R4 Ballot #1 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v3.3.0: R4 Ballot 2). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

Medicationstatementexample1.json

Pharmacy Work GroupMaturity Level: N/ABallot Status: InformativeCompartments: Patient, Practitioner, RelatedPerson

Raw JSON (canonical form)

Patient reports they are taking Tylenol PM and has the bottle

{
  "resourceType": "MedicationStatement",
  "id": "example001",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: example001</p><p><b>contained</b>: </p><p><b>identifier</b>: 12345689 (OFFICIAL)</p><p><b>status</b>: active</p><p><b>category</b>: Inpatient <span>(Details : {http://hl7.org/fhir/medication-statement-category code 'inpatient' = 'Inpatient', given as 'Inpatient'})</span></p><p><b>medication</b>: id: med0309; Tylenol PM <span>(Details : {http://hl7.org/fhir/sid/ndc code '50580-506-02' = '50580-506-02', given as 'Tylenol PM'})</span>; Film-coated tablet (qualifier value) <span>(Details : {SNOMED CT code '385057009' = 'Film-coated tablet', given as 'Film-coated tablet (qualifier value)'})</span></p><p><b>subject</b>: <a>Donald Duck</a></p><p><b>effective</b>: 23/01/2015</p><p><b>dateAsserted</b>: 22/02/2015</p><p><b>informationSource</b>: <a>Donald Duck</a></p><p><b>derivedFrom</b>: <a>MedicationRequest/medrx002</a></p><p><b>reasonCode</b>: Restless Legs <span>(Details : {SNOMED CT code '32914008' = 'Restless legs', given as 'Restless Legs'})</span></p><p><b>note</b>: Patient indicates they miss the occasional dose</p><p><b>dosage</b>: </p></div>"
  },
  "contained": [
    {
      "resourceType": "Medication",
      "id": "med0309",
      "code": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/sid/ndc",
            "code": "50580-506-02",
            "display": "Tylenol PM"
          }
        ]
      },
      "form": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "385057009",
            "display": "Film-coated tablet (qualifier value)"
          }
        ]
      },
      "ingredient": [
        {
          "itemCodeableConcept": {
            "coding": [
              {
                "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
                "code": "315266",
                "display": "Acetaminophen 500 MG"
              }
            ]
          },
          "amount": {
            "numerator": {
              "value": 500,
              "system": "http://unitsofmeasure.org",
              "code": "mg"
            },
            "denominator": {
              "value": 1,
              "system": "http://hl7.org/fhir/v3/orderableDrugForm",
              "code": "Tab"
            }
          }
        },
        {
          "itemCodeableConcept": {
            "coding": [
              {
                "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
                "code": "901813",
                "display": "Diphenhydramine Hydrochloride 25 mg"
              }
            ]
          },
          "amount": {
            "numerator": {
              "value": 25,
              "system": "http://unitsofmeasure.org",
              "code": "mg"
            },
            "denominator": {
              "value": 1,
              "system": "http://hl7.org/fhir/v3/orderableDrugForm",
              "code": "Tab"
            }
          }
        }
      ],
      "batch": {
        "lotNumber": "9494788",
        "expirationDate": "2017-05-22"
      }
    }
  ],
  "identifier": [
    {
      "use": "official",
      "system": "http://www.bmc.nl/portal/medstatements",
      "value": "12345689"
    }
  ],
  "status": "active",
  "category": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/medication-statement-category",
        "code": "inpatient",
        "display": "Inpatient"
      }
    ]
  },
  "medicationReference": {
    "reference": "#med0309"
  },
  "subject": {
    "reference": "Patient/pat1",
    "display": "Donald Duck"
  },
  "effectiveDateTime": "2015-01-23",
  "dateAsserted": "2015-02-22",
  "informationSource": {
    "reference": "Patient/pat1",
    "display": "Donald Duck"
  },
  "derivedFrom": [
    {
      "reference": "MedicationRequest/medrx002"
    }
  ],
  "reasonCode": [
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "32914008",
          "display": "Restless Legs"
        }
      ]
    }
  ],
  "note": [
    {
      "text": "Patient indicates they miss the occasional dose"
    }
  ],
  "dosage": [
    {
      "sequence": 1,
      "text": "1-2 tablets once daily at bedtime as needed for restless legs",
      "additionalInstruction": [
        {
          "text": "Taking 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://hl7.org/fhir/dose-rate-type",
                "code": "ordered",
                "display": "Ordered"
              }
            ]
          },
          "doseRange": {
            "low": {
              "value": 1,
              "unit": "TAB",
              "system": "http://hl7.org/fhir/v3/orderableDrugForm",
              "code": "TAB"
            },
            "high": {
              "value": 2,
              "unit": "TAB",
              "system": "http://hl7.org/fhir/v3/orderableDrugForm",
              "code": "TAB"
            }
          }
        }
      ]
    }
  ]
}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.