This page is part of the US Drug Formulary (v0.1.0: STU 1 Draft) based on FHIR R4. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions
<MedicationKnowledge xmlns="http://hl7.org/fhir"> <id value="formularydrugV1002"/> <meta> <profile value="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyDrug"/> </meta> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p><b>*** Formulary Drug Example #1 (MedicationKnowledge) ***</b></p><p><b>id</b>: formularydrugV2001</p><p><b>Drug Product</b>: Acetaminophen 325 MG / Oxycodone Hydrochloride 5 MG Oral Tablet [Percocet]</p><p><b>Drug Class</b>: Anilides (ATC code: N02BE); Barbiturates and derivatives (N02AA) </p><p><b>Drug Tier ID</b>: Brand </p><p><b>Prior Authorization</b>: false </p><p><b>Step Therapy Limit</b>: false</p><p><b>Quantity Limit</b>: false</p></div> </text> <extension url="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierID-extension"> <valueCodeableConcept> <coding> <system value="http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS"/> <code value="BRAND"/> <display value="Brand"/> </coding> </valueCodeableConcept> </extension> <extension url="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorization-extension"> <valueBoolean value="false"/> </extension> <extension url="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-StepTherapyLimit-extension"> <valueBoolean value="false"/> </extension> <extension url="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-QuantityLimit-extension"> <valueBoolean value="false"/> </extension> <extension url="http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PlanID-extension"> <valueString value="40308VA0240008"/> </extension> <code> <coding> <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/> <code value="1049640"/> <display value="Percocet 5 MG / 325 MG Oral Tablet"/> </coding> </code> </MedicationKnowledge>