CARIN Consumer Realtime Pharmacy Benefit Check
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This page is part of the Consumer Real-time Pharmacy Benefit Check (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

XML Format: MedicationRequest-rtpbc-medicationrequest-03

Raw xml 


<MedicationRequest xmlns="http://hl7.org/fhir">
  <id value="rtpbc-medicationrequest-03"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/carin/StructureDefinition/rtpbc-medicationrequest"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: rtpbc-medicationrequest-03</p><p><b>meta</b>: </p><p><b>status</b>: draft</p><p><b>intent</b>: proposal</p><p><b>reported</b>: true</p><p><b>medication</b>: Prozac 10mg capsule <span style="background: LightGoldenRodYellow">(Details : {http://terminology.hl7.org/CodeSystem/ndc-11 code '00777310402' = 'Prozac 10mg capsule', given as 'Prozac 10mg capsule'})</span></p><p><b>subject</b>: <a href="Patient-rtpbc-patient-03.html">Generated Summary: id: rtpbc-patient-03; Jane Doe ; gender: female; birthDate: 1975-12-05</a></p><p><b>requester</b>: <a href="Practitioner-rtpbc-practitioner-03.html">Generated Summary: id: rtpbc-practitioner-03; 1234567890; Johnson </a></p><h3>DispenseRequests</h3><table class="grid"><tr><td>-</td><td><b>Quantity</b></td><td><b>ExpectedSupplyDuration</b></td><td><b>Performer</b></td></tr><tr><td>*</td><td>60 EA</td><td>30 days<span style="background: LightGoldenRodYellow"> (Details: UCUM code d = 'd')</span></td><td><a href="Organization-rtpbc-organization-03.html">Generated Summary: id: rtpbc-organization-03; 0999017; <span title="Codes: {http://ncpdp.org/pharmacy-type R}">Retail</span>; name: Hometown Drug; ph: 6081234567</a></td></tr></table><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="draft"/>
  <intent value="proposal"/>
  <reportedBoolean value="true"/>
  <medicationCodeableConcept>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/ndc-11"/>
      <code value="00777310402"/>
      <display value="Prozac 10mg capsule"/>
    </coding>
  </medicationCodeableConcept>
  <subject>
    <reference value="Patient/rtpbc-patient-03"/>
  </subject>
  <requester>
    <reference value="Practitioner/rtpbc-practitioner-03"/>
  </requester>
  <dispenseRequest>
    <quantity>
      <value value="60"/>
      <unit value="EA"/>
    </quantity>
    <expectedSupplyDuration>
      <value value="30"/>
      <unit value="days"/>
      <system value="http://unitsofmeasure.org"/>
      <code value="d"/>
    </expectedSupplyDuration>
    <performer>
      <reference value="Organization/rtpbc-organization-03"/>
    </performer>
  </dispenseRequest>
  <substitution>
    <allowedBoolean value="false"/>
  </substitution>
</MedicationRequest>