Usage

CRD Clients SHALL use this profile to resolve references to MedicationRequest resources passed to CRD Servers (e.g. selections context references) and to populate draftOrders context objects when invoking the when invoking the following CDS Hooks:

• order-select
• order-sign
• order-dispatch

Information provided in Must Support elements will commonly be required for CRD Servers to perform coverage requirements discovery.

NOTE: This profile is not currently based on US Core because US Core accidentally constrained out PractitionerRole. When a future version of US-Core adds support back in, this profile will be revised to extend the US Core profile

• Differential Table
• Key Elements Table
• Snapshot Table
• Statistics/References
• All

This structure is derived from USCoreMedicationRequestProfile

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest			USCoreMedicationRequestProfile(7.0.0)	This profile also complies with the profile US Core MedicationRequest Profile (6.1.0)
Slices for extension				Content/Rules for all slices
Coverage-Information	S	0..*	(Complex)	Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
identifier	S	0..*	Identifier	External ids for this request
status		1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Example General: draft
doNotPerform		0..0
reported[x]		0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(CRD Patient | US Core Practitioner Profile(7.0.0) | CRD Organization)
encounter		0..1	Reference(CRD Encounter)	Encounter created as part of encounter/admission/stay
authoredOn		1..1	dateTime	When request was initially authored
requester		1..1	Reference(US Core Practitioner Profile(7.0.0))	Who/What requested the Request
performer	S	0..1	Reference(US Core Practitioner Profile(7.0.0) S | HRex PractitionerRole Profile S)	Intended performer of administration
reasonCode	S	0..*	CodeableConcept	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication
reasonReference	S	0..*	Reference(Condition | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription
basedOn		0..*	Reference(CRD Medication Request | CRD Service Request)	What request fulfills
substitution	S	0..1	BackboneElement	Any restrictions on medication substitution
priorPrescription	S	0..1	Reference(CRD Medication Request)	An order/prescription that is being replaced
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	USCoreMedicationRequestProfile(7.0.0)	Ordering of medication for patient or group This profile also complies with the profile US Core MedicationRequest Profile (6.1.0) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management us-core-21: requester SHALL be present if intent is "order"
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
medicationAdherence		0..*	(Complex)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
Coverage-Information	S	0..*	(Complex)	Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	S	0..*	Identifier	External ids for this request ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. ele-1: All FHIR elements must have a @value or children Example General: draft
intent	?!SΣC	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. ele-1: All FHIR elements must have a @value or children
Slices for category	S	0..*	CodeableConcept	Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. ele-1: All FHIR elements must have a @value or children
category:us-core	S	0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets ele-1: All FHIR elements must have a @value or children
reported[x]	SΣ	0..1		Reported rather than primary record ele-1: All FHIR elements must have a @value or children
reportedBoolean			boolean
reportedReference			Reference(US Core Practitioner Profile(7.0.0))
medication[x]	SΣ	1..1		Medication to be taken Binding: Medication Clinical Drug (extensible) ele-1: All FHIR elements must have a @value or children
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile(7.0.0))
subject	SΣ	1..1	Reference(US Core Patient Profile(7.0.0))	Who or group medication request is for ele-1: All FHIR elements must have a @value or children
encounter	S	0..1	Reference(CRD Encounter)	Encounter created as part of encounter/admission/stay ele-1: All FHIR elements must have a @value or children
authoredOn	SΣ	1..1	dateTime	When request was initially authored ele-1: All FHIR elements must have a @value or children
requester	SΣC	1..1	Reference(US Core Practitioner Profile(7.0.0))	Who/What requested the Request ele-1: All FHIR elements must have a @value or children
performer	S	0..1	Reference(US Core Practitioner Profile(7.0.0) | HRex PractitionerRole Profile)	Intended performer of administration ele-1: All FHIR elements must have a @value or children
reasonCode	S	0..*	CodeableConcept	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible) ele-1: All FHIR elements must have a @value or children
reasonReference	S	0..*	Reference(Condition | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription ele-1: All FHIR elements must have a @value or children
basedOn	Σ	0..*	Reference(CRD Medication Request | CRD Service Request)	What request fulfills ele-1: All FHIR elements must have a @value or children
dosageInstruction	S	0..*	Dosage	How the medication should be taken ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG ele-1: All FHIR elements must have a @value or children
timing	SΣ	0..1	Timing	When medication should be administered ele-1: All FHIR elements must have a @value or children
doseAndRate	SΣ	0..*	Element	Amount of medication administered ele-1: All FHIR elements must have a @value or children
dose[x]	SΣ	0..1		Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding ele-1: All FHIR elements must have a @value or children
doseQuantity			Quantity(SimpleQuantity)
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
numberOfRepeatsAllowed	S	0..1	unsignedInt	Number of refills authorized ele-1: All FHIR elements must have a @value or children
