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

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: Medication Request Example - XML Representation

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<MedicationRequest xmlns="http://hl7.org/fhir">
  <id value="MedicationRequestExample"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/profile-medicationrequest"/>
  </meta>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <status value="active"/>
  <intent value="order"/>
  <medicationCodeableConcept>
    <coding>
      <system value="http://hl7.org/fhir/sid/ndc"/>
      <code value="0777-3105-02"/>
    </coding>
  </medicationCodeableConcept>
  <subject>🔗 
    <reference value="Patient/BeneficiaryExample"/>
  </subject>
  <authoredOn value="2005-06-02"/>
  <requester>🔗 
    <reference value="Practitioner/ReferralPractitionerExample"/>
  </requester>
  <dosageInstruction>
    <timing>
      <extension
                 url="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-timingcalendarpattern">
        <valueCodeableConcept>
          <coding>
            <system value="https://codesystem.x12.org/005010/678"/>
            <code value="L"/>
            <display value="Monday through Thursday"/>
          </coding>
        </valueCodeableConcept>
      </extension>
      <extension
                 url="http://hl7.org/fhir/us/davinci-pas/StructureDefinition/extension-timingdeliverypattern">
        <valueCodeableConcept>
          <coding>
            <system value="https://codesystem.x12.org/005010/679"/>
            <code value="D"/>
            <display value="A.M."/>
          </coding>
        </valueCodeableConcept>
      </extension>
    </timing>
  </dosageInstruction>
  <dispenseRequest>
    <quantity>
      <value value="300"/>
      <unit value="mg"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="mg"/>
    </quantity>
  </dispenseRequest>
</MedicationRequest>