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Aetna

Aetna Drug Formulary FHIR API

Da Vinci PDex US Drug Formulary 2.0.0 STU 2 formulary data, delivered as part of the Patient Access API product rather than as a separate base URL. MedicationKnowledge carries covered drugs, tiers, cost sharing and restrictions such as prior authorization and step therapy; formulary InsurancePlan, Basic and Location resources were added on 2024-04-19 when the older List API was decommissioned.

Documentation Provider Profile APIs.io OpenAPI GitHub

This API exposes 40 operations across 40 paths, and defines 298 schemas. It is described by OpenAPI 3.0.3, at version 1.0.0.

Requests are made against a single base URL, https://apif1.aetna.com/fhir.

40 operations 40 paths 298 schemas 40 GET

Metadata

The identity and technical contract details declared by the specification.

Specification
OpenAPI 3.0.3
API Version
1.0.0
Base URL
https://apif1.aetna.com/fhir
Authentication
OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0, OAuth 2.0
Contact
Aetna Interoperability Developer Support
Resource Areas
1

Authentication & Security 23

Aetna Drug Formulary FHIR API declares 23 security schemes for authenticating requests. It supports OAuth 2.0 (FHIR_Patient_Allergy_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_Binary_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_CarePlan_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_CareTeam_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_Condition_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_Coverage_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_Device_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_DiagnosticReport_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_DocumentReference_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_Encounter_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_Endpoint_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_EOB_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_Goal_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_Immunization_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_MedicationKnowledge_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_MedicationRequest_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_Medication_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_Observation_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_Organization_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_Patient_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_PractitionerRole_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_Practitioner_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes. It supports OAuth 2.0 (FHIR_Patient_Procedure_Read_AccessCode_Oauth) using the authorizationCode flow, exposing 4 scopes.

  • FHIR_Patient_CareTeam_Read_AccessCode_Oauth — { "BuildEieHeader" : "Header 3.2", "SecurityTemplate" : "FHIRCareTeamRead", "Backend" : "IIB", "Errorhandlingpolicy": "Transparent" "Consumer":"External", "Mut…
  • FHIR_Patient_Condition_Read_AccessCode_Oauth — { "BuildEieHeader" : "Header 3.2", "SecurityTemplate" : "FHIRPatientConditionRead", "Backend" : "IIB", "Errorhandlingpolicy": "Transparent" "Consumer":"Externa…
  • FHIR_Patient_Device_Read_AccessCode_Oauth — { "BuildEieHeader" : "Header 3.2", "SecurityTemplate" : "FHIRDeviceRead", "Backend" : "IIB", "Errorhandlingpolicy": "Transparent" "Consumer":"External", "Mutua…
  • FHIR_Patient_DiagnosticReport_Read_AccessCode_Oauth — { "BuildEieHeader" : "Header 3.2", "SecurityTemplate" : "FHIRPatientDiagnosticReportRead", "Backend" : "IIB", "Errorhandlingpolicy": "Transparent" "Consumer":"…
  • FHIR_Patient_DocumentReference_Read_AccessCode_Oauth — { "BuildEieHeader" : "Header 3.2", "SecurityTemplate" : "FHIRPatientDocumentReferenceRead", "Backend" : "IIB", "Errorhandlingpolicy": "Transparent" "Consumer":…
  • FHIR_Patient_Encounter_Read_AccessCode_Oauth — { "BuildEieHeader" : "Header 3.2", "SecurityTemplate" : "FHIRPatientEncounterRead", "Backend" : "IIB", "Errorhandlingpolicy": "Transparent" "Consumer":"Externa…
  • FHIR_Patient_Endpoint_Read_AccessCode_Oauth — { "BuildEieHeader" : "Header 3.2", "SecurityTemplate" : "FHIRPatientEndpointRead", "Backend" : Non-IIB, FHIRServer APIGEE APIs, requires Mutual TLS", "Errorhan…
  • FHIR_Patient_EOB_Read_AccessCode_Oauth — { "BuildEieHeader" : "Header 3.2", "SecurityTemplate" : "FHIRPatientEOBRead", "Backend" : "IIB", "Errorhandlingpolicy": "Transparent", "Consumer":"External", "…
  • FHIR_Patient_Goal_Read_AccessCode_Oauth — { "BuildEieHeader" : "Header 3.2", "SecurityTemplate" : "FHIRPatientGoalRead", "Backend" : "IIB", "Errorhandlingpolicy": "Transparent" "Consumer":"External", "…
  • FHIR_Patient_MedicationRequest_Read_AccessCode_Oauth — { "BuildEieHeader" : "Header 3.2", "SecurityTemplate" : "FHIRPatientMedicationRequestRead", "Backend" : "IIB", "Errorhandlingpolicy": "Transparent" "Consumer":…
  • FHIR_Patient_Procedure_Read_AccessCode_Oauth — { "BuildEieHeader" : "Header 3.2", "SecurityTemplate" : "FHIRPatientProcedureRead", "Backend" : "IIB", "Errorhandlingpolicy": "Transparent" "Consumer":"Externa…

Paths & Operations 40

Across 40 paths, the API surfaces 40 operations — 40 GET. Each is listed below with its method, path, parameters, and response codes.