quantity	S	0..1	SimpleQuantity	Amount of medication to supply per dispense ele-1: All FHIR elements must have a @value or children
substitution	S	0..1	BackboneElement	Any restrictions on medication substitution ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
allowed[x]		1..1		Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed. ele-1: All FHIR elements must have a @value or children
allowedBoolean			boolean
allowedCodeableConcept			CodeableConcept
priorPrescription	S	0..1	Reference(CRD Medication Request)	An order/prescription that is being replaced ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.category:us-core	required	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationRequest.reasonCode	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard Additional Bindings Purpose UCUMCodes Max Binding
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
us-core-21	error	MedicationRequest	requester SHALL be present if intent is "order" : (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	USCoreMedicationRequestProfile(7.0.0)	Ordering of medication for patient or group This profile also complies with the profile US Core MedicationRequest Profile (6.1.0) us-core-21: requester SHALL be present if intent is "order"
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
medicationAdherence		0..*	(Complex)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence
Coverage-Information	S	0..*	(Complex)	Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	S	0..*	Identifier	External ids for this request
status	?!SΣ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. Example General: draft
statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent	?!SΣC	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
Slices for category	S	0..*	CodeableConcept	Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
category:us-core	S	0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
reported[x]	SΣ	0..1		Reported rather than primary record
reportedBoolean			boolean S
reportedReference			Reference S(CRD Patient | US Core Practitioner Profile(7.0.0) S | CRD Organization)
medication[x]	SΣ	1..1		Medication to be taken Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile(7.0.0))
subject	SΣ	1..1	Reference(US Core Patient Profile(7.0.0) S | Group)	Who or group medication request is for
encounter	S	0..1	Reference(CRD Encounter)	Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Resource)	Information to support ordering of the medication
authoredOn	SΣ	1..1	dateTime	When request was initially authored
requester	SΣC	1..1	Reference(US Core Practitioner Profile(7.0.0) S)	Who/What requested the Request
performer	S	0..1	Reference(US Core Practitioner Profile(7.0.0) S | HRex PractitionerRole Profile S)	Intended performer of administration
performerType	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder		0..1	Reference(Practitioner | PractitionerRole)	Person who entered the request
reasonCode	S	0..*	CodeableConcept	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible)
reasonReference	S	0..*	Reference(Condition | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription
instantiatesCanonical	Σ	0..*	canonical()	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CRD Medication Request | CRD Service Request)	What request fulfills
groupIdentifier	Σ	0..1	Identifier	Composite request this is part of
courseOfTherapyType		0..1	CodeableConcept	Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
note		0..*	Annotation	Information about the prescription
dosageInstruction	S	0..*	Dosage	How the medication should be taken
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	Patient or consumer oriented instructions
timing	SΣ	0..1	Timing	When medication should be administered
asNeeded[x]	Σ	0..1		Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	SΣ	0..*	Element	Amount of medication administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x]	SΣ	0..1		Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity S(SimpleQuantity)
doseRange			Range
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity		0..1	SimpleQuantity	First fill quantity
duration		0..1	Duration	First fill duration
dispenseInterval		0..1	Duration	Minimum period of time between dispenses
validityPeriod		0..1	Period	Time period supply is authorized for
numberOfRepeatsAllowed	S	0..1	unsignedInt	Number of refills authorized
quantity	S	0..1	SimpleQuantity	Amount of medication to supply per dispense
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser
substitution	S	0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
allowed[x]		1..1		Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean			boolean
allowedCodeableConcept			CodeableConcept
reason		0..1	CodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription	S	0..1	Reference(CRD Medication Request)	An order/prescription that is being replaced
detectedIssue		0..*	Reference(DetectedIssue)	Clinical Issue with action
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status from the FHIR Standard
MedicationRequest.statusReason	example	medicationRequest Status Reason Codes http://hl7.org/fhir/ValueSet/medicationrequest-status-reason from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.category:us-core	required	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
MedicationRequest.reasonCode	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.courseOfTherapyType	example	medicationRequest Course of Therapy Codes http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationRequest.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationRequest.dosageInstruction.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard
MedicationRequest.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard Additional Bindings Purpose UCUMCodes Max Binding
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
us-core-21	error	MedicationRequest	requester SHALL be present if intent is "order" : (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

