Health eData 1 Sandbox
0.1.0 - CI Build

Health eData 1 Sandbox, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/argonautproject/USCDIV7/ and changes regularly. See the Directory of published versions

## Resource Profile: US Core AllergyIntolerance Profile

Official URL: http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance | Version: 0.1.0
Active as of 2026-05-19 | Maturity Level: 5 | Computable Name: USCoreAllergyIntolerance
Other Identifiers: OID:2.16.840.1.113883.4.642.40.2.42.5

The US Core AllergyIntolerance Profile inherits from the FHIR AllergyIntolerance resource; refer to it for scope and usage definitions. This profile meets the requirements of the U.S. Core Data for Interoperability (USCDI) Allergies and Intolerances Data Class and its Allergy Intolerance Criticality Data Element. It sets minimum expectations for the AllergyIntolerance resource to record, search, and fetch allergies and adverse reactions associated with a patient. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.

Example Usage Scenarios:

The following are example usage scenarios for the US Core AllergyIntolerance profile:

- Query for Allergies belonging to a Patient
- [Record or update] a Patient Allergy

### Mandatory and Must Support Data Elements

The following data elements must always be present ([Mandatory] definition) or must be supported if the data is present in the sending system ([Must Support] definition). They are presented below in a simple human-readable explanation. Profile specific guidance and examples are provided as well. The [Formal Views] below provides the formal summary, definitions, and terminology requirements.

Each AllergyIntolerance Must Have:

1. a clinical status of the allergy (e.g., active or resolved)1
2. a code that tells you what the patient is allergic to
3. a patient

Each AllergyIntolerance Must Support:

1. a verification status
2. an estimate of the potential clinical harm of the reaction (e.g., low, high, or unable-to-assess)
3. a reaction manifestation

Additional USCDI Requirements:

These [Additional USCDI Requirements] elements are not Mandatory or Must Support but are required for ONC Health IT certification testing and are included in the formal definition of the profile and the AllergyIntolerance examples.

1. a recorder2

1,2 see guidance below

### Profile Specific Implementation Guidance

This section provides detailed implementation guidance for the US Core Profile to support implementation and certification.

- 1 The `AllergyIntolerance.clinicalStatus` element has the following constraints: SHALL be present if verification status is not "entered-in-error"[§][CONF-0302] and SHALL NOT be present if verification Status is "entered-in-error".[§][CONF-0303]

- No Known Allergies MAY be represented using the US Core-AllergyIntolerance profile[§][CONF-0305] with the appropriate negation code in `AllergyIntolerance.code`[§][CONF-0306] and the appropriate verification status in `AllergyIntolerance.verificationStatus`.[§][CONF-0307]

  If a patient has not been asked about their allergies, this would be represented as:[§][CONF-0308]

  - `AllergyIntolerance.code` = "1631000175102" (Patient not asked (contextual qualifier) (qualifier value))
  - `AllergyIntolerance.verificationStatus` = "unconfirmed" or empty (in other words, the element omitted)

  If a patient has been asked, but has indicated they have no known allergies, this would be represented as:[§][CONF-0309]

  - `AllergyIntolerance.code` = "716186003" (No known allergy (situation))
  - `AllergyIntolerance.verificationStatus` = "confirmed"
- FOO

### Liquid Script to Generate StructureDefinition All Nice N Pretty Like

{% include structure-table.md sd=sd source="differential" show_must_support=true show_uscdi=true %}

## USCoreAllergyIntolerance — US Core AllergyIntolerance Profile

The US Core AllergyIntolerance Profile inherits from the FHIR AllergyIntolerance resource; refer to it for scope and usage definitions. This profile meets the requirements of the U.S. Core Data for Interoperability (USCDI) Allergies and Intolerances Data Class and its Allergy Intolerance Criticality Data Element. It sets minimum expectations for the AllergyIntolerance resource to record, search, and fetch allergies and adverse reactions associated with a patient. It specifies which core elements, extensions, vocabularies, and value sets SHALL be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.