Operations 40
GET
/v2/patientaccess/AllergyIntolerance
Retrieves all Allergy Intolerances associated to an Authenticated User based on the search criteria (patient fhir logical id)
get_v2_patientaccess_AllergyIntolerance 4 params → 200400404500x-USCoreAllergyIntolerance
GET
/v2/patientaccess/AllergyIntolerance/{id}
Retrieves AllergyIntolerance details using the Id and formats the response in USCoreAllergyIntolerance profile.
get_v2_patientaccess_AllergyIntolerance_id 1 param → 200400404500x-USCoreAllergyIntolerance
GET
/v2/patientaccess/Binary/{id}
This operation returns a Binary Resource associated with the Logical Id
get_v2_patientaccess_Binary_id 1 param → 200400404500
GET
/v2/patientaccess/CarePlan
Retrieves all Care Plans associated to an Authenticated User based on the search criteria (patient fhir logical id, date, status and category)
get_v2_patientaccess_CarePlan 5 params → 200400404500x-USCoreCarePlan
GET
/v2/patientaccess/CarePlan/{id}
Retrieves CarePlan details using the Id and formats the response in USCoreCarePlan profile.
get_v2_patientaccess_CarePlan_id 1 param → 200400404500x-USCoreCarePlan
GET
/v2/patientaccess/CareTeam
This operation retrieves all CareTeam records associated to an Authenticated User based on the search criteria
get_v2_patientaccess_CareTeam 5 params → 200400500x-USCoreCareTeam
GET
/v2/patientaccess/CareTeam/{id}
This operation returns a CareTeam Resource associated with the Logical Id
get_v2_patientaccess_CareTeam_id 1 param → 200400404500
GET
/v2/patientaccess/Condition
Retrieves all Conditions associated with a patient and formats the response to the USCoreCondition profile.
get_v2_patientaccess_Condition 4 params → 200400404500x-USCoreCondition
GET
/v2/patientaccess/Condition/{id}
Retrieves conditon details using the Id and formats the response to the USCoreCondition profile.
get_v2_patientaccess_Condition_id 1 param → 200400404500
GET
/v2/patientaccess/Coverage
Retrieves a patient's coverage details using the Id and formats the response to the CARIN profile.
get_v2_patientaccess_Coverage 4 params → 200400404500
GET
/v2/patientaccess/Coverage/{id}
Retrieves a patient's coverage details using the Id and formats the response to the CARIN profile.
get_v2_patientaccess_Coverage_id 1 param → 200400404500
GET
/v2/patientaccess/Device
This operation retrieves all Device records associated to an Authenticated User based on the search criteria
get_v2_patientaccess_Device 4 params → 200400404500x-USCoreImplantableDevice
GET
/v2/patientaccess/Device/{id}
This operation returns a Device Resource associated with the Logical Id
get_v2_patientaccess_Device_id 1 param → 200400404500
GET
/v2/patientaccess/DiagnosticReport
This operation retrieves all DiagnosticReports associated to an Authenticated User based on the search criteria (patient fhir logical id, date, code, category)
get_v2_patientaccess_DiagnosticReport 7 params → 200400404500x-USCoreDiagnosticReportLabx-USCoreDiagnosticReportNote
GET
/v2/patientaccess/DiagnosticReport/{id}
This operation returns a DiagnosticReport Resource associated with the Logical Id
get_v2_patientaccess_DiagnosticReport_id 1 param → 200400404500x-USCoreDiagnosticReportLabx-USCoreDiagnosticReportNote
GET
/v2/patientaccess/DocumentReference
This operation retrieves all DocumentReferences associated to an Authenticated User based on the search criteria (patient fhir logical id, date, category, type)
get_v2_patientaccess_DocumentReference 8 params → 200400500x-USCoreDocumentReference
GET
/v2/patientaccess/DocumentReference/{id}
This operation returns a DocumentReference Resource associated with the Logical Id
get_v2_patientaccess_DocumentReference_id 1 param → 200400404500
GET
/v2/patientaccess/Encounter
This operation retrieves all Encounters associated to an Authenticated User based on the search criteria (patient fhir logical id, date)
get_v2_patientaccess_Encounter 6 params → 200400404500x-USCoreEncounterx-Provenance
GET
/v2/patientaccess/Encounter/{id}
This operation returns a Encounter Resource associated with the Logical Id
get_v2_patientaccess_Encounter_id 1 param → 200400404500x-USCoreEncounter
GET
/v2/patientaccess/Endpoint/{id}
This operation returns a Endpoint Resource associated with the Logical Id.