Differential View

This structure is derived from USCoreMedicationRequestProfile

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest			USCoreMedicationRequestProfile(7.0.0)	This profile also complies with the profile US Core MedicationRequest Profile (6.1.0)
Slices for extension				Content/Rules for all slices
Coverage-Information	S	0..*	(Complex)	Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
identifier	S	0..*	Identifier	External ids for this request
status		1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Example General: draft
doNotPerform		0..0
reported[x]		0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(CRD Patient | US Core Practitioner Profile(7.0.0) | CRD Organization)
encounter		0..1	Reference(CRD Encounter)	Encounter created as part of encounter/admission/stay
authoredOn		1..1	dateTime	When request was initially authored
requester		1..1	Reference(US Core Practitioner Profile(7.0.0))	Who/What requested the Request
performer	S	0..1	Reference(US Core Practitioner Profile(7.0.0) S | HRex PractitionerRole Profile S)	Intended performer of administration
reasonCode	S	0..*	CodeableConcept	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication
reasonReference	S	0..*	Reference(Condition | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription
basedOn		0..*	Reference(CRD Medication Request | CRD Service Request)	What request fulfills
substitution	S	0..1	BackboneElement	Any restrictions on medication substitution
priorPrescription	S	0..1	Reference(CRD Medication Request)	An order/prescription that is being replaced
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	USCoreMedicationRequestProfile(7.0.0)	Ordering of medication for patient or group This profile also complies with the profile US Core MedicationRequest Profile (6.1.0) dom-2: If the resource is contained in another resource, it SHALL NOT contain nested Resources dom-3: If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource dom-4: If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated dom-5: If a resource is contained in another resource, it SHALL NOT have a security label dom-6: A resource should have narrative for robust management us-core-21: requester SHALL be present if intent is "order"
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created ele-1: All FHIR elements must have a @value or children
Slices for extension				Content/Rules for all slices
medicationAdherence		0..*	(Complex)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
Coverage-Information	S	0..*	(Complex)	Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
identifier	S	0..*	Identifier	External ids for this request ele-1: All FHIR elements must have a @value or children
status	?!SΣ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. ele-1: All FHIR elements must have a @value or children Example General: draft
intent	?!SΣC	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order. ele-1: All FHIR elements must have a @value or children
Slices for category	S	0..*	CodeableConcept	Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment. ele-1: All FHIR elements must have a @value or children
category:us-core	S	0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets ele-1: All FHIR elements must have a @value or children
reported[x]	SΣ	0..1		Reported rather than primary record ele-1: All FHIR elements must have a @value or children
reportedBoolean			boolean
reportedReference			Reference(US Core Practitioner Profile(7.0.0))
medication[x]	SΣ	1..1		Medication to be taken Binding: Medication Clinical Drug (extensible) ele-1: All FHIR elements must have a @value or children
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile(7.0.0))
subject	SΣ	1..1	Reference(US Core Patient Profile(7.0.0))	Who or group medication request is for ele-1: All FHIR elements must have a @value or children
encounter	S	0..1	Reference(CRD Encounter)	Encounter created as part of encounter/admission/stay ele-1: All FHIR elements must have a @value or children
authoredOn	SΣ	1..1	dateTime	When request was initially authored ele-1: All FHIR elements must have a @value or children
requester	SΣC	1..1	Reference(US Core Practitioner Profile(7.0.0))	Who/What requested the Request ele-1: All FHIR elements must have a @value or children
performer	S	0..1	Reference(US Core Practitioner Profile(7.0.0) | HRex PractitionerRole Profile)	Intended performer of administration ele-1: All FHIR elements must have a @value or children
reasonCode	S	0..*	CodeableConcept	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible) ele-1: All FHIR elements must have a @value or children
reasonReference	S	0..*	Reference(Condition | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription ele-1: All FHIR elements must have a @value or children
basedOn	Σ	0..*	Reference(CRD Medication Request | CRD Service Request)	What request fulfills ele-1: All FHIR elements must have a @value or children
dosageInstruction	S	0..*	Dosage	How the medication should be taken ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG ele-1: All FHIR elements must have a @value or children
timing	SΣ	0..1	Timing	When medication should be administered ele-1: All FHIR elements must have a @value or children
doseAndRate	SΣ	0..*	Element	Amount of medication administered ele-1: All FHIR elements must have a @value or children
