Test Sandbox APIs
API Reference
Capability Statement
MedicationKnowledge
The MedicationKnowledge API provides the drug name and corresponding codes, along with details about the drug’s tier, quantity limits, any requirements for prior authorization and/or step therapy, and whether or not the drug is available via mail order. This API functions in accordance with HL7 R4 FHIR specification and the DaVinci Drug Formulary implementation guide, which can be reviewed at: http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition-usdf-CoveragePlan.html
URL
Sample Request
curl -X GET \
https://fhir.humana.com/api/MedicationKnowledge \curl -X GET \
https://fhir.humana.com/api/MedicationKnowledge \Sample Response
{
"resourceType": "Bundle",
"id": "7a1fd61d041b489f971cfd332b473a0f",
"meta": {
"lastUpdated": "2021-06-30T15:11:22.8063975+00:00"
},
"type": "searchset",
"link": [
{
"relation": "next",
"url": "https://fhir.humana.com/api/MedicationKnowledge?ct=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"
},
{
"relation": "self",
"url": "https://fhir.humana.com/api/MedicationKnowledge"
}
],
"entry": [
{
"fullUrl": "https://fhir.humana.com/api/MedicationKnowledge/c0c117c314b7eb52ec8099dcfb618c30eb7f672393524977a1911d2d9da1cc90",
"resource": {
"resourceType": "MedicationKnowledge",
"id": "c0c117c314b7eb52ec8099dcfb618c30eb7f672393524977a1911d2d9da1cc90",
"meta": {
"versionId": "4",
"lastUpdated": "2021-06-26T00:16:25.075+00:00"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierID-extension",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.humana.com/documentation/glossary/DrugTierID",
"code": "1",
"display": "Preferred Generic"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorization-extension",
"valueBoolean": false
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-StepTherapyLimit-extension",
"valueBoolean": true
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-QuantityLimit-extension",
"valueBoolean": true
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PlanID-extension",
"valueString": "H4461-030-002-2021"
}
],
"code": {
"coding": [
{
"system": "https://fhir.humana.com/documentation/glossary/ndc11",
"code": "65862063790",
"display": "90 TABLET in 1 BOTTLE"
},
{
"system": "http://hl7.org/fhir/sid/ndc",
"code": "65862-637-90",
"display": "90 TABLET in 1 BOTTLE"
},
{
"system": "https://fhir.humana.com/documentation/glossary/product_ndc",
"code": "65862-637",
"display": "Irbesartan"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "200094"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "200095"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "200096"
}
],
"text": "Irbesartan"
},
"status": "active"
},
"search": {
"mode": "match"
}
},
{
"fullUrl": "https://fhir.humana.com/api/MedicationKnowledge/d84f7910bf3ed139c6dc7223270bb9f2cf859c99c0e54046aa7866d922ac887e",
"resource": {
"resourceType": "MedicationKnowledge",
"id": "d84f7910bf3ed139c6dc7223270bb9f2cf859c99c0e54046aa7866d922ac887e",
"meta": {
"versionId": "4",
"lastUpdated": "2021-06-26T00:16:24.385+00:00"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierID-extension",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.humana.com/documentation/glossary/DrugTierID",
"code": "0",
"display": "Non-Formulary Drug"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorization-extension",
"valueBoolean": false
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-StepTherapyLimit-extension",
"valueBoolean": false
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-QuantityLimit-extension",
"valueBoolean": false
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PlanID-extension",
"valueString": "H4461-030-002-2021"
}
],
"code": {
"coding": [
{
"system": "https://fhir.humana.com/documentation/glossary/ndc11",
"code": "51552078502"
}
]
},
"status": "active"
},
"search": {
"mode": "match"
}
},
{
"fullUrl": "https://fhir.humana.com/api/MedicationKnowledge/d1ca9bf0ce8da8b88cda282665b357a359ab17d8dbe8e8be1e018c1e3013a05b",
"resource": {
"resourceType": "MedicationKnowledge",
"id": "d1ca9bf0ce8da8b88cda282665b357a359ab17d8dbe8e8be1e018c1e3013a05b",
"meta": {
"versionId": "4",
"lastUpdated": "2021-06-26T00:16:25.491+00:00"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierID-extension",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.humana.com/documentation/glossary/DrugTierID",
"code": "1",
"display": "Preferred Generic"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorization-extension",
"valueBoolean": false
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-StepTherapyLimit-extension",
"valueBoolean": false
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-QuantityLimit-extension",
"valueBoolean": false
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PlanID-extension",
"valueString": "H4461-030-002-2021"
}
],
"code": {
"coding": [
{
"system": "https://fhir.humana.com/documentation/glossary/ndc11",
"code": "68382002301",
"display": "100 TABLET in 1 BOTTLE"
},
{
