Da Vinci - Coverage Requirements Discovery
2.2.0-snapshot - STU 2.2 Peer Review

Da Vinci - Coverage Requirements Discovery, published by HL7 International / Financial Management. This guide is not an authorized publication; it is the continuous build for version 2.2.0-snapshot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/davinci-crd/ and changes regularly. See the Directory of published versions

## Resource Profile: CRD Medication Request

Official URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-medicationrequest | Version: 2.2.0-snapshot | Highlight text changes?
Standards status: Trial-use Active as of 2026-02-19 | Maturity Level: 4 | Computable Name: CRDMedicationRequest
Other Identifiers: OID:2.16.840.1.113883.4.642.40.18.42.12

This profile specifies additional constraints on the US Core MedicationRequest profile to support coverage requirements discovery.

### Usage

CRD Clients SHALL use the CRD MedicationRequest profile to resolve references to MedicationRequest resources passed to CRD Servers (e.g. `selections` context references) and to populate `draftOrders` context objects when invoking the following CDS Hooks: §prof-9

- order-select
- order-sign
- order-dispatch

!

Information provided in Must Support elements will commonly be required for CRD Servers to perform coverage requirements discovery.

Usages:

- Use this Profile: CRD CDSHooks Additional Orders Response (Logical Definition), CRD CDSHooks Alternate Request Response (Logical Definition), CRD CDSHooks Coverage Information Response (Logical Definition) and CRD Bundle of Request Resources
- Refer to this Profile: Coverage Information, CRD Appointment with Order, CRD Medication Request and CRD Service Request
- CapabilityStatements using this Profile: CRD Client USCDI 1, CRD Client USCDI 3 and CRD Client USCDI 4

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description Differentials, Snapshots, and other representations.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest | C | 0..* | USCoreMedicationRequestProfile(7.0.0) | Ordering of medication for patient or group This profile also complies with the profile US Core MedicationRequest Profile (6.1.0) Constraints: us-core-21
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  |  |  | Content/Rules for all slices
extension:medicationAdherence |  | 0..* | (Complex) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence
extension:Coverage-Information | S | 0..* | (Complex) | Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S | 0..* | Identifier | External ids for this request
status | ?!S Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. Example General: draft
intent | ?!S Σ C | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
Slices for category | S | 0..* | CodeableConcept | Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
category:us-core | S | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:encounterType | S | 0..1 | CodeableConcept | inpatient, outpatient, etc. Binding: ActEncounterCode (3.0.0) (required)
category:serviceType | S | 0..1 | CodeableConcept | X-ray, Lab, consulation, surgical, etc. Binding: X12 Service Type (required)
reported[x] | S Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean S |
reportedReference |  |  | Reference S(CRD Patient | CRD Practitioner | CRD Organization) |
Slices for medication[x] | S Σ | 1..1 |  | Medication to be taken Slice: Unordered, Closed by type:$this Binding: MedicationClinicalDrug (20240606) (extensible)
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(CRD Medication) |
medication[x]:medicationCodeableConcept | S Σ | 0..1 | CodeableConcept | Medication to be taken Binding: MedicationClinicalDrug (20240606) (extensible)
Slices for extension |  |  |  | Content/Rules for all slices
extension:BillingOptions | S | 0..* | CodeableConcept | Expected Billing Code(s) URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options Binding: CRD Billing Codes Value Set (extensible)
medication[x]:medicationReference | S Σ | 0..1 | Reference(CRD Medication) | Medication to be taken
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0) S | Group) | Who or group medication request is for
encounter | S | 0..1 | Reference(CRD Encounter) | Encounter created as part of encounter/admission/stay
authoredOn | S Σ | 1..1 | dateTime | When request was initially authored
requester | S Σ C | 1..1 | Reference(CRD Practitioner) | Who/What requested the Request
performer | S | 0..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Intended performer of administration
reasonCode | S | 0..* | CodeableConcept | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: USCoreConditionCodes (7.0.0) (extensible)
reasonReference | S | 0..* | Reference(Condition | Observation) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription
basedOn | Σ | 0..* | Reference(CRD Medication Request | CRD Service Request) | What request fulfills
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
timing | S Σ | 0..1 | CRDTiming | When medication should be administered
doseAndRate | S Σ | 0..* | Element | Amount of medication administered
dose[x] | S Σ | 0..1 |  | Amount of medication per dose Binding: Common UCUM units (preferred)
Additional Bindings | Purpose
UCUMCodes | Max Binding
doseQuantity |  |  | Quantity S(SimpleQuantity) |
doseRange |  |  | Range |
dispenseRequest | S | 0..1 | BackboneElement | Medication supply authorization
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
numberOfRepeatsAllowed | S | 0..1 | unsignedInt | Number of refills authorized
quantity | S | 0..1 | SimpleQuantity | Amount of medication to supply per dispense
performer | S | 0..1 | Reference(CRD Organization) | Intended dispenser
substitution | S | 0..1 | BackboneElement | Any restrictions on medication substitution
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
allowed[x] |  | 1..1 |  | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (3.0.0) (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
priorPrescription | S | 0..1 | Reference(CRD Medication Request) | An order/prescription that is being replaced
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.status | Base | required | Medicationrequest status | 📦4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📦4.0.1 | FHIR Std.
MedicationRequest.category | Base | example | Medication request category codes | 📦4.0.1 | FHIR Std.
MedicationRequest.category:us-core | Base | required | Medication request category codes | 📦4.0.1 | FHIR Std.
MedicationRequest.category:encounterType | Base | required | ActEncounterCode | 📍3.0.0 | THO v7.0
MedicationRequest.category:serviceType | Base | required | X12 Service Type | 📦2.2.0-snapshot | This IG
MedicationRequest.medication[x] | Base | extensible | Medication Clinical Drug | 📍20240606 | VSAC v0.19
MedicationRequest.medication[x]:medicationCodeableConcept | Base | extensible | Medication Clinical Drug | 📍20240606 | VSAC v0.19
MedicationRequest.reasonCode | Base | extensible | US Core Condition Codes | 📍7.0.0 | US Core v7.0
MedicationRequest.dosageInstruction.​doseAndRate.dose[x] | Base | preferred | Common UCUM units | 📦4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📍3.0.0 | THO v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
us-core-21 | error | MedicationRequest | requester SHALL be present if intent is "order" | `(intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()`