get_v2_patientaccess_Endpoint_id 1 param → 200400404500
GET
/v2/patientaccess/ExplanationOfBenefit
Retrieves a patient's Explanation Of Benefit details using the Member Id and formats the response to the available CARIN profiles.
get_v2_patientaccess_ExplanationOfBenefit 6 params → 200400404500
GET
/v2/patientaccess/ExplanationOfBenefit/{id}
Retrieves a patient's Explanation Of Benefit details using the EOB Logical Identifier and formats the response to the available CARIN profiles.
get_v2_patientaccess_ExplanationOfBenefit_id 1 param → 200400404500
GET
/v2/patientaccess/Goal
This operation retrieves all Goal records associated to an Authenticated User based on the search criteria
get_v2_patientaccess_Goal 4 params → 200400500x-USCoreGoal
GET
/v2/patientaccess/Goal/{id}
This operation returns a Goal Resource associated with the Logical Id
get_v2_patientaccess_Goal_id 1 param → 200400404500
GET
/v2/patientaccess/Immunization
This operation retrieves all Immunizations associated to an Authenticated User based on the search criteria patient fhir logical id.
get_v2_patientaccess_Immunization 4 params → 200400404500x-USCoreImmunization
GET
/v2/patientaccess/Immunization/{id}
This operation returns a Immunization Resource associated with the Logical Id
get_v2_patientaccess_Immunization_id 1 param → 200400404500
GET
/v2/patientaccess/MedicationKnowledge
Retrieves all MedicationKnowledge resources associated with an authenticated patient and formats the response to the USDFFormularyDrug profile.
get_v2_patientaccess_MedicationKnowledge 11 params → 200400500
GET
/v2/patientaccess/MedicationKnowledge/{id}
Returns a MedicationKnowledge resource associated with the unique logical id.
get_v2_patientaccess_MedicationKnowledge_id 1 param → 200400404500
GET
/v2/patientaccess/MedicationRequest
This operation retrieves all MedicationRequests associated with an Authenticated User based on the search criteria (patient fhir logical id, status, intent)
get_v2_patientaccess_MedicationRequest 6 params → 200400404500x-USCoreMedicationRequest
GET
/v2/patientaccess/MedicationRequest/{id}
This operation returns a MedicationRequest Resource associated with the Logical Id
get_v2_patientaccess_MedicationRequest_id 1 param → 200400404500
GET
/v2/patientaccess/Medication/{id}
This operation returns a Medication Resource associated with the Logical Id
get_v2_patientaccess_Medication_id 1 param → 200400404500
GET
/v2/patientaccess/Observation
This operation will retrieve all Observation details associated with a patient and formats the response to the Observation profile.
get_v2_patientaccess_Observation 7 params → 200400404500x-Provenancex-Observation
GET
/v2/patientaccess/Observation/{id}
Retrieves observation details using the Id and formats the response in Observation profile.
get_v2_patientaccess_Observation_id 1 param → 200400404500
GET
/v2/patientaccess/Organization/{id}
Read the current state of the resource using the Logical (unique) ID [FHIR Base]/Organization/{id}
get_v2_patientaccess_Organization_id 1 param → 200400404500
GET
/v2/patientaccess/Patient
Retrieves a patient's details
get_v2_patientaccess_Patient 4 params → 200400404500x-CARINBBPatient
GET
/v2/patientaccess/Patient/{id}
Retrieves a patient's details using the Id and formats the response to the CARINBBPatient profile.
get_v2_patientaccess_Patient_id 1 param → 200400404500
GET
/v2/patientaccess/PractitionerRole/{id}
Read the current state of the resource using the Logical (unique) ID [FHIR Base]/PractitionerRole/{id}
get_v2_patientaccess_PractitionerRole_id 1 param → 200400404500x-USCorePractitionerRole
GET
/v2/patientaccess/Practitioner/{id}
Read the current state of the resource using the Logical (unique) ID [FHIR Base]/Practitioner/{id}
get_v2_patientaccess_Practitioner_id 1 param → 200400404500
GET
/v2/patientaccess/Procedure
This operation retrieves all Procedures associated to an Authenticated User based on the search criteria patient fhir logical id.
get_v2_patientaccess_Procedure 5 params → 200400404500x-USCoreProcedure
GET
/v2/patientaccess/Procedure/{id}
This operation returns a Procedure Resource associated with the Logical Id
get_v2_patientaccess_Procedure_id 1 param → 200400404500

