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PBM Demo — SilverCare Formulary
Scenario: Maria Johnson (SC-2026-00147) calls her PBM asking about Lipitor coverage. Run each cell in order.
14 cells · updated Mar 20, 2026
This is a read-only view. Responses shown were saved when the notebook was published —
open it in your own Aidbox to run the cells against live data.
Step 1 — Identify the member
REST
Send
Cells run only inside Aidbox. Use Run in Aidbox above to open this notebook in your own instance.
GET /fhir/Patient/member-maria-johnson
Response:
Body
Status:
200
{
"address": [
{
"use": "home",
"city": "Baltimore",
"line": [
"456 Oak Avenue"
],
"state": "MD",
"postalCode": "21201"
}
],
"meta": {
"lastUpdated": "2026-03-20T12:08:56.567820Z",
"versionId": "17",
"extension": [
{
"url": "https://aidbox.app/ex/createdAt",
"valueInstant": "2026-03-20T12:08:56.567820Z"
}
]
},
"name": [
{
"use": "official",
"given": [
"Maria",
"Elena"
],
"family": "Johnson"
}
],
"birthDate": "1958-07-15",
"resourceType": "Patient",
"id": "member-maria-johnson",
"identifier": [
{
"type": {
"coding": [
{
"code": "MB",
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"display": "Member Number"
}
]
},
"value": "SC-2026-00147",
"system": "https://www.silvercare-health.example.com/member-id"
}
],
"gender": "female"
}Step 2 — Find her active coverage
REST
Send
Cells run only inside Aidbox. Use Run in Aidbox above to open this notebook in your own instance.
GET /fhir/Coverage?beneficiary=member-maria-johnson&status=active
Response:
Body
Status:
200
{
"resourceType": "Bundle",
"type": "searchset",
"meta": {
"versionId": "0"
},
"total": 1,
"link": [
{
"relation": "first",
"url": "http://localhost:8080/fhir/Coverage?beneficiary=member-maria-johnson&status=active&page=1"
},
{
"relation": "self",
"url": "http://localhost:8080/fhir/Coverage?beneficiary=member-maria-johnson&status=active&page=1"
}
],
"entry": [
{
"resource": {
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-InsurancePlanCoverage"
],
"lastUpdated": "2026-03-20T12:08:56.567820Z",
"versionId": "35",
"extension": [
{
"url": "https://aidbox.app/ex/createdAt",
"valueInstant": "2026-03-20T12:08:56.567820Z"
}
]
},
"beneficiary": {
"display": "Maria Johnson",
"reference": "Patient/member-maria-johnson"
},
"relationship": {
"coding": [
{
"code": "self",
"system": "http://terminology.hl7.org/CodeSystem/subscriber-relationship",
"display": "Self"
}
]
},
"type": {
"coding": [
{
"code": "DRUGPOL",
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"display": "Drug Policy"
}
]
},
"resourceType": "Coverage",
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-InsurancePlanReference-extension",
"valueReference": {
"display": "SilverCare Gold Medicare Advantage",
"reference": "InsurancePlan/silvercare-gold-plan"
}
}
],
"subscriber": {
"display": "Maria Johnson",
"reference": "Patient/member-maria-johnson"
},
"payor": [
{
"display": "SilverCare Health Inc.",
"reference": "Organization/silvercare-health"
}
],
"status": "active",
"id": "coverage-maria-gold",
"class": [
{
"name": "SilverCare Gold Medicare Advantage",
"type": {
"coding": [
{
"code": "plan",
"system": "http://terminology.hl7.org/CodeSystem/coverage-class",
"display": "Plan"
}
]
},
"value": "silvercare-gold-plan"
}
],
"period": {
"end": "2026-12-31",
"start": "2026-01-01"
}
},
"search": {
"mode": "match"
},
"fullUrl": "http://localhost:8080/Coverage/coverage-maria-gold",
"link": [
{
"relation": "self",
"url": "http://localhost:8080/Coverage/coverage-maria-gold"
}
]
}
]
}Step 2b — Load the plan details (copay tiers, coverage area)
REST
Send
Cells run only inside Aidbox. Use Run in Aidbox above to open this notebook in your own instance.
