This page is part of the Da Vinci Prior Authorization Support (PAS) FHIR IG (v2.1.0-preview: QA Preview) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 2.0.1. For a full list of available versions, see the Directory of published versions

• Narrative Content
• XML
• JSON
• TTL

: Medication Request Example - JSON Representation

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{
  "resourceType" : "MedicationRequest",
  "id" : "MedicationRequestExample",
  "meta" : {
    "profile" : [
      🔗 "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-medicationrequest"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: MedicationRequest MedicationRequestExample</b></p><a name=\"MedicationRequestExample\"> </a><a name=\"hcMedicationRequestExample\"> </a><a name=\"MedicationRequestExample-en-US\"> </a><p><b>status</b>: Active</p><p><b>intent</b>: Order</p><p><b>medication</b>: <span title=\"Codes:{http://hl7.org/fhir/sid/ndc 0777-3105-02}\">Prozac, 100 CAPSULE in 1 BOTTLE (0777-3105-02) (package)</span></p><p><b>subject</b>: <a href=\"Patient-BeneficiaryExample.html\">JESSE SMITH  Female, DoB: 1947-01-18 ( http://example.org/MIN#12345678902)</a></p><p><b>authoredOn</b>: 2005-06-02</p><p><b>requester</b>: <a href=\"Practitioner-ReferralPractitionerExample.html\">Practitioner SUSAN WATSON </a></p><h3>DosageInstructions</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Timing</b></td></tr><tr><td style=\"display: none\">*</td><td></td></tr></table><h3>DispenseRequests</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Quantity</b></td></tr><tr><td style=\"display: none\">*</td><td>300 mg<span style=\"background: LightGoldenRodYellow\"> (Details: UCUM  codemg = 'mg')</span></td></tr></table></div>"
  },
  "status" : "active",
  "intent" : "order",
  "medicationCodeableConcept" : {
    "coding" : [
      {
        "system" : "http://hl7.org/fhir/sid/ndc",
        "code" : "0777-3105-02"
      }
    ]
  },
  "subject" : {
    🔗 "reference" : "Patient/BeneficiaryExample"
  },
  "authoredOn" : "2005-06-02",
  "requester" : {
    🔗 "reference" : "Practitioner/ReferralPractitionerExample"
  },
  "dosageInstruction" : [
    {
      "timing" : {
        "extension" : [
          {
            "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-timingcalendarpattern",
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "https://codesystem.x12.org/005010/678",
                  "code" : "L",
                  "display" : "Monday through Thursday"
                }
              ]
            }
          },
          {
            "url" : "http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-timingdeliverypattern",
            "valueCodeableConcept" : {
              "coding" : [
                {
                  "system" : "https://codesystem.x12.org/005010/679",
                  "code" : "D",
                  "display" : "A.M."
                }
              ]
            }
          }
        ]
      }
    }
  ],
  "dispenseRequest" : {
    "quantity" : {
      "value" : 300,
      "unit" : "mg",
      "system" : "http://unitsofmeasure.org",
      "code" : "mg"
    }
  }
}