Schemas 298

The contract defines 298 schemas that model the data the API accepts and returns. The most detailed are Observation (48 properties), Observation_Component (18 properties), Observation_ReferenceRange (9 properties), Resource (5 properties). Each schema is shown below with its type and property counts.

Meta
DomainResource
Address
USCoreCodeableConceptAssessPlan
This class is associated with the category property in the USCoreCarePlan Required.
Attachment
Count
AllergyIntolerance
Identifier
Coding
Narrative
OperationOutcome
SampledData
Distance
Resource
object
5 properties 1 required
Period
Duration
Bundle_Link
Range
RelatedArtifact
GeolocationLongitudeExt
GeolocationLatitudeExt
Bundle_Entry_Search
UsageContext
Bundle_Entry_Response
Timing
CodeableConcept
Element
object
2 properties
OperationOutcome_Issue
Timing_Repeat
Bundle_Entry_Request
ContactPoint
HumanName
Money
USCoreCodeableConceptLaboratorySlice
This class is associated with the category property in the USCoreDiagnosticReportLab Required.
Ratio
Age
Reference
Bundle
SimpleQuantity
Quantity
USCoreAllergyIntolerance
Annotation
Extension
ContactDetail
BackboneElement
Signature
USCoreIdentifier
Bundle_Entry
USCoreIdentifierCLIA
Clinical Laboratory Improvement Amendments (CLIA) Number for laboratories This class is associated with the identifier property in the USCoreOrganization Requi…
USCoreIdentifierNPI
National Provider Identifier (NPI) This class is associated with the identifier property in the USCorePractitioner and USCoreOrganization Required Pattern: At…
GeolocationExt
AllergyIntolerance_Reaction
Binary
CarePlan
USCoreCarePlan
Summary of the Mandatory Requirements 1. A Narrative in CarePlan.text - which must have a code value in CarePlan.text.status with a required binding to US Core…
CarePlan_Activity
CarePlan_Activity_Detail
CareTeam_Participant
CareTeam
USCoreCareTeam
Summary of the Mandatory Requirements 1. A Patient Reference in CareTeam.subject 2. One or more Participants in CareTeam.participant with the following constra…
Condition_Evidence
USCoreCondition
Summary of the Mandatory Requirements 1. One or more CodeableConcepts in Condition.category with an extensible binding to US Core Condition Category Codes 2. A…
Condition
Condition_Stage
CARINBBPatientIdentifierMedicalRecordNumber
http://hl7.org/fhir/us/core/STU3.1/general-guidance.htmlmustSupport type.coding.code="MR"
USDFDrugTierIDExt
A code that describes the coverage status of a drug in a health plan (e.g., preferred generic, specialty, etc.) 1..1https://hl7.org/fhir/conformance-rules.html…
USDFDTDCSPharmacyTypeExt
CARINBBPatientIdentifierPatAcctNum
http://hl7.org/fhir/us/core/STU3.1/general-guidance.htmlmustSupport type.coding.code="PT"
PlannetPractitionerQualificationExt
http://hl7.org/fhir/us/core/STU3.1/general-guidance.htmlmustSupport status whereValid
PlannetCommunicationProficiencyExt
USDFDTDCSCoinsuranceOptionExt
USDFSummaryURLExt
The URL that goes directly to the formulary brochure for the specific standard plan or plan variation. 1..1https://hl7.org/fhir/conformance-rules.htmlmustSuppo…
USDFMarketingURLExt
The URL that goes directly to the plan brochure for the specific standard plan or plan variation. 0..1https://hl7.org/fhir/conformance-rules.htmlmustSupport
USDFDTDCSCopayOptionExt
PlannetBaseExt
PlannetQualificationExt
USDFDTDCSCoinsuranceRateExt
PlannetMeta
https://hl7.org/fhir/conformance-rules.htmlmustSupport http://hl7.org/fhir/R4/datatypes.htmlContactPoint contactS 0..ContactPoint Contact details for source (e…
PlannetAddress
https://hl7.org/fhir/conformance-rules.htmlmustSupport http://hl7.org/fhir/R4/datatypes.htmlAddress adressS 0..Address |-- geoLocationS 0..1 (Complex) http://h…
USDFEmailPlanContactExt
An email address for developers/public to report mistakes in the network and formulary data. 0..1https://hl7.org/fhir/conformance-rules.htmlmustSupport
PlannetContactPoint
https://hl7.org/fhir/conformance-rules.htmlmustSupport http://hl7.org/fhir/R4/datatypes.htmlContactPoint contactS 0..ContactPoint Contact details for source (e…
CARINBBOrganizationIdentifierNPI
system="http://hl7.org/fhir/sid/us-npi" type.coding.code="NPI"
PlannetEndpointUsecaseStandardExt
https://hl7.org/fhir/conformance-rules.htmlmustSupport
PlannetHealthcareServiceExt
CARINBBRelatedPersonIdentifierSubscriberId
type.coding.code="SN"