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  |  | USCoreMedicationRequestProfile(7.0.0) | This profile also complies with the profile US Core MedicationRequest Profile (6.1.0)
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  |  |  | Content/Rules for all slices
extension:Coverage-Information | S | 0..* | (Complex) | Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
identifier | S | 0..* | Identifier | External ids for this request
status |  | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Example General: draft
Slices for category |  |  |  | Content/Rules for all slices
category:encounterType | S | 0..1 | CodeableConcept | inpatient, outpatient, etc. Binding: ActEncounterCode (3.0.0) (required)
category:serviceType | S | 0..1 | CodeableConcept | X-ray, Lab, consulation, surgical, etc. Binding: X12 Service Type (required)
doNotPerform |  | 0..0 |  | True if request is prohibiting action
reported[x] |  | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(CRD Patient | CRD Practitioner | CRD Organization) |
Slices for medication[x] |  | 1..1 |  | Medication to be taken Slice: Unordered, Open by type:$this
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(CRD Medication) |
medication[x]:medicationCodeableConcept | S | 0..1 | CodeableConcept | Medication to be taken
Slices for extension |  |  |  | Content/Rules for all slices
extension:BillingOptions | S | 0..* | CodeableConcept | Expected Billing Code(s) URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options Binding: CRD Billing Codes Value Set (extensible)
medication[x]:medicationReference | S | 0..1 | Reference(CRD Medication) | Medication to be taken
encounter |  | 0..1 | Reference(CRD Encounter) | Encounter created as part of encounter/admission/stay
authoredOn |  | 1..1 | dateTime | When request was initially authored
requester |  | 1..1 | Reference(CRD Practitioner) | Who/What requested the Request
performer | S | 0..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Intended performer of administration
reasonCode | S | 0..* | CodeableConcept | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication
reasonReference | S | 0..* | Reference(Condition | Observation) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription
basedOn |  | 0..* | Reference(CRD Medication Request | CRD Service Request) | What request fulfills
dosageInstruction |  |  |  |
timing |  | 0..1 | CRDTiming | When medication should be administered
dispenseRequest |  |  |  |
performer | S | 0..1 | Reference(CRD Organization) | Intended dispenser
substitution | S | 0..1 | BackboneElement | Any restrictions on medication substitution
priorPrescription | S | 0..1 | Reference(CRD Medication Request) | An order/prescription that is being replaced
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.category:encounterType | Base | required | ActEncounterCode | 📍3.0.0 | THO v7.0
MedicationRequest.category:serviceType | Base | required | X12 Service Type | 📦2.2.0-snapshot | This IG

