The MedicationRequest resource can be used to record a patient’s medication prescription or order. The US Core Medication Request profile sets minimum expectations for the MedicationRequest resource to record, search, and fetch medications associated with a patient. It identifies which core elements, extensions, vocabularies and value sets SHALL be present in the resource when using this profile. In addition to the requirements set forth in US Core Medication Request the derived profile is designed to add requirements to the following elements:

MedicationRequest.extension:resource-pertainsToGoal (Must Support) to encourage linking to the goal the medication hopes to facilitate and/or to encourage systems to be able to receive and understand a goal linkage if present. Medication.reasonReference (Must Support) to encourage linking back to the health concern, problem or observation it was ordered for and/or to encourage systems to be able to receive and understand a reason for a medication, if present.

Comments are welcome with respect to the pragmatic use of the “Must Support” rules defined on these elements.

No additional value sets beyond those bound in the US Core MedicationRequest profile are defined in this guide. The binding in US Core Medication Request value set is RxNorm Medication Clinical Drug

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

This structure is derived from USCoreMedicationRequestProfile

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
medication[x]		1..1	CodeableConcept, Reference(US Core Medication Profile)	Please see the Medication Value Set Library (link?) for value sets that are subsets of Medication Clinical Drug 2.16.840.1.113762.1.4.1010.4 that can be used at MedicationRequest.medication.codableConcept
reasonReference	S	0..*	Reference(Condition | Observation)	(USCDI) US Core Condition or Observation that supports the prescription
Documentation for this format

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group us-core-21: requester SHALL be present if intent is "order"
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	(USCDI) 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.
intent	?!SΣC	1..1	code	(USCDI) 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	(USCDI) 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	(USCDI) 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
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	SΣ	0..1		(USCDI) Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(US Core Practitioner Profile)
medication[x]	SΣ	1..1		Please see the Medication Value Set Library (link?) for value sets that are subsets of Medication Clinical Drug 2.16.840.1.113762.1.4.1010.4 that can be used at MedicationRequest.medication.codableConcept Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who or group medication request is for
encounter	S	0..1	Reference(US Core Encounter Profile)	(USCDI) Encounter created as part of encounter/admission/stay
authoredOn	SΣ	0..1	dateTime	(USCDI) When request was initially authored
requester	SΣC	0..1	Reference(US Core Practitioner Profile)	(USCDI) Who/What requested the Request
reasonReference	S	0..*	Reference(Condition | Observation)	(USCDI) US Core Condition or Observation that supports the prescription
dosageInstruction	S	0..*	Dosage	(USCDI) How the medication should be taken
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	(USCDI) Free text dosage instructions e.g. SIG
timing	SΣ	0..1	Timing	(USCDI) When medication should be administered
doseAndRate	SΣ	0..*	Element	(USCDI) Amount of medication administered
dose[x]	SΣ	0..1		(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity
dispenseRequest	S	0..1	BackboneElement	(USCDI) Medication supply authorization
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
numberOfRepeatsAllowed	S	0..1	unsignedInt	(USCDI) Number of refills authorized
quantity	S	0..1	SimpleQuantity	(USCDI) Amount of medication to supply per dispense
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.category:us-core	required	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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
MedicationRequest	C	0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group us-core-21: requester SHALL be present if intent is "order"
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
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External ids for this request
status	?!SΣ	1..1	code	(USCDI) 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.
statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent	?!SΣC	1..1	code	(USCDI) 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	(USCDI) 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	(USCDI) 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
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	SΣ	0..1		(USCDI) Reported rather than primary record
reportedBoolean			boolean S
reportedReference			Reference S(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile)
medication[x]	SΣ	1..1		Please see the Medication Value Set Library (link?) for value sets that are subsets of Medication Clinical Drug 2.16.840.1.113762.1.4.1010.4 that can be used at MedicationRequest.medication.codableConcept Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who or group medication request is for
encounter	S	0..1	Reference(US Core Encounter Profile)	(USCDI) Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Resource)	Information to support ordering of the medication
authoredOn	SΣ	0..1	dateTime	(USCDI) When request was initially authored
requester	SΣC	0..1	Reference(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device)	(USCDI) Who/What requested the Request
performer		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)	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		0..*	CodeableConcept	(USCDI) Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible)
reasonReference	S	0..*	Reference(Condition | Observation)	(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(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)	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	(USCDI) 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	SΣ	0..1	string	(USCDI) 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	SΣ	0..1	Timing	(USCDI) 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	SΣ	0..*	Element	(USCDI) 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]	SΣ	0..1		(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity S
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	(USCDI) 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	(USCDI) Number of refills authorized
quantity	S	0..1	SimpleQuantity	(USCDI) Amount of medication to supply per dispense
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser
substitution		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 (example): Identifies the type of substitution allowed.
allowedBoolean			boolean
allowedCodeableConcept			CodeableConcept
reason		0..1	CodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription		0..1	Reference(MedicationRequest)	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	Conformance	ValueSet	URI
MedicationRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status from the FHIR Standard
MedicationRequest.statusReason	example	medicationRequest Status Reason Codes http://hl7.org/fhir/ValueSet/medicationrequest-status-reason from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.category:us-core	required	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
MedicationRequest.reasonCode	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.courseOfTherapyType	example	medicationRequest Course of Therapy Codes http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationRequest.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationRequest.dosageInstruction.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard
MedicationRequest.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
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