"system": "http://hl7.org/fhir/sid/ndc",
"code": "68382-023-01",
"display": "100 TABLET in 1 BOTTLE"
},
{
"system": "https://fhir.humana.com/documentation/glossary/product_ndc",
"code": "68382-023",
"display": "Atenolol"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "197379"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "197380"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "197381"
}
],
"text": "Atenolol"
},
"status": "active"
},
"search": {
"mode": "match"
}
},
{
"fullUrl": "https://fhir.humana.com/api/MedicationKnowledge/0dcbeb1b1baae9a5d857aec2ce88be7471383b2ef51ca688343c3b7efb9ff4cf",
"resource": {
"resourceType": "MedicationKnowledge",
"id": "0dcbeb1b1baae9a5d857aec2ce88be7471383b2ef51ca688343c3b7efb9ff4cf",
"meta": {
"versionId": "4",
"lastUpdated": "2021-06-26T00:16:29.737+00:00"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierID-extension",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.humana.com/documentation/glossary/DrugTierID",
"code": "2",
"display": "Generic"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorization-extension",
"valueBoolean": false
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-StepTherapyLimit-extension",
"valueBoolean": false
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-QuantityLimit-extension",
"valueBoolean": true
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PlanID-extension",
"valueString": "H4461-030-002-2021"
}
],
"code": {
"coding": [
{
"system": "https://fhir.humana.com/documentation/glossary/ndc11",
"code": "00378876593",
"display": "30 POUCH in 1 CARTON > 1 FILM in 1 POUCH (0378-8765-16)"
},
{
"system": "http://hl7.org/fhir/sid/ndc",
"code": "0378-8765-93",
"display": "30 POUCH in 1 CARTON > 1 FILM in 1 POUCH (0378-8765-16)"
},
{
"system": "https://fhir.humana.com/documentation/glossary/product_ndc",
"code": "0378-8765",
"display": "Buprenorphine and Naloxone"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1010600"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1010604"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1307056"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1307061"
}
],
"text": "Buprenorphine and Naloxone"
},
"status": "active"
},
"search": {
"mode": "match"
}
},
{
"fullUrl": "https://fhir.humana.com/api/MedicationKnowledge/b1e1e2cbe1e1b049a772770239ee7fc454f07c68726b2c94f715d4728ce72302",
"resource": {
"resourceType": "MedicationKnowledge",
"id": "b1e1e2cbe1e1b049a772770239ee7fc454f07c68726b2c94f715d4728ce72302",
"meta": {
"versionId": "4",
"lastUpdated": "2021-06-26T00:16:27.616+00:00"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierID-extension",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.humana.com/documentation/glossary/DrugTierID",
"code": "0",
"display": "Non-Formulary Drug"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorization-extension",
"valueBoolean": false
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-StepTherapyLimit-extension",
"valueBoolean": false
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-QuantityLimit-extension",
"valueBoolean": false
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PlanID-extension",
"valueString": "H4461-030-002-2021"
}
],
"code": {
"coding": [
{
"system": "https://fhir.humana.com/documentation/glossary/ndc11",
"code": "63323026910",
"display": "10 VIAL in 1 BOX > 10 mL in 1 VIAL"
},
{
"system": "http://hl7.org/fhir/sid/ndc",
"code": "63323-269-10",
"display": "10 VIAL in 1 BOX > 10 mL in 1 VIAL"
},
{
"system": "https://fhir.humana.com/documentation/glossary/product_ndc",
"code": "63323-269",
"display": "Diprivan"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1808217"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1808219"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1808222"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1808223"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1808224"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1808225"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1808234"
},
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "1808235"
}
],
"text": "Diprivan"
},
"status": "active"
},
"search": {
"mode": "match"
}
},
{
"fullUrl": "https://fhir.humana.com/api/MedicationKnowledge/ba3d8f72214ee73b397fd668cb73ff01bb154fa52e5340b7af91526d30da307e",
"resource": {
"resourceType": "MedicationKnowledge",
"id": "ba3d8f72214ee73b397fd668cb73ff01bb154fa52e5340b7af91526d30da307e",
"meta": {
"versionId": "4",
"lastUpdated": "2021-06-26T00:16:30.71+00:00"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierID-extension",
"valueCodeableConcept": {
"coding": [
{
"system": "https://fhir.humana.com/documentation/glossary/DrugTierID",
"code": "2",
"display": "Generic"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorization-extension",
"valueBoolean": false
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-StepTherapyLimit-extension",
"valueBoolean": false
},
{
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