Formulary Drugs

Datasets

Part of the Drug Formulary feed, built to Da Vinci PDex US Drug Formulary STU 2.1.0. The feed's data conventions apply.

Dataset	US Drug Formulary STU 2.1.0 target profile
`formulary_drugs`	Formulary Drug (MedicationKnowledge)

formulary_drugs

One row per prescribable product on any of your formularies, identified by RxNorm at the strength-and-form level.

Column	Required	Format / values	Example
`drug_id`	Yes	your stable key for the drug; `formulary_items` reference it. The RxCUI itself is a good key when you list each product once	`RX-1049640`
`rxnorm_code`	Yes	RxCUI with term type SCD, SBD, GPCK or BPCK: the ingredient, strength and dose form, branded or not SemanticDrugVS	`1049640`
`rxnorm_form_group_code`	Yes for SCD and SBD, blank for packs	RxCUI of the drug's form group, term type SCDG or SBDG: the ingredient and dose form without strength SemanticDrugFormGroupVS	`1185784`
`rxnorm_display`	No	the RxNorm name; Payerbox derives it, send only to pin a spelling
`ndc_codes`	If a specific product	NDCs this row is limited to, `;`-separated, when one RxNorm code has products with different coverage	`00069-0197-30`
`gpi_code`	If available	14-digit Medi-Span Generic Product Identifier your formulary system uses for the drug	`21360019000320`
`status`	Yes	`active`, `inactive`, `entered-in-error` medicationknowledge-status	`active`
`dose_form_code`	If available	SNOMED CT dose form	`385055001`
`dose_form_text`	If no `dose_form_code`	the dose form as your system spells it	`TABLET`
`last_updated`	Yes	datetime the drug record last changed in your system	`2026-10-01T09:00:00-05:00`
`is_deleted`	If retracting	`true` retracts this row	`true`

rxnorm_code is the searchable identity of the drug: the IG requires the strength-and-form code (SCD or SBD) or the pack code (GPCK or BPCK), so a member's app can find the exact product prescribed. An ingredient-level RxCUI is rejected.
rxnorm_form_group_code is mandatory whenever the IG's invariant applies: every SCD and SBD drug must also carry its SCDG or SBDG group, which lets a member search without knowing the strength. Packs have no group. Payerbox does not derive the group from the strength code, so send it.
The IG lets one RxNorm code appear as several drug rows when products under it are covered differently. Give each its own drug_id and list the NDCs it applies to in ndc_codes; each becomes an additional coding on the resource.
A drug taken off every formulary is inactive, not deleted, for the rest of the plan year.
dose_form_code and dose_form_text are one FHIR element. Send the SNOMED CT code where your drug file has one; send the text where it has only a label such as TABLET, and Payerbox publishes the text. Both may be sent together.

Codes

A formulary drug is one MedicationKnowledge whose code carries every identifier you send for the product, each as its own coding. Members' apps search by RxNorm; the others are there so a drug can be matched to claims, pharmacy files and your own systems.

Column	Code system published	Note
`rxnorm_code`	`http://www.nlm.nih.gov/research/umls/rxnorm`	mandatory; the strength-and-form or pack concept
`rxnorm_form_group_code`	`http://www.nlm.nih.gov/research/umls/rxnorm`	mandatory for SCD and SBD; the form-group concept
`ndc_codes`	`http://hl7.org/fhir/sid/ndc`	one coding per NDC. Send the NDC in any of its usual forms; Payerbox publishes it under the FHIR NDC system whatever URI your source uses for it
`gpi_code`	the GPI code system URI agreed at scoping	GPI has no HL7-registered system URI, so the one Payerbox publishes is fixed per engagement and stays stable across snapshots
`dose_form_code`	`http://snomed.info/sct`	`doseForm.coding`; `dose_form_text` becomes `doseForm.text`

These resources are served by Patient Access.