- URL: `http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance`
- Version: 0.1.0
- Status: active
- Kind: resource
- Type: `AllergyIntolerance`
- Base Definition: `http://hl7.org/fhir/StructureDefinition/AllergyIntolerance`
- Derivation: constraint

### Elements (differential)

Element | Must Support | Add'l USCDI | Cardinality | Type | Description
--- | --- | --- | --- | --- | ---
`AllergyIntolerance` |  |  | 0..* |  | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance.
↳ `clinicalStatus` | ✅ |  | 0..1 | `CodeableConcept` | active | inactive | resolved The clinical status of the allergy or intolerance. Binding: `http://hl7.org/fhir/ValueSet/allergyintolerance-clinical` (required)
↳ `verificationStatus` | ✅ |  | 0..1 | `CodeableConcept` | unconfirmed | confirmed | refuted | entered-in-error Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product). Binding: `http://hl7.org/fhir/ValueSet/allergyintolerance-verification` (required)
↳ `criticality` | ✅ |  | 0..1 | `code` | low | high | unable-to-assess Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance. Binding: `http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality` (required)
↳ `code` | ✅ |  | 1..1 | `CodeableConcept` | Code that identifies the allergy or intolerance Code for an allergy or intolerance statement (either a positive or a negated/excluded statement). This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., "Latex"), an allergy or intolerance condition (e.g., "Latex allergy"), or a negated/excluded code for a specific substance or class (e.g., "No latex allergy") or a general or categorical negated statement (e.g., "No known allergy", "No known drug allergies"). Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'. If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance. Binding: `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.43` (extensible)
↳ `patient` | ✅ |  | 1..1 | `Reference` target: http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient | Who the sensitivity is for The patient who has the allergy or intolerance.
↳ `recorder` |  | ✅ | 0..1 | `Reference` target: http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner target: http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient target: http://hl7.org/fhir/StructureDefinition/PractitionerRole target: http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson | Who recorded the sensitivity Individual who recorded the record and takes responsibility for its content.
↳ `reaction` | ✅ |  | 0..* | `BackboneElement` | Adverse Reaction Events linked to exposure to substance Details about each adverse reaction event linked to exposure to the identified substance.
↳ `manifestation` | ✅ |  | 1..* | `CodeableConcept` | Clinical symptoms/signs associated with the Event Clinical symptoms and/or signs that are observed or associated with the adverse reaction event. Binding: `http://hl7.org/fhir/ValueSet/clinical-findings` (extensible)

    ## USCoreAllergyIntolerance — US Core AllergyIntolerance Profile

    The US Core AllergyIntolerance Profile inherits from the FHIR [AllergyIntolerance](https://hl7.org/fhir/R4/allergyintolerance.html) resource; refer to it for scope and usage definitions. This profile meets the requirements of the U.S. Core Data for Interoperability (USCDI) *Allergies and Intolerances Data Class* and its *Allergy Intolerance Criticality Data Element*. It sets minimum expectations for the AllergyIntolerance resource to record, search, and fetch allergies and adverse reactions associated with a patient. It specifies which core elements, extensions, vocabularies, and value sets **SHALL** be present in the resource and constrains how the elements are used. Providing the floor for standards development for specific use cases promotes interoperability and adoption.

