Release 4B R5 Final QA

This page is part of the FHIR Specification (v4.3.0: R4B (v5.0.0-draft-final: Final QA Preview for R5 - STU see ballot notes ). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3

Medicationrequest0302.json

Example MedicationRequest/medrx0302 (JSON)

Pharmacy Work Group Maturity Level : N/A Standards Status : Informative Compartments : Encounter , Patient , Practitioner

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

Active Order with link to encounter, reasonCode, note multiple dosage lines, dispenseRequest and substitution - Azithromycin

{
  "resourceType": "MedicationRequest",
  "id": "medrx0302",
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource &quot;medrx0302&quot; </p></div><p><b>identifier</b>: id: 12345689 (OFFICIAL)</p><p><b>status</b>: active</p><p><b>intent</b>: order</p><p><b>medication</b>: <a name=\"med0320\"> </a></p><blockquote><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource &quot;med0320&quot; </p></div><p><b>code</b>: Azithromycin 250mg capsule (product) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#324252006)</span></p></blockquote><p><b>subject</b>: <a href=\"patient-pat1.html\">Patient/pat1: Donald Duck</a> &quot;Duck DONALD&quot;</p><p><b>encounter</b>: <a href=\"encounter-f001.html\">Encounter/f001: encounter who leads to this prescription</a></p><p><b>supportingInformation</b>: <a href=\"coverage-sp1234.html\">Coverage/SP1234</a></p><p><b>authoredOn</b>: 2015-01-15</p><p><b>requester</b>: <a href=\"practitioner-f007.html\">Practitioner/f007: Patrick Pump</a> &quot;Simone HEPS&quot;</p><p><b>reasonCode</b>: Traveller's Diarrhea (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#11840006)</span></p><p><b>note</b>: Patient told to take with food</p><blockquote><p><b>dispenseRequest</b></p><p><b>validityPeriod</b>: 2015-01-15 --&gt; 2016-01-15</p><p><b>numberOfRepeatsAllowed</b>: 1</p><p><b>quantity</b>: 6 TAB<span style=\"background: LightGoldenRodYellow\"> (Details: http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm code TAB = 'Tablet')</span></p></blockquote><h3>Substitutions</h3><table class=\"grid\"><tr><td>-</td><td><b>Allowed[x]</b></td><td><b>Reason</b></td></tr><tr><td>*</td><td>true</td><td>formulary policy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/3.1.0/CodeSystem-v3-ActReason.html\">ActReason</a>#FP)</span></td></tr></table></div>"