dose[x]	SΣ	0..1		Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding ele-1: All FHIR elements must have a @value or children
doseQuantity			Quantity(SimpleQuantity)
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
numberOfRepeatsAllowed	S	0..1	unsignedInt	Number of refills authorized ele-1: All FHIR elements must have a @value or children
quantity	S	0..1	SimpleQuantity	Amount of medication to supply per dispense ele-1: All FHIR elements must have a @value or children
substitution	S	0..1	BackboneElement	Any restrictions on medication substitution ele-1: All FHIR elements must have a @value or children
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized ele-1: All FHIR elements must have a @value or children ext-1: Must have either extensions or value[x], not both
allowed[x]		1..1		Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed. ele-1: All FHIR elements must have a @value or children
allowedBoolean			boolean
allowedCodeableConcept			CodeableConcept
priorPrescription	S	0..1	Reference(CRD Medication Request)	An order/prescription that is being replaced ele-1: All FHIR elements must have a @value or children
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.category:us-core	required	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationRequest.reasonCode	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard Additional Bindings Purpose UCUMCodes Max Binding
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
us-core-21	error	MedicationRequest	requester SHALL be present if intent is "order" : (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	USCoreMedicationRequestProfile(7.0.0)	Ordering of medication for patient or group This profile also complies with the profile US Core MedicationRequest Profile (6.1.0) us-core-21: requester SHALL be present if intent is "order"
id	Σ	0..1	id	Logical id of this artifact
meta	Σ	0..1	Meta	Metadata about the resource
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
language		0..1	code	Language of the resource content Binding: CommonLanguages (preferred): A human language. Additional Bindings Purpose AllLanguages Max Binding
text		0..1	Narrative	Text summary of the resource, for human interpretation
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
medicationAdherence		0..*	(Complex)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence
Coverage-Information	S	0..*	(Complex)	Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier	S	0..*	Identifier	External ids for this request
status	?!SΣ	1..1	code	active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. Example General: draft
statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent	?!SΣC	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
Slices for category	S	0..*	CodeableConcept	Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
category:us-core	S	0..*	CodeableConcept	Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
reported[x]	SΣ	0..1		Reported rather than primary record
reportedBoolean			boolean S
reportedReference			Reference S(CRD Patient | US Core Practitioner Profile(7.0.0) S | CRD Organization)
medication[x]	SΣ	1..1		Medication to be taken Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile(7.0.0))
subject	SΣ	1..1	Reference(US Core Patient Profile(7.0.0) S | Group)	Who or group medication request is for
encounter	S	0..1	Reference(CRD Encounter)	Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Resource)	Information to support ordering of the medication
authoredOn	SΣ	1..1	dateTime	When request was initially authored
requester	SΣC	1..1	Reference(US Core Practitioner Profile(7.0.0) S)	Who/What requested the Request
performer	S	0..1	Reference(US Core Practitioner Profile(7.0.0) S | HRex PractitionerRole Profile S)	Intended performer of administration
performerType	Σ	0..1	CodeableConcept	Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder		0..1	Reference(Practitioner | PractitionerRole)	Person who entered the request
reasonCode	S	0..*	CodeableConcept	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible)
reasonReference	S	0..*	Reference(Condition | Observation)	𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription
instantiatesCanonical	Σ	0..*	canonical()	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CRD Medication Request | CRD Service Request)	What request fulfills
groupIdentifier	Σ	0..1	Identifier	Composite request this is part of
courseOfTherapyType		0..1	CodeableConcept	Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance		0..*	Reference(Coverage | ClaimResponse)	Associated insurance coverage
note		0..*	Annotation	Information about the prescription
dosageInstruction	S	0..*	Dosage	How the medication should be taken
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
sequence	Σ	0..1	integer	The order of the dosage instructions
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
additionalInstruction	Σ	0..*	CodeableConcept	Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction	Σ	0..1	string	Patient or consumer oriented instructions
timing	SΣ	0..1	Timing	When medication should be administered
asNeeded[x]	Σ	0..1		Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean			boolean
asNeededCodeableConcept			CodeableConcept
site	Σ	0..1	CodeableConcept	Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route	Σ	0..1	CodeableConcept	How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method	Σ	0..1	CodeableConcept	Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate	SΣ	0..*	Element	Amount of medication administered