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest | C | 0..* | USCoreMedicationRequestProfile(7.0.0) | Ordering of medication for patient or group This profile also complies with the profile US Core MedicationRequest Profile (6.1.0) Constraints: us-core-21
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:medicationAdherence |  | 0..* | (Complex) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence
extension:Coverage-Information | S | 0..* | (Complex) | Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S | 0..* | Identifier | External ids for this request
status | ?!S Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. Example General: draft
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!S Σ C | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
Slices for category | S | 0..* | CodeableConcept | Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
category:us-core | S | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:encounterType | S | 0..1 | CodeableConcept | inpatient, outpatient, etc. Binding: ActEncounterCode (3.0.0) (required)
category:serviceType | S | 0..1 | CodeableConcept | X-ray, Lab, consulation, surgical, etc. Binding: X12 Service Type (required)
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
reported[x] | S Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean S |
reportedReference |  |  | Reference S(CRD Patient | CRD Practitioner | CRD Organization) |
Slices for medication[x] | S Σ | 1..1 |  | Medication to be taken Slice: Unordered, Closed by type:$this Binding: MedicationClinicalDrug (20240606) (extensible)
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(CRD Medication) |
medication[x]:medicationCodeableConcept | S Σ | 0..1 | CodeableConcept | Medication to be taken Binding: MedicationClinicalDrug (20240606) (extensible)
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:BillingOptions | S | 0..* | CodeableConcept | Expected Billing Code(s) URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options Binding: CRD Billing Codes Value Set (extensible)
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
medication[x]:medicationReference | S Σ | 0..1 | Reference(CRD Medication) | Medication to be taken
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0) S | Group) | Who or group medication request is for
encounter | S | 0..1 | Reference(CRD Encounter) | Encounter created as part of encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | S Σ | 1..1 | dateTime | When request was initially authored
requester | S Σ C | 1..1 | Reference(CRD Practitioner) | Who/What requested the Request
performer | S | 0..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Intended performer of administration
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder |  | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request
reasonCode | S | 0..* | CodeableConcept | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: USCoreConditionCodes (7.0.0) (extensible)
reasonReference | S | 0..* | Reference(Condition | Observation) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(CRD Medication Request | CRD Service Request) | What request fulfills
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
courseOfTherapyType |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage
note |  | 0..* | Annotation | Information about the prescription
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | S Σ | 0..1 | CRDTiming | When medication should be administered
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | S Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | S Σ | 0..1 |  | Amount of medication per dose Binding: Common UCUM units (preferred)
Additional Bindings | Purpose
UCUMCodes | Max Binding
doseQuantity |  |  | Quantity S(SimpleQuantity) |
doseRange |  |  | Range |
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient
dispenseRequest | S | 0..1 | BackboneElement | Medication supply authorization
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
initialFill |  | 0..1 | BackboneElement | First fill details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity |  | 0..1 | SimpleQuantity | First fill quantity
duration |  | 0..1 | Duration | First fill duration
dispenseInterval |  | 0..1 | Duration | Minimum period of time between dispenses
validityPeriod |  | 0..1 | Period | Time period supply is authorized for
numberOfRepeatsAllowed | S | 0..1 | unsignedInt | Number of refills authorized
quantity | S | 0..1 | SimpleQuantity | Amount of medication to supply per dispense
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense
performer | S | 0..1 | Reference(CRD Organization) | Intended dispenser
substitution | S | 0..1 | BackboneElement | Any restrictions on medication substitution
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
allowed[x] |  | 1..1 |  | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (3.0.0) (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
reason |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (3.0.0) (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription | S | 0..1 | Reference(CRD Medication Request) | An order/prescription that is being replaced
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical Issue with action
eventHistory |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
MedicationRequest.status | Base | required | Medicationrequest status | 📦4.0.1 | FHIR Std.
MedicationRequest.statusReason | Base | example | Medication request status reason codes | 📦4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📦4.0.1 | FHIR Std.
MedicationRequest.category | Base | example | Medication request category codes | 📦4.0.1 | FHIR Std.
MedicationRequest.category:us-core | Base | required | Medication request category codes | 📦4.0.1 | FHIR Std.
MedicationRequest.category:encounterType | Base | required | ActEncounterCode | 📍3.0.0 | THO v7.0
MedicationRequest.category:serviceType | Base | required | X12 Service Type | 📦2.2.0-snapshot | This IG
MedicationRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | extensible | Medication Clinical Drug | 📍20240606 | VSAC v0.19
MedicationRequest.medication[x]:medicationCodeableConcept | Base | extensible | Medication Clinical Drug | 📍20240606 | VSAC v0.19
MedicationRequest.performerType | Base | example | Procedure Performer Role Codes | 📦4.0.1 | FHIR Std.
MedicationRequest.reasonCode | Base | extensible | US Core Condition Codes | 📍7.0.0 | US Core v7.0
MedicationRequest.courseOfTherapyType | Base | example | Medication request course of therapy codes | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | example | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​method | Base | example | SNOMED CT Administration Method Codes | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.type | Base | example | DoseAndRateType | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.dose[x] | Base | preferred | Common UCUM units | 📦4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📍3.0.0 | THO v7.0
MedicationRequest.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📍3.0.0 | THO v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
us-core-21 | error | MedicationRequest | requester SHALL be present if intent is "order" | `(intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()`