GET /fhir/InsurancePlan/silvercare-gold-plan
Response:
Body
Status:
200
{
"coverageArea": [
{
"display": "State of Maryland",
"reference": "Location/state-of-maryland"
}
],
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PayerInsurancePlan"
],
"lastUpdated": "2026-03-20T12:08:56.567820Z",
"versionId": "27",
"extension": [
{
"url": "https://aidbox.app/ex/createdAt",
"valueInstant": "2026-03-20T12:08:56.567820Z"
}
]
},
"name": "SilverCare Gold Medicare Advantage",
"coverage": [
{
"type": {
"coding": [
{
"code": "DRUGPOL",
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"display": "Drug Policy"
}
]
},
"benefit": [
{
"type": {
"coding": [
{
"code": "drug",
"system": "http://terminology.hl7.org/CodeSystem/insurance-plan-type",
"display": "Drug"
}
]
}
}
],
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyReference-extension",
"valueReference": {
"display": "SilverCare Gold 2026 Formulary",
"reference": "InsurancePlan/silvercare-gold-formulary"
}
}
]
}
],
"type": [
{
"coding": [
{
"code": "medical",
"system": "http://terminology.hl7.org/CodeSystem/insurance-plan-type",
"display": "Medical"
}
]
}
],
"resourceType": "InsurancePlan",
"alias": [
"SC Gold MA"
],
"status": "active",
"id": "silvercare-gold-plan",
"identifier": [
{
"type": {
"coding": [
{
"code": "NIIP",
"system": "http://terminology.hl7.org/CodeSystem/v2-0203",
"display": "National Insurance Payor Identifier"
}
]
},
"value": "SC-GOLD-MA-2026",
"system": "https://www.silvercare-health.example.com/plan-id"
}
],
"administeredBy": {
"display": "SilverCare Health Inc.",
"reference": "Organization/silvercare-health"
},
"ownedBy": {
"display": "SilverCare Health Inc.",
"reference": "Organization/silvercare-health"
},
"period": {
"end": "2026-12-31",
"start": "2026-01-01"
},
"plan": [
{
"type": {
"coding": [
{
"code": "drug",
"system": "http://terminology.hl7.org/CodeSystem/insurance-plan-type",
"display": "Drug"
}
]
},
"specificCost": [
{
"benefit": [
{
"cost": [
{
"type": {
"coding": [
{
"code": "copay",
"system": "http://terminology.hl7.org/CodeSystem/insurance-plan-cost-type",
"display": "Copay"
}
]
},
"value": {
"code": "USD",
"unit": "USD",
"value": 5,
"system": "urn:iso:std:iso:4217"
},
"qualifiers": [
{
"coding": [
{
"code": "after-deductible",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-CostShareOptionCS",
"display": "After Deductible"
}
]
}
]
}
],
"type": {
"coding": [
{
"code": "1-month-in-retail",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS",
"display": "1 month supply via in-person at a retail pharmacy"
}
]
}
},
{
"cost": [
{
"type": {
"coding": [
{
"code": "copay",
"system": "http://terminology.hl7.org/CodeSystem/insurance-plan-cost-type",
"display": "Copay"
}
]
},
"value": {
"code": "USD",
"unit": "USD",
"value": 0,
"system": "urn:iso:std:iso:4217"
},
"qualifiers": [
{
"coding": [
{
"code": "no-charge",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-CostShareOptionCS",
"display": "No Charge"
}
]
}
]
}
],
"type": {
"coding": [
{
"code": "3-month-in-mail",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS",
"display": "3 month supply via mail order"
}
]
}
}
],
"category": {
"coding": [
{
"code": "generic",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS",
"display": "Generic"
}
]
}
},
{
"benefit": [
{
"cost": [
{
"type": {
"coding": [
{
"code": "copay",
"system": "http://terminology.hl7.org/CodeSystem/insurance-plan-cost-type",
"display": "Copay"
}
]
},
"value": {
"code": "USD",
"unit": "USD",
"value": 30,
"system": "urn:iso:std:iso:4217"
},
"qualifiers": [
{
"coding": [
{
"code": "after-deductible",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-CostShareOptionCS",
"display": "After Deductible"
}
]
}
]
}
],
"type": {
"coding": [
{
"code": "1-month-in-retail",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS",
"display": "1 month supply via in-person at a retail pharmacy"
}
]
}
},
{
"cost": [
{
"type": {
"coding": [
{
"code": "copay",
"system": "http://terminology.hl7.org/CodeSystem/insurance-plan-cost-type",
"display": "Copay"
}
]
},
"value": {
"code": "USD",
"unit": "USD",
"value": 75,
"system": "urn:iso:std:iso:4217"
},
"qualifiers": [
{
"coding": [
{
"code": "after-deductible",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-CostShareOptionCS",
"display": "After Deductible"
}
]
}
]
}
],
"type": {
"coding": [
{
"code": "3-month-in-mail",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS",
"display": "3 month supply via mail order"
}
]
}
}
],
"category": {
"coding": [
{
"code": "preferred-brand",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS",
"display": "Preferred Brand"
}
]
}
}
]
}
]
}Step 3 — Search for Lipitor on formulary
Returns both generic atorvastatin and brand Lipitor — shows generic alternative immediately.