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations Slice: Unordered, Open by value:url
type	Σ	0..1	CodeableConcept	The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x]	SΣ	0..1		Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity S(SimpleQuantity)
doseRange			Range
rate[x]	Σ	0..1		Amount of medication per unit of time
rateRatio			Ratio
rateRange			Range
rateQuantity			Quantity(SimpleQuantity)
maxDosePerPeriod	Σ	0..1	Ratio	Upper limit on medication per unit of time
maxDosePerAdministration	Σ	0..1	SimpleQuantity	Upper limit on medication per administration
maxDosePerLifetime	Σ	0..1	SimpleQuantity	Upper limit on medication per lifetime of the patient
dispenseRequest	S	0..1	BackboneElement	Medication supply authorization
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity		0..1	SimpleQuantity	First fill quantity
duration		0..1	Duration	First fill duration
dispenseInterval		0..1	Duration	Minimum period of time between dispenses
validityPeriod		0..1	Period	Time period supply is authorized for
numberOfRepeatsAllowed	S	0..1	unsignedInt	Number of refills authorized
quantity	S	0..1	SimpleQuantity	Amount of medication to supply per dispense
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser
substitution	S	0..1	BackboneElement	Any restrictions on medication substitution
id		0..1	string	Unique id for inter-element referencing
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
allowed[x]		1..1		Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean			boolean
allowedCodeableConcept			CodeableConcept
reason		0..1	CodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription	S	0..1	Reference(CRD Medication Request)	An order/prescription that is being replaced
detectedIssue		0..*	Reference(DetectedIssue)	Clinical Issue with action
eventHistory		0..*	Reference(Provenance)	A list of events of interest in the lifecycle
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.language	preferred	CommonLanguages http://hl7.org/fhir/ValueSet/languages from the FHIR Standard Additional Bindings Purpose AllLanguages Max Binding
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status from the FHIR Standard
MedicationRequest.statusReason	example	medicationRequest Status Reason Codes http://hl7.org/fhir/ValueSet/medicationrequest-status-reason from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.category:us-core	required	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
MedicationRequest.reasonCode	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.courseOfTherapyType	example	medicationRequest Course of Therapy Codes http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationRequest.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationRequest.dosageInstruction.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard
MedicationRequest.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard Additional Bindings Purpose UCUMCodes Max Binding
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
dom-2	error	MedicationRequest	If the resource is contained in another resource, it SHALL NOT contain nested Resources : contained.contained.empty()
dom-3	error	MedicationRequest	If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource : contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()
dom-4	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated : contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()
dom-5	error	MedicationRequest	If a resource is contained in another resource, it SHALL NOT have a security label : contained.meta.security.empty()
dom-6	best practice	MedicationRequest	A resource should have narrative for robust management : text.`div`.exists()
ele-1	error	**ALL** elements	All FHIR elements must have a @value or children : hasValue() or (children().count() > id.count())
ext-1	error	**ALL** extensions	Must have either extensions or value[x], not both : extension.exists() != value.exists()
us-core-21	error	MedicationRequest	requester SHALL be present if intent is "order" : (intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()

This structure is derived from USCoreMedicationRequestProfile

Summary

Mandatory: 2 elements
Must-Support: 7 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

• CRD Patient (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient)
• US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
• CRD Organization (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-organization)
• CRD Encounter (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-encounter)
• HRex PractitionerRole Profile (http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-practitionerrole)
• CRD Medication Request (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-medicationrequest)
• CRD Service Request (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-servicerequest)

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information

Maturity: 3

Notes

While the codes for the medication are expected to be drawn from RxNorm, EHRs MAY send additional coding repetions to communicate other code systems (e.g. HCPCS J codes). This may be necessary for the payer to appropriately respond to coverage information regarding medications associated with medical and DME benefits.