Summary

Mandatory: 2 elements
Must-Support: 14 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

- CRD Patient (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient)
- CRD Practitioner (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-practitioner)
- CRD Organization (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-organization)
- CRD Medication (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-medication)
- CRD Encounter (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-encounter)
- HRex PractitionerRole Profile (http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-practitionerrole)
- CRD Medication Request (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-medicationrequest)
- CRD Service Request (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-servicerequest)
- CRD Timing Data Type (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-timing)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.medication[x]

Maturity: 4

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest | C | 0..* | USCoreMedicationRequestProfile(7.0.0) | Ordering of medication for patient or group This profile also complies with the profile US Core MedicationRequest Profile (6.1.0) Constraints: us-core-21
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  |  |  | Content/Rules for all slices
extension:medicationAdherence |  | 0..* | (Complex) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence
extension:Coverage-Information | S | 0..* | (Complex) | Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S | 0..* | Identifier | External ids for this request
status | ?!S Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. Example General: draft
intent | ?!S Σ C | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
Slices for category | S | 0..* | CodeableConcept | Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
category:us-core | S | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:encounterType | S | 0..1 | CodeableConcept | inpatient, outpatient, etc. Binding: ActEncounterCode (3.0.0) (required)
category:serviceType | S | 0..1 | CodeableConcept | X-ray, Lab, consulation, surgical, etc. Binding: X12 Service Type (required)
reported[x] | S Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean S |
reportedReference |  |  | Reference S(CRD Patient | CRD Practitioner | CRD Organization) |
Slices for medication[x] | S Σ | 1..1 |  | Medication to be taken Slice: Unordered, Closed by type:$this Binding: MedicationClinicalDrug (20240606) (extensible)
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(CRD Medication) |
medication[x]:medicationCodeableConcept | S Σ | 0..1 | CodeableConcept | Medication to be taken Binding: MedicationClinicalDrug (20240606) (extensible)
Slices for extension |  |  |  | Content/Rules for all slices
extension:BillingOptions | S | 0..* | CodeableConcept | Expected Billing Code(s) URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options Binding: CRD Billing Codes Value Set (extensible)
medication[x]:medicationReference | S Σ | 0..1 | Reference(CRD Medication) | Medication to be taken
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0) S | Group) | Who or group medication request is for
encounter | S | 0..1 | Reference(CRD Encounter) | Encounter created as part of encounter/admission/stay
authoredOn | S Σ | 1..1 | dateTime | When request was initially authored
requester | S Σ C | 1..1 | Reference(CRD Practitioner) | Who/What requested the Request
performer | S | 0..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Intended performer of administration
reasonCode | S | 0..* | CodeableConcept | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: USCoreConditionCodes (7.0.0) (extensible)
reasonReference | S | 0..* | Reference(Condition | Observation) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription
basedOn | Σ | 0..* | Reference(CRD Medication Request | CRD Service Request) | What request fulfills
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
timing | S Σ | 0..1 | CRDTiming | When medication should be administered
doseAndRate | S Σ | 0..* | Element | Amount of medication administered
dose[x] | S Σ | 0..1 |  | Amount of medication per dose Binding: Common UCUM units (preferred)
Additional Bindings | Purpose
UCUMCodes | Max Binding
doseQuantity |  |  | Quantity S(SimpleQuantity) |
doseRange |  |  | Range |
dispenseRequest | S | 0..1 | BackboneElement | Medication supply authorization
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
numberOfRepeatsAllowed | S | 0..1 | unsignedInt | Number of refills authorized
quantity | S | 0..1 | SimpleQuantity | Amount of medication to supply per dispense
performer | S | 0..1 | Reference(CRD Organization) | Intended dispenser
substitution | S | 0..1 | BackboneElement | Any restrictions on medication substitution
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
allowed[x] |  | 1..1 |  | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (3.0.0) (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
priorPrescription | S | 0..1 | Reference(CRD Medication Request) | An order/prescription that is being replaced
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.status | Base | required | Medicationrequest status | 📦4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📦4.0.1 | FHIR Std.
MedicationRequest.category | Base | example | Medication request category codes | 📦4.0.1 | FHIR Std.
MedicationRequest.category:us-core | Base | required | Medication request category codes | 📦4.0.1 | FHIR Std.
MedicationRequest.category:encounterType | Base | required | ActEncounterCode | 📍3.0.0 | THO v7.0
MedicationRequest.category:serviceType | Base | required | X12 Service Type | 📦2.2.0-snapshot | This IG
MedicationRequest.medication[x] | Base | extensible | Medication Clinical Drug | 📍20240606 | VSAC v0.19
MedicationRequest.medication[x]:medicationCodeableConcept | Base | extensible | Medication Clinical Drug | 📍20240606 | VSAC v0.19
MedicationRequest.reasonCode | Base | extensible | US Core Condition Codes | 📍7.0.0 | US Core v7.0
MedicationRequest.dosageInstruction.​doseAndRate.dose[x] | Base | preferred | Common UCUM units | 📦4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📍3.0.0 | THO v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
us-core-21 | error | MedicationRequest | requester SHALL be present if intent is "order" | `(intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()`