REST
Send
Cells run only inside Aidbox. Use Run in Aidbox above to open this notebook in your own instance.
GET /fhir/Basic?formulary=InsurancePlan/silvercare-gold-formulary&subject=MedicationKnowledge/drug-lipitor-20mg
Response:
Body
Status:
200
{
"resourceType": "Bundle",
"type": "searchset",
"meta": {
"versionId": "0"
},
"total": 1,
"link": [
{
"relation": "first",
"url": "http://localhost:8080/fhir/Basic?formulary=InsurancePlan/silvercare-gold-formulary&subject=MedicationKnowledge/drug-lipitor-20mg&page=1"
},
{
"relation": "self",
"url": "http://localhost:8080/fhir/Basic?formulary=InsurancePlan/silvercare-gold-formulary&subject=MedicationKnowledge/drug-lipitor-20mg&page=1"
}
],
"entry": [
{
"resource": {
"code": {
"coding": [
{
"code": "formulary-item",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS",
"display": "Formulary Item"
}
]
},
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyItem"
],
"lastUpdated": "2026-03-20T12:08:56.567820Z",
"versionId": "33",
"extension": [
{
"url": "https://aidbox.app/ex/createdAt",
"valueInstant": "2026-03-20T12:08:56.567820Z"
}
]
},
"subject": {
"display": "atorvastatin 20 MG Oral Tablet [Lipitor]",
"reference": "MedicationKnowledge/drug-lipitor-20mg"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyReference-extension",
"valueReference": {
"display": "SilverCare Gold 2026 Formulary",
"reference": "InsurancePlan/silvercare-gold-formulary"
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-AvailabilityStatus-extension",
"valueCode": "active"
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierID-extension",
"valueCodeableConcept": {
"coding": [
{
"code": "preferred-brand",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS",
"display": "Preferred Brand"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PharmacyBenefitType-extension",
"valueCodeableConcept": {
"coding": [
{
"code": "1-month-in-retail",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS",
"display": "1 month supply via in-person at a retail pharmacy"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PharmacyBenefitType-extension",
"valueCodeableConcept": {
"coding": [
{
"code": "3-month-in-mail",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS",
"display": "3 month supply via mail order"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorization-extension",
"valueBoolean": true
},
{
"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
}
],
"id": "formulary-item-lipitor",
"resourceType": "Basic"
},
"search": {
"mode": "match"
},
"fullUrl": "http://localhost:8080/Basic/formulary-item-lipitor",
"link": [
{
"relation": "self",
"url": "http://localhost:8080/Basic/formulary-item-lipitor"
}
]
}
]
}Step 4 — Check Lipitor formulary item
⚠️ Preferred Brand — Prior Auth required, Step Therapy required, Quantity Limit applies.
REST
Send
Cells run only inside Aidbox. Use Run in Aidbox above to open this notebook in your own instance.