USDFPlanIDTypeExt
Type of Plan ID. For all Marketplace plans this should be: HIOS-PLAN-ID. 1..1https://hl7.org/fhir/conformance-rules.htmlmustSupport
PlannetEndpointUsecaseExt
USDFFormularyDrugExt
usdf-DrugAlternatives-extension0.. http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugAlternatives-extension usdf-PriorAuthorization-ex…
PlannetLocationtIncludedExt
USDFDTDCostSharingExt
CARINBBIdentifierMemberId
http://hl7.org/fhir/us/core/STU3.1/general-guidance.htmlmustSupport type.coding.code="MB"
PlannetAccessibilityExt
https://hl7.org/fhir/conformance-rules.htmlmustSupport
PlannetContactPointAvailableTimeIncludedExt
PlannetContactPointAvailableStartTimeExt
https://hl7.org/fhir/conformance-rules.htmlmustSupport
PlannetEndpointUsecaseTypeExt
https://hl7.org/fhir/conformance-rules.htmlmustSupport
PlannetOrgDescriptionExt
PlannetContactPointAvailableTimeExt
PlannetQualificationIssuerExt
http://hl7.org/fhir/us/core/STU3.1/general-guidance.htmlmustSupport
PlannetLocationBoundaryGeoJSONExt
https://hl7.org/fhir/conformance-rules.htmlmustSupport
PlannetDeliveryMethodTypeExt
1..1 extension
PlannetNewPatientFromNetworkExt
https://hl7.org/fhir/conformance-rules.htmlmustSupport
PlannetLocationReferenceExt
Required extension
PlannetNewPatientAcceptingPatientsExt
https://hl7.org/fhir/conformance-rules.htmlmustSupport
PlannetEndpointUsecaseIncludedExt
PlannetNewPatientIncludedExt
USDFPriorAuthorizationExt
A Boolean indication of whether the coverage plan imposes a prior authorization requirement on this drug. 0..1https://hl7.org/fhir/conformance-rules.htmlmustSu…
USDFStepTherapyUnitExt
A Boolean indication of whether the coverage plan imposes a step therapy limit on this drug. 0..1https://hl7.org/fhir/conformance-rules.htmlmustSupport
USDFDrugTierDefinitionExt
A description of the drug tiers used by the formulary and how those tiers implement copay and coinsurance amounts. Drug tiers do not have any inherent meaning…
PlannetNewPatientsExt
PlannetNewPatientCharacteristicsExt
https://hl7.org/fhir/conformance-rules.htmlmustSupport
PlannetQualificationPeriodExt
CARINBBOrganizationIdentifier
USDFDrugAlternativesExt
DrugAlternatives are Generic or Branded Drugs included within the CoveragePlan’s formulary that could be prescribed as alternatives to the current FormularyDru…
USDFCoveragePlanExt
usdf-DrugTierDefinition-extension 1.. http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-DrugTierDefinition-extension https://hl7.org/fhir/…
CARINBBRelatedPersonIdentifier
CARINBBPatientIdentifier
USDFFormularyURLExt
The URL that goes directly to the formulary brochure for the specific standard plan or plan variation. 0..1https://hl7.org/fhir/conformance-rules.htmlmustSuppo…
USDFDTDMailOrderExt
USDFDTDCSCopayAmountExt
PlannetQualificationIncludedExt
PlannetPractitionerRoleExt
PlannetNetworkReferenceExt
Required extension
PlannetQualificationCodeExt
http://hl7.org/fhir/us/core/STU3.1/general-guidance.htmlmustSupport
PlannetQualificationStatusExt
USDFDTDDrugTierIDExt
PlannetContactPointViaIntermediaryExt
PlannetOrganizationExt
PlannetPractitionerCommuncationCodeableConcept
https://hl7.org/fhir/conformance-rules.htmlmustSupport communication-proficiency 0..1
PlannetQualificationWhereValidExt
http://hl7.org/fhir/us/core/STU3.1/general-guidance.htmlmustSupport The value attributes are sliced, so only one is allowed. You must include at least one.
PlannetDeliveryMethodIncludedExt
USDFPlanIDExt
Unique, 14-character, HIOS-generated Plan ID number. (Plan IDs must be unique, even across different markets.) 1..1https://hl7.org/fhir/conformance-rules.htmlm…
PlannetContactPointDaysOfWeekExt
https://hl7.org/fhir/conformance-rules.htmlmustSupport
PlannetDeliveryMethodVirtualModalitiesExt
https://hl7.org/fhir/conformance-rules.htmlmustSupport
PlannetContactPointExt
PlannetQualificationIdentifierExt
http://hl7.org/fhir/us/core/STU3.1/general-guidance.htmlmustSupport
PlannetContactPointAllDayExt
https://hl7.org/fhir/conformance-rules.htmlmustSupport
CARINBBOrganizationIdentifierTIN
system="urn:oid:2.16.840.1.113883.4.4" type.coding.code="TAX"
C4BBMeta
PlannetDeliveryMethodExt
USDFQuantityLimitExt
A Boolean indication of whether the coverage plan imposes a quantity limit on this drug. 0..1https://hl7.org/fhir/conformance-rules.htmlmustSupport
PlannetContactPointAvailableEndTimeExt
https://hl7.org/fhir/conformance-rules.htmlmustSupport