Differential View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  |  | USCoreMedicationRequestProfile(7.0.0) | This profile also complies with the profile US Core MedicationRequest Profile (6.1.0)
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  |  |  | Content/Rules for all slices
extension:Coverage-Information | S | 0..* | (Complex) | Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
identifier | S | 0..* | Identifier | External ids for this request
status |  | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Example General: draft
Slices for category |  |  |  | Content/Rules for all slices
category:encounterType | S | 0..1 | CodeableConcept | inpatient, outpatient, etc. Binding: ActEncounterCode (3.0.0) (required)
category:serviceType | S | 0..1 | CodeableConcept | X-ray, Lab, consulation, surgical, etc. Binding: X12 Service Type (required)
doNotPerform |  | 0..0 |  | True if request is prohibiting action
reported[x] |  | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(CRD Patient | CRD Practitioner | CRD Organization) |
Slices for medication[x] |  | 1..1 |  | Medication to be taken Slice: Unordered, Open by type:$this
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(CRD Medication) |
medication[x]:medicationCodeableConcept | S | 0..1 | CodeableConcept | Medication to be taken
Slices for extension |  |  |  | Content/Rules for all slices
extension:BillingOptions | S | 0..* | CodeableConcept | Expected Billing Code(s) URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options Binding: CRD Billing Codes Value Set (extensible)
medication[x]:medicationReference | S | 0..1 | Reference(CRD Medication) | Medication to be taken
encounter |  | 0..1 | Reference(CRD Encounter) | Encounter created as part of encounter/admission/stay
authoredOn |  | 1..1 | dateTime | When request was initially authored
requester |  | 1..1 | Reference(CRD Practitioner) | Who/What requested the Request
performer | S | 0..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Intended performer of administration
reasonCode | S | 0..* | CodeableConcept | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication
reasonReference | S | 0..* | Reference(Condition | Observation) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription
basedOn |  | 0..* | Reference(CRD Medication Request | CRD Service Request) | What request fulfills
dosageInstruction |  |  |  |
timing |  | 0..1 | CRDTiming | When medication should be administered
dispenseRequest |  |  |  |
performer | S | 0..1 | Reference(CRD Organization) | Intended dispenser
substitution | S | 0..1 | BackboneElement | Any restrictions on medication substitution
priorPrescription | S | 0..1 | Reference(CRD Medication Request) | An order/prescription that is being replaced
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.category:encounterType | Base | required | ActEncounterCode | 📍3.0.0 | THO v7.0
MedicationRequest.category:serviceType | Base | required | X12 Service Type | 📦2.2.0-snapshot | This IG