    - **URL:** `http://hl7.org/fhir/us/core/StructureDefinition/us-core-allergyintolerance`
    - **Version:** 0.1.0
    - **Status:** active
    - **Kind:** resource
    - **Type:** `AllergyIntolerance`
    - **Base Definition:** `http://hl7.org/fhir/StructureDefinition/AllergyIntolerance`
    - **Derivation:** constraint

    ### Elements (differential)

    | Element | Must Support | Add'l USCDI | Cardinality | Type | Description |
    |---|:---:|:---:|---|---|---|
    | `AllergyIntolerance` |  |  | 0..* |  | **Allergy or Intolerance (generally: Risk of adverse reaction to a substance)**<br/>Risk of harmful or undesirable, physiological response which is unique to an individual and associated with exposure to a substance. |
    | <span style="padding-left: 1.5em;">↳</span> `clinicalStatus` | ✅ |  | 0..1 | `CodeableConcept` | **active \| inactive \| resolved**<br/>The clinical status of the allergy or intolerance.<br/><span style="font-size: 0.85em;">**Binding:** `http://hl7.org/fhir/ValueSet/allergyintolerance-clinical` (required)</span> |
    | <span style="padding-left: 1.5em;">↳</span> `verificationStatus` | ✅ |  | 0..1 | `CodeableConcept` | **unconfirmed \| confirmed \| refuted \| entered-in-error**<br/>Assertion about certainty associated with the propensity, or potential risk, of a reaction to the identified substance (including pharmaceutical product).<br/><span style="font-size: 0.85em;">**Binding:** `http://hl7.org/fhir/ValueSet/allergyintolerance-verification` (required)</span> |
    | <span style="padding-left: 1.5em;">↳</span> `criticality` | ✅ |  | 0..1 | `code` | **low \| high \| unable-to-assess**<br/>Estimate of the potential clinical harm, or seriousness, of the reaction to the identified substance.<br/><span style="font-size: 0.85em;">**Binding:** `http://hl7.org/fhir/ValueSet/allergy-intolerance-criticality` (required)</span> |
    | <span style="padding-left: 1.5em;">↳</span> `code` | ✅ |  | 1..1 | `CodeableConcept` | **Code that identifies the allergy or intolerance**<br/>Code for an allergy or intolerance statement (either a positive or a negated/excluded statement).  This may be a code for a substance or pharmaceutical product that is considered to be responsible for the adverse reaction risk (e.g., "Latex"), an allergy or intolerance condition (e.g., "Latex allergy"), or a negated/excluded code for a specific substance or class (e.g., "No latex allergy") or a general or categorical negated statement (e.g.,  "No known allergy", "No known drug allergies").  Note: the substance for a specific reaction may be different from the substance identified as the cause of the risk, but it must be consistent with it. For instance, it may be a more specific substance (e.g. a brand medication) or a composite product that includes the identified substance. It must be clinically safe to only process the 'code' and ignore the 'reaction.substance'.  If a receiving system is unable to confirm that AllergyIntolerance.reaction.substance falls within the semantic scope of AllergyIntolerance.code, then the receiving system should ignore AllergyIntolerance.reaction.substance.<br/><span style="font-size: 0.85em;">**Binding:** `http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1267.43` (extensible)</span> |
    | <span style="padding-left: 1.5em;">↳</span> `patient` | ✅ |  | 1..1 | `Reference`<br/><span style="font-size: 0.85em;">target: http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient</span> | **Who the sensitivity is for**<br/>The patient who has the allergy or intolerance. |
    | <span style="padding-left: 1.5em;">↳</span> `recorder` |  | ✅ | 0..1 | `Reference`<br/><span style="font-size: 0.85em;">target: http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner</span><br/><span style="font-size: 0.85em;">target: http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient</span><br/><span style="font-size: 0.85em;">target: http://hl7.org/fhir/StructureDefinition/PractitionerRole</span><br/><span style="font-size: 0.85em;">target: http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson</span> | **Who recorded the sensitivity**<br/>Individual who recorded the record and takes responsibility for its content. |
    | <span style="padding-left: 1.5em;">↳</span> `reaction` | ✅ |  | 0..* | `BackboneElement` | **Adverse Reaction Events linked to exposure to substance**<br/>Details about each adverse reaction event linked to exposure to the identified substance. |
    | <span style="padding-left: 3.0em;">↳</span> `manifestation` | ✅ |  | 1..* | `CodeableConcept` | **Clinical symptoms/signs associated with the Event**<br/>Clinical symptoms and/or signs that are observed or associated with the adverse reaction event.<br/><span style="font-size: 0.85em;">**Binding:** `http://hl7.org/fhir/ValueSet/clinical-findings` (extensible)</span> |

