This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v1.1.0-ballot: STU 1.1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

• Narrative Content
• JSON

: MedicationRequest annotated example - JSON Representation

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{
  "resourceType" : "MedicationRequest",
  "id" : "annotated-example",
  "text" : {
    "status" : "extensions",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource \"annotated-example\" </p></div><blockquote><p><b>Coverage Information</b></p><p><b>value</b>: Prior Authorization (Details: http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverageGuidance code prior-auth = 'Prior authorization', stated as 'Prior Authorization')</p><p><b>value</b>: <a href=\"Coverage-example.html\">Coverage/example</a></p><p><b>value</b>: 2019-02-15</p></blockquote><p><b>status</b>: draft</p><p><b>intent</b>: original-order</p><p><b>medication</b>: Cellcept 250 MG Oral Capsule <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.0.0/CodeSystem-v3-rxNorm.html\">RxNorm</a>#616447)</span></p><p><b>subject</b>: <a href=\"http://example.org/Patient/123\">http://example.org/Patient/123: Jane Smith</a></p><p><b>encounter</b>: <a href=\"http://example.org/Encounter/ABC\">http://example.org/Encounter/ABC</a></p><p><b>authoredOn</b>: 2019-02-15</p><p><b>requester</b>: <a href=\"http://example.org/PractitionerRole/987\">http://example.org/PractitionerRole/987: Dr. Jones</a></p><p><b>note</b>: Unsolicited prior authorization for Jane Smith to receive 6 tablets Cellcept 250 MG Oral Capsule BID granted.  Please note prior authorization # 12345 on claim submission. (By XYZ Insurance @Feb 15, 2019 8:07:18 PM)</p></div>"
  },
  "extension" : [
    {
      "extension" : [
        {
          "url" : "coverageInfo",
          "valueCoding" : {
            "system" : "http://hl7.org/fhir/us/davinci-crd/CodeSystem/coverageGuidance",
            "code" : "prior-auth",
            "display" : "Prior Authorization"
          }
        },
        {
          "url" : "coverage",
          "valueReference" : {
            "reference" : "Coverage/example"
          }
        },
        {
          "url" : "date",
          "valueDate" : "2019-02-15"
        }
      ],
      "url" : "http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information"
    }
  ],
  "status" : "draft",
  "intent" : "original-order",
  "medicationCodeableConcept" : {
    "coding" : [
      {
        "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
        "code" : "616447",
        "display" : "Cellcept 250 MG Oral Capsule"
      }
    ]
  },
  "subject" : {
    "reference" : "http://example.org/Patient/123",
    "display" : "Jane Smith"
  },
  "encounter" : {
    "reference" : "http://example.org/Encounter/ABC"
  },
  "authoredOn" : "2019-02-15",
  "requester" : {
    "reference" : "http://example.org/PractitionerRole/987",
    "display" : "Dr. Jones"
  },
  "note" : [
    {
      "authorString" : "XYZ Insurance",
      "time" : "2019-02-15T15:07:18-05:00",
      "text" : "Unsolicited prior authorization for Jane Smith to receive 6 tablets Cellcept 250 MG Oral Capsule BID granted.  Please note prior authorization # 12345 on claim submission."
    }
  ],
  "dosageInstruction" : [
    {
      "text" : "6 tablets every 12 hours.",
      "timing" : {
        "repeat" : {
          "frequency" : 1,
          "period" : 12,
          "periodUnit" : "h"
        }
      },
      "doseAndRate" : [
        {
          "doseQuantity" : {
            "value" : 6,
            "unit" : "tablet"
          }
        }
      ]
    }
  ]
}