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Example MedicationStatement/example001 (XML)

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

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

Patient reports they are taking Tylenol PM and has the bottle (id = "example001")

<?xml version="1.0" encoding="UTF-8"?>

<!--   This example is a fully populated example where a patient reports they are taking
 a certain medication and has the bottle    --><MedicationStatement xmlns="http://hl7.org/fhir">
  <id value="example001"/> 
  <contained> 
    <Medication> 
      <id value="med0309"/> 
      <code> 
        <coding> 
          <system value="http://hl7.org/fhir/sid/ndc"/> 
          <code value="50580-608-02"/> 
          <display value="Tylenol PM Extra Strength, 1 BOTTLE in 1 CARTON (50580-608-02) &gt; 100 TABLET,
           FILM COATED in 1 BOTTLE (package)"/> 
        </coding> 
        <text value="Tylenol PM"/> 
      </code> 
      <doseForm> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="385057009"/> 
          <display value="Film-coated tablet (basic dose form)"/> 
        </coding> 
      </doseForm> 
      <ingredient> 
        <item> 
          <concept> 
            <coding> 
              <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/> 
              <code value="315266"/> 
              <display value="Acetaminophen 500 MG"/> 
            </coding> 
          </concept> 
        </item> 
        <strengthRatio> 
          <numerator> 
            <value value="500"/> 
            <system value="http://unitsofmeasure.org"/> 
            <code value="mg"/> 
          </numerator> 
          <denominator> 
            <value value="1"/> 
            <system value="http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm"/> 
            <code value="TAB"/> 
          </denominator> 
        </strengthRatio> 
      </ingredient> 
      <ingredient> 
        <item> 
          <concept> 
            <coding> 
              <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/> 
              <code value="901813"/> 
              <display value="Diphenhydramine Hydrochloride 25 mg"/> 
            </coding> 
          </concept> 
        </item> 
        <strengthRatio> 
          <numerator> 
            <value value="25"/> 
            <system value="http://unitsofmeasure.org"/> 
            <code value="mg"/> 
          </numerator> 
          <denominator> 
            <value value="1"/> 
            <system value="http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm"/> 
            <code value="TAB"/> 
          </denominator> 
        </strengthRatio> 
      </ingredient> 
      <batch> 
        <lotNumber value="9494788"/> 
        <expirationDate value="2017-05-22"/> 
      </batch> 
    </Medication> 
  </contained> 
  <identifier> 
    <use value="official"/> 
    <system value="http://www.bmc.nl/portal/medstatements"/> 
    <value value="12345689"/> 
  </identifier> 
  <status value="recorded"/> 
  <category> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/medication-statement-category"/> 
      <code value="inpatient"/> 
      <display value="Inpatient"/> 
    </coding> 
  </category> 
  <medication> 
    <!--   Linked to a RESOURCE Medication   -->
    <reference> 
      <reference value="#med0309"/> 
    </reference> 
  </medication> 
  <subject> 
    <reference value="Patient/pat1"/> 
    <display value="Donald Duck"/> 
  </subject> 
  <effectiveDateTime value="2015-01-23"/> 
  <dateAsserted value="2015-02-22"/> 
  <informationSource> 
    <reference value="Patient/pat1"/> 
    <display value="Donald Duck"/> 
  </informationSource> 
  <derivedFrom> 
    <reference value="MedicationRequest/medrx002"/> 
  </derivedFrom> 
  <reason> 
    <concept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="32914008"/> 
        <display value="Restless Legs"/> 
      </coding> 
    </concept> 
  </reason> 
  <note> 
    <text value="Patient indicates they miss the occasional dose"/> 
  </note> 
  <dosage> 
    <sequence value="1"/> 
    <text value="1-2 tablets once daily at bedtime as needed for restless legs"/> 
    <additionalInstruction> 
      <text value="Taking at bedtime"/> 
    </additionalInstruction> 
    <timing> 
      <repeat> 
        <frequency value="1"/> 
        <period value="1"/> 
        <periodUnit value="d"/> 
      </repeat> 
    </timing> 
    <asNeededFor> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="32914008"/> 
        <display value="Restless Legs"/> 
      </coding> 
    </asNeededFor> 
    <route> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="26643006"/> 
        <display value="Oral Route"/> 
      </coding> 
    </route> 
    <doseAndRate> 
      <type> 
        <coding> 
          <system value="http://terminology.hl7.org/CodeSystem/dose-rate-type"/> 
          <code value="ordered"/> 
          <display value="Ordered"/> 
        </coding> 
      </type> 
      <doseRange> 
        <low> 
          <value value="1"/> 
          <unit value="TAB"/> 
          <system value="http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm"/> 
          <code value="TAB"/> 
        </low> 
        <high> 
          <value value="2"/> 
          <unit value="TAB"/> 
          <system value="http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm"/> 
          <code value="TAB"/> 
        </high> 
      </doseRange> 
    </doseAndRate> 
  </dosage> 
</MedicationStatement> 

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.