  "resourceType" : "MedicationRequest",
  "id" : "medrx0302",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: MedicationRequest</b><a name=\"medrx0302\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource MedicationRequest &quot;medrx0302&quot; </p></div><p><b>identifier</b>: id: 12345689 (use: OFFICIAL)</p><p><b>status</b>: active</p><p><b>intent</b>: order</p><h3>Medications</h3><table class=\"grid\"><tr><td>-</td><td><b>Reference</b></td></tr><tr><td>*</td><td><span title=\"  Linked to a RESOURCE Medication  \"><a name=\"med0320\"> </a></span><blockquote><p/><p><a name=\"med0320\"> </a></p><p><b>code</b>: Azithromycin 250mg capsule (product) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#324252006)</span></p></blockquote></td></tr></table><p><b>subject</b>: <a href=\"patient-example-a.html\">Patient/pat1: Donald Duck</a> &quot;Donald DUCK&quot;</p><p><b>encounter</b>: <a href=\"encounter-example-f001-heart.html\">Encounter/f001: encounter who leads to this prescription</a></p><p><b>supportingInformation</b>: <a href=\"coverage-example-selfpay.html\">Coverage/SP1234</a></p><p><b>authoredOn</b>: 2015-01-15</p><p><b>requester</b>: <a href=\"practitioner-example-f007-sh.html\">Practitioner/f007: Patrick Pump</a> &quot;Simone HEPS&quot;</p><h3>Reasons</h3><table class=\"grid\"><tr><td>-</td><td><b>Concept</b></td></tr><tr><td>*</td><td>Traveller's Diarrhea (disorder) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#11840006)</span></td></tr></table><p><b>note</b>: Patient told to take with food</p><blockquote><p><b>dosageInstruction</b></p><p><b>sequence</b>: 1</p><p><b>text</b>: Two tablets at once</p><p><b>additionalInstruction</b>: With or after food <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#311504000)</span></p><p><b>timing</b>: Once per 1 days</p><p><b>route</b>: Oral Route <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#26643006)</span></p><p><b>method</b>: Swallow - dosing instruction imperative (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#421521009)</span></p><blockquote><p><b>doseAndRate</b></p></blockquote></blockquote><blockquote><p><b>dosageInstruction</b></p><p><b>sequence</b>: 2</p><p><b>text</b>: One tablet daily for 4 days</p><p><b>additionalInstruction</b>: With or after food <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#311504000)</span></p><p><b>timing</b>: Once per 1 days</p><p><b>route</b>: Oral Route <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#26643006)</span></p><blockquote><p><b>doseAndRate</b></p></blockquote></blockquote><blockquote><p><b>dispenseRequest</b></p><p><b>validityPeriod</b>: 2015-01-15 --&gt; 2016-01-15</p><p><b>numberOfRepeatsAllowed</b>: 1</p><p><b>quantity</b>: 6 TAB<span style=\"background: LightGoldenRodYellow\"> (Details: http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm code TAB = 'Tablet')</span></p><h3>ExpectedSupplyDurations</h3><table class=\"grid\"><tr><td>-</td><td><b>Value</b></td><td><b>Unit</b></td><td><b>System</b></td><td><b>Code</b></td></tr><tr><td>*</td><td>5</td><td>days</td><td><a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-v3-ucum.html\">Unified Code for Units of Measure (UCUM)</a></td><td>d</td></tr></table></blockquote><h3>Substitutions</h3><table class=\"grid\"><tr><td>-</td><td><b>Allowed[x]</b></td><td><b>Reason</b></td></tr><tr><td>*</td><td>true</td><td>formulary policy <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-v3-ActReason.html\">ActReason</a>#FP)</span></td></tr></table></div>"

  },
  "contained": [
    {
      "resourceType": "Medication",
      "id": "med0320",
      "code": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "324252006",
            "display": "Azithromycin 250mg capsule (product)"
          }
        ]
      }

  "contained" : [{
    "resourceType" : "Medication",
    "id" : "med0320",
    "code" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "324252006",
        "display" : "Azithromycin 250mg capsule (product)"
      }]

    }
  ],
  "identifier": [
    {
      "use": "official",
      "system": "http://www.bmc.nl/portal/prescriptions",
      "value": "12345689"

  }],
  "identifier" : [{
    "use" : "official",
    "system" : "http://www.bmc.nl/portal/prescriptions",
    "value" : "12345689"
  }],
  "status" : "active",
  "intent" : "order",
  "medication" : {
    "reference" : {
      "reference" : "#med0320"

    }
  ],
  "status": "active",
  "intent": "order",
  "medicationReference": {
    "reference": "#med0320"

  },
  "subject": {
    "reference": "Patient/pat1",
    "display": "Donald Duck"

  "subject" : {
    "reference" : "Patient/pat1",
    "display" : "Donald Duck"

  },
  "encounter": {
    "reference": "Encounter/f001",
    "display": "encounter who leads to this prescription"

  "encounter" : {
    "reference" : "Encounter/f001",
    "display" : "encounter who leads to this prescription"

  },
  "supportingInformation": [
    {
      "reference": "Coverage/SP1234"
    }
  ],
  "authoredOn": "2015-01-15",
  "requester": {
    "reference": "Practitioner/f007",
    "display": "Patrick Pump"

  "supportingInformation" : [{
    "reference" : "Coverage/SP1234"
  }],
  "authoredOn" : "2015-01-15",
  "requester" : {
    "reference" : "Practitioner/f007",
    "display" : "Patrick Pump"

  },
  "reasonCode": [
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "11840006",
          "display": "Traveller's Diarrhea (disorder)"
        }
      ]
    }
  ],
  "note": [
    {
      "text": "Patient told to take with food"

  "reason" : [{
    "concept" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "11840006",
        "display" : "Traveller's Diarrhea (disorder)"
      }]