Usages:

- Examples for this Profile: AllergyIntolerance/low-criticality and AllergyIntolerance/unable-to-assess-criticality
- CapabilityStatements using this Profile: US Core Client CapabilityStatement and US Core Server CapabilityStatement

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

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

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance | C | 0..* | AllergyIntolerance | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) Constraints: ait-1, ait-2
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required)
criticality | S Σ | 0..1 | code | low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required)
code | S Σ | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations. (extensible)
patient | S Σ | 1..1 | Reference(US Core Patient Profile(9.0.0-ballot)) | Who the sensitivity is for
recorder |  | 0..1 | Reference(US Core Practitioner Profile | US Core Patient Profile(9.0.0-ballot) | PractitionerRole | US Core RelatedPerson Profile) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Who recorded the sensitivity
reaction | S | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
manifestation | S | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (extensible)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
AllergyIntolerance.clinicalStatus | Base | required | AllergyIntolerance Clinical Status Codes | 📦4.0.1 | FHIR Std.
AllergyIntolerance.verificationStatus | Base | required | AllergyIntolerance Verification Status Codes | 📦4.0.1 | FHIR Std.
AllergyIntolerance.criticality | Base | required | AllergyIntoleranceCriticality | 📦4.0.1 | FHIR Std.
AllergyIntolerance.code | Base | extensible | Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations. | ⏿20260321 | tx.fhir.org
AllergyIntolerance.reaction.​manifestation | Base | extensible | SNOMED CT Clinical Findings | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
ait-1 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. | `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()`
ait-2 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error | `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()`
dom-2 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | AllergyIntolerance | 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 | AllergyIntolerance | 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 | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | AllergyIntolerance | 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()`

This structure is derived from AllergyIntolerance

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance |  | 0..* | AllergyIntolerance | Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
clinicalStatus | S | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required)
verificationStatus | S | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required)
criticality | S | 0..1 | code | low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required)
code | S | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations. (extensible)
patient | S | 1..1 | Reference(US Core Patient Profile(9.0.0-ballot)) | Who the sensitivity is for
recorder |  | 0..1 | Reference(US Core Practitioner Profile | US Core Patient Profile(9.0.0-ballot) | PractitionerRole | US Core RelatedPerson Profile) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Who recorded the sensitivity
reaction | S | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
manifestation | S | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (extensible)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
AllergyIntolerance.clinicalStatus | Base | required | AllergyIntolerance Clinical Status Codes | 📦4.0.1 | FHIR Std.
AllergyIntolerance.verificationStatus | Base | required | AllergyIntolerance Verification Status Codes | 📦4.0.1 | FHIR Std.
AllergyIntolerance.criticality | Base | required | AllergyIntoleranceCriticality | 📦4.0.1 | FHIR Std.
AllergyIntolerance.code | Base | extensible | Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations. | ⏿20260321 | tx.fhir.org
AllergyIntolerance.reaction.​manifestation | Base | extensible | SNOMED CT Clinical Findings | 📦4.0.1 | FHIR Std.