This structure is derived from USCoreMedicationRequestProfile

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest		0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
medication[x]		1..1	CodeableConcept, Reference(US Core Medication Profile)	Please see the Medication Value Set Library (link?) for value sets that are subsets of Medication Clinical Drug 2.16.840.1.113762.1.4.1010.4 that can be used at MedicationRequest.medication.codableConcept
reasonReference	S	0..*	Reference(Condition | Observation)	(USCDI) US Core Condition or Observation that supports the prescription
Documentation for this format

Key Elements View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group us-core-21: requester SHALL be present if intent is "order"
implicitRules	?!Σ	0..1	uri	A set of rules under which this content was created
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
status	?!SΣ	1..1	code	(USCDI) 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.
intent	?!SΣC	1..1	code	(USCDI) 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	(USCDI) 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	(USCDI) 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
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	SΣ	0..1		(USCDI) Reported rather than primary record
reportedBoolean			boolean
reportedReference			Reference(US Core Practitioner Profile)
medication[x]	SΣ	1..1		Please see the Medication Value Set Library (link?) for value sets that are subsets of Medication Clinical Drug 2.16.840.1.113762.1.4.1010.4 that can be used at MedicationRequest.medication.codableConcept Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who or group medication request is for
encounter	S	0..1	Reference(US Core Encounter Profile)	(USCDI) Encounter created as part of encounter/admission/stay
authoredOn	SΣ	0..1	dateTime	(USCDI) When request was initially authored
requester	SΣC	0..1	Reference(US Core Practitioner Profile)	(USCDI) Who/What requested the Request
reasonReference	S	0..*	Reference(Condition | Observation)	(USCDI) US Core Condition or Observation that supports the prescription
dosageInstruction	S	0..*	Dosage	(USCDI) How the medication should be taken
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
text	SΣ	0..1	string	(USCDI) Free text dosage instructions e.g. SIG
timing	SΣ	0..1	Timing	(USCDI) When medication should be administered
doseAndRate	SΣ	0..*	Element	(USCDI) Amount of medication administered
dose[x]	SΣ	0..1		(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity
dispenseRequest	S	0..1	BackboneElement	(USCDI) Medication supply authorization
modifierExtension	?!Σ	0..*	Extension	Extensions that cannot be ignored even if unrecognized
numberOfRepeatsAllowed	S	0..1	unsignedInt	(USCDI) Number of refills authorized
quantity	S	0..1	SimpleQuantity	(USCDI) Amount of medication to supply per dispense
Documentation for this format

Terminology Bindings

Path	Conformance	ValueSet	URI
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.category:us-core	required	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard

Constraints

Id	Grade	Path(s)	Details	Requirements
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()