Snapshot ViewView

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest | C | 0..* | USCoreMedicationRequestProfile(7.0.0) | Ordering of medication for patient or group This profile also complies with the profile US Core MedicationRequest Profile (6.1.0) Constraints: us-core-21
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained | S | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:medicationAdherence |  | 0..* | (Complex) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Medication Adherence Extension URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-medication-adherence
extension:Coverage-Information | S | 0..* | (Complex) | Coverage Info URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | S | 0..* | Identifier | External ids for this request
status | ?!S Σ | 1..1 | code | active | on-hold | cancelled | completed | entered-in-error | stopped | draft | unknown Binding: medicationrequest Status (required): A code specifying the state of the prescribing event. Describes the lifecycle of the prescription. Example General: draft
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!S Σ C | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
Slices for category | S | 0..* | CodeableConcept | Type of medication usage Slice: Unordered, Open by pattern:$this Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
category:us-core | S | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (required): The type of medication order. Note that other codes are permitted, see Required Bindings When Slicing by Value Sets
category:encounterType | S | 0..1 | CodeableConcept | inpatient, outpatient, etc. Binding: ActEncounterCode (3.0.0) (required)
category:serviceType | S | 0..1 | CodeableConcept | X-ray, Lab, consulation, surgical, etc. Binding: X12 Service Type (required)
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
reported[x] | S Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean S |
reportedReference |  |  | Reference S(CRD Patient | CRD Practitioner | CRD Organization) |
Slices for medication[x] | S Σ | 1..1 |  | Medication to be taken Slice: Unordered, Closed by type:$this Binding: MedicationClinicalDrug (20240606) (extensible)
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(CRD Medication) |
medication[x]:medicationCodeableConcept | S Σ | 0..1 | CodeableConcept | Medication to be taken Binding: MedicationClinicalDrug (20240606) (extensible)
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
extension:BillingOptions | S | 0..* | CodeableConcept | Expected Billing Code(s) URL: http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options Binding: CRD Billing Codes Value Set (extensible)
coding | Σ | 0..* | Coding | Code defined by a terminology system
text | Σ | 0..1 | string | Plain text representation of the concept
medication[x]:medicationReference | S Σ | 0..1 | Reference(CRD Medication) | Medication to be taken
subject | S Σ | 1..1 | Reference(US Core Patient Profile(7.0.0) S | Group) | Who or group medication request is for
encounter | S | 0..1 | Reference(CRD Encounter) | Encounter created as part of encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | S Σ | 1..1 | dateTime | When request was initially authored
requester | S Σ C | 1..1 | Reference(CRD Practitioner) | Who/What requested the Request
performer | S | 0..1 | Reference(CRD Practitioner S | HRex PractitionerRole Profile S) | Intended performer of administration
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder |  | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request
reasonCode | S | 0..* | CodeableConcept | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Reason or indication for ordering or not ordering the medication Binding: USCoreConditionCodes (7.0.0) (extensible)
reasonReference | S | 0..* | Reference(Condition | Observation) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: US Core Condition or Observation that supports the prescription
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(CRD Medication Request | CRD Service Request) | What request fulfills
groupIdentifier | Σ | 0..1 | Identifier | Composite request this is part of
courseOfTherapyType |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage
note |  | 0..* | Annotation | Information about the prescription
dosageInstruction | S | 0..* | Dosage | How the medication should be taken
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | S Σ | 0..1 | string | Free text dosage instructions e.g. SIG
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | S Σ | 0..1 | CRDTiming | When medication should be administered
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | How drug should enter body Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | S Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
dose[x] | S Σ | 0..1 |  | Amount of medication per dose Binding: Common UCUM units (preferred)
Additional Bindings | Purpose
UCUMCodes | Max Binding
doseQuantity |  |  | Quantity S(SimpleQuantity) |
doseRange |  |  | Range |
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity | Upper limit on medication per lifetime of the patient
dispenseRequest | S | 0..1 | BackboneElement | Medication supply authorization
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
initialFill |  | 0..1 | BackboneElement | First fill details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity |  | 0..1 | SimpleQuantity | First fill quantity
duration |  | 0..1 | Duration | First fill duration
dispenseInterval |  | 0..1 | Duration | Minimum period of time between dispenses
validityPeriod |  | 0..1 | Period | Time period supply is authorized for
numberOfRepeatsAllowed | S | 0..1 | unsignedInt | Number of refills authorized
quantity | S | 0..1 | SimpleQuantity | Amount of medication to supply per dispense
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense
performer | S | 0..1 | Reference(CRD Organization) | Intended dispenser
substitution | S | 0..1 | BackboneElement | Any restrictions on medication substitution
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
allowed[x] |  | 1..1 |  | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (3.0.0) (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
reason |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (3.0.0) (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription | S | 0..1 | Reference(CRD Medication Request) | An order/prescription that is being replaced
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical Issue with action
eventHistory |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.language | Base | preferred | Common Languages | 📦4.0.1 | FHIR Std.
MedicationRequest.status | Base | required | Medicationrequest status | 📦4.0.1 | FHIR Std.
MedicationRequest.statusReason | Base | example | Medication request status reason codes | 📦4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📦4.0.1 | FHIR Std.
MedicationRequest.category | Base | example | Medication request category codes | 📦4.0.1 | FHIR Std.
MedicationRequest.category:us-core | Base | required | Medication request category codes | 📦4.0.1 | FHIR Std.
MedicationRequest.category:encounterType | Base | required | ActEncounterCode | 📍3.0.0 | THO v7.0
MedicationRequest.category:serviceType | Base | required | X12 Service Type | 📦2.2.0-snapshot | This IG
MedicationRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | extensible | Medication Clinical Drug | 📍20240606 | VSAC v0.19
MedicationRequest.medication[x]:medicationCodeableConcept | Base | extensible | Medication Clinical Drug | 📍20240606 | VSAC v0.19
MedicationRequest.performerType | Base | example | Procedure Performer Role Codes | 📦4.0.1 | FHIR Std.
MedicationRequest.reasonCode | Base | extensible | US Core Condition Codes | 📍7.0.0 | US Core v7.0
MedicationRequest.courseOfTherapyType | Base | example | Medication request course of therapy codes | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | example | SNOMED CT Route Codes | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​method | Base | example | SNOMED CT Administration Method Codes | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.type | Base | example | DoseAndRateType | 📦4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.dose[x] | Base | preferred | Common UCUM units | 📦4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📍3.0.0 | THO v7.0
MedicationRequest.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📍3.0.0 | THO v7.0