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance | C | 0..* | AllergyIntolerance | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) Constraints: ait-1, ait-2
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 |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External ids for this item
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required)
type | Σ | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
category | Σ | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
criticality | S Σ | 0..1 | code | low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required)
code | S Σ | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations. (extensible)
patient | S Σ | 1..1 | Reference(US Core Patient Profile(9.0.0-ballot)) | Who the sensitivity is for
encounter |  | 0..1 | Reference(Encounter) | Encounter when the allergy or intolerance was asserted
onset[x] |  | 0..1 |  | When allergy or intolerance was identified
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
recordedDate |  | 0..1 | dateTime | Date first version of the resource instance was recorded
recorder |  | 0..1 | Reference(US Core Practitioner Profile | US Core Patient Profile(9.0.0-ballot) | PractitionerRole | US Core RelatedPerson Profile) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Who recorded the sensitivity
asserter | Σ | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy
lastOccurrence |  | 0..1 | dateTime | Date(/time) of last known occurrence of a reaction
note |  | 0..* | Annotation | Additional text not captured in other fields
reaction | S | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
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
substance |  | 0..1 | CodeableConcept | Specific substance or pharmaceutical product considered to be responsible for event Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).
manifestation | S | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (extensible)
description |  | 0..1 | string | Description of the event as a whole
onset |  | 0..1 | dateTime | Date(/time) when manifestations showed
severity |  | 0..1 | code | mild | moderate | severe (of event as a whole) Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
exposureRoute |  | 0..1 | CodeableConcept | How the subject was exposed to the substance 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.
note |  | 0..* | Annotation | Text about event not captured in other fields
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
AllergyIntolerance.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
AllergyIntolerance.clinicalStatus | Base | required | AllergyIntolerance Clinical Status Codes | 📦4.0.1 | FHIR Std.
AllergyIntolerance.verificationStatus | Base | required | AllergyIntolerance Verification Status Codes | 📦4.0.1 | FHIR Std.
AllergyIntolerance.type | Base | required | AllergyIntoleranceType | 📍4.0.1 | FHIR Std.
AllergyIntolerance.category | Base | required | AllergyIntoleranceCategory | 📍4.0.1 | FHIR Std.
AllergyIntolerance.criticality | Base | required | AllergyIntoleranceCriticality | 📦4.0.1 | FHIR Std.
AllergyIntolerance.code | Base | extensible | Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations. | ⏿20260321 | tx.fhir.org
AllergyIntolerance.reaction.​substance | Base | example | Substance Code | 📍4.0.1 | FHIR Std.
AllergyIntolerance.reaction.​manifestation | Base | extensible | SNOMED CT Clinical Findings | 📦4.0.1 | FHIR Std.
AllergyIntolerance.reaction.​severity | Base | required | AllergyIntoleranceSeverity | 📍4.0.1 | FHIR Std.
AllergyIntolerance.reaction.​exposureRoute | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
ait-1 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. | `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()`
ait-2 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error | `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()`
dom-2 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | AllergyIntolerance | 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 | AllergyIntolerance | 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 | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | AllergyIntolerance | 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()`

This structure is derived from AllergyIntolerance

Summary

Mandatory: 1 element
Must-Support: 7 elements

Structures

This structure refers to these other structures:

- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
- US Core RelatedPerson Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson)

Maturity: 5

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance | C | 0..* | AllergyIntolerance | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) Constraints: ait-1, ait-2
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required)
criticality | S Σ | 0..1 | code | low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required)
code | S Σ | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations. (extensible)
patient | S Σ | 1..1 | Reference(US Core Patient Profile(9.0.0-ballot)) | Who the sensitivity is for
recorder |  | 0..1 | Reference(US Core Practitioner Profile | US Core Patient Profile(9.0.0-ballot) | PractitionerRole | US Core RelatedPerson Profile) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Who recorded the sensitivity
reaction | S | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
manifestation | S | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (extensible)
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
AllergyIntolerance.clinicalStatus | Base | required | AllergyIntolerance Clinical Status Codes | 📦4.0.1 | FHIR Std.
AllergyIntolerance.verificationStatus | Base | required | AllergyIntolerance Verification Status Codes | 📦4.0.1 | FHIR Std.
AllergyIntolerance.criticality | Base | required | AllergyIntoleranceCriticality | 📦4.0.1 | FHIR Std.
AllergyIntolerance.code | Base | extensible | Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations. | ⏿20260321 | tx.fhir.org
AllergyIntolerance.reaction.​manifestation | Base | extensible | SNOMED CT Clinical Findings | 📦4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
ait-1 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. | `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()`
ait-2 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error | `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()`
dom-2 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | AllergyIntolerance | 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 | AllergyIntolerance | 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 | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | AllergyIntolerance | 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()`

