Cigna Drug Formulary API

naftiko: 1.0.0-alpha2
info:
  label: Cigna Drug Formulary API
  description: Public FHIR-based Drug Formulary API exposing Cigna's covered drug lists, formulary tiers, prior authorization,
    step therapy, and quantity limits. Implements the HL7 Da Vinci PDex US Drug Formulary IG required by the CMS Interoperability
    and Patient Access rule.
  tags:
  - Cigna
  - API
  created: '2026-05-06'
  modified: '2026-05-06'
capability:
  consumes:
  - type: http
    namespace: cigna
    baseUri: https://fhir.cigna.com/DrugFormulary/v1
    description: Cigna Drug Formulary API HTTP API.
    resources:
    - name: metadata
      path: /metadata
      operations:
      - name: getcapabilitystatement
        method: GET
        description: Retrieve the FHIR capability statement
        outputRawFormat: json
        outputParameters:
        - name: result
          type: object
          value: $.
    - name: insuranceplan
      path: /InsurancePlan
      operations:
      - name: searchformularyplan
        method: GET
        description: List drug formulary plans offered by Cigna
        inputParameters:
        - name: status
          in: query
          type: string
        outputRawFormat: json
        outputParameters:
        - name: result
          type: object
          value: $.
    - name: medicationknowledge
      path: /MedicationKnowledge
      operations:
      - name: searchmedicationknowledge
        method: GET
        description: Search covered drugs and formulary tier, step therapy, and prior auth
        inputParameters:
        - name: code
          in: query
          type: string
          description: RxNorm or NDC code
        - name: DrugPlan
          in: query
          type: string
          description: InsurancePlan id of the formulary
        outputRawFormat: json
        outputParameters:
        - name: result
          type: object
          value: $.
  exposes:
  - type: rest
    port: 8080
    namespace: cigna-rest
    description: REST adapter for Cigna Drug Formulary API.
    resources:
    - path: /metadata
      name: getcapabilitystatement
      operations:
      - method: GET
        name: getcapabilitystatement
        description: Retrieve the FHIR capability statement
        call: cigna.getcapabilitystatement
        outputParameters:
        - type: object
          mapping: $.
    - path: /InsurancePlan
      name: searchformularyplan
      operations:
      - method: GET
        name: searchformularyplan
        description: List drug formulary plans offered by Cigna
        call: cigna.searchformularyplan
        outputParameters:
        - type: object
          mapping: $.
    - path: /MedicationKnowledge
      name: searchmedicationknowledge
      operations:
      - method: GET
        name: searchmedicationknowledge
        description: Search covered drugs and formulary tier, step therapy, and prior auth
        call: cigna.searchmedicationknowledge
        outputParameters:
        - type: object
          mapping: $.
  - type: mcp
    port: 9090
    namespace: cigna-mcp
    transport: http
    description: MCP adapter for Cigna Drug Formulary API for AI agent use.
    tools:
    - name: getcapabilitystatement
      description: Retrieve the FHIR capability statement
      hints:
        readOnly: true
        destructive: false
        idempotent: true
      call: cigna.getcapabilitystatement
      outputParameters:
      - type: object
        mapping: $.
    - name: searchformularyplan
      description: List drug formulary plans offered by Cigna
      hints:
        readOnly: true
        destructive: false
        idempotent: true
      call: cigna.searchformularyplan
      with:
        status: tools.status
      inputParameters:
      - name: status
        type: string
        description: status
      outputParameters:
      - type: object
        mapping: $.
    - name: searchmedicationknowledge
      description: Search covered drugs and formulary tier, step therapy, and prior auth
      hints:
        readOnly: true
        destructive: false
        idempotent: true
      call: cigna.searchmedicationknowledge
      with:
        code: tools.code
        DrugPlan: tools.DrugPlan
      inputParameters:
      - name: code
        type: string
        description: RxNorm or NDC code
      - name: DrugPlan
        type: string
        description: InsurancePlan id of the formulary
      outputParameters:
      - type: object
        mapping: $.