drug with the RxNorm code of '1000091':

  
    GET [base]/Basic?code=http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS|formulary-item&subject:MedicationKnowledge.code=http://www.nlm.nih.gov/research/umls/rxnorm|1000091&_include=Basic:formulary