    }
  ],
  "dosageInstruction": [
    {
      "sequence": 1,
      "text": "Two tablets at once",
      "additionalInstruction": [
        {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "311504000",
              "display": "With or after food"
            }
          ]
        }
      ],
      "timing": {
        "repeat": {
          "frequency": 1,
          "period": 1,
          "periodUnit": "d"
        }
      },
      "route": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "26643006",
            "display": "Oral Route"
          }
        ]
      },
      "method": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "421521009",
            "display": "Swallow - dosing instruction imperative (qualifier value)"
          }
        ]
      },
      "doseAndRate": [
        {
          "type": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                "code": "ordered",
                "display": "Ordered"
              }
            ]
          },
          "doseQuantity": {
            "value": 2,
            "unit": "TAB",
            "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
            "code": "TAB"
          }
        }
      ]

  }],
  "note" : [{
    "text" : "Patient told to take with food"
  }],
  "dosageInstruction" : [{
    "sequence" : 1,
    "text" : "Two tablets at once",
    "additionalInstruction" : [{
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "311504000",
        "display" : "With or after food"
      }]
    }],
    "timing" : {
      "repeat" : {
        "frequency" : 1,
        "period" : 1,
        "periodUnit" : "d"
      }

    },
    {
      "sequence": 2,
      "text": "One tablet daily for 4 days",
      "additionalInstruction": [
        {
          "coding": [
            {
              "system": "http://snomed.info/sct",
              "code": "311504000",
              "display": "With or after food"
            }
          ]
        }
      ],
      "timing": {
        "repeat": {
          "frequency": 4,
          "period": 1,
          "periodUnit": "d"
        }

    "route" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "26643006",
        "display" : "Oral Route"
      }]
    },
    "method" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "421521009",
        "display" : "Swallow - dosing instruction imperative (qualifier value)"
      }]
    },
    "doseAndRate" : [{
      "type" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
          "code" : "ordered",
          "display" : "Ordered"
        }]

      },
      "route": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "26643006",
            "display": "Oral Route"
          }
        ]

      "doseQuantity" : {
        "value" : 2,
        "unit" : "TAB",
        "system" : "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
        "code" : "TAB"
      }
    }]
  },
  {
    "sequence" : 2,
    "text" : "One tablet daily for 4 days",
    "additionalInstruction" : [{
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "311504000",
        "display" : "With or after food"
      }]
    }],
    "timing" : {
      "repeat" : {
        "boundsDuration" : {
          "value" : 4,
          "unit" : "days",
          "system" : "http://unitsofmeasure.org",
          "code" : "d"
        },
        "frequency" : 1,
        "period" : 1,
        "periodUnit" : "d"
      }
    },
    "route" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "26643006",
        "display" : "Oral Route"
      }]
    },
    "doseAndRate" : [{
      "type" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
          "code" : "ordered",
          "display" : "Ordered"
        }]

      },
      "doseAndRate": [
        {
          "type": {
            "coding": [
              {
                "system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                "code": "ordered",
                "display": "Ordered"
              }
            ]
          },
          "doseQuantity": {
            "value": 1,
            "unit": "TAB",
            "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
            "code": "TAB"
          }
        }
      ]
    }
  ],
  "dispenseRequest": {
    "validityPeriod": {
      "start": "2015-01-15",
      "end": "2016-01-15"

      "doseQuantity" : {
        "value" : 1,
        "unit" : "TAB",
        "system" : "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
        "code" : "TAB"
      }
    }]
  }],
  "dispenseRequest" : {
    "validityPeriod" : {
      "start" : "2015-01-15",
      "end" : "2016-01-15"

    },
    "numberOfRepeatsAllowed": 1,
    "quantity": {
      "value": 6,
      "unit": "TAB",
      "system": "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
      "code": "TAB"

    "numberOfRepeatsAllowed" : 1,
    "quantity" : {
      "value" : 6,
      "unit" : "TAB",
      "system" : "http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm",
      "code" : "TAB"

    },
    "expectedSupplyDuration": {
      "value": 5,
      "unit": "days",
      "system": "http://unitsofmeasure.org",
      "code": "d"

    "expectedSupplyDuration" : {
      "value" : 5,
      "unit" : "days",
      "system" : "http://unitsofmeasure.org",
      "code" : "d"

    }
  },
  "substitution": {
    "allowedBoolean": true,
    "reason": {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
          "code": "FP",
          "display": "formulary policy"
        }
      ]

  "substitution" : {
    "allowedBoolean" : true,
    "reason" : {
      "coding" : [{
        "system" : "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "code" : "FP",
        "display" : "formulary policy"
      }]

    }
  }
}

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.