{
  "resourceType" : "MedicationRequest",
  "id" : "example-medicationrequest-with-extensions",
  "meta" : {
    "profile" : ["https://fhir.dha.go.ke/erx/StructureDefinition/ke-medication-request",
    "https://fhir.dha.go.ke/fhir/StructureDefinition/ke-medication-request"]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Prescription RX-2025-EXT-00001 – Extension Demonstration</b></p><p>Metformin 500 mg twice daily for James Otieno, prescribed by Dr. Sarah Njoroge. Demonstrates: digital signature, refill authorization (3 refills), controlled substance schedule (not controlled), and SHA insurance pre-authorization SHA-2025-AUTH-001234 valid 15 Jun–15 Sep 2025.</p></div>"
  },
  "extension" : [{
    "extension" : [{
      "url" : "signatureType",
      "valueCoding" : {
        "system" : "urn:iso-astm:E1762-95:2013",
        "code" : "1.2.840.10065.1.12.1.1",
        "display" : "Author's Signature"
      }
    },
    {
      "url" : "signatureValue",
      "valueBase64Binary" : "U0lHTkFUVVJFX1BMQUNFSE9MREVS"
    },
    {
      "url" : "signedBy",
      "valueReference" : {
        "reference" : "Practitioner/example-practitioner-njoroge"
      }
    },
    {
      "url" : "signedOn",
      "valueInstant" : "2025-06-15T09:30:00+03:00"
    }],
    "url" : "https://fhir.dha.go.ke/fhir/StructureDefinition/prescription-digital-signature"
  },
  {
    "extension" : [{
      "url" : "authorizedRefills",
      "valueUnsignedInt" : 3
    },
    {
      "url" : "remainingRefills",
      "valueUnsignedInt" : 3
    },
    {
      "url" : "earliestRefillDate",
      "valueDate" : "2025-07-15"
    }],
    "url" : "https://fhir.dha.go.ke/fhir/StructureDefinition/refill-authorization"
  },
  {
    "extension" : [{
      "url" : "isControlled",
      "valueBoolean" : false
    }],
    "url" : "https://fhir.dha.go.ke/fhir/StructureDefinition/controlled-substance-schedule"
  },
  {
    "extension" : [{
      "url" : "authorizationNumber",
      "valueString" : "SHA-2025-AUTH-001234"
    },
    {
      "url" : "insurerName",
      "valueString" : "Social Health Authority (SHA)"
    },
    {
      "url" : "validFrom",
      "valueDate" : "2025-06-15"
    },
    {
      "url" : "validTo",
      "valueDate" : "2025-09-15"
    }],
    "url" : "https://fhir.dha.go.ke/fhir/StructureDefinition/insurance-pre-authorization"
  }],
  "identifier" : [{
    "system" : "https://ilm-hie.dha.go.ke/fhir/NamingSystem/prescription-identifier",
    "value" : "RX-2025-EXT-00001"
  }],
  "status" : "active",
  "intent" : "order",
  "category" : [{
    "coding" : [{
      "system" : "http://terminology.hl7.org/CodeSystem/medicationrequest-category",
      "code" : "outpatient",
      "display" : "Outpatient"
    }]
  }],
  "medicationCodeableConcept" : {
    "coding" : [{
      "system" : "https://fhir.dha.go.ke/fhir/CodeSystem/generic-products-cs",
      "code" : "GE10002",
      "display" : "Metformin 500 mg Oral Tablet"
    }]
  },
  "subject" : {
    "reference" : "Patient/example-patient-otieno"
  },
  "authoredOn" : "2025-06-15",
  "requester" : {
    "reference" : "Practitioner/example-practitioner-njoroge"
  },
  "dosageInstruction" : [{
    "text" : "Take 1 tablet (500 mg) by mouth twice daily with meals",
    "timing" : {
      "repeat" : {
        "frequency" : 2,
        "period" : 1,
        "periodUnit" : "d"
      }
    },
    "route" : {
      "coding" : [{
        "system" : "https://fhir.dha.go.ke/fhir/CodeSystem/route-of-administration-cs",
        "code" : "RT10025",
        "display" : "Oral"
      }]
    },
    "doseAndRate" : [{
      "doseQuantity" : {
        "value" : 500,
        "unit" : "mg",
        "system" : "http://unitsofmeasure.org",
        "code" : "mg"
      }
    }]
  }],
  "dispenseRequest" : {
    "numberOfRepeatsAllowed" : 3,
    "quantity" : {
      "value" : 60,
      "unit" : "tablet",
      "system" : "http://unitsofmeasure.org",
      "code" : "1"
    }
  },
  "substitution" : {
    "allowedCodeableConcept" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v3-substanceAdminSubstitution",
        "code" : "G",
        "display" : "equivalent generic composition"
      }]
    }
  }
}