PDex Formulary Production
Number of APIs: 22
Navitus Formulary Collection
This API enables you to use a FHIR interface to retrieve a health insurer's drug formulary information for patients, consumers and prescribers.
The current iteration of Opala's Drug Formulary API is an unauthenticated API, which means that it exchanges formulary data exclusively without including any PHI or PII.
Opala's Sandbox environment provides complete functionality. Use the Sandbox to test your application's connectivity and validate all aspects of your application against the test data. Opala recommends validating your application against the sandbox environment before registering your application.
For each resource profile in the collection, you can expand the description beneath the title for more information by clicking the caret icon. Within each folder are pre-defined requests you can run using Qodex.
The base URL for Navitus Formulary is https://public.opalahealth.io/formulary/v1/fhir/r4/navitus/.
Formulary Structure
Formularies in the United States are normally published by health insurers on an annual basis, with minor updates during the year. Each formulary contains a set of drugs with their limits or requirements. Drugs are placed into tiers; the number and purpose of drug tiers varies across payers. Each tier has an associated cost-sharing model that includes deductibles and/or coinsurance components for drugs in the tier when purchased through various pharmacy benefit types.
In addition to the drug tier, drugs may also list requirements on the patient (e.g., age or gender) or limitations on prescription (e.g., quantity limits).
Supported Capabilities
This table provides a summary of the supported capabilities of the Drug Formulary API.
| Resource Type | Supported Interactions | Supported Profiles | Supported Searches | Supported _includes | Supported _revincludes | Supported Operations |
|---|---|---|---|---|---|---|
| InsurancePlan | create search-type read vread update patch delete history-instance history-type | Payer Insurance Plan, Formulary | _id _lastUpdated identifier status period type name coverage-type formulary-coverage coverage-area | formulary-coverage | ||
| Basic | create search-type read vread update patch delete history-instance history-type | Formulary Item | _id _lastUpdated code subject status period formulary pharmacy-benefit-type drug-tier | subject, formulary | ||
| MedicationKnowledge | create search-type read vread update patch delete history-instance history-type | Formulary Drug | _id _lastUpdated status code drug-name doseform | |||
| Location | create search-type read vread update patch delete history-instance history-type | Insurance Plan Location | _id _lastUpdated address address-city address-state address-postalcode |
Search
Searching for resources is fundamental to the mechanics of FHIR. Search operations traverse through an existing set of resources filtering by parameters supplied to the search operation. For more inforamtion on searching FHIR resources, see Search {External Link}.
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metadata - Capability Statement metadata GET {{base_url}}/metadata
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Basic-{rid}-_history-{hid} - Read a past state of the resource GET {{base_url}}/Basic/000007c6-b6c4-469d-b1f0-d8a01c7991f4/_history/1?_summary=false&_format=<string>&_pretty=<boolean>&_elements=
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Basic-{rid}-_history - Read the past states of the resource GET {{base_url}}/Basic/000007c6-b6c4-469d-b1f0-d8a01c7991f4/_history?_summary=false&_format=<string>&_pretty=<boolean>&_elements=&_count=<number>&_since=2022-11-06T23:59:44Z
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Basic-{rid} - Read the current state of the resource GET {{base_url}}/Basic/000007c6-b6c4-469d-b1f0-d8a01c7991f4?_summary=false&_format=<string>&_pretty=<boolean>&_elements=
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Basic-_history - Read the past states of the resource GET {{base_url}}/Basic/_history?_summary=false&_format=<string>&_pretty=<boolean>&_elements=&_count=<number>&_at=2023-06-20T21:03
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Basic - Find All FormularyDrugs and the FormularyItems that Include them by Basic Formulary GET {{base_url}}/Basic?code=http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS|formulary-item&formulary=InsurancePlan/a5845397-57d1-4eff-ba22-646a639e418b&pharmacy-benefit-type:text=Unavailable&_include=Basic:subject
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InsurancePlan-{rid}-_history-{hid} - Read a past state of the resource GET {{base_url}}/InsurancePlan/:rid/_history/:hid?_summary=false&_format=<string>&_pretty=<boolean>&_elements=
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InsurancePlan-{rid}-_history - Read the past states of the resource GET {{base_url}}/InsurancePlan/:rid/_history?_summary=false&_format=<string>&_pretty=<boolean>&_elements=&_count=<number>&_since=2256-11-06T23:59:44Z&_at=2256-11-06T23:59:44Z&_list=<string>
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InsurancePlan-{rid} - Read the current state of the resource GET {{base_url}}/InsurancePlan/:rid?_summary=false&_format=<string>&_pretty=<boolean>&_elements=
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InsurancePlan-_history - Read the past states of the resource GET {{base_url}}/InsurancePlan/_history?_summary=false&_format=<string>&_pretty=<boolean>&_elements=&_count=<number>&_since=2256-11-06T23:59:44Z&_at=2256-11-06T23:59:44Z&_list=<string>