USDFNetworkExt
Array of Networks within a plan. 1..https://hl7.org/fhir/conformance-rules.htmlmustSupport
Device_Version
Device_Property
Device
USCoreImplantableDevice
Device Summary of the Mandatory Requirements 1. A CodeableConcept in Device.type with an extensible binding to FHIR Device Types 2. A Patient Reference in Devi…
Device_UdiCarrier
Device_DeviceName
Device_Specialization
USCoreDiagnosticReportLab
Summary of the Mandatory Requirements 1. A code in DiagnosticReport.status with a required binding to DiagnosticReportStatus 2. One or more CodeableConcepts Co…
DiagnosticReport
USCoreDiagnosticReportNote
http://hl7.org/fhir/us/core/StructureDefinition/us-core-diagnosticreport-note Summary of the Mandatory Requirements 1. A code in DiagnosticReport.status with a…
DiagnosticReport_Media
DocumentReference
DocumentReference_RelatesTo
DocumentReference_Context
USCoreDocumentReference
http://hl7.org/fhir/us/core/StructureDefinition/us-core-documentreference Summary of the Mandatory Requirements 1. A code in DocumentReference.status with a re…
DocumentReference_Content
Provenance
Encounter_Location
Provenance_Entity
USCoreProvenance_AgentAuthor
Encounter_ClassHistory
USCoreProvenance_AgentTransmitter
Encounter
USCoreProvenance
http://hl7.org/fhir/us/core/StructureDefinition/us-core-provenance Summary of the Mandatory Requirements 1. One or more Target References in Provenance.target…
Provenance_Agent
Encounter_Diagnosis
Encounter_Hospitalization
Encounter_Participant
USCoreEncounter
Encounter Summary of the Mandatory Requirements A code in Encounter.status with a required binding to EncounterStatus A Coding in Encounter.class with an exten…
Encounter_StatusHistory
Endpoint
ExplanationOfBenefit_AddItem_Detail
ExplanationOfBenefit_CareTeam
ExplanationOfBenefit_Payee
CARINBBExplanationOfBenefit_SupportingInfoAttendingNetworkContractingStatus
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="attendingnetworkcontractingstatus"
CARINBBExplanationOfBenefit_SupportingInfoTypeOfService
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="typeofservice"
CARINBBExplanationOfBenefit_SupportingInfoReferringNetworkContracting
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="attendingnetworkcontractingstatus"
CARINBBExplanationOfBenefit_SupportingInfoFacilityTypeCode
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="tob-typeoffacility"
CARINBBExplanationOfBenefit_Item_Adjudication
C4BBExplanationOfBenefit
CARIN v1.0.0 Extension to base FHIR http://hl7.org/fhir/us/carin-bb/StructureDefinition-C4BB-ExplanationOfBenefit.html
CARINBBExplanationOfBenefit_SupportingInfoSiteNetworkContractingStatus
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="sitenetworkcontractingstatus code bind…
CARINBBExplanationOfBenefit_SupportingInfoRxOriginCode
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="rxorigincode"
ExplanationOfBenefit_AddItem_Detail_SubDetail
ExplanationOfBenefit_SupportingInfo
CARINBBExplanationOfBenefit_InsuranceSecondaryInsurance
focal="true"
ExplanationOfBenefit_Related
CARINBBExplanationOfBenefit_InsurancePrimaryInsurance
focal="false"
CARINBBExplanationOfBenefit_SupportingInfoPatientDischargeStatusCode
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="discharge-status"
ExplanationOfBenefit_Item_Detail_SubDetail
ExplanationOfBenefit_BenefitBalance
ExplanationOfBenefit_Item
CARINBBExplanationOfBenefit_SupportingInfoMsDrg
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="ms-drg" code Binding: CARIN Blue Butto…
ExplanationOfBenefit_Procedure
CARINBBExplanationOfBenefit_SupportingInfo
CARINBBExplanationOfBenefit_SupportingInfoFrequencyCode
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="tob-frequency"
CARINBBExplanationOfBenefit_SupportingInfoPerformingNetworkContractingStatus
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="performingnetworkcontractingstatus" co…
ExplanationOfBenefit_Diagnosis
C4BBExplanationOfBenefitInpatientInstitutional
CARIN v1.0.0 Extension to base FHIR http://hl7.org/fhir/us/carin-bb/StructureDefinition-C4BB-ExplanationOfBenefit-Inpatient-Institutional.html
CARINBBExplanationOfBenefit_Item_AdjudicationDenialReason
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-adjudicationcategory" category.coding.code="denialreason" reasonbinding: CARIN Blue Bu…
ExplanationOfBenefit_Total
