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Example DeviceRequest/wheelchair-request (JSON)

Orders and Observations Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Device, Encounter, Group, Patient, Practitioner

Raw JSON (canonical form + also see JSON Format Specification)

Standard wheelchair request

{
  "resourceType" : "DeviceRequest",
  "id" : "wheelchair-request",
  "identifier" : [{
    "value" : "wheelchair_request.1"
  }],
  "status" : "active",
  "intent" : "order",
  "priority" : "routine",
  "product" : {
    "concept" : {
      "coding" : [{
        "system" : "http://www.cms.gov/Medicare/Coding/HCPCSReleaseCodeSets",
        "code" : "K0001"
      }],
      "text" : "Standard wheelchair"
    }
  },
  "subject" : {
    "reference" : "Patient/bob"
  },
  "occurrencePeriod" : {
    "start" : "2025-05-01",
    "end" : "2025-07-06"
  },
  "authoredOn" : "2025-05-01T09:33:27+07:00",
  "requester" : {
    "reference" : "Practitioner/example",
    "display" : "Dr. Adam Careful"
  },
  "reason" : [{
    "concept" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "11865081000119107"
      }],
      "text" : "Injury of left leg"
    }
  }],
  "insurance" : [{
    "reference" : "Coverage/primiary-insurance",
    "display" : "Blue Cross Blue Shield"
  }],
  "location" : [{
    "concept" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v3-RoleCode",
        "code" : "PTRES"
      }],
      "text" : "Patient's Residence"
    }
  }],
  "supportingInfo" : [{
    "reference" : "Observation/cognitive-status-observation"
  }],
  "note" : [{
    "text" : "Patient has a broken left fibula and requires a wheelchair to move about their home while immobilizing the leg during recovery. Because the patient is a fall risk, as indicated after a cognitive assessment was completed, other mobility devices are not appropriate. A home assessment has been completed and the patient will be able to use the wheelchair without home modifications"
  }]
}

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.