Da Vinci - Coverage Requirements Discovery
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This page is part of the Da Vinci Coverage Requirements Discovery (CRD) FHIR IG (v2.1.0: STU 2.1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions

: MedicationRequest example - XML Representation

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<MedicationRequest xmlns="http://hl7.org/fhir">
  <id value="example"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: MedicationRequest example</b></p><a name="example"> </a><a name="hcexample"> </a><a name="example-en-US"> </a><p><b>identifier</b>: <code>http://www.bmc.nl/portal/prescriptions</code>/12345689 (use: official, )</p><p><b>status</b>: Draft</p><p><b>intent</b>: Order</p><p><b>medication</b>: <a href="#hcexample/med0320">Medication Azithromycin 250 mg oral tablet</a></p><p><b>subject</b>: <a href="Patient-example.html">Amy V. Shaw  Female, DoB: 1987-02-20 ( Medical Record Number: 1032702 (use: usual, ))</a></p><p><b>encounter</b>: <a href="Encounter-example.html">Encounter: identifier = http://www.amc.nl/zorgportal/identifiers/visits#v1451 (use: official, ); status = in-progress; class = ambulatory (ActCode#AMB); type = Patient-initiated encounter; priority = Non-urgent cardiological admission; reasonCode = Heart valve replacement</a></p><p><b>authoredOn</b>: 2015-01-15</p><p><b>requester</b>: <a href="Practitioner-full.html">Practitioner Bone </a></p><p><b>reasonCode</b>: <span title="Codes:{http://snomed.info/sct 11840006}">Traveler's Diarrhea (disorder)</span></p><p><b>insurance</b>: <a href="Coverage-example.html">Coverage: identifier = Member Number; status = active; type = extended healthcare; dependent = 0; relationship = Self; period = 2011-05-23 --&gt; 2012-05-23</a></p><p><b>note</b>: Patient told to take with food</p><blockquote><p><b>dosageInstruction</b></p><p><b>sequence</b>: 1</p><p><b>text</b>: Two tablets at once</p><p><b>additionalInstruction</b>: <span title="Codes:{http://snomed.info/sct 311504000}">With or after food</span></p><p><b>timing</b>: Once per 1 days</p><p><b>route</b>: <span title="Codes:{http://snomed.info/sct 26643006}">Oral Route</span></p><p><b>method</b>: <span title="Codes:{http://snomed.info/sct 421521009}">Swallow - dosing instruction imperative (qualifier value)</span></p><h3>DoseAndRates</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Dose[x]</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/dose-rate-type ordered}">Ordered</span></td><td>2 TAB<span style="background: LightGoldenRodYellow"> (Details: Orderable Drug Form  codeTAB = 'Tablet')</span></td></tr></table></blockquote><blockquote><p><b>dosageInstruction</b></p><p><b>sequence</b>: 2</p><p><b>text</b>: One tablet daily for 4 days</p><p><b>additionalInstruction</b>: <span title="Codes:{http://snomed.info/sct 311504000}">With or after food</span></p><p><b>timing</b>: 4 per 1 days</p><p><b>route</b>: <span title="Codes:{http://snomed.info/sct 26643006}">Oral Route</span></p><h3>DoseAndRates</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Dose[x]</b></td></tr><tr><td style="display: none">*</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/dose-rate-type ordered}">Ordered</span></td><td>1 TAB<span style="background: LightGoldenRodYellow"> (Details: Orderable Drug Form  codeTAB = 'Tablet')</span></td></tr></table></blockquote><blockquote><p><b>dispenseRequest</b></p><p><b>validityPeriod</b>: 2015-01-15 --&gt; 2016-01-15</p><p><b>numberOfRepeatsAllowed</b>: 1</p><p><b>quantity</b>: 6 TAB<span style="background: LightGoldenRodYellow"> (Details: Orderable Drug Form  codeTAB = 'Tablet')</span></p><h3>ExpectedSupplyDurations</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Value</b></td><td><b>Unit</b></td><td><b>System</b></td><td><b>Code</b></td></tr><tr><td style="display: none">*</td><td>5</td><td>days</td><td><a href="http://terminology.hl7.org/5.0.0/CodeSystem-v3-ucum.html">http://unitsofmeasure.org</a></td><td>d</td></tr></table></blockquote><h3>Substitutions</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Allowed[x]</b></td><td><b>Reason</b></td></tr><tr><td style="display: none">*</td><td>true</td><td><span title="Codes:{http://terminology.hl7.org/CodeSystem/v3-ActReason FP}">formulary policy</span></td></tr></table><hr/><blockquote><p class="res-header-id"><b>Generated Narrative: Medication  #med0320</b></p><a name="example/med0320"> </a><a name="hcexample/med0320"> </a><a name="example/med0320-en-US"> </a><p><b>code</b>: <span title="Codes:{http://snomed.info/sct 1145423002}">Azithromycin 250 mg oral tablet</span></p></blockquote></div>