Differential View

This structure is derived from AllergyIntolerance

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance |  | 0..* | AllergyIntolerance | Allergy or Intolerance (generally: Risk of adverse reaction to a substance)
clinicalStatus | S | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required)
verificationStatus | S | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required)
criticality | S | 0..1 | code | low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required)
code | S | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations. (extensible)
patient | S | 1..1 | Reference(US Core Patient Profile(9.0.0-ballot)) | Who the sensitivity is for
recorder |  | 0..1 | Reference(US Core Practitioner Profile | US Core Patient Profile(9.0.0-ballot) | PractitionerRole | US Core RelatedPerson Profile) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Who recorded the sensitivity
reaction | S | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
manifestation | S | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (extensible)
Documentation for this format

#### Terminology Bindings (Differential)

Path | Status | Usage | ValueSet | Version | Source
AllergyIntolerance.clinicalStatus | Base | required | AllergyIntolerance Clinical Status Codes | 📦4.0.1 | FHIR Std.
AllergyIntolerance.verificationStatus | Base | required | AllergyIntolerance Verification Status Codes | 📦4.0.1 | FHIR Std.
AllergyIntolerance.criticality | Base | required | AllergyIntoleranceCriticality | 📦4.0.1 | FHIR Std.
AllergyIntolerance.code | Base | extensible | Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations. | ⏿20260321 | tx.fhir.org
AllergyIntolerance.reaction.​manifestation | Base | extensible | SNOMED CT Clinical Findings | 📦4.0.1 | FHIR Std.