GET /fhir/Basic?formulary=InsurancePlan/silvercare-gold-formulary&subject=MedicationKnowledge/drug-atorvastatin-20mg
Response:
Body
Status:
200
{
"resourceType": "Bundle",
"type": "searchset",
"meta": {
"versionId": "0"
},
"total": 1,
"link": [
{
"relation": "first",
"url": "http://localhost:8080/fhir/Basic?formulary=InsurancePlan/silvercare-gold-formulary&subject=MedicationKnowledge/drug-atorvastatin-20mg&page=1"
},
{
"relation": "self",
"url": "http://localhost:8080/fhir/Basic?formulary=InsurancePlan/silvercare-gold-formulary&subject=MedicationKnowledge/drug-atorvastatin-20mg&page=1"
}
],
"entry": [
{
"resource": {
"code": {
"coding": [
{
"code": "formulary-item",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS",
"display": "Formulary Item"
}
]
},
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyItem"
],
"lastUpdated": "2026-03-20T12:08:56.567820Z",
"versionId": "31",
"extension": [
{
"url": "https://aidbox.app/ex/createdAt",
"valueInstant": "2026-03-20T12:08:56.567820Z"
}
]
},
"subject": {
"display": "atorvastatin 20 MG Oral Tablet",
"reference": "MedicationKnowledge/drug-atorvastatin-20mg"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyReference-extension",
"valueReference": {
"display": "SilverCare Gold 2026 Formulary",
"reference": "InsurancePlan/silvercare-gold-formulary"
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-AvailabilityStatus-extension",
"valueCode": "active"
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierID-extension",
"valueCodeableConcept": {
"coding": [
{
"code": "generic",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS",
"display": "Generic"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PharmacyBenefitType-extension",
"valueCodeableConcept": {
"coding": [
{
"code": "1-month-in-retail",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS",
"display": "1 month supply via in-person at a retail pharmacy"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PharmacyBenefitType-extension",
"valueCodeableConcept": {
"coding": [
{
"code": "3-month-in-mail",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS",
"display": "3 month supply via mail order"
}
]
}
},
{
"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
}
],
"id": "formulary-item-atorvastatin",
"resourceType": "Basic"
},
"search": {
"mode": "match"
},
"fullUrl": "http://localhost:8080/Basic/formulary-item-atorvastatin",
"link": [
{
"relation": "self",
"url": "http://localhost:8080/Basic/formulary-item-atorvastatin"
}
]
}
]
}Step 4b — Compare: generic atorvastatin
Generic tier, $5 copay. No PA, no step therapy, no quantity limit.
REST
Send
Cells run only inside Aidbox. Use Run in Aidbox above to open this notebook in your own instance.
GET /fhir/Basic?formulary=InsurancePlan/silvercare-gold-formulary&_include=Basic:subject
Response:
Body
Status:
200
{
"resourceType": "Bundle",
"type": "searchset",
"meta": {
"versionId": "0"
},
"total": 3,
"link": [
{
"relation": "first",
"url": "http://localhost:8080/fhir/Basic?formulary=InsurancePlan/silvercare-gold-formulary&_include=Basic:subject&page=1"
},
{
"relation": "self",
"url": "http://localhost:8080/fhir/Basic?formulary=InsurancePlan/silvercare-gold-formulary&_include=Basic:subject&page=1"
}
],
"entry": [
{
"resource": {
"code": {
"coding": [
{
"code": "formulary-item",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS",
"display": "Formulary Item"
}
]
},
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyItem"
],
"lastUpdated": "2026-03-20T12:08:56.567820Z",
"versionId": "29",
"extension": [
{
"url": "https://aidbox.app/ex/createdAt",
"valueInstant": "2026-03-20T12:08:56.567820Z"
}
]
},
"subject": {
"display": "metformin hydrochloride 500 MG Oral Tablet",
"reference": "MedicationKnowledge/drug-metformin-500mg"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyReference-extension",
"valueReference": {
"display": "SilverCare Gold 2026 Formulary",
"reference": "InsurancePlan/silvercare-gold-formulary"
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-AvailabilityStatus-extension",
"valueCode": "active"
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierID-extension",
