DaVinci Payer Data Exchange (PDex) US Drug Formulary
2.0.1 - STU 2 United States of America flag

This page is part of the US Drug Formulary (v2.0.1: STU 2) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: FormularyD1002 - XML Representation

Page standards status: Informative

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<InsurancePlan xmlns="http://hl7.org/fhir">
  <id value="FormularyD1002"/>
  <meta>
    <lastUpdated value="2021-08-22T18:36:03.000+00:00"/>
    <profile
             value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-Formulary"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: InsurancePlan</b><a name="FormularyD1002"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource InsurancePlan &quot;FormularyD1002&quot; Updated &quot;2021-08-22 18:36:03+0000&quot; </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-usdf-Formulary.html">Formulary</a></p></div><p><b>identifier</b>: id: D1002</p><p><b>status</b>: active</p><p><b>type</b>: drug policy <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-v3-ActCode.html">ActCode</a>#DRUGPOL)</span></p><p><b>name</b>: Sample Medicare Advantage Part D Formulary D1002</p><p><b>period</b>: 2021-01-01 --&gt; 2021-12-31</p></div>
  </text>
  <identifier>
    <value value="D1002"/>
  </identifier>
  <status value="active"/>
  <type>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <code value="DRUGPOL"/>
    </coding>
  </type>
  <name value="Sample Medicare Advantage Part D Formulary D1002"/>
  <period>
    <start value="2021-01-01"/>
    <end value="2021-12-31"/>
  </period>
</InsurancePlan>