This page is part of the Specialty Medication Enrollment (v2.0.0: STU2) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

• Content
• Detailed Descriptions
• Mappings
• Examples

Resource Profile: Specialty Rx Medication Request

This profile tailors the MedicationRequest resource to support specialty medication dispensing and enrollment in related programs.

Usage:

• Use this Resource Profile: Specialty Rx Bundle - Query Response - Unsolicited Message and Specialty Rx Bundle - Query Message
• Refer to this Resource Profile: Specialty Rx Parameters - Query Response - Unsolicited and Specialty Rx Parameters - Query
• Examples for this Resource Profile: MedicationRequest/specialty-rx-medicationrequest-1

Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

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

This structure is derived from USCoreMedicationRequestProfile

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group
dosageInstruction	S	1..*	Dosage	How the medication should be taken
dispenseRequest
initialFill
quantity	S	1..1	SimpleQuantity	First fill quantity
numberOfRepeatsAllowed	S	0..1	unsignedInt	Number of refills authorized
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
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.
intent	?!SΣ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	SΣ	0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile)
medication[x]	SΣ	1..1		Medication to be taken Binding: US Core Medication Codes (RxNorm) (extensible): Prescribable medications
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who or group medication request is for
encounter	S	0..1	Reference(Encounter)	Encounter created as part of encounter/admission/stay
authoredOn	SΣ	1..1	dateTime	When request was initially authored
requester	SΣ	1..1	Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile)	Who/What requested the Request
dosageInstruction	S	1..*	Dosage	How the medication should be taken
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
dispenseRequest		0..1	BackboneElement	Medication supply authorization
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity	S	1..1	SimpleQuantity	First fill quantity
numberOfRepeatsAllowed	S	0..1	unsignedInt	Number of refills authorized
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
MedicationRequest.status	required	medicationrequest Status
MedicationRequest.intent	required	medicationRequest Intent
MedicationRequest.medication[x]	extensible	USCoreMedicationCodes

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()

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group
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
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		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.
statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent	?!SΣ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category		0..*	CodeableConcept	Type of medication usage 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.
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	SΣ	0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile)
medication[x]	SΣ	1..1		Medication to be taken Binding: US Core Medication Codes (RxNorm) (extensible): Prescribable medications
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who or group medication request is for
encounter	S	0..1	Reference(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	SΣ	1..1	Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile)	Who/What requested the Request
performer		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)	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		0..*	CodeableConcept	Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference		0..*	Reference(Condition | Observation)	Condition or observation that supports why the prescription is being written
instantiatesCanonical	Σ	0..*	canonical()	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)	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	1..*	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	Σ	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	Σ	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]	Σ	0..1		Amount of medication per dose
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
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		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	S	1..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		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		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		0..1	Reference(MedicationRequest)	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
MedicationRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
MedicationRequest.status	required	medicationrequest Status
MedicationRequest.statusReason	example	medicationRequest Status Reason Codes
MedicationRequest.intent	required	medicationRequest Intent
MedicationRequest.category	example	medicationRequest Category Codes
MedicationRequest.priority	required	RequestPriority
MedicationRequest.medication[x]	extensible	USCoreMedicationCodes
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes
MedicationRequest.reasonCode	example	Condition/Problem/DiagnosisCodes
MedicationRequest.courseOfTherapyType	example	medicationRequest Course of Therapy Codes
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes
MedicationRequest.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
MedicationRequest.dosageInstruction.route	example	SNOMEDCTRouteCodes
MedicationRequest.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes
MedicationRequest.dosageInstruction.doseAndRate.type	example	DoseAndRateType
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
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()

This structure is derived from USCoreMedicationRequestProfile

Summary

Mandatory: 1 element (1 nested mandatory element)
Must-Support: 3 elements

Differential View

This structure is derived from USCoreMedicationRequestProfile

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group
dosageInstruction	S	1..*	Dosage	How the medication should be taken
dispenseRequest
initialFill
quantity	S	1..1	SimpleQuantity	First fill quantity
numberOfRepeatsAllowed	S	0..1	unsignedInt	Number of refills authorized
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
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.
intent	?!SΣ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	SΣ	0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile)
medication[x]	SΣ	1..1		Medication to be taken Binding: US Core Medication Codes (RxNorm) (extensible): Prescribable medications
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who or group medication request is for
encounter	S	0..1	Reference(Encounter)	Encounter created as part of encounter/admission/stay
authoredOn	SΣ	1..1	dateTime	When request was initially authored
requester	SΣ	1..1	Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile)	Who/What requested the Request
dosageInstruction	S	1..*	Dosage	How the medication should be taken
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	Free text dosage instructions e.g. SIG
dispenseRequest		0..1	BackboneElement	Medication supply authorization
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
initialFill		0..1	BackboneElement	First fill details
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
quantity	S	1..1	SimpleQuantity	First fill quantity
numberOfRepeatsAllowed	S	0..1	unsignedInt	Number of refills authorized
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet
MedicationRequest.status	required	medicationrequest Status
MedicationRequest.intent	required	medicationRequest Intent
MedicationRequest.medication[x]	extensible	USCoreMedicationCodes

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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group
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
extension		0..*	Extension	Additional content defined by implementations
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		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.
statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent	?!SΣ	1..1	code	proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category		0..*	CodeableConcept	Type of medication usage 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.
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	SΣ	0..1		Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(US Core Patient Profile | US Core Practitioner Profile | US Core Organization Profile)
medication[x]	SΣ	1..1		Medication to be taken Binding: US Core Medication Codes (RxNorm) (extensible): Prescribable medications
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	SΣ	1..1	Reference(US Core Patient Profile)	Who or group medication request is for
encounter	S	0..1	Reference(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	SΣ	1..1	Reference(US Core Practitioner Profile | US Core Organization Profile | US Core Patient Profile)	Who/What requested the Request
performer		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)	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		0..*	CodeableConcept	Reason or indication for ordering or not ordering the medication Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
reasonReference		0..*	Reference(Condition | Observation)	Condition or observation that supports why the prescription is being written
instantiatesCanonical	Σ	0..*	canonical()	Instantiates FHIR protocol or definition
instantiatesUri	Σ	0..*	uri	Instantiates external protocol or definition
basedOn	Σ	0..*	Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)	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	1..*	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	Σ	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	Σ	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]	Σ	0..1		Amount of medication per dose
doseRange			Range
doseQuantity			Quantity(SimpleQuantity)
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		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	S	1..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		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		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		0..1	Reference(MedicationRequest)	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
MedicationRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding
MedicationRequest.status	required	medicationrequest Status
MedicationRequest.statusReason	example	medicationRequest Status Reason Codes
MedicationRequest.intent	required	medicationRequest Intent
MedicationRequest.category	example	medicationRequest Category Codes
MedicationRequest.priority	required	RequestPriority
MedicationRequest.medication[x]	extensible	USCoreMedicationCodes
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes
MedicationRequest.reasonCode	example	Condition/Problem/DiagnosisCodes
MedicationRequest.courseOfTherapyType	example	medicationRequest Course of Therapy Codes
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes
MedicationRequest.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes
MedicationRequest.dosageInstruction.route	example	SNOMEDCTRouteCodes
MedicationRequest.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes
MedicationRequest.dosageInstruction.doseAndRate.type	example	DoseAndRateType
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
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()

This structure is derived from USCoreMedicationRequestProfile

Summary

Mandatory: 1 element (1 nested mandatory element)
Must-Support: 3 elements

Other representations of profile: CSV, Excel, Schematron