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
AllergyIntolerance | C | 0..* | AllergyIntolerance | Allergy or Intolerance (generally: Risk of adverse reaction to a substance) Constraints: ait-1, ait-2
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 |  | 0..* | Resource | Contained, inline Resources
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier | Σ | 0..* | Identifier | External ids for this item
clinicalStatus | ?!S Σ C | 0..1 | CodeableConcept | active | inactive | resolved Binding: AllergyIntoleranceClinicalStatusCodes (required)
verificationStatus | ?!S Σ C | 0..1 | CodeableConcept | unconfirmed | confirmed | refuted | entered-in-error Binding: AllergyIntoleranceVerificationStatusCodes (required)
type | Σ | 0..1 | code | allergy | intolerance - Underlying mechanism (if known) Binding: AllergyIntoleranceType (required): Identification of the underlying physiological mechanism for a Reaction Risk.
category | Σ | 0..* | code | food | medication | environment | biologic Binding: AllergyIntoleranceCategory (required): Category of an identified substance associated with allergies or intolerances.
criticality | S Σ | 0..1 | code | low | high | unable-to-assess Binding: AllergyIntoleranceCriticality (required)
code | S Σ | 1..1 | CodeableConcept | Code that identifies the allergy or intolerance Binding: Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations. (extensible)
patient | S Σ | 1..1 | Reference(US Core Patient Profile(9.0.0-ballot)) | Who the sensitivity is for
encounter |  | 0..1 | Reference(Encounter) | Encounter when the allergy or intolerance was asserted
onset[x] |  | 0..1 |  | When allergy or intolerance was identified
onsetDateTime |  |  | dateTime |
onsetAge |  |  | Age |
onsetPeriod |  |  | Period |
onsetRange |  |  | Range |
onsetString |  |  | string |
recordedDate |  | 0..1 | dateTime | Date first version of the resource instance was recorded
recorder |  | 0..1 | Reference(US Core Practitioner Profile | US Core Patient Profile(9.0.0-ballot) | PractitionerRole | US Core RelatedPerson Profile) | 𝗔𝗗𝗗𝗜𝗧𝗜𝗢𝗡𝗔𝗟 𝗨𝗦𝗖𝗗𝗜: Who recorded the sensitivity
asserter | Σ | 0..1 | Reference(Patient | RelatedPerson | Practitioner | PractitionerRole) | Source of the information about the allergy
lastOccurrence |  | 0..1 | dateTime | Date(/time) of last known occurrence of a reaction
note |  | 0..* | Annotation | Additional text not captured in other fields
reaction | S | 0..* | BackboneElement | Adverse Reaction Events linked to exposure to substance
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
substance |  | 0..1 | CodeableConcept | Specific substance or pharmaceutical product considered to be responsible for event Binding: SubstanceCode (example): Codes defining the type of the substance (including pharmaceutical products).
manifestation | S | 1..* | CodeableConcept | Clinical symptoms/signs associated with the Event Binding: SNOMEDCTClinicalFindings (extensible)
description |  | 0..1 | string | Description of the event as a whole
onset |  | 0..1 | dateTime | Date(/time) when manifestations showed
severity |  | 0..1 | code | mild | moderate | severe (of event as a whole) Binding: AllergyIntoleranceSeverity (required): Clinical assessment of the severity of a reaction event as a whole, potentially considering multiple different manifestations.
exposureRoute |  | 0..1 | CodeableConcept | How the subject was exposed to the substance 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.
note |  | 0..* | Annotation | Text about event not captured in other fields
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
AllergyIntolerance.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
AllergyIntolerance.clinicalStatus | Base | required | AllergyIntolerance Clinical Status Codes | 📦4.0.1 | FHIR Std.
AllergyIntolerance.verificationStatus | Base | required | AllergyIntolerance Verification Status Codes | 📦4.0.1 | FHIR Std.
AllergyIntolerance.type | Base | required | AllergyIntoleranceType | 📍4.0.1 | FHIR Std.
AllergyIntolerance.category | Base | required | AllergyIntoleranceCategory | 📍4.0.1 | FHIR Std.
AllergyIntolerance.criticality | Base | required | AllergyIntoleranceCriticality | 📦4.0.1 | FHIR Std.
AllergyIntolerance.code | Base | extensible | Allergen Concepts (Medications, Foods, and Environmental Substances) including refutations. | ⏿20260321 | tx.fhir.org
AllergyIntolerance.reaction.​substance | Base | example | Substance Code | 📍4.0.1 | FHIR Std.
AllergyIntolerance.reaction.​manifestation | Base | extensible | SNOMED CT Clinical Findings | 📦4.0.1 | FHIR Std.
AllergyIntolerance.reaction.​severity | Base | required | AllergyIntoleranceSeverity | 📍4.0.1 | FHIR Std.
AllergyIntolerance.reaction.​exposureRoute | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
ait-1 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL be present if verificationStatus is not entered-in-error. | `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').exists() or clinicalStatus.exists()`
ait-2 | error | AllergyIntolerance | AllergyIntolerance.clinicalStatus SHALL NOT be present if verification Status is entered-in-error | `verificationStatus.coding.where(system = 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' and code = 'entered-in-error').empty() or clinicalStatus.empty()`
dom-2 | error | AllergyIntolerance | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | AllergyIntolerance | 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 | AllergyIntolerance | 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 | AllergyIntolerance | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | AllergyIntolerance | 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()`

This structure is derived from AllergyIntolerance

Summary

Mandatory: 1 element
Must-Support: 7 elements

Structures

This structure refers to these other structures:

- US Core Patient Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient)
- US Core Practitioner Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-practitioner)
- US Core RelatedPerson Profile (http://hl7.org/fhir/us/core/StructureDefinition/us-core-relatedperson)

Maturity: 5

Other representations of profile: CSV, Excel, Schematron