  </text>
  <contained>
    <Medication>
      <id value="med0320"/>
      <code>
        <coding>
          <system value="http://snomed.info/sct"/>
          <code value="1145423002"/>
          <display value="Azithromycin 250 mg oral tablet"/>
        </coding>
      </code>
    </Medication>
  </contained>
  <identifier>
    <use value="official"/>
    <system value="http://www.bmc.nl/portal/prescriptions"/>
    <value value="12345689"/>
  </identifier>
  <status value="draft"/>
  <intent value="order"/>
  <medicationReference>
    <reference value="#med0320"/>
  </medicationReference>
  <subject>🔗 
    <reference value="Patient/example"/>
  </subject>
  <encounter>🔗 
    <reference value="Encounter/example"/>
  </encounter>
  <authoredOn value="2015-01-15"/>
  <requester>🔗 
    <reference value="Practitioner/full"/>
  </requester>
  <reasonCode>
    <coding>
      <system value="http://snomed.info/sct"/>
      <code value="11840006"/>
      <display value="Traveler's Diarrhea (disorder)"/>
    </coding>
  </reasonCode>
  <insurance>🔗 
    <reference value="Coverage/example"/>
  </insurance>
  <note>
    <text value="Patient told to take with food"/>
  </note>
  <dosageInstruction>
    <sequence value="1"/>
    <text value="Two tablets at once"/>
    <additionalInstruction>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="311504000"/>
        <display value="With or after food"/>
      </coding>
    </additionalInstruction>
    <timing>
      <repeat>
        <frequency value="1"/>
        <period value="1"/>
        <periodUnit value="d"/>
      </repeat>
    </timing>
    <route>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="26643006"/>
        <display value="Oral Route"/>
      </coding>
    </route>
    <method>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="421521009"/>
        <display
                 value="Swallow - dosing instruction imperative (qualifier value)"/>
      </coding>
    </method>
    <doseAndRate>
      <type>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/dose-rate-type"/>
          <code value="ordered"/>
          <display value="Ordered"/>
        </coding>
      </type>
      <doseQuantity>
        <value value="2"/>
        <unit value="TAB"/>
        <system
                value="http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm"/>
        <code value="TAB"/>
      </doseQuantity>
    </doseAndRate>
  </dosageInstruction>
  <dosageInstruction>
    <sequence value="2"/>
    <text value="One tablet daily for 4 days"/>
    <additionalInstruction>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="311504000"/>
        <display value="With or after food"/>
      </coding>
    </additionalInstruction>
    <timing>
      <repeat>
        <frequency value="4"/>
        <period value="1"/>
        <periodUnit value="d"/>
      </repeat>
    </timing>
    <route>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="26643006"/>
        <display value="Oral Route"/>
      </coding>
    </route>
    <doseAndRate>
      <type>
        <coding>
          <system
                  value="http://terminology.hl7.org/CodeSystem/dose-rate-type"/>
          <code value="ordered"/>
          <display value="Ordered"/>
        </coding>
      </type>
      <doseQuantity>
        <value value="1"/>
        <unit value="TAB"/>
        <system
                value="http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm"/>
        <code value="TAB"/>
      </doseQuantity>
    </doseAndRate>
  </dosageInstruction>
  <dispenseRequest>
    <validityPeriod>
      <start value="2015-01-15"/>
      <end value="2016-01-15"/>
    </validityPeriod>
    <numberOfRepeatsAllowed value="1"/>
    <quantity>
      <value value="6"/>
      <unit value="TAB"/>
      <system
              value="http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm"/>
      <code value="TAB"/>
    </quantity>
    <expectedSupplyDuration>
      <value value="5"/>
      <unit value="days"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="d"/>
    </expectedSupplyDuration>
  </dispenseRequest>
  <substitution>
    <allowedBoolean value="true"/>
    <reason>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
        <code value="FP"/>
        <display value="formulary policy"/>
      </coding>
    </reason>
  </substitution>
</MedicationRequest>