This page is part of the Specialty Medication Enrollment (v0.1.0: STU1 Ballot 1) based on FHIR R4. . For a full list of available versions, see the Directory of published versions

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: Specialty Rx MedicationRequest 1 - XML Representation

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<MedicationRequest xmlns="http://hl7.org/fhir">
  <id value="specialty-rx-medicationrequest-1"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/specialty-rx/StructureDefinition/specialty-rx-medicationrequest"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>medication</b>: <span title="Codes: {http://www.nlm.nih.gov/research/umls/rxnorm 1872980}, {http://hl7.org/fhir/sid/ndc 00074055401}">Humira 40 MG in 0.4 ML Auto-Injector</span></p><p><b>subject</b>: <a href="Patient-specialty-rx-patient-1.html">Generated Summary: id: 1234; active; Timothy V. Doe ; Phone: 555-555-5555, tim.doe@example.com; gender: male; birthDate: 1987-02-20</a></p><p><b>authoredOn</b>: 2020-03-10</p><p><b>requester</b>: <a href="Practitioner-specialty-rx-practitioner-1.html">Generated Summary: id: 9941339108; Jane Smith ; Phone: 555-555-5555, Fax: 555-555-1234, jane.smith@example.org</a></p><h3>DosageInstructions</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><blockquote><p><b>dispenseRequest</b></p><h3>InitialFills</h3><table class="grid"><tr><td>-</td><td><b>Quantity</b></td></tr><tr><td>*</td><td>4 {each}</td></tr></table><p><b>numberOfRepeatsAllowed</b>: 2</p><h3>ExpectedSupplyDurations</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>performer</b>: <span>Our Specialty Pharmacy</span></p></blockquote><h3>Substitutions</h3><table class="grid"><tr><td>-</td><td><b>Allowed[x]</b></td></tr><tr><td>*</td><td>false</td></tr></table></div>
  </text>
  <status value="active"/>
  <intent value="order"/>
  <medicationCodeableConcept>
    <coding>
      <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
      <code value="1872980"/>
      <display value="Humira 40 MG in 0.4 ML Auto-Injector"/>
    </coding>
    <coding>
      <system value="http://hl7.org/fhir/sid/ndc"/>
      <code value="00074055401"/>
    </coding>
  </medicationCodeableConcept>
  <subject>
    <reference value="Patient/specialty-rx-patient-1"/>
  </subject>
  <authoredOn value="2020-03-10"/>
  <requester>
    <reference value="Practitioner/specialty-rx-practitioner-1"/>
  </requester>
  <dosageInstruction>
    <text
          value="Inject 2 pens on Day 1. Inject 1 pen on Day 8 and every other week thereafter"/>
  </dosageInstruction>
  <dispenseRequest>
    <initialFill>
      <quantity>
        <value value="4"/>
        <unit value="{each}"/>
      </quantity>
    </initialFill>
    <numberOfRepeatsAllowed value="2"/>
    <expectedSupplyDuration>
      <value value="30"/>
      <unit value="days"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="d"/>
    </expectedSupplyDuration>
    <performer>
      <identifier>
        <value value="TBD Pharmacy ID"/>
      </identifier>
      <display value="Our Specialty Pharmacy"/>
    </performer>
  </dispenseRequest>
  <substitution>
    <allowedBoolean value="false"/>
  </substitution>
</MedicationRequest>