Snapshot View

Name	Flags	Card.	Type	Description & Constraints
MedicationRequest	C	0..*	USCoreMedicationRequestProfile	Ordering of medication for patient or group us-core-21: requester SHALL be present if intent is "order"
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
contained		0..*	Resource	Contained, inline Resources
Slices for extension		0..*	Extension	Extension Slice: Unordered, Open by value:url
resource-pertainsToGoal	S	0..*	Reference(Goal)	The resource-pertainsToGoal relates the resource to the goal(s) that pertain to it. Whenever there is a goal associated with a health concern or problem, this extension should be present and populated in activity (event or intent) resources. URL: http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal
modifierExtension	?!	0..*	Extension	Extensions that cannot be ignored
identifier		0..*	Identifier	External ids for this request
status	?!SΣ	1..1	code	(USCDI) 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.
statusReason		0..1	CodeableConcept	Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent	?!SΣC	1..1	code	(USCDI) 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	(USCDI) 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	(USCDI) 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
priority	Σ	0..1	code	routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform	?!Σ	0..1	boolean	True if request is prohibiting action
reported[x]	SΣ	0..1		(USCDI) Reported rather than primary record
reportedBoolean			boolean S
reportedReference			Reference S(US Core Practitioner Profile S | US Core Organization Profile | US Core Patient Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile)
medication[x]	SΣ	1..1		Please see the Medication Value Set Library (link?) for value sets that are subsets of Medication Clinical Drug 2.16.840.1.113762.1.4.1010.4 that can be used at MedicationRequest.medication.codableConcept Binding: Medication Clinical Drug (extensible)
medicationCodeableConcept			CodeableConcept
medicationReference			Reference(US Core Medication Profile)
subject	SΣ	1..1	Reference(US Core Patient Profile)	(USCDI) Who or group medication request is for
encounter	S	0..1	Reference(US Core Encounter Profile)	(USCDI) Encounter created as part of encounter/admission/stay
supportingInformation		0..*	Reference(Resource)	Information to support ordering of the medication
authoredOn	SΣ	0..1	dateTime	(USCDI) When request was initially authored
requester	SΣC	0..1	Reference(US Core Practitioner Profile S | US Core Patient Profile | US Core Organization Profile | US Core PractitionerRole Profile | US Core RelatedPerson Profile | Device)	(USCDI) Who/What requested the Request
performer		0..1	Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam)	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		0..*	CodeableConcept	(USCDI) Reason or indication for ordering or not ordering the medication Binding: US Core Condition Codes (extensible)
reasonReference	S	0..*	Reference(Condition | Observation)	(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(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation)	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	(USCDI) 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	SΣ	0..1	string	(USCDI) 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	SΣ	0..1	Timing	(USCDI) 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	SΣ	0..*	Element	(USCDI) 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]	SΣ	0..1		(USCDI) Amount of medication per dose Binding: Common UCUM units (preferred) Additional Bindings Purpose UCUMCodes Max Binding
doseQuantity			Quantity S
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	(USCDI) 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	(USCDI) Number of refills authorized
quantity	S	0..1	SimpleQuantity	(USCDI) Amount of medication to supply per dispense
expectedSupplyDuration		0..1	Duration	Number of days supply per dispense
performer		0..1	Reference(Organization)	Intended dispenser
substitution		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 (example): Identifies the type of substitution allowed.
allowedBoolean			boolean
allowedCodeableConcept			CodeableConcept
reason		0..1	CodeableConcept	Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription		0..1	Reference(MedicationRequest)	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	Conformance	ValueSet	URI
MedicationRequest.language	preferred	CommonLanguages Additional Bindings Purpose AllLanguages Max Binding http://hl7.org/fhir/ValueSet/languages from the FHIR Standard
MedicationRequest.status	required	medicationrequest Status http://hl7.org/fhir/ValueSet/medicationrequest-status from the FHIR Standard
MedicationRequest.statusReason	example	medicationRequest Status Reason Codes http://hl7.org/fhir/ValueSet/medicationrequest-status-reason from the FHIR Standard
MedicationRequest.intent	required	medicationRequest Intent http://hl7.org/fhir/ValueSet/medicationrequest-intent from the FHIR Standard
MedicationRequest.category	example	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.category:us-core	required	medicationRequest Category Codes http://hl7.org/fhir/ValueSet/medicationrequest-category from the FHIR Standard
MedicationRequest.priority	required	RequestPriority http://hl7.org/fhir/ValueSet/request-priority|4.0.1 from the FHIR Standard
MedicationRequest.medication[x]	extensible	MedicationClinicalDrug http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1010.4 from https://vsac.nlm.nih.gov
MedicationRequest.performerType	example	ProcedurePerformerRoleCodes http://hl7.org/fhir/ValueSet/performer-role from the FHIR Standard
MedicationRequest.reasonCode	extensible	USCoreConditionCodes http://hl7.org/fhir/us/core/ValueSet/us-core-condition-code
MedicationRequest.courseOfTherapyType	example	medicationRequest Course of Therapy Codes http://hl7.org/fhir/ValueSet/medicationrequest-course-of-therapy from the FHIR Standard
MedicationRequest.dosageInstruction.additionalInstruction	example	SNOMEDCTAdditionalDosageInstructions http://hl7.org/fhir/ValueSet/additional-instruction-codes from the FHIR Standard
MedicationRequest.dosageInstruction.asNeeded[x]	example	SNOMEDCTMedicationAsNeededReasonCodes http://hl7.org/fhir/ValueSet/medication-as-needed-reason from the FHIR Standard
MedicationRequest.dosageInstruction.site	example	SNOMEDCTAnatomicalStructureForAdministrationSiteCodes http://hl7.org/fhir/ValueSet/approach-site-codes from the FHIR Standard
MedicationRequest.dosageInstruction.route	example	SNOMEDCTRouteCodes http://hl7.org/fhir/ValueSet/route-codes from the FHIR Standard
MedicationRequest.dosageInstruction.method	example	SNOMEDCTAdministrationMethodCodes http://hl7.org/fhir/ValueSet/administration-method-codes from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.type	example	DoseAndRateType http://hl7.org/fhir/ValueSet/dose-rate-type from the FHIR Standard
MedicationRequest.dosageInstruction.doseAndRate.dose[x]	preferred	Common UCUM units Additional Bindings Purpose UCUMCodes Max Binding http://hl7.org/fhir/ValueSet/ucum-common from the FHIR Standard
MedicationRequest.substitution.allowed[x]	example	ActSubstanceAdminSubstitutionCode http://terminology.hl7.org/ValueSet/v3-ActSubstanceAdminSubstitutionCode
MedicationRequest.substitution.reason	example	SubstanceAdminSubstitutionReason http://terminology.hl7.org/ValueSet/v3-SubstanceAdminSubstitutionReason

Constraints

Id	Grade	Path(s)	Details	Requirements
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()

This structure is derived from USCoreMedicationRequestProfile

Summary

Must-Support: 2 elements

Extensions

This structure refers to these extensions:

• http://hl7.org/fhir/StructureDefinition/resource-pertainsToGoal