"valueCodeableConcept": {
"coding": [
{
"code": "generic",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS",
"display": "Generic"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PharmacyBenefitType-extension",
"valueCodeableConcept": {
"coding": [
{
"code": "1-month-in-retail",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS",
"display": "1 month supply via in-person at a retail pharmacy"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PharmacyBenefitType-extension",
"valueCodeableConcept": {
"coding": [
{
"code": "3-month-in-mail",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS",
"display": "3 month supply via mail order"
}
]
}
},
{
"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
}
],
"id": "formulary-item-metformin",
"resourceType": "Basic"
},
"search": {
"mode": "match"
},
"fullUrl": "http://localhost:8080/Basic/formulary-item-metformin",
"link": [
{
"relation": "self",
"url": "http://localhost:8080/Basic/formulary-item-metformin"
}
]
},
{
"resource": {
"code": {
"coding": [
{
"code": "formulary-item",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS",
"display": "Formulary Item"
}
]
},
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyItem"
],
"lastUpdated": "2026-03-20T12:08:56.567820Z",
"versionId": "31",
"extension": [
{
"url": "https://aidbox.app/ex/createdAt",
"valueInstant": "2026-03-20T12:08:56.567820Z"
}
]
},
"subject": {
"display": "atorvastatin 20 MG Oral Tablet",
"reference": "MedicationKnowledge/drug-atorvastatin-20mg"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyReference-extension",
"valueReference": {
"display": "SilverCare Gold 2026 Formulary",
"reference": "InsurancePlan/silvercare-gold-formulary"
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-AvailabilityStatus-extension",
"valueCode": "active"
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierID-extension",
"valueCodeableConcept": {
"coding": [
{
"code": "generic",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS",
"display": "Generic"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PharmacyBenefitType-extension",
"valueCodeableConcept": {
"coding": [
{
"code": "1-month-in-retail",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS",
"display": "1 month supply via in-person at a retail pharmacy"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PharmacyBenefitType-extension",
"valueCodeableConcept": {
"coding": [
{
"code": "3-month-in-mail",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS",
"display": "3 month supply via mail order"
}
]
}
},
{
"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
}
],
"id": "formulary-item-atorvastatin",
"resourceType": "Basic"
},
"search": {
"mode": "match"
},
"fullUrl": "http://localhost:8080/Basic/formulary-item-atorvastatin",
"link": [
{
"relation": "self",
"url": "http://localhost:8080/Basic/formulary-item-atorvastatin"
}
]
},
{
"resource": {
"code": {
"coding": [
{
"code": "formulary-item",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-InsuranceItemTypeCS",
"display": "Formulary Item"
}
]
},
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyItem"
],
"lastUpdated": "2026-03-20T12:08:56.567820Z",
"versionId": "33",
"extension": [
{
"url": "https://aidbox.app/ex/createdAt",
"valueInstant": "2026-03-20T12:08:56.567820Z"
}
]
},
"subject": {
"display": "atorvastatin 20 MG Oral Tablet [Lipitor]",
"reference": "MedicationKnowledge/drug-lipitor-20mg"
},
"extension": [
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyReference-extension",
"valueReference": {
"display": "SilverCare Gold 2026 Formulary",
"reference": "InsurancePlan/silvercare-gold-formulary"
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-AvailabilityStatus-extension",
"valueCode": "active"
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierID-extension",
"valueCodeableConcept": {
"coding": [
{
"code": "preferred-brand",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-DrugTierCS",
"display": "Preferred Brand"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PharmacyBenefitType-extension",
"valueCodeableConcept": {
"coding": [
{
