AmeriHealth Caritas

AmeriHealth Caritas Formulary FHIR API

HL7 FHIR R4 Formulary API published to satisfy CMS-9115-F drug formulary publication requirements for Medicaid managed care and D-SNP populations. Covered drug lists, tier information, and prior authorization indicators are exposed through FHIR MedicationKnowledge and List resources. Documented at developer.amerihealthcaritas.com as a public, no-authentication surface; the canonical public base URL is not separately published at api-ext.amerihealthcaritas.com and formulary resources are currently surfaced inside the Patient Access API under MedicationKnowledge / List.

AmeriHealth Caritas Formulary FHIR API is one of 4 APIs that AmeriHealth Caritas publishes on the APIs.io network.

This API exposes 1 machine-runnable capability that can be deployed as REST, MCP, or Agent Skill surfaces via Naftiko.

Tagged areas include Formulary, Drug Formulary, FHIR, Pharmacy Benefits, and CMS. The published artifact set on APIs.io includes API documentation and 1 Naftiko capability spec.

GitHub

Documentation

📖
Documentation
https://developer.amerihealthcaritas.com/dvp/v1/apiadditionaldocsinfo/

Other Resources

🔗
Portal
https://developer.amerihealthcaritas.com/
🔗
NaftikoCapability
https://raw.githubusercontent.com/api-evangelist/amerihealth-caritas/refs/heads/main/capabilities/amerihealth-caritas-medications-and-formulary.yaml

API entry from apis.yml

apis.yml Raw ↑ 
aid: amerihealth-caritas:formulary-api
name: AmeriHealth Caritas Formulary FHIR API
description: HL7 FHIR R4 Formulary API published to satisfy CMS-9115-F drug formulary publication requirements
  for Medicaid managed care and D-SNP populations. Covered drug lists, tier information, and prior authorization
  indicators are exposed through FHIR MedicationKnowledge and List resources. Documented at developer.amerihealthcaritas.com
  as a public, no-authentication surface; the canonical public base URL is not separately published at
  api-ext.amerihealthcaritas.com and formulary resources are currently surfaced inside the Patient Access
  API under MedicationKnowledge / List.
humanURL: https://developer.amerihealthcaritas.com/dvp/v1/apiadditionaldocsinfo/
baseURL: https://api-ext.amerihealthcaritas.com/0500/patient-api
tags:
- Formulary
- Drug Formulary
- FHIR
- Pharmacy Benefits
- CMS
properties:
- type: Portal
  url: https://developer.amerihealthcaritas.com/
- type: Documentation
  url: https://developer.amerihealthcaritas.com/dvp/v1/apiadditionaldocsinfo/
- type: NaftikoCapability
  url: capabilities/amerihealth-caritas-medications-and-formulary.yaml