ExplanationOfBenefit_Insurance
CARINBBExplanationOfBenefit_SupportingInfoPlaceOfServiceCode
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="placeofservice"
CARINBBExplanationOfBenefit_SupportingInfoSourceInpatientAdmissionTypeCode
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="admtype"
ExplanationOfBenefit_ProcessNote
ExplanationOfBenefit_Item_Adjudication
CARINBBExplanationOfBenefit_SupportingInfoBrandGenericCode
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="brandgenericcode"
CARINBBExplanationOfBenefit_SupportingInfoTobBillClassification
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="tob-billclassification"
C4BBExplanationOfBenefitProfessionalNonClinician
CARIN v1.0.0 Extension to base FHIR http://hl7.org/fhir/us/carin-bb/StructureDefinition-C4BB-ExplanationOfBenefit-Professional-NonClinician.html
CARINBBExplanationOfBenefit_SupportingInfoReferringProviderNetworkStatus
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="referringnetworkcontractingstatus"
CARINBBExplanationOfBenefit_SupportingInfoSourceInpatientAdmissionCode
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="admsrc" code Binding: NUBC Point of Or…
ExplanationOfBenefit
ExplanationOfBenefit_BenefitBalance_Financial
ExplanationOfBenefit_AddItem
CARINBBExplanationOfBenefit_SupportingInfoDaysSupply
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="dayssupply"
C4BBExplanationOfBenefitPharmacy
CARIN v1.0.0 Extension to base FHIR http://hl7.org/fhir/us/carin-bb/StructureDefinition-C4BB-ExplanationOfBenefit-Pharmacy.html
CARINBBExplanationOfBenefit_SupportingInfoTobFrequency
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="tob-frequency"
CARINBBExplanationOfBenefit_Item
CARINBBExplanationOfBenefit_SupportingInfoTobTypeOfFacility
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="tob-typeoffacility"
ExplanationOfBenefit_Payment
ExplanationOfBenefit_Item_Detail
CARINBBExplanationOfBenefit_SupportingInfoAdmSrc
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="admsrc"
CARINBBExplanationOfBenefit_SupportingInfoDAWCode
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="dawcode"
CARINBBExplanationOfBenefit_SupportingInfoClaimReceivedDate
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="clmrecvddate "
CARINBBExplanationOfBenefit_SupportingInfoDischargeStatus
ategory.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="discharge-status" code Binding: CARIN B…
CARINBBExplanationOfBenefit_SupportingInfoReferringNetworkContractingStatus
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="referringnetworkcontractingstatus" cod…
ExplanationOfBenefit_Accident
CARINBBExplanationOfBenefit_SupportingInfoBillingProviderNetworkStatus
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="billingnetworkcontractingstatus"
C4BBExplanationOfBenefitOutpatientInstitutional
CARIN v1.0.0 Extension to base FHIR http://hl7.org/fhir/us/carin-bb/StructureDefinition-C4BB-ExplanationOfBenefit-Outpatient-Institutional.html
CARINBBExplanationOfBenefit_SupportingInfoAdmType
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="admtype" code binding: CARIN Blue Butt…
CARINBBExplanationOfBenefit_SupportingInfoRefillNum
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code=""refillnum
CARINBBExplanationOfBenefit_SupportingInfoBillingNetworkContractingStatus
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="billingnetworkcontractingstatus" code…
CARINBBExplanationOfBenefit_Insurance
CARINBBExplanationOfBenefit_SupportingInfoPlaceOfService
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="placeofservice" code Binding: CARIN Bl…
CARINBBExplanationOfBenefit_Item_AdjudicationAmountType
category Binding: CARIN Blue Button Adjudication Amount Category Value Set (required)
CARINBBExplanationOfBenefit_SupportingInfoServiceClassificationCode
category.coding.system="http://hl7.org/fhir/us/carin/CodeSystem/carin-bb-claiminformationcategory" category.coding.code="tob-billclassification"
CARINBBExplanationOfBenefitInpatientFacility
Summary - Mandatory: 3 elements (13 nested mandatory elements) - Fixed Value: 14 elements Slices - This structure defines the following Slices: - The element E…
CARINBBExplanationOfBenefit
Summary Mandatory: 2 elements (5 nested mandatory elements) Must-Support: 26 elements Fixed Value: 2 elements Structures This structure refers to these other s…
