This page is part of the Da Vinci Payer Data Exchange (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

3-6-5 MedicationDispense

<a href=3-6_Data_Mapping.html" id="markdown-toc-mapping">- Data Mapping</a>

The Da Vinci HRex MedicationDispense profile SHALL be used to record a member’s prescription drug claims.

The essential fields to be provided in the MedicationDispense resource are:

R4 Hierarchical Name	R4 Name	Card.	Type
MedicationDispense	MedicationDispense		DomainResource
MedicationDispense.identifier	identifier	0..*	Identifier
MedicationDispense.status	status	1..1	code
MedicationDispense.medication[x]	medication[x]	1..1
MedicationDispense.subject	subject	0..1	Reference(Patient	Group)

3-6-5-1 Health Plan Mapping Assistance

A collaboration of Health Plan experts have performed an evaluation of claims information and developed a mapping of data for Members to the MedicationDispence profile. This is shown below as an assistance to implementers:

Line	PayerSourceRecord	CMS BB 2.0 Field	Data Descriptor	FHIR Profile	Profile Field	ValueSet	Notes
1.3	Member	BENE_ID	Patientid	MedicationDispense	.subject		Reference(Patient)
1.1	Claim-Pharmacy		Days supply	MedicationDispense	.daysSupply
2.1	Claim-Pharmacy		RX service reference number	MedicationDispense	.identifier
4.1	Claim-Pharmacy		Refill number	MedicationDispense	.type	http://hl7.org/fhir/R4/v3/ActPharmacySupplyType/vs.html	Calculate First Fill or Refill
7.1	Claim-Line		Number of units	MedicationDispense
9.1	Claim-Line		National drug code	MedicationDispense	.medication.medcationCodeeableConcept		SNOMED CT Code
10.1	Claim-Line		Compound code	MedicationDispense	.medication.medcationReference(Medication)
11.1	Claim-Line		Quantity dispensed	MedicationDispense	.quantity
12.1	Claim-Line		Quantity qualifier code	MedicationDispense	.category
5.1	Claim-Pharmacy		Prescription origin code	US Core MedicationRequest	.authorizingPrescription.Reference(MedicationRequest).identifier.value

Where an entry is provided in the CMS BB2.0 FIELD column the definition of the field can be reviewed using the following URL:

https://bluebutton.cms.gov/resources/variables/{CMS_BB2.0_FIELD}/

Where {CMS_BB2.0_FIELD} is replaced with the Field value in lower case. For example:

https://bluebutton.cms.gov/resources/variables/bene_id/ https://bluebutton.cms.gov/resources/variables/dob_dt/

3-6-5-2 Example MedicationDispense Resource

An example mapping of a MedicationDispense resource is shown here for a Dispense for Over the Counter medication - Tylenol PM (NDC code) - on hold with as needed dosage with a condition, a dose Range and an Event History:

{
  "resourceType": "MedicationDispense",
  "id": "meddisp0312",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">Generated Narrative with Details
id: meddisp0312
contained: 
status: on-hold
medication: Tylenol PM. Generated Summary: id: med0309; Tylenol PM (Details : {http://hl7.org/fhir/sid/ndc code '50580-506-02' = '50580-506-02', given as 'Tylenol PM'})
subject: Donald Duck
Performers
- Actor
* Practitioner/f006
authorizingPrescription: MedicationRequest/medrx0310
type: First Fill (Details : {http://terminology.hl7.org/CodeSystem/v3-ActCode code 'FF' = 'First Fill', given as 'First Fill'})
quantity: 100 TAB (Details: http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm code TAB = 'Tablet')
daysSupply: 30 Day (Details: UCUM code d = 'd')
whenPrepared: 15/01/2015 10:20:00 AM
whenHandedOver: 15/01/2015 4:20:00 PM
dosageInstruction: </div>"
  },
  "contained": [
    {
      "resourceType": "Medication",
      "id": "med0309",
      "code": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/sid/ndc",
            "code": "50580-506-02",
            "display": "Tylenol PM"
          }
        ]
      }
    }
  ],
  "status": "on-hold",
  "medicationReference": {
    "reference": "#med0309",
    "display": "Tylenol PM"
  },
  "subject": {
    "reference": "Patient/pat1",
    "display": "Donald Duck"
  },
  "performer": [
    {
      "actor": {
        "reference": "Practitioner/f006"
      }
    }
  ],
  "authorizingPrescription": [
    {
      "reference": "MedicationRequest/medrx0310"
    }
  ],
  "type": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
        "code": "FF",
        "display": "First Fill"
      }
    ]
  },
  "quantity": {
    "value": 100,
    "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
    "code": "TAB"
  },
  "daysSupply": {
    "value": 30,
    "unit": "Day",
    "system": "http://unitsofmeasure.org",
    "code": "d"
  },
  "whenPrepared": "2015-01-15T10:20:00Z",
  "whenHandedOver": "2015-01-15T16:20:00Z",
  "dosageInstruction": [
    {
      "sequence": 1,
      "text": "Take 1-2 tablets once daily at bedtime as needed for restless legs",
      "additionalInstruction": [
        {
          "text": "Take at bedtime"
        }
      ],
      "timing": {
        "repeat": {
          "frequency": 1,
          "period": 1,
          "periodUnit": "d"
        }
      },
      "asNeededCodeableConcept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "32914008",
            "display": "Restless Legs"
          }
        ]
      },
      "route": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "26643006",
            "display": "Oral Route"
          }
        ]
      },
      "doseAndRate": [
        {
          "type": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                "code": "ordered",
                "display": "Ordered"
              }
            ]
          },
          "doseRange": {
            "low": {
              "value": 1,
              "unit": "TAB",
              "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
              "code": "TAB"
            },
            "high": {
              "value": 2,
              "unit": "TAB",
              "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
              "code": "TAB"
            }
          }
        }
      ]
    }
  ]
}

-	Actor
*	Practitioner/f006