"code": "1-month-in-retail",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS",
"display": "1 month supply via in-person at a retail pharmacy"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PharmacyBenefitType-extension",
"valueCodeableConcept": {
"coding": [
{
"code": "3-month-in-mail",
"system": "http://hl7.org/fhir/us/davinci-drug-formulary/CodeSystem/usdf-PharmacyBenefitTypeCS",
"display": "3 month supply via mail order"
}
]
}
},
{
"url": "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-PriorAuthorization-extension",
"valueBoolean": true
},
{
"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
}
],
"id": "formulary-item-lipitor",
"resourceType": "Basic"
},
"search": {
"mode": "match"
},
"fullUrl": "http://localhost:8080/Basic/formulary-item-lipitor",
"link": [
{
"relation": "self",
"url": "http://localhost:8080/Basic/formulary-item-lipitor"
}
]
},
{
"resource": {
"code": {
"coding": [
{
"code": "861004",
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"display": "metformin hydrochloride 500 MG Oral Tablet"
}
]
},
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyDrug"
],
"lastUpdated": "2026-03-20T12:08:56.567820Z",
"versionId": "19",
"extension": [
{
"url": "https://aidbox.app/ex/createdAt",
"valueInstant": "2026-03-20T12:08:56.567820Z"
}
]
},
"status": "active",
"doseForm": {
"coding": [
{
"code": "385055001",
"system": "http://snomed.info/sct",
"display": "Tablet"
}
]
},
"id": "drug-metformin-500mg",
"resourceType": "MedicationKnowledge"
},
"search": {
"mode": "include"
},
"fullUrl": "http://localhost:8080/MedicationKnowledge/drug-metformin-500mg",
"link": [
{
"relation": "self",
"url": "http://localhost:8080/MedicationKnowledge/drug-metformin-500mg"
}
]
},
{
"resource": {
"code": {
"coding": [
{
"code": "617311",
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"display": "atorvastatin 20 MG Oral Tablet [Lipitor]"
}
]
},
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyDrug"
],
"lastUpdated": "2026-03-20T12:08:56.567820Z",
"versionId": "21",
"extension": [
{
"url": "https://aidbox.app/ex/createdAt",
"valueInstant": "2026-03-20T12:08:56.567820Z"
}
]
},
"status": "active",
"doseForm": {
"coding": [
{
"code": "385055001",
"system": "http://snomed.info/sct",
"display": "Tablet"
}
]
},
"id": "drug-lipitor-20mg",
"resourceType": "MedicationKnowledge"
},
"search": {
"mode": "include"
},
"fullUrl": "http://localhost:8080/MedicationKnowledge/drug-lipitor-20mg",
"link": [
{
"relation": "self",
"url": "http://localhost:8080/MedicationKnowledge/drug-lipitor-20mg"
}
]
},
{
"resource": {
"code": {
"coding": [
{
"code": "259255",
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"display": "atorvastatin 20 MG Oral Tablet"
}
]
},
"meta": {
"profile": [
"http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyDrug"
],
"lastUpdated": "2026-03-20T12:08:56.567820Z",
"versionId": "23",
"extension": [
{
"url": "https://aidbox.app/ex/createdAt",
"valueInstant": "2026-03-20T12:08:56.567820Z"
}
]
},
"status": "active",
"doseForm": {
"coding": [
{
"code": "385055001",
"system": "http://snomed.info/sct",
"display": "Tablet"
}
]
},
"id": "drug-atorvastatin-20mg",
"resourceType": "MedicationKnowledge"
},
"search": {
"mode": "include"
},
"fullUrl": "http://localhost:8080/MedicationKnowledge/drug-atorvastatin-20mg",
"link": [
{
"relation": "self",
"url": "http://localhost:8080/MedicationKnowledge/drug-atorvastatin-20mg"
}
]
}
]
}Step 6 — Member medication history
Active prescriptions with prescriber — bridges to member 360 story.
REST
Send
Cells run only inside Aidbox. Use Run in Aidbox above to open this notebook in your own instance.
GET /fhir/MedicationRequest?subject=85&status=active&_include=MedicationRequest:requester
Response:
Body
Status:
200
{
"resourceType": "Bundle",
"type": "searchset",
"meta": {
"versionId": "0"
},
"total": 0,
"link": [
{
"relation": "first",
"url": "http://localhost:8080/fhir/MedicationRequest?subject=85&status=active&_include=MedicationRequest:requester&page=1"
},
{
"relation": "self",
"url": "http://localhost:8080/fhir/MedicationRequest?subject=85&status=active&_include=MedicationRequest:requester&page=1"
}
]
}