CARINBBExplanationOfBenefitPharmacy
CARINBBExplanationOfBenefitOutpatientFacility
Summary - Mandatory: 0 element (1 nested mandatory element) Slices - This structure defines the following Slices: - The element ExplanationOfBenefit.supporting…
CARINBBExplanationOfBenefitProfessionalNonClinician
Goal
USCoreGoal
Goal Summary of the Mandatory Requirements A code in Goal.lifecycleStatus with a required binding to GoalLifecycleStatus A CodeableConcept in Goal.description…
Goal_Target
Immunization
Immunization_Performer
DataAbsentReason
USCoreImmunization
Immunization Summary of the Mandatory Requirements 1. A code in Immunization.status with a required binding to Immunization Status Codes 2. A CodeableConcept i…
Immunization_Education
Immunization_ProtocolApplied
Immunization_Reaction
Entry
object
An entry in a bundle resource - will contain a resource(s) returned in the bundle
1 property
MedicationKnowledge
object
See the appropriate Implementation Guide for proper documentation to use This is the HL7 FHIR Release 4.0.1 MedicationKnowledge resource. Full Documentation is…
Dosage
MedicationRequest_Substitution
USCoreMedicationRequest
MedicationRequest Summary of the Mandatory Requirements 1. A code in MedicationRequest.status with a required binding to Medicationrequest status 2. A code in…
Dosage_DoseAndRate
MedicationRequest
MedicationRequest_DispenseRequest
MedicationRequest_DispenseRequest_InitialFill
Medication_Batch
Medication
Medication_Ingredient
USCoreMedication
Medication Summary of the Mandatory Requirements 1. A CodeableConcept in Medication.code with an extensible binding to US Core Medication Codes (RxNorm)
Observation_ReferenceRange
object
9 properties
Observation_Component
object
18 properties 1 required
Observation
object
48 properties 3 required
Organization
C4BBOrganization
http://hl7.org/fhir/us/carin-bb/StructureDefinition-C4BB-Organization.html
USCoreOrganization
Organization 3.1.1 Summary of the Mandatory Requirements 1. A boolean in Organization.active 2. A string in Organization.name Summary of the Must Support Requi…
Organization_Contact
Patient_Contact
USCorePatientRaceOMBCategoryExt
USCorePatientExt
object
Patient_Communication
Patient_Link
USCorePatientRaceTextExt
USCorePatient
Patient Summary of the Mandatory Requirements 1. One or more Identifiers in Patient.identifier - which must have an uri value in Patient.identifier.system - wh…
USCorePatientEthnicityOMBCategoryExt
USCorePatientRaceDetailedExt
USCorePatientEthnicityExt
USCorePatientEthnicityDetailedExt
USCorePatientBirthSexExt
Patient
USCorePatientEthnicityTextExt
USCorePatientRaceExt
C4BBPatient
CARIN v1.0.0 Extension to USCorePatient 3.1.1
PractitionerRole_AvailableTime
USCorePractitionerRole
http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitionerrole Summary of the Mandatory Requirements 1. A Practitioner Reference in PractitionerRole.…
PractitionerRole
PractitionerRole_NotAvailable
USCorePractitioner
Practitioner Summary of the Mandatory Requirements 1. One or more Identifiers in Practitioner.identifier - which must have an uri value in Practitioner.identif…
Practitioner
Procedure_FocalDevice
Procedure
Procedure_Performer
USCoreProcedure
http://hl7.org/fhir/us/core/StructureDefinition/us-core-procedure Summary of the Mandatory Requirements 1. A code in Procedure.status with a required binding t…

Specification

The full machine-readable OpenAPI contract behind this narrative.

Source

aetna-patient-access-api-openapi.yml Raw ↑
#FHIR#Drug Formulary#Da Vinci#Pharmacy#MedicationKnowledge#CMS Mandate
← Back to A APIs
API Details
ID
aetna:aetna-drug-formulary-fhir-api
Base URL
https://apif1.aetna.com/fhir
Docs
https://developerportal.aetna.com/
Provider
Aetna
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This is an independent, third-party profile of Aetna Drug Formulary FHIR API, published by API Evangelist. We do not operate, host, resell, or support these APIs, and we are not affiliated with or endorsed by the company unless stated above. Everything here is built from publicly available information — the company's own site, developer portal, documentation, public repositories, and the specifications it publishes for public use. Nothing is obtained by breaching a system, defeating an access control, or using credentials.

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