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
us-core-21 | error | MedicationRequest | requester SHALL be present if intent is "order" | `(intent='order' or intent='original-order' or intent='reflex-order'or intent='filler-order' or intent='instance-order') implies requester.exists()`

Summary

Mandatory: 2 elements
Must-Support: 14 elements
Prohibited: 1 element

Structures

This structure refers to these other structures:

- CRD Patient (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-patient)
- CRD Practitioner (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-practitioner)
- CRD Organization (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-organization)
- CRD Medication (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-medication)
- CRD Encounter (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-encounter)
- HRex PractitionerRole Profile (http://hl7.org/fhir/us/davinci-hrex/StructureDefinition/hrex-practitionerrole)
- CRD Medication Request (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-medicationrequest)
- CRD Service Request (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-servicerequest)
- CRD Timing Data Type (http://hl7.org/fhir/us/davinci-crd/StructureDefinition/profile-timing)

Extensions

This structure refers to these extensions:

- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-coverage-information
- http://hl7.org/fhir/us/davinci-crd/StructureDefinition/ext-billing-options

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.medication[x]

Maturity: 4

Other representations of profile: CSV, Excel, Schematron

### Notes:

### Notes

While the codes for the medication are expected to be drawn from RxNorm, EHRs MAY send additional coding repetions to communicate other code systems (e.g. HCPCS J codes). §prof-14 This may be necessary for the payer to appropriately respond to coverage information regarding medications associated with medical and DME benefits.